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A-C Shoulder Separations

Self-Help Supplies

All of the supplies needed or necessary that are mentioned in our rehab guidelines and rehab exercising self-help programs are available in our Bookstore.

The term A-C is short for the Acromio-Clavicular shoulder joint. Let's start by first looking at a normal shoulder joint and its respective bones that make up the complete shoulder joint. The shoulder joint is made up from three different bones. They are the:
1. Scapula or Shoulder Blade
2. Clavicle bone or Collar Bone
3. Humerus bone of the arm

The scapula attaches to the back part of the shoulder joint and extends over the posterior portion of the rib cage up to almost the spine. The clavicle attaches to the front portion of the shoulder joint and extends over the top portion of the rib cage attaching to the top part of the sternum. The Humerus bone of the upper arm attaches in the middle portion of the shoulder joint and extending freely down from its point of attachment to exhibit a complete free range of motion.

These two above diagrams of the normal right shoulder joint clearly show the relationship between the three bones that make it up.

Normal Relationship

Note that the top portion of the shoulder blade that makes up the posterior of the shoulder joint is call the acromio process. And it is this attachment site where the clavicle attaches to the shoulder blade. This attachment site is better known at the acromioclavicular or A-C joint. And it is the ligament structure that attaches and holds these two bones together. All connective tissue is elastic and plastic. That is to say that it can be stretched within its own normal limit of stretch forces and then will return back to its normal relationship when the stretching force is removed. The term plastic means that it has a 100% memory program and is ability to return to its original position and status.

Over Stretching & Tearing

When the acromioclavicular ligament is over stretched the ligament looses some of its memory as well as its ability to hold the joint together. In ligament tissue this loss is classified as a strain (over stretching of a ligament with plastic memory loss in the tissue).

Notice in the two x-rays views above that the clavicle is stretched and displaced superiorly and inwardly from the acromio process of the scapula.

Also, if you follow the borders of the clavicle inwardly about 1/2 of the way towards the sternum you will see a transverse fracture (see chapter on Broken Bones). Upon more care examination you will see that the inferior border of the clavicle has continuity and is therefore not fractured. This incomplete fracture known as a Greenstick (see chapter on Broken Bones) fracture. This is an unusually collar bone fracture as it has anatomical alignment. Almost all collar bone fractures will fracture and overlay and lie along side of each other. See Collar Bone Fractures. So the above x-rays show both an A-C separation and a fractured clavicle.

Outward Physical Signs & Symptoms

Next, let's see what the outward physical signs and symptoms that are present. Sometimes there may be not history of any accident or injury however the shoulders may present an appearance of A-C separation.

No history of injury to shoulders

This rider has not history of injury or accidents to either shoulder yet both take on the outward physical observations of A-C joint separations.

Right Shoulder A-C Separation

This rider has an A-C separation of his right shoulder joint. Note the yellow-light brown skin discoloration (jaundice) from the A-C tearing, bleeding, and bruising in the right chest area below the right shoulder. Gravity has pulled the blood lower than the actual site of injury. This process of gravity pulling blood to a lower site is known as ecchymosis. Also note the higher and dimpled right distal clavicle in its relationship to the acromio process of the right shoulder joint when compared to the same area of the left shoulder joint. Also note the inflammation across the top of the right shoulder area.

Muscle Strength and Range Of Motion

In most cases A-C separation will produce muscle weakness but the individual can express an unrestricted almost normal full range of motion.

Let's review the treatment protocol

2. The Application of Hot and Cold temperatures mixed with water. Apply the
    RICES-Rule from the chapter on "Hot & Cold Application" as outlined in the
    chapter.
3. Skin Brushing is one of the best self-help applications for accelerating
    recovery, bruise, swelling and pain elimination, and connective tissue
    regeneration. It is listed as Skin Brushing. Do this two to three times a day at
    least. See Skin Brushing.
4. Epsom Salt & Apple Cider Vinegar Bathing at least once a day, preferably
    just before going to bed. Combine this one with skin brushing. It is listed as
    Epsom Salts Bath.
5. Piezo Electric Stimulator is a small hand held unit about the size of a ink pen.
    Electric stimulation to troubled or injured areas allows these areas, not only heal
    faster, but in most cases heal without the formation of scar tissue. Applying
    electrical stimulation early in any problem allow the body to repair before the
    advance needs of chemical poisonous (drugs) or surgery. Electricity allows the
    body's repair program to repair and regenerate the troubled or injured tissues
    back to an identical replacement tissue, making it like new.
6. Essential Oils

Essential Oils is a soothing, penetrating herbal oil and balm that eases pain and, at the same time promote healing for a wide variety of conditions including aches, pains, soreness, tenderness, swelling, and tightness. It was originally developed by the Sholin Priests to aid their recovery from injuries they sustained while practicing extremely rigorous martial arts training and activities. It is a highly successful home treatment for over 30 known conditions including; injuries, sinus, back pain, headaches, high stress conditions, sore throats, heartburn, arthritis, rheumatism & sprains & strains.

Historical, Essential Oils was applied in different manners to produce its amazing successful results. The Chinese would rub Essential Oils (in Herb form) gently with a circular motion (CW = increases its action, CCW = slows its action, in the Northern Hemisphere). The Essential Oils would begin to liquefy, and a small ridge would adhere to the finger. With that amount of balm or oil, the Chinese would then use it for many conditions and ailments, .

Electromagnetics
Electromagnetic therapies (Diapulse) have performance of healing this bone fracture to a level 2 (normal activity) within 7 days. And it will reach a level #3 in 14 days (practice riding and racing) and will reach a level #4 by 21 days (fully race ready). Medical protocol will have you do nothing for 6 to 8 to 12 weeks. After surgery MD's offer you nothing that works well at all and in the process encourage the connective tissues at the site to atrophy. I have never been impressed with their protocol. For Diapulse treatment settings see Diapulse Treatment Protocols.
Also see Ceramic Magnets, Piezo Stimulator, Rehab Exercising,

Exercising
The muscle groups necessary to exercise in the shoulder, whether to the uninvolved or contralateral side or to the injured side are:
1. Shoulder Flexion
2. Shoulder Extension
3. Vertical abduction
4. Vertical adduction
5. Horizontal abduction
6. Horizontal adduction
7. Internal rotation
8. External rotation

Let's take a closer look at how to specifically exercise the above muscle groups.
Shoulder Flexion
Shoulder Extension
Vertical abduction
Vertical adduction
Horizontal abduction
Horizontal adduction
Internal rotation
External rotation

Rehab Exercising Program
The chapter on rehab exercising works very well. Start off with crossover. That is to say work or exercise the good arm through its full range of motion (isotonic surgical tubing). The bone is required to heal by over lapping the two broken bone pieces with fibrous connective tissues. This process varies depending on the practitioner's level of understanding and their ability to apply Wholistic therapeutics. Drugs only slow down the healing process. Pain is controlled very easily with N-1 and N-2 ceramic magnetic (see Ceramic magnetic in the Electromagnetic Therapies in the Health Care section of the library). Also exercising in the green (pain free) zones for overflow work exceptional well. For more on "Cross Over" and "Overflow" see our web site in the Health Care section listed as "Rehab Exercise Program" For sets and reps also see Rehab Exercise Program.

Also read about how Arch Supports can accelerate broken bones to heal by balancing the body's biomechanical musculoskeleto system and greatly reduces stress. Do the simple tape test listed towards the end of the chapter to see if arch supports will help your condition.

Herbs and Vitamins

Nothing can perform or compete against the herb Solomon's Seal and Cal Phos. Horsetail and Golden Seal come close but get lapped in the race to heal at your best possible rate. See Herbs & Vitamins in the Health Care section of the library.