Shoulder Separation and Treatment

shutterstock_19723270The shoulders are involved in so many of our day-to-day activities, everything from unloading the dishwasher to unloading a fastball. They are prone to injury because they are so involved with so many movements. Here are descriptions of the degrees of shoulder separations, along with treatments.

Degrees of separation

The most common cause for a shoulder separation is a fall directly onto the shoulder. The fall can injure the ligaments that surround and stabilize the AC joint.

  • A mild shoulder separation involves the sprain of the acromioclavicular (AC) ligament (the connector between the collarbone and the shoulder blade). But the injury doesn’t move the collarbone, nor does it show up on X-rays.
  • A moderate injury tears the AC ligament and sprains or slightly tears a second ligament, the coracoclavicular ligament (CC), which puts the collarbone out of alignment.
  • A severe separation completely tears both the AC and CC ligaments and puts the AC joint well out of position.


Non-surgical treatments are preferable for shoulder separations. Slings, cold packs, and pain medication are all used. The key is to minimize the motion of the AC joint to lessen the pain.

Most people, with time, can return to near full function after shoulder separation. There may be a propensity to re-separation, however, in some people once the joint has been loosened. Some people also continue to experience pain in the AC joint, despite just minimal separation. The reasons behind this are not readily obvious but can be caused by injury to a disk-like piece of cushioning cartilage often found between the bone ends in this joint.

Surgery is an option if pain persists or the deformity is severe. The collarbone can be shortened so that it doesn’t rub against the shoulder blade. Or the ligaments that attach to the underside of the collarbone can be reconstructed and tightened.