T Nation

AC impingement


so i finally saw an orthopedic surgeon about my shoulder and he said its an impinged AC joint but osteolysis hasn't occurred yet, which is good. my options are cortisone shots to see if it "calms" itself down or surgery if theres no improvement. and while i searched cortisone shots on the search engine i couldnt find a definate answer, whether people thought it was the best option or not. any input would be appreciated



How long have you had these problems? What have you done to resolve the situation? E.g., have you done any therapy or exercises to try and remedy the CAUSE (not the symptom itself)?

With regards to the cortisone, it will probably numb the area up pretty good and make you feel ok, but it does nothing for the healing process itself and if anything actually slows down your body's natural healing. If you haven't done any type of rehab or therapy first, that would be my first course of action if I were you. While I don't have any specifics to your situation, I'm always leary when someone tells me that so-and-so recommended going under the knife or getting a cortisone shot; often times all this does is mask the true problem until it manifests itself further (and more destructively) down the line.

If you are interested in basic therapy and exercises, check out my article "Heal that Hunchback" as well as Eric Cressey's "Cracking the Rotator Cuff Conundrum." Without a little more info, though, it's hard to help you out. Hope this helps!

Stay strong


Thanks alot mike, i've had these problems for a little over a month and have completely stopped doing any upperbody work, except for your kyphosis correcting excercises (thanks a million for that article by the way) and they don't cause any pain in my shoulder.

at first i thought it was a bone spur so i kept any shoulder movement minimal, but instead the doc says to just stay out of the gym and its fairly common in lifters and cortisone shots are usually enough to fix it. when he said 'fix' he meant cure the problem, and i have no idea how a cortisone shot could do this.

to anyone whos had or knows someone with a similar injury: what type of rehab/therapy was done for it?



I had AC impingment in my right AC joint. X-ray showed that it was arthritic. My ortho gave me 1 cortisone shot to see if there was any tendon or ligament damage. It got rid of the pain temporarily. He went in and snipped back the rough bone ends. I was in rehab within 1 week, back working out anything that did not require shoulder rotation in 2 weeks, back to my normal routine within a month. No problems since.



hey lumbur,

i had a class I AC sprain which went untreated for 6 months and caused an impingement syndrome just like yours. at this point i did a round of NSAIDs and PT. sure it worked, and the doc cleared me but as soon as i went back to lifting the problem got worse. so i did PT again. same result. talked to orthos and they said injection or surgery because they A) don't know of anything else or B)just recommend that because that's what they do.

a year and a half after the incident that caused my injury, i had had enough. i'm a chiropractic student and the spinal adjustments at the clinic weren't helping my shoulder condition. so i found a Graston clinician (who happened to be a chiro) and went for treatment. 8 visits and i was BETTER THAN NEW!! this technique is similar to Active Release which is touted on this site. with this treatment and a new chiro who specialized in extremity adjusting, i am a new man. your condition is new. DO NOT HESITATE!!


see, the thing is i play d-1 hockey and really can't afford any down time from surgery in the next 3 months but it never hurt during play, just in the weight room and more specifically, push/pull movements. and this was not caused by a traumatic incident, like your sprain BH. so it seems as though the general consensus is cortisone shots are a quick fix and i either need the end of the bone shaved eventually (like don) or look for graston clinicians, which i've never heard of. thanks for your replies/help


who do you play for?


the bone shave will not fix your problem. you want to fix the cause of impingement, which is fibrotic or scar tissue in your chronic case. if you have surgery, most likely your symptoms will return down the road. several folks on here can attest to active release curing injuries like this, i'm the only one i know on here that has experience with graston. if you can lay off upper body for 2-4 weeks depending on the severity, then you should try this type of treatment. but i can tell you from experience, after the first treatment i had better ROM and less pain than in over a year and a half....just one treatment did that!!


I just got off the phone with the team doctor and it turns out hes a certified active release therapist and ironically hes the one who misdiagnosed it as a bonespur in the first place. He says go ahead with the cortisone shots for now and he'll start therapy on me the week i come back to school. thanks for your help/info


If you do not get ART then you are an idiot. I cant say it any simpler than that. This is the type of injury ART was made for. Go read the testimonials of guys on the website who needed surgery until they got ART.


yeah i'm starting ART when i go back to school in 3 weeks but he recommends cortisone shots for now for comfort purposes