What is a shoulder separation?
A shoulder separation is the partial or complete separation of two parts of the shoulder: the collarbone (clavicle) and the end of the shoulder blade (acromion). See a picture of shoulder separation injuries.
The collarbone and the shoulder blade (scapula) are connected by the acromioclavicular (AC) joint, which is held together primarily by the acromioclavicular (AC) and the coracoclavicular (CC) ligaments. In a shoulder separation (also called an acromioclavicular joint injury), these ligaments are partially or completely torn. A shoulder separation is classified according to how severely these ligaments are injured:
There are three further classifications, types IV through VI, which are uncommon. These types of shoulder separations may involve tearing of the muscle that covers the upper arm and shoulder joint (deltoid muscle) and the one that extends from the back of the head, neck, and upper back across the back of the shoulder (trapezius muscle).
What causes a shoulder separation?
A direct blow to the top of the shoulder or a fall onto the shoulder, such as a fall from a bicycle, can cause a shoulder separation.
What are the symptoms?
Signs and symptoms of a shoulder separation include:
How is a shoulder separation diagnosed?
A shoulder separation is diagnosed through a medical history, a physical exam, and an X-ray.
Your doctor will check:
Your doctor will probably X-ray your injured shoulder and possibly your uninjured shoulder to help diagnose the severity of the separation.
How is it treated?
Treatment of a shoulder separation depends on its severity. For a type I or II injury, you support your shoulder with a sling. You typically need the sling until the discomfort decreases (a few days to a week). Early physical therapy to strengthen your shoulder and regain range of motion is important for recovery and to prevent frozen shoulder, a condition that limits shoulder motion (adhesive capsulitis). You can return to normal exercises and activities as your pain and other symptoms go away.
Treatment for type III injuries is controversial. Some doctors treat them with a sling and physical therapy, while others feel surgery may be needed.
Type IV through VI injuries should be evaluated for possible surgery.
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