The clavicle, or collarbone, is the horizontal strut connecting the shoulder complex to the chest. A “dislocated collarbone” usually refers to one of two distinct, painful injuries involving the joints at either end of this bone. Because the clavicle protects major nerves and blood vessels traveling to the arm, any injury causing significant displacement is a serious orthopedic event requiring careful assessment and stabilization before manual therapy is considered.
Understanding the Types of Collarbone Injuries
Collarbone injuries resulting in dislocation involve either the acromioclavicular (AC) joint or the sternoclavicular (SC) joint. An AC joint separation occurs at the outer end of the clavicle where it meets the shoulder blade, usually from a direct fall onto the shoulder. This injury is graded, often using the Rockwood classification, from a mild sprain (Grade I) to a complete tear with gross displacement (Grade VI).
The SC joint is at the inner end of the collarbone, connecting it to the sternum. SC joint dislocations are less common but often result from high-impact trauma. An SC dislocation can be anterior or posterior, with posterior dislocations posing a greater risk due to potential compression of the trachea, esophagus, or major blood vessels.
Is Chiropractic Spinal Adjustment Safe for Acute Dislocation
A chiropractor should not attempt to perform the acute reduction, or “resetting,” of a severely dislocated collarbone joint. The primary reason is the high risk associated with manipulating an acutely unstable joint that has suffered significant ligamentous trauma. Manipulation of a joint that is not structurally intact can easily cause further displacement or tear surrounding tissues.
For an unstable AC separation (Grade III or higher) or an SC joint dislocation, forceful adjustment risks damaging underlying structures. These include the neurovascular bundle beneath the clavicle, such as the brachial plexus nerves and the subclavian artery or vein. Acute traumatic instability falls outside the safe scope of manual manipulation and requires immediate referral to a hospital setting for diagnostic imaging and orthopedic consultation.
Necessary Medical Care for Joint Reduction and Stabilization
Immediate medical evaluation in an emergency setting is the first step for a suspected collarbone dislocation. The medical team will order diagnostic imaging, typically X-rays, to confirm the injury type and grade. For SC dislocations or when assessing internal damage, a computed tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
Treatment is managed by an orthopedic specialist, who determines the need for joint reduction and stabilization. Lower-grade AC separations (Grade I and II) are typically treated non-surgically with a sling and rest. More severe AC injuries (Grade IV, V, or VI) often require surgical intervention, such as open reduction and internal fixation, to restore the joint and stabilize it with hardware. For SC joint dislocations, a closed reduction may be performed by an orthopedic or thoracic surgeon, often under anesthesia, to manually guide the clavicle back into position.
Adjunctive Chiropractic Care During Rehabilitation
Once the collarbone joint has been medically reduced, stabilized, and cleared by the orthopedic physician, chiropractic care can play a supportive, adjunctive role during rehabilitation. This care focuses on addressing secondary issues arising from the trauma and subsequent immobilization. Extended use of a sling or brace can cause stiffness and pain in adjacent areas, particularly the neck, upper back, and shoulder blade muscles.
The chiropractor may use gentle mobilization techniques on spinal segments and other joints distant from the injury site to restore normal movement patterns. Soft tissue therapy, such as therapeutic massage, can alleviate muscle spasms and tension. Furthermore, a chiropractor can prescribe specific therapeutic exercises designed to safely restore range of motion, improve postural stability, and gradually strengthen the muscles supporting the shoulder complex after the initial healing phase.