How to Strengthen & Stretch for an AC Shoulder Injury

An acromioclavicular (AC) joint injury — also known as a shoulder separation — can make it difficult for you to go about your daily life, especially if it involves your dominant arm. Here's what you need to know about AC joint rehab, and some exercises you can do to help your shoulder heal.

Read more: 8 Possible Reasons Your Shoulder Pops or Cracks During Workouts

The Mayo Clinic Sports Medicine explains that the AC joint is where the collarbone (clavicle) meets part of the shoulder blade (acromion). This joint plays an important role in maintaining the position of the shoulder. It also helps with shoulder control, strength and motion. Ligaments and a capsule help stabilize this joint. Damage to any of these structures results in an AC joint injury.

According to the American Academy of Orthopaedic Surgeons (AAOS), the most common cause of an AC joint injury is a fall directly onto the shoulder. Saint Luke's Health System says falling on your outstretched hand or receiving a direct blow to the shoulder can also cause this injury.

The Mayo Clinic Sports Medicine notes that the AC joint is also susceptible to arthritis, which can be extremely painful. This is especially common among laborers and weight lifters, due to years of degeneration, or wear and tear, of the joint. A July 2018 study published in the journal EFORT Open Reviews states that athletes and people who play contact sports are also at a higher risk of injuring their AC joints.

Read more: Exercises That Could Hurt Your Shoulders (and What to Do Instead)

Depending on the amount of force to the shoulder when the injury occurred, the ligaments attached to the underside of the collarbone could also tear, causing it to separate from the shoulder blade. Per the AAOS, this causes the shoulder blade to droop downward with the weight of the arm, and creates a big bump above the shoulder. An AC joint injury can range from a mild sprain with no bump in sight to a complete disruption of the joint with a very large bump.

A December 2018 study published in the World Journal of Orthopedics reviews the current practices in AC joint rehabilitation. The authors of the study note that AC joint injuries are typically graded in severity on a scale of I to VI. While Types I and II typically don't require surgery, Types IV, V and VI usually do. Type III injuries are controversial, because some doctors prefer to operate whereas others don't.

Saint Luke's Health System explains that non-surgical AC joint rehabilitation can involve rest, ice packs, pain medication, a sling and certain arm and shoulder exercises.

Read more: 4 Steps to Treating a Shoulder Muscle Strain at Home

Kaiser Permanente lists some exercises that can help rehabilitate your shoulder. You should ask your doctor whether these exercises are safe for you to do and perform them under clinical supervision to ensure proper form. Your doctor will also tell you when you should start doing the exercises and how often you should do them.

These exercises are intended to stretch and strengthen your shoulder. According to the AAOS, stretching your shoulder can help dispel muscle soreness, restore your range of motion and prevent further injury. Strengthening the muscles that support your shoulder helps stabilize the joint and relieves pain. You shouldn't feel any pain beyond mild discomfort while you do the exercises.

You will need a stick for some of the exercises listed here. Kaiser Permanente says you can use a broom handle (with the bristles removed) or a piece of PVC pipe. The stick should be about 1 foot longer than the width of your shoulders.
Move 1: Neck Rotation

1. Sit in a chair or stand upright with your back, shoulders and head straight.
2. Keeping your chin level, slowly turn your head to one side.
3. Hold this position for 15 to 30 seconds.
4. Bring your head back to the center.
5. Repeat this exercise two to four times on each side.

Move 2: Shoulder Rolls

1. Sit in a firm chair or stand upright with your feet planted shoulder-width apart.
2. Roll your shoulders first upward, then downward, in a smooth, circular motion.
3. Repeat this exercise two to four times.

Move 3: Neck Stretches

1. While looking straight ahead, drop your head to the right side, toward your right shoulder.
2. Keep your left shoulder in place as you drop to the right side; don't let it rise upward toward your left ear.
3. Hold this position for 15 to 30 seconds.
4. Bring your head back to the center.
5. Repeat this exercise two to four times on each side.

Move 4: Shoulder Blade Squeeze

1. Stand upright with your arms by your sides.
2. Without raising your shoulders, squeeze your shoulder blades together, bringing them as close to each other as you can.
3. Hold there for six seconds, then release.
4. Repeat this exercise eight to 12 times.

Move 5: Shoulder Flexion

You will need a stick for this exercise.

1. Lie down on your back, bend your knees and plant your feet on the floor.
2. Hold the ends of the stick in your hands, keeping your elbows straight and your palms facing the floor.
3. Slowly raise your arms over your head, until you feel a stretch in your chest, back and shoulders. Don't let your arms bend at any point during this movement.
4. Hold this position for 15 to 30 seconds.
5. Bring your arms back to their original position.
6. Repeat this exercise two to four times.

Move 6: Standing Shoulder Extension

You will need a stick for this exercise.

1. Stand upright and hold the stick in both hands behind your back.
2. Your hands should be placed shoulder-width apart on the stick, with your palms facing away from your body.
3. Move the stick backward, away from your body. Take it as far back as you can without feeling pain.
4. Hold this position for six seconds.
5. Bring your arms back to their original position.
6. Repeat this exercise eight to 12 times.

Move 7: Goal Post Stretch

You will need a stick for this exercise.

1. Lie down on your back, bend your knees and plant your feet on the floor.
2. Hold the ends of the stick in your hands, with your palms facing your knees.
3. Rest your elbows on the floor, perpendicular to your body. The stick should be above your chest.
4. Move the stick backward over your head. Go as far back as you can without feeling pain. Try to reach far back enough that you can rest the stick on the floor behind your head.
5. Hold this position for 15 to 30 seconds.
6. Bring your arms back to their original position.
7. Repeat this exercise two to four times.

Read more: 5 Exercises to Do When Shoulder Pain Flares Up