Shoulder (ACJ) Separation

Shoulder (ACJ) Separation is a common injury that involves a disruption of the acromioclavicular joint (ACJ). This injury is often the result of a fall or a direct blow to the shoulder, which causes the acromion (part of the shoulder blade) to separate from the clavicle (collarbone).


Typical symptoms of an ACJ Separation include:

  • Pain in the shoulder area, particularly upon moving or touching
  • Swelling or tenderness over the ACJ
  • A visible bump on top of the shoulder
  • Limited shoulder movement due to pain


To diagnose an ACJ Separation, doctors typically use the following methods:

  • Physical Examination: The doctor will check for signs of tenderness, swelling, and a bump on top of the shoulder.
  • Imaging Tests: An X-ray is usually sufficient to confirm an ACJ Separation. In some cases, a CT scan or MRI may be needed for further detail.


Preventing ACJ Separation primarily involves:

  • Protective Gear: Using appropriate protective gear when participating in sports or physical activities can help prevent injuries.
  • Conditioning Exercises: Regular exercises to strengthen shoulder muscles can provide additional support and prevent injuries.
  • Safe Practices: Practising safe techniques in sports and physical activities can reduce the chance of trauma to the shoulder.


The treatment plan for an ACJ Separation depends on the severity of the injury and the patient’s overall health. Treatment options include:

  • Non-Surgical Treatment: This approach often involves rest, ice, compression, and elevation (RICE). Pain medication and the use of a sling to immobilise the shoulder may also be part of the treatment.
  • Surgical Treatment: Severe cases may require surgery to reposition the displaced bones and secure them with pins, screws, or a synthetic ligament.
  • Physiotherapy: Whether treated surgically or non-surgically, physiotherapy is crucial for restoring strength, flexibility, and functionality in the shoulder. This can involve a range of exercises and stretches tailored to the individual’s recovery needs.