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Shoulder Separation

Shoulder Separation

Shoulder separation is a common sporting injury. Referring to damage of the ligaments in the Acromioclavicular (AC) joint, part of the shoulder, the condition causes acute pain.

Injury can occur as a result of a fall or a collision where the tip of the shoulder is exposed to additional force. On impact, the ligaments are stretched in the opposite direction to the collar bone and the shoulder blade is forced downwards. This causes the shoulder blade and the collar bone to separate. There will be immediate shoulder pain and a shoulder support will be required.

Detailed Overview

Types of Shoulder Separation Injury

Type 1: A mild ligament sprain.

Type 2: Where greater force has been applied, the AC joint may separate slightly but remains intact.

Type 3: This is the most severe, where the joint dislocates and the ligaments rupture. The collar bone will move around.

Signs and Symptoms

The collar bone will be painful, especially on movement. A type 3 separated shoulder may result in a lump where the collar bone has dislocated and moved upwards. Diagnosis can be confirmed with an x-ray to determine the extent of separation that has occurred.

Treatment for Shoulder Separation

In the first few days following an AC joint sprain, medication may be required to relieve shoulder pain. Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are usually recommended to reduce inflammation and minimise discomfort.

Applying wrapped ice to the area can also help with pain and reduce bruising and swelling. Never place ice directly on the skin. The ice pack can be used for about twenty minutes and repeated every two to three hours.

It can be beneficial to tape the collar bone to push it downwards and back into a more natural position. Tape should be applied only by a chartered physiotherapist. Placing the shoulder in a shoulder support will ensure the joint can be rested. When wearing a shoulder sling, exercises to maintain the movement of the fingers, wrist and elbow should be carried out about once every four hours. If shoulder pain is minimal, a resistance band can be used for strengthening exercises.

Symptoms of type 1 injuries typically take 7 to 10 days to subside. Some gentle exercises can be initiated to gradually increase range of movement. Patients should wait until there is full movement without pain before undertaking any heavy lifting.

A type 2 injury will take longer to heal. The shoulder support may be required for approximately two weeks. After the first week, however, it is important to remove the sling and complete some simple exercises to increase the range of movement in the shoulder. These should be performed within the limits of any pain. Contact sports and heavy lifting are best avoided for six weeks while the injury heals. A shoulder sling can be worn to prevent a relapse.

A type 3 injury may require surgery and recovery time is significantly longer.