Separated Shoulder
A separated shoulder is an injury to the acromioclavicular (AC) joint, where the collarbone (clavicle) meets the top of the shoulder blade (acromion). Unlike a shoulder dislocation, it doesn’t affect the main ball-and-socket joint.
This injury occurs when the ligaments connecting the clavicle and acromion are stretched or torn, causing the joint to loosen and the bones to move apart. It’s also known as an AC joint separation or acromioclavicular joint separation.
Athletes may notice:
- Pain at the top of the shoulder
- Visible bump near the collarbone
- Limited shoulder movement
- Swelling, tenderness, and bruising
A shoulder separation can range from mild to severe and is classified using the Rockwood classification based on the ligaments involved:
Type I: Sprain or partial tear of the AC ligaments. Causes mild swelling and tenderness; heals within a few weeks.
Type II: Complete tear of the AC ligaments and partial tear of the CC ligaments. Causes moderate swelling and tenderness.
Type III: Complete tear of both AC and CC ligaments. Results in a visible bump, significant swelling, and severe tenderness.
Management and Treatment
Most separated shoulders heal within 2–12 weeks without surgery.
Non-surgical Treatment
Sling: Keeps the shoulder stable during healing.
Ice and medications: NSAIDs, aspirin, or acetaminophen reduce pain and swelling.
Physical therapy: Strengthens shoulder muscles and ligaments once approved by a surgeon.
Activity restriction: Avoid lifting heavy objects for 8–12 weeks.
Surgical Treatment
Surgery is needed for severe injuries (Rockwood type IV–VI) or if nonsurgical care fails. Signs include numbness, weakness, or significant deformity. Procedures may include:
Trimming the end of the collarbone to prevent rubbing.
Reattaching torn ligaments to the underside of the collarbone, sometimes using grafts if the injury is old.
