Shoulder Separation Repair – The AC Joint Injury


A shoulder separation injury is quite painful. It is actually not an injury to the shoulder; rather it is an injury to the acromioclavicular joint, also known as the AC joint, which is located where the collarbone connects to the highest point of the shoulder blade.

The most common cause of a shoulder separation injury is a fall onto the shoulder. A fall with enough impact or the right angle will result in the ligaments that stabilize the AC getting damaged, which cause the shoulder to separate.

If the force of the fall is great enough, the collarbone and the wing bone separates causing the wing bone to move down, which can be identified by a lump or bulge above the shoulder. The injury can result in very little damage to severe damage causing great deformity. The greater the deformity means it will take much longer for the shoulder to be pain free.

· A mild shoulder separation involves a sprain of the AC ligament that does not move the collarbone and looks normal on X-rays.

· A more serious injury tears the AC ligament and sprains or slightly tears the coracoclavicular (CC) ligament, putting the collarbone out of alignment to some extent.

· The most severe shoulder separation completely tears both the AC and CC ligaments and puts the AC joint noticeably out of position.

A mild to moderate shoulder sprain or separation can heal without surgical intervention. The most common nonsurgical treatments include rest, pain medication and physical therapy. People typically must wear a sling, which keeps the arm and shoulder from bearing weight that can aggravate and lead to further injury.

Shoulder Separation Surgery

Surgery should be considered if pain persists and the deformity is severe. A surgeon may recommend trimming the collarbone so that it does not rub against the nearby acromion.

When the deformity is severe, surgery may be needed to reconstruct the ligaments that attach underneath the collarbone. When surgery is required, extensive rehabilitation is required to gain back full mobility and pain free movement.

Shoulder separation injuries can happen to anyone. The most common cause is a fall, trip or direct blow to the shoulder area. Active youths and adults that participate in sports as well as elderly individuals that slip or fall are the most at-risk individuals.

If you have experienced a fall or direct impact to the shoulder, you should see your healthcare provider immediately to have it assessed.