We use our shoulders for so many tasks, from weight lifting 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 the proper medical treatment, you could be suffering from that injury for quite some time.
If you are experiencing pain from a shoulder separation, 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 determine 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, what causes them, 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 a lot more freedom to move around than any other joint in your body. It’s how you are able to 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 referred to as the acromioclavicular joint (AC), is so mobile, it also is 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, called the acromion, is attached to your collarbone by two of those 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, then that means your upper arm bone came 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, which is why it’s important to visit a healthcare provider for proper diagnosis. Common causes may include:
- Slipping and falling: Slip and fall 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 in a rollerblading incident.
Sometimes, this type of injury could even occur simply because the ligaments are weakened in some way, 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 one 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, one ligament is completely torn and the other one is either partially torn or still intact.
- Type III: In a type III separation, both ligaments are completely torn and the shoulder blade is separated fully from the collarbone.
There are three other types of shoulder separation injuries, types IV through VI, that are even more severe, but are seen less commonly. These may include muscle tearing as well as ligament injury and joint separation.
Symptoms of a shoulder separation
The main indicator of a shoulder separation injury 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 a shoulder separation diagnosed?
When you experience shoulder pain and go to visit a physician, they will take certain steps to ensure that your shoulder separation is properly diagnosed. 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 damage to the nerves or tendons will also occur.
To get a clear picture of the situation, they may do an X-ray of not just your injured shoulder, but also the other one so they can accurately assess everything and determine if you had a separation and the level of that separation. 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 come up with 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, as they will be the ones repairing any damage in surgery.
For types I and II, 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 of the joint. After the pain improves, physical therapy will begin. Your physical therapist will demonstrate exercises that will 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 are able to 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 such as hockey or football.
A type III shoulder separation may end up requiring surgery, or your physician may end up determining that it can be treated with a sling as well. There are many factors that 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 type recommended will depend on your medical history, allergies, and any 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 itself will weaken over time and you could end up needing a total shoulder replacement. Getting a shoulder separation treated quickly is the recommended course of treatment so that you will not face further complications down the road and require more extensive medical attention. Your doctor or an orthopedic surgeon can advise you 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 feeling shoulder pain after a fall, a car accident, or other impact, we may be able to 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.