Treating a Shoulder Separation, Conservatively and Surgically

Symptoms of a shoulder separation can range from mild discomfort to excruciating pain. The injury occurs when the clavicle separates from the scapula, stretching or tearing the acromioclavicular (AC) joint. This can cause pain that lasts for a few weeks or many months. It’s an injury most typically experienced by athletes, especially those involved in high-contact sports.

Most commonly, a shoulder separation will be classified into one of three grades:

  • Grade I – The ligament is partially stretched or torn, resulting in a slight displacement of the joint. Symptoms include tenderness when the joint is touched, bruising and minor pain when moving the arm.
  • Grade II – This is a partial joint dislocation in which the AC ligament is completely torn. Symptoms include swelling, moderate to severe joint pain, and pain when moving the arm.
  • Grade III – This is a total joint separation in which the ligaments and capsule surrounding the joint are torn. Symptoms include severe pain and swelling. A telltale sign of a Grade III shoulder separation is shoulder deformity and a bump on the top of the shoulder.

There are three additional grades to classify AC separation (IV, V, VI), but these are uncommon and typically the result of a serious motor vehicle crash or other high-energy injury.

Generally, a grade I, II or III shoulder separation does not require surgery and conservative treatment provides adequate relief. Methods commonly recommended by Florida Medical Orthopaedics, Sports Medicine & Spine include icing the joint, using a protective sling, taking anti-inflammatory medication and physical therapy. If you’ve already tried conservative treatment for your shoulder separation and are still experiencing pain and discomfort after two to three months, you may want to consider your surgical options.

Dr. Ira Guttentag, M.D., F.A.C.S., of Florida Medical Orthopaedics, Sports Medicine & Spine performs minimally invasive surgery for individuals suffering from a Grade III or higher shoulder separation. This procedure involves reconstructing the coracoclavicular ligaments, excising the distal end of the clavicle, and stabilizing the AC joint with a screw or suture loop.

Dr. Guttentag is board certified by the American Board of Orthopaedic Surgery and has served as the Medical Director and Head Team Physician for the Tampa Bay Lightning since 2002. He has extensive experience in sports medicine and shoulder reconstruction, so you can trust that he will help you get better quickly so you can resume your normal daily activities.

To schedule a shoulder separation consultation with Dr. Guttentag, contact Florida Medical Orthopaedics, Sports Medicine & Spine today.

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