OVERVIEW

Where is the sternoclavicular joint located?

The sternoclavicular joint is situated in the center of the chest, near the throat. It is the only joint connecting the upper limb to the torso.

Place your hands on the collarbone and move them inward along the collarbone toward the center of the body. When you reach the innermost part of the collarbone, close to the center of the chest, this is where the sternoclavicular joint is located.

What is sternoclavicular joint subluxation?

Sternoclavicular joint dislocation occurs when the ligaments or joint capsule around the joint rupture, causing the clavicle or sternum to shift out of its normal position. In most cases, dislocation of the clavicle is more common ^[1].

Based on the direction of displacement of the sternal end of the clavicle, it can be classified as anterior or posterior dislocation. Anterior dislocation is more frequent, while posterior dislocation is rare.

Are sternoclavicular joint dislocations and subluxations common?

They are uncommon and are often missed or misdiagnosed clinically, significantly affecting daily function. The incidence of sternoclavicular joint injuries is very low. Some studies suggest that sternoclavicular joint dislocations account for only 3% of shoulder dislocations ^[1].

SYMPTOMS

What are the manifestations of sternoclavicular joint subluxation?

1. Impaired upper limb mobility. The movement of the arm relies on the shoulder joint, which is closely connected to the sternoclavicular joint. Therefore, sternoclavicular joint subluxation significantly affects arm movements, such as raising the arm, rotating it, combing hair, reaching for high objects, or playing badminton.

2. Joint popping or clicking during movement. During extensive upper limb activity, the sternoclavicular joint loses ligament restraint, leading to symptoms like popping.

CAUSES

What are the causes of sternoclavicular joint subluxation?

1. Direct trauma

When force is directly applied to the anteromedial part of the clavicle, pushing it behind the sternum, it can damage the ligaments around the sternoclavicular joint, leading to subluxation. Such injuries may occur in scenarios like an athlete in a supine position being stepped on the chest or the medial clavicle being struck directly by a knee during a jump.

2. Indirect trauma

Force can indirectly affect the sternoclavicular joint from the posterolateral or anterolateral side of the shoulder joint, which is the most common mechanism of sternoclavicular joint injury. Studies have shown that 3/4 of sternoclavicular joint dislocations are caused by indirect trauma. If the shoulder is compressed forward and rotated, it can lead to posterior dislocation of the ipsilateral sternoclavicular joint.

Therefore, in real-life situations, the most common cause of sternoclavicular joint injuries is traffic accidents, followed by sports-related incidents ^[1][2].

Who is more prone to sternoclavicular joint subluxation?

1. Individuals who experience accidents such as traffic collisions, sports injuries, heavy object compression, or falls from heights. Trauma with sudden high-impact force is also the most common cause of sternoclavicular joint subluxation.

2. Athletes engaged in high-risk contact sports, such as football players or hockey players.

3. Individuals with congenital clavicular deformities, generalized hypermobility syndrome, Ehlers-Danlos syndrome, abnormal muscle patterns, infections, or sternoclavicular arthritis.

DIAGNOSIS

Is sternoclavicular joint subluxation the same as shoulder dislocation?

No. Sternoclavicular joint dislocation involves the displacement of the inner end of the clavicle from the sternum, with pain typically located near the midline of the body. In contrast, shoulder dislocation refers to the displacement of the humeral head from the glenohumeral joint, with pain concentrated near the shoulder and upper arm.

TREATMENT

Does sternoclavicular joint subluxation require a hospital visit?

Hospital treatment is necessary if significant deformity occurs. If pain persists for more than 3 days or there is obvious deformity at the junction of the clavicle and sternum (e.g., the clavicle is noticeably higher than the opposite side), medical attention is recommended.

If pain occurs at the clavicle-sternum junction after trauma but without noticeable positional changes (e.g., only joint tenderness without one clavicle protruding more than the other) or if the pain gradually subsides within 2–3 days, immediate medical treatment is usually unnecessary. Rehabilitation exercises can be performed after the pain subsides.

Which department should I visit for sternoclavicular joint subluxation?

Common departments include the emergency department and orthopedics.

What should I do after a sternoclavicular joint subluxation injury (acute phase)?

After the injury, rest immediately and apply ice to reduce swelling and pain, alleviating inflammation. Ice application: every 2 hours for 10–20 minutes each time.

Are medications needed for sternoclavicular joint subluxation?

If pain is severe and accompanied by swelling, pain-relieving and anti-inflammatory medications may be taken. Specific medications should be prescribed by a doctor ^[2][3].

Can massage be performed for sternoclavicular joint subluxation?

Not recommended.

After reduction, the tissues need time to heal, so massage is not advised during this period.

Can sternoclavicular joint subluxation heal on its own?

Usually not.

Sternoclavicular joint subluxation often involves severe damage to surrounding ligaments and tissues. Without timely and proper reduction and fixation, serious consequences (e.g., restricted shoulder movement) may occur. Professional medical treatment is recommended.

Can physical therapy be performed for sternoclavicular joint subluxation?

Yes, but it should be done at a professional rehabilitation facility or hospital.

Generally, appropriate heat therapy, light therapy, etc., can eliminate blood stasis and promote fluid absorption. Small doses of shortwave, ultrashort wave, magnetic therapy, or ultraviolet therapy can improve blood circulation and tissue repair. During recovery, ultrasound and iontophoresis can help loosen adhesions and soften scars.

Additionally, shoulder-chest and shoulder-back fascia relaxation techniques may be used.

How to perform rehabilitation exercises during shoulder immobilization for sternoclavicular joint subluxation?

Generally, shoulder-elbow sling immobilization lasts 2–4 weeks to reduce inflammation and pain. During immobilization, wrist movements (e.g., gripping, rotating a ball, wrist flexion/extension, and radial/ulnar deviation—similar to waving goodbye) can be performed ^[3][4].

Specific exercises include:

1. Finger resistance exercises
2. Ball-gripping exercises
3. Wrist ulnar deviation exercises
4. Wrist radial deviation exercises

How to perform shoulder mobility exercises after removing immobilization for sternoclavicular joint subluxation?

After immobilization (usually after 4 weeks), focus on improving shoulder, elbow, wrist, and hand mobility and coordination.

Shoulder mobility exercises:

• Pendulum exercises: Hold the chest with hands and perform controlled pendulum movements.
• Shoulder abduction exercises: Raise arms sideways to 90°, palms facing down. If pain-free, increase flexion/abduction beyond 90° or even overhead movements. Daily activities can be performed if they do not cause discomfort.
• Wall-climbing exercises: Face a wall, place hands on it, and slowly "climb" upward with fingers, then lower back down.

How to perform strength recovery exercises for sternoclavicular joint subluxation?

1. Pectoralis major strength training (from no weight to weighted):
   • Standing wall push: Lie on a bench, feet apart for stability. Hold dumbbells wider than shoulder-width, lower them to nipple level, then push up. 3 sets of 12 reps, resting 1–2 minutes between sets (increase dumbbell weight gradually).
   • Curls: Stand with dumbbells, palms forward, elbows close to the body, bend elbows fully, then lower slowly. 3 sets of 12 reps, resting 1–2 minutes.
2. Triceps strength training (from no weight to weighted): Seated dumbbell extension: Sit upright, hold a dumbbell behind the head, extend arms upward (control weight initially).
3. Rotator cuff strength training:
   • Bent-over "T" raises: Bend knees, lean forward 30°–45°, elbows bent, thumbs out. Lift arms sideways to form a "T," pause, then lower. 3 sets of 12 reps, resting 1–2 minutes (avoid shrugging, gradually add weight).
   • Bent-over "Y" raises: Same position, arms straight, thumbs forward. Lift arms to form a "Y," then lower. 3 sets of 12 reps, resting 1–2 minutes (avoid shrugging, gradually add weight).
4. Muscle relaxation near the sternoclavicular joint:
   • Scapular muscle relaxation: Use a foam roller or massage ball on the upper back.
   • Rhomboid relaxation: Lie on a foam roller along the spine, arms crossed, roll gently for 15–30 seconds per side.
   • Pectoralis major/minor relaxation: Use a massage ball against a wall to roll the chest muscles.
   • Deltoid relaxation:
     • Anterior: Kneel, foam roller vertical, press shoulder forward.
     • Middle: Side-lying, foam roller horizontal, roll up/down.
     • Posterior: Lie back, foam roller horizontal, roll up/down.

How long does sternoclavicular joint subluxation take to heal?

2–3 months.

Recovery time varies with severity. Mild cases may heal in about a week. Moderate or severe cases with proper treatment usually take 6–8 weeks for ligament healing.

DIET & LIFESTYLE

Does sternoclavicular joint subluxation require bed rest? (Is activity restriction necessary?)

Mild subluxation may require activity restriction for 1–2 days in the early stage. Moderate or severe subluxation and dislocation require professional medical treatment, and specific recommendations should follow the advice of doctors and rehabilitation specialists.

How long after sternoclavicular joint subluxation can exercise resume?

If surgery is not recommended by the doctor, apply cold compresses within the first 12–24 hours post-injury, use a sling for protection for 5–7 days, and gradually resume activity afterward.

If surgery or manual reduction is advised, follow medical instructions. While immobilized, move adjacent joints to prevent secondary dysfunction. Generally, immobilization lasts 4–6 weeks, followed by rehabilitation training ^[5].

What should be noted daily after sternoclavicular joint subluxation?

After reduction, follow medical advice for rehabilitation and adjust lifestyle and exercise habits to promote joint function recovery and prevent recurrence ^[6].

Keep the wound clean, maintain a balanced diet with adequate protein intake, eat more vegetables and fruits, avoid spicy foods, refrain from smoking and alcohol, prevent late nights, and adopt a healthy lifestyle.

Choose appropriate rehabilitation exercises based on condition, avoiding high-load or high-intensity activities in the early stages.

PREVENTION

Can Sternoclavicular Joint Subluxation Be Prevented? How to Prevent It?

Dislocations during sports can be prevented:

1. Warm up before exercise and wear protective gear during sports.

2. Avoid sudden, high-intensity movements beyond daily activity levels, such as rugby, basketball, or push-ups.