A separated shoulder is usually the result of:

• a fall onto an outstretched hand (my separated shoulder occurred as the result of a fall while skiing)
• a direct impact to the shoulder (often seen in football, rugby, lacrosse, or any other contact sport / activity)

(photo used courtesy of Neil Rickards)

Dr. William Pennington has been one of the developers of a new arthroscopic technique which results in less pain and less scarring. This procedure is specially designed to treat shoulder separations that are at least three months old.

Shoulder Separations are Distinguished by Severity of the Injury

The following data is used courtesy of Wikipedia – Shoulder Separation

Type I

A Type I AC separation involves trauma to the ligaments that form the joint, but no severe tearing or fracture. It is commonly referred to as a sprain. Most doctors treat this type of dislocation with anti-inflammatory drugs, pain medication and the placement of the arm in a sling or an immobilizer.

Type II

A Type II AC separation involves complete tearing of the acromioclavicular ligament, as well as a sprain or partial tear of the coracoclavicular ligaments. This often causes a noticeable bump on the shoulder. By pressing on the sternal aspect of the clavicle you force the acromial end down, and by releasing, watch it pop back up (eliciting a piano key sign due to the tearing of the AC ligament)[3]. Severe pain and loss of movement are common. Treatment is typically an arm sling, bedrest, ice and heat therapy, and anti-inflammatory drugs. Most people recover full motion of the shoulder and arm within 6 to 8 weeks, often with the assistance of physical therapy.

Type III

In a Type III AC separation both acromioclavicular and coracoclavicular ligaments are torn. A significant bump is formed by the lateral end of the clavicle. This bump is permanent. The clavicle can be moved in and out of place on the shoulder. It may take 12 weeks to heal, and physical therapy can be beneficial. It may take even longer for the shoulder strength to approach feeling normal. The injured shoulder may not be able to take the abuse that it could previously, but for most purposes it will be quite usable and sufficient. However, there still is controversy as to whether or not surgery may be necessary for optimal shoulder use in sport.

Type IV

This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius. This injury is generally acknowledged to require surgery.

Type V

This is type III but with exaggeration of the vertical displacement of the clavicle from the scapula. This injury generally requires surgery.

Type VI

This is type III with inferior dislocation of the lateral end of the clavicle below the coracoid. It is extremely rare and generally only involved with motor vehicle collisions. This requires surgery.

A Short Video Explaining Shoulder Separation and Treatments

• push
• pull
• reach overhead
• lift
• carry
• swing a baseball bat or tennis racket
• swim
• drive a nail
• serve or spike a volleyball
• throw a baseball, softball, football, javelin or anything else
• do a bench press, shoulder press or chin-up

…your shoulder is being called on to “carry” the load. Injuries abound. I’ve experienced everything from a torn rotater cuff to a full-blown separation requiring extensive surgery. As a person who has spent most of his life involved in athletics, I was thrilled when Scott Kay first described his invention to me.

Simple is best

Scott has the ability to get outside the box and view things in their simplest terms. He has invented and improved a number of different devices, but the Rotater is the one that I am most excited about.

This video was filmed during an interview for an article (Pair hope patients turn to ROTATER) that featured the Rotater and took place on December 4th at the Montgomery Advertiser offices in Montgomery Alabama. Click here to see Scott’S video and hear his passion as he explains the Rotater and its benefits.

Front Page News

On December 6^th, Scott and I were interviewed by Don Prater of the Auburn-Opelika News. Don had heard about two industrial mechanics who were receiving quite a bit of attention from physical therapists, athletic trainers and athletes due to a shoulder rehabilitation and stretching device that they had invented and were marketing.

We spent about an hour answering Don’s questions and taking a few pictures. At the conclusion, Don told us that the article would probably land in the “Lifestyle or Living” section of the Sunday paper.

We were completely (and happily) surprised to discover that we had been featured on the front page of Friday’s (Dec 7, 2007) edition of the Auburn-Opelika News. Read the article – Local inventor revolutionizes rehab

More to come

The Rotater has attracted the attention of several media outlets – from daily print to monthly magazines to television. Though simple in design, the Rotater is proving to everyone who uses it why it’s becoming so popular.

The shoulder is a complex joint made up of three bones:

• the HUMERUS – the upper arm bone
• the SCAPULA – the shoulder blade
• the CLAVICLE – the collar bone

The scapula has a shallow socket called the glenoid, which the ball of the humerus fits into. The union of these bones is referred to as the glenohumeral–joint or shoulder-joint. (To see a very good animation – click here)

Shoulder Dislocation

When the glenohumeral joint is disrupted, the humerus loses contact with the glenoid and results in the condition known as shoulder dislocation.

Shoulder Separation

The uppermost part of the scapula (shoulder blade) is known as the acromion. The union of the clavicle (collar bone) and the acromion is called the acromioclavicular joint or AC joint. When this joint is disrupted, a shoulder separation / AC separation results.

Shoulder separations classified by severity of injury

Shoulder separations are classified according to the severity of the injury. You may hear it described as different levels, grades, types or degrees of separation.

All joints are held in place by ligaments (extremely tough, tissue structures that connect bone to bone). In the AC joint, one set of ligaments forms the joint capsule around the AC joint (this is known as the acromioclavicular ligament). Two other ligaments connect the clavicle to a bony protrusion of the scapula, called the coracoid process. These are called the coracoclavicular ligaments.

• TYPE I – there is a partial tear of the acromioclavicular ligament (AC ligament), with no change of the position of the clavicle (collar bone).
• TYPE II – there is the rupture of the AC ligament and partial tearing of the coracoclavicular ligament with some change of the position of the clavicle (collar bone).
• TYPE III – there is the rupture of the AC ligament and coracoclavicular ligament, definite upwardly displaced clavicle.
• TYPE IV – there is posterior (rearward) displacement of the clavicle, behind the AC joint.
• TYPE V – there is an upward displacement of the clavicle, puncturing muscle tissue.
• TYPE VI – there is a downward displacement of the clavicle, which becomes lodged beneath the acromion or coracoid process.

TYPE I and TYPE II separations are the most common types of AC separations and rarely require surgery.

TYPES IV, V and VI are rare injuries and commonly result in surgical repair.

TYPE III separations are the most controversial. They are fairly common, but there is still some debate as to whether surgery is the “right” treatment, though surgery may be recommended for high level throwing athletes. Some feel that the joint will heal without surgery if the injury is managed properly.

Surgery for a TYPE III separation usually involves relocating the AC joint and repairing the torn ligaments. The clavicle will also be secured, either by screw or possibly goretex tape, until the ligaments have had sufficient time to heal. If a screw is used to secure the clavicle, then it is normally removed within eight weeks of surgery.

In the event that you are faced with a TYPE III AC separation, consult with your physician about the pros and cons of surgical and non-surgical treatment. Ask about:

• possible physical restrictions you may face
• mobility issues
• the strength of your shoulder
• possible future complications
• your rehabilitation time
• any possible risks