Jock Doc

Does a separated shoulder require surgery to fix?

Q: Last week, I fell off my bike and landed on my left shoulder. I had severe pain and noticed a bump on the top of my shoulder. I went to the emergency room where X-rays were taken and I was told that I had a separated shoulder. A doctor put my arm in a sling and I was referred to an orthopedic doctor who advised me to have surgery to fix the separation once my abrasions healed. I did research online and some websites said separated shoulders can usually get better without surgery. I am now confused and wonder what I should do?

A: There are two main joints in the shoulder region. The ball and socket joint called the “glenohumeral joint” can pop out of place or dislocate and if it remains unstable, it will frequently need surgery to restore normal stability and function.

The other main joint is the acromioclavicular joint, which is on the top of the shoulder where the collar bone attaches to the upper part of the scapula. There are two pairs of ligaments that stabilize this joint that when injured, result in a shoulder separation.

Mild and moderate sprains are usually treated with rest and rehabilitation. Severe injuries of the acromioclavicular joint, in which both pairs of ligaments are completely torn, may result in a large bump where the collar bone rises out of place. Depending upon the age of the patient and the degree of deformity, some of the more severe injuries may require surgery.

It is not wise to operate until your abrasions heal as this would increase your risk of infection. Since you are not sure of your best options, I recommend you get a second opinion.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to