A painful separation

by Dr. Chris Singh

I recently had a professional truck driver come to my clinic complaining of severe shoulder pain following a fall from his trailer. He reported that he had slipped on the wet deck of his flatbed trailer and fell to the ground below. As he fell, his shoulder struck the outside edge of the trailer.

Upon examination, I immediately noticed a bump at the top of his shoulder which is usually a telltale sign of a shoulder separation.

A separated shoulder is an injury to the ligaments that connect the collarbone to the shoulder blade. Shoulder separations can range in severity from mild to severe. In severe cases, the ligaments involved are completely torn or ruptured. 

The most common symptom of a shoulder separation is pain and swelling on the top part of the shoulder. Bruising and arm weakness may also be present in moderate to severe cases. It is also very common for the patient to experience a limited range of motion of the injured shoulder. 

A doctor can usually diagnose a separated shoulder by performing a physical examination, however, an X-ray may be necessary to confirm the diagnosis. 

There are many different causes of this type of injury, however by far the most common cause is a direct blow to the point of the shoulder or a direct fall on the shoulder. People who participate in contact sports such as football and hockey are at a higher risk of sustaining a separated shoulder. 

The good news is that most people fully recovery from a separated shoulder with conservative treatment. A minor injury will usually heal on its own within a few weeks. More severe separations may take months to fully heal. 

The treatment of shoulder separations usually begins with rest and over-the-counter pain relievers such as acetaminophen and ibuprofen. It may be necessary to place the shoulder in a sling to relieve pressure and promote healing. In addition, ice application can help reduce pain and swelling. In severe cases, physical therapy may be needed to help restore strength and motion to the shoulder. 

If conservative treatments fail or the separation is severe, surgery may be an option. The goal of surgery in to stabilize and reposition the injured bones by reconnecting the torn ligaments. The recovery from this type of surgery varies.

As I always say, prevention is the best treatment. It is important for professional truck drivers to use extra caution in situations that may result in a slip or fall. Wearing proper footwear which provides adequate traction is vital. 

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