Dr. Jeffrey E. Budoff is a board-certified orthopedic surgeon who wades through misleading coach-speak and vague team injury information to offer advice for your fantasy team.
Acromio-Clavicular Joint Injuries
The acromio-clavicular (AC) joint is the joint on top of the shoulder where the clavicle attaches to the acromion, the top part of the shoulder blade bone. These two bones are held together by strong ligaments that prevent excessive motion between them. These ligaments may be torn by a strong force that pushes on the acromion, such as happens when landing on the point of the shoulder or tackling someone (which is why shoulder pads are worn).
A Grade 1 injury is a sprain of the AC ligaments (microscopic tears without visual abnormality). A Grade 2 injury is a tearing of these ligaments, but the ‘back-up’ CC (coraco-clavicular) ligaments are still intact, so the joint doesn’t fully dislocate. A small bump is present on top of the shoulder because the clavicle rises up a little. A Grade 3 injury is an AC joint dislocation, where both the AC and CC ligaments are torn. This leads to a noticeable bump on top of the shoulder, more pain and a longer recovery period. Grade 4-6 AC joint injuries are more severe, and less common, dislocations.
AC joint injuries lead to pain with the arm raised up above the head, or when that arm crosses the body.
Alshon Jeffery, Chicago’s top wide receiver sprained his AC joint on 8/2. This is not believed to be serious. By diagnosing a ‘sprain,’ I am assuming they mean a Grade 1 injury. Or want us to believe that. Jeffery also has a ‘mild calf strain’, but we’re focusing on the AC joint for purposes of this article.
DeSean Jackson reportedly landed on his shoulder while making a catch on 8/6, and then rolled into a nearby blocking sled in end zone, leading to an AC joint sprain, i.e. another Grade 1 injury. He was expected to miss 1-2 weeks, and we’re told he is close to returning.
Grade 1-2 AC joint injuries can usually be played through. Extra padding on top of the shoulder helps, as does a pain-killing pregame injection. However, athletes are often at less than 100 percent until the pain fully subsides. How long this takes depends on the severity of the injury, the amount of rest the player is able to give his shoulder, and the pain-tolerance of the individual player. Wide receivers with bad AC joint sprains can have difficulty fighting for the ball above their head for up to six to eight weeks.
Of interest, last year Jimmy Graham had an AC joint sprain and then had a good game only three weeks after injury. The main problem with these injuries comes when landing on the shoulder. This can easily reinjure the shoulder, and their odds of hanging onto the football for a catch when this happens are not good. An injection won’t fully help with this, because the injection is only placed into the joint, and the tissues around the joint gets stressed when the shoulder is landed on without full ligament stability. In addition, traumatizing an injured joint can lead to muscle spasm about the shoulder, which affects function.
Fortunately, these injuries occurred during the preseason, when the players have more time to rest. Assuming these two AC joint injuries are as mild as they’re being billed, neither player should be limited much by their shoulders for the start of the regular season.