Separated Shoulder Injury Sidelines Another Athlete……

Whether a soccer player in Carlsbad, mountain biker in San Diego,  or an ice hockey player on the ice, shoulder injury such as a separation are a dime-a-dozen but need to be taken seriously.  Pittsburgh Steelers’ rookie Martavis Bryant is the latest professional football player to suffer an AC joint sprain, commonly known as a shoulder separation.sports-shoulder-injury

The wide receiver could miss much of the season, depending upon the extent of the damage in his shoulder, ESPN reported.The source of the shoulder pain resulting from such a shoulder injury is the acromioclavicular (AC) joint, between the shoulder blade (scapula) and collarbone (clavicle) on the top of the shoulder. The scapula and clavicle form the joint socket, which holds the rounded end of the arm bone (humerus). A shoulder separation happens at the point where the shoulder blade (acromion) attaches to the clavicle.

Falling on a shoulder while the arm is extended is often responsible for an AC joint separation. This shoulder injury can happen while playing sports, or when riding a horse or bicycle.  Extraordinarily common with mountain bikers going over the handle bars.  A collision or direct blow to the shoulder also may cause this shoulder injury.


The impact of falling or getting hit damages ligaments that stabilize the joint. When the ligaments under the clavicle tear, a separation of the collarbone and wingbone occurs. The wingbone shifts into a lower position, producing a bulge above the shoulder.

The severity of AC sprains varies. In some cases, people feel only slight shoulder pain, along with some swelling and bruising. More serious shoulder injuries involve additional pain and physical deformity. The more a joint is distorted, the longer it takes for the patient to recover.

Shoulder separations are classified in six categories, based on the degree of damage. A Type 1 separation, in which the bones are not forced out of alignment, is only an injury to the capsule that surrounds the AC joint. Patients feel pain, but typically recover quickly.

A person with a Type II separation also has an injured AC joint capsule, as well as a partially torn coracoclavicularone ligament (which supports the clavicle). The injury is often characterized by a small bump. A Type III sprain is similar to a Type II separation, but more extensive. The bump on the top of the shoulder is pronounced.shoulder-injury-types

A less common diagnosis, Type IV shoulder separation, features a clavicle that has been forced behind the AC joint. In a Type V separation, the end of the clavicle punctures the muscle above the joint, causing a large bump. A Type VI separation is rare. It involves the clavicle being pushed down, below the corocoid (a section of the scapula).


Treatments for AC joint separations include rest, ice and medication. Patients often wear slings, and refrain from intense physical activity, until the pain subsides and normal joint mobility returns. Most people, even those who suffer deformities, regain shoulder function. Some continue to experience pain, because the AC joint has been misshapen in a way that causes bones to rub together. Cartilage damage and arthritis also can cause persistent pain.


If a patient’s condition does not improve, surgery is an option. A common procedure entails trimming the end of the collarbone to prevent it from irritating the shoulder blade.  Dedicated shoulder surgeons like the award winning doctors at Orthopedic Surgery San Diego can perform even more cutting edge procedures that reconstruct the damaged shoulder ligaments.  To correct deformities, orthopedic surgeons reconstruct the ligaments that support the bottom of the collarbone.  Call Orthopedic Surgery San Diego for an appointment to discuss your injury.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow