As football season gets underway, fans will no doubt stay glued to the television for an update of their injured star. Tennessee Titans fans were relieved this morning to learn that star rookie QB Jake Locker is expected to play next week after sustaining a shoulder separation to his non throwing shoulder.
What is a shoulder separation?
A "shoulder" or AC (acromioclavicular) separation, is when the joint between the collarbone ("clavicle") and shoulder blade ("scapula") is injured. The ligaments and capsule connecting the bones can be injured to variable degrees depending upon the severity of the injury. It is commonly caused by a fall directly on the "point" of the shoulder or a direct blow, as occurs during a quarterback sack. The pain is most severe when an athlete attempts overhead movements or throwing. As the AC joint is relatively superficial, separation injuries are usually accompanied by a "bump" from the prominence of the collarbone at this location, and can be clearly seen as asymmetric from the uninjured side. Point tenderness to this location usually confirms the diagnosis clinically. Radiographs are helpful in ruling out associated fractures and in grading the severity of the separation.
The severity of an AC joint injury depends on how severely the ligaments and capsule that stabilize this joint are damaged. Low grade injuries are stable whereas high grade injuries, involve a more extensive injury pattern resulting in superior migration of the clavicle relative to the acromion. These injuries are more serious because they render the arm and shoulder more unstable. Throwing or overhead athletes may be particularly affected and limited in their sport if these more serious injuries are not treated.
In general, most AC injuries can be treated without surgery, but it depends on the severity of the injury. (We grade these injuries 1-6 with 6 being the worst) Low grade injuries will typically heal with rest and rehabilitation. Higher grade injuries, however, often do require surgery to reduce the joint and normalize shoulder function- something that is particularly important to quarterbacks. The outcomes are generally good, and most athletes recover with full function of the shoulder.
If you suspect that you have an AC joint injury or have suffered a shoulder separation, it is critical to seek the urgent consultation of a local sports injuries doctor for appropriate care. For more information, please visit us here or contact us at 1-800-321-9999.
Christopher Dodson, MD