Separation > Treatments
Sling, Rest, Medication, Physical Therapy
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:
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.
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
sling helps protect you from further injury. You can
remove it frequently to perform activities of daily
living, such as bathing, sleeping, and eating.
should move your fingers and hands in the sling as much
as possible to help circulate blood.
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:
to three weeks for minor type I separations.
to six weeks for moderate type II separations.
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.