by James Hubbard, M.D., M.P.H.

When I was growing up and heard the sports announcer say some player suffered a shoulder separation, I’d picture the poor athlete with his shoulder actually separated in two. Horrible. How could he ever play again?

Now I know it’s usually not quite as bad as it sounds. Okay, it’s never happened to me, but … shoulder (or AC) separations, clavicle fractures, and rotator cuff tears and strains are some of the most common shoulder injuries I see. Fortunately, until you can get to a doctor, the initial treatment for all is similar:

  • A sling because broken bones need to stay immobile to heal
  • Ice packs to reduce swelling
  • Pain relievers, such as ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol)

Still, it’s good to have some idea of the injury you’re dealing with since some of the details differ. Here are some tips that might help if it’s going to be a while until you can get X-rayed and treated by medical personnel:

Clavicle (collarbone) break: Suspect a break if there’s been direct trauma (maybe a fall) and part of the bone is very tender. Sometimes there’s a knot. It takes about six weeks for a clavicle fracture to heal. Some need a surgical plate or pin. A doctor should determine that.

AC (acromio-clavicular) separation: Ligaments attach the clavicle to the shoulder at part of the bone called the acromion. An AC separation can be a bruise, strain, or tear of these ligaments, usually caused by a direct fall on the shoulder. The AC joint will be tender, sometimes swollen, and painful to move. Treatment is a sling usually for one to four weeks. If the ligaments are torn badly (fairly rare), healing may take quite a bit longer. Of course, see a doctor as soon as you can to assess the severity and make sure nothing’s broken.

Rotator cuff strain or tear: The rotator cuff is a group of ligaments, tendons, and muscles that surround the shoulder joint. Any one of these can be strained or torn. Until you can get expert care, put your arm in a sling.

For more details on treating these common shoulder injuries, including how to make a sling out of your own shirt, see the video above.

In my next video, I’ll talk about how to treat shoulder dislocations.