Acromioclavicular Sprain - self diagnosis made

The internet is a wonderful thing to athletes who don't want to go to the doc for every little bump, bruise, and tweak.

I hurt my shoulder playing hockey - - actually, I'm suprised this is the first time, considering I play against people that typical way about 150% of me. Anyways... going into the boards, I stuck my elbow out and jammed my shoulder. This was a few weeks ago (actually, maybe 2-months) and it's still kinda sore.

Stoopid me, I continue to try to lift thinking that it's more of a bruise then anything.... but that's how I come to the conclusion that it's a little something more than a bruise: doing chest press with dumb bells, if the dumb bell starts to go slightly off axis, falling away from your chest rather than straight up and down, when you flext your shoulder a bit to bring it back into plane, that's when it would hurt.

So I google "shoulder anatomy" and find the process that hurts (acromion) and then google "acromion injury" and find this awesome write-up on shoulder injuries - - tailored to a PCP so he/she knows to either treat or refer to a specialist: http://www.aafp.org/afp/20041115/1947.html

After reading through, I was positive for the following diagnostic criterion: "Patients with type I injuries should have tenderness over the AC joint, no visible deformity of the distal clavicle, and normal radiographs. They also will have a positive cross-arm test (sharp pain at the AC joint if the patient holds the arm out straight and brings it across the chest)." Also, the following applies: "With type II injuries, the distal clavicle may be slightly more prominent on inspection, and the patient may have pain at the distal end of the clavicle from the sprained coracoclavicular ligament."

For treatment of type I or Type II injuries, the following is written: "Treatment of type I and II injuries focuses on symptomatic relief and includes use of a sling for one to three weeks, ice, and nonsteroidal anti-inflammatory drugs (NSAIDs). Once the acute pain is alleviated, range-of-motion and general strengthening exercises are started. Athletes may return to sports when pain-free function is restored. Most patients are able to return to sports, but some may complain of nuisance symptoms such as clicking and pain with push-ups. Nonoperative treatment of type III injuries is similar to that for types I and II, except that rest in a sling lasts for two to four weeks."

Sooooo...... the sling and ice are out... but any idea what some good therapeutic range of motion and general strengthening exercises would be? My google powers have evaporated it seems...

I've suffered from this before (AC separation).

My rehab consisted of getting those rubber exercise tube things (different colors have different strengths) and attach to a doorknob. Do 3 sets of 15 across the front of the body, then rotate, and do the same thing, but pulling away from your body. Works great.

When there's no pain, graduate to dumbell and pulley exercises for the shoulders.

Thanks, Peter! I'll take that recommendation to the trainer at my fitness center and see if they have the bands - - I've used enough of 'em for ankle injuries in the past, but they didn't make the list of transferable items on my recent move.

basically if you have a grade 1 or 2 AC sprain. There is not a whole lot to do except let the ligament heal. gr 1 sprains will last about 1-2 weeks, grade 2 a bit longer.

For the intial injury use ice for the first 2-3 days, after that try some heat packs before activity and ice after.

If you are still playing hockey, look into buying an AC pad. It is basically a hard plastic shell with a donut pad under it. This will protect it by deflecting and diffusing the force of hitting the shoulder on anything.

theraband stuff is fine to do but for minor injuries is probably not very important for recovery. These come into play more when the shoulder has been immobilized for a period of time to regain any lost strength.

Thanks again, Vin! Always a wealth of knowledge. As much as I hate it, I'm going to have to give up on lifting for a few weeks. And I hate it not because I'm a meathead (as anybody that knows me can atest!) but because I'll drop from 150 pounds soaking wet to about 135 in a matter of minutes!