The AC (acromioclavicular) joint is the joint between the clavicle (collarbone) and the acromion (the tip of the shoulder blade). The AC joint provides a link between the arm and trunk and it transmits the load from the arm to the trunk when pulling, pushing, punching or resting on the arm.

What is acromioclavicular (ACJ) pain?

ACJ pain is any painful sensation around the ACJ area.

What causes acromioclavicular (ACJ) pain?

There are two main causes of ACJ pain:

  • AC joint disruption- trauma leads to different degrees of displacement of the clavicle from the muscles and ligaments surrounding it. There are 6 classifications of AC joint disruption from type I being sprained with no tear to Type VI where the clavicle is completely separate from the scapula with gross upward displacement of the clavicle behind tendons.
  • Osteoarthritis (OA) and osteolysis of the AC joint: OA may occur after injury or due to repetitive overuse. Clavicular osteolysis can occur spontaneously in rheumatoid arthritis and other conditions.

What are the symptoms of acromioclavicular (ACJ) pain?

There are different symptoms of ACJ pain depending on the severity of the cause of the pain and severity of the condition:

AC joint disruption:

  • Tenderness around the AC joint and a ‘step’ if there is a clavicular separation.
  • Pain around the top of the shoulder which may increase when lying on the affected side, moving the arm across the body, overhead activity or pushing/pulling movements.


  • Aching or pain lifting arm over head
  • Upper arm may feel weak
  • Sleeping may be painful

How is acromioclavicular (ACJ) pain diagnosed?

Your physiotherapist can carry out a full shoulder examination to determine the cause of your acromioclavicular pain and is usually sufficient for diagnosing a joint spreain however further scans such as X-ray, MRI or CT scans may be required to confirm diagnosis and determine the extent of the damage or if any other structures are involved and rule out a fracture.

What treatment can Farrell Physiotherapy offer for acromioclavicular (ACJ) pain?

A specialist physiotherapist can assess your ACJ and surrounding structures to determine what the cause of the pain is and will provide an individual treatment plan. Treatment often includes:

  • Ice therapy to decrease swelling
  • Taping to allow normal shoulder alignment
  • Gradual passive range of movement exercises to prevent stiffness
  • Active range of movement exercises to improve joint flexibility and range of movement
  • Strengthening exercises to keep the joint strong
  • Joint mobilisation
  • Sport specific exercises and a graded return to sports to ensure safety
  • Soft tissue massage

Benefit of physiotherapy for acromioclavicular (ACJ) pain?

Physiotherapy should be started as early as possible to ensure the best outcome. The benefits you feel from physiotherapy will be dependent on your symptoms and goals.

Treatment helps with:

  • Reduced pain
  • Improved range of movement
  • Increased strength
  • Prevention of re-injuring the ACJ

If you would like to book an assessment or enquire further, please call 01245 830280 or e-mail: