Not to be confused with a shoulder dislocation, the term shoulder separation refers to the stretching/tearing of ligaments where the clavicle (i.e., collarbone) meets the scapula (i.e., shoulder blade), which is referred to as the acromioclavicular joint (AC). Such an injury is usually caused by falling forward onto an outstretched hand, or by an impact to the front of the shoulder. In severe cases, where the ligaments tear, the collarbone can move forward and detach from the should blade. The primary symptom is should pain, and sometimes a small bump will be present on top of the shoulder. A separated shoulder should not be confused with a dislocated shoulder.
Shoulder separations are classified into one of six types, as follows.
Type I: Injury to the capsule that surrounds the AC joint. The bones do not move out of position, and the primary symptom is pain.
Type II: Injury to the AC joint capsule as well as a partial tear of the coracoclavicular ligament. Patients with a Type II separation may have a small bump over the injury.
Type III: Same as Type II, but more severe. Patients with a Type III separation usually have a large bump over the injured AC joint.
Type IV: An unusual type of separation where the clavicle is pushed behind the AC joint.
Type V: An exaggerated Type III injury, wherein the muscle above the AC joint is punctured by the end of the clavicle, resulting in a significant bump.
Type VI: an exceedingly rare injury wherein the clavicle pushes downward and become lodged below part of the scapula (the corocoid).
Treatment: The recommended course of treatment depends on the severity of the injury. Conservative treatment, involving rest and wearing a sling until the ligament heal, is the simplest option. Ice may help reduce the pain and swelling, and physical therapy can be used to increase range of motion and strength. Most shoulder separations heal within 2-3 months without complications, but in the case of severe injuries, surgical repair may be indicated. Seek the advice of a trained medical professional.