NFL quarterback Derek Carr's AC joint sprain necessitates evidence-based treatment pathways. Orthopedic specialists highlight a structured approach prioritizing healing and functional recovery.
Immediate Management
Initial focus targets pain control and inflammation reduction:
- Protected Rest: Avoiding motions exacerbating instability; sling use often indicated early.
- NSAIDs & Cryotherapy: Ibuprofen/Naproxen under physician guidance with ice application.
- Potential Corticosteroid Injection: Considered if pain severely limits rehab; used sparingly to avoid tissue weakening. Platelet-Rich Plasma (PRP) injections represent an alternative for potential accelerated healing.
Diagnostic Confirmation
Grade determination via MRI or Weighted Radiographs is critical. "Precise grading dictates intervention intensity and timeline expectations," stresses Dr. Neil ElAttrache, Kerlan-Jobe Institute.
Conservative Management (Grades I-III)
Most AC joint injuries respond to non-surgical care:
- Physical Therapy Progression: Initial passive ROM transitions to active-assisted then resistive exercises. Scapular stabilization drills are paramount.
- Modalities: Therapeutic ultrasound, TENS, or LASER therapy adjunctively manage pain/swelling.
- Graduated Throwing Program: Implemented after restoration of pain-free strength and motion, typically weeks 4-6 onwards. Strict adherence prevents re-injury.
- Supportive Taping/Bracing: May provide symptom relief during early return to activity.
Surgical Intervention (Severe Grade III, IV-VI)
Indicated for significant displacement or persistent instability:
- AC Joint Reconstruction: Gold standard uses tendon autograft/allograft to reconstruct coracoclavicular ligaments, restoring stability. "Anatomic reconstruction techniques provide reliable outcomes," notes Dr. Anikar Chhabra, Mayo Clinic Arizona.
- Potential Distal Clavicle Excision: Addressed concurrently if arthritic changes exist.
- Post-Op Protocol: Mandates structured rehab focusing first on ROM recovery, then graded strengthening over 4-6 months.
Rehabilitation Timeline
- Weeks 1-2: Pain/swelling control, protected ROM.
- Weeks 3-6: Progressive active ROM, isometric strengthening, neuromuscular control.
- Weeks 7-12: Advanced strengthening (plyometrics, eccentric loading), sport-specific drills initiation.
- Months 4+: Unrestricted functional activities contingent on strength symmetry and clinical clearance.
Return-to-play hinges on functional performance metrics and clinical exam, not solely time elapsed. Full QB duties generally resume around 6 weeks for lower-grade injuries managed conservatively; complex cases or post-surgical recovery often extends beyond 3 months.
