Sternoclavicular Dislocations

SC joint
The sternoclavicular joint is the joint between the end of the clavicle and the sternum (white circle).
The sternoclavicular joint is the joint between the clavicle (collarbone) and sternum (breast bone). It is an uncommon injury when you consider all shoulder injuries. It typically occurs in contact and collision sports, such as football and rugby. It is a very painful, and potentially dangerous, injury, and a sports medicine physician should see athletes who are suspected of having this injury immediately.

Typically the athlete is injured with a direct blow, either to the chest or shoulder. Depending on the direction of the force, a blow to the shoulder can cause an anterior or posterior sternoclavicular dislocation. An anterior dislocation of this joint means that the collarbone has popped out in front of the sternum. A posterior dislocation means that the collarbone has gone behind the sternum. While both types of dislocations are very serious, a posterior dislocation can be a surgical emergency, as the end of the collarbone becomes extremely close to the airway and large blood vessels of the heart and chest.

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The athlete will complain of pain in the shoulder and/or chest immediately. He likely will have difficulty moving the arm due to the pain. Posterior dislocations can often cause the athlete to have difficulty breathing, and the physician may notice that he is short of breath or wheezing.

Posterior sternoclavicular dislocation
Note how the end of the left clavicle (which is the one on the right in the image) has dislocated behind the sternum.
Physical examination usually shows that the end of the collarbone is very prominent on the injured side if it is an anterior dislocation, and the athlete will be very tender at that location. Evaluation with x-rays, and a CT scan if needed, is critical, so I send players with suspected sternoclavicular dislocations to the emergency room right away.

Posterior sternoclavicular dislocation
On this three-dimensional CT scan, note how close the dislocated clavicle is to the large blood vessels of the chest. This injury needs urgent reduction.
Treatment of these injuries depends on the direction of the dislocation. Anterior dislocations can be put back in place with gentle pressure on the clavicle, pushing it back in line with the sternum. Sometimes it’s difficult to reduce into the proper position, or it pops back out of place, but fortunately an anterior dislocation leaves only a cosmetic deformity. Usually little long-term functional deficit exists after the athlete has recovered.

A posterior dislocation, on the other hand, needs urgent reduction. Whether this reduction is done in the emergency room or the operating room is controversial. The clavicle needs to be reduced back into place with the sternum to prevent the clavicle from causing injury to the blood vessels and airway nearby. Occasionally surgery to open the joint and manually put the clavicle back into place is needed.

If you have specific questions about sternoclavicular dislocations, please Ask Dr. Geier directly or Schedule an Appointment.

24 Responses to Sternoclavicular Dislocations

  1. Hi,
    I’m a 14 year old swedish boy that dislocated my collarbone by the sternum two days ago and I have a big rugby game in 5 weeks.
    Will I be able to play?

    • Generally athletes can return to play when pain, swelling, motion, and strength return to normal after an anterior SC dislocation.

  2. I was involved in a bicycle crash on June 6. I have a broken 4th rib in my back.also my doctor says that Ihave a anterior collarbone – sternum dislocation .there’s not much pain in the collar bone. Some clicking though Full range of colours in bruising on right side of chest. doc says to just leave it alone ,and start doing some light range of motion exercises .In your opinion is this the correct course of action ?I was in the whirlpool today and did some easy yoga moves,good results. Not using sling , able to drive car ,shift gears. Am I making things better or worse? Using less Ibuprofen each day.

  3. I have a dislocation in both my right AC & SC joints, they both make the clavicle to appear raised to the outside (piano-key), the displacement is about half centimeter (quarter inch) near the AC end and quarter centimeter (eighth of an inch) from the SC end of the clavicle, is there away to force the clavicle into its place manually without surgery?
    (if so please what’s this process called, and what specialist should I be seeing?). Thank you so much.

    • Typically it is not possible to reduce the clavicle and keep it in place without a surgical procedure. Depending on the extent of injury, though, many patients do not need surgery to regain full function.

  4. Hi
    Three months ago I suffered from an anterior SC dislocation I now have full range of motion with little to no pain on my on my collarbone. But I’m not sure if it healed properly the bone is still patruding and I get a lot of pain when I reach over the opposite shoulder and try to grab my shoulder blade! So does that maybe mean it’s still dislocated??? Oh yeah and for some reason I get a lot of pain on my SC joint out to my shoulder when I smoke pot.

  5. I’m a previously healthy 43 year old woman. Diagnosed with a posterior and superior sc dislocation. After figure 8 surgery clavicle still moves around causing pain/thoracic outlet syndrome and claw-hand symptoms. (And much more)
    If you have experienced similar, please respond here, or at my email. I am searching for doctors with expertise that can help. Thank you for your time. H

  6. My 14 yr old has a anterior dislocated SC joint doctor says all of the things that are said here about recovery just not clear on how you can manage after it heals and you get range back he plays sports what is he gets hit there in a yr will it make it worse. What about lifting weights or anything really. Will it move out of place then. Just confused he people can do everyday things even with it slightly out of place.

  7. My daughter dislocated her anterior SC about 3 months ago while diving off of 5 meter platform. She took a few days off but continued to dive after she was no longer in pain.i took her to the doctor after she noticed that it was popping on and out. Just recently a trainer told her that she has instability there and will not be able to strengthen her shoulder muscles unless it heals. Should she continue to dive? Should she strengthen her muscles. She has had a lot of rotator cuff pain and pectoral strains in the same side maybe due to the SC issue.

  8. Do you need to strap your shoulder if you are returning to play football after having an operation for posterior dislocation.
    My son was operated was on 10 weeks ago and wanting to return to football.

    • Generally many orthopaedic surgeons don’t brace athletes when they return to play after stabilization surgery for shoulder dislocations, although it often take 4-6 months before return is possible.

  9. Hello Doctor,

    My R SCJ is subluxed posteriorly. I have seen sports med doc. He does not seem to think I will have any long term issues with this once it is healed. In your opinion, what is the prognosis for posterior subluxation w no intervention?

    I am having trouble understanding how this joint can function properly and pain free when its original alignment is off. I have worked back up to using R arm lightly for daily activities w minor swelling and pain. I am very apprehensive to advance to normal level of activity w it but will continue to push it (per dr reccommendation). Im about 6 weeks from onset of atraumatic subluxation whch originated w freestyle swimming.

    FYI my sport is triathlon. Also I am a firefighter/EMT. Enjoy all outdoor pursuits – very active lifestyle. I am concerned about how I will be limited by the injury long term.

    Thank you


    • I suppose it depends on how much displacement of the clavicle there is. Full posterior dislocations worry orthopaedic surgeons due to a risk of injuring the nearby airway or large blood vessels.

  10. I am a 44 year old male. Healthy except for my recent posterior dislocation of my right clavicle. When they did surgery to put the clavicle back in place they realized that i had also broken the end off the clavicle. They ended up removing about 1/2 inch of my clavicle. They could not reattach it. I am just trying to find someone that would have some experience with this injury so that i know i am making the right decisions going forward I live near Green Bay Wisconsin but am willing to travel where need be Would you have any suggestions or recomendations

    Thanks for your help in advance

    • You might try the AOSSM website and use its Find a Doctor tool to find a sports medicine orthopaedic surgeon in your area who might be able to help.

  11. Hello. Just over 4 months ago on the 2nd of may I injured my SCJ playing rugby. My right shoulder was pressed hard into the ground and there was a large cracking noise. I assume ligaments. Immediately after I seemed medical help at A&E and then various trips to doctors for help. Despite my complaints of pain and a clear asymmetry with the clavice no action was taken. I am now seeing an osteopath who recognised immediately the SCJ was dislocated anteriorly. I’ve had therapy for about a month and a half but there is still pain and asymmetry. Will having the bone pushed back into the place be a solution and will it allow me to continue playing cricket rowing and rugby. All sports that require free and painless motion in my shoulder. My osteopaths treatment at the moment seems to be pain management rather than seeking a solution.

    • Typically pushing the clavicle back into place doesn’t work. Either it won’t go, or it won’t stay. Usually the only lingering finding after a patient does PT to regain motion and strength is the visual cosmetic difference.

  12. Hello, I wonder if you can help me to find some answers regarding my symptoms. I have dislocated my right clavicle last February. I can see my bone popping out so I assume it must be anterior dislocation, at the same time I have started to experience discomfort in my throat and my voice became crokey from time to time, I also have pain in my shoulder. I can feel discomfort only on the right side of my throat, also it seems to reach my neck as well. This discomfort comes and goes, some days I can’t feel any pain some days it feels very very uncomfortable. Can anterior dislocation affect vocal cords?, I have no problem with breathing. Thank you

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