Mrs C Prosser

The acromioclavicular joint (ACJ) is the articulation on top of the shoulder between the acromion part of the scapula (shoulder blade) and the clavicle (collar bone). It is stabilised by ligaments. When moving the arm above the head, the ACJ undergoes movement.

ACJ injuries may result from a direct fall on to the shoulder. They can ran range from minor ligament sprains which usually heal with conservative treatment (sometimes with a sling, initially followed by physiotherapy) through to more severe tears causing disruption and separation of the joint and occasionally requiring surgical repair. This injury is sometimes called AC separation. Symptoms include pain over the ACJ and, in more severe cases, a visible or palpable deformity.

A physical examination and sometimes x-rays are required to make the diagnosis and rule out more serious injuries such as a fracture. In minor injuries, a combination of rest, ice, anti-inflammatories and physiotherapy may be all that is necessary.

If your shoulder is still very uncomfortable after a ride, it may be advisable to hold off cycling for the time being. Although exercises can be helpful to strengthen the joint, I would recommend seeking professional advice from a physiotherapist first, especially in view of your ongoing discomfort. ACJ exercises should usually begin when the ligament has healed and there is no pain.

Dr Matt Brooks

Cycling GP

This was first published in the August/September  2015 edition of CTC's Cycle magazine.