• 12-12-2012
    Andy17
    Wow thats great Dave. Your about 6 weeks post surgery and are making great progress!! How long until you could ride woods do you think? How is the rom and strength at about 1 week post sling? My shouder is drying up and getting stiff. I'm just wondering how long to get it back up to speed. I am thinking about 2 months post sling to regain enough strenght and allow the repair enough time to get strong enough before we can get back at it. I think another couple months after that before we can go fast. I am hoping maybe 4 weeks and maybe I can get to dirt roads? I will do what ever the doc says but from reading, a lot here, ( good info) this may be about what we are in for..
  • 12-12-2012
    dwnhlldav
    My first day out of the sling was rough. I didn't know what to do with my arm.

    I saw my PT the day after and ROM was pretty limited. But it's coming back very fast. Within a week it had improved to 75% of ideal in my worst movement, 95% in my best movement. I missed my 1.5 week appoint due to work. I'll go back tomorrow and it will be two weeks out of the sling.

    As far as woods riding goes, I don't know. My doctor says he'll release me to ride outside after my next appointment on January 2nd which will be 3 months post operation. But, we won't have any trails open at that point. I could go to Ray's in Milwaukee, but I've never ridden there without falling and I don't think it would be fun to go and not push myself. My plan is to get back to commuting to work 2-3 weeks and then hit the single track when it opens here in the spring. Maybe a late winter trip to Rays...
  • 01-04-2013
    dwnhlldav
    Saw my doctor last week. His words were "You can ride your bike, but you can't fall." So I'm sticking to the trainer for now.

    His explanation was that the old thinking was that by 8-10 weeks the tendon and bone junction would be fairly well healed. But newer studies are pushing that out closer to 16 weeks. So, he eased up my restrictions, but said the longer I can be conservative the better.

    ROM is back to normal in all directions except the one most limited when I was in the sling. That's external rotation with my elbow at my side and bent 90 degrees (like it was in the sling). But I'm up to 90% on that movement. Started light strengthening and was okayed to do easy swimming (breast stroke only) for 20 minutes, 2x/week.
  • 01-05-2013
    jhhall
    Quote:

    Originally Posted by dwnhlldav View Post
    Saw my doctor last week. His words were "You can ride your bike, but you can't fall." So I'm sticking to the trainer for now.
    ek.

    Sounds like a good decision on your part. This recovery is something I don't want to ever have to do again so I'd opt for the conservative route too!

    Andy - how are you doing?

    I'm just over 3 weeks post op. on meds for 2 weeks and now just OTC if needed. Still a decent amount of pain but the past week I've seen pretty good improvements. I have a 4 week post op appt next week. My guess is another 2-3 weeks with sling and then start PT.
  • 01-05-2013
    Andy17
    I went to dr on 31st and took sling off. My first appointment for PT was Thursday and it went pretty good pain wasn't too bad but it did hurt. I'm doing all the home work and like Dave I'm going conservative. I can't put more than 5lbs pressure for 6 full weeks which will take me to the 3 month stage also. To me Dave and I have the same treatment routine. Getting out of the sling is not fun it is a lot of work to get ROM back. I think it will come back fairly quick as you guys have said.
    I have no hump at all bones are lined up perfectly right now. It's a long road but I feel it was the best for me.
  • 01-05-2013
    dwnhlldav
    Quote:

    Originally Posted by jhhall View Post
    Sounds like a good decision on your part. This recovery is something I don't want to ever have to do again so I'd opt for the conservative route too!

    Andy - how are you doing?

    I'm just over 3 weeks post op. on meds for 2 weeks and now just OTC if needed. Still a decent amount of pain but the past week I've seen pretty good improvements. I have a 4 week post op appt next week. My guess is another 2-3 weeks with sling and then start PT.

    Glad you're improving. I went off the hardcore pain meds after about a week, but found that I wasn't sleeping well. I kept rolling in my sleep and waking myself up with the pain. Started back on the percocet at night and it helped a lot so I think I ended up taking a half dose every night for a total of 4 weeks. When I finally ran out, I switched to simply sleep for another couple weeks. I'm off all pain meds and sleep aids at this point. I'm a side sleeper and tend to switch sides during the night. This is still my biggest issue. My doctor said it's okay at this point to lay on my side, but it's uncomfortable so I'm still waking up multiple times during the night from pain. I guess if this is the only discomfort I'm experiencing then I'm doing pretty good.
  • 01-05-2013
    dwnhlldav
    Quote:

    Originally Posted by Andy17 View Post
    I went to dr on 31st and took sling off. My first appointment for PT was Thursday and it went pretty good pain wasn't too bad but it did hurt. I'm doing all the home work and like Dave I'm going conservative. I can't put more than 5lbs pressure for 6 full weeks which will take me to the 3 month stage also. To me Dave and I have the same treatment routine. Getting out of the sling is not fun it is a lot of work to get ROM back. I think it will come back fairly quick as you guys have said.
    I have no hump at all bones are lined up perfectly right now. It's a long road but I feel it was the best for me.

    It comes back quick. Keep working at it and you will start feeling better quickly.
  • 01-06-2013
    Andy17
    Yes then there is sleep or the lack there of. I went off pain meds after 3 days and use Advil at night but it really doesn't help get a good night sleep. I also sleep on my side and sleeping on just one side is hard. I can't sleep on the bad shoulder at all yet. I can lay on it but for just a few mins.
    I'm working on the stretching and strength exercise program and can see results already. Good to hear you guys have good results quick. Thanks guys!
  • 01-12-2013
    giantfox
    about a month since i last posted, quite an improvement.

    been back on the trails, nothing too difficult, but there were no issues at all with my shoulder (although i did have very heavy legs)

    1 week on skis - absolutely no issues (including a fairly impressive wipeout)
    can SUP no problem, running no issues (was painful early on when running)
    swimming no issues

    this week i had the gym, bit of a mid-life crisis due to other issues.
    absolutely no issues in strength, but just the occasional twinge.

    can sleep on it..

    so 5 months after the injury, no surgery, I would rate my shoulder at 98 to 99%.
    it just took its own time to get there.

    still looks awful, but hey!
  • 01-12-2013
    dwnhlldav
    I'm back on skis now. That was another "You can ski, but you can't fall" conversation from my doctor. I joined the National Ski Patrol this year so I'm working on getting certified with the toboggan. Had my first day in the handles. My shoulder did fine with the weight of the sled, but we won't have passengers for another few weeks.
  • 01-13-2013
    TranceX
    When I asked my doc about mountain biking and falling again he just laughed and said, "you've already ripped it apart so you don't have to worry about that...." His attitude was no surgery for grade 3 as the data 1 year out doesn't suggest it is needed, and not to worry about it... That being said I just completed my first 50 mile mtn bike ride yesterday at the Tour de Felasco 9 months out from my injury.
  • 01-13-2013
    dwnhlldav
    Quote:

    Originally Posted by TranceX View Post
    When I asked my doc about mountain biking and falling again he just laughed and said, "you've already ripped it apart so you don't have to worry about that...." His attitude was no surgery for grade 3 as the data 1 year out doesn't suggest it is needed, and not to worry about it... That being said I just completed my first 50 mile mtn bike ride yesterday at the Tour de Felasco 9 months out from my injury.

    I was back on my bike, and falling a week after I did the grade 3 separation. You're doc is right, it doesn't need to heal. Just stop hurting.

    I didn't go for surgery until I fell and made it a grade 5.

    But with surgery, falling would be a major setback.
  • 02-08-2013
    Andy17
    I went to doctor a week ago and got the ok to ride dirt roads at 12 weeks but "don't fall". My range of motion is coming back but has been a little slow. Seems I am sone of those people who get really tight. I have around 85% ROM or better now. The bones are still lined up great. I am going on a 28 mile ride saturday and looking forward to it. The recovery is long and hard but I have no regrets with the surgery. The doctor says I can get back in the woods when I get strong enoough but go easy until the 6 month mark. He said the new parts will reach max strength around 6-9 months and be as strong or stronger than the original. Thats my 12 week post op up date.
  • 02-08-2013
    jhhall
    Congrats Andy! That's incredible progress. I can't imagine being allowed or ready to ride in 4 more weeks. Enjoy the ride on Saturday!!

    I am 8 weeks post-op and was out of the sling at 4 weeks due to frozen shoulder. I was nowhere near ready to be out and the first few days were tough. I immediately started PT and have seen pretty good progress. I'm probably at 40% ROM now and can ride the trainer as of 2 weeks ago. I rest my arm on the bar but can't put any weight on it. I'm being super diligent on the home exercises. I have my 8 week appointment with my surgeon on Monday.
  • 02-08-2013
    Andy17
    Ac Separation (shoulder Separation)
    Progress is speeding up for sure. At 8 weeks I couldn't have rode either. The last two weeks I have made a lot of progress. There is no way I could ride in the woods right now I have not got enough strength to begin to even think of it. Dirt roads only and they have to be smooth, he didn't even want me to cross the smallest ditch log or rut in the road. Oh and do not fall.
    My shoulder was frozen up pretty bad too but he wouldn't let me out of sling until 6 weeks. I had very little ROM and have still not regained it all yet.
    Looking forward to the ride!!!!
  • 02-16-2013
    dwnhlldav
    Went in for my most recent appointment at 15 weeks. Up till this, my PT has been doing only ROM and very light strengthening with me. She asked me to see if we could get going with heavier stuff. Doc's words were "You can go to town." I love that guy.

    I really haven't gotten back on the bike that much. Went to Ray's in Milwaukee and made it about 30 minutes of mild riding before the shoulder was telling me it was time to stop. I was given the okay to do easy swimming at 12 weeks. I'm up to 750 yards at an easy pace, planning on doing 1000 yards a couple times this week and seeing how much I can push the pace since given the all clear. I have a standing invitation from one my customers/local tri coach to go swim with his group on Wednesday evenings, but need to get a bit more fit before I show up there.

    ROM is at 100% for all motions except external rotation which is 85%. Though I notice a big difference when I'm in the pool. Good swimming form takes a lot of shoulder flexibility and even though I'm being measured at "100%" I'm very unequal so we are still working on ROM in PT.

    In closing, I'm finally feeling like I'm better than before surgery. Progress has been substantial in the last month so I'm fairly confident saying I made the right call in going under the knife.
  • 02-17-2013
    Ricisan
    Over reaching?
    My injury was about as bad as can be fixed. I'm almost 8 months in and making progress. Here are a few thgings that have worked for me, and a few that have NOT!

    The plyo ball allows me to work my back and core, as well as both shoulders so as to keep the strong one strong and flexible.
    I started doing the rab exercises every day, no good.
    I now do the exercises every third day followed by circuit training.
    That has been my best move yet, I improve every workout!

    I went on to doing compound exercises "weight lifting" on my basic
    lifts. Found out my lack of tendon strength was holding me back.
    So I am back to working on my tendon strength first in the morning,
    then circuit training later that day if I feel up to it.

    I noticed that I was neglecting a few exercises that were very difficult.
    I had to go back and be honest w/myself about what exactly is the weak link in my chain, and follow up on refocusing on those.

    Leave the ego behind, do what you can when you can. ;)

    I make my rehab the most important thing in my day, other than work!

    Don't forget the Ice machines to keep things chill.

    R
  • 02-17-2013
    AC Straighter
    Im curious to know if anyone has had a surgery for a grade 3 separation years after the initial injury. I separated my dominant shoulder almost 12 years ago and it has always bothered me, but I've had complete ROM and noticed very little reduction in strength. Of course I have the huge bump but the appearance never really bothered me. It has always been sore/painful, and made lots of crepitus/clicking, crunching, popping sounds, but I was told on initial eval to not have surgery. I have always wondered if I should have. Almost 2 yrs I had gone thru 1st yr medical residency and didn't have much time to work out. When I did get back into it last year I began to have pain with that shoulder with push ups and pullups etc. so went to see Ortho. Long story short, we never found out exactly what the new injury was and although I can do push ups and pull ups again, I get much more sore afterwards and I now have a painful click when I draw down on my opposite site (a motion as if I'm drawing down with a gun on someone standing at my opposite side) as well as a "jump" when I rotate my dominant right arm internally when standing upright arms at my side. My ortho said he could do an arthroscopy but still doesnt think I should get the AC reconstructed. My fear is that the separation caused a shoulder dysfunction which will predispose to degeneration of the joint from altered mechanics. Sorry this is long but has anyone ever had a tight rope procedure years after the injury?
  • 02-17-2013
    Ricisan
    I'm glad I'm not the only one that puts nicknames on the rehab exercises. lol
    I do the gunfigher crossdraw, the comes across my chest into an overhead hitch-hiker
    thumb out move.
    This is my most difficult move. I could only do 6-8 w/#1 weight.
    Yesterday I did 14 good ones! :)

    I also lie on side and do a 45* side raise for superspinatus.
    Went from 5 reps to 15 w/#1 weight.

    The final is lying on my back, shoulder at 90*.
    Like I am throwing something overhand.
    I just went from #3 to #5, very happy.
    Feel like celebrating.

    My injury was getting worse.
    My sergon told me mine was second oldest/worst seen.
    Last guy let his go 12 yrs, it was too much to fix properly.
    Mine had fatty deposits and bursa that had to be removed.

    I just turned 59, so yrmv!

    R
  • 02-17-2013
    AC Straighter
    Glad to know you're doing better. What procedure did you have done and how long after you're initial injury was it done? Why did you decide to get cut?
  • 02-17-2013
    dwnhlldav
    Quote:

    Originally Posted by AC Straighter View Post
    Im curious to know if anyone has had a surgery for a grade 3 separation years after the initial injury. I separated my dominant shoulder almost 12 years ago and it has always bothered me,

    I waited 5 years after the initial injury. I was forced into surgery by another fall that made the grade 3 into a grade 5. In some ways, I wish I had done it immediately after the initial injury. But in the end, I'm glad I waited because I found a doctor who was doing more advance repairs than what I was told about initially.

    Don't go for the weaver-dunn or any of it's modified versions. It's outdated. But because it's been widely used for 3 decades, it is still performed. Studies indicate that it only produces a joint that has 10-30% of the strength of the original joint. (source) http://isakos.omnibooksonline.com/20...icl/ICL_10.pdf

    The most recent technique, that has better results, doesn't have a short name yet. The long version is Anatomic Coracoclavicular Reconstruction using Semitendinosus tendon, either allograft using a cadavor tendon or autograft using your own tendon.

    The newer procedure has been shown to reliably produce a joint that has 85-95% of the strength of the original joint, with outliers above 100%. (Unfortunately I can't find the source, this is from memory, though I have a very good memory for statistics like this, I'll keep trying to track down the source)

    I went with my own tendon because of the higher risk of rejection with a cadaver tendon.

    The procedure described, starting on page 10 of this paper is the one that most closely describes what my Doctor performed, though mine was done as an open surgery with a 5cm incision.
    http://isakos.omnibooksonline.com/20...icl/ICL_10.pdf

    This one made me glad I waited, as the first two surgeons I talked to recommended the modified weaver-dunn (though one of them didn't know that was it's name...). Hopefully you can access it, my doctor printed it for me when I was doing pre-decision research on surgery.
    Semitendinosus tendon graft versus a modifie... [Am J Sports Med. 2009] - PubMed - NCBI

    Another one that sold me on the newer technique.
    http://depts.washington.edu/shoulder...-Technique.pdf

    If you can access it, this is a good article as well. My doctor also printed this one.
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  • 02-18-2013
    Ricisan
    Ive had 5 shoulder injuries over the years. The last was an OTH and I landed on my arm. I asked for an MRI, twice! I was turned down twice.
    When I couldn't raise my arm over my head any more, that did it!
    I got my own MRI, then they couldn't pretend that I did not need the surgery.
    If I learmed one thing through all this: BE YOUR OWN ADVOCATE!
    Be informed and know your options.

    My Superior rotator cuff was retracted beyond the glenoid.

    If a year of rest and rehab has not made real change, get an MRI.

    R
  • 02-18-2013
    shredjunkie
    1 Attachment(s)
    Looks like I've joined AC separation club. Dodging around the outside of a waterbar, I cutback too quick catching my tire on the edge of the log, locking up the front wheel, and was sent flying over the bars and straight into the base of tree. The crash was intense: helmet and shoulder took the impact, stars and little birdies encircled my head, sunglasses blasted from my head landing six feet away. My Tallboy LTc sat in a crumpled heap 10 feet behind me, undamaged save the slightly misaligned bars.

    The least of my worries is the tree bark temporarily imprinted into my shoulder in the strangest bruising pattern I've seen. Although my shoulders look to still be level, I've got sore bumps both on the shoulder in the typical AC injury location as well as on my collar bone just off center in the front far away from the impact location. Sore muscles and slight swelling extend across my my entire upper back. Two days in and I feel like I was run over by a truck.

    Has anyone else experienced such a wide range of impacted area without the usual evidence of actual separation besides a small bump on my shoulder? Seems the entire right side of my upper body was compressed by the impact resulting in strain on the entire shoulder/neck/back structure rather than just the AC. My sports doc is open again for business tomorrow, so hope to find out more then. In the mean time its ice, advil, and rest for me. At nearly 44, I might be getting a bit old for this.

    Below my new tree bark temporary tatoo. If you know your trees, you'll recognize it as an oak.

    Attachment 773381
  • 02-18-2013
    Ricisan
    If you have any doubts, get an MRI.
    Mine was $550, Kaiser refused to reimburse me. lmfao
    I had no visible damage, other than a dent where
    my rc was torn.
    If they find enough damage, it becomes a
    Medical Necessity and they have to do the surgery!

    R
  • 02-19-2013
    shredjunkie
    Quote:

    Originally Posted by shredjunkie View Post
    Looks like I've joined AC separation club. Dodging around the outside of a waterbar

    Just a quick update. I was very fortunate. X-rays showed no AC ligament damage or bone fractures. The pain on the front of my chest was simply from the strain put on the clavicle, and looking at the model of the shoulder in the docs office it was clear how the force would travel from the AC joint down the clavicle and strain that connection.

    To those less fortunate in their injuries, I feel for you. Best wishes a
    and a rapid recovery to all.