Patient education: Separated shoulder (The Basics)

What is a separated shoulder? — 

This condition causes shoulder pain and swelling. It happens when certain ligaments in the shoulder joint tear or get stretched too much. Ligaments are strong bands of tissue that connect bones to other bones. The shoulder joint is made up of 3 bones: the collarbone (clavicle), shoulder blade (scapula), and upper arm bone (humerus).

The most common causes of a separated shoulder are falling on the shoulder or getting hit in the shoulder.

A separated shoulder can be mild or severe, depending on how many ligaments are torn. Doctors sometimes call a mild injury a "shoulder sprain."

What are the symptoms of a separated shoulder? — 

Symptoms can be mild or severe. They usually include:

●Shoulder pain

●Swelling in the shoulder

●Trouble moving the shoulder, or shoulder stiffness

●Bruising

In some cases, there might be a bump or point where the collarbone pushes out against the skin.

Will I need tests? — 

Maybe. Your doctor or nurse will talk with you and do an exam. They will also probably do X-rays of your shoulder.

How is a separated shoulder treated? — 

Treatment depends on how severe the injury is. If your separated shoulder is not severe, certain exercises can help after your shoulder starts healing. It's important to work with an expert to learn which exercises to do and how to do them correctly. This usually involves seeing an exercise expert, such as a physical therapist or athletic trainer. They can also tell you when to start these exercises and how often to do them.

Some exercises help keep your shoulder from getting too stiff. One example is pendulum exercises (figure 1). To do these, let your arm relax and hang down. Move your arm back and forth, then side to side, and then around in small circles in both directions. Do these exercises for 5 minutes, 1 or 2 times a day.

Other exercises can help strengthen the shoulder muscles. Your doctor, nurse, or exercise expert can show you how to do these.

When you do shoulder exercises, it's important to:

●Warm up your shoulder first. You can do this by taking a hot shower or bath, putting a warm moist towel or heating pad on your shoulder, massaging the area, or doing gentle movements.

●Start slowly, and gradually make the exercises harder over time. For example, when you do the pendulum exercises, make small circles with your arm at first. Over time, make this exercise harder by making bigger circles or holding weights in your hand. Follow all instructions for how often to do the exercises and how many times to repeat each motion.

●Know some soreness is normal. If you have sharp or tearing pain, stop what you're doing and tell your doctor or nurse.

If you have a severe separated shoulder, you might need surgery.

What can I do on my own to feel better? — 

You can:

●Rest – Avoid doing things that cause pain or strain your shoulder. These can include lifting things, reaching overhead or across your chest, or sleeping on the affected shoulder.

●Wear a shoulder sling (figure 2) – This is important to protect your shoulder and keep it still. Your doctor or nurse will tell you how long you need to wear it.

●Apply ice – Put a cold gel pack, bag of ice, or bag of frozen vegetables on your shoulder every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin. Use the ice (or other cold object) for at least 6 hours after your injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Take pain medicines – Ask your doctor or nurse about taking an over-the-counter medicine for pain. Examples include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve).

When can I do my usual activities again? — 

It depends on how severe your separated shoulder is. If it is mild, you might be able to return to your usual activities after a few days. If your injury is more serious, it might take weeks to months. If you do sports or other very physical activities, ask your doctor when you can start doing these again.

How can I prevent getting a separated shoulder again? — 

To reduce the chances of getting a separated shoulder again:

●Do exercises to keep all the muscles in your shoulder strong. Warm up your muscles before exercising to help prevent injury.

●Be careful during certain activities – Some sports can put you at risk of another shoulder injury. These include football, hockey, rugby, and skateboarding. Always wear proper padding and safety gear. You should also be aware when you are more likely to have a fall that could injure your shoulder. For example, it can help to be more careful when you are on a ladder or roof.

When should I call the doctor? — 

Call your doctor or nurse if:

●Your arm, hand, or fingers are blue, gray, or numb.

●The area around your shoulder looks abnormal, bent, or not the usual shape, especially if you heard your shoulder make a "popping" sound or had severe pain just before.

●Your shoulder feels loose or "gives out."

●Your pain or swelling gets worse.

●Your symptoms do not get in 2 to 3 days.

●You cannot move your shoulder or arm.

●You have signs of infection – This can sometimes happen if a bone was forced out of place and injured the skin. Signs of infection include a fever of 100.4°F (38°C) or higher, chills, red or purple skin, or fluid draining from a wound.

More on this topic

Patient education: Shoulder pain (The Basics)
Patient education: How to use a shoulder sling (The Basics)
Patient education: Frozen shoulder (The Basics)
Patient education: Shoulder arthroscopy (The Basics)

Patient education: Acromioclavicular joint injury (shoulder separation) (Beyond the Basics)
Patient education: Frozen shoulder (Beyond the Basics)