Ouch! You did something to your shoulder, and now it aches and twinges when you move your arm. In all likelihood, you’ve sprained your shoulder. But what exactly is a shoulder sprain, and how should it be treated for a full recovery?
Anatomy of Your Shoulder
Sprains occur at the highest point of your shoulder, where the collarbone (clavicle) meets the bony knob (acromion) at the top of the shoulder blade (scapula). These are connected by ligaments, and the whole area is referred to as the acromioclavicular joint (AC joint).
Shoulder Sprain Severity
A sprain is a tear or separation of a ligament. This is different from a strain, which involves tearing of the muscle or tendon, or a labrum tear, which involves the lining of the joint socket itself.
There are three commonly referenced “grades” of tearing or separation when it comes to shoulder sprains.
Grade I
In a Grade I tear, the acromioclavicular ligament is partially torn. However, the next connecting ligament, the coracoclavicular, is undamaged. This means the collarbone and shoulder blade stay bound together and there isn’t a noticeable separation. The acromioclavicular joint remains tightly joined thanks to the coracoclavicular ligament, and in most cases the shoulder will heal with non-invasive treatment, bracing, and rehabilitation.
Grade II
In a Grade II tear, the acromioclavicular ligament is completely torn through, and typically the coracoclavicular ligament is partially torn. The collarbone is still somewhat connected to the shoulder blade, but there is a lot of instability and some separation is usually visible as the collarbone will angle out of alignment. The acromioclavicular joint will need to be stabilized, and the joint may require minimally invasive surgery like arthroscopy to repair damage. Expect some weeks of bracing and rehabilitation.
Grade III
In a Grade III tear, both the acromioclavicular ligament and the coracoclavicular ligament are torn all the way through and the collarbone is completely separated from the shoulder blade. The damage is very visible, and surgery will be required to unfasten the ligaments and put the collarbone back into place. Recovery from a Grade III tear can take months, ranging from complete immobilization in the brace to repeated rehabilitative therapy sessions to restore range of motion.
In most cases, a sprain is caused by an acute injury. This can include an impact on the sports field that causes abrupt wrenching, extension of the shoulder, or by an overuse injury in which case the damage accumulates over time. Treatment for a shoulder sprain should be sought sooner rather than later, so the ligaments can be correctly positioned for healing.
If you think you have a shoulder sprain, we can help. Contact Syracuse Area Health – Strasburger Orthopaedics for a consultation today.