Friday, March 26, 2010

Shoulder Separation


A shoulder separation is an injury to ligaments the AC joint, not the should joint. AC is the acromio-clavicular joint. The acromion is part of the scapula (shoulder blade) and the clavicle is the long narrow bone that comes across the should and attaches to your sternum.

A separation of this joint comes from a blunt force and not a twisting force like you would see in the knee or ankle. Falling, being hit in a contact sport, and car accidents are all prime candidate for AC separation injuries.

Like all ligament injuries, an AC separation comes in different severities. Listed below are the different grades of severity.




Type I Shoulder Separation:
This is the least severe. In a type 1 injury there is minor disruption to the capsule that surrounds the AC joint. Minor swelling and pain are the only symptoms. X-rays will look normal. There is no ligament damage in a type 1

Type II Shoulder Separation: The second level of injury is where the capsule and some damage to the coracoclavicular ligament. A small displacement in the clavicle can be seen. Pain and swelling are still minor.

Type III Shoulder Separation: A type three is nothing more than a more exacerbated version of a type two. The pain and swelling increase and the displacement near the AC joint is more pronounced

Type IV Shlder Separation: This type is when the clavicle is pushed inward and ends up behind the acromion. This is a rare injury.

Type V Shoulder Separation: This is an exaggerated version of a type three. The clavicle is dislodged and damages muscle tissue in the surrounding area. A prominent bump can be seen.

Type VI Shoulder Separation: This is the most rare version. The clavicle is pushed downward and moves into the coracoid process which is a part of the scapula (shoulder blade).



Treatment for AC separation includes icing the joint and taking non-steroidal anti-inflammatory drugs such as Advil, Ibuprofen, Motrin, and Excedrin. Tylenol and Aspirin are not anti inflammatory's. Type's IV through VI will likely require surgery to repair. Fortunately these are extremely rare and require tremendous force to occur.

Therapy can help speed up the recovery process. As the joint heals you will notice the lack of range of motion (ROM) in the should. Passive and active ROM exercises will be required to achieve full functionality. Never move the arm to position that gives you pain.

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