What gives shoulder separations their reputation isn’t the pain, recovery time, or treatment options, but the fact that they are so commonly misunderstood. With older adults, doctors frequently misdiagnose these injuries as arthritis or chronic pain, leaving the proper treatment out of reach. When it comes to shoulders, a mismanaged recovery can lead to long-term pain or disfigurement. That is why having a full understanding of your shoulder separation is the first step toward receiving the best care possible. Find out how to maintain strong shoulders with helpful treatment paths, exercises, and dieting tips.
What is commonly misunderstood by those experiencing a shoulder separation injury is that the condition is actually best described as a separation of the AC joint in the shoulder. The AC, or acromioclavicular joint, is the junction between two major bones that make up our shoulders, the scapula and clavicle. Without it, there would be little to hold our upper arms in place.
When a shoulder AC joint separation takes place, either through falling or another type of injury, it is because the soft tissues in this joint become stretched, strained, torn, or completely broken. The length of time your AC shoulder separation recovery will take depends on how severely the joint is damaged.
Shoulder Separation Grades
A separation of shoulder can come in six grades of severity, which will be determined by a doctor upon examination. Grades one through three describe the most common types, ranging from partial shoulder separations to complete dislocations. Grades four and above are much more rare and are usually caused by high-energy impacts.
Grade 1 Shoulder Separation
A grade 1 shoulder separation is the most common and the most easily treated.
Type 1 shoulder separations are the most common and consist of a minor stretch or partial tear of the ligament. As the most slight shoulder separation of them all, you will experience a short period of discomfort and soon regain full function of the arm.
Grade 2 Shoulder Separation
A grade 2 shoulder separation may not be visible to the naked eye but is more severe than a grade one separation.
A type 2 shoulder separation often includes some amount of displacement, but is often not apparent during a physical examination. While it is still considered a more mild shoulder separation, pain and discomfort can continue for weeks although full function will be restored.
Grade 3 Shoulder Separation
A grade 3 shoulder separation involves complete separation of the joint, but prompt treatment results in a full recovery.
Type 3 shoulder separations differ from the previous two in that it is defined as a complete separation of the joint. A physical should be able to quickly identify a level 3 shoulder separation, and while some will suffer a slight cosmetic defect, the arm’s function will return to normal.
Grade 4 Shoulder Separation and Beyond
Those with shoulder separations more severe than grade 3 may not regain full joint functionality.
Beyond AC shoulder separation grade 3 there are an additional three levels. The categorical difference of grades four through six is that surgery is usually required and the function of the arm may not be restored completely. Luckily, these higher grades are extremely rare and usually only suffered by athletes.
Shoulder AC Separation Causes
For older adults, shoulder joint separation is usually caused by falling and will not be terribly severe. However, there are a number of factors which can increase the risk of a separation after a fall or other accident, including age, anatomy, gender, and previous injury. Below, we will look at two of the most significant factors which increase the likelihood of AC separation.
Age
The American Academy of Orthopedic Surgeons finds that shoulder separations are equally as common among older adults as they are in the young, despite statistical decrease of physical activity. This can be due to a variety of factors including arthritis, weakened joints, or a general lack of flexibility.
Be aware that shoulder separations are more commonly misdiagnosed in older adults. This often results in prolonged pain which might otherwise have been prevented.
Previous Injury
The other risk factor for older adults is the greater likelihood that they have experienced a previous injury in their past. Previous damage, especially a stage 3 shoulder separation, will lead to a long-term weakening of the entire area. This is why those who have experienced a separation in the past should protect themselves with regular stretching.
Shoulder Separation Symptoms
A shoulder separation below grade three is not visible, but a severe separation will show physical deformity.
Whether you are experiencing a right or left shoulder separation, symptoms will vary depending on the grade of the injury. Expect more severe symptoms with increased grades, although obvious disfiguration should not appear until a grade 3 shoulder separation.
Pain: Shoulder separation pain can be mild or severe, but should subside within a few weeks.
Swelling: Your body’s natural response to injury and inflammation, swelling is a positive sign that your healing process is underway.
Loss of Function: A damaged shoulder joint can range from slightly stiff to completely immobile, depending on the severity.
Disfiguration: Known as a “shoulder separation bump” this symptom will be visible to the naked eye.
Shoulder Separation Treatment
Your treatment for shoulder separation will depend entirely on the grade of the injury. Grades one through three can most often be treated without surgery, although a shoulder separation X-ray may be needed to know for sure.
During your treatment process, controlling the joint’s motion during your day-to-day life is important. Arm slings can be an effective way to accomplish just this, while hot and cold therapy will reduce the pain and swelling.
An arm sling will prevent dangerous joint movement to help you recover fully. (See Product )
Shoulder Support
A shoulder separation may require more support than a sling offers. A shoulder brace will immobilize the joint, allowing it to heal and protecting it from further damage. You may also use a shoulder support after you have healed, especially during exercise, to reduce the risk of re-injury.
A brace will support and stabilize your shoulder, preventing further damage and re-injury. (See Product )
AC Shoulder Separation Rehab
Most AC shoulder separation treatment can be handled non-operatively, through rehabilitation. This is good news for those experiencing joint injuries, as there are plenty of shoulder separation exercises which can be completed at home, without additional cost. Of course, an initial consultation with your doctor is advised.
Choosing a variety of different stretches and exercises is the best way to overcome the stiffness and pain associated with a shoulder joint injury. Try a few of these for a comprehensive workout:
Front Stretch
Choose a point on a doorframe or hand rail to brace your arm firmly. Then, slowly turn your torso outward and away from this point so that the front muscles of your shoulders begin to stretch. Hold for 15 seconds and release, repeating three times.
Pendulum
Gently swing your arm side to side while bent over, using a table or chair to support your weight. As you become more comfortable with the exercise, extend the range of motion. Your ultimate goal will be to reach a full 90 degrees in every direction.
Rotation Exercises
Stand next to a clear wall with your injured shoulder pointed inward to it. With your upper arm at your side and your forearm extended outward at 90 degrees, place the back of your wrist against the wall. From this position you can rotate your shoulder forwards (external rotation) or backwards (internal rotation) for a gentle stretch.
Shoulder Separation Surgery
Most grade 3 shoulder separation treatment can be managed without surgery, but in some cases operative treatment will be recommended. AC shoulder separation surgery is a low-risk procedure and is a good option for those concerned about the cosmetic defects caused by the injury.
The goal of grade 3 shoulder separation surgery will be to reconnect torn ligaments and stabilize broken bones. While the pain will persist for a few more weeks, this will ensure a healthy recovery and mitigate long-term complications. Shoulder separation surgery recovery time may range from just a few days to up to 12 weeks.
The best way to speed AC shoulder separation recovery time of levels one through three is to maintain a healthy regimen of stretches and other exercises. Consult your doctor for more information if pain persists.
Grade 1 Recovery
Shoulder separation recovery for grade 1 should last just a few days if treated with regular stretching and exercises. The recovery should be complete, leaving no visible abnormalities and restoring full functionality.
Grade 2 Recovery
Grade 2 shoulder separation recovery time will be slightly longer, up to two or three weeks, but will end with full function of the injured arm. Surgery should never be required at this stage, but seeking help from a partner or therapist with stretches could be helpful.
Grade 3 Recovery
Recovery from grade 3 shoulder separation surgery can range from a couple weeks to over a month. Surgery should not extend this process significantly, but can reduce the likelihood of complications during your recovery.
Shoulder Separation Prevention
The best defense against an AC joint injury actually happens before the accident even occurs. A few healthy habits that can be practiced on a week-by-week basis will not only keep your shoulders strong, but leave you feeling fitter and happier.
Incorporate shoulder stretches into a brief morning fitness routine.
Strive for a well-balanced diet that includes anti-inflammatory foods like cherries, blackberries, and salmon.
If you have a previous shoulder injury, even if it is years old, take extra care to protect that area.
Get a professional opinion on shoulder pain that lasts longer than a week, to ensure proper recovery.
Coming Back From a Shoulder Separation
As seen above, the first step toward recovering from your shoulder joint injury is arming yourself with the knowledge you need to seek the right treatment. After a proper diagnosis, keeping up regular exercise or seeking surgery will have you in top form in a matter of days or weeks. While the pain and discomfort may leave you down and out in the short-term, the correct treatment will go miles toward eliminating any long-term effects.
A grade 1 shoulder separation is the most common and the most easily treated.
A grade 2 shoulder separation may not be visible to the naked eye but is more severe than a grade one separation.
A grade 3 shoulder separation involves complete separation of the joint, but prompt treatment results in a full recovery. 
Those with shoulder separations more severe than grade 3 may not regain full joint functionality.
A shoulder separation below grade three is not visible, but a severe separation will show physical deformity.
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