Shoulder Separation

Acromioclavicular joint (AC joint) dislocation or shoulder separation is one of the most common injuries of the upper arm. It involves separation of the AC joint and injury to the ligaments that support the joint. The AC joint forms where the clavicle (collarbone) meets the shoulder blade (acromion).

What are the causes of shoulder separation?

It commonly occurs in athletic young patients and results from a fall directly onto the point of the shoulder. A mild shoulder separation is said to have occurred when there is AC ligament sprain that does not displace the collarbone. In a more serious injury, the AC ligament tears and the coracoclavicular (CC) ligament sprains or tears slightly causing misalignment in the collarbone. In the most severe shoulder separation injury, both the AC and CC ligaments get torn and the AC joint is completely out of its position.

What are the symptoms of shoulder separation?

Symptoms of a separated shoulder may include shoulder pain, bruising or swelling, and limited shoulder movement.

How is shoulder separation diagnosed?

The diagnosis of shoulder separation is made through a medical history, a physical exam, and an X-ray.

What are the treatment options?

Nonoperative treatment options

Nonoperative treatment options include rest, cold packs, medications, and physical therapy.


Surgery may be an option if pain and disability persist or if you have a severe separation. Reconstruction is performed by rebuilding the CC and AC ligaments with allograft (cadaver). This surgery is often performed through an open technique and sometimes assisted with arthroscopy. The new ligaments gradually heal and help restore the normal anatomy and function of the shoulder. Post-operative rehabilitation includes use of a shoulder sling for 6 weeks and then physical therapy exercises to restore movements and improve strength. Return to full activity is usually 5-6 months after surgery.