Anyone who windsurfs knows the feeling of being launched forward in your harness on a gusting day. But what if it is stronger than anticipated and you end up being catapulted into your boom or sail? Assuming your shoulder hits first, you will probably end up with some degree of shoulder separation. Sprains of the acromioclavicular joint, or AC separations, are usually the result of a direct blow to the top of the shoulder causing the ligament to become stretched out or torn completely. Immediate pain is felt at the top of the shoulder and the distal end of the clavicle (collarbone) can be seen higher than the opposite side. There will also be an inability to lift the arm comfortably.

It is important to follow-up with an orthopaedic surgeon for accurate diagnosis. At The Stone Clinic in San Francisco, we first rule out a fracture to the clavicle or humeral head, as well as assess the degree of the sprain. If it is a partial separation, where some or most of the ligament is still attached, we treat these with sling use for the first few days for comfort, regular icing, putty/forearm gripping exercises, as well as shoulder taping to reduce the pull of the separated bones. Neck stretches, shoulder blade squeezes, bicep, tricep and rotator cuff exercises are started after the first few days. Range of motion and strengthening exercises for shoulder height and above are instituted after about 2-3 weeks. ETW (Estimated Time to Windsurfing): about 4-6 weeks.

In complete tears of the ligament, surgical repair is usually recommended in the windsurfing community. Problems such as persistent pain, weakness and possible future degenerative changes in active populations are not uncommon. Surgical repair consists of using a special tape to stabilize the area where the ligaments are torn. Sling use for 2 weeks post-op, along with below the shoulder strengthening exercises are performed. After 4 weeks, above the shoulder strengthening exercises are instituted. ETW: 3 months post-op.

Careful adherence to a regular strengthening program helps guarantee a comfortable return to the water. Take care of the shoulder to avoid "Separation Anxiety".