• Swain M
• Pollard H

• Acromioclavicular Joint / surgery
• Adult
• Male
• Manipulation, Extremities
• Open Access Document
• Rugby / injuries
• Shoulder Injuries / rehabilitation
• Sports Chiropractic / Australia

Sports chiropractors are increasingly being sought by professional and amateur athletes to fulfil their sports medicine needs. This paper describes a case of successful chiropractic clinical management of a post-surgical shoulder rehabilitation program.

Case Presentation: A 25-year-old  male  suburban-districts  level  (amateur)  rugby  union  player  sought  assistance from a AICE titled sports chiropractor who was acting in their capacity as a qualified team sports trainer during the match whilst on-field for right shoulder pain and dysfunction following a tackle where he fell heavily onto the point of his right shoulder. Subsequent     radiographic     and     orthopaedic     referral     identified     an     unstable     acromioclavicular  joint  dislocation  (type  III)  and  reconstructive  surgery  was  performed.  Following  the  surgical  procedure,  the  post-surgical  rehabilitation  was  completed  under  the  guidance  of  a  sports  chiropractor.  Over  a  fifteen  week  period  a  multimodal  management  approach  was  applied  in  the  post-surgical  care  that  included:  physical modalities,  soft  tissue  therapy,  functional  shoulder  and  spine  exercises,  spinal  and  peripheral  joint  mobilisations  and  manipulations.  Emphasis  during  management  was  given  to  the  sports  specific  functional  exercise  progressions.  Outcome  measures  at weeks six, nine, fifteen and 21 weeks 18 months post-surgery, recorded patient change and  included:  the  disabilities  of  the  arm,  shoulder,  and  hand  questionnaire  (DASH),  goniometric  measures,  visual/verbal  analogue  scales  for  pain  and  shoulder  muscle  str   ength  by  manual  muscle  testing.  This  case  describes  the  clinical  management  after  surgical repair of the grade three acromioclavicular ligament tear over a 20-week period with  a  12-month  follow-up  and  a  full  return  to  pre  injury  status,  function  and  sporting activity. Management was divided into acute, early recovery, late recovery and functional phases of care. Functional goals and advancement criteria are described for each phase of rehabilitation. 

Conclusion: This case documents a sports chiropractor’s approach to multimodal rehabilitation of a rugby  athlete.  This  paper  describes  an  example  of  the  integration  of  the  sports  chiropractor  into  the  sports  medicine  team  and  the  skill  set  in  assessment  and  management required of that role

Author keywords: Shoulder, Acromioclavicular Joint, Rehabiliation, Chiropractic, Spinal, Extremity, Manipulation

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