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Shoulder Separation

Contrary to popular belief, a shoulder separation does not involve the true shoulder joint.  The shoulder joint is a ball-and-socket joint.  Sitting above this joint the end of the collar bone (clavicle) meets the tip of the shoulder blade (acromion).  This is collectively known as the acromioclavicular joint (AC joint).  When this joint is injured, it is commonly referenced as a separated shoulder.

 

The most common mechanism of injury for a separated shoulder is a direct impact on the tip of the shoulder.  This causes a depression of the scapula tearing the AC joint’s stabilizing ligaments.  When these ligaments are torn the clavicle will appear to stick up revealing a bump on the top of the shoulder.  There are different levels of severity for this type of injury.  If you have a mild AC joint sprain, you may experience point tenderness over the joint and some pain with active shoulder range-of-motion.  More serious injuries to this joint can significantly limit range-of-motion, cause significant pain and cause injuries to other structures near the joint.

 

Typically this type of injury is treated conservatively with rest, ice, immobilization, non-steriodal anti-inflammatories (ibuprofen, aspirin, etc) and rehabilitation.  Even if the deformity is moderate to severe, motion and strength is often fully restored.  Surgery to stabilize the joint may be recommended if the separation is significant enough to cause tearing of many ligaments and/or puncture of other surrounding structures.  Your doctor can discuss these different options with you and help choose what is right for you.