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.


Shoulder pain.  It can plague us all, even the great ones!  There is very little debate over who the NFL’s greatest wide receiver of all time is. Jerry Rice is the best there ever was. But did you know that Jerry’s football DNA has been passed on to a son, Jerry Rice Jr.? That is correct. He is an incoming rookie wide receiver.  With some experience at my old alma mater, UCLA.   He was set to potentially follow in his father’s footsteps until an unfortunate injury. Jerry Rice Jr. suffered a significant shoulder injury when he landed awkwardly on it during practice. The diagnosis: a labrum tear.

The labrum is a fibrous cartilage that is located in the shoulder joint. The shoulder joint is one of the most common examples of a ball and socket joint. This joint is where the shoulder blade cavity (glenoid cavity) and upper arm bone (humerus) meet and form the respective ball and socket. The labrum acts as a joint stabilizer that both deepens the socket and sucks the humerus into the socket.

If the labrum tears, the shoulder can become unstable. Labrum tear causes decreased range of motion, decreased strength, and pain. In addition, severe labrum tears tend to cause abnormal shoulder joint interactions such as grinding, locking, popping, and catching. While these interactions sound like a set of trendy new dance moves, they can be painful and quite discomforting.

There are a number of different types of labrum tear; the main types are SLAP tears and bankart tears, but these also has a set of sub-categorizations based on the severity of the tear. A SLAP (Superior Labrum Anterior and Posterior) tear involves the top of the shoulder and essentially involves the disconnection of the labrum from its ball and socket attachment points. A SLAP tear is usually diagnosed in terms of severities from type 1 to type 4. Type 1 is a partial tear where the edges of the labrum fray but do not become completely detached. Type 2 is the most common and does involve a complete detachment of the upper labrum from the socket. Type 3 is where the tear from the socket causes the labrum to actually folds over itself between the ball and socket. Type 4 is where the tear actually extends to the bicep tendon. The bankart tear involves the front of the shoulder. The reverse bankart tear involves the back of the shoulder.

Treatment can involve anything from rest followed by rehabilitation to arthroscopic surgery.  In the case of type 1 SLAP labrum tears the typical treatment would just be rest, anti-inflammatory medications, and rehabilitation if needed. Most large tears will require surgery, which will involves trimming, repair or reattachment. After successful surgery, recovery time involves using a sling for approximately a month followed by anywhere from a month to three months of rehabilitation to regain complete strength and range of motion.

In the case of Jerry Rice Jr., his torn labrum did require surgery and it is considered season ending. But if he has half of the heart that his father had, you can bet that Jerry Rice Jr. will have a bright future in the NFL.

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