Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this afternoon to quickly receive a condition that I see quite often in my office, and that is the Shoulder Separation also known as Acromioclavicular Separation or AC Separation, not to be confused with a Shoulder Dislocation. We often hear people say that they separated their shoulder, but what does that mean? Today, I will answer that question.
In the image above by Healthwise, Incorporated, we can easily see the three different grades of an AC Separation. The grades of the AC Separation are based on the severity of the injury. There are also six different types of AC Separations based on the directionality of the collar bone after separation. Grade I (first degree) indicates some tearing of the AC ligament, but there is no instability. Grade II (second degree) indicates a rupture of the AC ligament, and Grade III (third degree) involves tearing of the coracoclavicular ligaments. Both the Grade II and the Grade III separations are unstable.
These patients usually come into my office with shoulder pain following either a fall on an outstretched arm or a fall onto the top of the shoulder. I see the fall onto the top of the shoulder mainly in football players, mostly quarterbacks, and we see the fall on the outstretched arm in football players; however, I see it a lot in my extreme sports patients such as skateboarders, BMX riders, motocross, cyclocross, and so forth.
All AC Separations can be treated conservatively; however, Grade III separations will leave a permanent bump as depicted in the image below, and for some patients may be a site for minor persistent discomfort. Surgery is an option for those that require cosmetic perfection, or for those that attempted conservative care and are not back to full function. Standard care for an AC Separation includes some time in a Kinney-Howard sling followed by mild isometric and on to isotonic exercises with the focus being the deltoid and upper trapezius muscles followed by biceps and pectoral exercises. This is also couple with soft-tissue therapies such as Active Release Techique (ART) and Graston Technique to encourage healing and prevent scar tissue formation.
If you are struggling with Shoulder Pain contact my office today (480) 366-4041. We can Help!