AC joint pain

The acromioclavicular (AC) joint sits at the top of the shoulder where the collarbone meets the acromion. Arthritis or sprain there often hurts with cross-body reach and pressing movements.

What it feels like

Pain is usually pinpoint at the top of the shoulder and flares with crossing the arm across the chest or reaching high.

Weightlifting (bench, dips, presses) commonly aggravates AC joint arthritis.

After a fall onto the shoulder, deformity and tenderness can signal an AC separation rather than simple arthritis.

What is going on

The AC joint can develop osteoarthritis, osteolysis in lifters, or sprain after trauma.

Local tenderness and cross-body adduction pain are classic exam clues.

Cuff and neck problems can coexist, so we still examine the whole kinetic chain.

How we evaluate

Palpation of the AC joint, cross-body testing, and strength exam of the cuff come first.

X-rays assess arthritis or separation grade. Advanced imaging is selective.

A small diagnostic injection into the AC joint can confirm the pain source when needed.

What we may offer

Activity modification around pressing and dips, plus targeted rehab, helps many arthritis patterns.

Image-guided AC joint corticosteroid injection may provide a useful window for selected patients.

Refractory AC arthritis or certain traumatic separations may lead to surgical discussion.

Is AC joint pain the same as a rotator cuff tear?

No. AC pain is usually top-of-shoulder and cross-body. Cuff pain is more lateral arm with weakness patterns.

Can I keep lifting?

Often with temporary changes to grip width, range, and exercise selection while symptoms settle.

What is a shoulder separation?

It usually means a sprain of the AC joint ligaments after trauma, graded by how much the clavicle displaces.

Do I need surgery for AC arthritis?

Most people do not. Injections and load changes come first.