- [Home](https://ortopediaevolutiva.com/en) - [Pediatric Orthopaedics Blog — Dr. Priano](https://ortopediaevolutiva.com/en/blog) - Low-grade acromioclavicular injuries in pediatric athletes: treatment and return to sport # Low-grade acromioclavicular injuries in pediatric athletes: treatment and return to sport March 10, 2026 2 min read Edited and medically reviewed by [Dr. Daniele Priano](https://ortopediaevolutiva.com/en/about) ![Low-grade acromioclavicular injuries in pediatric athletes: treatment and return to sport](https://ortopediaevolutiva.com/blog-images/lesioni-acromion-claveari-basso-grado-atleta-pediatrico-trattamento-conservativo-neutral-v1.webp) This English version is based on the original Italian article. For wording nuances, you can refer to the Italian version. ## In short, for parents - • Low-grade acromioclavicular injuries in young athletes are usually treated without surgery. - • In the cited cohort, median return to sport was 21 days among patients with a recorded return date; this is not an individual deadline. - • Treatment and return depend on pain, mobility, sport-specific function and associated injuries. Low-grade acromioclavicular joint injuries in pediatric and adolescent athletes are almost always treated non-surgically. The most frequent question, rather, concerns the duration of symptoms and the timing of return to sport. A recent study in the *Journal of Pediatric Orthopaedics* analyzed 110 shoulders in 108 patients under 18 years old evaluated between 2014 and 2024. The average age was 12.8 years, and 95% of the injuries were low-grade. All cases were treated conservatively. [1] ## How they were treated 40% of patients used a simple sling, 29% underwent physical therapy, 17% were managed with rest, and 15% with a sling combined with physical therapy. [1] This variability accurately reflects clinical practice: for minor injuries, there is no single protocol that works for everyone. Pain, mobility, and usual activity guide the duration of immobilization and when to start recovering movement and strength. ## Return to sport timelines The return date was not available for all patients. In patients where it was documented, the median time was 21 days. [1] Three weeks is not a deadline to be applied automatically. Return depends on the recovery of mobility, the absence of significant pain, and the ability to perform sport-specific movements. ## What slows down recovery Patients with concomitant injuries took longer to return to sport. [1] This is clinically plausible: an isolated acromioclavicular sprain has a different course than a shoulder [trauma](https://ortopediaevolutiva.com/en/conditions/injuries-fractures) with other injuries, more diffuse pain, or greater stiffness. ## Study limitations It is a retrospective cohort, without a control group, and return to sport was not documented in all patients. The results mainly concern low-grade injuries and should not be extended to more severe forms. [1] For minor acromioclavicular sprains, the most useful data is nonetheless reassuring: conservative treatment is the norm, and sports recovery is often relatively quick, provided that associated injuries have been ruled out and return is guided by symptoms and function. Disclaimer This content is for informational purposes and does not replace an individual clinical evaluation. References [1] Reed JM, Epner E, Hymel AM, Dale KM, LeClere LE. Nonoperative Treatment of Low-grade AC Joint Injuries in Pediatric Athletes. Journal of Pediatric Orthopaedics. 2026 Mar 2. Online ahead of print. DOI: 10.1097/BPO.0000000000003256. PMID: 41770030. PubMed: [https://pubmed.ncbi.nlm.nih.gov/41770030/](https://pubmed.ncbi.nlm.nih.gov/41770030/) ![Dott. Daniele Priano](https://ortopediaevolutiva.com/assets/doctor-avatar-3d-CTvqnoPa.webp) ### Concerned about your child? If you recognize any of these signs in your child, a specialist assessment can give you clarity. I see children at Gaetano Pini and CTO institutes in Milan. 5.0 · Google & MioDottore [Book a private visit](https://ortopediaevolutiva.com/en/locations#prenota) ### Related Conditions [Fractures and trauma](https://ortopediaevolutiva.com/en/conditions/injuries-fractures) ### Related Surgery Pages [Fracture treatment](https://ortopediaevolutiva.com/en/surgery/injuries-fractures) ### Related Articles [Electric scooters and adolescents: how are injuries changing? Read](https://ortopediaevolutiva.com/en/blog/electric-scooter-injuries-adolescents)[Ankle sprain and distal fibula avulsion in children: recovery and return to sport Read](https://ortopediaevolutiva.com/en/blog/childhood-ankle-sprain-return-to-sport)[First patellar dislocation in children: what MRI adds Read](https://ortopediaevolutiva.com/en/blog/first-patellar-dislocation-in-children-mri) ![Dott. Daniele Priano](https://ortopediaevolutiva.com/assets/doctor-avatar-3d-BiLSxBxW.webp) Author and medical reviewer ## Dr. Daniele Priano [Pediatric orthopaedic care in Milan](https://ortopediaevolutiva.com/en) — Gaetano Pini & CTO [Read full bio](https://ortopediaevolutiva.com/en/about) --- Canonical: https://ortopediaevolutiva.com/en/blog/low-grade-ac-joint-injuries-in-young-athletes Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.