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  1. #651
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    May I play too?

    Went over the bars 2 1/2 weeks ago and landed on my shoulder. Grade 3+ AC separation. Ortho doc wants me to have an ortho surgeon look at it because the bump is pretty big, but he's been booked up. Hopefully I can get by with just PT.

    The pain has pretty much gone away except when I lift anything over 30 lbs. I can sleep on my right side again.

    I hope you guys are doing well.
    Tequila is a pallid flame that passes through walls and soars over tile roofs to allay despair. A. Mutis

  2. #652
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    Dos and Don'ts

    For those with Grade 3 (and below) separation (without surgery), did your PTs advise what exercises to avoid, and those that would help in strengthening the surrounding muscles? I am referring to the stage where rehab has been completed, perhaps several months post-injury.

    Would push ups, pull ups, swimming, bench/military presses aggravate the joint after "complete recovery". I am thinking in terms of how biomechanics could put (repetitive) stress on the joint. Some say that overhead motions should be avoided. That would mean swimming front crawl, overhead presses and pull ups. Any truth in this?

  3. #653
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    Quote Originally Posted by Rustiee View Post
    For those with Grade 3 (and below) separation (without surgery), did your PTs advise what exercises to avoid, and those that would help in strengthening the surrounding muscles? I am referring to the stage where rehab has been completed, perhaps several months post-injury.

    Would push ups, pull ups, swimming, bench/military presses aggravate the joint after "complete recovery". I am thinking in terms of how biomechanics could put (repetitive) stress on the joint. Some say that overhead motions should be avoided. That would mean swimming front crawl, overhead presses and pull ups. Any truth in this?
    I had a grade 3 a little over 2 years ago, and found swimming a great help in my rehab. Started off going back to breaststroke, then freestyle, finally butterfly. All with the blessing of my PT at the time.

    Swimming better than ever now.

    My earlier post on this is here: Ac Separation (shoulder Separation)

  4. #654
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    I was diagnosed with a grade 5 AC separation 1 week ago. My orthopedic surgeon recommended surgery and I agreed. He also recommended using the Arthrex dogbone for the procedure. Have any of you had this procedure done? My limited search indicates it's a relatively new method but it seems promising.

  5. #655
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    Quote Originally Posted by hlmrspd View Post
    I was diagnosed with a grade 5 AC separation 1 week ago. My orthopedic surgeon recommended surgery and I agreed. He also recommended using the Arthrex dogbone for the procedure. Have any of you had this procedure done? My limited search indicates it's a relatively new method but it seems promising.
    I dunno anything about it, but it sure looks good. Reminds me of those really cool hi-tech replacement lumbar discs some German outfit came up with about 5 years ago......titanium, carbon fiber mesh, latest gen. elastomers; made wish that I was German and that I had a blown disc......almost.

    Good luck with the procedure. If you have never had shoulder surgery before, be ready in advance for the post-op pain. It can last for a couple of months, in some cases, before it subsides to a less-than-opiod level.
    I'm trying very hard to be a good boy and rehab the latest AC separation on my already reconstructed shoulder, because, a) I really can't afford either the additional debt or the down-time, and b) the last shoulder surgery I had was a real biatch to deal with. I got a good 4" scar from that one. Lots of sensory nerves pass through that area.
    Re-Cycled Person who rides a mountain bicycle.

  6. #656
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    My repair was very similar but with a cadaver tendon. This is a living repair which is better as far as durablity. ( thats what I have read and was told by the doc). If the cord breaks with use your back to grade 3 instantly. So far I am doing great. I still work out more than I use to but thats not a bad thing. My shoulder is 98% normal now the only thing holding it back is total strenght which is coming along good but not 100%. It has been a year on 11-20-13 since my surgery. It is a long slow recovery with a living repair because of the growth of the tendon into a new ligament which can be as strong as the original according to some.
    I didn't have very bad pain with my surgery (pain yes but no drugs after the 3rd day execpt advil) Good luck with your surgery!

  7. #657
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    Ugh, separated shoulder from a crash this Monday. Not sure on the severity level yet, as diagnosis was in immediate care first after the wreck and a follow up appoinment with my PCP tomorrow morning. Man this feels odd.....small ache at rest, big, sharp pain if I lift it. Weird lump on shoulder that tipped me off on something wrong with it when I felt the lump pushing into my Osprey pack's strap.

    Not looking forward to being down, but will deal with it head on. At least it is winter and I should be staying off the trails anyways. Just not thrilled with this. Thanks for this thread as it is encouraging to read the comments.

    Damn, this post took way too long to type!!!
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  8. #658
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    Thanks to all that have posted in here about recovery. Definitely a good read.

    I'm almost 4 weeks out of surgery from a high grade 3 separation. I had also tore my labrum. I'm feeling pretty good, just some soreness and some odd feelings when I move it wrong. Its been hard for me to isolate my arm and even though I'm in the sling, I still use it quite a bit. I am definitely careful, but I figure if I'm not experiencing any pain, I'm probably not hurting anything. I don't lift anything with it.

    The hardest part is just making the time go by. I'm out of work for another 3 weeks as I need both arms to do what I do for work. I've been going with friends to cyclocross races on the weekends which definitely helps with my sanity. Its also a bummer because I want to be out there racing, but I'm confident in my recovery and that I'll come back stronger next season.

    I have a follow up in a couple weeks and hopefully I'll get the sling off and be able to get back to work. I'm not sure when I'll be cleared to ride again, but I can't wait to get back on a bike. It feels like my fitness is waning and my arm strength is wasting away. Thats the hardest thing for me to accept. I'll post some updates as things progress.

  9. #659
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    Just an update, I have a grade 2 separation, and as per my doc, on the higher side of the 2. Regardless, he suggested no suregery and cited a 75% success rate of just rehabing for this level of separation. Surgery can always be the backup if this doesn't work out.

    Today is one week to the day since my injury, and I have actually had some progess yesterday and today with ROM and overall pain level. I'm just antsy. He advised that I give it 6 weeks of playing it really careful to not injure it further, and another 6 weeks of easing it into daily use and normal activity.

    Oh well, I'll the hitting the exercize bike over the winter months that I am down, am thinking of selling my bike and saving for the other one I want, and having that be my intro back into it with a first ride on a new whip!!!! Hell, I won't be diverting my funds to upgrades on my current ride, as it won't be used for the next couple months!

    - "The true object of all human life is play" - GK Chesterton
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  10. #660
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    I had a grade 4 separation from a taco grande on a downhill on 9/13/13. ER trip, x-rays, and meds with an ortho shoulder expert on 9/16/13. Activity and mobility was very limited over the weekend. Ortho gave me another anti-inflammatory and recommended the conservative approach which had me in PT for 4 weeks before next evaluation. Immediately after I took new meds, pain disappeared and I was able to get active again; jogging, lifting, yoga etc.... I couldn't do any push up or pull up type movements though. Through the 4 week PT, I was able to regain all ROM and throw passes with a football at the same velocity as pre-crash. Bump, lack of strength, loose feel to shoulder when doing push up moves, inability to do pull ups, major drop in shoulder position, increased chance of arthritis, etc. had me opt to get my shoulder fixed surgically. 10/21/13 was the date. 2 screws, a cadaver tendon, and 5 scars later (biceps tendon repair as well) the job was done. Woke up with a sling and ice machine on and ready to go. Nerve block set to last 24hrs from surgery. Once it wore off, the pain was ridiculous. Oxycodone didn't come close to touching it, however once past the second day, it wasn't that bad. Pendulum swings and arm curls for the first 10 days till first post op visit, then phase 1 PT - stretching ROM stuff. Sleeping sucks, i was in a recliner for 30 days. Then, i had to force my way to bed because my lower back and hamstrings were all kinds of jacked up. i woke up every 2 hours, then every 4 hours, then 6 until i was able to sleep though the night. Slow process. Physically and mentally grueling. Atrophy sets in, so you want to start doing more, however the healing process isn't ready for more yet. About 6-8 weeks out, when the sling is off and you have healed enough, you will be able to do more PT. I am curling with up to 25lbs now, doing tricep extensions, and benching about 50lbs. Over 300 before surgery. This is only due to being very cautious not to destroy the repair. More to follow as I go through PT. 1/11/14 update. The bike has been repaired! And, it will be a recreational bike going forward. Full suspension in my future. I'm up on my 12 week post op review. Current state: Most regular daily functions are no issue. Cross body ROM is still not good. It is no more than 50%. I can throw a football again. Nowhere near the velocity or distance as pre-surg though. I also stated playing basketball again, shooting the ball no further than the free throw line. I am curling 35lbers and benching over 70lbs. 3 sets of 10. These will continue to increase as I get back into the gym. I also started doing pulldowns and can easily get over 100lbs. The weakest muscles seem to be the pecs and triceps, since you don't use them to push off when in the sling. They will need the most work to get back the strength. As for pain, there is a dull throb every other day or so and when I work it real good. I also have sharp nerve pain and pain from busting through scar tissue from time to time. Full size and definition of muscles have not been achieved yet, however I have recovered a good deal back since the onset of Atrophy. Massage and chiropractic work are the next stage of rehab for me. More to follow....
    Last edited by Jmartin78; 01-11-2014 at 09:16 AM.

  11. #661
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    Ac separation

    Pics of my bike and before/after surgery
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-image.jpg  

    Ac Separation (shoulder Separation)-image.jpg  

    Ac Separation (shoulder Separation)-image.jpg  


  12. #662
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    I read the heck out of this thread post injury and have been hearing voices telling me to take a moment and share my experience. If you have spent anytime reading this thread you will see opinions on both sides of the surgery/no surgery debate. I am not trying to sell you either way. It is nice to hear that some have skipped surgery and say they are now back to 100%. I personally opted for surgery. My type 3 happened May 31, 2012 and I had the "ac graft rope" procedure on June 4, 2012. I did a lot of reading in those four days. What ultimately swayed me was the fact that my surgeon had the same injury and surgery. He tried going 6 months and didn't like the results he was experiencing. The day before my surgery my shoulder's pain was almost non existent so it seemed counter intuitive to be going under the knife. Of course when you lose all of your connective tissue there is nothing left to hurt. I am now fully functional in every way and my strength is at 100%, but I wont lie to you, I think I will always know that I separated my shoulder. I wouldn't describe it as pain so much as sensation. The procedure I had is very invasive. Stuff gets cut, drilled and screwed, so yes, you are going to feel it. I was in the sling for 8 weeks. When the sling came off, I began to realize just how much work lay ahead of me. You have to be patient, that is for sure. Push too hard and you set yourself back. I learned that the hard way more than once. By September I was taking easy rides and had regained a good bit of ROM. I remember that first December though being very paranoid about falling on skis. Fall I did and nothing bad happened. By late winter early spring of this year I was feeling so much better. This years riding season, it was a non-issue. I have crashed (although not right on to my shoulder) and been punched by my son (in the shoulder) with no ill effects. Some days my shoulder is stiff, other days it is pretty normal. I have a scar but no bump. ROM is 100%. Although my shoulder joint doesn't feel like the one I was born with, I am optimistic that it will continue to improve. Whatever decision you make, keep your head up. It gets better with time.

  13. #663
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    AC joint separation type ?

    Hi all,

    I just wanted to thank you all for this very helpful thread. Lots to learn here about AC injury.

    It seems I am also coming to the AC injury club. But I hurt it on my gym day doing bench press. At first I didn't think much of it. Shoulder pain is something I live with for a long time. This time pain was sharper and lasted longer. Nevertheless I continued with my training for a next 3 weeks. Going out on bike and doing heavy lifts.

    But, suddenly I noticed that I have a small bump on my right shoulder. That"s when I knew something is really wrong. I searched internet and...

    I have full RoM. I have o pain when moving my hand , but I can hear popping sounds when moving shoulder in certain way.

    I will see my doctor in 2 days and we will make x-rays. Than I will know for sure...

    Here are 2 pictures you can look. If you have any comment as what else this injury could be or how severe I would appreciate it very much. I will post my results in 2 days.
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-ac-22.jpg  

    Ac Separation (shoulder Separation)-ac-11.jpg  


  14. #664
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    Quote Originally Posted by Igik View Post
    Hi all,

    I just wanted to thank you all for this very helpful thread. Lots to learn here about AC injury.

    It seems I am also coming to the AC injury club. But I hurt it on my gym day doing bench press. At first I didn't think much of it. Shoulder pain is something I live with for a long time. This time pain was sharper and lasted longer. Nevertheless I continued with my training for a next 3 weeks. Going out on bike and doing heavy lifts.

    But, suddenly I noticed that I have a small bump on my right shoulder. That"s when I knew something is really wrong. I searched internet and...

    I have full RoM. I have o pain when moving my hand , but I can hear popping sounds when moving shoulder in certain way.

    I will see my doctor in 2 days and we will make x-rays. Than I will know for sure...

    Here are 2 pictures you can look. If you have any comment as what else this injury could be or how severe I would appreciate it very much. I will post my results in 2 days.
    It could be that you tore your Labrum. My other shoulder may have this same issue. I injured it doing bench press in the gym. It makes all kinds of popping and cracking noises. I am waiting to recover from the AC before I look at getting this fixed. Good luck with your visit.

  15. #665
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    Quote Originally Posted by Jmartin78 View Post
    It could be that you tore your Labrum. My other shoulder may have this same issue. I injured it doing bench press in the gym. It makes all kinds of popping and cracking noises. I am waiting to recover from the AC before I look at getting this fixed. Good luck with your visit.
    JMartin thx very much for your post. I really didn't think of Labrum hmmm. Will have to check it. But are you sure that Labrum tear would cause this small bump on the picture?

  16. #666
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    I am curious on the labrum as well. I had a grade 3 separation 1 1/2 years ago and have the life long bump, last week I went over the bars landing on my elbow and did something to the same shoulder. I don't think I separated it again (if that's even possible). My problem is lifting my arm at all, there seems to be absolutely no strength and pain when I try but I don't have the same droop I had as when I had the separation. I am hoping I did not tear anything, weather is beautiful here and not riding & going to the gym is killing me.

  17. #667
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    No and I am not an orthopedic doctor. What made me say that was the noises that you have with it. I have the same thing going on and was loosely diagnosed with a torn labrum. By loosely I mean that the doctor examined the shoulder and determined it was not a rotator cuff and started leaning towards the labrum. X-ray and/or MRI will tell you what is going on. I haven't done that yet due to my still dealing with my other shoulder recovery. AC joint is usually from a direct impact to the shoulder. Benching doesn't typically cause that injury.

  18. #668
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    I just joined the club, somewhat unwillingly. Just wanted to say thanks for all the information it has been most helpful as well as comforting and scary at the same time.

    Basically what happened with me was my first time going down a fast DH track I cleared all the doubles except the last set. Went OTB and landed on head and RHS shoulder.

    Xrays show a class 2, maybe 3 separation of the AC joint. Physio and GP have both referred me to the orthopedic surgeon for a second opinion as to whether recover naturally with physiotherapy or do surgery. From all the reading I have doing here it sounds like natural is probably the way to go.

    Got away pretty lucky to be honest with usual soreness all over, hips, neck, fingers, and a very decent and long cork down my inner thigh from the bars. Was wearing a full face helmet and goggles there were scratches across the lens. Arm is in a sling for the meantime and only minor throbbing ache but still useable.

    In hindsight should have taken it more easily after spending all day riding up to top of the mountain, so going down a new track should have been a slower sighting lap given the fatigue after such a hot day of riding. Luckily we went in a few cars so my mate was able to drive my car home, since there was no way I could drive those twisty roads back to the bottom with stick shift, a messed up shoulder, and jacked up on painkillers.

    Got it on Gopro! It was probably what made me ride like a hero and crash though :/

    Take care on the trails everyone I'll be sure to share any updates in the following weeks.

    Ac Separation (shoulder Separation)-1560640_10151806857391813_1918467894_n.jpg


  19. #669
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    That's an awesome vid, not many of us have a record of our accident. I think you will be fine without surgery. I had a grade 3 and took the advice of the doc and opted to heal up on my own and live with the "bump". He mentioned that many people who have the surgery deal with terrible arthritis later in age. Its a tough frustrating road but do what your told & be patient with it.

  20. #670
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    Ac Separation (shoulder Separation)

    Holy sh!t did I wince on your video impact. Takes me right back there - aargh!

    Heal up!


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  21. #671
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    Thanks for the comments!

    I'm 10 days out from the injury and most pain has subsided just he dull ache here and there. Range of motion and strength is OK but I am not reaching above my shoulders or to the extreme left for now.

    Saw the ortho surgeon today he confirmed without doubt it's a class 3 separation. The shoulder and clavical are still fairly well aligned fore/aft so he recommended natural healing and to start physio no earlier than 1 month from now. The ligaments should scar over and my shoulder should stabilise somewhat in its current position if I strengthen the shoulder.

    So for the next few weeks I am just to take it easy, not do any overhead or far left reaching.

    Got a big race in just under 7 weeks hopefully I'll be right by then!

  22. #672
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    If you have access to a swimming pool or even better spa/Jacuzzi, works wonders in recovery for strength & range of motion. I am getting some strength back myself but still cannot raise my arm above shoulder height or reach across my body.

  23. #673
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    Unsure of local doctor. I need your opinions!

    I might have joined the club Friday morning, 1/24/14. I thought it would be great to ride in the snow... I hit some ice. You know the rest.

    The old doctor at my local clinic never touched my shoulder. She only looked at the x-rays and told me to sling it for 10 days and get an MRI if weakness and pain persists. She said I probably dislocated it and pulled/tore muscles. I'm not entirely convinced.

    I have copies of the x-rays. Is that gap at the end of my clavicle normal? Does it look like any of your lower level separations? I'm not sure since the clavicle isn't raised or anything. It's just not touching anything at the end. Hopefully I can get an appointment with my usual doctor in the next few days.

    Here's my x rays:

    Ac Separation (shoulder Separation)-peytonshoulder1.jpg

    Ac Separation (shoulder Separation)-peytonshoulder2.jpg

    Thanks for your help.

  24. #674
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    PTA wife says looks a bit jammed up but that could be swelling...says wont see fracture till swelling is down.... i had this pleasure back in 08 or so... good luck it sucks...

  25. #675
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    Hi Peyton I think that looks like a grade 1 separation or a sprain (when the ligament is stretched). As post above says, you may need to wait until swelling goes down before further assessment. In meantime stay off the arm and ice it regularly; take some over the counter anti inflammatories.

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