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

No one realizes how much they depend on their shoulder – that is until they’ve injured their shoulder, have surgery and can’t use it. Frequently people want to know how long their particular shoulder injury will take to heal.

Answers that don’t help.

Imagine that you’ve sprained your shoulder and you want to know how to treat this injury. You could look at these suggestions for your shoulder information. However, these comments are the thoughts and advice of laymen who may or may not know what they are talking about.

Here is a thread from the Injury Update Forum that seeks to answer the question – How long will it take to recover from shoulder reconstruction?

Here is a discussion on the issue of How long to heal from a dislocated shoulder that resulted from being hit by a car.

Would you let your friend work on your $40,000.00 automobile?

It should be obvious by now that everyone has an opinion about everything – including your shoulder injury. But who are you going to trust with the care of your most versatile joint? Where can you find credible shoulder information? What you need is believable information about your shoulder and there are a number of sources that are quite extensive.

See a Doctor – an Orthopedic Surgeon who specializes in Shoulder Repair!

(photo courtesy of soldiersmediacenter)

Visit Shoulderdoc – this is a vast web site filled with:

• Medical Educational Material – What’s the difference between SLAP, SLIP and SLOP? Do you want to purchase a book about shoulders? This is the place to look.
• The Latest Shoulder News – Do you want to read about the latest research in shoulder surgery techniques or shoulder rehab?
• Rehab Protocols – this is an immense section of information about shoulder rehab procedures.
• Much, much more.

Shoulderdoc offers a wealth of information on all aspects of your shoulder. Use this web site to educate yourself.

- - -

“Thanks to the rotater I was able to get back to work and not lose the use of my shoulder in this demanding profession.”
- Officer D. Pesko

Now that we are in our 40’s and above, we are beginning to realize that we should learn:

• the steps we can take to extend our quality of life
• to eat properly as well as the effects that foods have on both our bodies and minds
• to exercise to keep our bodies lean and fit
• which supplements to embrace and which ones to avoid

Joint failure

I’ve had orthopedic surgery three times.

• reconstructed shoulder – a snow boarder collided with me in Snowshoe West Virginia resulting in a complete and severe AC separation
• cartilage repaired in my knee – the result of a night of partying and dancing
• thumb re-attached – a table saw cannot tell the difference between “meat” and wood

Each of my surgeries was successful (thanks to outstanding surgeons) and I suffer no aches or pains (due to nerve damage in my thumb, it has no sense of feeling – however, it works just fine.)

None of my surgeries was the result of “worn out” joints.  But this is not the case with many of my friends.  I know of at least twenty to thirty people who have had:

• knees ‘scoped
• knees repaired
• knees replaced
• hips replaced
• rotator surgery

And almost all of these are due to the “wear and tear” of repetitive use type of injuries.  The kinds of injuries that occur because of the job or activities that you participate in.  They are due to the cumulative effect of the countless times that a person has repeated the same movement.

Educate yourself

There is help.  Even though surgery can repair many of our joint ailments, there are other ways that we can help ourselves.

1. Brad Baggett has written an article entitled, “Nutrition and Joint Health”, in which he provides information about the joint and some of the supplements that can have a positive effect on our bodies.
2. Supplement MSM for Joint Health makes a strong case for using MSM to help repair our joints.
3. Fish Oils for Joint Health
4. Neil Levin, a board certified nutritionist, has written a well documented article about the Nutrients that contribute to your joint health.

My rotator is torn

I experienced a torn rotator while pitching during a pony league baseball game when I was fourteen. I knew right away that something was wrong, but it wasn’t until the following day that I realized that I may have done permanent damage when I could not even mimic a throwing motion without excruciating pain.

At that time (the late ‘70’s), shoulder surgery for a young high school athlete was not even considered. Fortunately, my shoulder healed and it was not until my senior year (1979) that I succeeded in tearing my rotator again. Up until that point, I had dreams of a college scholarship and possibly a professional career.

Shoulder surgery is common today

Today, shoulder surgery is common. I know of countless people who have had some form of shoulder surgery or another. It remains the most viable option for shoulder repair – UNTIL NOW!

Stem cell procedure may be the answer to surgery

WATCH THIS VIDEO – Dr. Chris Centeno, using the Regenexx procedure, extracts stem cells from the bone marrow in a patients hip, multiplies those stem cells in the lab to increase the total number of stem cells and then injects the patients own stem cells back into the patients damaged tissues.

Results have been promising and patients are are spreading the news of their experience with this new procedure.

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

The Good News and The Bad News

The shallow socket that affords you the most movement, is also the same shallow socket that gives you the least amount of stability. This lack of stability makes the shoulder joint the most prone to dislocation.

The 3 Bones that make up the shoulder

• The Upper Arm Bone ( Humerus )
• The Shoulder Blade ( Scapula )
• The Collar Bone ( Clavicle )

It seems that these animations are prepared by Understand.com, a company that produces excellent animations used by medical professionals and others to inform and educate patients (or anyone else) about medical issues.

If you are in the market for superior quality animations, then it may be worth your time to give Understand.com a look. I was certainly impressed.