Conservative Rehabilitation of a Grade III Acromioclavicular Joint Separation in a 72-year-old Female: A Case Report
Document Type
Poster
Start Date
28-4-2026 12:00 PM
End Date
28-4-2026 2:00 PM
Description
Background and Purpose: Grade III acromioclavicular (AC) joint sprains involve complete disruption of the acromioclavicular and coracoclavicular ligaments and remain controversial regarding operative versus nonoperative management. Although conservative care is commonly recommended for patients over 35 years old, limited literature exists describing outcomes in elderly individuals. The purpose of this case report was to examine the effectiveness of conservative physical therapy management for a grade III AC joint sprain in a 72-year-old woman utilizing an impairment-based rehabilitation approach.
Case Description: The patient sustained a traumatic fall onto her right shoulder, resulting in a grade III AC joint separation with a visible step-down deformity. She presented with pain, limited shoulder range of motion, and functional limitations affecting return to work at a bakery requiring lifting of up to 50 pounds. Conservative management included temporary immobilization followed by progressive restoration of range of motion, improving periscapular motor control, rotator cuff strengthening, and task-specific lifting. Treatment was delivered twice weekly for 8 weeks.
Outcomes: After 10 visits, shoulder flexion improved to 170° and abduction to 172°. At discharge (14 visits), flexion and abduction reached 175°, her deformity was significantly reduced, strength was 5/5 in all planes, and the FOTO score improved from 29 to 95. The patient successfully returned to work without pain and avoided surgical intervention.
Discussion: This case demonstrates that conservative, impairment-focused rehabilitation emphasizing scapular stabilization and rotator cuff strengthening may be effective for managing grade III AC joint sprains in elderly patients, supporting nonoperative management as a viable first-line approach.
Recommended Citation
Scully, Calvin, "Conservative Rehabilitation of a Grade III Acromioclavicular Joint Separation in a 72-year-old Female: A Case Report" (2026). School of Allied Health Professions Research Day. 11.
https://digitalscholar.lsuhsc.edu/ahrd/2026/posters/11
Conservative Rehabilitation of a Grade III Acromioclavicular Joint Separation in a 72-year-old Female: A Case Report
Background and Purpose: Grade III acromioclavicular (AC) joint sprains involve complete disruption of the acromioclavicular and coracoclavicular ligaments and remain controversial regarding operative versus nonoperative management. Although conservative care is commonly recommended for patients over 35 years old, limited literature exists describing outcomes in elderly individuals. The purpose of this case report was to examine the effectiveness of conservative physical therapy management for a grade III AC joint sprain in a 72-year-old woman utilizing an impairment-based rehabilitation approach.
Case Description: The patient sustained a traumatic fall onto her right shoulder, resulting in a grade III AC joint separation with a visible step-down deformity. She presented with pain, limited shoulder range of motion, and functional limitations affecting return to work at a bakery requiring lifting of up to 50 pounds. Conservative management included temporary immobilization followed by progressive restoration of range of motion, improving periscapular motor control, rotator cuff strengthening, and task-specific lifting. Treatment was delivered twice weekly for 8 weeks.
Outcomes: After 10 visits, shoulder flexion improved to 170° and abduction to 172°. At discharge (14 visits), flexion and abduction reached 175°, her deformity was significantly reduced, strength was 5/5 in all planes, and the FOTO score improved from 29 to 95. The patient successfully returned to work without pain and avoided surgical intervention.
Discussion: This case demonstrates that conservative, impairment-focused rehabilitation emphasizing scapular stabilization and rotator cuff strengthening may be effective for managing grade III AC joint sprains in elderly patients, supporting nonoperative management as a viable first-line approach.