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Shoulder Separation

Acromioclavicular Joint (ACJ) Injury

What is the acromioclavicular joint?

The acromioclavicular joint (ACJ) along with coracoclavicular ligaments connects your collarbone (clavicle) and your shoulder blade. You may recognise this area as a raised bump at the tip of your shoulder.

What causes shoulder separation?

An ACJ injury, or shoulder separation, often happens if you fall onto an outstretched arm or take a hit to the tip of your shoulder, such as when falling off a bicycle or landing on your shoulder when making or getting tackled in a sport like rugby.

What are the symptoms of shoulder separation?

Symptoms of acute shoulder separation include:

Pain - for acute injuries the pain is usually localised to a specific point of the shoulder. You may find it is worse with your arm hanging down by the side. If the injury is longstanding you can still get pain in the area when you try to lift your arm above shoulder height or bring your arm across your body - as if to scratch the back of the other shoulder.

Limited shoulder range of motion - mostly due to pain, particularly if the injury is recent.

Swelling, bruising and tenderness at the tip of the shoulder. 

Depending on the severity of the injury you may also notice the collarbone sticking up at the tip of the shoulder.

When to seek medical advice regarding ACJ injuries

ACJ separation injuries are common in sports that involve body-to-body collision (rugby league/union), and body to surface impact (martial arts or cycling). They can be described/classified by how badly you tear the joint capsule, the surrounding ligaments and the final position of the collarbone and this classification determines how the injury is treated.

The most common types of ACJ injuries (Types I-II) do not require surgery. A Type III injury may require surgery depending on your individual case and higher-grade injuries will usually require surgical repair. 

Although the majority of ACJ separations do not need surgery, frequently, a fracture at the tip of the collarbone (distal clavicle fracture) can occur along with the injury or present like an ACJ injury. This can affect how the injury is managed and affect your recovery time. For these reasons, it is important you seek medical advice to confirm the diagnosis and assess the severity if you get a shoulder separation injury.

If you have injured your shoulder playing sport and would like advice on how to recover and safely return to sport Click here to schedule an appointment with Dr Ade.

I can meet you in Central London or Hertfordshire or via a Zoom video consultation

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