Separated Shoulder (A/C joint)

Symptoms: Shoulder pain and point tenderness at the junction of the clavical/collar bone and the front point of the scapula AKA acromioclavicular joint. It is usually accompanied by laxity of the joint which can be seen by pressing down on the collar bone and seeing a piano key effect, movement, and pain at the A/C joint. The collar bone portion of the A/C joint is usually high with visible inflammation present with acute injury. Shoulder pain with movement.

Causes: Traumatic injury is the most common mechanism of injury. Usually following a fall on the affected shoulder in which the ligaments that secure the collar bone to the shoulder blade partially or fully rupture and damage to the A/C joint capsule occurs. Sometimes damage can occur to the collar bone as well resulting in fracture.

Relief: The correct treatment approach is determined based on the level of severity of the injury. Shoulder seperations are classified into Grade I, II, or III. Grade 1 shoulder seperation is usually a sprain/strain senario where the soft tissue structures/ligaments are overstretched but still intact with possible partial tearing. Grade II shoulder seperation is usually a moderate to severe sprain/strain with definite partial tearing of ligamentous structures. And Grade III is severe sprain with complete tearing of ligamentous structures resulting in moderate to severe laxity. Grade III shoulder seperations are usually treated with surgical intervention although conservative treatment can sometimes be effective.

Initially immobilization, anti-inflammatory medication, and Physical Therapy intervention is the most common treatment. Anti-inflammatory injection is used during sub-acute phase. Physical Therapy intervention includes pain/inflammation reducing modalities incuding: ultrasound, laser, iontophoresis, and electric stimulation. Manual Therapy treatment that includes passive range of motion of the scapula and shoulder joint. Gravity reduced excercises to address posture and muscles that stabilize the shoulder girdle within pain free range to reduce inflammation, reduce stress to A/C joint and allow healing to occur