AC Separation
Perhaps the most common traumatic injury to an athlete’s shoulder is known as a shoulder separation. This occurs at the acromio-clavicular joint (A/C joint) where the collarbone and shoulder meet. This joint is on top of your shoulder and should be differentiated from the glenohumeral joint (the ball and socket joint).
Causes
An A/C separation occurs when the acromion (bone at top of shoulder) is pushed down from a force, such as a fall. The clavicle, which is attached to the acromion by ligaments, tries to move with the acromion. The force is too much and the ligaments either stretch or tear depending on the strength of the force.
Symptoms
- Pain with overhead reaching and reaching across your body toward the other shoulder
- Popping, clicking or grinding at top of shoulder
- Tenderness at top of shoulder
- Bruising and swelling at shoulder
- A bump at the top of the shoulder
Treatment
Mild AC Separation
A sling is used to immobilize the shoulder. This will help to minimize the pain. Ice and anti-inflammatories for the first 2 days will also help with the pain and swelling. Once pain has decreased the sling may be discarded. It may be helpful to work with a physical therapist or trainer to make your recovery smoother. Treatment begins by allowing the pain to subside and then by gradually increasing motion as tolerated. Full recovery is often achieved by 6 weeks.
Severe AC Separation
May need surgery to repair. A significant deformity will be seen at the shoulder. Overhead athletes and heavy laborers are two groups where surgical intervention is more commonly needed. The surgery may consist of arthroscopic removal of a small piece of bone at the end of the clavicle (mumford procedure) vs. an open repair of the AC joint.