OrthoVirginia Blog

Shoulder Separation

Dr. Klein specializes in shoulder injuries and sports medicine and practices in our Reston office.

A shoulder separation is an injury to the acromioclavicular joint(also called the AC joint) on the top of the shoulder. The AC joint is where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion). The most common cause for a separation of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint. The injury can range from a little change in configuration with mild pain, to quite deforming and very painful.

Shoulder separation vs. shoulder dislocation:

These two injuries are commonly confused, but they are very different conditions. As described above, the shoulder joint is located at the junction of three different bones: the clavicle, the scapula, and the humerus. In a shoulder separation, the junction of the clavicle and scapula is disrupted. In a shoulder dislocation, the humerus (arm bone) is displaced from the socket.

Symptoms and Diagnosis:

Pain is the most common symptom of a separated shoulder, and is usually severe at the time of injury. Evidence of traumatic injury to the shoulder, such as swelling and bruising, are also commonly found. The injury is easy to identify when it causes deformity. When there is less deformity, the location of pain and X-rays help the doctor make the diagnosis. Sometimes having the patient hold a weight in the hand can increase the deformity, which makes the injury more obvious on X-rays.


Treatment of a separated shoulder depends on the type of injury. The initial treatment of a separated shoulder consists of controlling the inflammation, and resting the joint. The early steps of treatment should consist of a sling, ice pack and anti-inflammatory medications.

Surgery can be considered if pain persists or the deformity is severe. A surgeon might recommend trimming back the end of the collarbone so that it does not rub against the acromion. Where there is significant deformity, reconstructing the ligaments that attach to the underside of the collarbone is helpful. This type of surgery works well even if it is done long after the problem started.

Whether treated conservatively or with surgery, the shoulder will require rehabilitation to restore and rebuild motion, strength, and flexibility.

For more information about Dr. Klein, read his bio on our website.