We use our shoulders for many tasks, from weightlifting to carrying a child to driving a car. Sustaining a shoulder injury, particularly a shoulder separation, can be debilitating and hinder you from living your everyday life. Without proper medical treatment, you could suffer from that injury for quite some time.
If you are experiencing shoulder separation symptoms, you should see a medical professional as soon as possible so that they can determine the extent of your injuries and refer you to a specialist for further treatment. An orthopedic surgeon can examine the separation and choose the best course of treatment.
An untreated separated shoulder can lead to many complications down the road, which may require extensive treatment, physical therapy, or orthopedic surgery. Learn about separated shoulders, their causes, and how they are commonly treated.
What is a separated shoulder?
Your shoulder joint is also called a ball-and-socket joint, which means the shoulder has much more freedom to move around than any other joint. It’s how you can throw a ball, reach behind to scratch your back, or move your arm out quickly to catch a falling drinking glass.
Since the joint, also called the acromioclavicular joint (AC), is so mobile, it is also more prone to injury. That AC joint is held together by ligaments to help keep the shoulder joint more stable. The upper part of your shoulder blade, the acromion, is attached to your collarbone by two ligaments.
If those ligaments are severely damaged in some way, usually from a fall or a direct hit to the shoulder, then your shoulder becomes separated and may even move in a downward direction due to the weight of your upper and lower arm. Shoulder separations can happen during something like a fall from a bicycle or in an automobile accident.
Note that a shoulder separation is different from a shoulder dislocation. If your shoulder is dislocated, your upper arm bone comes out of the shoulder joint.
Common causes of shoulder separation
Typically, shoulder separations occur when your shoulder hits something abruptly or receives a direct blow to the AC joint. Shoulder separations often have the same causes as shoulder dislocation, so visiting a healthcare provider for a proper diagnosis is essential. Common causes may include:
- Slipping and Falling: Slipping and falling injuries are some of the most common injuries that send someone to an emergency room, and if you fall directly onto your shoulder, that can damage the ligaments that hold it together.
- Sports: High-impact sports can cause tough falls to the ground, and if your shoulder bears the most impact, it can separate.
- Trauma: Other types of trauma, such as a car accident, could lead to a shoulder separation injury. This can also happen after falling from a bicycle or rollerblading incident.
Sometimes, this type of injury could occur simply because the ligaments are weakened somehow, and you twist your shoulder or pick something up that is too heavy.
Types of shoulder separation injuries
There are different types of shoulder separation injuries, each increasing in severity. These types include:
- Type I: In this type of shoulder separation, one of the ligaments connecting your shoulder blade to your clavicle is partially torn while the other remains intact.
- Type II: For type II, the AC ligament is completely torn, and the other coracoclavicular (CC) ligament is either partially torn or still intact.
- Type III: In a type III injury, both your AC and CC ligaments are completely torn, and the shoulder blade is separated fully from the collarbone.
Three other types of shoulder separation injuries, types IV through VI, are even more severe injuries but less common. These may include muscle tearing, ligament injury, and joint separation.
Shoulder separation symptoms
The leading shoulder separation symptom is severe pain around the area. However, other symptoms will likely arise, which may include:
- Swelling
- Inability to move or lift your shoulder due to severe pain
- Shoulder deformity (bump or shoulder blade sticking out)
- Tenderness near the AC joint
If you are experiencing any or all of these symptoms after a fall or a direct hit to the shoulder, you should seek medical treatment.
How is shoulder separation diagnosed?
When you experience shoulder pain and visit a physician, they will take specific steps to diagnose your shoulder separation correctly. They will explore your medical history, perform a thorough physical exam, and do an X-ray of your shoulder joint.
During the exam, the doctor will check for signs of shoulder separation by looking for a visible bump or feeling for one and checking for a shoulder deformity. They will also test how much you can move your shoulder by looking at your range of motion. This may include trying to get you to lift your arm, which could be a painful part of the process. Examining muscle strength, blood flow, and nerve or tendon damage will also occur.
To get a clear picture of the situation, they may perform an X-ray of your injured shoulder and your other one to accurately assess torn ligaments and determine whether you had a mild shoulder separation, sprain, or more severe injury. The level of separation will dictate the direction of your treatment plan.
Separated shoulder treatment
Once your physician has diagnosed you with a separated shoulder, they will devise a treatment plan that will be the most effective and efficient way to get you back to tip-top shape. Depending on the severity of your separation, the first step may be to consult with an orthopedic surgeon, who will repair any damage in surgery.
Can a separated shoulder heal without surgery?
For types I and II, yes, these mild separations can usually heal with non-surgical treatment. You will likely need to wear a sling for the first week or so until the pain subsides. The sling supports your shoulder and holds your arm in place to avoid further strain on the joint.
After the pain improves, physical therapy will begin. Your physical therapist will demonstrate exercises to help with your range of motion and increase shoulder strength. This early intervention is key, as physical therapy may help to prevent a condition known as adhesive capsulitis, or “frozen shoulder.” Once you can do these exercises without pain, you will be cleared to resume your normal activities. If you are an athlete, you may have to wait longer to begin playing again, especially if you play high-contact sports like hockey or football.
A type III AC joint separation may require surgery, or your physician may also determine that it can be treated with a sling. Many factors go into this decision, including the severity of the tear and your medical history.
If you do sustain a type IV through VI separation, you may face surgery and a longer recovery process since these are worse. In any shoulder separation, there are other things your doctor may recommend, such as ice and pain medicine. The recommended type will depend on your medical history, allergies, and other factors but could include ibuprofen, acetaminophen, or naproxen.
What can happen if a shoulder separation is not treated?
Without proper treatment, you could end up with weaker muscles, loss of range of motion, and much more. The joint will weaken over time, and you could need a total shoulder replacement. Getting a shoulder separation treated quickly is the recommended course of treatment so that you will not face further complications and require more extensive medical attention. Your doctor or an orthopedic surgeon can offer medical advice on what should be done to fix the separation.
Learn about your shoulder separation treatment options today!
At Alexander Orthopedics, we work with patients who have sustained shoulder separations and help them on their path to recovery. Our specialists will assess your injury, get a detailed medical history, and create a custom treatment plan tailored to your needs. If you are experiencing shoulder separation symptoms after a fall, a car accident, or other impact, we can help you. Schedule an appointment today so that you can speak with one of our healthcare providers as soon as possible and get your injury treated.
Schedule an appointment today, and a member of our team will contact you within 24 hours to begin your separated shoulder recovery.
Schedule an appointment today and a member of our team will contact you within 24 hours to begin your separated shoulder recovery.
FAQ
How serious is an AC joint injury?
An AC joint injury can range from mild to severe, depending on the extent of the ligament damage. A type I or type II injury, where ligaments are only partially torn, is generally less serious and often heals with rest, a sling, and anti-inflammatory treatments. However, a type III or more severe injury, which could involve complete tears of both the AC and CC ligaments, may result in significant pain, a visible deformity at the top of the shoulder, and loss of shoulder movement. These severe injuries could require surgical intervention to restore function and alignment, particularly if the scapula and the end of the collarbone are significantly displaced. Consulting with a sports medicine specialist is crucial to assess the injury and develop a tailored treatment plan.
How to sleep with a separated shoulder?
Sleeping with a separated shoulder can be challenging due to discomfort and limited shoulder movement. To alleviate pain and reduce strain, you should sleep on your back with your upper body slightly elevated using pillows. This position helps to minimize pressure on the injured part of the shoulder and promotes better alignment of the shoulder area. Some individuals find relief sleeping on the uninjured side while supporting the injured humerus and shoulder with a cushion. Anti-inflammatory medications before bed can also help reduce pain and swelling, allowing for a more restful sleep.
How long does it take to heal a separated shoulder?
The recovery time for a separated shoulder depends on the severity of the injury. For mild injuries like type I or type II AC joint separations, healing can take 2 to 6 weeks and typically involves rest, ice, anti-inflammatory medications, and physical therapy to restore shoulder movement and strengthen surrounding muscles like the rotator cuff. More severe injuries, such as type III and beyond, may take several months to heal, especially if surgery is required. Post-surgery recovery includes extensive physical therapy and careful monitoring by a sports injuries professional. Prompt treatment and adherence to a tailored rehabilitation program can significantly speed up healing and reduce the likelihood of long-term complications.