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  1. #26
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    I have grade I AC Separation maybe more

    Happened last Sat 9-1, haven't been to the doc yet but it really hurts to move my arm across my chest and rest my palm on the opposite shoulder.
    Also had some pulling/tightness in the muscle on the side of my neck and in my back and lats, but that's subsided quite a bit after a week; however the shoulder tighntess,pain is not.

    I think I got REALLY lucky, actually, since riding group videod this particular descent and crash on DH section and it was pretty violent. My buddy rode the whole section and made a mistake at the end (a drop into a berm) and broke his collarbone. Buds said my crash looked way more violent than his, yet I get away with AC separation and he breaks a bone!

    My advise for those who still want a cardio workout but can't get on the bike yet, if you can, ride road or use the recumbant bike in the gym - I've gotten 3 pretty good cardio workouts this week on it and it puts minimal load on the shoulder- up right bike might be better. Not sure about the road bike but going to try that tomorrow.

    There sure are a lot of shoulder injuries on here and I didn't think about googling "AC Separation" or "Shoulder Injury" until tonight, when a friend mentioned it.

    FAst healing everyone, and try to as active as you can (if you can at all) in the meantime.

  2. #27
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    Had a type 3 seperation a few years back. Opted for the surgery route for several reasons. Def. slows the recovery process, but I'm glad I did. (2 times under the knife actually, had to go back to get a pin removed.) Have a nice huge battle scar to show for it now too. Now I'm laid up again with some huge gashes on my arm from a slide down some rocks today.

    Def stick with the PT and training though, but don't over do it. It's easy to set yourself back when you start getting overzealous.

  3. #28
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    Oh wow. I am 4 weeks into a AC separation. Doc told me same story about
    the wait and let it heal strategy taken these days.

    Sleeping has been a real pain, as has removing shirts.

    He told me to give it a solid 8 weeks before I worry about the pain aspect.

    He did say to try riding on flatter ground. The visit before when I saw him
    was for a broken thumb, messed up wrist ligament and messed up nerve in my elbow.

  4. #29
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    I too, am a member of the "lumpy shoulder club"

    Did my right one 13 years ago playing judo....took a long time to get right, but anymore the only reminder is the lump on my shoulder and an occasional twinge when I overdo the push ups, or if I lay off the PT for a while and pick it up again. No surgery and no arthritis so far, still follow up with my ortho doc and he says not doing the surgery probably saved me a lot of pain in the long run. On the other hand the knees have been in the body and fender shop a couple times and the initial injury to my shoulder was far and away more painful than they were.

  5. #30
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    Four weeks out on a 3rd degree separation. Classic over the bars fall. God bless my brand new Bell Sweep that saved my melon. I second the pain being terrible, I'm not the toughest guy, but ouch.
    How soon did some of you with 3rd degree injuries get back on your bike? I rode some slow single track yesturday, with no pain. Really scanned the trail like never before, and the trees seemed VERY close to my shoulder. I probably shouldn't be riding, but couldn't resist.

  6. #31
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    I'm glad I saw this post. I feel a bunch better after just receiving a grade 3
    separation a week and 1/2 ago. I blasted down a 4 foot drop and the front
    wheel hit something in the leaves and just stopped. I did a bad body slam
    causing the separation. I've been a bit worried about it, as many of you, the
    doctors, even a 2nd opinion opted no surgery.

    Thanks for all your input. I feel a lot better knowing it will come around. The
    doctor said to take it out of the sling as soon as I could do so without much
    pain. I took if off this past Thursday and seem to be getting some use out of
    it now. It will be two weeks into it the day after tomorrow so I guess I'll just
    keep counting.

    Thanks again, everyone.

    ODN
    Caffeine ! "Do stupid things faster and with more energy" ! !

  7. #32
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    I am 5 months out on a AC 3 separation (no treatment) and have been riding since the third week. Funny thing is that the position while riding since the separation has always seemed stable and not induced any pain. My problems have been laying on my side to sleep and also pushing straight up with the affected shoulder from a laying/sitting position on the floor.

    Went OTB again 2 weeks ago and landed on the same shoulder. Heard all the same crunching and scratched my arm and leg up pretty badly and had some deep bruising on my leg. With the exception of my bump sticking up a little more for a few days the shoulder though was OK. I am glad that I did not do the surgery. Would have probably messed it up real bad.

  8. #33
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    Grade 4 separation

    Its been about four years ago now, did mine snowboarding. I opted for the non surgical route, no PT and no drugs. I still cant lift as much as before and rock climbing is a lot less stable but I dont notice it in daily life other than the big lump. I would recommend letting the injury heal on its own unless the bone is sticking out of your skin, but thats just me. Be patient with your bodies healing process and seek out some myofascial bodywork to keep the shoulder girdle opened up things stop working.

  9. #34
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    My AC seperation has a little twist

    About 3 years or so ago I was working out on a shoulder press machine at the local Y. Pressing the weight back up I felt a pop by my right shoulder blade and dropped the plates. I was in a lot of pain and went to my Doc. I obviously strained myself and "rest and never lift that much weight again" was my doctors response. For the longest time I had a tough time with my right shoulder and my range of motion was quite limited. I could not for the life of me grab the back of the collar of my shirt to pull it over my head with my right hand. Due to my limited strength and flexibility working out became quite annoying and I stopped.

    As a result of a trip OTB last year I received a class 2 separation on that shoulder. Within 4 months I could not believe how much better my shoulder was feeling. I regained much of my range of motion and was able to exercise that shoulder without pain. It's been a little over a year now since the separation and I've been back in the gym for about 3 months. I'm taking it slow but all of my strength is finally starting to come back.

  10. #35
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    Update:
    I am now 11 months out, coming up soon on the anniversary of my crash and my surgery (modified weaver dunn, read my previous post). Crash was on 12/26/06 and surgery on 12/28/06.

    I have been religious about working out, mostly core exercises and power cal's (pushups of all kinds, pullups, etc. I can recommend books) and I am feeling strong and so is the shoulder. Occasionally it might feel a little sore if I push hard, but this is progressively reducing in what it takes to make it sore. I feel I am better off with the surgery, and it looks almost as before.

    I have lifted weights heavy for 25 years. After the accident I had to learn new workout techniques and also learned how bad the bench press is for you (google bench press and paul chek), I would recommend you guys who are obsessing over the bench press (how much ya bench) to stop doing it and change your focus. My workouts leave me much more wiped out and I feel stronger, more of the entire body is worked out at once, has more real world applications for skiiing, biking, etc than isolated weight lifting, and this is coming from a former hard core weightlifter!

    If you can find a good surgeon I would recommend it. Arthritis isn't an issue since they trim off a bit of the clavicle in the modified weaver dunn procedure. I would also recommend you thoroughly research that procedure first so you understand what they will be doing. Plenty of info on the net. I have heard guys have gone back to playing rugby after the surgery.

    I went biking two weeks ago, played it real cautiously as I wanted the shoulder to be close to 100%. I think its about 98% right now.

    Anyhow, thought I owed it to those who are looking for feedback. I know I was when I was contemplating surgery. I scoured the net and read everything I could.
    The Trick to carrying on is not to get carried away

  11. #36
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    Wow, good thread. I'm about 4 months out from a level 2 separation on my left shoulder. I too have the big bump now. My sports specialist said surgery was really for cosmetics and that in the long run, I'd heal up just fine, albeit with the "lump." If I chose surgery, the recovery time would be significantly longer.

    I've also got a really bum rotator cuff that I'm going in for surgery on in January. My ortho said the same thing about the A/C separation - surgery would be more for cosmetics and would really increase recovery time. Although when I saw him last week, he said that he could shave off a little of the end of the clavical (about a 1/2") to reduce the bump and allow for better rotational movement.

    Race season starts in April, so I think I'll just stick to the arthroscopic surgery for the rotator cuff and be back in shape for Sea Otter.

    In the meantime, I think I'll do some more research on the Weaver Dunn procedure.

    Last edited by Surfinguru; 11-19-2007 at 08:54 PM.



  12. #37
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    Quick info update for those interested. Here's a really good overview of the modified Weaver-Dunn procedure.

    http://www.shoulderdoc.co.uk/educati...sp?article=525



  13. #38
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    Surfinguru,

    You are correct you will incur a much longer recovery, however, my ortho said I would achieve more strength then without the surgery and from everything I have experienced myself and read; replies, studies, etc I think he is right. Look at some of the people who have replied on this thread. I don't experience the same issues as they do after the surgery. Not trying to push this on anyone just trying to provide a response by someone who has had the surgery as it seems I am in the minority on this thread.

    Your link was a good one also, I read that one when I was researching my procedure. The only difference was that they used a fastener rather than a piece of string or twine of some sort to anchor the clavicle down. I have after pics but unfortunately no before pics.
    The Trick to carrying on is not to get carried away

  14. #39
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    SkiBikeMan, sent you a PM, but I want to ask if anyone else here knows a surgeon in the California Bay Area that does the arthroscopic modified Weaver Dunn procedure?



  15. #40
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    This thread has been a great resource. I dislocated and fractured my shoulder just over 3 weeks ago and had no idea what to expect as far as recovery besides the standard stuff from the doc. Thanks everyone for sharing your experiences. Looking forward to getting back on my bike ASAP!

    xray.jpg

  16. #41
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    Hey nice x-ray. So what procedure did they do there for your clavical? Looks like they've done a Weaver-Dunn?


    edit: Oh yeah, meant to ask if any of that stuff will be coming out?
    Last edited by Surfinguru; 11-28-2007 at 01:18 PM.



  17. #42
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    I crashed in September went to the ER and the doc said I had a bad bruise. When I asked about the huge lump on my shoulder she said it was tight muscles if I was still in pain I should go see an Ortho doc. Because we were in the middle of moving I didn't get into see the Orthopod untill late Novemeber. Did a grade 3 of my left shoulder. I also did a grade 1 to my right last february.

    I'm kind of glad I didn't know about the second one. I was riding 6 days later. Crashed on the 7th day. And kept riding. Riding really didn't aggrevate the injury. Bunny hopping/pulling up on the bars did.

    As far as the healing thing goes. I asked the Ortho Doc because of this thread. He said that what they find if they go in for surgery a couple years down the line is that the scar tissue develops into a cartilage type substance that helps to stabilize the join. That is what they mean by healing.

    No surgery here as I was basically back to normal in 6 weeks. Just some pain if I lift things over 30 pounds, or hold lighter items for extended periods (think squirming 1 year old) but it's getting better.
    Disclaimer: I no longer fix bikes for a living.
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  18. #43
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    Just a quick update for those interested, I went to get a second opinion from a guy named Tim McAdams yesterday since I was starting to get that "no so good" feeling from my other ortho. Dr. McAdams is the current team physician for the San Francisco 49ers and used to be the team physician for the Stanford basketball team.

    They took a fresh x-ray and he prescribed a new MRI which I'm getting done tonight. I asked him about the arthroscopic Weaver-Dunn and he point blank said it's still VERY experimental and that he wouldn't do it. (Case studies have revealed alot of complications.) He said he can do the AC reconstruction with at the most a two inch incision to implant a cadiver hamstring tendon, so that's not very invasive at all. He'll also do the arthroscopy proceedure for the labral, supraspinata tear etc. when he's in there and feels confidant I'll be back and ready for race season in three months.

    I'll continue to post follow up on events as they occur since it sounds like it could be useful for others on the board.



  19. #44
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    I have a twist too

    I have an AC grade 3. Big bump. I can actually grabg the end of the clavicle and move it around. It happened in 1990. FWIW, I was in pretty good upper body shape when it occurred. I was recommended at the time against surgery and for PT, unless I wanted it ground down for cosmetic purposes...I went to the Jobe Clinic...Lakers docs. I did PT and still do...in the gym, I do some minor/fun exercises now and it is all it takes. Riding my bike seems to make it feel better. I ride regular one gear type of bikes and I think b/c I mix up my technique so much that it has had a positive effect on my shoulder...standing and reefing up and out vs. seated spinning pulling back, etc. etc. I climbed through it and I think that was some great PT as well. I was in the Valley for a couple years and I gotta say I think I had this minor advantage in offwidths and squeeze chimneys…the Steck-Salathe comes to mind, but anyway….

    No under the knife for me...not when just a minor change in lifestyle would do it...you know like going to the gym, stretching and whatnot. this little change has benefited me in many other ways as well....think of the whole.
    The AC separation is a weird thing…I have spoken with folks who have had exactly the opposite experience of me…I forget I have one most of the time. After a couple years I could sleep on that shoulder again. I have been MTBing since ’84. I have full range of motion.
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  20. #45
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    Body Armor

    About 10 years back I had my AC joint removed due to a bad skiing fall. Haven't been able to body build since because of the pain afterwords. Started MTB over the summer and it does'nt bother it.

    Can someone recommend some type of shoulder protection for aggresive trial riding, something you can move and feel somewhat lively in? I don't want to break or separate another shoulder.

    David

  21. #46
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    Another update. I started swimming laps 10 weeks after the grade 3. I had some pain at first but on the whole my shoulders feel better then before my first separation. I can sleep on it no problem. Basically the only time I remember it is when I move my shoulder in such away that the bone sticks out to it's farthest. It just feels weird.
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  22. #47
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    Quote Originally Posted by MTB'n Louie
    About 10 years back I had my AC joint removed due to a bad skiing fall. Haven't been able to body build since because of the pain afterwords. Started MTB over the summer and it does'nt bother it.

    Can someone recommend some type of shoulder protection for aggresive trial riding, something you can move and feel somewhat lively in? I don't want to break or separate another shoulder.

    David
    Hey David, I separated mine while wearing a 661 Pro Pressure suit. I don't think there is anything one can do to completely eliminate the possibility of injury. There are only degrees of mitigation.



  23. #48
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    Well for anybody that might still be following this thread and my situation in particular, I had surgery on Friday the 11th. Doc said they did ALOT of work, but said it went exceptionally well. He took care of the bone spur, fixed the rotator cuff, bursa sack tear and the supraspinata tear. Then he went on to do the distal a/c reconstruction. (cadiver tendon graft slight clipping the last 1/8" of the bone to get the clavical back in place.)

    I woke up from anesthesia with the worst pain I've ever experienced. As a result, they decided to keep me overnight and hooked me up with the PCA machine (morphine drip) and a bunch of vicodin. About 6hrs later came one of the worst sicknesses I've had. (I'll never take that again - I'll sack up and writhe in pain before going through that nightmare.) Got discharged about 3pm the next day. Staying overnight in the hospital is one of worst experiences to be sure.

    I'm home now with strict orders to ice and not do anything with the arm for two weeks to ensure the tendon graft doesn't get screwed up. (Basically immobilization and lot's of percocet and darvocet - yeah!) Sleeping is a bit tough as I have to sit upright and sleep in the bolster/sling.

    I've got a follow up appointment next thursday to have the stitches removed and then it's physical therapy. I'm really stoked so far despite the pain. Only got one stitch for each of the three arthroscopy entry points and the incision for the tendon graft was only like 1-1/2" long.

    The goal is to be back in the saddle for Sea Otter. Keep you posted!



  24. #49
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    Me Too!

    Long story short…I’m in the club.
    The Details: I crashed out at mi 25 or so of the Chequamegon40. Spent some time in the Hayward ER, got some X-rays. And then was told that I probably dislocated something but it popped back into place and I will be sore for a while. Here is you sling and ice pack, have a nice day. I then pointed out the giant bump on my shoulder that the old ass Dr missed while yanking my arm around in his earlier inspection. He replies, “Oh, I missed that….that’s an AC separation, here’s a prescription.” Really? Ya didn’t see that? Any ways I’ve got an appointment with a Ortho later today to get a good check out.
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  25. #50
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    Well the verdict was level 3-4, with the dead guy ligament surgery as the recommendation. He only thought it would add a few weeks to recovery compared to leaving it alone. Being an active person was a big part of them suggesting surgery, and this was from a respected Ortho from a sports medicine clinic. He implied that doing nothing and just leaving it there, especially with grade 3, was more for folks who don’t plan on hitting the gym after re-hab. The dead guy ligament is to reconstruct the inner ligaments and then they can repair the outer one, eventually giving a 100 percent joint without the crazy bump and equal length arms.
    Slowly slipping to retrogrouchyness

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