Shoulder Bone Separation
Shoulder bone separation occurs when the ligaments between the collarbone (clavicle) and part of the shoulder blade (acromion) are torn. The tear loosens the joint connection between the collarbone and shoulder blade, causing them to separate or move apart from one other. A separated shoulder does not actually involve damage to the main ball-and-socket joint of the shoulder.
Other names for this condition are acromioclavicular joint separation or AC joint separation. These names reflect the medical references for the collarbone (clavicle), and the outer end of the scapula (acromion) that extends over the shoulder joint at its highest point.
Causes of Shoulder bone Separation
Most shoulder separations are caused by falling directly onto the shoulder with enough force to tear ligaments. Besides falls, car accidents and sports injuries are frequent causes.
- Pain at the very top of the shoulder.
- A bump on the top of the shoulder at the end of the collarbone. As a result of torn ligaments, the shoulder blade moves downward from the weight of the arm, causing the top end of the collarbone to protrude up.
Diagnosis of Shoulder bone Separation
- Review of current symptoms and appearance of the injured shoulder.
- Review of medical history.
- A physical examination.
- Imaging tests such as X-rays
- MRI (magnetic resonance imaging).
The patient may be asked to hold a weight in the hand during these tests to make the injury stand out more on the images that are captured.
Most people will recover from a separated shoulder within two to 12 weeks without surgery. Non-surgical treatments include the following:
- Use of a sling to keep the shoulder in place while healing.
- Ice packs and medications such as ibuprofen, naproxen, aspirin or acetaminophen to reduce pain.
- Physical therapy or an exercise program to strengthen the muscles and ligaments of the shoulder once it has healed. A doctor’s approval should be received before starting a rehabilitation program.
- Avoidance of lifting heavy objects for eight to 12 weeks after the injury has healed.
Surgery may be required in more serious cases (such as a type IV, V or VI injuries on the Rockwood scale) or after determining that non-surgical treatments are not the best option. More serious injuries are indicated when the fingers are numb or cold, arm muscles are weak, or deformity of the shoulder is severe.
Surgical treatments include:
- Shaving the end of the collarbone to prevent it from rubbing against the shoulder blade.
- Reattaching torn ligaments to the underside of the collarbone. This surgery can be performed even long after the injury has occurred, but may require a graft tissue to help reconstruct the ligaments if a lot of time has passed since the injury.