T Nation

Separated Shoulder


Hopefully someone with some expertise in the area could help, otherwise any info will be greatly appreciated. I separated my shoulder(grade 1) about ten weeks ago and the pain has not subsided, but i need to get back into the gym. Should i just start training with what is tolerable or just suck it up until the pain fully subsides?


You never want to workout through pain (bad pain, that is). Especially with the shoulder joint.

First, go see a doc and maybe a sports PT and get their opinions on the situation. You do not want to fuck up that shoulder anymore than it already is.

If you want to do anything right now, I'd say just simple movements and stretches for it, to help get more bloodflow to the area to help speed up the healing process.


I agree with Sepecialized. I've separated both of my shoulders over the course of the last two years and it's a bitch trying to come back from it.

Once you're able to lift anything again, start with Cuban presses (while humbling to have difficulty doing it with a can of greenbeans, it does indeed help). They made a world of difference in rehab for me.


From a doc's perspective: I would hold off on any lifting over the head or across the body and ideally would not lift at all for a couple of weeks. Hopefully since you know it's a grade 1 sprain/seperation, then you have already seen a dr. Ice three times a day for 10-15 minutes, ibuprofen 800mg thre times a day, and a figure-of-eight brace work best, but an arm sling works too.

If it does not improve, sometimes you can get chronic inflammation there and we can inject it, but then you can't work out for an additional few weeks. Just my 2 cents.


Doc, I've read some material about the adverse effects of NSAIDs on the natural healing process. Something about decreased protein synthesis...?? I think the idea was that NSAIDs treat the symptons and not really the cause of the problem. They reduce the inflamation that causes pain, but not the underlying cause of the problem itself, ie loose muslces/tendons/ligaments.

Isn't some inflamation conducive to the healing process? Since inflamation is the result of increased bloodflow to a region, that would mean more nutrients are being carried to the affected area, and more waste is being carried away. (??)

I'm not a doctor, but I play one on the internet.


Most injuries that I read about on this site are virtually impossible to diagnose because I can't see the person. So, it is pretty tough to give advice on rehab. This is one where I feel comfortable in lending my opinion. Remember this is just my opinion and not a substitute for actually seeing a medical practitioner.

There are several degrees of shoulder separation with grade one being the least amount of ligament damage. Some texts will tell you there are three different grades (I,II, & III) while others go up to VII grades. Grade I is painful, but structurally not horrible unless you push it too much and increase the amount of tearing. At this point you have to let pain be your guide. If it hurts, back off.

I have separated my shoulder twice while lifting. Both times it took months to get to the point where I could go heavy again. If you have to start benching with 5lb dumbbells, then that's what you have to do. Remember there is a fine line between tough and stupid.

As far as treatment goes, you could see a PT for exercises, but there is probably little he/she will do that will accelerate the healing process. They may be able to alleviate some pain for the short term with ultrasound or e-stim, but ice massage at home will be just as effective in this case. Take a styrofoam cup and fill it with water then put it in the freezer. When it is frozen, peel off the lip of the cup to expose the ice and rub it on your skin around the injured area. You can also use an ice cube, but I don't think it is as convenient. Make sure to cover a rather large area on the shoulder (about the size of a baseball) don't just focus on the AC joint or you may frostbite your skin.

When the skin is numb to the touch, you are done. Usually 5-7 minutes, never go longer than 10 minutes. You can do this as many times a day as you can fit it in. I would suggest at least 4. Before work, after work, after dinner and before you go to bed are times when you will generally have a few minutes to spare. If you have any sort of bad reaction to the ice (some are actually "allergic" to the cold but that is another topic) stop immediately.

The exercises that will place extra stress on muscles attached to the clavicle are the ones that will probably be the most painful i.e. bench press, pushups, overhead presses, etc. Once again, let pain be your guide.

Unfortunately you have to be patient when you are injured. If you aren't getting ready for a competition of some sort then there should be no sense of urgency. It is just a speedbump in your training life. Try not to get too frustrated. Hope this helps.


Well I had a grade II separation. One week after this football injury, my physical trainer had me doing stretches as well as a rubber band pulling....I forget what it was called but I think you probably know what Im talking about, but anyways, it took me about a month and a half to get back in the gym. Aside from this knot that I have, I haven't had any pain on shoulder press, military, etc. Just keep it good and stretched. Let me know if this helps.




 As far as your question on NSAIDS.  I try not to take them unless necessary because muscle building is in effect an inflammatory process and I don't want to limit that repair.  However, in your case, and when necessary...you should take them regularly (tree times a day whether it hurts or not, for a period of 5-7days) because the benefit your injured area will receive far outways the very slight detriment the NSAID might have to muscle repair.  Again, just my 2 cents.


sorry for the mispelling of "outweighs" and "three". By the way, the rubber band thingy is usually either "theraband" which comes in increasing resistances differentiated by color, or elastic rubber tubbing, which increases in resistance based on thickness/diameter.


How about bodyweight single leg squats / step-ups / lunges and other exercises that are challenging but don't involve the shoulders?

I read somewhere that you can actually get some (decent?) upper body development by hammoring the lower body - the GH / testosterone level increases help with the upper body too, not just the legs that actually do the work (nutrition is critical, of course).

This might not be what you were hoping for, but at least you don't risk further screwing up your shoulder.

Just a thought. Speedy recovery to you!



eventually once the initial injury has healed which it should have by now... muscular rehabiltation is probably the most important part of treating shoulder problems...

How did you seperate your shoulder? Are you experiencing a lot of impingement? when/what positions cause the shoulder pain? What do you do for a living... what kind of chronic activities is your shoulder still involved in?

I suffered a 1st/2nd degree AC joint seperation in January. The acromoclavicular ligament was not completely torn but there was a fair amount of trauma to the coracoclavicular ligaments and my clavical is "popped up" a noticeable amount.

For a while I did lots of leg and core work avoiding the shoulder... After the initial healing the avoidance really wasn't making the joint any better... I subsequently spent a lot of time strengthening the scapular retractors, especially the rhomboids and medial trapezius. External rotaters and rear delts were also a priority; serratus anterior also helped... Eventually, after the initial healing process, you won't return to full functionality until you stabilize the joint via the surrounding musculature. Mike Robertson or Eric Cressey are awesome guys on this site to consult with.