Shoulder Separation

separated shoulder

What Is A Shoulder Separation?

A shoulder "separation" refers to a tearing of the acromioclavicular joint. Shoulder "separation" (an acromioclavicular joint injury) should not be confused with a shoulder "dislocation" (a glenohumeral joint injury).

The acromioclavicular (AC) joint is comprised of the section where the collar bone (the clavicle) meets the Acromion (the most superior projection of bone off the scapula).

A tearing of this joint may occur as a result of a fall on the shoulder, and is common in sports such as football, hockey, rugby, and mountain biking. The severity of the tear will often determine how long it will take the joint to heal as well as how much residual pain or disability will result.

AC joint injuries may also occur with repetitive sprains as in weight lifting. Many weightlifters inflict "micro" trauma to their AC joint by going too deep into a dip exercise, or by taking their shoulders too far back in a fly exercise or bench press exercise.

Most AC joint injuries are only mild to moderate and will heal with little or no complication.

What's Going Wrong In A Shoulder Separation?

1. Adhesion. Adhesions do not cause shoulder separations directly. Instead, adhesions are a result of a shoulder separation. When the acromioclavicular ligament tears, it heals with scar tissue. In this case, some of the scar tissue that is laid down is GOOD. It adds stability to the joint. Remember, with an AC separation, there are NO muscles that cross the joint. Therefore, it doesn't have to be as resilient like muscle. On the other hand, too much scar tissue can result in a very tight AC that gets very painful with certain movements. HOWEVER, adhesion buildup in the middle traps, deltoids, and subclavius muscles can abnormally pull on the clavicle and prevent the AC joint from healing. Once the adhesions are cleared, the joint can heal.
2. Strength and Flexibility Imbalances. Because muscles do not cross this joint, the strength and flexibility of the rotator cuff and other shoulder muscles do not play a very large role with shoulder separations. HOWEVER, again, the traps, deltoids, and subclavius (which attach to the upper parts of the clavicle / scapula) can create some degree of imbalance in the clavicle and AC joint.
3. Structural Damage or Alteration. Structural differences in the shape of the clavicle and the AC joint play a much larger role for AC separations. These are structural alterations that we are born with. Everyone's AC joint is a little bit different in size, shape, and angle that it attaches. The more shallow the angle of the joint, the more likely the AC joint is to separate. On the other hand, the more steep the angle, the more likely it is for the clavicle to break rather than separate.

How Can ART Help A Shoulder Separation?

The most important aspect of allowing an AC joint injury to heal is rest and avoiding activities that will strain it, such as the weight lifting mistakes mentioned above. More severe AC joint injuries will require the use of braces or taping techniques that hold the joint in alignment and in a stable position while the ligaments have a chance to become strong again.

In the case of AC joint injuires, scar tissue is good, because we want as much scar tissue to form around that AC joint so that it becomes stable again. But, too much can be detrimental. Remember, the AC joint is connected by a ligament, NOT muscle or tendon. This ligament needs to be strong and firm. A special technique called "cross friction massage" is very useful for stimulating the increase of scar tissue development around the AC joint so that it becomes stable. This is a non-surgical technique and is the most common treatment technique that we use in our office for AC joint injuries.

Success Stories Of Those With Shoulder Separations

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