The "separated shoulder" or acromio-clavicular joint injury sprain is one of the most common shoulder injuries diagnosed. A separated shoulder injury is most commonly seen in sporting activities such as football, cycling, skiing and snowboarding as well as soccer. The injury mechanism is one of a fall directly onto the point of the shoulder or a jamming upward of the arm from a fall onto the point of the elbow. Injury severity is graded mild (Grade I), moderate (Grade II), severe (Grade III).
In separated shoulder grades I and II there involves mild to moderate stretching to the ligaments that stabilize the collarbone. In a severe, or Grade III injury, the ligaments that hold the collar bone down completely rupture which causes the collarbone to rise upward and appear very prominent.
Grade 3, severe separated shoulder/ shoulder tear injuries involve disruption of both the Coraco Clavicular and Acromio clavicular ligaments. This disruption results in the deformity or bump on top of the shoulder. Due to the repositioning of the collarbone and the nature of the injury, these ligaments fail to heal completely. The severity of the separated shoulder injury is determined from the clinical examination and X-rays which may be done holding a weight for downward distraction of the arm.
Grade I and II shoulder sprain separations are normally and successfully treated through immobilization with a sling for 2 weeks followed by light, progressive range of motion and physical therapy for strengthening to return to normal function. Most patients in this category do not need surgery. Early intervention to treat shoulder sprain discomfort may include ice, pain and or anti-inflammatory medicine and rest.
Once a shoulder injury has been diagnosed as a severe sprain or separation a decision may be made to treat this level of injury either conservatively or surgically. Often times this injury results primarily in cosmetic changes as a result of the upward tilt of the collarbone due to the ligamentous instability that results from this degree of force. In the event that continued pain, weakness or disability occur, the orthopaedic surgeon may suggest surgical fixation to stabilize and approximate the collarbone near its original position. This type of fixatin can be accomplished in a variety of ways and is generally considered very successful. Post-operatively there is a period of immobilization followed by Physical Therapy to regain mobility, strength and function.
For more information on how the shoulder sprain specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!
Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC