On Friday, March 24th in a Cactus League contest against the Cubs, Lonnie Chisenhall crashed forcefully into the outfield wall and was unable to finish the game. Initial reports indicated Chisenhall suffered a left shoulder strain as a result of the collision; however, upon further examination it was revealed that the 28-year-old had suffered a mild left AC joint sprain. The team has indicated Chisenhall will be shut down for three days before being re-evaluated.
What is it? An acromioclavicular (AC) joint sprain occurs when the ligaments which stabilize to joint become overstretched or in some cases torn. The term “separated shoulder” is synonymous with “AC joint sprain” and the two terms can be used interchangeably. The AC joint is formed where the clavicle (collarbone) articulates/meets with the acromion process (part of the shoulder blade). Furthermore, the integrity of the joint is maintained by ligaments that provide static stability and allow the joint to function normally. Injuries to these ligaments in the form of being stretched or torn are classified as AC joint sprains and usually occur as a result of a direct trauma to the top of the shoulder. As a result of this particular mechanism of injury, the clavicle and shoulder blade no longer meet as well as they would in a non-injured shoulder and in turn become unstable. Injuries to the AC joint are classified based on severity and are graded 1 through 6, with 1 being least severe and 6 being most severe.
How is it fixed? Most, less severe AC joint separations can be managed conservatively using physical therapy. Conservative intervention involves a period of rest and pain control initially, followed by range of motion exercises and strengthening exercises. Once an individual is able to achieve pain free range of motion and improved strength of the shoulder and the muscles that surround the shoulder blade, rehabilitation is typically advanced to the final stage. The last part of the rehab process is traditionally resumption of functional exercises/activities. In the case of Lonnie Chisenhall, these functional exercises would be throwing, batting practice, etc. Once a player or individual is able to complete functional activities to the satisfaction of their rendering health care provider they will be cleared to resume unrestricted activity. In some instances, more severe cases of AC joint separations can be managed via surgical intervention.
My take. From the information the Indians have provided, it doesn’t appear they expect Chisenhall to be on the shelf for long. If all other structures in his shoulder are in tact, I expect this injury to be a relatively small bump in the road. We will have a better idea of the length of time Chisenhall will miss following his re-evaluation in the next few days.
We will continue to monitor the status of Lonnie Chisenhall as he progresses through the rehab process and will provide the most up to date injury analysis and breakdown as new information becomes available.
Brandon Bowers, PT, DPT, is a graduate of the University of Toledo, Doctor of Physical Therapy Program and currently practices in Columbus, Ohio. He is an avid Cleveland sports fan and has experience rehabbing athletes of all levels and from a variety of sports. Follow Brandon on Twitter for more Cleveland Indians injury insight and analysis: @blbowers12
The information provided is the professional opinion of Brandon Bowers, PT, DPT and is based on his clinical experience and the most current clinical evidence available. This information should not be interpreted as or substituted for medical advice for a specific condition or diagnosis.