There are various types of common shoulder injuries. One of the most painful is a shoulder separation, also known as an acromioclavicular joint separation (aka AC separation).

What Happens with a Shoulder Separation?

A shoulder separation occurs when the clavicle (the collar bone) separates from the scapula (shoulder blade). An AC injury can be classified at different grades depending on the extent of the joint damage and the amount of separation. There are big differences between a mild dislocation and a complete shoulder separation.

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  • Grade I – This is a common shoulder injury to the AC joint. It represents a slight displacement of the joint in which the ligament is partially torn or stretched beyond normal.

  • Grade II – This is a partial dislocation of the shoulder in which the AC ligament is completely torn. However, the coracoclavicular ligaments are still intact.

  • Grade III – This is a full separation of the shoulder joint. The acromioclavicular, coracoclavicular and the capsule surrounding the joint are completely torn. There will be a very noticeable bump on the shoulder and the shoulder will fall under the weight of the arm.

  • Grades IV-VI — There are actually more full separation grades depending on the severity of the separation and ligament damage. Any that fall in this range will require surgery to repair while others may be healed with physical therapy and other medical treatment as recommended by a physician.


Immediate Treatment


As with any joint injury, the initial first aid treatment should follow the RICE principle. This stands for rest, ice, compression and elevation. Apply ice (not directly to the skin) and pressure to reduce pain and swelling. Immobilize the shoulder with a sling to minimize further risk. An anti-inflammatory drug may be recommended to also help reduce swelling and pain.

Long-Term Treatment and Therapy

Every shoulder injury will vary and all will require different paths to repair and recovery. Surgery is usually only recommended with complete high-grade shoulder separations and typically only when other forms of treatment and therapy fail. Otherwise, using a sling and avoiding lifting the arm will help the damaged joint rest and recover. Physical therapy will help regain mobility and increase strength. Depending on the severity of the injury, you can expect up to 6-8 weeks of physical therapy. A throwing athlete like a baseball player or football quarterback may be out of action for 4-6 months to ensure a full recovery.

If you think you have a shoulder injury or have experienced a shoulder dislocation, consult your physician and contact CORE Physical Therapy today to schedule a therapy consultation. We deal with shoulder injuries often because they are very common with athletes. We can help you get on the road to recovery through targeted physical therapy programs that will allow you to regain mobility and strength.