How to Return from a Separated Shoulder
There's a difference between a separated shoulder and a dislocated shoulder. If the ligaments in the shoulder joint (the abbreviated medical term is AC joint) are stretched or torn, doctors call it a separated shoulder or sprained shoulder. A dislocated shoulder means the bone in the upper arm (humerus) has popped out of its socket.
A separated/sprained shoulder is fairly common and relatively easy to treat without surgery. Shoulder dislocations are much more serious and may require surgery to correct. The information in this report deals with a separated or sprained shoulder.
How It Happens
A separated shoulder happens when an athlete takes a direct hit on the shoulder from another athlete, falls and hits the ground first with the shoulder, or hits the ground with an extended arm. The trauma can stretch or tear the ligaments that act to stabilize the shoulder joint. The injury may cause the bones in the shoulder to separate, creating a bump on top of the shoulder. Typical scenarios for a separated shoulder are:
- a quarterback taking a hit during the passing motion
- a hockey player being checked by an opponent
- a gymnast breaking a fall with the arm
By the Numbers
Number of bones that make up the AC joint
Number of classifications used by physicians to determine treatment for separated shoulders
Percentage of football injuries involving shoulder separation, according to one study
Who’s At Risk
Contact sports athletes, such as football and hockey players, are at higher risk for shoulder separations. Next in line are athletes who frequently fall during training or competition, including skiers, gymnasts and cyclists, as well as rugby, lacrosse and volleyball players.
- Shoulder pain, bruising, and/or swelling
- Tenderness to touch on the outside tip of the collarbone
- Shoulder weakness, perhaps arm weakness
- Restricted shoulder joint movement
- A bump on the top of the shoulder or deformed shoulder
“With AC joint sprains, poor posture can make the pain worse,” says Anna Hartman, a physical therapist at Athletes’ Performance in Phoenix, Arizona. “Immediately after injury you will want to keep the arm in a sling so the weight of the arm does not pull on the joint and open it up.”
Here are other immediate care measures:
- Stop the activity that caused the injury.
- Apply ice packs for 15-20 minutes, 3-4 times a day.
- Aspirin, acetaminophen, ibuprofen and naproxen may relieve pain. Aspirin, ibuprofen and naproxen may relieve pain and reduce inflammation.
After initial treatment, Hartman says you can progress to exercises with a focus on improving scapular (shoulder blade) stability, posture improvement and rotator cuff strength.
Incorporate these prehab exercises into your comeback routine:
- Y,T,W & L - Standing
- Foam roll - Pec
- Thoracic spine mobility with tennis ball
- Heel sit mid-thoracic rotation stretch
- Floor posture slides
- Internal Shoulder Rotation with Cables
- External Shoulder Rotation with Cables
Depending on the severity of the injury, comeback time can range from a couple of weeks after a minor sprain to several months for a contact sport athlete who has sustained a serious (grade 3 or higher) sprain.
How to Avoid This Injury
Wear the gear appropriate to your sport (shoulder pads in football, hockey) to protect the shoulder.
Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.
- Anna J. Hartman, MS, ATC, CSCS, Manager, Performance Physical Therapy Services, Athletes’ Performance, Phoenix, Arizona
- The Steadman-Hawkins Clinic
- National Athletic Trainers’ Association
- The Physician and SportsMedicine