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Best Shoulder Seperation Treatment in Delhi

Shoulder separation treatment and cure
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What is Shoulder Seperation ?

A shoulder separation, medically known as an acromioclavicular (AC) joint separation or AC joint sprain, is an injury to the joint where your collarbone (clavicle) meets the highest point of your shoulder blade (acromion). It is distinct from a “shoulder dislocation,” which involves the main ball-and-socket joint of the shoulder (glenohumeral joint).

Causes
  • Shoulder separations typically occur due to trauma or a direct impact to the shoulder. Common causes include:-
    • Direct Fall onto the Shoulder: This is the most frequent cause, where a person falls directly onto the top of their shoulder, often with the arm close to the body.
    • Direct Impact to the Shoulder: This can happen in contact sports (e.g., football, rugby, hockey) during a tackle or collision.
    • Fall onto an Outstretched Hand: While less common for AC joint separations, this can sometimes transmit force up the arm to the shoulder.
    • Car Accidents: The shoulder can be injured during a car accident due to direct impact or sudden forceful movements.
Symptoms
    • Pain: Localized pain at the top of the shoulder, often made worse by moving the arm, lifting, or reaching overhead.
    • Swelling and Bruising: Inflammation and discoloration around the AC joint.
    • Tenderness: The area over the AC joint will be tender to the touch.
    • Limited Range of Motion: Difficulty and pain when moving the arm, especially overhead or across the body.
    • Deformity or “Bump”: In more severe separations (Grade II and above), a visible bump or prominence may appear at the top of the shoulder where the collarbone has separated from the shoulder blade. This is due to the collarbone being pushed upwards.
    • Instability: A feeling of instability in the shoulder.
    • Clicking or Popping: May be felt or heard with movement in some cases.
  • Types (Grades) of Shoulder Separation:-
    • Type I: Mild sprain of the AC ligament. The ligaments are stretched but not torn. No visible deformity.
    • Type II: Complete tear of the AC ligament and a partial tear or sprain of the coracoclavicular (CC) ligaments (which connect the collarbone to a different part of the shoulder blade, the coracoid process). There may be a slight visible bump.
    • Type III: Complete tears of both the AC and CC ligaments. This results in a noticeable bump or deformity at the shoulder as the collarbone is significantly displaced.
    • Type IV-VI: These are rarer and more severe injuries involving displacement of the clavicle in different directions, often with associated muscle or fascial tears.

They almost always require surgical intervention.

  • Treatment Options:-
    • Treatment depends on the severity (grade) of the separation:
    • Non-Surgical Treatment (Common for Grade I, II, and often III):
    • Immobilization: A sling may be used for a few days to weeks to support the arm, reduce pain, and allow the ligaments to heal.
    • Ice: Applying ice packs to the affected area helps reduce pain and swelling.
    • Pain Medication: Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen or naproxen can help manage pain and inflammation.
    • Physiotherapy: This is a critical component of recovery for all grades once initial pain subsides.
Advanced Physiotherapy for Shoulder Separation

Physiotherapy is essential for both non-surgical and post-surgical rehabilitation of shoulder separations. “Advanced” physiotherapy for AC joint injuries goes beyond basic exercises and focuses on restoring optimal function, strength, and stability, especially for athletes or individuals with high physical demands.

  • Phases of Advanced Physiotherapy:-
    • Acute/Protection Phase (0-2 weeks, varies by grade):
    • Goal: Pain and inflammation control, protect healing tissues, prevent stiffness.
    • Rest and Sling Use: As advised by the physician.
    • Ice Application: Regularly.
    • Gentle Passive Range of Motion (PROM): Pendulum exercises, assisted range of motion to prevent stiffness without stressing the joint.
    • Scapular Setting: Gentle isometric exercises for scapular stabilizers (shoulder blade muscles) to improve posture and provide a stable base for the arm.
    • Education: Instruction on proper posture, avoiding aggravating movements, and protecting the healing joint.
  • Intermediate/Restoration Phase (2-6 weeks, varies):
    • Goal: Restore pain-free range of motion, begin strengthening, improve muscular control.
    • Active-Assisted and Active Range of Motion (AAROM & AROM): Progressing from assisted movements to independent movement of the shoulder.
    • Isometric Strengthening: Gentle contractions of shoulder muscles (rotator cuff, deltoid, scapular stabilizers) without movement.
    • Scapular Strengthening: Exercises like rows, retraction, and depression to strengthen the muscles that control the shoulder blade, crucial for AC joint stability.
    • Manual Therapy: Joint mobilizations and soft tissue release for surrounding tight muscles (e.g., upper trapezius, pectoralis).
    • Proprioceptive Exercises: Early balance and joint position sense exercises for the shoulder (e.g., light weight-bearing on the hand, gentle perturbations).
  • Advanced/Strengthening & Functional Phase (6-12+ weeks, varies):
    • Goal: Maximize strength, power, endurance, return to full functional activities and sport.
    • Progressive Resistance Exercises: Concentric and eccentric strengthening of all shoulder girdle muscles (rotator cuff, deltoid, lats, pecs, triceps, biceps). This includes weight training, resistance bands, and bodyweight exercises.
    • Plyometric Exercises: For higher-grade injuries or athletes, incorporating exercises that involve quick, powerful movements (e.g., medicine ball throws, push-up variations) to restore dynamic stability and power.
    • Sport-Specific Drills: Gradually reintroducing movements specific to the individual’s sport or occupation (e.g., throwing mechanics, overhead reaching, lifting techniques).
    • Advanced Proprioception and Balance: Exercises on unstable surfaces, closed kinetic chain activities (e.g., push-ups, planks) to challenge the AC joint’s stability.
    • Load Management: Careful monitoring and progression of training load to prevent overuse and re-injury.
    • Return-to-Sport Testing: Functional assessments to determine readiness for full activity, ensuring the shoulder can withstand the demands of the sport/activity.
  • Maintenance/Prevention Phase (Ongoing):
    • Goal: Maintain strength, flexibility, and prevent recurrence.

Ongoing strengthening and stretching program, proper warm-up, and cool-down routines, attention to technique in sports/activities, and regular self-monitoring for any signs of discomfort.

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