As we’ve mentioned on the blog in the past, a shoulder separation involves an injury to the acromioclavicular (AC) joint. The separation occurs when the ligaments between the clavicle and the part of the shoulder blade known as the acromion are torn. Tears in these ligaments loosen the joint connection between the collarbone and the shoulder blade, causing the two areas to separate from one another, hence the name shoulder separation.
Like a number of soft tissue injuries, shoulder separations are classified into different grades based on their severity. Shoulder separations are classified into one of three grades, and in today’s blog, we take a closer look at the three grades of shoulder separations, and we explain how each injury is typically treated.
Grading Separated Shoulders
Shoulder separations are quite common in contact sports or in situations where someone falls and lands hard on their shoulder. For example, a football player who leads with their shoulder while making a tackle or a cyclist who flips over their handlebars and lands on their shoulder may each experience a shoulder separation as a result of damage to the AC joint ligaments. If you have experienced trauma to the shoulder area and are dealing with any of the following symptoms, you may want to be evaluated for a possible shoulder separation:
- Pain at the top of the shoulder
- Range of motion restrictions
- Shoulder and arm weakness
- Tenderness
- Swelling
- One arm hanging differently than the other
If you suspect that you have suffered a shoulder separation, your doctor will ask about your symptoms, conduct a physical exam and may order an imaging test to take a closer look at the soft tissues in the area. If a shoulder separation is confirmed, they will group it into one of three grades. Here’s a closer look at each of the three classifications of shoulder injuries.
- Grade I – A Grade I shoulder separation is the most mild form of injury. It involves a sprain of the AC ligament that does not move or shift the collarbone, and the area looks normal when viewed with an X-ray. Rest, anti-inflammatory medications and gentle return to activity can typically help a person overcome a Grade I shoulder separation.
- Grade II – A Grade II shoulder separation is marked by a slight tear in the AC ligament and/or damage to the coracoclavicular (CC) ligament. When viewed with the help of an imaging test, the doctor may notice a slight misalignment of the collarbone and possibly a visible bump at the site of the separation. Longer periods of rest coupled with weeks of physical therapy can generally help to resolve a Grade II shoulder separation.
- Grade III – A Grade III shoulder separation is the most serious of the three types of separations. Severe trauma to the area results in a complete tear of the AC and CC ligaments, and the AC joint is clearly displaced when viewed through an X-ray. Despite the significant nature of the injury, many patients can still make a strong recovery through conservative techniques. Icing, rest, controlled stretching and a prolonged physical therapy program can oftentimes help these ligaments heal and resolve symptoms. In rare instances, surgery is needed to address the ligament damage.
So if you are dealing with pain and discomfort along the top side of your shoulder after the area absorbed trauma, consider reaching out to a shoulder specialist to see if you actually separated your AC joint. Odds are you won’t need surgery, but you will want to proactively pursue some active treatments to alleviate symptoms and restore function in the shoulder. For more information, or for help with a different shoulder issue, reach out to Dr. Holloway and his team today at (865) 410-7887.
