Sternoclavicular Joint Separation
What Is A Sternoclavicular Joint Separation? The sternoclavicular joint is located where the collarbone (clavicle) attaches to the breast bone (sternum). These bone are held together by a piece of connective tissue called a ligament. A sternoclavicular separation occurs when the ligaments tears.
How Does It Occur? A sternoclavicular joint separation most commonly occurs when there is a direct blow to the sternum or a fall onto the shoulder or outstretched hands that causes a force along the length of the collarbone. It may occur in a contact sport when a player's shoulder hits the ground and another player lands on top of the other shoulder.
What Are The Symptoms Of A Sternoclavicular Joint Separation? You will have pain, swelling, and tenderness over the sternoclavicular joint. There may be movement between the breastbone and the collarbone. Your collarbone may be displaced either in front of your breast bone or behind your breast bone.
How Is It Diagnosed? Your doctor will review your symptoms and examine your sternoclavicular joint. An x-ray or CT (computed tomography) scan may be ordered to see if there is a gap between your collarbone and breast
How Is It Treated? Treatment may include:
- putting ice packs on the injury for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away.
- taking anti-inflammatory medication or pain medications prescribed by your doctor
- wearing a sling.
- resting your shoulder and arm on the side of the separation until the pain goes away.
In cases where the collarbone is forced behind the breastbone, there may be a risk of damage to the heart or blood vessels in the chest and surgery may be required to repair the separation.
In some cases, the sternoclavicular joint heals but may have some instability, or movement, when you move your arm or shoulder. If this instability causes pain, your doctor may recommend surgery.
When Can I Return To My Sport Or Activity? The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers at a different rate. Return to your sport or activity will be determined by how soon the injured area recovers, not by how many days or weeks it has been since your injury occurred.
You may safely return to your sport or activity when:
- 1. You no longer have pain in the sternoclavicular joint.
- 2. You have full range of motion and strength of your shoulder.
How Can I Prevent A Sternoclavicular Joint Separation? A sternoclavicular joint separation is usually caused by an accident that cannot be prevented.
Sternoclavicular Joint Separation Rehabilitation Exercises: You may do exercises 1 and 2 right away. You may do exercises 3 through 6 when the first two exercises are nearly painless.
1. Chest stretch: Grasp hands behind your back and lift your arms away from your body. Hold 10 seconds. Repeat 5 times.
2. Shoulder range of motion:
A. Flexion and extension: Standing with your elbows straight, slowly lift your arm in front of you and over your head. Return to the starting position, with your elbow straight and bring your arm back behind you. Repeat 10 times.
B. Abduction: Standing with your elbow straight, slowly bring your arm out to your side and over your head. Return to the starting position with your elbow straight. Repeat 10 times.
C. External rotation: Standing with your elbow at your side and bent 90 degrees, slowly rotate your forearm and hand out to the side. Return to the starting position. Repeat 10 times.
D. Horizontal motion: Standing with your arm out in front of you, elbow straight and at shoulder level, move your arm in a horizontal direction out to the side. Return to the starting position. Repeat 10 times.
3. Sitting shoulder flexion: Using a small weight of some kind (soup can, hammer), lift your arm up in front of you with the elbow straight and try to reach over your head. Return to the starting position with your elbow straight. Repeat 10 times.
4. Supine horizontal motion: Lie on your back, hold your arm up until your hand is toward the ceiling. Return your arm to the starting position. Repeat 10 times. As you get stronger, hold a weight in your hand as you do this exercise.
5. Prone extension: Lie on your stomach with your arm hanging over a table or bed. Lift your arm straight back behind you toward the ceiling. Keep your elbow straight. Repeat 10 times. As you get stronger, add a weight to your hand.
6. Prone horizontal motion: Lying on your stomach with your face facing the floor, raise your arms straight out from the side and squeeze your shoulders blades together. Keep your elbows straight and your thumbs up. Repeat 10 times. As you get stronger, add a weight.
All material provided is designed for information purposes only and should not be used to replace the care of a health care professional. Do not rely on any of the information for diagnosis or treatment. It is recommended that you visit a qualified health care professional for individual and personal attention.
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