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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).
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.
Signs and symptoms of a shoulder separation include:
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.
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.
Experts don't agree on the best treatment for type III injuries. 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.
To help relieve pain, put ice on the affected area and take nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen. Be safe with medicines. Read and follow all instructions on the label.
Other Works Consulted
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Acromioclavicular injuries. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 263–268. Rosemont, IL: American Academy of Orthopaedic Surgeons.
McMahon PJ, et al. (2014). Sports medicine. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 88–155. New York: McGraw-Hill.
Current as of: March 2, 2020
Author: Healthwise StaffMedical Review: William H. Blahd, Jr., MD, FACEP - Emergency MedicineAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicinePatrick J. McMahon, MD - Orthopedic Surgery, Sports Medicine
Current as of: March 2, 2020
Author: Healthwise Staff
Medical Review:William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Patrick J. McMahon, MD - Orthopedic Surgery, Sports Medicine
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