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.

48 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.

      • Me too. I also have a lump feeling in my throat and effecting my voice. I get dizzy and more pain in my hand and face when I look to the side that is dislocated. I was told I also dislocated my first rib. Desperate for the right person who can help.

  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

    Zac

    • 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.

    • Hi Dan, I too have the same injury, with extreme pain, in chest, shrtness of breath, and I can not move my arm to much or I get a poking sensation in my throat. I was wondering what ortho helped you? I live in Green Bay, and no doctors or orthos will help me. They say nothing can be done. My email is amijennings@yahoo.com thank you.

      • To both Dan and Amy!
        It seems like we are in the same position. Posterior sc dislocations and no one can help. Or will not even attempt to.. I’m sharing my email so hopefully we can get in touch?!

        Hege.christensen@hotmail.com

        Sorry dr geier for “hijacking” your page/thread, but it is hard to find others with this problem…

      • It seems there are not many people experienced in posterior dislocation. I’ve been looking for someone to understand my problem for two years. I’m going to try the hospital next. So so frustrating and I feel very alone.

  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.

      • Sounds posterior.I have the same symptoms as you have, I am so sorry for anyone going through this because no one seems to understand.I feel they think I am making it all up.

  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

    • Hello, all problems started when I was pushed violently from the right side, instinctively I put my arm out and landed on my left hand. Soon after I felt the muscles on the left of my neck pull all the way up the side of my face. Other problems are pain in my chest,it is hard to breath and talk. Shoulder pain, shoulder has dropped,pain all the way down my arm into my hand. Cannot straighten my ring finger sometimes the whole hand. I cannot push or pull or lift with that hand. I can’t hold anything for more the a few seconds. I had burning pain in my neck for many months. I had to lay flat on my back in bed with no pillow,I still do over a year later.when I turn left or sit up in bed I am extremely dizzy. My neck is still very painful even with the shower water running on the back left side. When I lay down my esophregus tightens. Then when I sit up is eases a little.
      I’ve also lost the use of the muscle on the left down the side of my torso.when I lean forward or sit up I need to support myself using other muscles. I also have to hold my head up with tape or the muscles on the right. As my head wants to fall left. My collar bone has retracted back about a centimetre. I keep saying I cannot feel that side of my arm and torso. I think because its not attached to my sternum. It is also pushed in further then the other. I have felt very very unwell since the injury. I now have a lot of problems with my system. In my mouth there are very strange symptoms. I haven’t seen and orthopaedic surgeon yet. But I’ve been told I dislocated my first rib and collar bones. He tried to put them back. But I think he broke my rib and now I have bursitis and tendinitis. As he pulled on my arm in several directions. Without seeing what’s what. The MRI shows to me and my chiropractor there is broken ribs both sides. The first ribs at least. Broken c6,7,8 vertebrae in some way. And left clavicle is detached something near attachment lookers broken. I need conformation. Can I send pics to you. It also looks like bits broken on the throat and behind sternum. I no way am exaggerating. I have felt gravely unwell. I haven’t gone to the hospital because I’m afraid they won’t take me serious. It’s been a long time since the injury.
      I’ve been desperate to go so many times. My body is trying to tell me something’s up, but no one is taking me seriously.
      Thank you for all your time you give to help others. It’s so appreciated.

  13. Hi my husband got smashed between two semi’s he broke his right side first rib and his collar bone sticks out on that side but ct scan is showing no dislocation do you think an mri would be helpful? Is it possible the bone will go back since it is showing it is in place? Thanks!

  14. Every time I lift my left arm my left collar bone pops out, and I can push my left collar bone up and down when I apply pressure to it. What does that mean?

  15. Hello,

    I am a 23 yr old male who was diagnosed with an anterior subluxation and fracture of the SC joint from wrestling in late August of this year. I was in extreme pain for about 2 weeks and have been gradually returning to activity. I am a lacrosse player and weight trainer and have residual deformity, discomfort and cracking, i can also feel the clavicle as out of place. My doctor prescribed nothing but PT, I am wondering if it will ever return to 100% with only physical therapy, and if there is anything i can do besides that to increase my recovery.

    Thank you,

    Josiah

  16. I’m 13, taking hot yoga classes. But i’ve never gotten hurt fron it.
    It looks like I dislocated something on my right side right below those two neck muscles. Something was poking out oddly, it was small and and was clearly not like the left side. I don’t think it was ever like that before, nothing hurts. There are no unusual marks. It feels very off if I press on it, and I pushed it back so it wasn’t sticking out like it was? I do have a habit of popping that shoulder somehow and I’m pretty sure its related. I cant find the bone thing on the other side and I don’t know if I should be worried.

    Somethig like anterior dislocation of the sternoclavicular joint, but then that seems unlikely

    • Hi im 14 and i play netball 4 times a week. Yesterday i noticed my left collarbone was sticking out, we went to the doctors and they took an xray and said come back in 2 weeks for results. But i get real discomfort from it, is it wise to go to A&E to see if they can process it faster and 2 weeks will that effect it?

  17. Hey dr,
    I dislocated my collar bone 3 weeks ago and my dr said to rest it until it stopped popping out when I raise my arm. He said it should be about a week or 2 but it is still popping out. How long do you think it should take to heal? As I am getting ansy to get back to practice.
    Thanks!
    Molly

  18. I have had a anterior separated scjoint for 2 years now.
    It continuously pops/clicks etc and I find that id very
    painful still.
    It as if the joint never scared up and continuously stays unstable.
    It is painful, but worse, is the pain/tightness that it presents to my neck region and especially the scalenes.
    It as if I suffer Thoracic outlet type symptoms.
    I know most anterior dislocation do not require surgery, and out comes for most are good, but that is not my case.
    If anything, the movement in the joint is greater and greater.
    Very painful, and worse, very hard to find a surgeon who can help.
    Mostly due to the unpredictable outcome from these type of surgeries, and low percentage of success (compared to other orthopedic surgeries).
    My question is:
    Are there any new techniques out there, or on the horizon that may result in better outcomes (percentage wise)
    I am one of the few, who is really struggling with pain from this
    injury, although range of motion is good, it’s almost a curse, as it causes my joint to move all day long.
    It seems as if the technique where they remove the end of the clavicle, and than reattach it to the 1st rib, is the only technique available, and is the one with unknown outcomes for the patient.
    I am in Canada, but am hoping to find out if there is another new technique.
    Any info would greatly appreciated.

  19. Ive been in pain for over a year and now just finally my physiotherapist is talking about collar bone or rib dislocation. Would love your quick opinion. Pain when pressure is applied to the spot circled in the picture above, raised slightly more than my left side. When my arms are outstretched I cannot raise it higher than my shoulder. Pain in should when laying down and my shoulder “falls” up towards my head when I lay on my side (extremely painful). 30 year old female, no injury that I recall.

    • I am 52 years old an also have SC dislocation with no known injury. How is this possible? Could muscle spasms from stress alone cause it? Are there diseases that affect the joints that could be a possible cause? I have had recurrent joint and tendon inflammation the past several years.

  20. I’m 20 years old and injured myself in the most simple way, I fell and to avoid falling straight back I stretched my arm out to catch my fall. The next morning I had pain between my clavicle and breastbone and it has been almost a week and my pain has not subsided. The area between my breast bone and clavicle is swollen and has a bump however I still can use my arm. I am just extremely uncomfortable moving around freely. I am almost positive I have Anterior Sternoclavicular dislocation. Will I recover on my own or do I need to see a doctor? Do you think I need surgery?

  21. Posterior SC dislocation with open surgery – what is the recovery time for an elite athletics?

    My 15 year old daughter made dips within her track and field training programme when something went wrong. In hospital she was diagnosed with posterior SC dislocation. Surgery was done within 6 hours. Closed treatment failed so that open surgery was performed and PDS was used for stabilization. Her shoulder was kept in one place for 6 weeks. The newest CT (6 weeks after the surgery) shows that everything is as it should be. Now my daughter wonders when she is able to continue with long and triple jump. The nationals in track and field are in the beginning of March and qualifications are now. Will she be able to participate? Reading the literature there is very little written on it and the doctor has unfortunately also no experience with elite athletics. Does anyone know?

  22. This same injury actually happened to me. It was a hockey incident and I had to get emergency surgery put my collarbone back in its correct position. So far it’s been three months and I have pretty good movement. I have not been able to skate yet. My doctor has done a great job of letting me know where I am in my recovery process but he has told me my recovery will be about a month or two longer. Just wanted to share my story!!

  23. Last week, I was crushed by a car that I was working on when supports failed. I was laying on my right side when the car fell. I managed to move to my back and slide out and call for help. At the ER, the xrays showed no broken bones, but no one mentioned a SCJ injury. My right side clearly protrudes out more than the left. It feels like I have something in my throat at times. I’m functional, but have reduced use of my right arm and shoulder. I’m still on pain meds and icing the area. Certain movements give me acute pain. While it “looks” like I have an anterior dislocation, because my shoulders were crushed towards each other toward my chest, it would reason that I have a posterior dislocation; which would makes sense with the feeling like I have something in my throat. All of the comments above have been extremely helpful. If anyone would like to share treatments that they have received or surgeries that they have had done or doctors that they have seen, please email me at toddlefort@verizon.net. I’m going to see if I can see my orthopedic surgeon who did surgery on my right shoulder 10 yrs ago and recently did surgery on a medial meniscus tear on my left knee. Both surgeries were a huge success. I’m confident he can help or at least steer me in the right direction. I will post back with any helpful information.

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