A Grade 1 separation is really not a separation at all and can be more accurately described as a Grade 1 “injury”. Although the joint has been injured, the x-ray remains normal. In a Grade 1 injury the capsule, also known as the acromioclavicular ligaments have been damaged at a microscopic level and visible lengthening or stretching of the structure is not apparent. While this can still result in significant local pain, the initial treatment is always non-surgical and in most cases symptoms will resolve within 4-6 weeks. In some instances the joint surface can be significantly damaged, however, and can result in the development of traumatic arthritis. Chronic pain can result and treatment requiring either local injections or even surgery can be necessary in some cases.
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