Shoulder Separation

Shoulder Separation Overview

A shoulder separation occurs after a fall or a sharp blow to the top of the shoulder. This injury is usually sports related. Some separations happen in car accidents or falls. This is not the same as a shoulder dislocation, which occurs at the large joint where the arm attaches to the shoulder, although the two may appear to be the same.

The shoulder separation, or acromioclavicular (AC) dislocation, is an injury to the junction between the collarbone and the shoulder. It is usually a soft-tissue or ligament injury but may include a fracture (broken bone).

Shoulder Separation Causes

A shoulder separation occurs when a sharp blow or a fall causes the collarbone (clavicle) to be forced away from the bone of the shoulder (the acromion of the scapula). Usually a sports injury, a shoulder separation is more common in football, rugby, hockey, or wrestling. For example, when the quarterback is sacked in football and forced to land on the top of his shoulder with the additional weight of the tackler, often his injury is a shoulder separation. A car accident or a fall may also cause your shoulder to separate.

Shoulder Separation Symptoms

The following signs and symptoms are associated with a shoulder separation.

• You usually feel pain to the top of the shoulder. Often, it is most comfortable to support your affected arm with the opposite hand.
  
  
• Swelling, cuts, or bruises may be present on the top of the shoulder.
  
  
• An obvious upward pointing lump on the top of the shoulder is seen in more serious separations. This is the end of the displaced collarbone (the clavicle bone) and it moves up if the affected arm is pulled toward the ground.
  
  
• Tenderness is felt at the junction, or joint, between the collarbone and shoulder. This is the site of the AC (acromioclavicular) joint.
  
  
• If nerve damage occurs, numbness or muscle weakness may be present in the shoulder or affected arm. If you have this symptom, seek immediate medical attention.

When to Seek Medical Care

It is often difficult to tell a moderately severe shoulder separation from a fracture of one of the shoulder bones or a dislocation of the shoulder (in which the bone in the upper arm [humerus] comes out of the shoulder joint).

Signs of a severe shoulder separation include severe pain, limited range of motion, and cold or numb fingers.

Because some cases of severe shoulder injury may give you only mild pain with a slight decrease in mobility, people with a shoulder injury often need physician's examination and an x-ray.

Mild tenderness to the top of the shoulder may be consistent with a minor bruise. If these symptoms go away with ice, acetaminophen ( Tylenol), or ibuprofen (Motrin), this injury is unlikely to produce serious or chronic problems.

Severe pain, cold or numb fingers, severe or persistent decreased range of motion, and deformity of the shoulder indicate the presence of a potentially serious shoulder injury. If you have these signs and symptoms, go to the hospital's emergency department for prompt diagnosis and treatment.