A shoulder separation — also called an AC (acromioclavicular) sprain — is a tear of the ligaments holding the collarbone to the shoulder blade, usually from a direct blow or fall onto the shoulder. It’s graded I to IV by how far the collarbone shifts out of place ; most grade I and II separations, and many grade III, heal without surgery.
Early management
Ice and a sling or shoulder immobilizer for support until pain-free movement returns. Severe grade III injuries may need an orthopedic surgeon’s input.
Rehab progression
- Phase 1 — Wand exercises: flexion, extension, and rotation using a stick, done gently while the ligament heals.
- Phase 2 — Active range of motion: shoulder flexion, abduction, and horizontal movements without assistance.
- Phase 3 — Progressive strengthening: prone shoulder extension, triceps and biceps work, and single-arm lifts, adding weight gradually.
A permanent small bump at the joint is common and usually not a medical problem. Return to sport once strength and pain-free range of motion match the uninjured side.
ACJ injury rehabilitation
This page is educational and general in nature and does not replace an individualized evaluation — see our medical disclaimer.