Separated Shoulder (Acromioclavicular Joint Injuries)
Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.
A separated shoulder is usually the result of a fall or high impact blow that tears one of the ligaments connecting your collarbone to your shoulder blade. This is not as severe as a dislocated shoulder and the pain can range anywhere from mild to severe.
Grades of Separated Shoulder:
- Grade I: This is the mildest type of injury and is a simple sprain of the AC ligaments.
- Grade II: This involves a tear of the AC ligaments and a sprain of the coracoclavicular ligaments.
- Grade III: A complete tear of the AC ligaments and the coracoclavicular ligaments. This injury will result in an obvious bump on the shoulder.
Causes of Separated Shoulder:
A separated shoulder is caused by trauma or acute injury to the shoulder. It can happen by falling on your shoulder or by if using your hand to break your fall. It can also happen if your shoulder runs into a solid object like the corner of a building or a large person. Separated shoulders are common in contact sports like rugby, football, or hockey, or from falling while mountain biking, ice skating, or skiing.
Symptoms of Separated Shoulder:
There is usually noticeable tenderness around the collarbone and shoulder in a Grade I level injury. A Grade II and III level separation would cause more intense and immediate pain at the shoulder. There is also bruising, swelling, and a limited range of pain-free motion. Injuries causing shoulder deformations are often seen in Grade III level shoulder separations.
Treatment of Separated Shoulder:
Grade I and II level separations are typically treated with a short period of rest and immobilization, followed by customized physical therapy to restore range of motion and shoulder strength. A Grade III level injury could require surgery, followed by rest and physical therapy.
Physical therapy is necessary after shoulder separation surgery and it can be effective treatment on its own. Physical therapy for a separated shoulder is geared towards building strength and restoring your full range of motion. Manual physical therapy is an important part of the healing process. It enables your joints and muscles to move more freely without pain. Massaging the neck, shoulder, or shoulder blade will improve mobility, increase circulation, and alleviate pain. Ultrasound, electrical stimulation, and hot & cold therapy are also common treatments for a separated shoulder. These methods of therapy will help to reduce swelling and decrease pain. There are some exercises as well that you can do to improve your arm strength and regain normal shoulder movement.
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