Cycling Injuries: AC Joint Separations Explained

Shoulder separations – known as acromioclavicular (AC) joint separations in the medical world – are among the most common injuries cyclists experience, and it’s easy to understand why if you’ve ever fallen from a bicycle.

It’s a natural reaction to try and break your fall by putting your hands out in front of you, but hitting the pavement this way sends pressure up the arms and into the shoulder, causing the joint to separate. Speed and distance at which a rider hits the pavement can impact the severity of their injury.

AC joint separations can range from mild to severe, with some requiring surgery to treat. Cyclists should be aware of the symptoms of an AC joint separation so that they can get the right treatment following a crash.

What is AC joint separation?

The AC joint is where ligaments hold the clavicle and scapula together. Unlike many other joints throughout the body, there isn’t much movement that happens in the AC joint. Even so, this region is critical for upper body movement.

There are two main types of separation: Type I occurs when a ligament is stretched, and Type II occurs when there is a complete tear of a ligament. Both will make it challenging for cyclists to continue riding without proper care. There are additional types of separation (Types III-VI) which are considered more severe and involve torn ligaments and the clavicle being pushed down or out of place.

Symptoms of an AC joint separation include:

• Extreme pain at the location of the joint
• A bump on the top of the shoulder
• Swelling
• Bruising
• Limited movement

These symptoms can be mistaken for other injuries, so it’s important to get the right treatment to confirm the injury is a shoulder separation. When meeting with a healthcare provider, remember to get confirmation on the type of separation you have. This will help determine the next steps throughout the recovery process.

Diagnosis, treatment, and recovery

Diagnosing an AC joint separation requires a physical examination and potentially an X-ray, ultrasound, or MRI scan. If the separation is moderate or severe, the patient may be referred to an orthopedist who can best treat the injury.

The good news is that statistics show that many AC joint separations are mild and treatment is pretty straight forward.

If the AC joint separation is mild – a Type I or II – rest and keeping the joint in one position may be the best option. For most, it takes no more than 12 weeks for the joint to begin to heal up, but a doctor may require the patient to avoid certain activities for many more months to ensure the joint heals properly. The patient may need to wear a sling, keep the region iced, and attend physical therapy to heal the ligaments.

In more intense separations – these are considered Type IV to Type VI – surgery may be required. In these scenarios, an orthopedic surgeon may need to reattach torn ligaments, which may require a graft tissue to reconstruct badly damaged ligaments. These types of injuries may be more likely when the crash involves higher speeds or a harder impact.

In some cases a surgeon may need to also shave the end of the collarbone so that it doesn’t rub against the shoulder blade.

In all separations, it will take time to recover, so it’s best to assume that getting back on a bicycle is possibly months away. An AC joint separation may also occur in addition to other injuries caused by a bicycle accident that may make recovery time longer or more intense.

Some doctors may advise physical therapy or exercises to regain mobility. It’s best to follow professional advice and avoid activities that may hinder recovery or re-injure the ligaments in the joint.

Compensation for injuries

A cycling crash that leads to pain, a long recovery, or even surgery can be distressing, especially as medical bills add up. For some, it’s impossible to work and earn money. This can cause further anguish.

In California, cyclists who are injured by negligent drivers may be entitled to a wide array of compensation, including past and future medical expenses, lost wages, lost earning capacity, loss of personal property, property repairs, and more. Some of these costs are not things one thinks about immediately after a crash.

Attorneys at Bay Area Bicycle Law are dedicated to getting clients what they’re entitled to after a crash. They’re experts in bicycle accidents because they only focus on bicycle accidents.

If you’ve experienced an AC joint separation at the fault of another road user, schedule a free consultation today.