Because of the range of motion the shoulder joint has, the various structures of the shoulder are susceptible to damage and injury. A separated shoulder occurs when one of the shoulder ligaments is torn or stretched. Some of the common causes of a separated shoulder include falls and other injuries which result in an impact to the structures that support the shoulder.
The joint where the collarbone and shoulder blade meet is called the acromioclavicular (AC) joint. When an injury occurs that does damage to the ligaments which stabilize the AC joint, the collarbone and shoulder blade can separate. This results in what is referred to as a separated shoulder.
Falling directly onto the shoulder is one of the most common causes of a separated shoulder. Another cause is a direct hit or blow to the shoulder. This can occur as a result of an automobile accident or a sudden forceful hit such as occurs in sports, such as football or hockey.
Depending on the amount of force, the ligaments supporting the joint may tear or stretch. Injuries involving a stretching, or sprain, of the ligament are considered mild. Tears of the ligaments result in more severe separations, and often longer rehabilitation periods.
The severity of symptoms depends on the degree of the injury. Mild injuries may result in minor pain, bruising, and swelling. More serious injuries can result in severe pain, limited movement, and a deformity, often a bump, along the top of the shoulder.
Diagnosis of a shoulder separation is made by conducting a physical examination and diagnostic testing. Physical exams may include observing the ability of a patient to lift their arm to the side and up above their head. Diagnostic imaging, such as an x-ray, can help identify the location and extent of the damage.
Treatment for a separated shoulder usually involves home care. This includes resting the shoulder, icing the area to reduce pain and swelling, and taking over-the-counter pain medications for pain relief. The use of a sling can help keep the shoulder immobilized and reduce further injury.
Moderate to severe injuries may require more specific treatment. For mild to moderate injuries, physical therapy may be recommended to help regain strength and range of motion in the injured shoulder. Surgery is reserved for severe cases where significant damage to the AC joint and surrounding structures has occurred. This can include damage to the rotator cuff.