Recommendations for

ACROMIOCLAVICULAR JOINT
PAIN & INJURY ASSESSMENT
From Sports injury assessment & treatment video 1 with Dr Rod Whiteley

When is the AC Imaging - MRI

2
joint the source AC joint bone marrow oedema
of your patient’s indicates a likely symptomatic
shoulder pain? joint (Shubin Stein et al., 2006)

3
History The presence of subchondral

1
cysts indicates a high likelihood
• Increased load on the (LR+ 7) for AC joint referred pain

4
AC joint
The absence of caudal
• Weight training with
osteophytes make the AC joint
a focus on chest
less likely (LR- 0.32) to be
exercises eg bench
responsible for pain (Strobel et al., 2003)
press and pushups

5
• Pain over the AC Pain referral patterns for the AC
joint +/- pain into joint are similar to subacromial
the shoulder, upper bursa, with the addition of pain
trapezius into the upper trapezius for the
AC joint (Gerber et al., 1998)

Objective testing for the AC joint

6 7 8
Pain reproduction:
• O’Brien’s
• Horizontal cross-body adduction 2 or 3 positive tests equals a 2 or 3 negative tests equals a
• Resisted extension high likelihood of having pain high likelihood of pain NOT being
from the AC joint (LR+ 7.3) from the AC joint (LR- 0.21)

Other tests for the AC joint

9
Shoulder external
10
Pushups
rotation (ER) and bench
strength is greater press - check Brought to you by
than internal for scapular
rotation (IR) protraction at Clinicaledge.co/sport
ER IR
strength - more the top of the
likely to have AC movement, which
@davidkpope
joint pain can aggravate AC
joint pain
STRENGTH