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  1. #51
    TurnURComputerOff&GoRide
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    Wow - I wish I found this thread 5 months ago. My story is very similar.

    First doc said it was grade 3 and I should put it in a sling and take it easy for 3 weeks.
    I couldn't help but notice the jagged bone end trying to rupture through my skin - so I found another doc..... I ended up in the hands of a really good Ortho that just does shoulders. I had done the ligaments, but I'd also smashed the end of my clavicle into lots of little bits. So surgery was the go.
    My ortho did 7 shoulder surgeries on the day he did mine. If you're living in a location that has specialists - I think you are way better trying to find a doc that does 7 shoulder opps a day rather than 1 every 3 months!!
    I had the Weaver-Dunn thing with some anchors and minor hardware (located further down the clavicle to get to a solid non smashed bone).
    The advice I got was that the big screw through the shoulder was not the way to go and had a high incidence of failure and problems.

    So 5 months....
    2 months of it really SUCKED - I mean depressing, intruded into work, ability to sleep, drive, etc. it SUCKED!!!
    I did no PT or any real movement for the first 2 months. Muscle wastage and all that sort of nasty stuff.
    Then 2 more months of recovery and PT.

    I've now been back on the bike for a month and fitness levels are returning.
    It's only been in the last 2 weeks where I've been having great rides where everything just feels great and the ride comes together.

    The arm/shoulder is 99.9% good now, with a full range of movement and only slight discomfort if I stretch it way up. My PT guy was blown away with how fast I managed to get my range of movement and strength back. I hit the PT exercises pretty hard as I was determined to get back on the bike.

    I'm so happy I found a good ortho and got the surgery.
    Post surgery I still had a bit of a bump, but that's gone away now.
    Now all I have is a cool looking scar.
    The memory of 4 months of pain and suffering washes away when you get back on the bike and have one of those rides where you're just in the zone.

  2. #52
    Ami Schwein
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    Well, its been now over a year with mine as well and i have no problems with the shoulder anymore. Back to jumping, dropping whatever. Strength and movement is good to go. Ive done PT on it continously since I was able to. I'll always have the lump, but i find it endearing.
    Wait until Spring Bandini

  3. #53
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    oh yea - my surgery was just a lil over 9 years ago - april of 1998.

  4. #54
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    Hmmm, well, since it seems there haven't been any 2008 entries regarding AC separations, I guess I'm going to have to be the one to post. Did mine on 11-09-2008. Passed out on a buddy a couple of minutes afterwards from the pain. Thought I dislocated my shoulder, but I could still move my arm. Had the "bump" immediately afterward, so I knew something wasn't right. Eventually went to the emergency department, got x-rays, received a sling and prescription for percocets that I didn't fill, and was told to follow up with the Core Institute (PHX). "AC separation" they said. Put off the follow-up for a couple of days, went and picked up my copies of the x-rays on disk along with the diagnostic report. Looked at the pics on my computer and saw the damage done. Did extensive research and learned about the grading of separations. Entertained the idea that mine wasn't that serious. Found myself freaking out from the lack of pain late the following Friday. (Mind you, I had been riding nearly everyday up until the time of my accident.) I had been taking ibuprofen as instructed since visiting the E.D., but boy, was I starting to wonder about my pain receptors and nerve endings. Range of movement? Check. Not all I had before the wreck, but damn near. I could move my arm above my head, behind my back, and across my chest. Feeling in my hands, arms, and shoulders? Check. I actually pinched myself with my fingernails atop my hurt (right) shoulder to confirm. Started thinking about "Unbreakable"... Wondered if I could do pull-ups? I know, I know. You are probably thinking, "Is he insane?" Well, maybe. So, I walk down to the spare bedroom housing my Soloflex, which was left setup for pull-ups. I grab the bars and begin to do pull-ups. Not just a couple, but more than I had been doing before. I actually stopped before I tired my muscles out. Man, something is wrong. Should I be able to do pull-ups with a separated shoulder? The next day I talked to a buddy who is basically a physical therapist and told him what I had done. He started laughing before I even finished telling him. Especially, when I told him the part about "Unbreakable." Then, he says that I have probably created scare tissue very quickly as a result of metabolism and being fit. I end the conversation still in disbelief. Today, on the 18th of November, I finally got my follow-up with Dr. Marcus at the Core Institute. After he is allowed to view my x-rays, he puts me through some simple range of motion/resistance tests. I ask him if I should be where I am for the injury sustained? His reply is no. He tells me that I am definitely a grade 3+. With some doctors, he says that I would probably be a grade 5. He weighs my age against whether or not he would consider surgery. (I'm 37 with about 5% body fat. I'm actually underfat from dedicating so much time to riding. I rarely do more than this actively, I swear.) I mention "Unbreakable", during the course of our conversation, but I couldn't bring myself to tell him about the pull-ups. He's familiar with the movie. He then proceeds to tell me that if it were him comtemplating the decision, nobody would be touching him surgically. At 44, he has 7 years on me. He honestly tells me that he could actually put me in a worse position than I currently am in. I would definitely be in some sort of pain following surgery. My range of motion might not recover as quickly or be as good. I could possibly develop complications from the materials used in the surgery. I would be taking a huge step back as far as progress is concerned. And, other than aesthetics, I probably wouldn't benefit from surgery at this point, and that he couldn't guarantee that there wouldn't be some form of movement upwards with the clavicle forming a bump on top of my shoulder. Basically, it's a preventative maintenance gamble for me. He ultimately leaves the choice up to me, but in his mind it's a no brainer. I could possibly be a candidate for reconstruction with cadaver ligaments at some point down the road after problems arise, or I could have him perform an acute operation to tie down my clavicle to the coracoid process so long as it is within 3 weeks of the episode (a small window). I'd flip a coin, but I think I'll take it easy for a bit instead and gamble with the hope that I never meet Dr. Marcus again. You might not be so lucky.

  5. #55
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    15 years later

    Jah Jah Man, I don't usually post here but I saw the word separation in the title and had to look. In June of '93 I was riding Walker Ranch outside of Boulder when I went over the handle bars and separated my shoulder. Still don't know if I hit a boulder or pulled on the front brakes.

    When I sat up and luckly avoided being hit by my best friend who was trailing behind, I too could tell I had messed up my shoulder. The doc in the ER, a orthopedic surgeon checking on another patient, told me I had a third degree sep. He said that he did not recommend surgery and that the sep. would close back up. He prescribed a certain sling. The place was closed so I could not get it that night.

    The next day when I went to see him in his office he started to look at it again. He had me stand up and he started pushing on the clavical. I soon asked him if I could sit because I did not feel so hot. He had me sit and went and got me water because he said I was turning green. He soon told me that the clavical had slipped behind the shoulder blade and he could not get it back up because it was being held down by a muscle. He said surgery was no longer an option.

    A few days later I was put back together with a big S on my shoulder. I was able to make it stronger than before. Later that year I had a slight sep. in my other shoulder from playing flag football and hit hurt worse.

    I think you will be alright without the surgery, maybe stronger.

    Good luck!
    "98% of us will die at some point in our lives" - Ricky Bobby

  6. #56
    wants a taco
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    another ac sep for 08. Mine happened 2 days ago, went to the hospital yesterday and found out the news. In researching this it seems like recovery time is really based on the quality of your doc. It also sounds like alot of docs dont take into account how serious alot of us are about our riding and think 90% is a great recovery, and then hearing from those with that 90% recovery mention alot of complications when riding that make it sound more like 70%

    Im needing to set up an appointment with a specialist and am currios what i need to look for. Sounds like i need someone who also specializes in sports medicine but i dont know. Im ready to do whatever it takes to get on the bike quickly (at least the roadie) im just worried about a shitty doc that doesnt consider the fact i ride almost every day, race etc.. and hope he doesnt treat me "good enough" like he would for alot of seditary people that would never really notice the diff.

  7. #57
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    Just did this last night. Riding the road bike home in the evening and took a corner while going at a decent speed and BAM before I knew it I was on the ground. Front wheel washed out on something I didn't see.

    Stood up and immediatly knew something was wrong. I actually thought I had broken my collarbone the way it was sticking up. Turns out it is seperated AC.

    So much for my trip to S.Utah I had planned for sunday-wednesday.

    Anyhow, just happened to notice this thread. I'll update later on how the recovery went.



    Quote Originally Posted by Nim
    Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.

  8. #58
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    a c sep grade III

    Quote Originally Posted by Jah Jah Man
    Hmmm, well, since it seems there haven't been any 2008 entries regarding AC separations, I guess I'm going to have to be the one to post. Did mine on 11-09-2008. Passed out on a buddy a couple of minutes afterwards from the pain. Thought I dislocated my shoulder, but I could still move my arm. Had the "bump" immediately afterward, so I knew something wasn't right. Eventually went to the emergency department, got x-rays, received a sling and prescription for percocets that I didn't fill, and was told to follow up with the Core Institute (PHX). "AC separation" they said. Put off the follow-up for a couple of days, went and picked up my copies of the x-rays on disk along with the diagnostic report. Looked at the pics on my computer and saw the damage done. Did extensive research and learned about the grading of separations. Entertained the idea that mine wasn't that serious. Found myself freaking out from the lack of pain late the following Friday. (Mind you, I had been riding nearly everyday up until the time of my accident.) I had been taking ibuprofen as instructed since visiting the E.D., but boy, was I starting to wonder about my pain receptors and nerve endings. Range of movement? Check. Not all I had before the wreck, but damn near. I could move my arm above my head, behind my back, and across my chest. Feeling in my hands, arms, and shoulders? Check. I actually pinched myself with my fingernails atop my hurt (right) shoulder to confirm. Started thinking about "Unbreakable"... Wondered if I could do pull-ups? I know, I know. You are probably thinking, "Is he insane?" Well, maybe. So, I walk down to the spare bedroom housing my Soloflex, which was left setup for pull-ups. I grab the bars and begin to do pull-ups. Not just a couple, but more than I had been doing before. I actually stopped before I tired my muscles out. Man, something is wrong. Should I be able to do pull-ups with a separated shoulder? The next day I talked to a buddy who is basically a physical therapist and told him what I had done. He started laughing before I even finished telling him. Especially, when I told him the part about "Unbreakable." Then, he says that I have probably created scare tissue very quickly as a result of metabolism and being fit. I end the conversation still in disbelief. Today, on the 18th of November, I finally got my follow-up with Dr. Marcus at the Core Institute. After he is allowed to view my x-rays, he puts me through some simple range of motion/resistance tests. I ask him if I should be where I am for the injury sustained? His reply is no. He tells me that I am definitely a grade 3+. With some doctors, he says that I would probably be a grade 5. He weighs my age against whether or not he would consider surgery. (I'm 37 with about 5% body fat. I'm actually underfat from dedicating so much time to riding. I rarely do more than this actively, I swear.) I mention "Unbreakable", during the course of our conversation, but I couldn't bring myself to tell him about the pull-ups. He's familiar with the movie. He then proceeds to tell me that if it were him comtemplating the decision, nobody would be touching him surgically. At 44, he has 7 years on me. He honestly tells me that he could actually put me in a worse position than I currently am in. I would definitely be in some sort of pain following surgery. My range of motion might not recover as quickly or be as good. I could possibly develop complications from the materials used in the surgery. I would be taking a huge step back as far as progress is concerned. And, other than aesthetics, I probably wouldn't benefit from surgery at this point, and that he couldn't guarantee that there wouldn't be some form of movement upwards with the clavicle forming a bump on top of my shoulder. Basically, it's a preventative maintenance gamble for me. He ultimately leaves the choice up to me, but in his mind it's a no brainer. I could possibly be a candidate for reconstruction with cadaver ligaments at some point down the road after problems arise, or I could have him perform an acute operation to tie down my clavicle to the coracoid process so long as it is within 3 weeks of the episode (a small window). I'd flip a coin, but I think I'll take it easy for a bit instead and gamble with the hope that I never meet Dr. Marcus again. You might not be so lucky.
    WOW amazing recovery time.. I got a grade III sep. on the same day u did lol 11-09-2008 - fell off the bike during a jump... 1st doc said surgery.. I did not like that answer.. saw a 2nd doc and he said PT and left the choice for surgery up to me... Its now 3 weeks I have full range of motion (with some pain and popping) and can ride on the road went hiking yesterday but had some pain after 3 miles or so... I wont get on the trails for 2 months, i want to heal right.

  9. #59
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    a c sep grade III

    got mine on 11-09-2008 its great!
    Attached Images Attached Images

  10. #60
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    Got mine in March, 2008. Looks pretty much like that X-Ray above.
    I had a little bit of pain for maybe 5 days and was off the bike for only 10 days.

  11. #61
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    When i did my grade III, I went on my first ride on the 5th week. no trails. just slow fireroads. There was no discomfort but I still slowly got back into it and my first hard ride was after 2 months...
    F. B. I.

  12. #62
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    Don't Know what "grade" mine is, but it's basically not connected at all. My collar bone just floats around in space where it's not connected anymore. Six weeks sounds about right but like the doctors always tell me.."Let pain be your guide". Thereapy will help the muscles perform what the ligaments can't anymore. Other looking nasty with that bump on my shoulder, it does not affect my riding. It only gets sore from lots of windsurfing from the constant pulling motion.

  13. #63
    Harrumph
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    I'm 8 weeks from mine, it's sitting at about 90%. I was able to ride gingerly at week 4. Lifting the front wheel to get up curbs hurt a bit. I posted the full report in the other AC thread: http://forums.mtbr.com/showthread.php?t=300318
    Slowly slipping to retrogrouchyness

  14. #64
    2006 Yeti AS-X
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    I had a level 1 separation back in July 2006 and it was about 5 weeks off the bike for me. Like everyone said, follow the doc's advice (It's hard because you want to be back on the bike so bad!) and with the Level 3 you definetly want to as soon as the doctor clears you to start working the range of motion exercises. With my level 1, the doc told me to work it ASAP.

    I pray you recover quickly!

  15. #65
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    Well I sustained what was first diagnosed as a Level 3 separation and after 4 months of PT with no improvement, while I went scuba diving 4 weeks after I did it with no problems at 4 months I still couldn't lift my children, push or pull on anything and had 24/7 pain, I went for a second opinion to learn it was Level 5 spearation. If I could figure out how to post my xray I would - my clavicle shot up and tented my skin and my arm fell a couple of inches. I did this in July 2007 tripping over a bump I never saw. I went up in the air and came down with the full weight of my 5'10", 140 lb body (I'm a female) on the tip of my right shoulder in the back. I still have the scar from the impact. I had no choice but to undergo the surgery - my arm was not going to realign itself. I had the surgery in November 2007. Cadaver graft, distal end of my clavicle cut off so that my clavicle could be put back where it belonged. I traded a huge bump for a 3 inch band scar. My problem now is at 12 months post op (of which I spent 2 months totally immobilized and 9 months in PT - and I'm fit) I still have pain and lack of function. I have full ROM but I can't throw a ball, lift more then 20 pounts, hang from anything (never mind a pull up), push, or hold weight in my hands and move my arms around. It just hurts too much (and I have a pretty high tolerance for pain) and it "clicks", "clicks", "clicks". I just went to my surgeon and he said that my biceps tendon is inflammed and I have a lot of scar tissue in the joint (and in my actual shoulder joint). I now need my 4th MRI of the year. Has anyone out there had such a severe separation and the surgery? If so, does any of this sound familiar? I just want to get on with my life and enjoy my 2 small children. I haven't been able to pick up my 4 year old since I did this. Thanks for any input.

  16. #66
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    I am sorry to hear about your long road to no recovery. I had a similar surgery in 1998 (I believe it was called a "Weaver Dunn" after the two doctors who invented it) and it took a lot of pt but after a 2 months it was close to 100% but with some pain (not near what you are experiencing).

    Here is the interesting part. On new years day 2006 I re-separated the shoulder and blew the surgery up in a crash. Other than looking like a freak with my shirt off it has felt fine ever since. Not that I recommend you "fix" the surgery by crashing on it but, it is an option.
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  17. #67
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    You actually made me laugh, thank you. When I hit and did this it was on asphalt. They had to pick asphalt embedded in my skin out in the ER and give me a tetanus shot. I've been told that I hit basically as hard as you can. In addition, I'm a female and apparently us girls don't have as much "padding" around our shoulders so an impact like that is devastating. My surgeon now says he wouldn't be surprised if I messed something else up in my shoulder at the same time. What pisses me off is the fact that I've been complaining about this since 6 months post op when I realized I got back my full ROM but was still have problems with daily living, never mind sports. I went to an anatomy book and determined that my pain was emanating from the area of my biceps tendon. I actually put "Xs" on my shoulder where the pain was coming from - which went from the upper biceps tendon to the area right under my scar where the graft is located. He looked at me like I was crazy and now he's saying "maybe it's your biceps tendon". I really don't know what to do. Hopefully, it's mainly scar tissue impinging on stuff in there and if they go in arthroscopically (I had open shoulder surgery the first time) they can scrap away the scar tissue and things will be better. I can't seem to find too many people with as severe a case as I had - I went to the top shoulder doctors in NYC - the ones who work on the famous people

    Maybe another fall would do the trick instead!

  18. #68
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    Glad to make you laugh.

    Have you seen a surgeon here in Colorado? Famous people rarely hit the ground hard where as a lot of skiers, snowboarders and mountain bikers do (I left out skaters because they don't have insurance). I believe (and have been told) the best orthopedists are in Aspen, Vail and Steamboat.
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  19. #69
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    I feel the pain along with you. in '98 I did something to my right shoulder playing football my freshman year of high school. I didn't see the ortho about it until it started really bothering me in December when I started wrestling. He said it was a grade 1 rotator cuff tear, and that I needed therapy. Long story short, I was cleared to wrestle on the day of my last therapy session, and that night, I tore it again. I went back and the doc said it was a grade 3, but that I didn't need surgery. Just no more wrestling and football. To this day, it still bothers me.
    Then in '02 I separated my right shoulder, though I don't remember to what degree. That came from playing tackle without pads against a guy who was easily over 300lbs (I'm about 165lbs). At least I took him down! It took about 5-6 weeks before I was able to actually use it for everyday tasks, and even longer before the pain completely went away. I had the option of surgery, but the doc said it would mostly be for cosmetic purposes. Fortunately, it healed to nearly 100% on its own. It just looks deformed now.

  20. #70
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    had surgery

    I had a grade 5, where you could stick your finger under the clavicle. I'd really freak people out before the surgery when I showed them how screwed up it was.

    I had the dunn weaver done and a couple years later it looks really good. The scar is almost gone and there is no hump.

    Problem with the injury is I was an avid surfer for 20+ years and after the injury I really don't have the same kind of snap in the shoulder to get into waves and out of critical situations while paddling. I only ride longboards in head high and under surf now, which I'm not always into, and have kind of left a sport and lifestyle I cherished behind.

    Anyways, get the surgery if you look like a freak. I don't think it does much for your strength though.

  21. #71
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    My orthopedic surgeon friend told me that, unless you NEED the surgery, to not go for it. He said that it's a pain in the butt to do as a surgery and it's pretty much for cosmetic reasons or to prevent the bones from hooking each other in the wrong position.
    I don't know anything about the subject, but he's an expert in the field, so I just wear my bump with pride.

  22. #72
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    I wouldn't get the surgery done just to reduce just a bump. This is heavy duty surgery, where you're knocked out and wake up in major pain. The pain lasts well over a week and it is almost impossible to get out of bed the first couple nights to pee. Recovery sucks, vicodin won't help with the pain and you'll be off the bike for about 3 months, maybe more. In my case there was a huge void and a big step from the clavicle to the scapula. It was pretty nasty looking. I also feel as if the surgery helped to tie the shouler back together in order to prevent more scaring, arthritis, bone spurs,etc. I did it, it looks good and I'm pleased. I have no idea if I'd be stronger or not if I didn't do the surgery. At least I was able to go on disability and chill for a bit

  23. #73
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    i've got one of these. EARNED it on Sunday morning . . . saw an ortho today, he said a lot of the same things about surgery not always being the best option. I'm waiting for two weeks to see him again, Jan. 5th to be exact. I want to do whatever it takes to ride ASAP.

  24. #74
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    Quote Originally Posted by BetterRide
    Glad to make you laugh.

    Have you seen a surgeon here in Colorado? Famous people rarely hit the ground hard where as a lot of skiers, snowboarders and mountain bikers do (I left out skaters because they don't have insurance). I believe (and have been told) the best orthopedists are in Aspen, Vail and Steamboat.
    You're a funny guy Gene
    I didn't have a surgery, but I'm always wondering what would happen if I crashed again on my already separated shoulder. Is the collar bone going to cut thru the skin?
    At that point I'd have it really sticking out and look like a freak

    Do you think the wever Dunn was worth it?

    ZT
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  25. #75
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    I am 16 months out from a type-V AC separation (which boils down to a very severe type-III) and just wrote about my experience on my blog. It's pretty long, so I won't repeat it here. If you are interested in hearing how it went for me to recover without surgery, you can read about it here. I went over the handlebars near the end of the Great Divide Mountain Bike Route. Some day I'll go back and ride the last seven days...

    I did not opt for surgery and did rehab in the weight room on my own. I don't necessarily advocate this option because every injury is different and every person is different - but it is an option. I'm a woman, 35, a multi-sport athlete, and have been a weight lifter since I was 19. This obviously helped me in my recovery. I'm probably at 95% now, and anticipate being at 100% before I hit the two year mark.

    I hope to be able to give some ideas to other people in the same situation.

    cheers,
    Michelle

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