A shoulder separation, also known as an acromioclavicular (AC) joint separation, is an injury where the outer end of the collarbone (clavicle) separates from the end (acromion) of the shoulder blade due to torn ligaments.

Common Symptoms

• Severe pain at the time of injury
• Limited shoulder movement due to pain (not weakness)
• Swelling and bruising
• Possible deformity with the collarbone appearing out of place or a bump on the shoulder

Cause & Anatomy

It occurs most often from a direct blow to the top of the shoulder or a fall onto the shoulder, common in contact sports and activities like football, biking, skiing.

The acromioclavicular joint is where the collarbone (clavicle) meets the highest part of the shoulder blade (acromion). The ligaments connecting these bones are torn or stretched in a separation injury.

Diagnosis

Physical exam findings like tenderness, swelling, deformity. X-rays are used to assess displacement and severity. MRI may be ordered for associated injuries. Holding a weight during X-ray can accentuate the separation.

Prevention

Being aware of risk factors like contact sports, falls. Using proper technique and protective gear.

Treatment

For mild cases: Ice, pain medication, sling, early motion exercises.
For severe cases: Surgery to repair/reconstruct torn ligaments using sutures or tendon grafts.

Surgery

Outpatient surgery under general anesthesia to reattach the ligaments holding the collarbone to shoulder blade using sutures or tendon grafts. Sling immobilization for 6 weeks.

Rehabilitation After Surgery

Passive range of motion at 4 weeks, active motion at 6-8 weeks. Gradual strengthening over 6 months to regain full function.

FAQ’s

What is the timing for a full recovery for mild cases?
12 weeks. Severe cases: Around 6 months