Understanding Your Condition

What is a shoulder separation?

Shoulder separation, known as acromioclavicular (AC) joint separation, is an injury to the ligaments of the shoulder that attach the collarbone to the shoulder blade. The severity of this injury can vary, and the injured ligaments can be stretched or torn. The shoulder joint is one of the most complex joints, consisting of the humerus and scapula bones as well as the rotator cuff, bursa, and labrum. Because the shoulder has a wide range of motion it is more vulnerable to injuries.

What are the causes and symptoms of an AC joint separation?

The cause of an AC joint separation is usually related to a blow to the shoulder or a fall. Injuries such as these can stretch or tear the ligaments holding the collarbone in place which stabilize the shoulder. If the ligaments attached to the underside of the clavicle become torn, the collarbone and shoulder blade can separate, resulting in the scapula moving downward due to the weight of the arm. Those who participate in contact sports are more likely to separate their shoulder. Sports such as football, hockey, gymnastics, or volleyball that can involve falls may put patients at higher risk of separating their shoulder. A shoulder separation can result in a minor sprain or a more severe injury such as a complete disruption. If the shoulder separation results in a mild sprain, the AC ligament will not move the collarbone and appear normal on x-rays. If there is a tear to the AC ligament or injures to the coracoclavicular ligament, the collarbone will be out of alignment and a small bump will be present. If the AC joint separation injury is very severe, both the AC and coracoclavicular ligaments can be torn and out of position, resulting in a larger bump. Symptoms of an AC joint separation can include shoulder weakness and pain, as well as bruising or swelling. Patients may also notice a bump at the top of their shoulder and experience a limited range of motion.

How is an AC separation diagnosed and treated?

In many cases, an AC joint separation does not require surgery. Treatments such as rest, ice, and pain relievers can usually treat the injury and allow the patient to regain full function of the shoulder in a few weeks. If the shoulder separation is the result of a more severe injury, it can take a longer to heal. In order to diagnose an AC joint separation, a doctor will conduct a physical exam and order x-rays to assess the injury. Nonsurgical treatments for AC joint separations include using a sling, icing the injured area, and medication. In certain cases, supports may be used to lessen joint motion in order to promote healing and reduce pain. If the shoulder does not return to normal function after a certain period, surgical treatment may be necessary.

Learn more about shoulder separation from the American Academy of Orthopaedic Surgeons. Make an appointment with a specialist at Mobility Bone & Joint Institute to discuss your options.