At a professional level, rugby league has an extremely high injury rate, particularly contact mechanism injury, with tackles occurring throughout the game every 10-15 seconds. Tackles are most strongly associated with shoulder injuries, one of the most injured joints in the sport, accounting for 20% of all rugby league injuries. Injuries to the acromioclavicular (AC) joint are common and amongst some of the most frequently occurring shoulder injuries in rugby league. An injury to the AC joint is often the result of a fall directly onto the shoulder, usually with the posterosuperior aspect of the shoulder striking the ground. This may result in a sprain or dislocation of this joint due to rupture of the AC ligaments. AC joint injuries typically require management by physiotherapists.
Sports Medicine Australia has outlined the procedure for immediate management and rehabilitation of an AC joint shoulder injury:
The immediate treatment of a soft tissue injury should consist of the RICER protocol (Rest, Ice, Compression, Elevation and Referral). The RICER protocol should be followed for the first 48-72 hours and aims to reduce bleeding and damage within the joint. The shoulder should remain rested in an elevated position with an ice pack applied for 20 minutes every two hours (never apply ice directly to the skin). The arm should also be immobilised in a sling for up to six weeks, depending on the severity of the injury.
To further ensure decreased swelling and bleeding of the injured area, the No HARM protocol should also be applied (no heat, no alcohol, no running or activity, and no massage).
A sports medicine professional should be seen as soon as possible to determine the extent of the injury, and to provide advice on treatment required. In some cases, a physical examination including x-rays of the shoulder may require to be performed.
Rehabilitation and Return to Sport
AC joint injuries are treated conservatively using various combinations of strengthening exercises, following the immobilisation phase, once pain permits. Surgery is typically reserved for cases where there is a complete dislocation of the AC joint, or where an injury fails to respond adequately to conservative treatment.
It is important to consult with a physiotherapist about your injury. Call one of our professionals today to ensure the right treatment for your unique circumstance.