Understanding Shoulder Separation

Understanding Shoulder Separation

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Understanding Shoulder Separation

A shoulder separation is when part of the shoulder blade separates from the collarbone. A separation is not the same as a dislocation. With a dislocation, the bone pulls out of a joint. Shoulder separation is common, especially in active people. It’s most often caused by an injury that damages the ligaments around the shoulder joint. The shoulder blade may move downward from the weight of your arm.

The parts of the shoulder joint

The shoulder joint is called the acromioclavicular (AC) joint. It’s where the collarbone (clavicle) meets the shoulder blade (scapula). Your shoulder blade connects to your upper arm bone and to your collarbone with ligaments. Ligaments are strong, stretchy tissue. The highest point of your shoulder blade is called the acromion. Two AC ligaments attach the acromion to your collarbone. This is the AC joint. The coracoclavicular (CC) ligament connects part of your shoulder blade to your collarbone.

What causes shoulder separation?

Different types of injuries can lead to shoulder separation. They include:

  • Falling on the shoulder with your arm close to your body

  • A direct blow to the shoulder

  • Falling onto an outstretched hand

  • Car accident

  • Sports injury

Symptoms of shoulder separation

Symptoms can vary a lot depending on how severe the injury is, and can include:

  • Pain at the top of your shoulder

  • Pain when touching your AC joint

  • Swelling

  • Bruising

  • Change in shape of your shoulder

  • Bulge above the shoulder

  • Shoulder that appears to droop

  • Collarbone that moves upward

  • Limited range of motion in your shoulder, such as when you try to lift your arm

Diagnosing shoulder separation

Your healthcare provider will ask about your health history and give you a physical exam. He or she will look at your shoulder and arm and press on your AC joint, which may hurt.

Severe shoulder separation injuries are easy to diagnose with just a physical exam. This is because the shoulder will clearly look deformed. In any case, you will likely need an X-ray of your joint. This will help give more information about the injury. During the exam or X-ray, your healthcare provider may have you hold a weight on the injured side. This can make a deformity easier to see.

An injury to the AC joint is rated based on how severe it is. The types are:

  • Type I. This injury is the mildest. It may cause only slight pain and swelling.

  • Type II. The AC ligaments are only partially torn. The bones remain in place.

  • Type III. Both the AC and CC completely tear. The collarbone and shoulder blade are slightly out of line.

  • Type VI. This is the most severe. The bones pull out of position even more. Other tissues around the area may be damaged.