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Understanding shoulder separation

This injury usually heals without surgery.

A shoulder separation isn't actually a problem with the shoulder joint.

In reality, it involves the acromioclavicular (AC) joint—the part of the body where the collarbone meets the top of the shoulder blade. Separation occurs when the ligaments that surround and support the AC joint stretch or tear. As a result, the collarbone can separate from the shoulder blade and slip out of place.

How it happens

Falling directly on the shoulder is the most common cause of shoulder separation, according to the American Academy of Orthopaedic Surgeons.

Having a bump or bulge on the top of your shoulder may be a sign that you have a separated shoulder. Bumps or bulges can form when the collarbone and shoulder blade separate.

If you think you've separated your shoulder, call your doctor right away, especially if lifting your injured arm with your other arm eases the pain, advises the American Academy of Family Physicians.

Treatment

Doctors typically treat separated shoulders conservatively. Consequently, if a physical exam or x-ray confirms that your shoulder is separated, your doctor may advise treatments such as:

  • Rest. You may need to temporarily immobilize your arm in a sling or another type of support.
  • Ice. Putting an ice pack wrapped in cloth on the shoulder soon after injury can ease pain and swelling.
  • Medication. Pain relievers that your doctor either prescribes or recommends can help you feel more comfortable.
  • Physical therapy. Shoulder exercises can help you regain muscle strength, flexibility and a full range of motion.

Surgery is typically a last resort for a separated shoulder, and doctors generally take a wait-and-see approach to give the injury a reasonable amount of time to heal.  

Rehabilitation is necessary after surgery to restore strength and flexibility in the shoulder.

Reviewed 12/12/2023

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