Shoulder Joint Separation (Subluxation)

Shoulder joint separation at a glance

  • Shoulder joint separation involves injury to the ligaments (fibrous tissue connecting bone to bone) in the AC joint (between the shoulder blade and the collarbone), ranging from partial tears to complete tears with dislocation.
  • Shoulder separation is different from a dislocated shoulder, which is when the upper arm bone is dislocated from the shoulder blade.
  • Shoulder joint separation is a common injury, especially in the athletic community.
  • Shoulder separation symptoms can include shoulder pain, tenderness, weakness, swelling, bruising, and a visible bump at the site of the injury.
  • Treatment includes rest, pain medication, strengthening exercises, and in some cases, surgery. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

Causes of shoulder joint separation

Shoulder joint separation is caused by the ligaments supporting the AC (acromioclavicular) joint becoming stretched or torn. This can be a simple injury through a sprain to the ligaments (Grade 1 shoulder joint separation). If the ligaments in the AC joint are torn, the condition is more severe (Grade 2). Tearing to AC joint ligaments and other ligaments attached to the collarbone can result in a complete dislocation of the AC joint (Grade 3).

Shoulder separation most commonly is caused by a blow to the shoulder, such as a fall directly on the shoulder as seen during football or extreme sports.

Symptoms of shoulder joint separation

Symptoms can vary depending on the severity of the injury, ranging from tenderness near the joint, to a complete dislocation of the joint. In general, shoulder separation symptoms include:

  • Shoulder pain, especially when reaching across the body
  • Tenderness over the AC joint (at the top of the shoulder)
  • Shoulder and arm weakness
  • Limited shoulder movement due to pain

Grade 2 and 3 separation may also include swelling, as well as bruising several days after the injury.

Grade 3 separation is usually accompanied by a popping sensation. If there is a complete shoulder dislocation, there will be a noticeable bump on the shoulder.

Treatment of shoulder joint separation

Treatment for Grade 1 or Grade 2 shoulder joint separation usually consists of rest, ice, a sling, and pain medication until the ligaments heal (usually within a few weeks). Activity should generally be continued as the separation heals, depending on the level of pain tolerance, to help maintain strength in the shoulder.

For Grade 3 separation, allowing a longer healing period (several weeks or months) or pursuing shoulder surgery are both treatment options. Surgery involves relocating the joint and repairing the torn ligaments. It is controversial whether rest or surgery is the better option to treat Grade 3 shoulder joint separation, as both options produce similar results.

If you have a separated shoulder, contact us to request an appointment with one of our orthopedic should specialists to learn about your treatment options.