Shoulder > Shoulder Separation > Treatments

    Sling, Rest, Medication, Physical Therapy

Home Recovery

After a shoulder separation, you may need to take steps to reduce the pain and inflammation in the shoulder for several weeks. Rest, ice, and anti-inflammatory painkillers such as ibuprofen or aspirin can ease pain and immobilizing the shoulder will keep it stabilized. Here is what you can expect and how you can cope with a sling immobilizing your shoulder:

   The first concern is to monitor swelling for the first 48 hours while wearing your sling. Physicians generally prescribe ice packs to be applied for 20 minutes at a time, three or four times a day.

   If the swelling has decreased after three days, you may be able to apply heat to help reduce pain. You should not apply heat to swollen areas because heat increases blood flow to the skin, which can prolong the healing process.

   The sling helps protect you from further injury. You can remove it frequently to perform activities of daily living, such as bathing, sleeping, and eating.

   You should move your fingers and hands in the sling as much as possible to help circulate blood.

   If you develop a rash or irritated skin around your sling, call your physician.

Light rehabilitation can usually begin within a week of the separation. The sling may make it difficult to use the hand on the side of the injured shoulder.

After your pain subsides and the ligaments start to heal, your physician or physical therapist may recommend some aerobic exercise, like stationary cycling, with your shoulder taped or in the sling to keep the rest of your body in shape. After about one or three weeks of immobilization in the sling, your physician may refer you to a physical therapist to begin specific shoulder rehabilitation exercises. However, many patients regain range of motion and strength without formal physical therapy. The average healing times with physical therapy are:

   One to three weeks for minor type I separations.

   Three to six weeks for moderate type II separations.

   Six weeks to three months for severe type III separations.

The first stage of physical therapy usually involves shoulder shrugging and range of motion exercises with the assistance of your physical therapist. You can usually begin performing light resistance exercises with elastic bands in the second week of physical therapy. Sometime between weeks three and six, depending on the severity of your separation, you can begin more intense strengthening exercises for the rotator cuff, chest, and back muscles. When the attachment between your collarbone and shoulder blade is strong enough to withstand stress, rehabilitation tends to become more activity oriented. Sport-specific exercises and coordination drills help prepare you to return to sports and activities. If you plan on participating in contact sports, your physical therapist may help you boost your confidence with exercises that involve falling on your shoulder and rolling on the floor.

The best way to prevent a repeat shoulder separation is to make the shoulder strengthening exercises you learned in physical therapy part of your everyday routine. Rotator cuff strengthening helps reduce the risk of overuse problems during athletic or work activities that require repetitive overhead motions. You should wear shoulder pads during contact sports and try to avoid activities like tackling if possible. In some cases, your physician may prescribe shoulder braces that are designed to help prevent your shoulder from moving out and back. These braces can help decrease stress on the shoulder ligaments. Having an athletic trainer tape your shoulder may also help to hold it in position. However, braces and taping should never be used as a substitute for strong and flexible muscles. Be sure to warm up before activities by rotating your arms and shoulders in different directions. After a shoulder separation, you should be careful to notice any pain or discomfort in your shoulder during athletics. Avoid playing through shoulder pain. The more often you separate your shoulder, the weaker the ligaments become, and the greater your risk of developing complications such as arthritis.

Many shoulder separations (acromioclavicular joint injuries) can be treated without surgery. Your physician will typically immobilize your shoulder in a removable sling. You typically wear the sling until your ligaments heal, which varies based on ligament damage and your ability to regenerate healthy tissue. In general, slings are worn for up to two weeks until pain is gone when you move your shoulder. Slings may be removed for short periods to perform activities like eating and bathing and for gentle range of motion exercises. Heavy lifting, sports, and vigorous overhead activities are discouraged until pain is gone. This may take seven days to three weeks depending on the severity of injury. Your physician typically teaches you a home treatment program that includes ice and heat therapy. Acetaminophen, aspirin, or ibuprofen can alleviate discomfort, but your physician may prescribe stronger pain relievers. A corticosteroid shot may be administered months or years after the injury to treat persistent pain.