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  1. #76
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    Dude,

    If you are still suffering from pain after 10 weeks, you need to see a good shoulder ortho today. You may have some other issues other than a separated AC joint. You should be able to return to activities after 6 - 8 weeks with little or no pain if the separation was a mild one. Good luck!

  2. #77
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    Here is my shoulder story. Last August (08) I dislocated my shoulder, it was out of the socket for a couple minutes and slid back in on its own. Being the stubborn (stupid) man that I am I chose not to go to the doctor. Basically just rested and worked on range of motion for a couple months. I tried lifting weights again this winter only to reaggrevate something in there, laid up for another few weeks.

    A couple days ago I took a pretty mild spill, arms outstretched to brace for impact. I felt the shoulder pop out a couple inches (out the front side) and as I was getting back up it it slid back into place. Not really much pain, I contemplated to keep riding. Now the rear of my shoulder is sore, and am kinda back to square 1.

    Does anyone have a link of exercises I can do to strengthen the entire shoulder. I travel a lot for work (months at a time) so its not the easist to get into a doctor or a regular PT program. Thanks for any insight given!

  3. #78
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    BTDT... Type 3 separation after flying over the handlebars going downhill in a race.

    I researched the hell out of this injury and read every article I could on it. Visited three orthopedic docs, all told me to let it heal on its own and see how I do. Six weeks of PT, and about 6 months later it was 90% of the way back to normal (normal being full range of motion and strength), a year later I was probably 98%.

    Will always have that hideous bump though. There goes my modeling career.




  4. #79
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    Shoulder Separation is different from Dislocations

    LAXCARP,

    You seem to be suffering from shoulder dislocations and this is a much different problem than a separated shoulder. There is a real limit to how much you can strengthen the shoulder to keep the shoulder socket from popping out, there are ligaments and other structures in the shoulder joint that hold the shoulder in place and these can get stretched and damaged when you pop the shoulder out. The bad news is that while proper PT will make your shoulder feel better it may not make that much of a difference in your shoulder stability. The good news is that there is alot that a good shoulder ortho can do to tighten things up - but it may involve a surgical procedure to do so. Best of Luck!

  5. #80
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    Just did myself a grade 2-3 AC separation yesterday while practicing 4x at the BMX track. You know, dumb crash because of a big round rock that rolled on the track accidently. Doctor said, after the X rays confirmed no fractures, to wear the sling for about 2 weeks and go to PT. Right now, the pain is not to bad, and I have a pretty good range of motion even if I feel limited in a couple of position.

    Any tips on what to do for sleeping, as it seems to be the worst part for me yet. Do you keep the brace on for sleeping?

    Thanks guys and fast healing to everybody.

  6. #81
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    Quote Originally Posted by zoro
    Just did myself a grade 2-3 AC separation yesterday while practicing 4x at the BMX track. You know, dumb crash because of a big round rock that rolled on the track accidently. Doctor said, after the X rays confirmed no fractures, to wear the sling for about 2 weeks and go to PT. Right now, the pain is not to bad, and I have a pretty good range of motion even if I feel limited in a couple of position.

    Any tips on what to do for sleeping, as it seems to be the worst part for me yet. Do you keep the brace on for sleeping?

    Thanks guys and fast healing to everybody.

    By the sound of it you have a fairly low grade separation for 2-3 since you can lift your arm at all at this stage. It took me at least a week to get my arm to shoulder level then I really had to work to lift to the sky. Do the physical therapy. After ripping your tendons/ligaments apart, the only thing that holds your shoulder in position is the strength of the muscles. Strength training for the shoulder became much more important to me after the separation.

    Sleeping was definitely the worst (with the exception of getting up off the floor from a lying position). The first few nights I tried sleeping on my back on some inclined pillows and could at least lean toward the side. After a while I got a really thick (firm) pillow that holds your head and neck up high off the bed. This takes a lot of the pressure off of your shoulder wanting to fold over.

    Two years out and still sometimes I get up and feel that I put too much stress on the shoulder while sleeping.

    Good luck, maybe you will heal fast.

  7. #82
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    Zoro,

    kmacon already gave you some great advice. Some stuff I would add to the mix is this:

    1. Try to get yourself off the sling as soon as you can. Only wear it if you feel discomfort.
    2. Start slow but try to recover your range of motion sooner rather than later.
    3. Be diligent about PT.

    Monitor the progress of your recovery. You should not be in pain after 4 - 8 weeks, you may still have some strength deflicit in the injured shoulder, but you will eventually work this out. If you are experiencing significant discomfort or have not regained your range of motion, you should consult with your doctor again. Also before you start doing strength training, you should get cleared by the PT or Doctor.

    While the shoulder will heal over time, you may have lost some (Grade 2) or all (Grade 3) of the ligaments that hold your shoulder together. Strength training will be key to you being able to return to your sport. You may also need to alter some of the things you do for strength training, i.e. NOT doing the bench press or at least modifying it since this excersize places such stain on the AC joint. Consult with a good sports trainer about how to proceed.

    Good luck.

  8. #83
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    Thanks for the support and tips guys!

    As for the sling, RacerX58, I thought having it stabilize your shoulder was supposed to be an important part of the healing process, as it helps to put everything 'in place' together again. I would feel comfortable to go on with my day without it, but I don't know if it's a good idea yet.

    Right now, (2 full days after the crash), I can move arm shoulder high without pain in most positions, except when moving it backwards. Pain mostly comes when I do a sudden move or try to lift something.

    Last question: when should one start the PT treatment? I know it varies from individual to individual, but what would be a rough guideline??

    Thanks again!

  9. #84
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    Zoro, it is important to use the sling - but if you use it too long - you may get some painful adhesions when you start using your shoulder again. So try to reduce your use of it, key here is that you do not feel discomfort. Another thing to consider is the position of your shoulder, chances are your shoulder is pulling a bit forward because your muscles are trying to support it. You might experience some tightness because of this. A person familiar with muscle release therapy can help you with this and it will really make you feel more comfortable. Just make sure that the person knows how to treat arm and shoulder injuries.

    As for PT, it varies quite a bit and you seem to have medium grade shoulder separation of either a type 2 or 3. If it is a type 2, you could return to activities and begin more active PT at 2-4 weeks, if you really have a type 3 - then it can take 6 - 12 weeks. It really has to do with your level of discomfort and the types of excersizes you can do. Range of motion stuff you can do as soon as you can tolerate it. But in general don't hurry and don't push yourself to get your strength back. The first 6-8 weeks of recovery from an injury is very important, so let your body heal. Here are a couple of links you might find useful:

    This is an excellent source of information about AC separations.
    http://www.uptodate.com/patients/con...8Xm8h.pwl70pNy

    This is a link with rehab excersizes that you may find beneficial
    http://www.med.umich.edu/1libr/sma/sma_shldsep_rex.htm

    This is a recent article about Grade/Type III AC separations and treatment
    http://www6.aaos.org/news/pemr/relea...releasenum=788

    Take care,

  10. #85
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    Thank you very much for the links and the tips (especially the one with the exercices). As for the position of the shoulder, you might have touched a point there. I just don't know if the position I have it in in my sling is the proper position to adopt. Seems to induce more pain when I am in the sling than when I have it loose.

    Will try to consult for that, or call PT maybe to schedule an early appointment in order to have tips for the use of the sling etc...

    Happpy healing to everybody (if there is such a thing...)!

  11. #86
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    Quote Originally Posted by racerx58
    Zoro, it is important to use the sling - but if you use it too long - you may get some painful adhesions when you start using your shoulder again. So try to reduce your use of it, key here is that you do not feel discomfort. Another thing to consider is the position of your shoulder, chances are your shoulder is pulling a bit forward because your muscles are trying to support it. You might experience some tightness because of this. A person familiar with muscle release therapy can help you with this and it will really make you feel more comfortable. Just make sure that the person knows how to treat arm and shoulder injuries.

    As for PT, it varies quite a bit and you seem to have medium grade shoulder separation of either a type 2 or 3. If it is a type 2, you could return to activities and begin more active PT at 2-4 weeks, if you really have a type 3 - then it can take 6 - 12 weeks. It really has to do with your level of discomfort and the types of excersizes you can do. Range of motion stuff you can do as soon as you can tolerate it. But in general don't hurry and don't push yourself to get your strength back. The first 6-8 weeks of recovery from an injury is very important, so let your body heal. Here are a couple of links you might find useful:

    This is an excellent source of information about AC separations.
    http://www.uptodate.com/patients/con...8Xm8h.pwl70pNy

    This is a link with rehab excersizes that you may find beneficial
    http://www.med.umich.edu/1libr/sma/sma_shldsep_rex.htm

    This is a recent article about Grade/Type III AC separations and treatment
    http://www6.aaos.org/news/pemr/relea...releasenum=788

    Take care,
    thanks for this list. very useful after today
    mike

  12. #87
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    Here's one more update at 1 year. I had a Cat 3, did no surgery. About the only type of movement I can't really do is wide grip pull ups. That kind of movement makes the end of my collar bone hit the little process that it used to be attached to on my scapula. Otherwise, full recovery. And I don't have to worry about injuring the joint again...as it does not exist. If you are thinking of surgery, that was the big reason my Ortho recommended against it. If you are likely to injure the shoulder again and it is surgically fixed, you run the risk of blowing up that surgery.
    Slowly slipping to retrogrouchyness

  13. #88
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    I did my shoulder in 3 months ago now, and the worst part it was because I was going too slow while exploring new routes to take some friends on. I hit that root so bad off of that little hop that I even bent my front forks. Sling was on for 5 weeks ( at which point only 60% healed according to the doc)

    Sleeping is still the rough point for me after 3 months. I find that some nights I must be tossing too much and when I wake it feels like my shoulder has shifted a bit out of place. Gonna ask the doc today about it as those days I feel I need to pull on the shoulder to get it to sit right and then I can get full motion. Still could be the healing process as the doc say it was a grade 3 and the only true way to fix it is to put a pin in but like the others above stated he doesn't recomend it.

    At the 3 month mark I am riding (pavement only) again and playing ball ( just can't cannon the ball anymore ). Still have yet to get up the nerve to hit the trails though as I don't want to do my shoulder in worse, as I am not a spring chicken anymore.

    The only good thing was the 5 weeks in a sling was that my wife was actually nice ( as nice as a sarcastic wife can be anyways) and even opened my beer and brought it to me.

    Glad I found this thread though.

  14. #89
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    Quote Originally Posted by Frosti
    I did my shoulder in 3 months ago now, and the worst part it was because I was going too slow while exploring new routes to take some friends on. I hit that root so bad off of that little hop that I even bent my front forks. Sling was on for 5 weeks ( at which point only 60% healed according to the doc)

    Sleeping is still the rough point for me after 3 months. I find that some nights I must be tossing too much and when I wake it feels like my shoulder has shifted a bit out of place. Gonna ask the doc today about it as those days I feel I need to pull on the shoulder to get it to sit right and then I can get full motion. Still could be the healing process as the doc say it was a grade 3 and the only true way to fix it is to put a pin in but like the others above stated he doesn't recomend it.

    At the 3 month mark I am riding (pavement only) again and playing ball ( just can't cannon the ball anymore ). Still have yet to get up the nerve to hit the trails though as I don't want to do my shoulder in worse, as I am not a spring chicken anymore.

    The only good thing was the 5 weeks in a sling was that my wife was actually nice ( as nice as a sarcastic wife can be anyways) and even opened my beer and brought it to me.

    Glad I found this thread though.
    Hey Frosti, I'll give you my opinion, but you know what they say about opinions...

    First, three months in a sling? Ouch, that would really suck. That's a lot to go through to get your wife to open your beers for you.

    With Grade 3 separation what is done is done and its not going back together no matter how long you baby it. All you are waiting for is for torn and bruised muscles to heal after a Grade 3. No ligaments/tendons etc. are going to magically reconnect. The only thing you can do now is to strengthen the shoulder muscles so that they can do the work that the blown joint used to do (ie holding your shoulder in place). If you have not done any physical therapy and been shown what exercises to do then you need to get to it pronto.

    At this point you should be OK to hit the trails again. If not then it is more than likely because you have lost muscle and strength due to using the sling too long.

    Grade 3 management = Exercise, Exercise, and more Exercise

    Good luck and happy trails.

  15. #90
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    I had a completely separated shoulder (not sure the grade; heard from one doc it was a grade 3, from another a grade 6), all to say, it was completely messed up. My neighbor is a Orthopaedic surgical assistant and she took a look at it and sent me to the ER immediately. She got me in a 8 a.m. on Monday morning to see her Ortho. His suggestion was the same; that they just let scar tissue form and surgery is only done if you are a high level athlete. My biggest suggestion is to be patient and let it heal. However, start PT as soon as possible with a certified PT tech. It helped me tremendously and I have all my flexibility and strength back and only have a big lump on my shoulder to show for the injury. Occassionaly I get a little slight pain if the weather is bad. Must be arthritis setting in. Best of luck to you for a speedy recovery.

  16. #91
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    Man I'm glad I found this thread. I just found out yesterday that I have a minor AC separation. The doctor didn't tell me the grade, but it's probably only 1 or maybe 2. I don't have a noticable lump, and I've got pretty good range of motion. We figure it happend about a year ago on a pretty good crash, but it just flared up real good 5 days ago bouldering. Same consensus on no surgery unless it gets much worse. Man I hate taking time off the rocks and even worse is time off the bike, but it sounds like that's what I have to do at this point to keep it from getting worse.

  17. #92
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    Hello everybody, my first post at the MTBR forums although I've been reading around for quite a while.

    Had a grade 3 separation one and a half week ago, I went over the bars from taking an unintended 1 meter drop onto a sidewalk. I have opted for the surgery after having read up alot before my decision and although I'm pretty much trading a lump for a scar (and a couple of additional months of rehabilitation) I still feel it's what I want. I'm 23 years old and having the surgery done on Tuesday. I'm not sure what procedure it will be but I will report back here later since not many of the riders here seem to have chosen the surgical route.

  18. #93
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    Hi all, suffered a grade III AC seperation five days ago.Doctor advises against surgery at this point.I did enjoy doing recreational powerlifting in my spare time and I'm concerned I will have to give this up now. Has anyone been able to resume heavy lifting after this type of injury even after a year or two? Thanks.

  19. #94
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    Separated mine yesterday (grade III), coming up short on a double and goin otb. Glad i found this thread. Thanks for all your stories.

    I gotta say it was one of the most painful injuries i've had. The ortho doc shot me up with some cortozone with novacain today... it's helped the pain a ton. I can actually lift my arm now. The hard part is... i also fractured my wrist . Should be a challenging recovery.

  20. #95
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    urt Collar bone bad in China today. Doctors no help. Need MTBRs advice. Hurts so Bad
    I have been riding my new cobia for 2 weeks now. Like 80 km a day weekdays after not riding for 8 years andbeing out of shape. Someone burglularised my home and stole 8 years of my life work 3 weeks ago I decided I was going to bury ky self in my mountainbiking, get my healthback and now today the worst thing happened.

    First woke up and am scared my youngest child might have the pigflu as he is showing flu symptoms...

    Then I left and rode 35 kilometers on one of my fastest commutes and had an accident. I was in a small back alley street and I saw this guy on the side of the road trying to walk out in front of me it looked like on the shoulder of the road..

    Then blam I hit a speed bump the same color as the street.. totally missed it and indo'd over my front handle pars feet locked in place and slammed head and shoulder into the pavement.

    The Chinese walked around me as if nothing happened. I walked for about a kilometer then felt the most horrific pain I have ever felt.

    Went to the hospital.. and then the doctors tok an exray and said somethinglike two tendons n my collar bone were ripped and I would need a surgery. First they said 10-15000 rmb, then their boss came in and saw I was a foriegner and was like "oh no... thats like 25000 rmb"

    This is some serious cash. I can tell you that this hurts soo bad. They gave me morphine and some other pills Celecoxib.

    That didnt really do anthing that I can tell. I cant stand up and have to hold my arm up and out words of my body in order to not feel any pain... I mean not bad pain. Even when I walk. MY woman has to hel me piss as I cant doi it myself. They put some kind of harness on me and a free hanging splint. I am under the impression they dont know how to make splints because I cant do anything unless Ihold my arm up with my other arm.

    I need You help.

    Can you help me with the following questions?

    1)I can attach a picture of the x-ray and can someone tell me the name of what I have in English?

    2) Whats a good a good painkiller,

    3) how to make the proper splint?

    4)and is an operation necessary?


    And what is it that I have in English?

    The google translation says:

    "The right shoulder is sorrowful place right shoulder lock joint space widened, distal clavicle upward shift"

    I hurt so bad. i need to take care of my two children and 25000 is so much/

    5) Will I ever be able to ride again?

    6) It hurts so bad.. when will it stop hurting?

    Thanks for your help

    Robert ...

    Dead sad. Hurting.
    Attached Images
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-smaller.jpg  

    Ac Separation (shoulder Separation)-img_0002.jpg  

    Ac Separation (shoulder Separation)-img_0001.jpg  


  21. #96
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    Good job! Wow!

    Robert,
    You've had a bad spell.
    First, don't panic about your son. I believe that China has the vaccination for H1N1, as well.? I have known a lot of people that have contracted it and they are all fine now.

    1. Broken Clavicle (collarbone)
    2. Vicodin - Pain Reliever/Anti Inflamitant
    Motrin
    3. How old are you? If you are concerned about the physical appearance you can get surgery and or use a brace. I did this exact break this summer and it just takes time. Put your arm in a sling and leave it there for 2 weeks. Find a good physical therapist.
    4. So, NO! It is not necessary to have an operation.
    5. Absolutley, you'll be riding after 6 weeks. Be careful! IT doesn't completely heal till about 4-6 months.
    6. Yes, it will stop and might be as you are reading this. Get/make a sling, soon!


    The healing that has to occur is the gap you see in your x-ray has to fill with bone. If youu were to go back in 6 weeks you'd see a cloudiness developing between the two bones that used to be one.

    I hope this helps? P.M. me if you have any further questions.

    Things should be brighter for you soon...good healing!
    [SIZE="2"]"You don't stop playing because you get old, you get old because you stop playing!" - Unigeezer [/SIZE]

  22. #97
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    Robert,

    Looks like a grade 3 separation. I don't see a fracture. Typically there will be some soft tissue trauma with these and and that is where the pain comes from. There are three ligiments that hold the clavicle down. From the look of the x-ray, you may have ruptured all three. Surgical options for this type of injury for for looks only. Very little gain in function (if any). It will take several weeks (6-8) to be pain free. Start taking Ibuprofen right now. Take 800mg every 8 hours for at least 10 days straight. A little tough on the stomach, but it will control the inflammation and help the rehab. Start doing active range of motion 5-7 days post injury. Sling your arm while sleeping so you don't reinjure in your sleep. Your pain will be your limiting factor while your awake so don't worry about the sling then. I don't reccomend surgical options as there are very little gains for your troubles and you also risk surgical site infection and post surgical arthritis. Many hockey players have this same injury to both shoulders and still keep playing. I had a similar accident about five years ago and was back on the bike in about three months riding hard. I had several broken ribs also and that was what took the time. Hang in there. Tincture of Time will heal this. Do your physical therapy. Good luck.
    A beginner since 1976

    I still have to explain to my wife how a 46 year old likes to get down and play in the mud.

  23. #98
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    Any of you all with type 3 Separations, feel the need to wear any kind of shoulder brace device, now that your back on the trails riding? My doctor said it was a personal preference thing, and didn't think it was needed, unless I felt more comfortable with one on. I'd like to hear other riders opinions/experiences, though.

  24. #99
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    Quote Originally Posted by Dominator13
    Robert,
    You've had a bad spell.
    First, don't panic about your son. I believe that China has the vaccination for H1N1, as well.? I have known a lot of people that have contracted it and they are all fine now.

    1. Broken Clavicle (collarbone)
    2. Vicodin - Pain Reliever/Anti Inflamitant
    Motrin
    3. How old are you? If you are concerned about the physical appearance you can get surgery and or use a brace. I did this exact break this summer and it just takes time. Put your arm in a sling and leave it there for 2 weeks. Find a good physical therapist.
    4. So, NO! It is not necessary to have an operation.
    5. Absolutley, you'll be riding after 6 weeks. Be careful! IT doesn't completely heal till about 4-6 months.
    6. Yes, it will stop and might be as you are reading this. Get/make a sling, soon!


    The healing that has to occur is the gap you see in your x-ray has to fill with bone. If youu were to go back in 6 weeks you'd see a cloudiness developing between the two bones that used to be one.

    I hope this helps? P.M. me if you have any further questions.

    Things should be brighter for you soon...good healing!

    Thanks for your advice...!

    I am happy to say that I dotn think anything is broken... Im not going with the operation for a lot of different reasons.. but most have said it is not necessary. Its not so disfigured... after 2.5 weeks It is still pretty week but I am gettign the feeling Id like to ride a little...


    Took bufferin, and ice... and wrapped it with a horse collar like brace...

    Have to say the brace helped the most.

  25. #100
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    Quote Originally Posted by guero grande
    Any of you all with type 3 Separations, feel the need to wear any kind of shoulder brace device, now that your back on the trails riding? My doctor said it was a personal preference thing, and didn't think it was needed, unless I felt more comfortable with one on. I'd like to hear other riders opinions/experiences, though.
    I feel much better wearing a brace... I am on 2.5 weeks and have not ridden yet.. I have this brace that wraps around both shoulders and velcros in the back. First I have my woman wrap the shoulder and diagonal across my chest. I take off the brace at night after work and put it on in the morning. Seems to have helped... I feel much mroe invincible with it on.l I can see the strength slowly returning. I ahve rasied my hand up twice since the accident.. once yesterday and once 5 minutes ago.. Couldnt even think about doing that last week. Id say wear the brace to you have full strength.. I definately dont at 2.5 weeks but am feeling like I would like to try riding the bike for 10 miles or so.... but at the same time in the middle of the day' when it aches I can easily realise its too soon to try to ride. I would hate to ride ten miles and be stranded in pain or roll back the clock on the healing process..

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