Shoulder Separation

Treating Shoulder Separation

The first task of managing a shoulder separation is to reduce the inflammation, temper acute pain and the immobilize the joint to prevent further injury. The treatment regiment for a shoulder separation is based upon the diagnosis of the type of separation and the severity:

• Type 1-2: separations are customarily placed in a sling to reduce pain and support the injury site. Physical therapy is started early to prevent frozen shoulder, increase your range of motion and strengthen the muscle.
• Type 3: separations are occasionally treated with surgery, but most respond to treatment with use of a sling combined with physical therapy. There is evidence to support that this nonsurgical approach is just as effective as surgery. Patients participating in overhead sporting activities or otherwise performing heavy lifting may benefit from surgery.
• Type 4-6: a trained health care professional should evaluate separations for surgery.

Physical Therapy Intervenes

If surgery is unnecessary, treatment will focus on the restoration of shoulder motion after the shoulder has been immobilized for a period of time to recover from the trauma. It is crucial to get the shoulder moving again while protecting the acromioclavicular joint to prevent frozen shoulder.

As the pain dissipates, strengthening exercises should be initiated to prevent muscle weakness and atrophy. Physical therapy following surgery for a shoulder separation will be delayed, but the program will have the same goals and purpose. Common treatment methods of a shoulder separation includes:

• Manual Therapeutic Technique (MTT) including mobilization, soft tissue massage and manual stretching to regain motion range and flexibility of the shoulder while protecting the acromioclavicular joint.
• Therapeutic Exercises (TE) to regain range of motion and strengthen the shoulder and surrounding joints by depressing and stabilizing the humeral head. This prevents it from irritating the acromioclavicular joint. Strengthening of the trapezius and deltoid muscles that help support the acromioclavicular joint should also be initiated.
• Neuro-muscular re-education to begin retraining the upper extremities for use in daily activities.
• Scapular and shoulder stabilization exercises to improve stability of shoulder and support the acromioclavicular joint may also be initiated.
• Modalities including the use of ultrasound, electrical stimulation, icing the area and cold laser to decrease pain at the shoulder.
• Home exercise program that includes stretching and strengthening exercises.