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Definition A shoulder separation is an injury to the ligaments that connect the collarbone (clavicle) to the one of the shoulder bones (the acromion).

Diagram of Normal Shoulder
Details A shoulder separation is known medically as an acromioclavicular or AC separation. Shoulder separations are classified into one of six types based on severity. Most injuries, however, fall into types I, II, or III.

Type I: Strain of the supporting ligaments without tearing
Type II: Partial tearing of the supporting ligaments
Type III: Complete tearing of the supporting ligaments

X-rays of a Type III (Complete) AC Separation
Causes A fall on the point of the shoulder is the typical mechanism for a shoulder separation. A direct blow to the shoulder or a fall on an outstretched hand may also produce one. Football and hockey are common sports associated with shoulder separations.
Diagnosis A shoulder separation is diagnosed by a history of pain, tenderness and swelling at the AC joint. If the injury is severe, significant deformity may occur. X-rays are taken to confirm the injury and rule out fractures around the shoulder. Rarely, an MRI may be needed to evaluate tendons and muscles.

Clinical Images of a Shoulder Separation 1

Clinical Images of a Shoulder Separation 2
Treatment Nonoperative: Most shoulder separations can be treated with a sling and activity restriction followed by a physical therapy program. Recovery may take 6-8 weeks or more.

Operative: Occasionally, surgery in form a screw may be indicated. This form of surgery is controversial and is best discussed with your physician on an individual basis.

Maintaining excellent strength and stability of the shoulder and upper back muscles may help prevent some separations.