AC Joint Separation | Separated Shoulder

AC Joint Separation Overview

An AC joint separation is a common injury among physically active individuals. A separated shoulder is not truly an injury to the shoulder joint, but instead involves the acromioclavicular joint, otherwise known as the AC joint. In an AC separation injury, the clavicle (collarbone) separates from the scapula (shoulder blade), and is commonly caused by a fall directly on the shoulder or a direct blow. Dr. Peter Millett is a leading orthopedic shoulder specialist 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 can be responsible for injuring the surrounding AC joint ligaments, the acromioclavicular ligament (AC) and the two coracoclavicular ligaments (CC), which stabilize the AC joint.

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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.

What are the Symptoms of a Separated Shoulder?

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, and instability. Often a popping sound is heard at the time of injury.

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How is an AC Joint Separation Diagnosed?

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. 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.

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How is a Separated Shoulder Treated?

AC joint separation treatment depends on the injury grade. Many patients will experience a full recovery with non-operative treatment which includes 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 performing a distal clavicle resection. During this procedure, Dr. Millett removes a tiny part of the collarbone, then transfers the AC ligament from the bottom of the shoulder blade to the end of the prepared collarbone, replacing the torn ligament. Dr. Millet can discuss the different surgical options individually, depending on the specific injury.

For additional information on an AC joint separation, or to learn more about treatment options for this shoulder condition, please contact Dr. Peter Millett.

Have you sustained an AC joint separation?

There are two ways to initiate a consultation with Dr. Millett:

You can provide current X-rays and/or MRIs for a clinical case review ($250).

You can schedule an office consultation with Dr. Millett.

Request Case Review or Office Consultation

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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