A separated shoulder is an injury to the ligaments that hold your collarbone to your shoulder blade. In a mild separated shoulder, the ligaments may just be stretched. In severe injuries, ligaments may be completely ruptured.

In most people, a separated shoulder doesn't usually require surgery. Instead, conservative treatment — such as rest, ice and pain relievers — is often enough to relieve the pain. Most people regain full shoulder function within a few weeks after experiencing a separated shoulder.

Signs and symptoms of a separated shoulder may include:

  • Shoulder pain
  • Shoulder or arm weakness
  • Shoulder bruising or swelling
  • Limited shoulder movement
  • A bump at the top of your shoulder

When to see a doctor

Contact your doctor if you experience persistent tenderness or pain near the end of your collarbone.

The most common cause of a separated shoulder is a blow to the point of your shoulder or a fall directly on your shoulder. The injury may stretch or tear the ligaments that hold your collarbone to your shoulder blade.

You may be at higher risk of a separated shoulder if you participate in contact sports, such as football and hockey, or in sports that may involve falls — such as downhill skiing, gymnastics and volleyball.

Most people fully recover from a separated shoulder with conservative treatment. Continued shoulder pain is possible, however, if:

  • You have a severe separation that involves significant displacement of the collarbone
  • You develop arthritis in your shoulder
  • Other structures around your shoulder, such as the rotator cuff, are damage

You're likely to start by seeing your family doctor or a general practitioner. However, if your separated shoulder is severe, you may be referred to a doctor who specializes in bones and joints.

Because appointments can be brief, it's a good idea to come prepared for your appointment. Write down any symptoms you're experiencing and any questions you want to ask your doctor, such as:

  • How severe is my injury?
  • Will I need surgery?
  • How long will it be before I regain strength in my shoulder?
  • Will I be able to play my sport again after I recover?
  • What can I do to protect my shoulder from future injuries?
  • Do you recommend any particular exercises to strengthen my shoulder?
  • Do you have any brochures or printed material that I can take home? What websites do you recommend for more information?

Your doctor will have questions for you, too. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • How severe is your shoulder pain?
  • When did your shoulder pain begin?
  • Do you have any numbness or tingling in your arm or hand?
  • Do you know what triggered your symptoms? For instance, have you experienced a fall or participated in contact sports recently?
  • Have you ever injured your shoulder in the past?
  • What, if anything, seems to improve your pain?
  • What, if anything, appears to worsen your pain?

A separated shoulder can usually be identified during a physical exam. X-rays can sometimes confirm the diagnosis and determine the severity of the injury. But in many people who have a separated shoulder, early X-rays are often normal.

Most people enjoy a full recovery after conservative treatment. A minor separation may heal within a few weeks. A more severe separation may take several weeks to months to heal. You may always have a noticeable bump on the affected shoulder, but it shouldn't affect your ability to use that shoulder.

Medications

Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help ease shoulder pain.

Therapy

  • Rest. Avoid activities that aggravate your shoulder pain, especially crossing the affected arm in front of your body. You might want to temporarily immobilize your arm in a sling to take pressure off your shoulder and promote healing.
  • Ice. Ice can reduce shoulder pain and swelling. Use a cold pack for 15 to 20 minutes at a time.
  • Physical therapy. Stretching and strengthening exercises can help restore strength and motion in your shoulder.

Surgical and other procedures

If pain persists or if you have a severe separation, surgery might be an option. Surgery can reconnect torn ligaments and reposition or stabilize injured bones.

Jan. 23, 2014