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  1. #1001
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    Quote Originally Posted by SikeMo View Post
    How long are you guys waiting to get back on the mountain bike? I'm 4 weeks into a grade 3 and feel like I still have at least another 4 weeks to go. I have decent range of motion, but still cannot reach over my head or behind my back. PT starts this week, for me.
    Grade III here.I was back on the road bike 3 weeks, mountain bike week four. I'm on week 9 now. Still sore at times, hurts if I pull up hard for a rock or jump. Drop off and small bumps are fine. Doc says do what ever I want within my pain threshold. Just do not fall on it. (have clipped a few trees OUCH). all in all. I only used the sling for the first week and only a few hours at a time. No pain killers, just IB prof. Based on other reviews I forced myself to keep it moving and deal with the pain early, that way I did not loose much ROM. Still cant sleep on that side and it will still hurt at random times, but pain is what you make of it. I like riding my bike more. Best of luck on speedy recovery

  2. #1002
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    It's amazing how much orthopedic recommendations vary in these scenarios. I was told 6-8 week recovery and don't lift anything over 5 pounds for the first 4 weeks. I wouldn't even think of getting on a bike at this point.
    Last edited by SikeMo; 09-20-2016 at 04:46 PM.

  3. #1003
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    My experience was very similar to the posts after my G3 separation in March 2015. I had good ROM after week 1 and was able to do pull ups/pushups, paddling, etc. by week 8 trying to get back to normal ASAP. I decided on surgery in late May because the annoying pain from the clavicle digging into my shoulder on every paddle stroke and instability when duck diving large waves.

    That is when things went south. I got staph in my shoulder and spent 3 months trying to kill it in order to salvage the surgery that ultimately failed. So, not only did I lose the CC/AC joint repairs, I had much more scar tissue and muscle loss particularly in my deltoid area that was concave (i.e. a divot) by September. My right shoulder (deltoid, trap, etc.) was a shrunken mess from its pre injury form.

    What helped me recover was getting a PT that was hands on: pulling, twisting, deep tissue messaging, etc. all the muscles, bones, ligaments, etc. in my shoulder area for 50 minutes followed by 10 minutes of heat therapy and a brief review on new home exercises. Some of these sessions were very painful but I could feel the improvement the next day. She warned against doing anything strenuous until the shoulder mechanics were fixed in order to avoid further injury to another area particularly the rotator cuff. I started PT in September, went once a week and was at full strength by December 2015: paddling, running, biking, weight lifting, etc.

    Now a year later, I am stronger than I was before the injury. I continue to lift weights because it feels good in the shoulder. I hadn’t been on a bench press in over 20 yrs but now go a couple times a week. I still have stiffness from the scar tissue and I don’t think this will ever go away although my PT said it takes about 2-3 years to eliminate. The bump is barely noticeable and both shoulders are nearly identical.

    I highly recommend getting a PT that knows what they are doing. Don’t waste money on these PT shops that want to sign you up for several months so you can waste your time and money doing exercises in their shop that can be done at home. You absolutely need the hands on PT if you want to accelerate the healing process in your shoulder.

  4. #1004
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    Thanks for that. Just had my first PT session today and it was as you described, with the addition of electrical stimulation. I will be going twice a week for six weeks. They've given me several ROM exercises to start with but said to lay off as soon as I feel any pain. Fortunately my insurance covers it.

  5. #1005
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    I dislocated,separated and tore my labrum in my shoulder 6 weeks ago in a crash. I am now 2 weeks post surgery and went to pt twice. I was going to ask other cyclists how long they waited with similar injury but there is obviously a wide range previously given for other injuries. But how much pain is everyone dealing with once back on the bike? And I'm guessing the torn labrum with the separation is why I feel I'm so much further behind then everyone else because I'll be in a sling for 2 more weeks. Thanks for any insight and everyone heal up!

  6. #1006
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    Broke mine 3 weeks ago. Broke at the end collarbone so not enough to for a screw to get any purchase. Have just started physio, it's dam sore.



    I'm not able to drive so can't work, I'm bored sat at home..
    Just wan't to know how long will it be before I can get back on my bike, bearing in mind winter is on it's way. Which usually means wet and muddy in the UK. I'm kinda leaning to heading to the gym once the doctor gives the go-ahead and leaving getting back on the bike in spring as I'm worried about breaking it again.
    I know I have to get back on at some point..

  7. #1007
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    Tomorrow is 8 weeks since my AC separation. I'm doing PT and only issue I had was they think my pectoral muscle was damaged when I fell. I have 2 weeks home rehab and go back to get it checked to see that its improving. As long as it is I'm done with having to go to PT and can do normal stuff at home. My goal was to ride park before the end of the year. Planning on riding the 30th which is the last day before they close for the season.

    As far as riding goes I'm trail riding now. Wednesday I did a few hops over logs with no issue. It felt pretty odd at first but it got better fast.
    I like to fart when I'm in front of you on a climb

  8. #1008
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    This time next month and it'll be 1 year since my grade 3...

    Shoulder still clunks when I do press ups, unless I splay hands out to the side and take a slightly wider stance.

    Shoulder doesn't affect my riding/confidence.

    The confidence thing took 5-6 months, maybe...

    I've since taken the odd tumble on same shoulder and it's held up.

    I am still conscious when in similar riding situations that caused the original injury.

    My Brain won't easily forget the events that occurred 11 months ago.

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    "Mountain biking: the under-rated and drug-free antidepressant"

  9. #1009
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    Just did this and hope it will not be affecting my bike set up.





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  10. #1010
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    It's been 5 weeks now since my accident. I returned to work Thursday, as my mental health was starting to wane . I have been having physio for the last 2 weeks and have to return to the fracture clinic this coming Wednesday. I'm still in pain and by the end of the day it is unbearable.
    Ac Separation (shoulder Separation)-14358990_10154052743777266_4070886604503884285_n.jpg

    The way I feel at the moment, It'll be a while before I'm back on my bike. Those of you who didn't have surgery how long was it before you were able to do some sort of exercise?

  11. #1011
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    Quote Originally Posted by abrooks View Post
    It's been 5 weeks now since my accident. I returned to work Thursday, as my mental health was starting to wane . I have been having physio for the last 2 weeks and have to return to the fracture clinic this coming Wednesday. I'm still in pain and by the end of the day it is unbearable.
    Click image for larger version. 

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    The way I feel at the moment, It'll be a while before I'm back on my bike. Those of you who didn't have surgery how long was it before you were able to do some sort of exercise?
    That one kinda looks like it should need surgery just saying you might want another opinion. My break is a 50/50 chance for surgery if it stays together.


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  12. #1012
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    Mine was between a grade 2 and 3. 3 weeks and I was 80. 5 weeks all Ok.

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  13. #1013
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    Those fracture/separations look a lot more painful! Gooseberry's fragment looks less displaced and more likely to heal. Can't believe how many new members there are every time I log in here!

  14. #1014
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    It's been 1 week since my fall. Grade 4 separation, surgery in 3 days. What should I expect for the first week? Thanks for any input.

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  15. #1015
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    Ac Separation (shoulder Separation)-img_5129.jpg


    Ac Separation (shoulder Separation)-img_5112.jpg


    Just thought I'd chime in since this thread has been very helpful to me.

    9 days ago on 11/3/16, I went over the bars at Bent Creek in Asheville, NC. I was wearing a helmet (thank God) and had a concussion, lost short term memory and was totally out of it...until I ate a rice krispie treat (no joke). Here's a video...notice I stop breathing for 12 seconds after the crash. The crash is right around the 1 minute mark...girlfriend found me shortly afterwards gasping for air with my eyes rolled into the back of my head. For anyone who followed my other thread, we still never found my iPhone.

    https://www.youtube.com/watch?v=dfAhIyT5dFM

    Anyways, we made it back to FL the next day, and for the first 2-3 days, I couldn't use my left arm at all and had to keep it in a sling. Day 4, I went to my physical therapist to show him the X-ray and have him apply some KT tape to strap down the clavicle and stabilize the joint, which helped a ton. Around day 5, I started to progress rapidly and gain back range of motion. Rode the stationary bike for 40 minutes and it felt really good to get some good blood flowing. The next day, I bought some Rocktape and really taped the shit out of the joint, following the pattern in this video:

    https://www.youtube.com/watch?v=eoSXi6vHKzI

    Day 7, I was able to ride my bike around the block without any pain (it only hurts getting on and off) but didn't want to push it.

    Day 9, yesterday, I felt so good and had back so much range of motion that I rode my bike 5 miles on pavement and did 30 minutes on the Airdyne (think of a bike with elliptical handles). Shoulder still feels unstable during certain movements, but I have back 75% of my range of motion.

    I had an MRI yesterday, but haven't received results yet.

    I've been taking Cissus Quadrangularis which has helped immensely with joint pain in the past. 2400mg Cissus, 800mg ibuprofen, 2-3 fish oil capsules and 3g curcumin 3x a day since day 1. Ice 4-5 times per day for 15-20 minutes.

    For the record, I separated my other AC joint back in 2009 when jumping over a 6 foot wall on an obstacle course. My legs went over the wall, but my arm didn't. I have a slight bump on the right shoulder, which healed 100% without any surgery. I'm an avid weightlifter and have full functionality in that arm. I always wondered why I had more range of motion when vertical pressing on the previously injured side...maybe I just evened myself out?

  16. #1016
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    13 days in, MRI results indicate my scapula is also fractured (non displaced). Can't see an ortho until next week so I'm just staying the course with ice/ibuprofen and light exercise when I can. Rode my bike for 1.5 hours this weekend on smooth dirt paths / grass etc with no pain, and managed to do a leg workout at the gym. Still not stable enough to do anything with my arms but I'm not in a rush.

  17. #1017
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    Thanks guys for the updates....it's been 1 day since surgery and it hurts like a mofo. Hopefully I can ride my trainer next week.

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  18. #1018
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    Quote Originally Posted by DudeDowne View Post
    Thanks guys for the updates....it's been 1 day since surgery and it hurts like a mofo. Hopefully I can ride my trainer next week.

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    I had a friend setup my bike in the trainer for me. Did some easy spinning to keep from being bored and keep blood moving. About a week later I was doing my ROM stretches on the trainer while I rode.
    I like to fart when I'm in front of you on a climb

  19. #1019
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    I sustained a grade 5 separation in August and had reconstruction surgery 2 weeks after the injury. I can tell you that for the first 4 to 5 weeks I was useless; unable to utilize the arm at all and too afraid to even go hiking. I started PT about 2 weeks after surgery. By week 8 I tried to do light mountain biking, making sure not to fall and to walk all of the challenging and technical stuff. I felt good that day but for the next almost week after that I was very sore and in a lot of pain. I think it may have set me back in my PT a little too. The phys. therapist yelled at me and when I saw the doctor 9 weeks after surgery he told me not to get on the bike. So now I'm heeding his warning and will ask him again about it in January when I see him again. Luckily I'm well enough to hike now and the strength in my arm has improved significantly. I feel like I can do light riding now, at 12 weeks out and I might cheat, still thinking about it.

  20. #1020
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    Quote Originally Posted by rocbike View Post
    I sustained a grade 5 separation in August and had reconstruction surgery 2 weeks after the injury. I can tell you that for the first 4 to 5 weeks I was useless; unable to utilize the arm at all and too afraid to even go hiking. I started PT about 2 weeks after surgery. By week 8 I tried to do light mountain biking, making sure not to fall and to walk all of the challenging and technical stuff. I felt good that day but for the next almost week after that I was very sore and in a lot of pain. I think it may have set me back in my PT a little too. The phys. therapist yelled at me and when I saw the doctor 9 weeks after surgery he told me not to get on the bike. So now I'm heeding his warning and will ask him again about it in January when I see him again. Luckily I'm well enough to hike now and the strength in my arm has improved significantly. I feel like I can do light riding now, at 12 weeks out and I might cheat, still thinking about it.
    Good luck with the recovery. After the surgery doc said I had a grade 5 due to the tissue damage that didn't show up on x-ray. I certainly over estimated my recovery, like you stated I am useless. I will heed your story and not push it. Thanks for sharing your story.


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  21. #1021
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    Grade 5 separation and Lockdown surgery

    I was excited to find this forum, and I hope you will accept my horse as my bike! I suffered a grade 5 separation 4 years ago and was told that unless I was a major league baseball player I should not have surgery. Thinking that I had no other option, I continued to compete, train ex-race horses, jump and fall off of horses with this injury - sometimes with my arm strapped to my chest to get the job done!

    After four years of great pain I finally got a second opinion. This doctor said he had never seen x-rays as bad as mine, and couldn't believe I had gone this long in that kind of pain. I am scheduled for lockdown surgery the day before Thanksgiving, and I feel like I'm going to get my life back! Any tips to get through the recovery period would be greatly appreciated!

    Wish I could figure out how to post my X-rays!

  22. #1022
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    Quote Originally Posted by Jackietrentlynch View Post
    I was excited to find this forum, and I hope you will accept my horse as my bike! I suffered a grade 5 separation 4 years ago and was told that unless I was a major league baseball player I should not have surgery. Thinking that I had no other option, I continued to compete, train ex-race horses, jump and fall off of horses with this injury - sometimes with my arm strapped to my chest to get the job done!

    After four years of great pain I finally got a second opinion. This doctor said he had never seen x-rays as bad as mine, and couldn't believe I had gone this long in that kind of pain. I am scheduled for lockdown surgery the day before Thanksgiving, and I feel like I'm going to get my life back! Any tips to get through the recovery period would be greatly appreciated!

    Wish I could figure out how to post my X-rays!
    Wow...good luck. I am in day 5 from surgery and finally feel somewhat human. Lessons I have learned: Make sure you have some sort of support system for the first few days. Setup your recovery area with a comfy couch, small pillows, TV, books etc. I can't sleep lying down yet so I spend much time there. Take pain killers and force yourself to eat something in the first days. I didn't eat for a couple of days and it really sucked. I now eat rice oatmeal stuff like that so the side effects from the oxy are tolerable and I sleep longer.

    Not sure how much this helps, but it is getting better every day.

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  23. #1023
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    Quote Originally Posted by matt.s67 View Post
    13 days in, MRI results indicate my scapula is also fractured (non displaced). Can't see an ortho until next week so I'm just staying the course with ice/ibuprofen and light exercise when I can. Rode my bike for 1.5 hours this weekend on smooth dirt paths / grass etc with no pain, and managed to do a leg workout at the gym. Still not stable enough to do anything with my arms but I'm not in a rush.
    Watched your video. Looked like such an innocuous stretch of trail, but in an instant your life changed. Glad you're recovering. Curious to hear how you think the taping works out. Do you think your first separation was a Grade II?

  24. #1024
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    Quote Originally Posted by FL mtb View Post
    Watched your video. Looked like such an innocuous stretch of trail, but in an instant your life changed. Glad you're recovering. Curious to hear how you think the taping works out. Do you think your first separation was a Grade II?
    I know right? I'm still not sure exactly what happened, whether I pulled back on the bars with uneven pressure, or if the rear wheel popped forward on the lip of the jump...or maybe both.

    Rocktape is awesome. Every time I remove it prior to re taping, my shoulder feels way less stable than it does with it. My physical therapist feels that it's going to be a substantial factor in my healing process.

    Weird thing, the X ray looks like a grade 2 or 3, but the MRI states it's only a grade 1. Perhaps that's why I'm recovering so quickly.

    Anyhow, my real main concern is that I may have a torn labrum as the pain from my AC joint area has dissipated and I now only feel pain coming from inside the shoulder socket, and my shoulder still feels unstable. Meeting with an ortho next Wednesday so we'll see what he says. MRI apparently didn't find any type of labral tear, but from what I hear an MRI isnt the best way to detect it.

  25. #1025
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    I seperated mine 4th degree about 11 years ago. i'd say it's 98-99% back to normal and forget it happened except when I see the scar or dragging fingernails across the top there is some slight numbness/tingling, I imagine from nerve damage from the surgery. I had surgery about 3 weeks after the accident. I can't believe Jackietrently had 5th degree and gone 4 years witho surgery, that is crazy.

    One thing I would suggest anyone who suffers this injury/surgery to push their doctors/insurance company for is one of these.
    https://www.activeforever.com/aircas...FUg2gQodlz0MQg

    It beats holding an ice pack on your shoulder and does a much better job. You have to wear a sling anyway, and this is a sling and ice pack in one.

  26. #1026
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    Quote Originally Posted by LemonDrops View Post
    I seperated mine 4th degree about 11 years ago. i'd say it's 98-99% back to normal and forget it happened except when I see the scar or dragging fingernails across the top there is some slight numbness/tingling, I imagine from nerve damage from the surgery. I had surgery about 3 weeks after the accident. I can't believe Jackietrently had 5th degree and gone 4 years witho surgery, that is crazy.

    One thing I would suggest anyone who suffers this injury/surgery to push their doctors/insurance company for is one of these.
    https://www.activeforever.com/aircas...FUg2gQodlz0MQg

    It beats holding an ice pack on your shoulder and does a much better job. You have to wear a sling anyway, and this is a sling and ice pack in one.
    I second this and love my coldrush unit. I will never use a ice pack again. Btw I'm back to normal for the most part and plan on riding next week


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  27. #1027
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    They had something like that at my PT to ice my shoulder. It was pretty awesome and really nice for after my PT.
    I like to fart when I'm in front of you on a climb

  28. #1028
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    I've been pain free for about 2 weeks and can say I'm now 100% healed with zero limitations 2 months following my injury. I can lift weights as heavy as I want with no pain, I'm sleeping on my left side again...I don't even think about it anymore.

    Weight training, although painful at first, helped a ton. I had to push through a lot of stuff and do what I could without aggravating it, and it would be very sore afterwards, but the following day I would have noticeably less pain and more range of motion.

  29. #1029
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    Quote Originally Posted by matt.s67 View Post
    I've been pain free for about 2 weeks and can say I'm now 100% healed with zero limitations 2 months following my injury. I can lift weights as heavy as I want with no pain, I'm sleeping on my left side again...I don't even think about it anymore.

    Weight training, although painful at first, helped a ton. I had to push through a lot of stuff and do what I could without aggravating it, and it would be very sore afterwards, but the following day I would have noticeably less pain and more range of motion.
    Great job and glad to hear! Keep the progress updates coming. Very helpful to hear sucess stories.

    I just got clearance to get rid of the cradle. For me it has been 8 weeks since crash and 6 weeks since surgery (grade 5). I can't lift my arm above chest high yet, but will be starting PT next week. Still some dull pain but getting better.

    On a related note, I started an indoor training plan with Trainer Road since I won't be able to ride trails for at least another 3 months. It has been great to have a structured plan to motivate me and focus on fitness. Something I have never really taken seriously. I am still planning on making the Pisgah Enduro first week of June.


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  30. #1030
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    I'm at 6 months since my AC separation and torn Pectoral muscle. Life is pretty much normal again. It gets bothered if I sleep on it wrong or if I yank on my arm a lot or push something down a lot. Unless I move it certain way I don't really notice the lump but when it does stick out its way out there.
    I like to fart when I'm in front of you on a climb

  31. #1031
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    I have a sneeky suspicion I have a seperated AC, so last week I went into hospital after a otb crash, took xrays but they said nothing wrong with my collar bone or shoulder just possible sprain, but now im home and the swelling has gone, I can see and feel that the collar bone sits way higher where it meets my shoulder then my other side. Still hurts quite bad especially in certain positions I guess I should see the Dr haha.

  32. #1032
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    update:
    I am 4.5 years down the line from a grade 3 separation - no surgery.

    shoulder is good, works fine

  33. #1033
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    I suffered a Grade 5 separation, torn pectoral muscles, and a sternocavicular dislocation from a crash in June 2013. Because I had surgery within 2 weeks of the injury, the surgeon was able to do it without any grafting. He used a tightrope device that simply reattaches the clavicle and let's the soft-tissue scarring hold everything together permanently. I was skeptical at first, but I was back in the bike in 6 months and was back playing racquet sports after a year with no ill effects (same side as surgery). Six years later, my chest muscles still sag, presumably from the upper pectoral tears, but I've regained most of my strength. The only other problem I have is the clavicle popping out at the sternocavicular joint, but apparently there is very little that can be done for that. It's only noticeable with arm extended out and wide rotations of the shoulder.

  34. #1034
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    I'm a cat 1 roadie and xc mountain biker that suffered a grade 3 on my left shoulder in March 2015 going over the bars on a long downhill after my new elbow armour slowly cut off the circulation to my hands and I had a braking 'malfunction' a few corners from the bottom of the trail. Doh.

    My shoulder bump was big, but my recovery was very fast and I had full range of movement within 4 weeks, and was back riding on the road around the 3 week mark. I had no pain with day to day activities though on the road bike I'd get pins and needles in my hand after about an hour of riding. I realised this was because I had the tendency to shrug and tense the shoulder and lock it in to the trap in order to get some stability. Another problem I realised early on is that the separation made my left arm about 1 inch functionally longer than my right when reaching for the bars. This would mean that when I was putting the hammer down on the road bike that I would tend to push off the left side pushing that hip back and the other hip forward.

    The shoulder however was definitely functional and pain free so I upped my training volume for a stage race mid last year and was faster and stronger than I've ever been, however developed bad pelvic nerve pain on the right side that has forced me off the bike ever since. After a lot of futile core work, scans revealed a hip labral tear and gluteal nerve impingement on the right hip that had turned my glute med to fat.

    It took quite a bit of detective work to discover that the AC separation was the main cause. I've only recognised in hindsight the importance of trying to keep both clavicles level in day to day activities (and how my AC separation made this almost impossible). For me, my brain would keep both shoulders level (even though the left now had a big drop) and this meant my clavicles developed an angle downwards to the right. This strengthened some muscles, weakened others, and kinked my spine, and eventually the scoliosis at the base of the spine started bringing my right hip upwards, rotated forward, and a decent training load entailed the hip and SI joint copped the full brunt of all my asymmetries.

    My AC surgery in 3 weeks will use a Lockdown artificial ligament, then I'll have hip arthoscopy a few months after that. I'm hoping after fixing the AC my spine can remember what being straight feels like and help my pelvis heal.

    Maybe I was prone to a malalignment problem (left footed, right handed) but I think if you're very sporty and young and have a grade 3 and the decision given to you by medical professionals for surgery is 'does my shoulder work without pain...' you should also seriously think about the downstream effects in the kinetic chain, or at the very least monitor them really closely.

  35. #1035
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    Quote Originally Posted by Jadw View Post
    I'm a cat 1 roadie and xc mountain biker that suffered a grade 3 on my left shoulder in March 2015 going over the bars on a long downhill after my new elbow armour slowly cut off the circulation to my hands and I had a braking 'malfunction' a few corners from the bottom of the trail. Doh.

    My shoulder bump was big, but my recovery was very fast and I had full range of movement within 4 weeks, and was back riding on the road around the 3 week mark. I had no pain with day to day activities though on the road bike I'd get pins and needles in my hand after about an hour of riding. I realised this was because I had the tendency to shrug and tense the shoulder and lock it in to the trap in order to get some stability. Another problem I realised early on is that the separation made my left arm about 1 inch functionally longer than my right when reaching for the bars. This would mean that when I was putting the hammer down on the road bike that I would tend to push off the left side pushing that hip back and the other hip forward.

    The shoulder however was definitely functional and pain free so I upped my training volume for a stage race mid last year and was faster and stronger than I've ever been, however developed bad pelvic nerve pain on the right side that has forced me off the bike ever since. After a lot of futile core work, scans revealed a hip labral tear and gluteal nerve impingement on the right hip that had turned my glute med to fat.

    It took quite a bit of detective work to discover that the AC separation was the main cause. I've only recognised in hindsight the importance of trying to keep both clavicles level in day to day activities (and how my AC separation made this almost impossible). For me, my brain would keep both shoulders level (even though the left now had a big drop) and this meant my clavicles developed an angle downwards to the right. This strengthened some muscles, weakened others, and kinked my spine, and eventually the scoliosis at the base of the spine started bringing my right hip upwards, rotated forward, and a decent training load entailed the hip and SI joint copped the full brunt of all my asymmetries.

    My AC surgery in 3 weeks will use a Lockdown artificial ligament, then I'll have hip arthoscopy a few months after that. I'm hoping after fixing the AC my spine can remember what being straight feels like and help my pelvis heal.

    Maybe I was prone to a malalignment problem (left footed, right handed) but I think if you're very sporty and young and have a grade 3 and the decision given to you by medical professionals for surgery is 'does my shoulder work without pain...' you should also seriously think about the downstream effects in the kinetic chain, or at the very least monitor them really closely.
    Jadw,

    Thanks for posting. I had a grade 5 separation in November and had surgery to repair left shoulder using donor ligaments. I was able to start indoor training in December and cleared for strength training in March. I still have a large bump and my clavicles are not symmetrical. My hope is continued strength training will reduce the imbalance.

    However I now have nagging right knee pain. In researching this it seems I found that glute med strengthening/activation may help. I found that performing glute exrcisines my right side is very limited compared to my left. I suspect that this imbalance is due to my left shoulder as well. I hope surgery is not required and PT can fix this.

    Good luck on your surgery and recovery.






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  36. #1036
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    Boy this thread has been a wealth of information and positivity.

    I was hit by a car going about 45 mph (the car not me) about 7 weeks ago, which took out the car windshield. I manned-up (aka was an idiot) for a few days and finally went to the doctor - discovering I had multiple fractures on my left ankle (for which I have had surgery for a screw) and a grade 3 shoulder separation on my left side. I had to go to two separate doctors and it's interesting that neither really takes the other injury into account - e.g. using crutches with a separated shoulder...hurts.

    The ankle was worse off and the focal point because I had to have it surgically repaired. The shoulder seemed to heal faster with ice and rest and the shoulder doc 'released' me 4 weeks after the crash because I had full range of emotion and just some soreness now and again. Weirdly enough once the ankle really started to improve a couple of weeks ago the shoulder got worse - not chronic pain but random spasms and soreness that would come and go. And it didn't get better. How could it go backwards?

    So I started PT on the shoulder and my therapist says what I'm experiencing isn't unusual - especially for someone with multiple injuries as the body can really only focus on so much repair/pain at once. Now that the ankle is much better, I'm just feeling the shoulder more - at least that's her contention.

    She also said the deltoid muscle has been over-compensating for the AC joint leading to spasms and discomfort as the AC joint has not been used. Muscle relaxers for the ankle taken multiple times a day probably did'n't help the situation (taken before bed is not a problem since the shoulder isn't moving anyway.)

    She gave me some basic exercises but warned me this might get a little more painful before it gets better - but it should get better and quickly but it will still take some time to get it 100%. She did not see a reason to return to the doctor to have the shoulder re-evaluated

    I get the ankle air cast off for good (with any luck) next week and hope to get back on the bike asap - since pedaling is actually good for getting range of motion back in the ankle...assuming you avoid cars. I am wondering if my shoulder will be able to take it - the leaning over, the gripping...but guess we'll see...

  37. #1037
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    I was pretty comfortable on the bike until I tried to pull the front wheel up for bunny hops, woop-de-doos, logovers, etc.

    Every once in a while a bump or drop would catch me off guard and cause a bit of a wince, but it only lasted for a second.
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  38. #1038
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    Wow. Reading this thread makes me wonder why im still biking. Mine still hurts after a few months after casing a jump with my shoulder. It didn't help that i clipped my handlebar on an extended tree going 25 and reinjured it. Now I'm concerned about range of motion later on in life.

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  39. #1039
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    Quote Originally Posted by jacksonlui View Post
    Wow. Reading this thread makes me wonder why im still biking. Mine still hurts after a few months after casing a jump with my shoulder. It didn't help that i clipped my handlebar on an extended tree going 25 and reinjured it. Now I'm concerned about range of motion later on in life.

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    It can be repaired. Mine will be this fall.

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  40. #1040
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    I've fallen on mine again since being separated. Its sore for a few days then back to normal.
    I like to fart when I'm in front of you on a climb

  41. #1041
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    I had a fourth or fifth degree sep, ten years ago at 39. Its right as rain today. Just get it taken care of.

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    Quote Originally Posted by jacksonlui View Post
    Wow. Reading this thread makes me wonder why im still biking. Mine still hurts after a few months after casing a jump with my shoulder. It didn't help that i clipped my handlebar on an extended tree going 25 and reinjured it. Now I'm concerned about range of motion later on in life.

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    I'm about a year from a grade 3, just did a rocky mtb race on a rigid bike yesterday with no problems from the shoulder. It did take a while for the pain to fade though, but I credit religious physical therapy for my recovery. In particular, I still occasionally do the range of motion exercises. Also, my injury-causing crash, aside from rider error, was caused by my seat popping me otb. I have a dropper now. Love the dropper!

  43. #1043
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    Another member to the club with, albeit different, story.

    I woke up this morning and in the shower mirror I noticed my left shoulder bone protruding slightly out of my body. A quick google session and I found correct medical term and by the looks of it I have level 3 ac joint separation. I haven’t fell or experienced any trauma to my left side ever! Nor I remember feeling pain in my left shoulder or having any immobility issues ever!

    After reading a few pages of this thread I started testing the symptoms. Did some pushups, pullups, chin-ups – nothing unusual. Not to mention sleeping on either side – no difference at all. However, after doing some slower shoulder rotations and elevations (to compare both shoulders) I felt some clicking in the left shoulder. Did “hindu” pushup and felt the clicking, but no pain. Does this mean I separated it a while back and already recovered from it?

    I started doing calisthenics recently and wonder if I should stop it and do correct recovery? Will the lump get worse? I’ve scheduled appointment with my doctor, but do wonder about your opinion.

  44. #1044
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    Quote Originally Posted by xtruder View Post
    Another member to the club with, albeit different, story.

    I woke up this morning and in the shower mirror I noticed my left shoulder bone protruding slightly out of my body. A quick google session and I found correct medical term and by the looks of it I have level 3 ac joint separation. I haven’t fell or experienced any trauma to my left side ever! Nor I remember feeling pain in my left shoulder or having any immobility issues ever!

    After reading a few pages of this thread I started testing the symptoms. Did some pushups, pullups, chin-ups – nothing unusual. Not to mention sleeping on either side – no difference at all. However, after doing some slower shoulder rotations and elevations (to compare both shoulders) I felt some clicking in the left shoulder. Did “hindu” pushup and felt the clicking, but no pain. Does this mean I separated it a while back and already recovered from it?

    I started doing calisthenics recently and wonder if I should stop it and do correct recovery? Will the lump get worse? I’ve scheduled appointment with my doctor, but do wonder about your opinion.
    You can't diagnose yourself as having a grade 3 separation by looking in a mirror and googling. If you had a grade 3, or even a grade 1, you would have known it - you'd experience a LOT of pain and not be able to move your entire arm for awhile. It's not just something you wake up with one day. If you never had any pain or trauma to your shoulder, I'm not sure why you think the AC ligaments are completely severed.

  45. #1045
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    Google says mine is a grade 3.14159. Wonder what the co-pay is with this obamacare

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  46. #1046
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    Quote Originally Posted by xtruder View Post
    Another member to the club with, albeit different, story.

    I woke up this morning and in the shower mirror I noticed my left shoulder bone protruding slightly out of my body. A quick google session and I found correct medical term and by the looks of it I have level 3 ac joint separation. I haven’t fell or experienced any trauma to my left side ever! Nor I remember feeling pain in my left shoulder or having any immobility issues ever!

    After reading a few pages of this thread I started testing the symptoms. Did some pushups, pullups, chin-ups – nothing unusual. Not to mention sleeping on either side – no difference at all. However, after doing some slower shoulder rotations and elevations (to compare both shoulders) I felt some clicking in the left shoulder. Did “hindu” pushup and felt the clicking, but no pain. Does this mean I separated it a while back and already recovered from it?

    I started doing calisthenics recently and wonder if I should stop it and do correct recovery? Will the lump get worse? I’ve scheduled appointment with my doctor, but do wonder about your opinion.
    If the bump has been there and you're just noticing it, then it is either a birth defect or related to an old injury. I doubt there is anything you can or should do at this point, especially since it doesn't seem to be hindering you in any meaningful way. I've separated both of mine, and never had the first one treated. It's fine now. The other one was a Grade 5 and required surgical repair. It's fine too except for the same popping or clicking that you describe, which I don't worry about.

  47. #1047
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    Quote Originally Posted by matt.s67 View Post
    You can't diagnose yourself as having a grade 3 separation by looking in a mirror and googling. If you had a grade 3, or even a grade 1, you would have known it - you'd experience a LOT of pain and not be able to move your entire arm for awhile. It's not just something you wake up with one day. If you never had any pain or trauma to your shoulder, I'm not sure why you think the AC ligaments are completely severed.
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  48. #1048
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    I don't recall what I had but the Dr said no surgery needed... was happy with that.

    Eighteen or more years ago I was showing a friend around on our bikes up behind the Broadmoor and coming down Chutes from Goldcamp at a good rate of downhill momentum, I spotted the Brady Bunch coming up the flat entry area. I moved over well early but my tire found a square-edged rut and bike and I were launched to the ground at impressive velocity.
    I was winded and although I got right up, my arm was completely dead and numb. I had to lift my right arm and lay it and hand on the handle bars to guide the bike back to the the car.

    It finally came back to haunt me with some minor pain and some range of motion issues here in the past year or so but thankfully nothing of consequence. Back then I was 38.
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  49. #1049
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    Disregard, I'm bad at forums.

  50. #1050
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    Quote Originally Posted by xtruder View Post
    Another member to the club with, albeit different, story.

    I woke up this morning and in the shower mirror I noticed my left shoulder bone protruding slightly out of my body. A quick google session and I found correct medical term and by the looks of it I have level 3 ac joint separation. I haven’t fell or experienced any trauma to my left side ever! Nor I remember feeling pain in my left shoulder or having any immobility issues ever!

    After reading a few pages of this thread I started testing the symptoms. Did some pushups, pullups, chin-ups – nothing unusual. Not to mention sleeping on either side – no difference at all. However, after doing some slower shoulder rotations and elevations (to compare both shoulders) I felt some clicking in the left shoulder. Did “hindu” pushup and felt the clicking, but no pain. Does this mean I separated it a while back and already recovered from it?

    I started doing calisthenics recently and wonder if I should stop it and do correct recovery? Will the lump get worse? I’ve scheduled appointment with my doctor, but do wonder about your opinion.
    Quote Originally Posted by matt.s67 View Post
    You can't diagnose yourself as having a grade 3 separation by looking in a mirror and googling. If you had a grade 3, or even a grade 1, you would have known it - you'd experience a LOT of pain and not be able to move your entire arm for awhile. It's not just something you wake up with one day. If you never had any pain or trauma to your shoulder, I'm not sure why you think the AC ligaments are completely severed.
    This is not true. I did not crash, have an accident or fall at all. I do a lot of weight lifting and woke up one morning with a somewhat sore shoulder. Collar bone bump on right side, took an x-ray, II-III separated shoulder. The doctor didn't believe I didn't fall. Going to ortho in 2 weeks.

    BTW, x-ray techs are not the best at diagnosing these. They look for fractures, breaks, and something way out of wack. My x-ray report said normal shoulder when you can clearly see the clavicle sitting above the acromium. An MRI is needed to see the ligament damage, x-rays won't show anything. Go to your doc if you have one and stop doing push-ups, bench, overhead press, etc.

  51. #1051
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    Grade V

    I had this injury in a hiking accident 7/15/17, the ER doc said grade II, yesterday on 7/26/17 the Ortho surgeon said Grade V. I really don't want to have to go through the surgery, but feel it's the best thing to do overall.

    Even after making the decision still having nagging thoughts. Having surgery and 4 weeks in an immobilizer is nothing to laugh about.

    I've attached two photos, hopefully they come through. The red on my shoulder is from having my shoulder taped and I may have ripped it off too vigorously.

    It's hard to get a straight answer, the surgeon said it's up to me, and this guy is a high ranking ortho sports medicine guy.

    Good luck with whatever you are doing, things can work out.
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-grade-v.jpg  

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  52. #1052
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    I had a grade 3 separation on my shoulder from a snow boarding accident in 2002 at 27 years old. I caught an edge and hit hard. The Dr at that time told me grade 3 was the worst. He told me surgery wasn't necessary and it was only for cosmetic looks due to the bone sticking up. My shoulder was completely immobilized for 8 weeks in a sling. When I removed the sling I had no muscle and after rehab and weights, I have 100% motion and never had any issues with my shoulder. Surgery wasn't needed for me. It's interesting to here the different recovery times and opinions from other Dr's. Fast forward to 2016, on my MTN bike I cut a side wall on a steep run and dislocated the same shoulder, but luckily popped it back in socket. The Dr told be it's completely unrelated to my first injury, but I will need surgery due to a torn Labrum. Three months later I washed out the front going somewhat fast and dislocated it again. It was only out of socket for about 3 hrs until the ER Dr. drove put it back in place. Drove myself to the ER after the Ranger picked me up and took me back to my truck. Pain was only 12 out of 10. I waited about 4 1/2 months to get back on the bike and my shoulder feels as good as it did before surgery. Fun times.

  53. #1053
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    Quote Originally Posted by savoi View Post
    I really don't want to have to go through the surgery, but feel it's the best thing to do overall.

    Even after making the decision still having nagging thoughts. Having surgery and 4 weeks in an immobilizer is nothing to laugh about.

    It's hard to get a straight answer, the surgeon said it's up to me, and this guy is a high ranking ortho sports medicine guy.
    Both the pic and xray look very similar to what I had, also diagnosed as Grade 5. I had surgery around 2 weeks after the accident after getting opinions from 2 ortho surgeons. One wanted to do a graft to reconstruct the joint. The other recommended a simpler approach involving a tightrope device that essentially just ties the clavicle back down to the shoulder blade allowing scar tissue to form. I opted for the second approach and haven't had any issues. This happened when I was 55 but I recovered nicely. I was back mountain biking after 4-5 months and eventually resumed playing racquetball and squash with that arm with no issues. I've had no regrets, although I really can't say how things would have turned out without the surgery. Feel free to PM me if you have any specific questions. Ac Separation (shoulder Separation)-biking-injury.jpgAc Separation (shoulder Separation)-x-ray-shoulder-cascade-er.jpgAc Separation (shoulder Separation)-cropped-shoulder-image.jpg

  54. #1054
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    Had my first shoulder separation 3 weeks ago.
    I have not had MRI, is this important to help me recover and choose right training?

    I work on a vessel in a foreign country, it would be a hassle to get to any hospital but something i could do if its important.
    If its no problem to do it in 4weeks, then i can do it at home.

    EDIT: When reading and looking more in this thread, i see that i have mixed up things. I had a dislocated shoulder, not AC separation.

  55. #1055
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    Quote Originally Posted by Skorp View Post
    Had my first shoulder separation 3 weeks ago.
    I have not had MRI, is this important to help me recover and choose right training?

    I work on a vessel in a foreign country, it would be a hassle to get to any hospital but something i could do if its important.
    If its no problem to do it in 4weeks, then i can do it at home.

    EDIT: When reading and looking more in this thread, i see that i have mixed up things. I had a dislocated shoulder, not AC separation.
    Can be a good idea to see a doctor and get an MRI, I had issues with my shoulder for about 7 years after dislocating it. Tore some ligaments and after having it dislocated a few more times it didn't sit right in the socket any more. Had to get surgery, and now it's stronger than my "healthy" shoulder, just a tiny bit less mobility after srugery.

  56. #1056
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    Quote Originally Posted by savoi View Post
    I had this injury in a hiking accident 7/15/17, the ER doc said grade II, yesterday on 7/26/17 the Ortho surgeon said Grade V. I really don't want to have to go through the surgery, but feel it's the best thing to do overall.

    Even after making the decision still having nagging thoughts. Having surgery and 4 weeks in an immobilizer is nothing to laugh about.

    I've attached two photos, hopefully they come through. The red on my shoulder is from having my shoulder taped and I may have ripped it off too vigorously.

    It's hard to get a straight answer, the surgeon said it's up to me, and this guy is a high ranking ortho sports medicine guy.

    Good luck with whatever you are doing, things can work out.
    I am no doctor, but having looked at many xrays of separated shoulders, I would say that is a IV to V.

    Ask your primary doctor for a second opinion from another ortho. This is common when contemplating surgery.

    That being said, if it's IV-V you should get surgery. With a III-V you have no ligaments holding your clavicle in place-not good.
    Last edited by Rocko99; 07-28-2017 at 12:09 PM.

  57. #1057
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    Quote Originally Posted by Rocko99 View Post
    With a V you have no tendons holding your clavicle in place-not good.
    It's actually the absence of attached ligaments that distinguish a Grade V. There are normally 3 that create the AC joint on that end of the clavicle. When all 3 are severed it is either grade III or V depending on degree of separation. A grade IV is different, involving a different type of displacement.

  58. #1058
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    Quote Originally Posted by throet View Post
    It's actually the absence of attached ligaments that distinguish a Grade V. There are normally 3 that create the AC joint on that end of the clavicle. When all 3 are severed it is either grade III or V depending on degree of separation. A grade IV is different, involving a different type of displacement.
    I was mistaken. Thanks for the info.

  59. #1059
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    Quote Originally Posted by Losvar View Post
    Can be a good idea to see a doctor and get an MRI, I had issues with my shoulder for about 7 years after dislocating it. Tore some ligaments and after having it dislocated a few more times it didn't sit right in the socket any more. Had to get surgery, and now it's stronger than my "healthy" shoulder, just a tiny bit less mobility after srugery.
    I think too you should see a shoulder specialist as soon as possible. I dislocated my left shoulder for the first time 2 years ago and it only got worse. I took too long to treat it proper, so ended up having to do a major reconstruction surgery. I lost time and suffered pain uncessessarily. For now, keep your arm as still as possible and go see a doctor when you can. If he says you should operate, do it quickly.

  60. #1060
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    Quote Originally Posted by Rocko99 View Post
    I am no doctor, but having looked at many xrays of separated shoulders, I would say that is a IV to V.

    Ask your primary doctor for a second opinion from another ortho. This is common when contemplating surgery.

    That being said, if it's IV-V you should get surgery. With a III-V you have no ligaments holding your clavicle in place-not good.
    Rocco,

    Agree with you, but no time left for a second opinion unless I can get it Monday. My surgery is scheduled for Tuesday morning. I have wrung my hands over this and feel it is right for me. Thanks for your reply

  61. #1061
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    Quote Originally Posted by pedromayall View Post
    I think too you should see a shoulder specialist as soon as possible. I dislocated my left shoulder for the first time 2 years ago and it only got worse. I took too long to treat it proper, so ended up having to do a major reconstruction surgery. I lost time and suffered pain uncessessarily. For now, keep your arm as still as possible and go see a doctor when you can. If he says you should operate, do it quickly.
    So much this!

  62. #1062
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    Did anyone get numbness or tingling in their hands or fingers on the side that was separated?

  63. #1063
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    AC Separation - Grade 2

    Got a grade 2.5 AC Separation on my right (dominant) shoulder 12 days ago after hitting the pavement at 30mph... This bruiser also came with 1) coracoclavicular tear (ac joint in tact though but I have a big bump that accompanies ac separations), 2) SLAP tear (superior labrum) as per the MRI (see below), 3) Edema extending on my clavicle into my trapezius muscle. Also sprained my left wrist and left ribs but I assume that will go within the next 2-4 weeks...

    Dr says to wait 4 weeks for swelling to subside and start physical therapy - revisit pain after PT sequence. My questions are the below:

    1) Does the CC tear merge back together over time or is surgery the only way for it to fuse back?
    2) I have my normal range of motion minus having to move much slower and weaker strength. However, I cant raise my arm in front of me above waist height - not sure if its the CC tear or SLAP tear so for those with AC grade 3, did you have limited range of motion similar to mine?

    Thanks in advance.

    Ac Separation (shoulder Separation)-shoulder-mri.jpg

  64. #1064
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    I couldn't raise my arm above my waist for a few weeks let alone take off my shirt. Its been a year and it only hurts a little at certain angles. Hindsight, i should've done some exercises to speed up recovery.

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  65. #1065
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    Quote Originally Posted by jacksonlui View Post
    I couldn't raise my arm above my waist for a few weeks let alone take off my shirt. Its been a year and it only hurts a little at certain angles. Hindsight, i should've done some exercises to speed up recovery.

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    Rehab helped a ton! Part of the rehab is strenghtening the muscles to help locate your shoulder and part is to retrain your shoulder to work right minus the AC. I have full ROM 1 year later(almost to the day actually). No pain but its more mobile than my other shoulder still. A few motions I was told I'd never be able to do I can do no problem. I was back to work as a auto tech in under 4 weeks from injury with a grade 3 separation and pectoral tear. I did rehab from day one and 6 weeks after I returned to work.
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  66. #1066
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    What type of exercises did you have to do?

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    I joined this club last sunday.

    Diagnosis by: parking lot diag from fellow rider/Dr., ER doc, and Ortho 1 day later: Grade 2 ac separation. Bummed I did this entering the best part of the season for riding, weather-wise - but content knowing how bad things could have been. Anxious to make some progress so we'll see...

  68. #1068
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    Fell on same spot but on right side. Did you have a swollen rhomboid/Traps for couple of weeks? I have edema in my Traps and when I put my back against the wall, my injured side touches well before. It's been 3 weeks since injury - ROM is 80prcnt but my arm gets tired at end of day and I get more swollen behind my right scapula.

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    Quote Originally Posted by matt.s67 View Post
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    Just thought I'd chime in since this thread has been very helpful to me.

    9 days ago on 11/3/16, I went over the bars at Bent Creek in Asheville, NC. I was wearing a helmet (thank God) and had a concussion, lost short term memory and was totally out of it...until I ate a rice krispie treat (no joke). Here's a video...notice I stop breathing for 12 seconds after the crash. The crash is right around the 1 minute mark...girlfriend found me shortly afterwards gasping for air with my eyes rolled into the back of my head. For anyone who followed my other thread, we still never found my iPhone.

    https://www.youtube.com/watch?v=dfAhIyT5dFM

    Anyways, we made it back to FL the next day, and for the first 2-3 days, I couldn't use my left arm at all and had to keep it in a sling. Day 4, I went to my physical therapist to show him the X-ray and have him apply some KT tape to strap down the clavicle and stabilize the joint, which helped a ton. Around day 5, I started to progress rapidly and gain back range of motion. Rode the stationary bike for 40 minutes and it felt really good to get some good blood flowing. The next day, I bought some Rocktape and really taped the shit out of the joint, following the pattern in this video:

    https://www.youtube.com/watch?v=eoSXi6vHKzI

    Day 7, I was able to ride my bike around the block without any pain (it only hurts getting on and off) but didn't want to push it.

    Day 9, yesterday, I felt so good and had back so much range of motion that I rode my bike 5 miles on pavement and did 30 minutes on the Airdyne (think of a bike with elliptical handles). Shoulder still feels unstable during certain movements, but I have back 75% of my range of motion.

    I had an MRI yesterday, but haven't received results yet.

    I've been taking Cissus Quadrangularis which has helped immensely with joint pain in the past. 2400mg Cissus, 800mg ibuprofen, 2-3 fish oil capsules and 3g curcumin 3x a day since day 1. Ice 4-5 times per day for 15-20 minutes.

    For the record, I separated my other AC joint back in 2009 when jumping over a 6 foot wall on an obstacle course. My legs went over the wall, but my arm didn't. I have a slight bump on the right shoulder, which healed 100% without any surgery. I'm an avid weightlifter and have full functionality in that arm. I always wondered why I had more range of motion when vertical pressing on the previously injured side...maybe I just evened myself out?
    Fell on same spot but on right side. Did you have a swollen rhomboid/Traps for couple of weeks? I have edema in my Traps and when I put my back against the wall, my injured side touches well before. It's been 3 weeks since injury - ROM is 80prcnt but my arm gets tired at end of day and I get more swollen behind my right scapula.

  70. #1070
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    ... I broke my ankle and separated my shoulder while screwing around on some jumps back in June (2017).

    At the time, the ER PA said injury was between Grades 2 and 3. I saw an ortho about a week later, and he said the same thing, and also indicated that I would get back 95% functionality through non-surgical treatment. This clown, who worked on Carolina Hurricanes hockey players, didn't even ask me to take off my shirt to look at it. Appt lasted all of 5mins.

    Between weeks 6 & 7, I saw another shoulder specialist (for a 2nd opinion), who happens to be known as the "King of Shoulders" in the Raleigh area, and he said that maybe it was a Grade 2-3 at the time but since has become closer to a Grade 5. Being how active my lifestyle is, he said that I would never be happy with it (non-surgically treating it).

    His procedure uses zero hardware. He debrides old scar tissue, shaves the end of the clavicle, and secures the collarbone with Fiberwire. He also puts your blood into a centrifuge to get the plasma. He then puts the plasma back into the ligament areas to stimulate healing/growth. He's been doing this procedure for 10yrs and has had 100% success.

    To the day, I'm currently 7wks out from the surgery.

    At the 4wk appt., I was given another 4wks to ween myself out of the sling. The goal at 8wks is to be able to extend my arm out and raise it above my head. I'm pretty close to doing this now. * side note; he said, there's nothing you can do at this point that would damage my work, but if you aggressively rehab, you're not going to be able to accelerate the progress - moreover, you're going to be sore as hell and wished you hadn't been aggressive with it. This is going to take time, and progress will be slow-going. Damn, if he wasn't right!!!

    So, I see the doc in a week, and provided he's happy with my efforts, he will instruct me to start some formal pt.

    Even though I have lots more time to rehab this thing, I am much happier now with how the shoulder and body feels (and looks) compared to where I was at 7wks with the non-surgical treatment.

    Now, all this being said, there's no sugar-coating - the surgery/recovery hurt like a bitch. I've broken many bones and have had plenty of surgeries but this shoulder crap blows big-time! Also, rehab ain't no joke... (and I would still do it all over again!)

    Btw, I got 2 screws in the ankle I busted, which, coincidentally, was the same ankle I got 2 screws in when I was a kid.
    Trek Stache 5
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  71. #1071
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    ^^^ Just curious how a grade 2-3 gets worse, by moving it? My grade 3 was immobilized in a retaining sling for 8 weeks and I was told no surgery was needed. After 8 weeks I had no muscle left and had to do extensive rehab and weights to build the muscle back up. Other then the clavicle being lifted up, I've never had an issue and have always had 100% motion. Yes the constant pain while wearing the sling was not fun. Heel quick!

  72. #1072
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    Quote Originally Posted by Chicane32 View Post
    ^^^ Just curious how a grade 2-3 gets worse, by moving it?
    Thanks! I don't know - the second doc just said that it looks worse than a Grade 2-3.

    Personally speaking, I don't think the severity increased that much, if at all, between the first and second diagnosis.
    Last edited by woodchips; 4 Weeks Ago at 04:11 PM.

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    Woodchips,

    That is an interesting surgery/procedure you had. I had a grade 4/5 and had open ACJ reconstruction surgery with graft. My surgeon told me my ligaments were too shredded to do much with but was able to bring some together. His clinic does do PRP but he never mentioned this as an option.

    At 6 weeks and out of the sling I have developed frozen shoulder which is delaying my recovery.

    Hope to hear more about how you are doing down the road and have a speedy recovery!

  74. #1074
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    Quote Originally Posted by savoi View Post
    Woodchips,

    That is an interesting surgery/procedure you had. I had a grade 4/5 and had open ACJ reconstruction surgery with graft. My surgeon told me my ligaments were too shredded to do much with but was able to bring some together. His clinic does do PRP but he never mentioned this as an option.

    At 6 weeks and out of the sling I have developed frozen shoulder which is delaying my recovery.

    Hope to hear more about how you are doing down the road and have a speedy recovery!
    I hear that. I've had full and about half frozen shoulders on both sides at different times. What started getting them moving for me was laying down on the bed, hold a broom stick with both hands and start lifting up. Your good arm will help your bad shoulder move. A little at a time and it will progress.

  75. #1075
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    Good to hear Chicane - I am doing that kind of work with a broom stick as you suggested and it seems to be helping. Externally rotating the arm while at my side is almost nil.

    I guess it's jut a little bump in the road compared to what I've been through the last 8 weeks.

    Thanks for responding!

  76. #1076
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    Quote Originally Posted by Chicane32 View Post
    ^^^ Just curious how a grade 2-3 gets worse, by moving it? My grade 3 was immobilized in a retaining sling for 8 weeks and I was told no surgery was needed. After 8 weeks I had no muscle left and had to do extensive rehab and weights to build the muscle back up. Other then the clavicle being lifted up, I've never had an issue and have always had 100% motion. Yes the constant pain while wearing the sling was not fun. Heel quick!
    My grade 3 I was back at work in under a month as a auto tech. The day I went in the ER I asked what I could start doing right away. ROM stretches and working my hand/forearm to keep things moving. Went back 2 week later and was told more things I could do. I never stopped using it just used my sling to hold it from sagging down.

    2 days after I went back to work I went to rehab. At this point I was doing everything I did before just felt a bit loose. 6 weeks later with rehab once a week I was released stronger than I was before. I hardly even notice my right shoulder is separated besides for the lump which has gotten smaller.

    Currently dealing with my left shoulder have a grade 1 again. Clipped a tree pretty fast, thank god it was just a clip. Effing grade 1 hurts worst than tearing the damned thing off but I'm haven't given it any down time just not riding for a bit. Still working though!
    I like to fart when I'm in front of you on a climb

  77. #1077
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    Quote Originally Posted by savoi View Post
    Woodchips,

    That is an interesting surgery/procedure you had. I had a grade 4/5 and had open ACJ reconstruction surgery with graft. My surgeon told me my ligaments were too shredded to do much with but was able to bring some together. His clinic does do PRP but he never mentioned this as an option.

    At 6 weeks and out of the sling I have developed frozen shoulder which is delaying my recovery.

    Hope to hear more about how you are doing down the road and have a speedy recovery!
    Thanks! I'll update as the healing progresses.

    I'm sorry to hear about your frozen shoulder. I was in the sling for 4wks and I was thankful to get out of it when I did because I could tell my body wanted out of it.

    Take care!
    Trek Stache 5
    Santa Cruz TB3c S

  78. #1078
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    Grade 4 surgery or not?

    Ac Separation (shoulder Separation)-img_4860.jpgI fell on my right shoulder 10 days ago. Went to ER, was x rayed. Been back to hospital today to be told it is a grade 4 separation. I've had it taped by my wife, who is a physio. I have a decent amount of movement, next to no pain. I've only taken 2 paracetamol today about 12 hours ago. I'm still undecided on whether to go under the knife?? Do I try and go down the physio route?? Or under the knife??

  79. #1079
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    Quote Originally Posted by Steveboxy View Post
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ID:	1158672I fell on my right shoulder 10 days ago. Went to ER, was x rayed. Been back to hospital today to be told it is a grade 4 separation. I've had it taped by my wife, who is a physio. I have a decent amount of movement, next to no pain. I've only taken 2 paracetamol today about 12 hours ago. I'm still undecided on whether to go under the knife?? Do I try and go down the physio route?? Or under the knife??
    A Grade 4 injury is a severe or significant displacement of the clavicle in the posterior direction - and is most often treated surgically.

    Did the doctor actually indicate that the clavicle was significantly displaced in the posterior direction? With a standard xray, it can sometimes be indistinguishable from a Grade 3 until 3D imagery is looked at.

    In any case, just by looking at your xray, I would, personally, get it surgically treated.

    You indicate a decent amount of movement and next to no pain. I was in the same boat but I didn't like how clunky my shoulder girdle felt. Sometimes there was rubbing and clicking, and I didn't like being asymmetrical, and the thought of the kinetic chain impact an injury, such as this, can have on other parts of the body, if left untreated surgically. Also, a big clavicle bump was not helping matters.

    I got a 2nd opinion and was told a severe Grade 3 or low Grade 5. In any case, he agreed with me to get it surgically treated due to how active my lifestyle is. He basically said I wouldn't be happy otherwise (if left untreated surgically). I'm currently a little over 7wks out from my surgery, and I feel much better than I did prior to surgery. Also, my shoulder contour (and symmetry) has been reestablished.

    So, maybe first talked to your ortho and get some more details regarding your injury, and if you feel at all that you should get a 2nd opinion, do it, and do it relatively soon. Search for a doctor that specializes in shoulders and does kickass work.

    If you decide you want surgery, it's usually best to have it sooner than later. Best results are usually had inside the 6-7wk window from date of injury.

    If you do decide to wait things out (16wks +) to see how you feel, you could always have the surgery then if you're not happy with it. PT is a must either way. Fyi, I waited... until 7wks, and then decided to have the surgery. There was a possibility it might feel better (without surgery) but I didn't want to wait 16wks, and then decide I wanted surgery to then go through many more weeks of rehab.

    I hope there's some info here that helps.

    Take care!
    Trek Stache 5
    Santa Cruz TB3c S

  80. #1080
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    Hi Woodchips,

    Thank you for your reply. Being in the UK, picking a choosing surgeons is not always a viable option. I will look at a second opinion, unfortunately the Otho and Dr left the ball in my park as to whether I should go down the surgery route. I am not getting the clicking/ rubbing feeling. I may give it a week to see where I'm at.

  81. #1081
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    Quote Originally Posted by Steveboxy View Post
    Hi Woodchips,

    Thank you for your reply. Being in the UK, picking a choosing surgeons is not always a viable option. I will look at a second opinion, unfortunately the Otho and Dr left the ball in my park as to whether I should go down the surgery route. I am not getting the clicking/ rubbing feeling. I may give it a week to see where I'm at.
    You're welcome ...

    I have my suspicion about this being a Grade 4. Typically, these are surgically repaired but your doctors are not pushing for surgery - which is interesting. Also, you seem to be feeling fairly good while I imagine a Grade 4 would feel pretty crappy, right?!

    As you are feeling good, maybe ride it out for another few weeks - time is on your side for now. Keep having your wife tape your clavicle down in hopes the scar tissue will eventually hold it down without the tape. I've seen a few cases where results have been good, and this has been with Grade 3's. It usually takes weeks of religious taping but it can work.
    Trek Stache 5
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  82. #1082
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    Quote Originally Posted by Steveboxy View Post
    Click image for larger version. 

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ID:	1158672I fell on my right shoulder 10 days ago. Went to ER, was x rayed. Been back to hospital today to be told it is a grade 4 separation. I've had it taped by my wife, who is a physio. I have a decent amount of movement, next to no pain. I've only taken 2 paracetamol today about 12 hours ago. I'm still undecided on whether to go under the knife?? Do I try and go down the physio route?? Or under the knife??
    I had a Grade 4/5 separation with clavicle posteriorly and superiorly more than 200% of its diameter.

    I was doing well in PT and ahead of schedule. The surgeon left it up to me whether I wanted to have surgery which I didn't understand exactly because from what I read - it is recommended to have it done with grades 4,5 and 6. There are however people who have sustained a grade 4 or 5 and opted out of surgery.

    Looking back I can see why it was left up to me, but would have liked to have more guidance in making the decision. Any surgery comes with it's risk and recovery time and if you choose to have it - it's set up so you can really only blame 'you' in most cases.

    In the end I chose surgery because I'm 65 and didn't want to run the risk of needing to have the surgery later on when I was much older. I am also very active and wanted my shoulder to function right and look normal as well.

    It is not an easy surgery and recovery as I also have the additional feature of a frozen shoulder after 6 weeks in the sling 24/7.

    Make sure you find a good sports ortho who specializes in shoulder surgery.

    Good luck with your decision!

  83. #1083
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    I'm not a doctor, but I play one on mtbr forums...

    In general, regarding Grade 3's, I don't think surgeons push to operate because results are basically a coin-toss.

    In other words, surgical treatment results are about the same as non-surgical treatment results. Why push for surgery when the outcome will more or less be the same as a non-surgical result.

    I believe better surgical results increase when you're referring to doctors who specialize in shoulders, and moreso, specifically, in AC separations.

    Typically, Grades 4-6 are operated on because patients are in some discomfort or pain, and/or do not have a good prognosis treating the injury non-surgically.

    Now, while it's atypical not to operate on Grades 4-6, I can understand doctors not pushing for surgery if the patient seems to be doing well, and the prognosis seems good.

    Having surgery is risky stuff. If it can be avoided, it should be.

    Also, recovery sucks (i.e., painful) - with this open operation, I left the operating room with a fanny pack of morphine attached that supplied a catheter drip on the nerve that supplied shoulder pain to the brain (for 3-days). On top of this I also was taking 10mg of Oxy every 3-4hrs. After initial recovery, then I was faced with all muscle content in my arm, shoulder and left chest and back reduced to nothing from being in a sling for 4wks. Now, almost 8wks from surgery, I'm working on ROM. This, at times, can be excruciatingly painful because all your muscles are gone.

    I still have a long way to go... but you get the idea...

    Nonetheless, in my case, from day one since the injury occurred, in thinking about whether or not to have surgery, I kept asking myself, "are you happy with how you feel?", "do you think treating this injury non-surgically will result in a better outcome than a surgical treatment?" and if leaning towards surgery, "can you find someone skilled and experienced enough to your satisfaction to operate on you?".

    When I determined I was leaning to towards surgical treatment, I researched doctors nationally. I was prepared to go across country if need be, but, fortunately, I was satisfied in choosing a doctor locally. Note - my doctor, who specializes in shoulders, and runs the Shoulder Center through Duke Hospital, has had 100% success in 10yrs of performing the procedure he did on me.

    Thus far, I am happy with my decision ... and in the end this is what it is all about, right?!

    Fyi, I'm 50, and was active as hell on wheels before the crash.
    Trek Stache 5
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  84. #1084
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    Quote Originally Posted by woodchips View Post
    I'm not a doctor, but I play one on mtbr forums...

    I believe better surgical results increase when you're referring to doctors who specialize in shoulders, and moreso, specifically, in AC separations.
    Woodchips,

    I wish I could have read your post before I had surgery! I found a knee and shoulder specialist, but maybe I should have looked deeper. Although the surgery seems to have turned out well up to this point the injury and having to have surgery really bothers me.

    I have great concern about the procedure failing and this has got me fairly depressed, even though the surgeon feels quite confident about the work he did. The mind is strange, at least my mind is.

    I went in to the procedure thinking my ligaments would be repaired (which they were the best he could do but they were really shredded), i.e. sewn back together arthroscopically and found out the day of the surgery with this grade of dislocation it could not be done. It was a simple yet disturbing miscommunication which I take responsibility for.

    I knew to look for a specialist and found a well recognized shoulder and knee specialist, but did not think of looking for one who specifically specializes in AC Joint repair and reconstruction. Even now when I search they don't seem to be jumping off the computer screen.

    I had a AC reconstruction with graft and FiberWire was used as well for clavicle reduction.

    Now it's just doing the rehab and doing the best I can.

  85. #1085
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    Quote Originally Posted by savoi View Post
    Woodchips,

    I wish I could have read your post before I had surgery! I found a knee and shoulder specialist, but maybe I should have looked deeper. Although the surgery seems to have turned out well up to this point the injury and having to have surgery really bothers me.

    I have great concern about the procedure failing and this has got me fairly depressed, even though the surgeon feels quite confident about the work he did. The mind is strange, at least my mind is.

    I went in to the procedure thinking my ligaments would be repaired (which they were the best he could do but they were really shredded), i.e. sewn back together arthroscopically and found out the day of the surgery with this grade of dislocation it could not be done. It was a simple yet disturbing miscommunication which I take responsibility for.

    I knew to look for a specialist and found a well recognized shoulder and knee specialist, but did not think of looking for one who specifically specializes in AC Joint repair and reconstruction. Even now when I search they don't seem to be jumping off the computer screen.

    I had a AC reconstruction with graft and FiberWire was used as well for clavicle reduction.

    Now it's just doing the rehab and doing the best I can.
    The mind is very powerful, and I know it's difficult, but try not to focus on the past. Think positively moving forward.

    You said that the surgery has gone well up to this point, and that the surgeon feels confident in the work he did - take stock in this. Frozen shoulders happen, it's not necessarily an indicator of "bad work" or that the prognosis going forward is not good. It's just another obstacle, at this point, that you need to work through.

    Stay strong!

    Btw, if I hadn't found my local doctor, another doctor I would have consulted with is Peter Millett MD | Shoulder Specialist, Knee, Elbow & Sports Medicine).
    Trek Stache 5
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  86. #1086
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    Quote Originally Posted by woodchips View Post

    Frozen shoulders happen, it's not necessarily an indicator of "bad work" or that the prognosis going forward is not good. It's just another obstacle, at this point, that you need to work through.

    Stay strong!

    [/URL]).
    Thanks for the encouragement Woodchips - I know you're right...and didn't mean to imply the frozen shoulder was any fault of the surgeons in any way.

  87. #1087
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    Quote Originally Posted by savoi View Post
    Thanks for the encouragement Woodchips - I know you're right...and didn't mean to imply the frozen shoulder was any fault of the surgeons in any way.
    You're most welcome, savoi!
    Trek Stache 5
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    Quick update

    So, it's 3 weeks since my accident. I am off daily painkillers, one every now and then. I've got 90% movement in my arm. I rode my bike for the first time today, did some local easy off road trails. Felt a bit stiff at first then I relaxed, all was good. Started on the weights tonight. Laying on my back doing an imaginary clock. Hurts between 3 and 6.

    I'm glad I didn't have surgery as I'm making good progress.

  89. #1089
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    3 years from my grade 3/4 separation. No surgery. I have 100% strength and ROM. Most important thing to do immediately is tape the bone down so scar tissue forms and bone stays down as low as possible.And I have the best shoulder brace to wear for first 3 weeks!

    This forum helped me a lot back then

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    I crashed Sunday and suffered AC separation on a back country ride. Rode/walked out 6 miles or so. Visited the ortho Monday morning, he x-rayed the shoulder and diagnosed me with grade 4 separation. He wanted to go ahead and schedule surgery with the plate and hook and use a ligament from my leg for reconstruction. I told him I needed time to digest it, study it and talk to my wife. He prescribed no pain medication or any means of isolating movement in the shoulder- no K-Tape or even a sling. He only scheduled for me to come back in a week to talk to him again. I have to say I was not impressed and decide on a second opinion. I will not have surgery in my local hospital if I have a choice.

    I talked to a friend who is a pro mountain biker with many sports injuries and has been living with a grade 3 AC separation for years with no problems. He suggested I get a second opinion from his regular ortho doc who is a highly rated shoulder specialist, is a mountain biker and has over 29 years of experience. I have an appointment with him next week.

    I'm not suffering from a lot of pain and have a good bit of movement and no clunkiness that I can feel. My clavicle is a little bit higher from the shoulder falling down, but not anything that bothers me aesthetically. Maybe 1/2" or so. It definitely went down since the initial injury.

    I'm guessing isolation from a sling and/or K-Tape can only be beneficial at this point, at least for my own comfort anyway. I'll keep taking 800 mg ibuprofren for the next few days at least and wait it out till the 2nd opinion.

  91. #1091
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    My grade 3 was a bit over a year ago, no real issues now besides for the lump. I did not have surgery. Keeping up on your fitness helps them as the muscles locate it now without the AC. Good call on the 2nd opinion, something seems off there. Wouldn't be a bad idea to sling it till then if its not usable. The first week mine was mostly useless but got better fast.
    I like to fart when I'm in front of you on a climb

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