A shoulder sprain (or separation) is a tear of the shoulder ligaments, the tough bands of fibrous tissue that connect bones to one another inside or around the shoulder joint. Thus, it is not actually an injury to the shoulder joint. Rather, it involves the acromioclavicular joint (also called the AC joint). The AC joint is where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion).
Download and print a PDF version of this page.
Patients can be seen by Texas Children's experts in Orthopedic Surgery.
Causes & Risk Factors
Shoulder sprains can be caused by a single event or by repetitive overuse activities. Contact or high-impact sports, such as football, wrestling, skiing and rugby, can lead to a separated shoulder. Athletic activities that involve a repetitive, overhead motion, such as swimming, tennis, pitching or weightlifting can lead to similar symptoms. These kinds of shoulder injuries can also be caused by more mundane activities such as washing walls, hanging curtains or gardening.
Symptoms & Types
A shoulder sprain will usually lead to 1 or more of the following symptoms:
- Pain and stiffness in the shoulder
- Inability to rotate the arm in all the normal positions
- Lack of strength in the shoulder to carry out daily activities
Presence of any of these symptoms in a young person suggests you should consult an orthopedic surgeon for help in determining the severity of the problem.
According to the American Academy of Orthopedic Surgeons, the severity of a shoulder sprain can range from mild pain to quite visible to the naked eye and very painful.
- A mild shoulder sprain involves the acromioclavicular (AC) ligament which does not cause the collarbone to move.
- A more serious injury tears the AC ligament and sprains or slightly tears the coracoclavicular (CC) ligament, putting the collarbone out of alignment to some extent.
- The most severe shoulder separation completely tears both the AC and CC ligaments and puts the AC joint noticeably out of position.1
Diagnosis & Tests
A shoulder sprain is generally easy for doctors to identify when it visible. When it is not clearly visible, the location of pain and X-rays help the doctor make the diagnosis. Sometimes having the patient hold a weight in her hand can make the injury visible and more obvious on X-rays.
Treatment & Care
Depending on the severity, a sprain may take up to 6 weeks to fully heal. Minor sprains can be treated without any special support. Moderate to severe shoulder sprains are treated with a sling or shoulder immobilizer.
Living & Managing
Where there is significant injury, your doctor may recommend reconstructing the ligaments that attach to the underside of the collarbone. This type of surgery works well even if performed long after the initial injury.
1 “Shoulder Separation,” American Academy of Orthopedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=a00033
“Shoulder Separation,” American Academy of Orthopedic Surgeons