The sternoclavicular (SC) joint is one of the four joints that complete the shoulder.  This joint is located in the area where the collarbone meets the sternum at the base of the neck.  The SC joint is generally classified as a plane style synovial joint and has a fibro-cartilage joint tissue.  The sternoclavicular joint is responsible for providing adequate support to the shoulder joint.  It is also the main connection between the shoulder and arms. The ligamentous reinforcements of this joint are very strong, often resulting a strain of the joint.  Although not common, sternoclavicular strain can arise from injury and other disorders.

Strain to the sternoclavicular joint typically results from motor vehicle accidents or participation in collision sports like football, rugby etc.  While these injuries can be painful, most are relatively minor and will heal well without surgery. Very rarely, a hard blow to the sternoclavicular joint can damage the vital organs and tissues that lie nearby. When this occurs, it is a serious injury that goes beyond a strain and requires immediate medical attention.

The sternoclavicular joint can also be damaged over time, as the protective tissue that covers the ends of the bones gradually wears away.  This type of degenerative change in the joint can lead to pain, stiffness, and reduced motion in the shoulder and arm.

Let’s delve a bit deep into the sternoclavicular strain.


What is sternoclavicular strain?

A sternoclavicular strain is an injury to the sternoclavicular joint and it is often referred to as shoulder strain.  However, shoulder strains can affect various structures within the shoulder joint.  A sternoclavicular joint strain is a distinct injury that is not as common as other strains that can occur within the joint.  A sternoclavicular strain generally happens when chest makes impact with an object or force. These injuries require a lot of force such as tackle in football or rugby (especially the player is struck on the back or side of the shoulder) or hitting the steering wheel during an automobile accident.  A sternoclavicular joint strain involves a tear of the muscles that constitutes this area of the shoulder.  A sternoclavicular strain, if severe, can dislocate the shoulder.  The clavicle can be dislocated forwards or backwards with regards to the sternum. Clavicle dislocating backwards can be very dangerous, as blood vessels, nerves, the trachea (windpipe), and the esophagus are located behind the clavicle and sternum.

Symptoms of sternoclavicular strain:

A sternoclavicular strain may induce a sudden pain in the sternoclavicular joint area.  Pain is predominantly present when the arm is lifted overhead, moved across the body or when lifting objects.  If the strain is severe, the patient may not be able to do activities of daily living.  Patient can experience swelling, bruising etc.  Other prominent symptoms of a sternoclavicular joint strain are the following:

  • Shoulder pain
  • Clavicle or sterna pain
  • A bump at the site of joint between the clavicle and sternum
  • Difficulty breathing
  • Difficulty swallowing

 Diagnosis of sternoclavicular strain:

People or athletes with a suspected sternoclavicular strain are evaluated by a physician.  A physician or a sports medicine specialist will perform a thorough history and physical exam to zero in on the source of the pain.  Often x-rays are done, but to evaluate the full extent of the injury, further testing like a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be ordered.  These scans can help determine the intensity of the sternoclavicular strain and rule out any other injuries to the shoulder joint.

Treatment for sternoclavicular strain:

For an SC strain, treatment may include icing, inflammation and/or pain control with medications.  In the unlikely event, if there is dislocation, treatment depends on which direction the clavicle is dislocated.  If the clavicle is dislocated forward, trying to put it back is the first-line of treatment.  Generally, this injury can be satisfactorily treated with a sling or a brace.  However, if the clavicle is dislocated backwards, an operative intervention is the way out.  This is often the case in instances where an athlete experiences difficulty breathing and warrants to be managed as a true emergency.

Sternoclavicular injury prevention:

Unfortunately, there is nothing specific a sportsman or general public can do prevent an SC strain.  As for sports people, being well trained and conditioned in order to be best prepared for safety and success in the sport of their choosing is a sensible thing to do.  People participating in contact sports would likely benefit from exercises designed to enhance shoulder and chest wall strength.

Returning to sports after a sternoclavicular strain:

An athlete can resume his/her sporting activities when the pain is under control and strength and range of motion is normal in the arm on the affected side.  Adequate time to allow the SC joint to recuperate is necessary to prevent long-term complications like pain and instability.  The time required to recover from an SC joint strain varies from person to person, depending on the intensity of the strain to an extent.  A quality rehabilitation program post sternoclavicular joint strain would improve the overall recovery process.

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