Shoulder separation

Shoulder separation involves partial or full separation of 2 parts of the shoulder, specifically the collarbone and acromion (end of the shoulder blade).

It is important to note that the collarbone and shoulder blade are linked together by the acromioclavicular (AC) joint that is supported mainly by the acromioclavicular (AC) and coracoclavicular (CC) ligaments. If an individual has shoulder separation, these ligaments are partly or fully torn.

Shoulder separation is categorized based on the severity of damage to the ligaments:

  • Type I – the AC ligament is partly ripped, but the CC ligament is not damaged.
  • Type II – the AC ligament is fully torn while the CC ligament is either unaffected or only partly ripped. The collarbone is partly disconnected from the acromion.
    Shoulder separation

    Tenderness over the AC joint on the top part of the shoulder

  • Type III – both the AC and CC ligaments are fully torn. The collarbone and acromion are separated entirely.

Causes of shoulder separation

Sustaining a direct strike on the top part of the shoulder or falling onto the shoulder while riding a bicycle can lead to shoulder separation.

Indications

  • Pain at the time of injury
  • Swelling and bruising
  • Limited movement in the shoulder region
  • Tenderness over the AC joint on the top part of the shoulder
  • Possible deformity in which the exterior end of the collarbone appears out of place or there is a lump on top of the shoulder

Management

The treatment for shoulder separation is based on its severity.

For type I or II, the shoulder must be supported with a sling. It should be worn until the discomfort is reduced. Early physiotherapy is also advised to strengthen the shoulder and restore range of motion for recovery and prevent frozen shoulder. The individual can resume normal exercises and activities as the pain and other symptoms settle.

As for type III injuries, some doctors recommend a sling and physiotherapy while others opt for surgery.

For pain relief, apply an ice pack on the affected area and provide non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen.

More Information / Disclaimer

The information posted on this page on shoulder separation is for learning purposes only. Learn to recognize and manage joint injuries including a separated shoulder by taking a standard first aid course with Vancouver First Aid.

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