Sternoclavicular Joint Separation

What is a sternoclavicular joint separation?

The sternoclavicular joint is located where the collarbone (clavicle) attaches to the breastbone (sternum). These bones are held together by a piece of connective tissue called a ligament. A sternoclavicular separation occurs when the ligament 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?

There is pain, swelling, and tenderness over the sternoclavicular joint. There may be movement between the breastbone and the collarbone. Your collarbone may be in front of or behind your breastbone.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine you. You may also have an X-ray, CT scan, or MRI.

How is it treated?

To treat this condition:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Wear a sling.
• Rest your shoulder and arm on the side of the separation until the pain goes away.

If the collarbone is forced behind the breastbone, there may be a risk of damage to the heart or the blood vessels in the chest. You may need surgery.

In some cases, the joint heals but may be unstable or shift when you move your arm or shoulder. If this instability causes pain, you may need surgery.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your injured area recovers, not by how many days or weeks it has been since your injury. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when:

• You no longer have pain at the sternoclavicular joint.
• You have full range of motion and strength of your shoulder.

How can I prevent it?

A sternoclavicular joint separation is usually caused by an accident that cannot be prevented.