Performed by – Ankit Desai, Gareth Hill, Philip Rosell

What is an ACJ injury?
An ACJ (acromioclavicular joint) injury is damage to the joint where your collarbone (clavicle) meets the highest point of your shoulder blade (acromion). This joint is small but plays a big role in shoulder movement, especially when lifting the arm or reaching overhead.

ACJ injuries are commonly caused by a fall directly onto the shoulder—often during contact sports, cycling accidents, or other high-impact activities. They can range from a mild sprain (where the ligaments are stretched) to a complete dislocation (where the clavicle is pushed out of place). These injuries are often referred to as a “shoulder separation,” which is different from a shoulder dislocation (which involves the ball-and-socket joint).

Common symptoms include pain right on top of the shoulder, swelling, bruising and sometimes a noticeable bump or step-off where the collarbone has shifted. Many people feel pain when moving the arm, especially when lifting it above shoulder height or across the body.

Treatment options for ACJ injuries
The best treatment for an ACJ injury depends on the severity of the damage. At Joint Reaction, we use physical exams and imaging (like X-rays or ultrasound) to determine how much the joint has been disrupted and whether ligaments are torn.

Non-surgical treatment
Most mild to moderate ACJ injuries (grades I–III) can be treated without surgery. Rest, ice, a short period in a sling and pain relief are usually enough in the early stages. Once the initial pain and swelling settle, physical therapy is introduced to restore movement, build strength and stabilise the shoulder.

Many people recover fully in a few weeks to a few months and return to sports or active work without surgery. However, lingering symptoms such as shoulder weakness, pain with overhead activity, or a visible bump may still require specialist review.

Surgical treatment for more severe ACJ injuries
For more severe ACJ injuries (grades IV–VI), or in cases where non-surgical treatment has failed, surgery may be recommended. Surgery is designed to realign and stabilize the joint and allow rehabilitation. The surgical technique can depend on the degree of injury and the time since the injury. With acute injuries , within 2 weeks of the date of surgery there are options to return the end of the clavicle back into the correct position and allow the ligaments to heal. This can be done with a metal plate or with strong suture material depending on the pattern.

If it has been more than 2 weeks then it is more likely that a reconstruction procedure may be required using an artificial ligament.

After either operation you will be in a sling for up to a month and it can take between 3 and 6 months to return to all activities.

At Joint Reaction, our orthopaedic surgeons are experienced in advanced ACJ reconstruction procedures. We also assess chronic injuries that didn’t heal well the first time—offering revision surgery and tailored rehabilitation plans if needed.

Why choose Joint Reaction?
Shoulder injuries like ACJ disruptions are often under-treated or misdiagnosed. At Joint Reaction, our team focuses specifically on shoulder and upper limb conditions. We understand the nuances of ACJ injuries and provide a clear, individualised plan based on your specific goals—whether you’re an elite athlete or simply want to get back to comfortable daily movement.

As these injuries have different treatments if seen early or late, you can remove the concern of delays in diagnosis by seeing one of our specialist surgeons after your injury.

You’ll have access to state-of-the-art diagnostics, a full spectrum of non-surgical and surgical options, and a care team that puts your recovery first. We’re here to help you understand your injury, make informed decisions, and return to full function with confidence.

Book your ACJ injury review
If you’ve injured your shoulder or are struggling with long-term pain or instability near the collarbone, we encourage you to come in for a specialist assessment. Early and accurate treatment makes a big difference—especially for active people or those with demanding physical routines.