The ligaments may be stretched, partially torn, or completely torn.

• A stretched ligament may not cause much pain, and it does not move the collarbone out of place. A stretched ligament looks normal on an X-ray.

• A partial tear causes an injury that is a bit worse, and it may move the collarbone slightly out of place.

• A complete tear causes serious injury. The surrounding shoulder ligaments are completely torn. This moves the collarbone out of position and creates a bad shape (deformity) of the shoulder.

Common causes of this condition include:

• Falling on the shoulder.

• Receiving a hard, direct hit to the top of the shoulder.

• Falling on an outstretched arm.

You may be at greater risk of a shoulder separation if you:

• Are male.

• Are younger than 35.

• Play a contact sport, such as football or hockey.

The most common symptom of a shoulder separation is pain on the top of the shoulder after falling on it or receiving a hard, direct hit to it. Other signs and symptoms include:

• Shoulder deformity.

• Swelling of the shoulder.

• Decreased ability to move the shoulder.

• Bruising on top of the shoulder.

Your health care provider may suspect a shoulder separation based on your symptoms and the details of a recent injury you experienced. The condition will be diagnosed based on:

• A physical exam. Your provider may:

  • Press on your shoulder.

  • Test the movement of your shoulder.

  • Ask you to hold a weight in your hand to see if the separation increases.

• Imaging tests, such as:

  • X-rays.

  • MRI.

Treatment for this condition depends on the cause and severity of the injury.

• A shoulder separation caused by a stretched ligament may require 2–12 weeks of the following:

  • Wearing a sling.

  • Taking medicines to help relieve pain.

  • Applying cold packs to your shoulder.

  • Physical therapy. If needed, a physical therapist will teach you to do daily exercises to strengthen your shoulder muscles and prevent stiffness.

• Surgery may be needed for severe injuries that include breaks (fractures) in a bone, or injuries that do not get better with nonsurgical treatments. To help with healing, you will need to keep your joint in place for a period of time (immobilization) and do physical therapy.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Do not drive or use heavy machinery while taking prescription pain medicine.

• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:

  • Drink enough fluid to keep your urine pale yellow.

  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.

  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

  • Take an over-the-counter or prescription medicine for constipation.

If you have a sling:

• Wear your sling as told by your health care provider. Remove it only as told by your health care provider.

• Loosen the sling if your fingers tingle, become numb, or turn cold and blue.

• Keep the sling clean.

• If the sling is not waterproof:

  • Do not let it get wet.

  • Cover it with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, apply ice to the top of your shoulder:

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 20 minutes, 2–3 times a day.

• Do not do any activities that make your pain worse.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you were told, until your health care provider says that it is safe.

• Rest your shoulder. Avoid activities that take a lot of effort (strenuous activities) for as long as told by your health care provider.

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

• Do range-of-motion exercises as told by your health care provider.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing. If you need help quitting, ask your health care provider.

• Keep all follow-up visits as told by your health care provider. This is important. These include visits for physical therapy as directed by your health care provider.