Sternoclavicular Joint Separation

Sternoclavicular Joint Separation

Diagnosis Explanation:

A sternoclavicular (SC) joint separation occurs when the ligaments connecting the clavicle (collarbone) to the sternum (breastbone) are stretched or torn, causing instability and pain at the base of the neck or upper chest. This injury is typically caused by direct trauma, falls, or impact to the shoulder.

Types of SC Joint Separations:

  • Grade 1 (Mild Sprain): Ligaments are stretched but intact; mild pain and swelling.
  • Grade 2 (Moderate Sprain): Partial ligament tear; noticeable pain, swelling, and joint instability.
  • Grade 3 (Severe Dislocation): Complete ligament tear; the clavicle shifts forward (anterior) or backward (posterior, which is more dangerous due to potential damage to major blood vessels and organs).

Symptoms:

  • Pain, swelling, and tenderness near the collarbone-sternum connection.
  • Clicking or popping sensation with movement.
  • Difficulty moving the shoulder or arm, especially across the chest.
  • Visible deformity if the joint is dislocated.
  • Shortness of breath or difficulty swallowing (if posterior dislocation is present).

Specific Work Modifications:

  • If your job requires standing or walking: Avoid lifting, pushing, or pulling with the affected arm.
  • If your job involves lifting: Avoid carrying heavy loads, especially across the body. Use both hands when possible.
  • If your job is desk-based: Keep the shoulder supported, avoid leaning on the affected side, and take breaks every 30 minutes.
  • Avoid: Overhead reaching, repetitive shoulder use, and activities that put pressure on the SC joint.

Specific Activity Modifications:

  • If you play sports: Avoid contact sports, throwing, and weight-bearing arm activities until cleared for return.
  • If you do weightlifting: Avoid bench presses, overhead presses, dips, and pull-ups; instead, focus on controlled, pain-free movements.
  • If you do yoga or Pilates: Modify poses to avoid deep shoulder stretches, deep breathing pain, or arm weight-bearing.
  • Avoid: Any activity that puts strain on the collarbone and chest, including push-ups, rowing, or heavy lifting.

Recommended Supplements:

  • Collagen Peptides – 10g daily for ligament and joint repair.
  • Vitamin C – 500mg daily to support collagen synthesis.
  • Glucosamine & Chondroitin – 1500mg/1200mg daily for joint lubrication and ligament health.
  • Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
  • Turmeric (Curcumin) – 500-1000mg daily for natural pain relief.

Recommended Nutrition and Hydration:

  • Increase Lean Protein (chicken, fish, tofu, eggs) to support ligament and muscle healing.
  • Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
  • Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
  • Limit Processed Foods & Sugars to prevent inflammation.
  • Hydration: Drink 8-10 cups of water daily to support joint function.

Home Exercise Prescription (Rehabilitation for SC Joint Separation)

Early Phase (0-2 Weeks, Reducing Pain & Protecting the Joint):

  • Immobilization – Wear a sling for 2-4 weeks, as directed by your doctor.
  • Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
  • Scapular Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
  • Neck & Chest Stretch – Gently tilt the head away from the injured side, hold 20 seconds, 3x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Mobility):

  • Wall Walks (Forward and Lateral) – Use fingers to "walk" the arm up the wall, hold 5 seconds, repeat 10 reps, 2x/day.
  • External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
  • Internal Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm inward, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Maintaining Mobility):

  • Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
  • Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
  • Modified Push-Ups (Wall or Knees, If Pain-Free) – Maintain control, 10 reps, 2x/day.

Helpful Books:

  1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
  2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.

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