A shoulder separation is tearing of the ligaments that hold your collarbone to your shoulder blade. Ligaments are strong bands of tissue that connect one bone to another. When the ligament tears, your collarbone may move out of its normal place and push up under the skin to the top of your shoulder. When you have a shoulder separation, you may also have broken bones.
Some separations heal by themselves in 2 to 4 weeks. A severe separation may take 2 months or more to heal.
What is the cause?
A shoulder separation is usually caused by a fall or a direct hit to your shoulder. It also can result from a fall on your outstretched hand or arm.
What are the symptoms?
Symptoms may include:
Severe pain at the moment you are injured
Limited shoulder movement
Tenderness on top of your shoulder at the end of your collarbone
Swelling and bruising of your shoulder
A change in the shape of your shoulder that makes it look crooked or out of place
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. You will have X-rays.
How is it treated?
Most often, you will need to wear a sling or shoulder immobilizer. The sling or immobilizer will keep you from lifting your arm away from your chest and help the ligaments heal. Your shoulder will be kept immobile until you are pain free. Then you will start rehabilitation exercises, because it is important to move your shoulder to prevent a frozen or stiff shoulder. You may need to work with a trainer or physical therapist to strengthen your shoulder.
In some cases surgery may be needed to repair the ligaments.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time.
Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Wear a sling as directed by your healthcare provider.
Rest your shoulder and arm on the side of the separation until the pain goes away.
Ask your provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent shoulder separation from happening again?
Exercise and lift weights under the supervision of a trainer or physical therapist to strengthen your shoulder muscles. This also helps to strengthen your ligaments and tendons.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-21 Last reviewed: 2014-09-25
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Shoulder Separation: References
DeLee, Jesse C., David Drez, and Mark D. Miller, Orthopaedic Sports Medicine: Principles and Practice, Saunders; 3rd ed. 2009.
Greene, Walter B., M.D., Griffin, Letha Y. (Ed), Essentials of Musculoskeletal Care, 4th ed. Amer Academy of Orthopaedic. 2010.
Kisner, Carol, and Lynn Colby, Therapeutic Exercise: Foundations and Techniques, F. A. Davis Company; 6th ed, 2012.