Page 11 of 21 FirstFirst ... 789101112131415 ... LastLast
Results 501 to 550 of 1027
  1. #501
    mtbr member
    Reputation:
    Join Date
    Dec 2011
    Posts
    75
    Quote Originally Posted by giantfox View Post
    i have developed a major bump on my belly over the last 11 weeks.

    i think it might be connected
    Ha ha!

  2. #502
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    I have joined this club too.. With a level 3 separation I am going to go for the sugery too. I have not found a good reason not to have this fixed from the start. Yes I know the rehab is longer but the outcome is better I hope. Does anyone have good advice.

    Andy

  3. #503
    mtbr member
    Reputation:
    Join Date
    Dec 2011
    Posts
    75
    Quote Originally Posted by Andy17 View Post
    I have joined this club too.. With a level 3 separation I am going to go for the sugery too. I have not found a good reason not to have this fixed from the start. Yes I know the rehab is longer but the outcome is better I hope. Does anyone have good advice.

    Andy
    Other than the bump I'm not sure the outcome is much different. Good luck with the surgery and be sure to do the PT as required! 6 months out and I surfed hurricane Sandy last week and have been mountain biking a lot....getting stronger all the time!

  4. #504
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    13 and 1/2 weeks since the fall.

    It still feels wierd but I can do everything I want so far, but it hasn't really been tested.
    For instance I have not hung my full weight on the arm and tried to pull up (yet)

    Cycling isn't an issue, have rode some bumps but no real test. Golf was terrible.
    Can SUP without too much drama, but is mildly painful swapping the paddle from one side to the other.
    last week had to put the winter tyres on which was a different test - carrying 8 wheels up and down to the basement and swapping them over. No real issues at the time but it ached that evening and I could feel it for a few days.
    It feels to me like evereytime you do something strenuous, the end of the bone is rubbing against all that soft tissue and must be damaging it slightly - then it takes a few days to heal.

    If you take some time to read the posts and do some research you won't find anything conclusive that leads towards surgery or no surgery. Which is quite frustrating.

  5. #505
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    I have some friends with AC separation that wasnt repaired and ALL 3 of them said to have it repaired period. They have been living with it for as many as 20 years and have limits to what they can do and pain that comes and goes with heavy use or over head use. All three of them have clicking which is painful at times. I would bet guys with surgery have some issues too but really havent heard them.
    My doc says the shoulder will be 100% and I can go back to anything I want to after a 6-9 month rehab.
    It's been a week after the crash and the shoulder is much better as far as pain but I am really amazed at how much closer my arm is to my body. The shoulder has rotated down so far there is a very noticeable difference. The top of the collar bone is still very tender where the bone fragments were torn from.
    Other than the rehab taking much longer I think the rebuilt shoulder will be better and trouble long term should be better. I have read most of this thread and haven't seen too many long term results. The one I have seen was only about a year out. Your right just not much conclusive results or posts. Like one guy said each person is different and so is the injury, level of rehab, actitivity level and results linked to them. This makes conclusive leads difficult. It would be nice to hear from both sides 2-10 years out but I dought we will.

  6. #506
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    an interesting tale.

    went sailing today and there was a guy with a bumpy shoulder same as mine....(but younger)

    he did it 3 years ago, no surgery and is doing all sports normally including MTB and wake boarding.

    No issues whatsoever...according to him

  7. #507
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    How bad was his separation? Glad you enjoyed it, not the story I wanted to be telling for sure.
    Just looking for info from non and cut guys. Thank you for yours.

  8. #508
    mtbr member
    Reputation:
    Join Date
    Dec 2011
    Posts
    75
    Quote Originally Posted by Andy17 View Post
    It would be nice to hear from both sides 2-10 years out but I dought we will.
    I promise to post up 3 years out on this! I'm only 6 months now. I went on a 9 mile easy mountain bike ride this morning and SUP'd in the ocean for an hour this afternoon. No pain...but it is a little tender. I know it is there. Here is where I'm currently weak.....prone paddling on a surfboard. I can surf but when it is overhead and offshore I had trouble getting my 5'6" fish into the waves (duh, wrong board choice). Nonetheless, I'm positive with some strength exercises I'll be pulling that off next hurricane season.

    I'll have to admit I may be different than others.....I'm 52 and not getting any younger but my mind keeps telling me to push and learn new things on my bike and on my boards. I have an office job and feel unsatisfied if I don't get a good workout at least on the weekends.

    What I don't know is if I would be better off 2 or 3 years out with the surgery than without.....

    Stay tuned.

  9. #509
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    I will do the same here with surgery. I don't have a date yet but expect it will be before the end of the month. All 3 of my buddies do most anything they want just maybe not as well or long. 2 of them bike with no problem.

  10. #510
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    Quote Originally Posted by Andy17 View Post
    How bad was his separation? Glad you enjoyed it, not the story I wanted to be telling for sure.
    Just looking for info from non and cut guys. Thank you for yours.
    separation was identical to mine except mine is left (non-dominant) and his right.

    Thing that impressed me was wakeboarding, which is about as full-on use of the shoulder as you can get.

    Mind you, maybe it is the less strenuous but more difficult movements that cause problems eg- overarm paddling motion.

    My bone aches this morning and I wasn't doing anything particularly sporty yesterday, just pulling on a few ropes and getting in and out of the boat.

  11. #511
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    Quote Originally Posted by TranceX View Post

    What I don't know is if I would be better off 2 or 3 years out with the surgery than without.....

    Stay tuned.
    this is the great question.....no way of knowing

  12. #512
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Quote Originally Posted by TahoeBC View Post
    I'm a year out from my grade 3 separation. Doc told me I'd be trading a lump on my shoulder for a scar with the same end results, so I went the no surgery route. Although my nude modeling days are over I have not regretted not going under the knife. Besides a lump it causes me no issues what so ever.
    My doc said the opposite, surgery will move shoulder back into normal position and you will be 100%. As strong as before, corrects posture and no bone interference (clicking or bone on bone issues). But will have scar and longer harder recovery time. I asked if it would be as durable as natural shoulder and he said as durable as before after the long rehab. He did give the option of no surgery and said a lot of guys do just fine without surgery.
    I'm only a week into this and don't want to have 2 recoveries. Most pain is gone but I a have no strength. The shoulder feels very unstable and much closer to the rib cage! I was thinking of long term shoulder issues including as one guy here had talked about frozen shoulder, limited mobility, posture issues and back problems as it would not be as balanced.

  13. #513
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    Quote Originally Posted by Andy17 View Post
    My doc said the opposite, surgery will move shoulder back into normal position and you will be 100%. .
    this is the great dilema.

    the medical fraternity is still not decided and it very much depends on which doctor you ask.

    like my surgeon, who would have been quite happy to take the money but recommended against the surgery

  14. #514
    mtbr member
    Reputation:
    Join Date
    Sep 2012
    Posts
    4
    Quote Originally Posted by Andy17 View Post
    I will do the same here with surgery. I don't have a date yet but expect it will be before the end of the month. All 3 of my buddies do most anything they want just maybe not as well or long. 2 of them bike with no problem.
    Hi Andy,

    Can your doc not do the tightrope procedure? It can be done with key hole surgery and you are left with 4 tiny scars if you can call them that. It must be done asap though after the injury. I dont think i would be waiting till the end of the month if i was you.(2 -3 weeks is optimal apparantley.)

    I am 6 weeks out from my tightrope op and i am so pleased i went this route. Every week my shoulder is improving and i think i would go as far as to say the last few days feels like its back to normal. It isnt of course as ive yet to stress it, i go back for a checkup this week where i can then start overhead stuff with my arm, but im hoping this will go smoothly so i can then concentrate on range of movement.

    Good luck with your injury

  15. #515
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Yes he is doing the tightrope. That sounds great!! I am glad to hear your doing so good so quick. My doc says since my ligaments are completly torn really doesn't matter when the sugery is done.
    I had read here people saying the sugery had to be done very quick but he said didn't matter the ligaments (AC and CC) are not reused. He is going in with a 2-3 inch cut to take end of bone off and bone frags too. I would rather had key hole but he didn't say and I didn't ask why cut really. I am hoping end of this week or at least before thanksgiving.
    How soon did they get you moving the arm? Can you feel the button or screw? Did the surgery put you down for a while? Could you sleep in a bed or chair? sorry for the questions

  16. #516
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Quote Originally Posted by giantfox View Post
    this is the great dilema.

    the medical fraternity is still not decided and it very much depends on which doctor you ask.

    like my surgeon, who would have been quite happy to take the money but recommended against the surgery
    Excatlly what doc said and he did recommend trying with out surgery. But also said the surgery would put shoulder back in normal position and be "100%" . I have (for now) good insurance this year and the cost is very minimal, around $500. for everything. Next year cost goes up to $5500. Thanks Obama care.
    That is why I am not waiting along with having to recover two times. If it had happend two months later I would have had to go no surgery route also....

  17. #517
    mtbr member
    Reputation:
    Join Date
    Sep 2012
    Posts
    4
    Im guessing your injury maybe slightly different to mine then as i had nothing taken off of the end of my collarbone. I had a grade 3 too so my ligaments were totally torn but from my understanding if the collar bone is put in place before 4 weeks have passed the ligaments will heal together. Although i think its more scar tissue and not a true ligament as it once was.

    I could take my arm out of the sling to wash but that was it for the 1st 2 weeks, i was sleeping on my back only at this time.

    After 2 weeks the doc advised taking my arm out of the sling when at home but on no account lift my arm above my shoulder.

    At four weeks i did not use the sling at all but my shoulder felt very odd and weak.

    Now at 6 weeks it feels normal to use with with light duties

    I cannot feel the button at all which is a relief.

  18. #518
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    He said taking off the end of the bone would stop interference or bone to bone contact. Yes he said the scar tissue that would form at the old ligaments would not hold and possibility of isssues with the scar tissue over time.
    Great information thank you! Sounds like yours is going great, I wish you the best also!

  19. #519
    mtbr member
    Reputation:
    Join Date
    Jun 2011
    Posts
    3

    No PT?

    I'm 47. Went OTB 9 days ago and received a level 3. Ortho Doc recommended non-surgery, but when I asked him about PT, he said not to worry about it, just let it heal naturally.

    My question: How many of you were given similar advice regarding PT? Did you follow that advice, and did you heal up just fine?

  20. #520
    mtbr member
    Reputation:
    Join Date
    Mar 2012
    Posts
    3
    Quote Originally Posted by Teh Smith View Post
    I'm 47. Went OTB 9 days ago and received a level 3. Ortho Doc recommended non-surgery, but when I asked him about PT, he said not to worry about it, just let it heal naturally.

    My question: How many of you were given similar advice regarding PT? Did you follow that advice, and did you heal up just fine?
    I had a grade 2 separation at the beginning of March. The first doc I saw just referred me elsewhere. The sports medicine guy I saw gave me a little pamphlet of stretches and exercises to do. If I'm honest, I didn't really do most of the stuff in the pamphlet. I'm all healed up now but it did take a few months before I stopped feeling twinges of pain while doing simple stuff.

    The biggest thing I can recommend is don't try to go too fast with recovery. After about three months, I was feeling 'good' and tried to do some light pressing movements in the gym and practically re-injured the shoulder. Now, 8 months later, I'm back to full strength and bench pressing heavy. With that said, I do still feel some slight discomfort in the shoulder when pressing heavy but I'm fine while riding.

    At 9 days out, you may want to start some small movements. Raise your arm up to the side, in front, try to cross it over your chest, etc. The crossing over the chest part was the most painful for me. Maybe do some arm circles. I didn't really follow any certain PT program. I just tried to move it around as much as I could without causing too much pain. A bit of pain with any movement will be normal for a few weeks/months.

    Sorry about your injury. Take it easy so you can get back out there.

  21. #521
    mtbr member
    Reputation: wreckingrob's Avatar
    Join Date
    Aug 2007
    Posts
    63
    Quote Originally Posted by Teh Smith View Post
    I'm 47. Went OTB 9 days ago and received a level 3. Ortho Doc recommended non-surgery, but when I asked him about PT, he said not to worry about it, just let it heal naturally.

    My question: How many of you were given similar advice regarding PT? Did you follow that advice, and did you heal up just fine?
    4 weeks ago I separated my shoulder, and yesterday I completed SWANK 65 in the Pisgah of NC. The shoulder was a total non-issue. I can't quite get over big log overs like I used to, but suspect that'll be over in a couple weeks.

    I didn't do any PT. I just rode. After two weeks I started doing those shoulder muscle exercises with the bungie cords, and 3 started shoulder presses and shruggs. Active recovery works.
    If your not wreckin', your not ridin'.

  22. #522
    I'd rather be riding!
    Reputation: kmacon's Avatar
    Join Date
    Nov 2006
    Posts
    253
    I shrugged off PT at first after my grade III and kept having dull pain that just kept getting worse to the point that I was totally obsessed with it. Went back to the orthopedic surgeon thinking I was going to have to go through surgery to stop the pain. He suggested first to do a round of PT and talk about surgery afterward. The result was after one and I mean only one visit to PT my constant pain went away. I did PT for like six weeks and it was the best treatment I could ask for without the surgery. Probably should do more on my own but well, after 4 years who has the time or desire.

  23. #523
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    Quote Originally Posted by Teh Smith View Post
    I'm 47. Went OTB 9 days ago and received a level 3. Ortho Doc recommended non-surgery, but when I asked him about PT, he said not to worry about it, just let it heal naturally.

    My question: How many of you were given similar advice regarding PT? Did you follow that advice, and did you heal up just fine?
    Interesting flurry of posts which illustrates the vast differences of medical opinion and patients' own experience.

    I am now 15.5 weeks since I did mine. Can SUP as strong as before, push ups, riding bike no problem (not yet MTB as I'm currently in the flatlands), however turning the steering wheel is painful and changing the car tyres was painful and left me with pain for a few days (minor)

    I'm going back to see my surgeon (who advised against surgery) on Monday as a follow up to see what he has to say.

    I'm wondering if I have some bone fragments attached to the loose ends of the ligaments that irritate the soft tissue when I move in a certain direction (arm out elbow down).

    Although people have done some fairly major exercise (and riding) within a few weeks, in my case this was not possible. Everytime I pushed it I was rewarded with a few days of pain, which receded and it has take 3 months to be able to get to where I am now. However, keep it moving from as early as possible so it doesn't stiffen up. I could touch my hands behind my back across opposite shoulders (don't know what the correct name for that stretch is) after 12 days - in fact first time I tried it.
    Above all my advice would be to stay positive and do what you can do. you will probably be surprised. Also, it is worth taking a few hours to read this thread, because everything you can think of has been posted at one time or another.
    Last edited by giantfox; 11-13-2012 at 09:04 PM.

  24. #524
    mtbr member
    Reputation:
    Join Date
    Jul 2009
    Posts
    2
    Hi All,

    First time post here but I owed it to this forum (and especially this thread) to contribute. I did a type 3 on May 30th of this year. I'm 46 and have crashed my bike many times in my lifetime but never like this. I saw a Ortho the next day and decided to have surgery. My Ortho is also an avid cyclist and had the same injury. He initially decided against surgery but changed his mind after six months and had the surgery. After 2 or 3 days had passed my pain level subsided considerably and I was having second thoughts. My research began in earnest. I learned that my pain was gone because all of my connective tissue was gone as well. There was nothing left to hurt any more aside from general soreness from the impact. After reading this thread and many other opinions, I decided to persevere. I had surgery on June 4th. I'm not gonna lie. Surgery and the rehab was a *****. The worst part was getting the sling off even though it was what I looked forward to the most. After 3 months, it starts getting steadily better though. I am now over five months and I feel so normal. I am still healing but at this point I really believe I made the right decision. Biking is a non issue. Strength and flexibility are about 95% and I am sure that 100% is right around the corner. Hope this helps. Good luck to all.

  25. #525
    mtbr member
    Reputation:
    Join Date
    Aug 2006
    Posts
    482

    The Weakest Link!

    After a lifetime of adventure and the consequences of that, I have learned this.
    When you push your body to the limit, the weakest link will let go first.
    The shoulder has 17 muscles and tendons crossing the joint.
    If any one othe them is weak or injued, it will be the first to go.
    For those that have been able to avoid the most painful movements,
    you can hide from them forever! LOL

    I agree w/rest and ice first. After that, you can't avoid the weak/damaged
    muscles that will get tested when you least expect it!

    I'm back to doing my circuit training, less overhear presses.
    If it hurts to do something, there is probably a reason.
    You can't protect your injury 24/7.

    JMHO

    R

  26. #526
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    hi guys. this could be a very long post but i will try to keep it short.

    16 weeks today since went OTB and over the drop...... started having flashbacks but that is another story...

    i have been following a conservative approach (no surgery) as advised by 3 different doctors/surgeons.

    went back to see my surgeon 2 days ago. I lost confidence in him... won't bore you with the details.

    Had a thorough going over and the conclusion was that I have a full range of movement and good power transfer, but I have lost some strength due to under use (because I neglected the physio and was doing my own thing)

    Just back from the physio with a whole set of very specific exercises to get going with.

    Still have the pain at the end of the bone feeling and the surgeon asked me if i can live with it.... I said yes.

    So for the moment I'm sticking without the surgery and working on my muscles

  27. #527
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Had surgery yesterday. Not too bad yet good drugs help. Dr said everything went good.

  28. #528
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    more physio

  29. #529
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    It's been about a week since surgery and I'm off all pain meds and have no pain. First 3-4 days were the worst not much pain but the drugs suck. I can't believe people want to take that stuff. Going to the doctor tomorrow the get stiches out and find out when I can start PT. As far as the shoulder goes it feels like it is hanging normal again but it's hard to tell with the sling. It's swollen but bump isn't noticeable. I just hope it heals up good and strong and I can get back to riding soon.
    Last edited by Andy17; 12-01-2012 at 07:51 AM.

  30. #530
    mtbr member
    Reputation: dwnhlldav's Avatar
    Join Date
    Feb 2006
    Posts
    1,027
    Quote Originally Posted by TranceX View Post
    For those of you considering surgery for a Grade 3 separation for cosmetic reasons here's what it looks like without the surgery.

    Here I am less than an hour after the "incident".



    This is 6 and a half months later. Notice the difference? Not much.



    Cracks me up when friends come up and say, "hey it's looking better!" I'm like "really? You do realize that's the end of my collar bone sticking up there right? It doesn't get better....lol."
    Not everyone looks like that with a grade 3. When I was just standing with my shoulders in a neutral position my clavicle sat in it's natural position and swimming kept my shoulders strong enough to support the weight of my arm. I had very little deformity or difference in height between my shoulders.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  31. #531
    mtbr member
    Reputation: dwnhlldav's Avatar
    Join Date
    Feb 2006
    Posts
    1,027
    I posted awhile back in this thread, but I can't remember what I said and I don't feel like looking through 22 pages to find out.

    So, here's my short back story. I did a grade 3 separation of my left shoulder 5 years ago, September of 2007. I ended up not having surgery and did pretty well. In 2010 I went to an orthopedic surgeon who specializes in shoulders and knees of athletes. I was having some issues. He kept me from doing surgery, we made some changes to my physical therapy and resolved the issue.

    In June of this year I went down on my shoulder. It was a really minor fall. But in the weeks after I started having issues. The most bothersome was subluxation of the joint. Basically at random times, my clavicle would slip up and over my scapula and then pop back into place. If you've dislocated a joint, you know it's not comfortable. This was happening 2-3 times a day. There was no clear pattern so I couldn't just stop doing the movement that caused. it. It was most problematic when it would happen while riding. I'd lose all the strength in my arm and almost crashed a couple times because of it.

    I went back to my surgeon, who by now knows me really well, he took care of a bone spur and torn ligament in my ankle in 20120. Also, in addition to being his patient, I take care of his bikes. After an extensive assessment he determined that I tore much of the muscle fascia in my stabilizing muscles. My surgeon suggested surgery.

    I've been researching AC reconstruction since my original injury. 5 years ago the prevailing thought was that those who under went surgery and those who used only physical therapy would end up at about the same level after a year. In the last couple years there have been some subsequent studies looking at long term results. New data suggests that even if you opt for the conservative route after a grade 3 separation, you will eventually end up going under the knife because you will develop arthritis in the joint much more quickly then those with an intact joint. This, combined with my now grade 5 separation made the decision to have surgery easy.

    So, I went under the knife just over 5 weeks ago. I was released from my immobilizer sling on Wednesday and started therapy on Thursday. Right now it's just stretching to restore range of motion lost from being immobilized for 5 weeks. I'm still in a decent amount of pain. Still popping percocet two or three nights a week. I'm limited to no lifting over 5 pounds for another 5 weeks, but I can already tell that all the popping and clicking is gone. Each day I feel much better. I'm optimistic that I'll be better off than prior to surgery. I think that having attempted the conservative approach with good results until I made things worse by crashing again puts me in a unique position to be able to assess the outcome of the surgical route vs physical therapy. I'll let you all know how things progress.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  32. #532
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    that is an interesting post.

    in my last update following the 3 month visit to the surgeon, I said that I had lost confidence..

    following his insistence that conservative approach is right for me, and it seems to be going well, he rounded it off by saying that I "shouldn't have any trouble at all" doing my job (I more or less work from a desk)

    Right from the beginning I told him that what was important to me was to be able to do the active things that I like doing....

    Due to a change in job i am also changing health insurance cover next friday. The new cover is supposed to cover existing conditions, but I will be moving country which means a new doctor.

    I'm tempted to find the best doctor I can in the new town and get a completely fresh opinion.

  33. #533
    mtbr member
    Reputation: dwnhlldav's Avatar
    Join Date
    Feb 2006
    Posts
    1,027
    I did just fine without surgery for 5 years and would have gone many more had I not made things works.

    Really, my only limitations were holding a heavy weight in my arm for a sustained time. I'm not a lifter, but I could lift anything I wanted to, I just couldn't hold things for an extended time (think, carry a kid around a store).

    I could swim (I had a mental lapse a few years ago and got into triathlon). I actually think swimming was very good for strengthening the stabilizer muscles. But, I had to limit how much I swam or my shoulder would get irritated. I found that I had to keep it below 6000 yards a week and was better closer to 4000 yards a week.

    Riding was fine.

    I didn't do any paddle sports post separation, but I imagine I'd have had the same limitations as swimming.

    That being said, after reading the more recent studies, it seems that if you are an active person with a grade 3 separation, you will eventually end up having surgery even if not doing it initially. You might not get reconstruction but you will have to deal with arthritis in the joint. I'll try and find a link to the studies.

    Look for a a surgeon who specializes in athletes. My surgeon specializes in the shoulders of athletes. He also knows that being able to ride, ski and play with my kids are much higher up my list of priorities than work. I couldn't have found a more qualified doctor.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  34. #534
    mtbr member
    Reputation:
    Join Date
    Jul 2010
    Posts
    5

    One Year Later, I'm 95%

    Those of you that just had it - there is hope! It's not over! Mine turned out pretty good.

    I posted on here a year ago - Grade 3 right shoulder after hitting a jump wrong at Whistler. Bruised or sprained the left too (apparently while I was doing a rag doll unconscious down the road). Broke a rib, finger, etc.

    I'm 39. Didn't get surgery. So glad I didn't. I was back on the bike in three weeks, probably six months before I felt really normal, but now I'd say I'm 95%. Like I said, I'm 39, half the joints on my body are at 95% so I figure that's pretty good!

    I can lift, ride, sleep on that side (for a few hours at least). Just got back in the thai kickboxing gym a month ago, straight right and right hook to the body are as hard as ever. Life is good.

  35. #535
    Harrumph
    Reputation: G-reg's Avatar
    Join Date
    Jan 2004
    Posts
    1,600
    Quote Originally Posted by dwnhlldav View Post

    That being said, after reading the more recent studies, it seems that if you are an active person with a grade 3 separation, you will eventually end up having surgery even if not doing it initially. You might not get reconstruction but you will have to deal with arthritis in the joint. I'll try and find a link to the studies.

    Please share the links if you find them. It sound like you are implying that a shoulder repaired via surgery will not have any arthritis problems.

    Which is 180 from my ortho's explanation of the injury. His opinion was that you'd have less arthritis problems with a AC sep that was not "repaired." If it is a problem they surgically zip off the last 1/4 of the clavicle and that's it. The joint itself is rarely repaired, the clavicle is just brought down....where it's more likely to bang into the process of your scapula where it used to be bonded.


    Interesting that the opinions on how to treat a AC tear are so polarized.
    Slowly slipping to retrogrouchyness

  36. #536
    mtbr member
    Reputation: dwnhlldav's Avatar
    Join Date
    Feb 2006
    Posts
    1,027
    Quote Originally Posted by G-reg View Post
    Please share the links if you find them. It sound like you are implying that a shoulder repaired via surgery will not have any arthritis problems.

    Which is 180 from my ortho's explanation of the injury. His opinion was that you'd have less arthritis problems with a AC sep that was not "repaired." If it is a problem they surgically zip off the last 1/4 of the clavicle and that's it. The joint itself is rarely repaired, the clavicle is just brought down....where it's more likely to bang into the process of your scapula where it used to be bonded.


    Interesting that the opinions on how to treat a AC tear are so polarized.
    I've been searching, I'll continue... The study didn't say that surgery would prevent arthritis. It said that those who did not get surgery in the beginning would develop arthritis that could/would be bad enough to require surgery in the future. It also said that those who had surgery immediately after the injury would also develop arthritis (supporting your doctors opinion). The short version of the conclusion was that surgery or not following the initial injury, people with grade 3 separations are very likely to require a surgery years down the line. Keep in mind that the study looked at the Weaver-Dunn procedure as the initial repair. The study I remember most clearly was published in the last year or two.

    As far as the difference of opinions, it seems to me that it's the difference between general orthopedic surgeons and shoulder/athletic specialists. Keep in mind, my sample size is limited and I am in no way criticizing your surgeon or putting down his abilities or knowledge.

    I've been to 3 different orthopedic surgeons for this injury. Initially I self diagnosed this injury because the ER doctor missed it. My clavicle was not displaced when my shoulders were in a neutral position so it was an easy mistake to make. Due to outside circumstances, I didn't get in to see an orthopod until 12 weeks post injury. In that time I did a lot of research. The first two doctors I went to shared your doctors opinions about this injury. They also had no idea what I was talking about when I brought up the newer procedures. The third doctor is an orthopedic surgeon who specializes in shoulders of athletes. Though he was aware of the most recent techniques, and helped develop one as a surgeon for the Navy, he kept me from doing surgery. At the time I first went to him it was a year post injury, or 4 years ago. I was back to all my normal activities. He suggested that since I wasn't having more than occasional discomfort I should continue therapy. He also said the if I did surgery then or years down the road, the surgery would be the same. So I didn't get surgery. I went back to him a couple years ago because I was having some issues. Again, we did not do surgery. I made some changes to my therapy and resolved my issue. It wasn't until I fell in June and upgraded from a grade 3 to a grade 5 separation that he thought surgery was the best route.

    Some of this you may know, but hopefully it helps others understand what's going on with this injury.

    AC joint separation involves two major ligaments. One goes out from the end of the clavicle, horizontally and attaches to the acromion. This ligament is rarely rebuilt. The second major ligament is vertically oriented and goes from the clavicle down to the coracoid process. When both of these ligaments are torn, you have a grade 3 separation. There are a couple different approaches, but from my discussions with my doctor and the studies I've read, the latest technique is to remove 1cm from the end of the clavicle, and then use a hamstring tendon to rebuilt the ligament from the clavicle to the coracoid process. The tendon can either be from a cadaver, or your own. It's the same tendon used in ACL reconstruction. This seems to be the most current technique and has produced better results that the Weaver-Dunn procedure. It's also what I had done. The method your doctor described will alleviate interference between the clavicle and acromion, but does not help to stabilize the joint and will certainly lead to arthritis down the road. The weaver-dunn is widely known and is still the defacto repair for surgeons not specializing in shoulder repair. The Weaver-Dunn was a decent fix for problematic grade 3 separations and for more severe separations, but it did not produce a joint as strong as the original and that is why it's not indicated for grade 3 separations that respond well to therapy.

    Here's an abstract to a study of the most recent technique. You have to have a subscription to see the full article. My doctor's PA printed it out for me. Clinical Outcomes of Coracoclavicular Ligament Reconstructions Using Tendon Grafts

    Studies have shown that there is little benefit in rebuilding the ligament from the clavicle to the acromion. They also show that using either a cadaver hamstring tendon or an autogenous (from you) hamstring tendon to rebuilt the Coracoclavicular Ligament resulted in a joint that was at least 95% as strong as the original joint. Sometimes stronger. Using your own tendon is less likely to have complications. Using a cadaver tendon puts you at risk for rejecting it.

    The testing is quite interesting. The way they tested these repairs was to rebuilt the joint on one side of a cadaver and then fail test both shoulders and compare the results of the rebuilt side to the uninjured other side. (I'm totally donating my body to science when I die)

    I can say that all of the clicking an popping I had prior to surgery, and for the last 5 years, is gone. I'm almost 6 weeks post surgery. My biggest issue is loss of range of motion do mostly to being in the immobilizer sling for 5 weeks. It's coming back quickly. I'll be very happy with the results if things continue to progress as that have.

    Disclaimer: I'm not a medical professional. This is a synopsis of my own personal research into AC joint reconstruction. I'd like to link all of my sources, but I replaced my computer since doing the research and lost many of the links. Should have switched to google chrome earlier...
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  37. #537
    mtbr member
    Reputation: wsmac's Avatar
    Join Date
    Sep 2010
    Posts
    542
    Quote Originally Posted by dwnhlldav View Post
    ... the latest technique is to remove 1cm from the end of the clavicle, and then use a hamstring tendon to rebuilt the ligament from the clavicle to the coracoid process. The tendon can either be from a cadaver, or your own. It's the same tendon used in ACL reconstruction....
    This is the technique I had done April 2011.
    I have fallen with my bike, as well as gone straight up over the bars, since then.
    I can say honestly that as I travel up and over, my thoughts do center around my shoulder and trying not to land on it.

    So far, I've been doing pretty good with that!

    I continue to stretch my upper body and shoulders frequently just to keep up my ROM, as well as other exercising when I make myself do it.

    I have been doing pullups for quite a while now with no issues concerning my shoulder.

    Basically, I am glad I had the surgery done (approx. 8 weeks after the injury).
    There is nothing so unusual about my shoulder that reminds me of my injury... either feeling anything different, or seeing anything different.

    I had cadaver ligament two times.
    As mentioned many pages ago here, the first time around the ligament stretched and my clavicle returned to the post-injury state.

    Two weeks later the surgeon went back in and put a new ligament in and this is the one I've been living with ever since.

    Thanks for all the up-to-date info... I enjoy reading this thread as more people add on!

  38. #538
    Harrumph
    Reputation: G-reg's Avatar
    Join Date
    Jan 2004
    Posts
    1,600
    Good info!
    Slowly slipping to retrogrouchyness

  39. #539
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    Quote Originally Posted by G-reg View Post
    Please share the links if you find them. It sound like you are implying that a shoulder repaired via surgery will not have any arthritis problems.

    Which is 180 from my ortho's explanation of the injury. His opinion was that you'd have less arthritis problems with a AC sep that was not "repaired." If it is a problem they surgically zip off the last 1/4 of the clavicle and that's it. The joint itself is rarely repaired, the clavicle is just brought down....where it's more likely to bang into the process of your scapula where it used to be bonded.


    Interesting that the opinions on how to treat a AC tear are so polarized.
    this was my surgeon's main argument against surgery.- that the risk of athritis was greater following the surgery than left alone

  40. #540
    mtbr member
    Reputation:
    Join Date
    Aug 2012
    Posts
    38
    i'm still no further forward in forming a definitive opinion..

    lifted up my son yesterday straight in fornt of me (about 30kg) That hurt a bit.

  41. #541
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    2
    I am 4 weeks out from a grade 2 AC. Day 1-3 were hell. Progress from there was fast and encouraging. I wore a sling for 3 days then ditched it. didnt take pain pills, just advil. Have been to the gym every week since week 2 at least twice. First time i was useless. Great improvement since then at about 25% of usual weight. I even did shrugs this weekend which was impossible previously.

    Just had follow up with dr. yesterday and he said gym is fine with high rep count. 25+.

    I rode at 3 weeks....gingerly with pain. Rode this weekend with almost no pain at about 80%.

    I am 37 btw.

    Good luck and speedy recovery to everybody.

  42. #542
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    2
    Oh and btw: My dr said that the ligament will indeed "fuse" back together on a grade 2. He didnt like the term regrow.

    On a grade 3 or above they generally do not he said. I mention this because i read conflicting info on here about ligaments healing/regrowing.

    I asked about reinjury from another fall and he said at 2 months it should be as strong as pre injury (ligament wise).

  43. #543
    SkreaminQuadz
    Reputation: jhhall's Avatar
    Join Date
    Nov 2005
    Posts
    37
    I joined the club about 2.5 weeks ago. Grade 3 AC Separation. Honestly the pain wasn't ridiculous at first but the discomfort since that has been bothersome. I initially opted for the non-surgical route but after reading more about it here and other places I think I'm going to get the surgery.

    I can't stand the thought of not being active on a bike for at least 3-4 months, but I think that in a years' time I'll be happy I went this route. I've never had surgery before and I really hope I'm doing the right thing here.

    Here's a pic from the ER.
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-xray0002.jpg  


  44. #544
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Looks like mine.. Sorry your here. I'm 3 week since surgery now going to doctor tomorrow for 3 week check up. I would like to get the sling off, at this point I dont feel I need it but I know its here for another 3 weeks. My shoulder is feeling really good but loosing muscle from being in the sling 24/7 and I have another 3 weeks in it. I am wondering how long it will take to rebuild and get back on the bike. I see 2-3 months rehab to get it back to a useable level or hard mountian biking level.
    Anyone want to chime in on rehab and time frame that have had surgery?

  45. #545
    banned
    Reputation:
    Join Date
    Sep 2010
    Posts
    4,816
    Quote Originally Posted by Andy17 View Post
    Looks like mine.. Sorry your here. I'm 3 week since surgery now going to doctor tomorrow for 3 week check up. I would like to get the sling off, at this point I dont feel I need it but I know its here for another 3 weeks. My shoulder is feeling really good but loosing muscle from being in the sling 24/7 and I have another 3 weeks in it. I am wondering how long it will take to rebuild and get back on the bike. I see 2-3 months rehab to get it back to a useable level or hard mountian biking level.
    Anyone want to chime in on rehab and time frame that have had surgery?
    For me, rehab time was pretty lengthy, but my injury was complex, and I had the surgery at age 55. In a sense, I'm more or less stuck with a a process of ongoing re-hab for life.

    All of which points out that there are so many variables that come into the equation of how long one can expect to rehab. Degree of separation, other damage done, age and health of the patient are some of the biggies. Some of them. There's lots more.

  46. #546
    mtbr member
    Reputation: wsmac's Avatar
    Join Date
    Sep 2010
    Posts
    542
    Quote Originally Posted by jhhall View Post
    I can't stand the thought of not being active on a bike for at least 3-4 months, but I think that in a years' time I'll be happy I went this route. I've never had surgery before and I really hope I'm doing the right thing here.
    It's a long read but this whole thread is full of info on rehab and such.
    I started my story on page 12.
    I did very little rehab with a PT, instead I worked on it at home, while driving in my car...
    The important thing for me was to be a COMPLIANT patient... which is damn near impossible for me.
    Take yesterday and today, for example. I am 4 weeks out from hernia surgery and not supposed to be lifting more than 10 lbs, but I rode up into the hills yesterday to clear some trail. A bit of sawing with a handsaw, mostly cutting branches, briars...
    Today I removed the bumper from my GF's p/u to hammer out a couple of dents she put in them. I took it all slow and easy, but still... I'm sure my surgeon would have given me the evil eye!

    Back to the topic at hand...
    I wore a soft sling with pillow block after my first surgery and the repair failed.
    After my second shoulder surgery in 2 weeks, I was put into a more rigid brace than the sling with foam block.
    I made sure I followed doctor's orders MUCH better that time and it paid off.

    Quote Originally Posted by Andy17 View Post
    Looks like mine.. Sorry your here. I'm 3 week since surgery now going to doctor tomorrow for 3 week check up. I would like to get the sling off, at this point I dont feel I need it but I know its here for another 3 weeks. My shoulder is feeling really good but loosing muscle from being in the sling 24/7 and I have another 3 weeks in it. I am wondering how long it will take to rebuild and get back on the bike. I see 2-3 months rehab to get it back to a useable level or hard mountian biking level.
    Anyone want to chime in on rehab and time frame that have had surgery?
    After 6 weeks waiting for surgery, then 2 weeks with a failed attempt at surgery, I spent another 6 weeks recovering from the second. The brace, a change in my attitude, and time spent moving my arm (as allowed per doctor's orders from initial rehab and after brace removal) through as much normal range-of-motion planes as possible, helped me get back pretty much everything in movement.

    I have recovered my strength as well. I can climb at the indoor rock gym with no issues, do pull-ups, lift weights, and most importantly... MOUNTAINBIKE!... as good as I could before.

    I did the wall crawls, stretches on every plane I could think of and could take, and created a pulley device to help.

    The device I made was similar to something I saw at the PT office.
    I used a bit of webbing and a slider, figure-8 descender, some rope, and two hand-width sized pieces of 3/4" pvc.

    I fashioned the webbing to have the slider on one side of a door, with the webbing passing through the jamb to the side I was on.
    With the door closed, it became my anchor.
    The other side of the webbing(loop) went through the figure-8.
    I ran rope through the other end of the figure-8 such that it was a length that would hang down to my sides.

    I slipped each piece of pvc onto the rope, then tied the rope back to itself to fashion handles.

    Holding onto the pvc handles, I could use my good arm to pull my recovering arm up from various positions.
    I could stand with my back to the door and pull my arm straight up in front of me.
    I could stand with my recovering side to the door and pull my arm up sideways.
    I could stand away from the door and pull my arm up behind me.
    I even took this on the road with me.

    You can get imaginative and do plenty of PT on your own as long as you understand the mechanics of what's happened to your shoulder, what's happened since the surgery, and what you are trying to accomplish with your PT.
    It really is simple mechanics, if that helps you think it through that way... it did for me.

    When driving, I would slowly raise my arm up to the steering wheel repeatedly as exercise until it was fairly easy, then I started walking my arm up over my head on the headliner of the car. After that, it was lifting my arm over to the passenger side, eventually getting my arm far enough back to get behind the headrest.
    The opposite of that was reaching across my chest to grab my seatbelt(not as great an extension as the other direction, but it was better than nothing).

    I just spoke to a friend of mine who had a ligament repair to his shoulder along with other work to the joint.
    He was given a unit that was basically a portable cold pack device.
    He had to pay for it (or hopefully his insurance will), but using that often after surgery has really helped him out, he said.
    I offered to buy it from him, figuring I'll probably have a need for it down the line if I keep up with my style of mountain biking! LOL

  47. #547
    SkreaminQuadz
    Reputation: jhhall's Avatar
    Join Date
    Nov 2005
    Posts
    37
    Quote Originally Posted by Andy17 View Post
    Looks like mine.. Sorry your here. I'm 3 week since surgery now going to doctor tomorrow for 3 week check up.
    Thanks Andy! Let us know how the appointment goes/went.

  48. #548
    SkreaminQuadz
    Reputation: jhhall's Avatar
    Join Date
    Nov 2005
    Posts
    37
    Quote Originally Posted by wsmac View Post
    It's a long read but this whole thread is full of info on rehab and such.
    I started my story on page 12.

    Back to the topic at hand...
    I wore a soft sling with pillow block after my first surgery and the repair failed.
    After my second shoulder surgery in 2 weeks, I was put into a more rigid brace than the sling with foam block.
    I made sure I followed doctor's orders MUCH better that time and it paid off.
    Thanks WSMAC - I went back and followed your story - good read. I'm glad to hear that it's all paying off for you.

  49. #549
    mtbr member
    Reputation:
    Join Date
    Sep 2011
    Posts
    99
    Everything going great, it's in perfect position. 3 more weeks in the sling.
    I cant wait to get back on the bike.
    Last edited by Andy17; 12-11-2012 at 05:31 PM.

  50. #550
    mtbr member
    Reputation: dwnhlldav's Avatar
    Join Date
    Feb 2006
    Posts
    1,027
    I got the go-ahead to start riding on the trainer. My doctor doesn't want me to risk falling for another few weeks so nothing outside.

    Now, I just need to find my trainer. I think I may have loaned it to someone...
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

Page 11 of 21 FirstFirst ... 789101112131415 ... LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •