What is a shoulder separation?

A shoulder separation occurs when you tear the ligaments that hold your collarbone (clavicle) to the joint where it meets the shoulder blade. Your collarbone may move out of its normal place and push up the skin on the top of your shoulder.

Another term for shoulder separation is acromioclavicular (AC) separation or sprain. Shoulder separations or sprains, are graded I, II, III, depending on how far the collarbone is separated from the shoulder. A grade I sprain has tenderness but no actual separation. A grade II sprain has slight separation of the clavicle from the shoulder, and grade III has a greater separation.

How does it occur?

A shoulder separation can result from a blow to your shoulder or a fall on your shoulder. It also can result from a fall on your outstretched hand or arm. It is a common injury in contact sports such as football, rugby, hockey, or lacrosse. It may occur from falling onto a hard surface, such as might happen during downhill skiing, volleyball, rock climbing, and soccer.

What are the symptoms?

Symptoms include the following:

• severe pain at the moment the injury occurs

• limited shoulder movement and tenderness on top of your shoulder at the end of your collarbone

• swelling and bruising of your shoulder area

• a misshapen shoulder

How is it diagnosed?

Your doctor will examine your shoulder for tenderness and a bump over the tip of your collarbone. To make sure it is an AC separation and not a fracture, x-rays are necessary.

How is it treated?

Immediateley after your injury put an ice pack on your shoulder for 20 to 30 minutes. Continue to put ice on your shoulder every 3 to 4 hours. Cold will help reduce the pain, swelling, and inflammation. The treatment of your separated shoulder depends on the severity and may be placed in a sling or shoulder immobilizer. This will keep you from lifting your arm away from your chest and help healing of the ligaments. Your shoulder will be immobilized until you are pain free. Then you will begin rehabilitation exercises. Your doctor may prescribe an anti-inflammatory medication or other pain medication. However, in some situations surgery may be needed to reposition the bones or repair torn ligaments. Your arm will then be in a sling for up to 6 weeks to allow healing before you begin rehabilitation exercises.