support includes grafting of tendons from the leg or the use of synthetic sutures or suture anchors. other surgeries have used a rockwood screw that is inserted initially and then removed after 12 weeks. physical therapy is always recommended after surgery, and most patients get flexibility back, although possibly somewhat limited. after one does have surgery, a sling should be worn to support and protect the shoulder for a few days. for the first couple physical therapy visits, the treatment will focus on controlling the pain and swelling. type of treatment can include, ice and electrical stimulation, massage, or other hand on treatment to help ease the pain and muscle spasm. after about four weeks range of motion exercises can be started. passive exercises are done which the shoulder joint is moved but the muscles stay relaxed. after about six to eight weeks active therapy is started. such exercises can include isometric strengthening which works the muscles without straining the healing of the joint. after about three months, more active strengthening will be incorporated which focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade. the exercises that the therapist gives the patient to be done at home should be done to be able to get a better recovery in the long run. physical therapy strengthening the shoulder joint. passively moving the shoulder joint side-lying external rotation start side-lying external rotation end some physical therapy exercises that can be performed to help rehab the shoulder are: while standing and using a theraband you can perform y, t, and i’s, internal shoulder rotation, external shoulder rotation, shoulder extensions, and scapula squeezes while lying on your side you can perform internal rotation and external rotation with a light weight. the light weight can be any type of object such as a 1-5 lb dumbbell weight, or a soup can. also you can foam roll the pectorals. with the foam roller you can also lie on your back on top of it and do snow angels. epidemiology acromioclavicular joint dislocation is a common injury to the shoulder and is occurs most often in athletes. this injury has a higher prevalence in men compared to women and approximately 5 men for every 1 women experience this type of injury. amongst women, the most common sport that lead to this injury type is cycling. amongst men, accidents or hits in sports such as boxing, football, ice hockey, and martial arts are the most common cause of this injury. italy in italy 1.8 out of 10,000 people are estimated to experience an acromioclavicular joint discolation per year, and this type of injury is the most common in injury experienced by adults who participate in sports that include body contact. united states in the united states, an estimated 41% of football players at the collegiate level and 40% of quarterback football players from the national football league level experience acromioclavicular dislocations.