Physical Therapy for Coracoclavicular Ligament Injuries: What to Expect

Should you’ve injured your coracoclavicular ligament, you’re probably contemplating what recovery looks like—and how physical therapy can help. Whether it’s a sprain or a full tear, the road back to normal shoulder function involves careful steps to avoid setbacks.

Initially, you’ll focus on easing pain and gently restoring movement, but as healing progresses, targeted exercises strengthen the surrounding muscles for better stability. The process is gradual, but with patience and the right guidance, you’ll regain confidence in your shoulder’s strength. Let’s analyze what to expect at each stage so you know how to prepare.

Coracoclavicular Ligament Injuries

Should you’ve ever taken a hard fall or gotten hit directly on the shoulder, you might’ve pondered why the pain lingers—and it could be due to a coracoclavicular ligament injury.

This tough band connects your collarbone to your shoulder blade, keeping things stable. Whenever it’s damaged—say, from a hard impact or sudden pull—you’ll feel sharp shoulder pain near the AC joint.

A physical exam helps spot the issue, and treatment options range from rest to therapy, depending on severity. Doctors use imaging to diagnose an AC joint injury properly, so don’t ignore persistent discomfort—it’s worth checking out.

Symptoms and Diagnosis of Coracoclavicular Ligament Injuries

In case you’ve ever had a shoulder injury, you know how frustrating it can be—especially whenever the pain sticks around or limits simple movements like lifting your arm.

Should you’ve hurt your coracoclavicular ligament, you’ll likely feel sharp pain near the AC joint, especially upon reaching overhead.

Swelling or a visible bump could appear should there be an AC joint separation. Your shoulder function weakens, and your range of motion drops.

To diagnose it, a doctor checks tenderness, mobility, and strength, possibly ordering X-rays or an MRI.

They’ll classify the injury’s severity to guide treatment, so you know exactly what’s going on.

Initial Treatment and Pain Management

The initial few days after a coracoclavicular ligament injury are critical for healing—and keeping pain under control makes a big difference.

Your shoulder needs rest and protection to recover properly. Here’s what you can expect during this phase:

1. Immobilizing the joint: A sling helps stabilize your shoulder, reducing strain on the ligament.
2. Pain management: Over-the-counter NSAIDs like ibuprofen ease discomfort and swelling.
3. Ice therapy: Apply ice packs for 15-20 minutes every few hours to minimize inflammation.
4. Gentle range of motion: Physical therapy might introduce light movements to prevent stiffness without stressing the injury.

Avoid lifting or overhead activities to let healing start strong.

Protective Phase: 0-6 Weeks Post-Operative

After surgery for a coracoclavicular ligament injury, your shoulder needs careful protection to heal properly—and the initial six weeks are all about gentle support. During this protective phase, you’ll wear a sling to limit movement and avoid straining the repair.

Your rehab focuses on passive range of motion (PROM) exercises, keeping movements below 90 degrees to prevent stress on the healing ligament. Gentle exercises for your hand, wrist, and elbow help maintain circulation while you work on neuromuscular control with light isometric contractions.

Avoid lifting, sudden motions, or pushing yourself—this phase is about patience, not progress. Stick to the plan, and you’ll set the stage for stronger recovery later.

Intermediate Phase: 6-8 Weeks Post-Operative

1. Shoulder mobility drills like passive and active-assisted range of motion to reach 140° flexion and 120° abduction.
2. Gentle strengthening exercises, such as sub-maximal isometrics, to rebuild shoulder stability without overloading.
3. Scapular stabilization moves to improve control and posture.
4. Behind-the-back internal rotation stretches to regain flexibility.

You’ll avoid heavy lifting but gradually increase activity as comfort allows.

This phase bridges healing with function, preparing you for tougher challenges ahead.

Initial Strengthening Phase: 8-12 Weeks Post-Operative

Progressing into the initial strengthening phase at 8-12 weeks post-op means shifting focus toward rebuilding full shoulder mobility and muscle control.

You’ll work on PROM and AROM to restore movement, then add light resistance range of motion exercises to strengthen your rotator cuff and scapular muscles. These moves help rebuild shoulder stability while avoiding heavy lifting overhead.

Endurance training, like using an upper body bike, boosts stamina without straining healing tissues. Stick to controlled motions—no sudden jerks or weights that feel too heavy.

Your therapist will guide you, ensuring progress stays safe and steady. Listen to your body; discomfort is normal, but sharp pain isn’t.

Advanced Functional Strength Phase: 12 Weeks and Beyond

At this stage, you’ll focus on strengthening your rotator cuff and improving scapular stability to build a solid foundation for movement.

Sport-specific drills help you regain the skills and confidence needed for your activities while reducing re-injury risks.

You’ll also learn long-term exercises to keep your shoulder strong and healthy beyond recovery.

Strengthening Rotator Cuff

By this stage—12 weeks or more into recovery—you’ve built a solid foundation, and now it’s time to take rotator cuff strength to the next level with movements that mirror real-life demands.

1. Resistance Training: Use bands or weights in functional positions to boost shoulder stability while mimicking daily motions.
2. Plyometrics: Add controlled explosive movements like medicine ball throws to build explosive strength for sports.
3. Sport-Specific Drills: Tailor exercises to your activity—like throwing or lifting—to smooth your return to play.
4. Progress Checks: Regular assessments verify your rehabilitation stays on track without overloading healing tissues.

Keep pushing safely—your shoulder’s ready for this!

Enhancing Scapular Stability

Now that your rotator cuff has built solid strength, it’s time to focus on the muscles around your shoulder blade—your scapular stabilizers.

Enhancing scapular stability helps your shoulder move smoothly and prevents future injuries. You’ll work on strengthening exercises like rows, scapular push-ups, and resistance band pulls to build endurance and control. These moves train your shoulder blade to stay steady during arm movements, supporting your rotator cuff.

As you progress, plyometric drills add dynamic power. Your therapist will adjust your rehabilitation plan based on your recovery, ensuring you regain full function without overloading your shoulder.

Consistency is key—stick with it!

Sport-Specific Training Drills

With your scapular stability stronger than ever, sport-specific training drills take your rehab to the next level by mimicking the movements you’ll need in competition.

Here’s how to build shoulder strength and agility while preparing for a safe return to sport:

1. Functional movements: Practice weighted overhead presses or lateral raises to match your sport’s demands, strengthening your rotator cuff and scapular muscles.
2. Plyometric exercises: Boost explosive power with medicine ball throws or jump squats for dynamic stability.
3. Agility drills: Use shuttle runs or cone drills to sharpen quick direction changes.
4. Progress tracking: Regular assessments guarantee your training stays tailored and effective.

Rehabilitation Exercises and Techniques

You’ll start with initial phase mobility exercises to gently restore shoulder movement without straining the injured ligament.

Strengthening your scapular muscles comes next, helping stabilize your shoulder as you regain strength.

Finally, functional movement drills prepare you for daily activities by improving coordination and control.

Early Phase Mobility Exercises

Recovery from a coracoclavicular ligament injury begins with careful protection of healing tissues while maintaining flexibility. In the initial phase, mobility exercises focus on gentle movements to restore function without straining the injury.

1. Passive range of motion: Your therapist will guide your shoulder flexion and abduction, moving your arm for you to avoid stress.
2. Assisted movements: You’ll use your other arm or a strap to help lift the injured shoulder safely.
3. Neuromuscular control: Light isometric squeezes engage muscles without moving the joint.
4. Rehabilitation protocols: Follow your therapist’s plan to progress slowly, avoiding pain.

Stay patient—this phase sets the foundation for healing.

Strengthening Scapular Muscles

Once your shoulder starts feeling more mobile, it’s time to rebuild strength in the muscles around your shoulder blade.

Strengthening your scapular muscles helps restore stability and support for your injured shoulder. Start with simple exercises like scapular retractions—squeezing your shoulder blades together—to activate those muscles without straining.

As you progress, try band pull-aparts or isometric holds to build endurance. Keep your movements controlled and focus on proper form to avoid overloading the joint.

These rehabilitation exercises gradually improve shoulder function, making daily tasks easier. Consistency is key, so stick with your routine to see steady progress in your recovery.

Functional Movement Drills

1. Scapular push-ups and wall slides – Improve shoulder function recovery by strengthening the muscles around your shoulder blade.
2. Therapy band rotations – Elevate control and stability as you move through different ranges.
3. Bear crawls and lateral lunges – Build full-body coordination while protecting your shoulder.
4. Kettlebell carries – Safely reintroduce weight once you’re ready for heavier tasks.

Long-Term Recovery and Return to Activity

Monitoring progress with your therapist guarantees you don’t push too hard too soon.