Diagnosis Explanation:

An AC joint sprain (shoulder separation) occurs when the ligaments connecting the clavicle (collarbone) to the acromion (top of the shoulder blade) are stretched or torn, usually due to a fall onto the shoulder, direct impact, or excessive overhead movements. Severity is classified as:

• Grade 1 (Mild): Ligament stretching, mild pain, no deformity.
• Grade 2 (Moderate): Partial ligament tear, swelling, noticeable pain.
• Grade 3 (Severe): Complete ligament tear, visible shoulder bump, significant pain and instability.

Specific Work Modifications:

• If your job requires standing or walking: Avoid carrying heavy objects on the affected side and take breaks to rest the shoulder.
• If your job involves lifting: Avoid overhead lifting, pushing, pulling, or reaching across the body. Use both hands for lifting when possible.
• If your job is desk-based: Keep shoulders relaxed, use proper arm support, and avoid hunched posture.
• Avoid: Repetitive overhead movements, carrying heavy loads, and activities that strain the shoulder.

Specific Activity Modifications:

• If you play sports: Avoid contact sports, throwing, and overhead motions until fully healed.
• If you do weightlifting: Avoid bench presses, shoulder presses, dips, and pull-ups. Focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid deep shoulder extension and overhead reaching.
• Avoid: High-impact activities, heavy lifting, and sudden shoulder movements.

Recommended Supplements:

• Collagen Peptides – 10g daily for ligament and joint repair.
• Vitamin C – 500mg daily to support collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support ligament healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue hydration.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support joint recovery.

Home Exercise Prescription (Rehabilitation for AC Joint Sprain)

Early Phase (0-2 Weeks, Reducing Pain & Swelling):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (sling if needed), Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Shoulder Blade Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Neck & Upper Trap Stretch – Gently tilt head to the opposite side, hold 20 seconds, 3x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Function):

• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.
• Internal & External Rotation (Resistance Band) – Keep elbow at 90 degrees, rotate forearm inward and outward, 10 reps, 2x/day.
• Wall Slides – Stand facing a wall, slowly slide hands up, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Restoring Strength & Preventing Recurrence):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.