AC separation

What is a shoulder separation?

A shoulder separation occurs when there is damage to the AC joint, a small joint at the top of the shoulder. The AC joint, or acromioclavicular joint, is the joint where the clavicle (collarbone) and the highest point of the scapula (shoulderblade) come together.


What causes a shoulder separation?

An AC separation occurs after a fall onto the shoulder. This can occur with sports or trauma.


How is a shoulder separation diagnosed?

A shoulder separation is diagnosed with X ray and physical exam. Typically, tenderness occurs at the top of the shoulder. Depending on the severity and grade of the separation, a bump can be identified at the top of the shoulder as well.


How is a shoulder separation treated?

Lower grade (less severe) shoulder separations are treated without surgery. It may take 4-6 weeks to heal, usually with a sling at first for support. Occasionally physical therapy is necessary to assist in regaining strength and function. It may take longer for return to sport or heavy physical activity.


When is surgery is necessary?

Surgery may be recommended for significant (Grade 3 or higher) shoulder separations, depending on the deformity, hand dominance, functional activity level, and concern about the deformity. Surgery can often be performed in an arthroscopically assisted fashion.

Arthroscopically assisted AC reconstruction is augmented with graft tissue. This procedure is done through an incision just a few centimeters in length.