Last updated: March 2020

Acromioclavicular Joint (ACJ) dislocation exercises

This exercise sheet is designed to guide you through the next few months with some simple exercises to gradually increase your movement, decrease your pain and steadily improve your function.

1. Sling

The sling is to keep you comfortable over the first few days – you should remove regularly to move your, elbow, wrist and hand. Start weaning from your sling, the easiest way is to gradually use the sling less and less over a few days. You should aim to stop using it by 3 weeks.

2. Using your arm

Try and use your arm as normally as possible – in the first 6 weeks try and avoid lifting the arm above shoulder height and reaching across your body.

Avoid heavy lifting, repetitive overhead activities and contact sports for 8-12 weeks

3. Pain relief

It is important to keep your shoulder comfortable use your pain relief as necessary. You can also use warmth and cool to help with this.

Supporting the weight of your arm on cushions or pillows whenever you are sitting can make your shoulder feel more comfortable.

4. Exercises

Start the “early” exercises as soon as you are able – these allow you to move your elbow, wrist and hand.

The pendulum position can also help with washing and dressing but may also help your shoulder feel more comfortable.

Once your shoulder feels more comfortable in a few days start the “early shoulder exercises”.

Early Exercises
Try and practice these little and often through the day

A. 
Stand beside a table, leaning on your forearm. Gently let your other arm hang relaxed down – this will allow you to wash under your arm

B.
Sitting. Tilt your head toward one shoulder until you feel the stretch on the opposite side. Hold approx. 2-3 seconds. Repeat 5 times. Repeat to the other side

C.
Sitting. Turn your head to one side until you feel a stretch. Hold approx. 2-3 seconds. Repeat 5 times. Repeat to other side.

D.
Stand – remove the sling – keep your upper arm close to the body. Slowly bend and straighten your elbow. Repeat 5 times

E.
Stand with your elbow bent and palm turned down. Turn your palm up and down rotating your forearm.

Keep your upper arm next to your body. Repeat 5 times.

D.
Practice regularly throughout the day:

• Move your wrist up and down
• Make a full fist and fully straighten your fingers
• Touch your thumb to the tips of all your fingers

Early Shoulder Exercises
Try and practise these little and often through the day.

A.
Lie on your back with your arm by your side, slightly away from your body. Place a folded towel under the upper arm. Elbow is bent to 90 degrees and hand points towards the ceiling. Hold a stick with both hands so that the palm of the affected side is facing upwards.

Keep your elbow bent during the movement. Rotate your arm outwards as far as comfortable. Return to the starting position.

You can also practice in sitting – but be careful to keep your body still.

B.
Lie on your back.

Use your un-injured arm to gently lift your injured shoulder up to shoulder height only.

You can also practice in sitting – but be careful to keep your body still.

C.
Slide your hands along the table until the upper arm is approximately at shoulder height. Let the un-injured arm help and the table will take the weight of the arm.

Strengthening exercises
From 2 weeks start these gentle strengthening exercises:

A.
Stand or sit. Hold your arm close to your body with your elbow at a right angle.

Try to move your hand inward, resisting the movement with the other hand. There should be no movement.

Hold 5 seconds.

Repeat 5 times

B.
Stand or sit. Hold your arm close to your body with your elbow at a right angle.

Try to move your hand inward, resisting the movement with the other hand. There should be no movement.

Hold 5 seconds. Repeat 5 times.

Exercises from 6 weeks
From 6 weeks – you may feel that you can start working on your strength – you can decrease or stop the other exercises if they are easy. If you can comfortably lift the weight of your arm – consider starting the next set of exercises.

Initially – practice just moving the weight of your arm, when that is easy try adding a small weight (partially filled bottle of water) and then gradually increase as able.

Practice each exercise until tired 1 x a day.

A.
Standing or sitting.

Start with no weights and gradually increase the weight as able. Lift your shoulders towards your ears and slowly lower them back down.

B.
Stand or sit holding your hands on your chest. Start with no weight and gradually increase as able.

Steadily lift both arms from your chest straight up and slowly back down – keeping your elbows tucked in by your side.

C.
Lie on your side. Place a folded towel between your upper arm and side. Bend your elbow to 90 degrees.

Start with no weight and gradually increase as able. Lift your hand up and slowly back down.

D.
Stand next to a wall. Place your hands on the wall, slightly wider than shoulder-width apart and fingers pointing upwards. Body is in a straight line.

Keep body in a straight line and shoulders down. Bend your arms and lower your chest towards the wall. Straighten your arms and push back away from the wall.

Return to sport
These exercises will help you get back to your normal full activities.

Returning to sport may take you up to 6 months. You should consider a phased return, return to training environment first prior to returning to a competitive environment.

Gradually increasing your contact and overhead activities.

This information was provided by North Bristol NHS Trust‘s orthopaedic team