AC joint injuries can be managed conservatively with rehab programs instead of surgery.
Clinical assessment is more reliable than x-rays in determining the severity and treatment approach for AC joint injuries.
Deep dives
Assessing and Treating Acute AC Joint Injuries
In this episode, Joe Gibson, a rehabilitation specialist physio, provides valuable insights on assessing, diagnosing, and effectively treating acute AC joint injuries. She emphasizes the need to determine if surgery or conservative management is necessary for patients with AC joint injuries. Gibson also discusses how to grade these injuries and helps patients make informed decisions about their treatment options. She highlights the importance of rehabilitation in promoting recovery and shares exercises targeting scapular stability and the muscle system surrounding the joint. Gibson emphasizes the need to rely on clinical pictures rather than x-rays, which have limited reliability in accurately classifying AC joint injuries.
Understanding the Rockwood Classification
Joe Gibson discusses the limitations of the Rockwood classification for AC joint injuries and the unreliability of x-ray views in accurately assessing these injuries. She explains the different sub-classifications in the Rockwood system and the extent of ligament damage associated with each type. Gibson emphasizes that MRI scans often disagree with x-ray classifications, showing either overestimation or underestimation of the severity of the injury. She highlights the challenges in determining the best treatment approach based solely on classification and advocates for a thorough clinical assessment to guide decision-making.
Rehabilitation and Return to Sport
Joe Gibson explores the role of rehabilitation in managing AC joint injuries, particularly in athletes wanting to return to their sport. She discusses the conservative management approach for low-grade injuries, encouraging range of movement exercises and gradual return to sport within one to six weeks. Gibson also highlights the controversy surrounding type-three injuries and emphasizes the importance of assessing progress and considering surgery if symptoms persist. She emphasizes the potential benefits of scapular-based exercises and targeting the muscle system surrounding the AC joint to promote stability and optimal mechanics.
Managing Complex AC Joint Injuries
Joe Gibson delves into the complexities of AC joint injuries that may require surgical intervention. She discusses the challenges in accurately assessing and treating these injuries and highlights the importance of considering patient symptoms and history alongside imaging findings. Gibson shares examples of patients who required surgical stabilization due to persistent pain and functional limitations. She also cautions against rushing rehabilitation and overloading the joint, which can lead to outcomes such as austere lysis. Gibson emphasizes the importance of collaboration with surgical colleagues and multimodal decision-making for optimal patient outcomes.
Do your acute ACJ injury patients require surgery, or can they be managed conservatively with a rehab program? Find out in this podcast as Jo Gibson (Upper Limb Rehabilitation Specialist Physio) reveals how to grade patients’ acute ACJ injuries, help patients decide on surgery or conservative management, and rehab your patients effectively.
