What is a shoulder separation?
Your shoulder is a very flexible ball-and-socket joint, called the glenohumeral joint. This is where the top of the humerus—the bone in your upper arm—fits into the socket of your scapula (your shoulder blade). If the ball (top of the humerus) comes out of the socket, this causes a dislocated shoulder. But a more common injury to this part of your body is a shoulder separation, which occurs where your clavicle (collar bone) attaches to your scapula. This is the acromioclavicular joint, or AC joint, and its role is to hold your shoulder in place. Occasionally, people mix up the two injuries and use the terms interchangeably, but acromioclavicular separation and glenohumeral dislocation are distinct injuries.
An AC joint separation can range from mild to serious. A mild AC separation injures the ligaments that hold the clavicle in place but there are no tears in the ligaments and your clavicle does not move out of place. A moderate shoulder separation occurs when there are tears in the ligaments and the clavicle moves slightly out of place. A severe shoulder separation occurs when the ligaments are completely torn and the clavicle is obviously moved out of place.
What are the symptoms of a separated shoulder?
If you have separated your shoulder, the first symptom you will experience is sudden, sharp pain in the shoulder area. You may also experience:
Weakness in the arm
Swelling or bruising on the shoulder
A bump on the top of your shoulder
Reduced shoulder movement
While a separated shoulder is not usually a medical emergency, you should seek medical help as quickly as possible if you experience AC joint pain, numbness or a cold feeling in your fingers and hand, muscle weakness in the arm, and/or an obvious deformity in your shoulder.
What causes shoulder separation?
Most often, an AC joint separation is the result of a fall, most often directly on the shoulder or upper arm. However, it can also happen if you fall on an outstretched hand as you try to break your fall. The force of the fall travels up your arm and injures the ligaments. A hard blow directly to the shoulder can also cause shoulder separation, as can a sudden sharp twist of the arm.
What are the risk factors for shoulder separation?
Because shoulder separations are often the result of a fall, they are a common sports injury from either contact sports, such as ice hockey, or individual sports like skiing or gymnastics—wherever there is a risk for a fall or hard blow to the shoulder. Shoulder separations are also common during the winter, when people may fall on the ice or snow.
This type of injury often occurs to young children who are pulled up by one or both arms.
Reducing your risk of a shoulder separation
You may be able to lower your risk of a shoulder separation by:
Preparing for your sport by exercising and strengthening the muscles in your arm and chest
Stopping your activity if you feel pain in your shoulder
Wearing recommended padding or protection for your particular activity
Wearing footwear with good treads when walking on ice or other slippery conditions
Not picking up children by their arms
How is shoulder separation treated?
Most shoulder separations heal on their own with conservative treatment. This includes:
Resting your arm and limiting the movement. You may find it less painful for the first few days if you wear a sling for support.
Icing your shoulder. Apply ice for 20 minutes at a time every few hours for the first 24 to 48 hours.
Taking over-the-counter pain relievers, such as ibuprofen, which is also an anti-inflammatory
Rehabilitation exercises may be necessary to help you regain full range of motion of your shoulder and to strengthen the muscles around the joint.
Surgery is not commonly needed to treat an AC separation although it may be necessary if the injury is severe or if the pain does not go away. Your orthopedic surgeon will repair or reconstruct the ligaments, either during arthroscopy or open shoulder surgery. After the incision has healed, orthopedic rehabilitation exercises for the shoulder are usually recommended.
What are the potential complications of shoulder separation?
It can take up to 12 weeks for a separated shoulder to fully heal. Most people who sustain this injury heal well without any long-term complications, but there is a small chance the injury will not heal well. Or, you experience continued pain in the shoulder.
If you must have surgery to repair the ligaments, there are some possible complications related to the procedure, such as infection, blood clots, or anesthesia problems.