Shoulder Separation: From Initial Injury to Recovery

Introduction

The shoulder is a complex joint that allows for a wide range of motion and plays a crucial role in various activities, including sports. However, athletes are susceptible to shoulder injuries, one of which is shoulder separation. Also known as acromioclavicular (AC) joint separation, this injury occurs when the ligaments connecting the collarbone (clavicle) and the shoulder blade (scapula) are damaged or torn.

Shoulder separation can be a painful and debilitating condition, affecting athletes of all levels and disciplines. It commonly occurs as a result of a fall or a direct blow to the shoulder, often observed in contact sports or activities that involve sudden impact. Understanding the causes, symptoms, and appropriate treatment options for shoulder separation is essential for athletes, coaches, and healthcare professionals alike.

What Is a Shoulder Separation?

A separated shoulder is also known as acromioclavicular joint separation. A separated shoulder is caused due to torn ligaments of the collarbone and the shoulder blade. The torn ligaments affect the attachment of the clavicle (collar bone) and the shoulder blade. These bones (clavicle and shoulder blade) get separated and loosen their joints. The joint of the shoulder (ball and socket joint) did not get disturbed in case of shoulder separation.

Who Is at Risk of Shoulder Separation?

Anyone can get affected due to shoulder separation, but frequent shoulder separations are commonly seen in sportspeople. People involved in contact sports are more likely to suffer shoulder separation.

What Causes Shoulder Separation?

Some reasons for shoulder separation are listed below -

• Falling seems to be a common cause of shoulder separation. If a person falls directly on the shoulder or with an outstretched hand, it can result in shoulder separation.

• Accidents such as car or bike accidents can result in shoulder separation.

• Contact sports such as football, hockey, wrestling, or kabaddi have high chances of injury and can result in shoulder separation.

• Fighting can be another cause of shoulder separation. Any direct hit or blow to the collarbone or shoulder blade can result in shoulder separation.

What Are the Symptoms of Shoulder Separation?

Symptoms of a shoulder separation are listed below -

• Pain in the affected area.

• Muscle weakness.

• Numbness in the affected area.

• Inability to lift any weight.

• Limited range of motion.

• Difficulty in daily household work.

• Protruded end of the collarbone looks like a lump.

How to Diagnose Shoulder Separation?

Diagnosis plays a crucial part in treatment planning. Without a proper diagnosis, it is not easy to treat any kind of disease or injury. Diagnosis of shoulder separations can be made in the following ways.

• The doctor will assess all the symptoms present.

• The doctor will ask for the medical history (to know about any disease) and sports history (to know if the affected person got injured during the sports).

• The doctor will take a physical examination. The affected person may ask to hold some weight in hand or move the shoulder to check the range of motion.

• Digital Imaging - Different angles of X-rays, ultrasound (sonography), and MRI helps in the diagnosis of shoulder separation.

• Rockwood Classification- This classification checks the severity of shoulder separation. This classification uses a scale ranging from one to six, where one denotes simple ligament sprain, and six denotes severe detachment of ligament or dislocation of bone. Based on these results, the doctor will plan the treatment procedure.

What Is the Treatment for Shoulder Separation?

Surgical and non-surgical both kinds of treatments are both available for shoulder separation. Most cases of shoulder separation get healed within three months of injury without any surgical treatment.

• Non-surgical Treatment - It is also known as conservative therapy; it includes -

  • Rest - An injured person should rest for plenty of time and avoid vigorous exercises or sports. Avoid lifting any weight, such as groceries.

  • Ice - The application of ice over the affected area helps reduce pain and inflammation. Apply ice for 10 to 15 minutes two to three times every day.

  • Sling - A sling is recommended the limit the mobility of affected bone. A sling should be worn during the treatment and after the injury's healing for a few weeks. It provides support to the shoulder and hand and prevents unnecessary movement.

  • Medicine - Painkillers such as naproxen and ibuprofen can be prescribed to lower pain intensity.

  • Physiotherapy - With the permission and help of a physiotherapist or orthopedic surgeon,some specific exercises can be done to increase strength and improve the flexibility of the affected area. Physiotherapy helps in faster recovery and early return to the normal routine.

• Surgical Treatment - In case of severe shoulder separation, surgical treatment is recommended. If non-surgical treatments cannot provide rest, surgical treatment is the option. Severe injuries of shoulder separations include numbness in fingers and hands, severe pain, and inability to move the shoulders. Surgical treatment provides reattachment of torn ligaments and reduction at the end of the collar bone.

What Are the Complications of Shoulder Separation?

Most people fully recover from shoulder separation and return to their routine. However, in some cases, pain is persistent. Damage cartilage causes loss of the cushioning effect, which results in friction between bones and causes pain. Sometimes a mild shoulder separation is left behind and causes discomfort.

How to Prevent a Shoulder Separation?

There is no known preventive measure for shoulder separation, but awareness about the possible reason for shoulder separation may help in the prevention of shoulder separation.

Possible reasons that can increase the chances of a shoulder separation are as follows -

• Sudden and repetitive movement.

• Sports injury.

• Falling directly on the shoulders with an outstretched hand.

• Road accidents.

• Fights.

• Overuse of the muscles.

When to Take Advice From a Doctor in Case of Shoulder Separation?

If someone has shoulder separation with the following symptoms, they should immediately consult a doctor-

• Severe pain.

• Discomfort.

• Injury to the shoulder.

• Inability to move the shoulder.

• Inability to perform daily activities.

• Numbness in the extremities.

Conclusion

A shoulder separation is a condition caused due to torn ligaments of the collarbone and Shoulder blades. Any person, regardless of age or gender, can be affected by shoulder separation. Injury due to falls, car accidents, sports, or fights can cause shoulder separation. The affected person may experience pain, weakness, and numbness in the affected area. Usually, shoulder separation heals within three months with the help of conservative therapy. But severely damaged cases may require surgical treatment.