Do I have a separated shoulder?

[jhoop1]

Yesterday, I injured my right shoulder playing basketball. There was definitely no dislocation because the pain was not excruciating and I never lost control of my arm.

I'm thinking it might be a minor separated shoulder. But I'd like some other opinions (please see pictures below) before deciding if it's necessary to make an appointment to see a sports medicine specialist.

In the pictures, you can clearly see there is a bump on my right shoulder when my arms are extended. Does that indicate a Type II Separated Shoulder?

If it's a Type III-VI Separated Shoulder, then I know I need to see a doctor. But Type I-II heal naturally over the course of a few weeks. I don't think it's Type IV-VI because there's not enough deformity (perhaps the bump is mostly swelling, although I don't think the size of the bump has changed since the initial injury).

Is the bump large enough for it to be a Type III Separated Shoulder?

Yesterday when the injury occurred, the pain was not too bad -- I assumed it was a stinger and played the rest of the basketball game. The pain got a little worse a few hours later, but I was able to do strength training (lower body) after the game. It only really hurt to lift my right arm over my head, especially if it tried to touch my left shoulder. Today the pain has lessened somewhat. This afternoon, I got in some exercise doing cardio on a stationary bike. I was careful not to jostle my right shoulder or put stress on it. After the workout, I did not notice any increased pain or soreness in my shoulder. If anything, the pain lessened -- perhaps some stretching loosened it up a little bit.











Shoulder injury history:

3 years ago, I suffered a minor separated shoulder (same shoulder - right) while mountain biking. I saw a sports medicine specialist about 1 week after the injury. The doctor said the shoulder should heal by itself and I didn't really need to rest it because there wasn't an increased risk of making the injury worse. He also prescribed me Mobic for the pain (I didn't end up taking any). My shoulder was back to normal in about 2-3 weeks. That minor separated shoulder (the doc didn't specify Type) feels very similar to my current injury, maybe a little less pain this time.

2 years ago, my left shoulder gave out when lifting weights -- on the 1st rep of a warm up set (only 40% of my max weight) of dumbbell shoulder presses. My shoulder felt sore, I didn't notice any bumps or deformities. The soreness gradually went away after about 2 weeks and I did not lose any strength in the shoulder.

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[physiobob]

Looks like an ACjt rupture but would need to do a physical assessment to be sure. It can be confirmed with an x-ray but that's not really needed. A complete rupture that is 'new' could heal with the aid of a screw from the collar bone to the acromion. Unfortunately left as it is (without surgical intervention) it will not heal and you will always have that step deformity.

Looking at your posture generally you seem to be a little lax in that area bilaterally. So maybe it is not a complete rupture but it does look like it.

[jhoop1]

Thanks for the insight, Bob.

Surprisingly my shoulder feels much better today -- 48 hours after the injury. Only a little bit of pain when I lift my right arm over my head and touch my left shoulder. But I'm basically pain-free.

Would the pain go away this quickly if it was a "new" AC joint rupture? When I injured the same shoulder 3 years good, it took 3-4 weeks for the pain to go away. To my untrained eye, I only notice the the bump when I extend my arms laterally. Could the bump/step-deformity be from that 3-year-old injury? If so, does this mean my shoulder is more susceptible to injury? I don't mind the minor deformity, but if it means I'm at an increased risk of injury, then surgical repair makes sense. My anecdotal evidence seems to indicate no increased risk -- I've only injured this shoulder twice in my life (I don't play any full contact sports, but basketball and mountain biking do involve some contact).

I do need to improve my posture. At 6'7, I've fallen into the habit of leaning down to talk people. Can you recommend any exercises for improving posture? Balancing a book on my head... haha.

[physiobob]

I'd suggest basketball is the real risk here, although as a fellow mountain-biker I can say falling off with an outstretched arm can be an issue

Your tear might be old and what we see is what's been there for yrs now. I can't really say. We will see more and more surgical repairs of these in the future. In general Dr's a to lazy to bother as most people do fine without. That said I think that there is longitudinal evidence to suggest a disrupted AC.jt leads to earlier onset of arthritic changes in the shoulder joint.

As to your height and posture, suggest finding a tall girlfriend!

[Tim2225]

Hello, I have hope's that I can gather some information in regard's to a grade 2+ shoulder separation. 2 months ago I fell on my L shoulder snowboarding, bummer too, it was right at the end of the snowboard season. After I took my slam I esessed the damage. My clavicle was sticking up and I had pain in my shoulder. Went home and got a xray from 2 different ortho doctor's, telling me rest and ice and my shoulder should be back to normal within 2-12 weeks. I'm also involed in many other sports including weightlifting. This plays a big part on my mental health. I am now 2 months into this injury and the only thing that has got better is the ache. My shoulder is weak and instable and I can't do a push up. Does it sound like I should be further along at this point with my recovery? Will I ever be able to workout, Benchpress,Free weight's? Is surgery have the best outcome for this injury? AnyAdvice or opinon's will help, this injury has effected my work, my income, and my lifestyle. Thank u