Shoulder Separation What isa shoulder separation? A shoulder separation occurs when you tar the liga- ‘ments that hold your collarbone (vice) tothe aunt ‘where it meets the shoulder bate, Your collarbone may move out of ts normal place and ush up the skin.on the top of your shoulde: Another term for shoulder separation is acromiodaviculst (AC) separa ‘ion or sprain. ‘Shoulder separations or sprains, are graded I ‘FI, depending on how far te collarbone is sepa ‘ated from the shoulder A grade I sprain hs tender- ‘ess but no actual separation. A grade sprain hat Slight separation ofthe clavicle om the shoulder, and grade Il has greater separation How does it occur? ‘A shoulder separation can res fom 2 blow to your “shoulder ora fall on your shoulter It azo can result froma fll on your outstretched Rand er arm. Itis a ‘omunon injury in contact sports sich a: football, rugby, hockey, or lacrosse. Te may occur from falling ‘onto a hard surface, such as might happen during downhill sking, volleyball, rock climbing and soccer. What are the symptoms? Symptoms include the following » severe pain atthe momen theinjury eccurs > limited shoulder movement and tendemess on top ‘of yourshoulder at the end of your colazbone > swelling and bruising of your shoulder area > amisshapen shoulder How is it diagnosed? ‘Yur health care provider will examine your shoulder for tendemess and a bump overthe fp of your cola. bone “To make sure it isan AC separation and nota frac ture, rays ae necessary. How is t treated? Immediately after Your injury put an ice pack on your shoulder for 20 1930 minutes. Continue to put ice on yout shoulder every 3to4 hours for the first 2 t0 3 days, then as needed fr the next several weeks. Cold helps rele the pain, swelling, and inflammation. ‘The treatment of your separated shoulder depends fn the severity: Grade separations and some grade {and grade Il separations may be placed ina sing ‘or shoulder immctilizer The sing or immobilizer will kep you from ting your arm away from your chest and help healing ofthe ligaments. Your shoul der willbe immobilized until you are pain fre. Then ‘you will begin rehabilitation exercises” Your health are provider may preseribe an ant inflammatory ‘medication or other ain medication. For most grade Mend grade I separations teat: sents the same, However i sone situa ar SHOULDER SEPARATION PAGE 1 OF & eresee _gery may be needed to reposition the bones of rep torn ligaments. Your arm will then bein a sing oe up to6 weeks to allow healing before you bepinreha- biliation exercises. You should consult an orthopedic surgeon if you have a severe grade Il injury. How long will the effects of a shoulder separation last? Some separations hes by themselves in 2to 4 wecks without any los of shoulder use, However, some: times slight siiness or loss of movement in the shoulder may occu which may be temporary of rarely, ong lasting "Asevere separation may’ take 2months oF more t9 heal, particularly if you have surgery to repair ‘You may havea permanent bump over your shoolder int after separation regardless of teat tent. The bump docs not normaly cause other med- ical problems. How can! take care of myself? Avoid participating in sports int the ijury has healed! ‘You should move your shoulder as the pain sub- sides to prevent a frozen or stif shoulder ‘With your healthcare provider’ permssion, work with a Hainer or physical thesapist to strengthen your When can Iretura tomy sport or activity? ‘The goal of rehabilitation i to etum you to Your sport or activity as som asi safely possible If you ‘tum too soon yourmay worsen your injury which ould lead ta permanent damage. Everyone recovers from injury ata dfferee rate. Return to Your sport will be determined ty how soon your shoulder recovers, not by how many days Or Weeks it has been. slace your injury occurred. "You may salely eur to your sport or activity when: » Your injure shoulder has fll range of motion without pain » Your injured shou der has regained normal strength compared othe uninjured shoulder In throwing sports, you must gradually build your tolerance to throwing. This means you should start with gentle tossing nd gradually how harder. In contact sports, yoursheulder must not be tender to touch and contact should progress from minimal con- tact to harder contact. What can | do tohelp prevent recurring shoulder separation? Exercise and lift weights under the supervision of « ‘eainer or physical terepst to tengthen your shoul stale der muscles. Muscle-strengthening exercises will also. help strengthen your ligaments and tendons. you [Reve symptoms, you should avoid activites that aggravate your pal, ele packs,and take an inflammatory enedktion neded Shoulder Separation Rehabilitation Exercises | phase . 1. WAND EXERCISES. ~SS c © | AFLEMION: Stand upright and hold a tick in both rab DS - ands, pls down. Stretch your arms by iting 4} (aes | thomveryour herd, lpn your bows i BS Straight Hold for Sscconds and return othe Sa Sorting poniion.Repest 10 nes. |B. EXTENSION: Stand upright and hold stick in both hands behind your back. Mave he stick tray fom yur ack old the end postin for Seconds Relax an return the starting posi tion Repeat 10 fe ( BETERNAL ROTATION: Le on your bck and hold a stick in both hands, palms up. Your upper farms should be resting on the floor, your elbows at your sides anc bext 90". Using your good farm, pash your injured arin out away from your body while keeping the elbow of the injured arm at your side, Hold the stretch for 5 seconds. Repeat 10 times, SHOULDER SEPARATION m PAGE 2 OF 4THE SPORTS MEDICINE PATIENT ADVISOR Phase I (continued) DLINTERNAL ROTATION: Stand upright holding a stick with both hands behind you: back. Place the hand on your uninjure side behind your ‘ead grasping the stick, and the hand on your injured side behind your tack at your waist. ‘Move the stick up and down your back by bend- {ing your elbows. Hold the bent pestion for 5 seconds and then return tothe stating positon Repeat 10 times. E, SHOULDER ABDUCTION AND ADDUCTION: Stand. "upright and hold a stick with both hands, pals down. Rest the stick agains the front of your thighs. While keeping your elbows straight, wse {your good arm fo push your injured arm out {the side and up a high as posible: Hold for 8 seconds. Repeat 10 times, Va F. NoRIZONTAL ABDUCTION AND ADOUCTION: Stand upright and bl a stk in both hans Pace yourarm aight out in onto you at shoulder level Keep yours sgh and Swing the sicko ene side, fel he thane ald for 8 second Then sving the stick the the side el teste, and had for se sna Repeat tines. ‘2.SHOULDERFLEXION: ‘Stand with your arms hanging down at your side Keep your elbow straight and lift Your arms up over your head as fara you can reach, iol the end positon for 5 sec fonds. Do Fis of 10. 2 SUDER ABDUCTION AN ADDUCT: Satuaareme ede dager” eats Me imadbe OS GR oo celing. Hold for sec. ra catia tang \ IH] Position. Repeat 10 mes a eee haere a as einer e aes, emt potters ace So, gees keep yourarms at shoulder level thoughout this exercise. 4 ‘5. SHOULDER EXTENSION: Stand with your arms at your side. Move the arm ‘on your inured side back, keeping your elbow straight. Hold this position for 3 seconds, Return othe starting positon and repeat 10 times. ‘S.SCAPULAR RANGE OF MOTION: Stand) Sts yor sour up and fer scone Tien spec you ol der bade back sod peter and ads { Q\) ssonds Nest palo shud, } SE domo pang tenn 2) ‘your back pocke: Relax. Repent this Sequence 10 times SHOULOER SEPARATION m PAGE 3 OF 4 SriSHOULDER o Phase il {7 SIDELYING HORIZONTAL ABDUCTION: Lie on | Jour uninjured side with your injured arm relaxed sos Your chest. Slowly bring your injured arm up off the Noor, bow ‘straight, s0 that your hand is point "ing toward the cling. Do 3 sets of 1. Hold weight in —____yourhand as the So exercise becomes {8 PRONE SHOULDER EXTENSION: Lie on your Stomach on a table of a bed with the arm on your injured side hanging down over the edge. With yout elbow straight slowly hit You arm straight back and de lg Retro 2 Srauning poston Dosis (= eidsko Re oom ei teeter YS (CO s0ePs cums: Sanda ol some \. kkind of weight (soup can or hammer} in your and, Bend your elbow and bring your hand (palm up) toward [our shoulder Hat Ssxconds Slowly Tetum to your stating position and ‘Straighten your elbow Do’ sets of 10. 10. TRICEPS STRENGTHENING: ‘on your back with your injured arn pointing toward the ceiling ‘Bend your elbow completely so that your hand is, resting on the same shoulder and your elbow is pointing toward the ceiling. Straighten the bow completely 2 thst your hand is pointing toward the ceiling. Return to the Sarting positon. De3setsof10,Hold |) + Seght nour fandinnen ie ==? ity. CE 11.SINGLE ARM SHOULDER ABDUCTION: Stand math our amet your es ik Jour puns ig apt "arses Win yours «Tight it the sm on your i ade ost these an ower he sing Hold the ) ae Sesser. ora SG 4) fi in 12. SINGLE ARM SHOULDER FLEXION: Stand with your injared arm hanging, ‘down at your side. Keeping your elbow Straight, bring your arc forward and ‘up toward the ceiling. Hold this pos tion fr 5 seconds. Do3 sets of 10. As this exercise becomes easier, ad a weight Coprit 004 McKeon Hoth Son LC Al ight ried Fermin to copy or pis ation worspersmedprescm SHOULDER SEPARATION ml PAGE 4 OF 4