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AC Joint Separation in Hockey

by Staff Writer / New Jersey Devils

BAMM!!!! You are squashed into the boards and now your shoulder hurts and looks funny. What can it be? Many collisions cause a separated shoulder. A separated shoulder is a common injury among contact athletes, especially hockey and football players, but it can happen to anyone who falls and lands on the tip of their shoulder or elbow. The result can be an injury to the muscles, tendons and ligaments that hold the bones in your shoulder together. It is very different than a shoulder dislocation, which is a separation of the large joint (glenohumeral) in the shoulder. Often these two types of injuries are confused. You may have a partial or complete tear of one or both of the main ligaments that connect your collarbone (clavicle) to your shoulder blade (scapula). These are the acromioclavicular (AC) joint and coracoclavicular (CC) ligaments. X-rays may be taken to help diagnose the extent of your problem and exclude a fracture at the end of your clavicle. Your shoulder separation is classified by the extent or magnitude of your injuries.

Grade 1: A mild shoulder separation involves a sprain of your AC ligament that does not move your clavicle and looks normal on X-rays.

Grade 2: A more serious injury tears the AC ligament and sprains or slightly tears the CC ligament, putting your clavicle out of alignment to some extent.

Grade 3: The most severe shoulder separation completely tears both your AC and CC ligaments and puts your shoulder joint noticeably out of position.

Grades 4, 5 and 6 AC separations are very rare.

Treatment: Since the severity of your injuries may vary greatly, all injuries are treated on a case-by-case basis. If your injury is a grade 1, 2, or 3 AC separation, you'll possibly wear a sling for a few days until the pain subsides. It is recommended that you ice your shoulder for 20 minutes, 3-4 times a day during the first 48 hours. You may also use anti-inflammatory medications and pain relievers. In most cases, your doctor will send you to your physical therapist or athletic trainer to restore and rebuild motion, strength, and flexibility.

You may resume your normal daily activities when the pain in your shoulder eases. You will be allowed to return to your sport once you have full range of motion and good strength in your shoulder. You may also be required to wear special protective devices or padding.

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