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AC Joint Conundrum

I’m stumped.

Doctor has me do some arm movements, applies moderate pressure to the right AC joint (you really have to press on it to elicit some pain). Nothing hurts. He suggests I take a few weeks off from lifting.That I do. Probably a minor sprain, so he tells me no need for MRI/xray.

However now that I’m back (3 weeks rest), I’ve been getting pain in the ac joint only when I incline bp, usually with dumbbells. Dips, Flat bp, flys all feel fine. So I try lowering the incline, changing the angle my elbows make with my torso to no avail. Have I been using incorrect form? I don’t believe so. But I do notice that when I keep my elbows tucked in, so when I lower the weight and have my hands touch my chest, there is hardly any pain.

Have any of you had similar problems with the ac joint? Naturally I should stay away from incline bp, but am I damaging my ac joint unknowingly by bp’ing flat? I mean there isn’t a whole lot of difference between the two motions, and I can’t figure out the mechanism of the injury, and whether it’s only a matter of giving it some more time to heal.

Your comments are appreciated. I’ve been searching the interweb for a solution and I’ve found nothing.


Go on intensemuscle.com

Doggpound forum

Theres a STICKY about shoulder problems…its a mobility drill


my recommendation is to eliminate things that could further irritate that area. Dips are very hard on the AC joint and I would be cautious even though there is no pain. Obviously you shouldn’t ever perform exercises that reproduce your pain, but if you must, don’t go into a range where your shoulder begins to hurt.

My biggest recommendation is to hit your rowing exercises hard and don’t be afraid to go heavy as long as you keep good form. When I say good form, you must really focus on retracting and stabilizing your shoulder blades. Also incorporate some rotator cuff exercises (face pulls are really good).

My left AC was painful for a good part of last year. At first I kept lifting through it (especially lifts that put pressure on the AC - bench press, dips). I had to stop doing those lifts that were painful for about… 6-7 months or so before the pain was completely gone.

My suggestion: back off anything that causes pain for at least a few months.

If you want to work out your chest, do pushups (add bands, do them on medicine balls, etc) and search around on this site for articles to learn about stabilizing the scapula (look up scapular winging and/or scapular tilt).

Some lifts like face pulls can be really helpful. The workouts in the neanderthan no more series can be helpful as well, but again, you’ll likely have to modify them to things you can do if you have pain.

I had an AC joint injury a few months ago that I’m still working through.

I would echo the recommendations for prehabilitory exercises like face pulls, and internal/external rotations for the rotator cuff, and avoidance of exercises like flat BB bench press and dips… but most importantly REST until the pain is gone (meaning rest the injury, obviously you can still do a legs workout and probably some other things with zero pain or discomfort)… then prehab exercises… then start lightly back into the regular stuff

Good luck!


 I have given the ac joint a total of two months rest and after doing my chest workout at 30%, not much has changed. I have gone to an ortho and x rays were normal. He suggested a possible sprain, but really just inflammation of the joint.
 I have gone to a PT for one session, but as she doesn't know much about training, I don't see an hour of ultrasound and massage doing miracles.

I plan on starting to lift again, without chest and shoulder days.
As Paul above suggested, this could take a few more months to heal, but the ortho wants to see me again, if I am not back to normal in a month.
Thanks for the input you have given or that you will give.

Honestly I am in the exact same spot right now.

I have given the shoulder enough time to rest and done enough rehabilitory exercises that day-to-day activity is completely normal. I hardly notice it at all, but then the gym is entirely different story.

I still can’t consistently lift with any sort of intensity on chest or shoulder days (well, I suppose I COULD if I wanted an aching joint for a week), and sometimes my back days will suffer too.

It’s extremely frustrating! So I am now out of advice for you, and instead looking for some myself. lol

My left shoulder is pretty messed up. It was diagnosed as ac joint arthritis. The ortho said it was primarily caused by overuse and the joint is inflammed leading to impingement. It is swollen and you can see the end of my clavicle through the skin. It was worse, but the swelling has gone down a bit.

The one thing that causes the most pain is putting my arm in front of me, thumb down, then trying to raise my arm againt resistance. This is usually me trying to hold the arm in place. It still hurts and I am using this as my marker for recovery, when I can do it w/o discomfort I will be recovered.

Aside from avoiding most exercises that really bother it, like cleans/front squats/ and jerks, I have been icing it a lot.

I put dixie cups filled w/ water in the freezer and massage them around my ac joint on and off in the shower. It is my form of constrast hydrotherapy. Ice packs throughout the day at work have been helping too.

This is mostly cutting down the inflammation, but it has been working enough for me start some form of productive training again.

I’m still experimenting w/ a rehab training protocol and my douchebag I’m a runner orthopedist can’t suggest anything. He wants to either give me cortisone or shave off the end of my collarbone.

It sucks and I need to find a good doctor/chiro/physical therapist that can pinpoint what is going on tell me how to fix it.

Mr. Popular, would you mind going over your rehab protocol, what you have been doing to fix it. I wnat to see what is working and not working for people.

Have you ever dislocated or seperated the shoulder in the past. If so u could of torn your labrum and it healed and you you are breaking loose scar tissue or your labrum could be partially torn still.

Also a x ray will not show you squat for a soft tissue injury you need a MRI on it the doctors just milking your insurance for more xrays instead of giving you what you need a MRI. X rays are for skeletal injurys only not what you are having problems with.

My ortho doc x rayed me for 4 months before he gave me the MRI and bam what do you know torn labrum torn bicep tendon.

This is my first time going to a physical therapist so I’m not sure what to expect. My injury causes me very little discomfort day to day, but it is debilitating in the weightroom.

I almost feel that a PT or ortho needs to see me lift to suggest a course of treatment and give me input into the mechanics of my injury. While I know one PT probably won’t differ from the next in what they prescribe, I’d like to go to someone with lifting experience.

I’ve noticed some PTs have a CSCS certification on their resumes. Would such a certificate indicate that they have experience with weightlifters and would be better able to tell me about my injury in the context of lifting? To be honest I have an almost perfect range of motion. But if you were to put a 40 pound dumbbell in my hand and ask me to incline bp, my joint would act up immediately.

Most PTs/Orthos have a battery of simple shoulder tests than can use to pinpoint problems.

Usually they can add some resistance to these tests, i.e. pushing down on your arm while pushing up.

My range of motion is good, but when my ortho did his tests, he was able to produce a pain greater than what I experience in the gym.

I would recommend looking for an ortho who understands the weight training population though, and a good way to go about it is to email a strength and conditioning coach of a local university and ask who the team chiro/ortho/pt guy is. Usually these people are more used to working with athletes, than geriatrics or the general sedentary population.

My ortho is a runner and simply told me to take time off, offered a cortisone shot, and told me he could shave off my collar bone if it continued to give me trouble, this is after my first visit where I let him give me a cortisone shot.

I was stupid enough to go to him a second time.

After seeing a new pt, he made two observations right off the bat. My right shoulder blade was higher than my left (uncommon for right handed people), and that this was most likely caused by weak rotator cuff muscles, the supraspinatus, and rhomboid.

He said the ac joint moves in coordination with the scapula, and that my strong chest and delts were not counteracted by the aforementioned muscles while lifting. He showed how weak these muscles were when I had difficulty pushing his hand away while my elbow was fixed in place at my side.

He also noticed that I have very little mobility in my neck, and that I need to work greatly on flexibility in the region. All in all, it was pretty in formative, and I plan on working on these lesser used muscles with a rubber band, as I assumed raises and presses must’ve gotten them stronger in addition to the primary target muscles. We shall see.