A shoulder separation occurs where the collarbone (clavicle) meets the shoulder blade (scapula). When ligaments that hold the joint together are partially or completely torn, the outer end of the clavicle may slip out of place, preventing it from properly meeting the scapula. Most often, the injury is caused by a blow to the shoulder or by falling on an outstretched hand.

Signs and symptoms: Shoulder pain or tenderness and, occasionally, a bump in the middle of the top of the shoulder (over the acromioclavicular (AC) joint) are signs that a separation may have occurred.

Diagnosis: Doctors may diagnose a separation by performing a physical examination. They may confirm the diagnosis and determine the severity of the separation by taking an x ray. While the x ray is being taken, the patient makes the separation more pronounced by holding a light weight that pulls on the muscles.

• Treatment: A shoulder separation is usually treated conservatively by rest and wearing a sling. Soon after injury, an ice bag may be applied to relieve pain and swelling. After a period of rest, a therapist helps the patient perform exercises that put the shoulder through its range of motion. Most shoulder separations heal within 2 or 3 months without further intervention. However, if ligaments are severely torn, surgical repair may be required to hold the clavicle in place. A doctor may wait to see if conservative treatment works before deciding whether surgery is required.