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Our son hurt his arm showing off at school. The physician's assistant we took him to said it was a mild AC (shoulder) sprain. They gave him a sling and told him to wear it for a week to 10 days and then come back for follow-up. It's only been about five days and he's already stopped wearing it. He says it doesn't hurt and he can move it all around. With such a quick recovery, do we even need to go back?

A fall on the shoulder or outstretched hand can disrupt the ligaments and capsule holding the acromioclavicular (AC) joint together. The result can be a dislocation of the AC joint. This joint is located where the end of the clavicle (collar bone) meets the acromion. The acromion is a curved bone that comes from the shoulder blade across the top of the shoulder. The AC joint is fairly complex with its many ligaments and strong capsule holding everything together. Damage to any of these soft tissues can be severe enough to require a surgical repair. But it sounds like your son may have had a mild sprain that can (and often does) recover nicely with a little TLC. Treatment for minor AC strains involved removing mechanical stress from the joint during the acute phase (first 10 to 14 days). The patient wears a sling or shoulder immobilizer. When the pain is mild or gone, gentle exercises can be done. A physical therapist guides the patient though a rehab program to restore motion, strength, and endurance. Not all patients recover completely from mild AC injuries. There may be some long-term symptoms such as clicking and pain or limitations with certain activities (e.g., push-ups). And some studies have reported patients later develop arthritis in that joint. More and more emphasis is being put on completing a rehab program even for mild sprains. Keeping your follow-up appointment is a good idea. It will give you a chance to ask some questions about the strength and stability of his shoulder/arm and find out if further treatment is needed to avoid problems later on.

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