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AC Separation

The Basics

The acromioclavicular joint is where the acromion (shoulder blade) meets the clavicle (collarbone). Separation of the AC joint occurs when the ligaments connecting these bones together are injured. This is normally caused by either a sudden blow to the outside of the shoulder or falling directly on the shoulder. The acute force from these blows that tears the ligaments can then cause the collarbone and shoulder blade to be separated. AC separation can range from a mild sprain of the ligaments to a complete tear that comes with joint separation.

Risk Factors

Separation commonly occurs in athletes, especially those that play contact sports like football, hockey, and basketball. They also occur in sports that involve falls, like gymnastics and downhill skiing.


The symptoms of an AC separation include pain, weakness, bruising and swelling, limited range of motion, and a bump at the top of the shoulder. This bump, which is more obvious in more serious injuries, makes it easier to diagnose a separation.


The initial treatment for this injury involves taking care of pain, with rest, ice, non steroidal anti-inflammatory medication, and immobilization via a sling. Then, exercises to improve range of motion and physical therapy are helpful. Maintaining motion after a shoulder injury is important in preventing frozen shoulder, which is a condition of immense stiffness and pain and the joint. Surgery for AC separation consists of either cutting back the acromion so it doesn’t rub against the acromion or repairing the ligaments beneath the acromion.

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AC Separation


Recovery for AC separation depends largely on the classification of injury, and if the AC and coracoclavicular ligaments are intact. It also depends on the age and activity level of the patient, as surgery is more likely to be considered for younger, more active patients. Nonsurgical treatment is typically considered for type 1 or 2 fractures, but ample discourse exists regarding the treatment of other classifications of injuries. Overall, the AC joint is a complex joint that can be injured in many different ways and severities, and treatments evolving to account for this.

Patient Resources
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