CASE HISTORY: The patient is a 20-year-old linebacker who sustained two AC sprains in the span of nine days. The patient sustained his right AC sprain by tackling with a lowered shoulder. After he was cleared to play from his first injury, he sustained his second AC sprain nine days after. Interestingly, the second shoulder injury occurred by tackling the same opponent with a lowered shoulder. PHYSICAL EXAM: The athletic training staff assessed the right shoulder immediately after injury and tested his shoulder strength. After examination the athletic training staff came to the conclusion that it was an AC sprain, so they removed him from practice. Nine days after the first injury, the patient sustained another AC sprain to the other shoulder the same way he sustained his first AC sprain. The athletic training staff assessed him right away and discovered it was another grade 2 AC sprain. DIFFERENTIAL DIAGNOSES: Shoulder dislocation, Shoulder Impingement Syndrome, Rotator cuff injury. TESTS & RESULTS: The patient did not receive a MRI or XRay. Special tests included (+) piano keys, (-) Jobe’s test, (-) Hawkins-Kennedy. FINAL DIAGNOSIS: The final diagnosis was a grade 2 AC sprain for both of the shoulders. DISCUSSION: This is abnormal to sustain two AC sprains in the same season, let alone within two weeks of each other. It is thought that due to pain from his first injury, he was posturing abnormally while playing and overcompensating with his left shoulder when tackling. This study shows the importance of posture and compensation when it comes to re-injury. Understanding the proper tackling form for specific football positions can prevent injury. Additionally, staying current on best practices for return to play after AC joint injuries is important. OUTCOME OF THE CASE: The athlete was in the Athletic Training Clinic everyday working on his rehabilitation program and received treatment. He was very disciplined and returned to play the next week. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: After the first AC sprain to the right shoulder, the athlete returned to practice the next day. Nine days later after his first injury, he sustained his second AC sprain, this time to his left shoulder. Since his second injury was worse, he practiced with padding for 3 days before returning as a non-contact player for 2 days. The next day he did not practice. After a day of no practice, he returned to full participation. He still deals with occasional pain, most likely due to an increase in tackling after changing his position to running back.



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