ACROMIOCLAVICULAR JOINT PART 2 – Pain management

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Acute management of AC joint pain resolves around relative deloading. This may be in the form of decreased training volume and/or intensity, or training modification. Athletes may need to avoid techniques/angles that cause the greatest aggravation. Body shots (where the arm is at a lower height than the shoulder upon impact), and hooks in particular can place stress on this area. A change in equipment (i.e. changing from mitts to paddles, changing to a lighter bag/water bag, even using large gloves) may also help allow the area to settle, before building loading back up again. 

Taping of the area may also be a useful adjunct intervention to help an athlete continue training while allowing the joint to settle. A useful strategy is to use symptom modification of the athlete’s painful movement, to ascertain if the AC joint pain can be modified by local compression or distraction, then taping in this direction. The clips attached demonstrate the symptom modification procedure and the relevant taping techniques. These taping techniques may extend further into the rehabilitation phase to allow the athlete to return to training while controlling symptoms.

In cases where symptoms do not respond to conservative management, a corticosteroid injection may be useful in settling symptoms and braking the pain barrier. While steroid injection is a controversial topic in sports medicine due to its potential side effects, as the AC joint is relatively immobile, the likelihood of these side effects are less than in other areas of the body. This being said, athletes should avoid excessive numbers of injections, and make sure they follow the advice of a trusted medical practitioner.

Part 3 will discuss rehabilitation principles.

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About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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