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Acromioclavicular Arthritis

The acromioclavicular (AC) joint is a joint in the shoulder that forms where the clavicle bone meets the highest part of the scapula (shoulder blade) called the acromion. The AC joint allows you to raise your arm over your head and move your arm across your body. Arthritis is a general term given to joint disease that leads to inflammation, pain, and stiffness. When arthritis affects the AC joint, this is called AC arthritis. Weightlifters often get a related condition called “weightlifter’s shoulder.” Weightlifter’s shoulder is osteolysis (breakdown of bone) of the distal (the end farthest from the neck) portion of the collarbone.

Acromioclavicular Arthritis Hero Image 2

The acromioclavicular (AC) joint is a joint in the shoulder that forms where the clavicle bone meets the highest part of the scapula (shoulder blade) called the acromion. The AC joint allows you to raise your arm over your head and move your arm across your body. Arthritis is a general term given to joint disease that leads to inflammation, pain, and stiffness. When arthritis affects the AC joint, this is called AC arthritis. Weightlifters often get a related condition called “weightlifter’s shoulder.” Weightlifter’s shoulder is osteolysis (breakdown of bone) of the distal (the end farthest from the neck) portion of the collarbone.

What causes Acromioclavicular Arthritis?

AC arthritis develops over time, with repetitive movements that place stress on the AC joint. A flexible tissue, called cartilage, covers and protects the end of the clavicle and the acromion, allowing these two bones to interact and move without rubbing up against each other. When the cartilage is inflamed, it can degenerate, leaving the clavicle and acromion susceptible to grinding against each other. This can lead to the development of tiny fractures in the distal (farthest from the head) end of the collarbone. When these fractures occur, this is called distal clavicular osteolysis or “weightlifter’s shoulder.”

AC arthritis can also occur years after an injury to the AC joint such as a AC separation.

AC arthritis is common in these sports:

Bodybuilding
Football
Rugby
Soccer
Weightlifting

Symptoms

You may have AC arthritis if you are experiencing one or more of the following symptoms:

• Pain on the top of the shoulder that may radiate to the neck
• Increased pain after working out
• Limited or reduced range of motion of your arm when reaching across your chest

When to see a doctor

If you’re experiencing symptoms of AC arthritis or weightlifter’s shoulder, make an appointment with an orthopedic specialist. Getting an accurate diagnosis is essential to getting the treatment you need. During your appointment, your doctor will examine your shoulder and look for signs of arthritis and/or osteolysis, like:

• Pain or tenderness when pressing on the AC joint
¶ Pain with reaching across the chest

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• X-ray (an X-ray image can show changes in the bone)

Non-operative treatment

AC arthritis and weightlifter’s shoulder are initially treated using conservative, non-operative treatments. If you have been diagnosed with AC arthritis or with weightlifter’s shoulder, non-operative treatments that may be prescribed to you by your doctor may include:

• Avoiding activities that cause pain
• Regular icing to decrease inflammation
• Anti-inflammatory medications to reduce inflammation
• Corticosteroid injection to reduce inflammation and pain (administered to you by your orthopedic specialist)
• Physical therapy to increase range of motion

You can also try these exercises at home to stretch the muscles surrounding the shoulder:

Acromioclavicular Arthritis

Surgical Treatment

If non-surgical treatments do not relieve your symptoms, your doctor may recommend surgery. AC arthritis and weightlifter’s shoulder are treated surgically by removing the damaged portion of the clavicle and/or the cartilage of the AC joint.

The goal of surgery for AC arthritis and weightlifter’s shoulder is to relieve pain by removing the damaged end of the clavicle. This procedure is called the Mumford procedure or AC joint arthroplasty. The removal of this piece of the clavicle relieves pain without resulting in loss of range of motion or strength. This can be done arthroscopically or through a small incision.

 

Recovery

Recovery time for AC arthritis will depend on the severity of arthritis as well as the treatments applied. If the disease is minimal, non-operative treatments can alleviate pain within a matter of weeks. Full rehabilitation following surgery can take up to three months.

You should only return to normal activities when directed by your doctor. Typically, you will need to be pain-free and regain full range of motion and strength before being cleared to play. If you don’t need surgical treatment, modifications in weight lifting routines can help prevent recurrence of this condition.

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