Acromioclavicular Joint Pain in Wrestlers
Ross Hauser, M.D.  Marion Hauser, M.S.,R.D.

Injuries to the AC joint are generally graded as first-, second-and third-degree based on physical findings and roentgenographic examination. The first-degree sprain has no elevation of the clavicle, the second-degree sprain has elevation of the clavicle less than the width of the acromion, and the third-degree sprain has elevation of the clavicle greater than the width of the acromion. (Bergfeld, J. Evaluation of the acromioclavicular joint following first- and second-degree sprains. American Journal of Sports Medicine. 1978; 6:153-159.)

A study was undertaken to review all AC joint injuries among the midshipmen population on duty at the U.S. Naval Academy, to determine the fate of the acromioclavicular joints involved in athletic injuries. (Bergfeld, J. Evaluation of the acromioclavicular joint following first- and second-degree sprains. American Journal of Sports Medicine. 1978; 6:153-159.) Of the 4,200 shipmen, 133 sustained 137 AC joint injuries. All of the injuries occurred during sporting activities. The sports most often involved in the injuries were football, followed closely by wrestling, rugby, lacrosse, fieldball, and judo. The midshipmen were evaluated by physical examination and x-rays. For those with first-degree AC joint sprains, 39 percent had residual symptoms. Forty-two percent of midshipmen with second-degree sprains experienced residual pain symptoms. Over half of the 42 percent in the latter group had significant symptoms to the point where they had to give up sporting activities or felt significant persistent shoulder pain while performing an athletic activity.

Most of the midshipmen reported the most painful activities were weight lifting, throwing, push-ups, pull-ups, and complained of aching after workouts. X-ray examination revealed degenerative arthritic symptoms in 29 percent of first-degree sprains and 48 percent of second-degree sprains. Remember that these sprains were only six months to three and a half years old. Ten of the x-rays revealed some resorption of the distal clavicle in men with first-degree sprains. What do you think would cause the bone to resorb when the ligament sprain was only minor? There could only be one thing strong enough to cause that amount of deterioration.

Cortisone injections
A high percentage of these people received cortisone shots. (Bergfeld, J. Evaluation of the acromioclavicular joint following first- and second-degree sprains. American Journal of Sports Medicine. 1978; 6:153-159.)

The authors did a nice job comparing the long-term results of the athletes who were treated with partial immobilization, with a sling, to those who received cortisone shots in their AC joints. In all parameters studied, cortisone shots caused a marked increase in the amount of long-term degeneration seen after first-degree AC joint sprain. Those athletes who received cortisone shots to the AC joint had 27 percent more positive physical findings, 16 percent more x-ray degenerative changes, and more symptoms of pain. (Bergfeld, J. Evaluation of the acromioclavicular joint following first- and second-degree sprains. American Journal of Sports Medicine. 1978; 6:153-159.)

Wrestling Injuries 1 2 3