AC Joint Sprain - Symptoms, Causes, and Treatment Options

Overview of AC joint sprain

An AC joint sprain happens when the ligaments that hold the collarbone and shoulder blade together are stretched or torn. It’s one of the most common shoulder injuries, especially in athletes, manual labourers, and people who fall directly on the shoulder. Prevalence varies, but studies estimate that AC joint injuries make up about 9% of all shoulder injuries, with sprains being the most frequent type (Rockwood et al., 1998).

How an AC joint sprain affects daily life

• Work: Jobs that require lifting, pushing, or overhead movement (e.g., construction, nursing, warehouse work) become difficult. Even office work may feel uncomfortable when sitting for long periods with poor posture.
• Sport & activity: Contact sports (football, hockey, rugby) and activities with sudden falls (cycling, skiing, snowboarding) are strongly linked to this injury. Athletes often struggle to return to play until pain and mobility improve.
• Sleep: Many people report trouble sleeping on the injured side, leading to fatigue and irritability.
• Relationships & daily tasks: Hugging, carrying children, or even simple chores like reaching for items on a shelf may trigger sharp pain.
• Mental health: Long-term pain and limited activity may lead to frustration, anxiety, or low mood, especially if the injury limits independence.

How AC joint sprain compares to other shoulder injuries

• Unlike rotator cuff tears, which involve the muscles and tendons around the shoulder, an AC joint sprain directly affects the ligaments at the joint.
• Unlike a dislocated shoulder, where the ball of the joint pops out of its socket, the AC joint sprain is localized at the top of the shoulder and doesn’t always involve bone displacement.

Learn more about related conditions such as rotator cuff injury, shoulder impingement, and shoulder dislocation.

Reference: Rockwood, C. A., Green, D. P., Bucholz, R. W., Heckman, J. D. (1998). Fractures in Adults. Philadelphia: Lippincott-Raven.

Symptoms of AC joint sprain

An AC joint sprain usually causes sharp pain at the top of the shoulder, swelling, and tenderness. Symptoms range from mild discomfort to severe functional loss, depending on the severity (graded from I–VI).

What are the main symptoms of AC joint sprain?

• Localized pain at the top of the shoulder, worse with pressure or movement.
• Swelling and bruising over the AC joint.
• Visible bump or deformity in higher-grade injuries where the collarbone shifts upward.
• Limited movement, especially when lifting the arm overhead, across the chest, or carrying heavy loads.

Types of pain and severity

• Mild sprains (Grade I–II): Soreness, mild swelling, pain when pressing the joint.
• Moderate sprains (Grade III): Significant pain, restricted movement, and visible collarbone elevation.
• Severe sprains (Grade IV–VI): Obvious deformity, severe pain, and inability to move the arm normally.

Functional impacts

• Work: Difficulty with lifting, overhead tasks, or even typing at a desk due to posture-related pain.
• Sport: Loss of power in throwing, hitting, or tackling. Recovery time varies from weeks to months.
• Sleep: Pain often worsens when lying on the injured side, disturbing rest.
• Daily performance: Even small actions like dressing, washing hair, or carrying groceries can cause sharp pain.

Psychological and lifestyle impacts

Living with an AC joint sprain may cause stress, frustration, and reduced confidence, especially for athletes or workers who rely on their shoulders. Long-term pain or repeated injuries can lead to avoidance of activities and affect social life.

Red flag signs – when to see a doctor:

• Severe deformity or the collarbone sticking up noticeably.
• Numbness, tingling, or weakness in the arm or hand.
• Persistent severe pain that doesn’t improve with rest.
• Difficulty moving the arm at all.

Causes and Risk Factors for AC joint sprain

An AC joint sprain is most often caused by a fall directly onto the shoulder or a strong impact, such as in contact sports or accidents. The injury occurs when the force stretches or tears the ligaments that stabilize the joint.

What causes an AC joint sprain?

• Falls onto the shoulder – common in cyclists, skiers, and skateboarders.
• Direct blows – frequent in sports like football, hockey, and rugby.
• Heavy lifting or overhead strain – can cause sprains in construction workers, movers, or weightlifters.
• Repetitive microtrauma – small, repeated stresses over time can weaken the joint.

Risk factors that increase your chances

• Age: Young adults and athletes are most at risk due to activity levels.
• Occupation: Jobs that involve overhead lifting, repetitive reaching, or heavy loads raise the risk.
• Sports participation: Contact sports and those with a risk of falling strongly increase the likelihood.
• Posture: Poor posture, rounded shoulders, and weak stabilizing muscles may increase strain on the AC joint.
• Pregnancy: Hormonal changes can loosen ligaments, making joints more vulnerable.
• Obesity: Extra weight can strain joints, increasing injury risk during falls or accidents.

Daily life examples

• A roofer slips on a ladder and lands on his shoulder.
• A cyclist crashes and hits the pavement directly on the side.
• A warehouse worker repeatedly lifts heavy boxes overhead.
• A hockey player takes a shoulder-to-shoulder hit and lands awkwardly.

How AC joint sprain is different from other shoulder conditions

Unlike arthritis (which develops slowly), an AC joint sprain is usually sudden and traumatic. Unlike bursitis or tendonitis (caused by inflammation), a sprain involves ligament damage.

See related hubs on shoulder arthritis and shoulder bursitis.

Reference: Tamaoki, M. J. S., Belloti, J. C., Lenza, M., et al. (2010). Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database of Systematic Reviews, 2010(8), CD007429. https://doi.org/10.1002/14651858.CD007429.pub2

Diagnosis, Recovery, and Management of AC joint sprain

An AC joint sprain can range from mild ligament stretching to complete joint disruption. Understanding how it is diagnosed, what recovery looks like, and the best management strategies can help you take clear steps toward healing.

Diagnosis of AC joint sprain

An AC joint sprain is diagnosed through a combination of physical examination, functional tests, and imaging when needed. The goal is to confirm the injury, rule out other causes of shoulder pain, and determine its severity.

How do doctors test for AC joint sprain?

• History and symptom review: A doctor starts by asking how the injury happened, when pain began, and what movements make it worse. Falls onto the shoulder or direct blows are strong clues.
• Physical examination:
  • Inspection: Checking for swelling, bruising, or a visible bump over the joint.
  • Palpation: Pressing on the AC joint to see if pain is reproduced.
  • Range of motion tests: Asking you to raise your arm overhead or across your chest, which typically increases pain in an AC joint sprain.
  • Special tests: The cross-body adduction test (moving your arm across your chest) and the O’Brien’s test can highlight AC joint problems.

What imaging is used for AC joint sprain?

• X-rays are the first step. They show if the collarbone is displaced and help rule out fractures. Stress X-rays may be taken with weights in the hands to reveal subtle separations.
• Ultrasound can detect ligament damage and inflammation in real time.
• MRI is reserved for complex cases to look at soft tissues in more detail.

How do practitioners find the root cause?

Not all shoulder pain is an AC joint sprain. Conditions like rotator cuff tears, shoulder impingement, or arthritis can cause similar pain. Practitioners identify the root cause by:

• Comparing movement limitations to typical injury patterns.
• Assessing posture, shoulder blade stability, and muscle balance.
• Considering contributing factors like occupation, repetitive strain, or prior injuries.

Comparison example: If pain is deep inside the shoulder and worse at night, a rotator cuff injury may be more likely. If pain is sharp and localized on top of the shoulder after trauma, an AC joint sprain is suspected.

Recovery Timeline for AC joint sprain

Recovery from an AC joint sprain depends on the severity of the injury and your overall health. Healing can range from a few weeks to several months.

How long does AC joint sprain usually take to heal?

• Mild sprain (Grade I–II): 1–3 weeks of rest, ice, and gentle activity. Most people return to work and sport in 3–6 weeks.
• Moderate sprain (Grade III): 6–12 weeks. A sling, structured rehab, and gradual return to lifting or contact sports are typical.
• Severe sprain (Grade IV–VI): Often requires surgery and several months of rehabilitation before resuming full activity.

If/then decision pathway for recovery

• If your sprain is mild, then you’ll likely recover from your AC joint sprain with rest, activity modification, and strengthening within a few weeks.
• If your sprain is moderate, then you may need structured physiotherapy and possibly bracing, with gradual return over 2–3 months.
• If your sprain is severe, then surgery may be recommended, followed by longer rehabilitation and strengthening.

Factors that affect recovery

• Age: Younger athletes often heal faster.
• Occupation: Manual workers may face delayed return compared to office workers.
• Adherence to rehab: Consistent exercises improve long-term outcomes.
• Previous injury: Recurrent sprains can weaken stability and increase chronic pain risk.

Return-to-life outcomes

• Work: Desk workers may return within days for mild sprains, while heavy laborers may need weeks to months.
• Sport: Return-to-play varies—non-contact athletes may resume quickly, while contact sport athletes require clearance and shoulder stability testing.
• Lifestyle: Long-term prognosis is generally good, though some people experience persistent tenderness or a visible bump on the shoulder.

Reference: Tamaoki, M. J. S., et al. (2010). Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database of Systematic Reviews, 2010(8), CD007429. https://doi.org/10.1002/14651858.CD007429.pub2

How to Manage AC joint sprain

Management of an AC joint sprain includes short-term pain relief, activity modification, rehabilitation, and long-term prevention strategies.

What’s the best way to manage AC joint sprain at home?

Step-by-step self-help tips:

• Rest and protect: Avoid heavy lifting or contact sports for the first days to weeks of your AC joint sprain.
• Ice the area: Apply cold packs for 15–20 minutes, 2–3 times daily to reduce swelling.
• Use a sling if needed: Helps limit painful movement in the first few days.
• Gentle movement: Begin pendulum swings or light range-of-motion exercises as pain allows.
• Gradual strengthening: Add resistance band exercises for shoulder stability after pain decreases.
• Posture correction: Sit tall, avoid slouching, and keep screens at eye level to reduce strain.

Therapy and long-term strategies

• Physiotherapy: Focuses on restoring strength, flexibility, and scapular control.
• Ergonomics: Adjusting workstation height and avoiding repetitive overhead tasks reduces recurrence.
• Lifestyle: Weight management and general fitness support healing.
• Community/social support: Group rehab classes or sports clubs can improve motivation and mental health.

Comparison with similar injuries

• Unlike a fracture, which may require prolonged immobilization, an AC joint sprain often benefits from early controlled movement.
• Unlike frozen shoulder, which causes long-term stiffness, an AC joint sprain usually allows near-normal recovery with proper rehab.

Reference: Gowd, A. K., Liu, J. N., Cabarcas, B. C., Cvetanovich, G. L., Garcia, G. H., & Romeo, A. A. (2019). Current concepts in the operative management of acromioclavicular dislocations: a systematic review and meta-analysis of operative techniques. American Journal of Sports Medicine, 47(11), 2745–2758. https://doi.org/10.1177/0363546518804802

Multidisciplinary Coordinated Care for AC joint sprain at CARESPACE

At CARESPACE, AC joint sprain is managed through a team-based, multidisciplinary approach that goes beyond symptom relief to focus on recovery, resilience, and long-term prevention. Unlike single-discipline care, our coordinated model integrates physiotherapy, chiropractic, massage therapy, kinesiology, psychotherapy, nutrition, fitness training, and more—ensuring that both your body and mind are supported throughout the healing journey.

How does CARESPACE treat AC joint sprain differently?

CARESPACE takes a team approach to AC joint sprain, meaning you don’t just see one provider in isolation. Instead, your care is personalized, coordinated, and adapted to your needs at every stage of recovery.

• Initial assessment: A physiotherapist may begin by testing range of motion, stability, and strength. If swelling and acute pain are present, gentle mobilization and protection strategies are introduced.
• Multidisciplinary support: You may be referred to massage therapy to reduce muscle tension around the shoulder, or chiropractic care to improve joint alignment and restore normal biomechanics.
• Mental health and stress management: Coping with pain can be frustrating and even impact sleep. CARESPACE integrates psychotherapy or coaching to help you manage pain-related stress, build resilience, and avoid the mental health pitfalls of prolonged recovery.

Learn more about physiotherapy for shoulder injuries, massage therapy for muscle tension, and chiropractic care for joint pain.

Why does a team approach help AC joint sprain recover faster?

Recovering from an AC joint sprain isn’t just about healing the ligament—it’s about restoring movement, confidence, and daily function. A multidisciplinary team helps because each provider focuses on a different aspect of your recovery.

• Physiotherapy: Restores motion, strength, and stability of the shoulder.
• Chiropractic care: Supports alignment of the shoulder, neck, and spine, reducing compensation patterns that can delay recovery.
• Massage: Relieves muscle tightness that develops from guarding or altered posture after injury.
• Kinesiology & fitness training: Builds long-term strength and injury prevention strategies, especially for athletes or workers returning to overhead or heavy tasks.
• Psychotherapy & mental performance coaching: Helps you cope with fear of reinjury, pain-related anxiety, or sleep disturbance.
• Nutrition & naturopathic medicine: Supports healing by addressing inflammation, energy balance, and overall wellness.

By working together, the CARESPACE team shortens recovery time, reduces the risk of reinjury, and ensures you return to work, sport, and daily life with confidence.

Explore our kinesiology and exercise programs and psychotherapy services for pain and stress.

What does coordinated care for AC joint sprain look like at CARESPACE?

Your recovery journey at CARESPACE is structured across phases—acute, subacute, and maintenance—so every step is supported.

Acute phase (first days to weeks):

• Pain and protection: Physiotherapy and chiropractic focus on pain relief, swelling reduction, and gentle movement.
• Massage may ease protective muscle tension.
• Psychotherapy or coaching can support stress management if pain is affecting your sleep or mood.

Subacute phase (weeks to months):

• Restoring function: Strengthening, mobility work, and posture training begin under physiotherapy and kinesiology guidance.
• Lifestyle optimization: Nutrition and naturopathic care may address inflammation, while fitness trainers guide safe reintroduction to activity.
• Integrated care: Your providers communicate regularly so treatments build on each other rather than working in silos.

Maintenance phase (long-term health and prevention):

• Performance and resilience: Fitness training, kinesiology, and massage help keep your shoulders strong and flexible to help you AC joint sprains.
• Mental health support: Ongoing psychotherapy, mindfulness strategies, or coaching may be recommended if the injury has had lasting psychological effects.
• Prevention: Ergonomic coaching, workplace strategies, and posture correction reduce your risk of recurrence.

This phased approach ensures that you don’t just “get back to normal” but move forward with better awareness, stronger shoulders, and healthier routines.

How does CARESPACE address the mental health side of AC joint sprain?

Living with shoulder pain can affect more than your body—it can impact your sleep, confidence, and mood. At CARESPACE, mental health is an integrated part of your recovery.

• Psychotherapy helps you manage pain-related stress, frustration, or low mood.
• Mental performance coaching supports athletes or professionals who need strategies for resilience and motivation during rehab.
• Sleep and stress management are addressed holistically through counseling, mindfulness, or even acupuncture to improve rest and coping.
• Nutrition support helps regulate energy, reduce inflammation, and improve recovery outcomes.

This integration ensures that your emotional and mental well-being are cared for alongside your physical healing, giving you the best chance of full recovery.

Learn more about mental health support at CARESPACE and nutrition for injury recovery.

The CARESPACE advantage in treating AC joint sprain

What sets CARESPACE apart is its coordinated, evidence-based, and whole-person approach. Rather than working in isolation, providers share notes, align treatment goals, and tailor care plans to your unique needs.

Key advantages of CARESPACE’s model:

• Faster recovery through integrated care.
• Lower recurrence risk by addressing not just the injury, but posture, movement, and lifestyle.
• Personalized care designed around your work, sport, and daily activities.
• Whole-person wellness—physical, emotional, and lifestyle support for long-term resilience.

Compared to traditional single-discipline care, which often stops at pain relief, CARESPACE’s approach gives you a clear path from injury to prevention.

Related Conditions, FAQs, and Disclaimer for AC joint sprain

An AC joint sprain often overlaps with or mimics other shoulder injuries, which is why careful diagnosis and a comprehensive care plan are so important. Below, we outline related conditions, answer common questions clients often ask, and provide an important disclaimer to support your health decisions.

Related Conditions for AC joint sprain

An AC joint sprain can sometimes be confused with other shoulder injuries that cause similar pain and movement problems. Understanding these related conditions helps you know what else may be going on.

• Rotator cuff injury: This affects the muscles and tendons that stabilize your shoulder. Unlike AC joint sprain, rotator cuff pain is usually deep in the shoulder and worse at night.
• Shoulder dislocation: This occurs when the ball of the shoulder comes out of the socket. Dislocations often look more dramatic than AC joint sprain and require immediate medical attention.
• Shoulder bursitis or impingement: These conditions cause pain with overhead movements but don’t usually cause the bump or tenderness on top of the shoulder that’s common in AC joint sprain.
• Collarbone fracture: A break in the clavicle can mimic AC joint sprain, but fractures show more clearly on imaging.

Explore our Conditions List for more related injuries and shoulder pain conditions.

Looking for information on a different condition? Visit our full Conditions List.