An AC joint separation is a common injury among physically active individuals. A separated shoulder is not truly an injury to the shoulder joint. The injury involves the acromioclavicular joint, otherwise known as the AC joint. In an AC separation injury, the clavicle (collarbone) separates from the scapula (shoulder blade), commonly caused by a fall directly on the shoulder or a direct blow. Dr. Peter Millett, orthopedic shoulder surgeon located in the Vail, Aspen and Denver, Colorado area, is a leading surgeon in the treatment of AC joint separations.
A separated shoulder is most commonly experienced when an individual falls directly on the “point” of the shoulder blade. The fall is responsible for injuring the surrounding AC joint ligaments, the acromioclavicular ligament (AC) and the two coracoclavicular ligaments (CC), that stabilize the AC joint.
An AC separation injury can range from a mild separated shoulder to a complete tear of both the AC ligament and CC ligaments. Many physicians range the injuries on a Grade I-III scale.
Separated Shoulder Symptoms
An AC joint separation has a wide range of symptoms dependent on the grade of injury.
- Grade I: A slight stretch or partially torn AC ligament may cause joint tenderness, bruising and minor shoulder pain.
- Grade II: A completely torn AC ligament and intact CC ligaments may cause moderate to severe shoulder pain, swelling and a small bump on the top of the shoulder.
- Grade III: Completely torn AC ligament and CC ligaments may cause swelling, severe shoulder pain, shoulder deformity, instability and popping sounds.
AC Joint Separation Diagnostic Testing
A separated shoulder is easy to diagnose when the injury causes deformity. When deformity is not present, a thorough physical examination must be performed to locate the area of pain and to compare the injured arm’s position to the uninjured arm’s position. During the physical examination, Dr. Millett will gently feel the bones and soft tissues in the injured area, evaluate the range of motion and perform tests to locate specific areas of shoulder pain and weakness.
Seperated Shoulder Treatment
AC joint separation treatment depends on the injury grade. Many patients will experience a full recovery with non-operative treatment measures such as rest, ice, shoulder immobilization, pain and anti-inflammatory medications and physical therapy.
Surgery may be recommended by Dr. Millett if the AC separation is too severe or if non-operative treatment measures do not alleviate the separated shoulder symptoms. A variety of surgical measures may be used. The most common technique involves the reconstruction of the CC ligaments and removing the shoulder end of the clavicle. Dr. Millett will discuss all surgical options with each patient on an individual basis.
For additional information on an AC joint separation, or to learn more about treatment options for this shoulder condition, please contact Dr. Peter Millett, orthopedic surgeon and sports medicine specialist in the Vail, Aspen and Denver, Colorado area.