Post-Surgery Shoulder Pain: Is Your Acromioclavicular Joint Unstable? - Orthopedics

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After undergoing surgery on your acromioclavicular (AC) joint, experiencing pain, clicking, or grinding sounds during shoulder movements can be concerning. It is essential to understand that while the surgery may have been deemed successful by your orthopedic surgeon, the presence of these symptoms could indicate several underlying issues, including instability of the AC joint, inflammation, or even complications related to the surgical procedure itself.


Understanding AC Joint Instability
The acromioclavicular joint is located at the top of the shoulder and connects the collarbone (clavicle) to the highest point of the shoulder blade (acromion). Instability in this joint can arise from various factors, including:
1. Incomplete Healing: If the ligaments that stabilize the AC joint did not heal properly after surgery, this could lead to instability, resulting in pain and abnormal sounds during movement.

2. Scar Tissue Formation: Post-surgical scar tissue can sometimes restrict movement or cause discomfort, leading to a sensation of grinding or catching during shoulder motions.

3. Re-injury: If the shoulder was subjected to stress or trauma after surgery, it could lead to a recurrence of instability or other injuries.

4. Rotator Cuff Issues: The rotator cuff muscles and tendons surround the shoulder joint and are crucial for stability. If there is an issue with the rotator cuff, it can contribute to pain and abnormal sounds.


Recommendations for Management
1. Follow-Up with Your Surgeon: It is crucial to communicate your symptoms to your orthopedic surgeon. They may recommend imaging studies, such as an MRI or ultrasound, to assess the integrity of the AC joint and surrounding structures.

2. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the shoulder, improve stability, and enhance range of motion. A physical therapist can also provide modalities to reduce pain and inflammation.

3. Activity Modification: Avoiding activities that exacerbate your symptoms is essential. This may include avoiding heavy lifting or overhead movements until you have a clearer understanding of your condition.

4. Pain Management: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help manage pain and reduce inflammation. However, consult your physician before starting any medication.

5. Consideration of Further Interventions: If conservative measures do not yield improvement, your surgeon may discuss the possibility of additional interventions, which could include injections or, in some cases, revision surgery to address any instability.

6. Gradual Return to Activity: Once symptoms improve, gradually reintroducing activities under the guidance of your healthcare provider is essential to prevent re-injury.


Conclusion
In summary, while your orthopedic surgeon may have indicated that the surgery was successful, the symptoms you are experiencing warrant further evaluation. AC joint instability is a possibility, but it is essential to rule out other factors contributing to your discomfort. A multidisciplinary approach involving your surgeon, physical therapist, and possibly a pain management specialist will provide the best chance for recovery and return to normal function. Always prioritize open communication with your healthcare team to ensure that your concerns are addressed appropriately.