Acromioclavicular Separation

ACROMIOCLAVICULAR SEPARATION is a common injury to the shoulder and usually results from a fall onto the point of the shoulder.  It is an injury that involves the clavicle/ collarbone separating from the top of the shoulder bone.  It is often seen in sporting accidents during cycling, skiing, or football.  The injury varies from mild to severe. 


In a mild or moderate separation, the ligaments involved are stretched and the clavicle does not shift significantly. 

In a severe injury, the ligaments that hold down the clavicle are torn and the end of the clavicle moves resulting in a mild deformity. 

Unfortunately, these ligaments never completely heal and can lead to ongoing problems with the shoulder.  The severity of the injury is determined by clinical examination and x-rays. 


A mild or moderate separation (grade 1 or grade 2) is usually successfully treated in a sling for a few weeks, followed by a course of physiotherapy and gradual mobilisation. Occasionally, surgery is required, but most people do well with non-operative treatment. The severe injury, (Grade 3), can be treated either with or without surgery. 

Severe separation, (Grade 4 or 5), often requires surgery.

The more significant separations often cause a bump or step to form on top of the shoulder. These remain prominent and occasionally cause arthritis of the acromioclavicular joint to develop. 

Unfortunately, the injury can lead to permanent weakness in people who do heavy overhead work, or a lot of throwing.  If you develop significant symptoms, then surgery may become an option.

If you would like an assessment of your shoulder injury, please call Sydney Shoulder Clinic on 9744-2201.