Recovery from a separated shoulder (AC joint sprain) depends on its grade. A mild sprain often settles enough for daily tasks in about 2 to 4 weeks. A moderate sprain often takes 4 to 8 weeks. A more severe separation with a clear bump is usually still treated without surgery and often takes about 3 months before heavy lifting or contact sport. The highest grades are less common and are usually discussed with a surgeon.
A separated shoulder is not a dislocated shoulder. The injury is at the top of the shoulder, where the outer end of the collarbone meets the tip of the shoulder blade (the acromioclavicular or AC joint). It usually follows a fall onto the point of the shoulder, from a bike, a tackle or a slip.
This page assumes a doctor has checked it. If the skin over the bump is tight, white or broken, go to the emergency section near the end first.
Key takeaways
- Where it is: a separated shoulder is a sprain of the AC joint, where the collarbone meets the shoulder blade on top of the shoulder.
- Typical recovery: often 2 to 4 weeks for a mild sprain, 4 to 8 weeks for a moderate one, and about 3 months for a severe separation.
- Most are treated without surgery: including many separations with a visible bump.
- The bump: a visible step on top of the shoulder often stays for good, and many people have little trouble from it.
- Surgery: usually discussed for the highest grades, types 4 to 6.
The grades in plain words
Grades run from type 1 to type 6, by how many ligaments are torn and how far the collarbone has moved.
- Type 1, mild: the ligament around the joint is stretched. Tender on top, no bump, X-ray looks normal.
- Type 2, moderate: the joint ligament is torn and the stronger ligaments below are stretched. A small step may show.
- Type 3, severe: both sets of ligaments are torn and the end of the collarbone sits up as a clear bump. Most people are still treated without surgery first.
- Types 4 to 6, high grade: the collarbone is pushed far up, backward or down. Less common, and surgery is usually discussed.
Where are you right now?
- It has just happened: check your grade above, then the week-by-week section.
- Weeks in and not settling: go to “If it isn’t going to plan”.
- After an injection or surgery: a steroid injection is sometimes used for AC joint pain that lingers months later. After a reconstruction, your surgeon’s protocol comes first.
- Getting back to work or sport: the “When can I…” table gives typical ranges by grade.
Week by week
- Days 1 to 7: a sling for comfort, a few days for a mild sprain and up to 2 to 3 weeks for a severe one. Keep the elbow, wrist and hand moving.
- Weeks 1 to 3: gentle movement below shoulder height. Reaching across the body and lying on that side usually still hurt.
- Weeks 3 to 6: shoulder blade and rotator cuff strengthening builds up. Many mild and moderate sprains reach full daily use by now.
- Weeks 6 to 12: a severe separation usually reaches overhead reaching and heavier lifting in this window. Push-ups, bench pressing and dips are usually the last to feel comfortable.
- Months 3 to 6: a minority, mostly after a severe separation, still ache with load. This is often when a surgical opinion is reconsidered.
The bump often stays. How the shoulder works matters more than how it looks.
Where else this could be coming from
- Broken collarbone (clavicle fracture): pain and a bump further along the collarbone rather than at its outer tip. An X-ray tells them apart.
- Dislocated shoulder: the ball of the upper arm leaves its socket. The side of the shoulder looks squared off.
- Rotator cuff tear: pain on the outer upper arm with weakness lifting the arm, especially after 40.
- AC joint arthritis: a gradual ache at the same spot over months or years, without one clear fall.
- The neck and upper trapezius: a broader ache sloping from the neck that changes with neck movement rather than reaching across.
Is this normal?
- “The bump has not gone down.” Common. With a type 2 or 3 injury, the step usually stays. Swelling around it settles over weeks.
- “Reaching across to the seatbelt still hurts.” Reaching across the body squeezes the AC joint, so it is often the last movement to feel easy.
- “It clicks on top.” Painless clicking at the AC joint is common after a sprain.
- “I cannot lie on that side.” Common for several weeks while the joint settles.
If it isn’t going to plan
It is week five. Carrying your work bag on that shoulder still sets off a deep ache on top, and you have started switching it to the other side without thinking. The thought in your head is that it is a sprain, so it just needs more time.
Time settles the sprain, but it does not rebuild the support around it. When the ligaments that hang the shoulder blade from the collarbone are torn, the shoulder blade muscles carry more of that work. If they weaken during weeks of rest, the AC joint keeps aching with load.
What a separated shoulder needs after the first weeks is graded strengthening of the shoulder blade and rotator cuff muscles, built up to the loads your work or sport asks for.
If you are 6 weeks in and not clearly improving, get assessed by a physical therapist or your doctor. Ask:
- Grade: what type is my AC joint injury, and what does that mean for my timeline?
- Shoulder blade: is my shoulder blade moving well, and which exercises target it?
- Surgery: at what point would a surgical opinion make sense for my grade and job?
When can I…
| Activity | Typical range |
|---|---|
| Sleep on that side | Often 2 to 4 weeks for a mild AC sprain; 6 to 12 weeks for a severe one |
| Drive | Often within 1 to 3 weeks, once out of the sling and able to steer safely |
| Reach overhead | Often 2 to 4 weeks for a mild sprain; 6 to 12 weeks for a severe one |
| Lift | Light loads within weeks; heavy lifting and pressing often 6 to 12 weeks |
| Desk work | Often within days to 1 week |
| Manual work or sport | Often 2 to 4 weeks for a mild sprain, 4 to 8 for moderate and around 3 months for severe; contact sport at the longer end |
If you have had surgery, your surgeon’s protocol comes first.
Call your local emergency number or go to the emergency department if
- Skin at risk: the end of the collarbone is pressing the skin tight and white, or has broken through it.
- Circulation: the arm or hand is cold, pale or blue.
- Breathing: chest pain or breathlessness after the fall.
- Head or neck injury: a blow to the head, confusion, or neck pain with arm weakness or tingling.
See a doctor today if
- Not yet checked: a new bump on top of the shoulder after a fall that no one has examined.
- Numbness: new numbness or tingling in the arm or hand.
- Cannot move the arm: you cannot lift it from your side at all.
Get it checked soon if
- Bump growing: the step on top of the shoulder looks bigger than it did after the first week.
- Stalled recovery: pain is not clearly better after 6 weeks, or after 3 months with a severe separation.
- Shoulder blade: the shoulder blade sticks out or the shoulder droops forward when you lift the arm.
More on this area: shoulder conditions.
Most separated shoulders recover without surgery, and the grade tells you roughly how long to expect.
Written by Louise Yow, Neck & Shoulder Physio.