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A shoulder separation is one type of injury you may actually hear as a tear or a snap at the time of injury. Other signs include pain and swelling in the joint area. The shoulder may appear deformed and shoulder movement will be limited and uncomfortable.

A shoulder separation occurs when the ligament connecting the collarbone (clavicle) to the shoulder blade (scapula) sustains a tear. Ligaments are strong bands of tissue that connect the bones and help to stabilize joints. The joint between the clavicle and the scapula is known as the acromioclavicular or AC joint.

A tear in a ligament is commonly known as a sprain. Grade I or mild sprains involve a tear of some of the fibers in the ligament, but leave the joint functional with relatively rapid healing. A moderate or Grade II sprain occurs when part of the ligament is torn from a bone. There is some loss of function and healing will probably take longer than with a mild sprain. A severe or Grade III sprain results when the ligament is torn completely apart, or separates from the bone. All joint function is lost and surgery may be required.

Causes
The primary cause of shoulder separation is high stress on the AC joint. Events that can lead to such stress include:

  • falling on your shoulder or outstretched hand
  • a strong blow by an object or another person (such as during contact sports)
  • trauma from a car accident.

Diagnosis
Your doctor will ask about your symptoms and the history of the injury. A physical examination will be conducted. And X-rays will be taken to rule out broken bones and identify the sprain. Sprains do not always appear on X-rays, so an MRI (magnetic resonance imaging) test may also be recommended.

Treatment Options
A conservative course of treatment includes a period of rest and immobilization of the shoulder. You may wear a sling for a few weeks to allow the ligament to heal, and to prevent further injury. An ice pack wrapped in a towel may be applied to the area 3 or 4 times a day to reduce pain and swelling. Your doctor also may recommend medication to control inflammation and discomfort. And you may be referred for physical therapy and occupational therapy.

Severe shoulder separations may require surgery. This allows the bones to be aligned and the ligaments repaired. Your doctor will discuss this option with you, along with the risks involved.

Mild separations can heal in a few weeks, but moderate to severe cases can take 2 to 3 months.

Possible Complications
Shoulder separations usually heal with good results and no loss of shoulder movement. In some patients, joint stiffness and loss of range of motion may occur. Recovery depends on a number of factors, including overall health, extent of the injury and how well you follow your rehabilitation program.