When it comes to shoulder separation, it is not actually an injury to the shoulder joint. It is important to note that the injury typically involves the acromioclavicular joint (AC joint) where the clavicle meets with the highest point of the shoulder blade.
How shoulder separation occurs
The usual cause for shoulder separation is from a fall straight onto a shoulder. The fall can damage the ligaments that surround and stabilize the AC joint. If substantial force is involved, the ligaments that attach to the underside of the clavicle are torn. This will cause the separation of the collarbone and wing bone. It is important to note that the wing bone moves downward from the weight of the arm which results to a bump above the shoulder.
The injury can range from a minimal change in configuration with mild pain to severe deformity that involves intense pain. If the deformity is severe, it will take a longer time to restore full functionality.
A minor shoulder separation involves an AC ligament sprain that does not move the collarbone and has a normal result in the X-ray. For serious tears on the AC ligament and sprains on the coracoclavicular ligament (CC ligament), it will put the collarbone out of alignment. The severe cases of shoulder separation involves full tears on both the AC and CC ligament as well as putting the AC joint evidently out of position.
Diagnosing shoulder separation
The injury is easy to identify when it causes deformity. If there is minimal deformity, the location of the pain and the X-ray result will help the doctor come up with a diagnosis. Oftentimes, if the individual holds a certain weight in the hand, it can increase the deformity which makes the injury apparent on the X-ray results.
The non-surgical treatment options which include application of cold packs, using a sling and medications can often help manage the pain. Oftentimes, the doctor will utilize complex supports to help reduce the AC joint motion and minimize the pain. You can learn pain management measures by enrolling in a class on first aid today.
Many individuals can achieve full functionality with this injury even if there is persistent and substantial deformity. In some cases, there is constant pain in the area of the AC joint even with mild deformity that can be due to the following:
- Unusual contact between the bone ends where the joints is in motion
- Injury to the disk-like cushioning cartilage that is often present in between the bone ends of this joint
- Development of arthritis
In most cases, it is best to wait and see if reasonable functionality returns without surgical treatment.
Surgery might be required if the pain continues or the irregularity is severe. The surgeon might endorse the trimming of the end of the collarbone so that it will not rub on the acromion.
If there is evident deformity, reconstruction of the ligaments that connect to the underside of the collarbone is beneficial. This surgery is effective even if it is performed long after the issue started. Whether treated with non-surgical measures or surgery, the shoulder requires rehabilitation in order to restore and rebuild motion, flexibility and strength.