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  1. #501
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    Quote Originally Posted by giantfox View Post
    i have developed a major bump on my belly over the last 11 weeks.

    i think it might be connected
    Ha ha!

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

    Andy

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

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

  4. #504
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    13 and 1/2 weeks since the fall.

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

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

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

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

  6. #506
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    an interesting tale.

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

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

    No issues whatsoever...according to him

  7. #507
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    How bad was his separation? Glad you enjoyed it, not the story I wanted to be telling for sure.
    Just looking for info from non and cut guys. Thank you for yours.

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

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

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

    Stay tuned.

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

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

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

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

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

  11. #511
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    Quote Originally Posted by TranceX View Post

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

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

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

  13. #513
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    Quote Originally Posted by Andy17 View Post
    My doc said the opposite, surgery will move shoulder back into normal position and you will be 100%. .
    this is the great dilema.

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

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

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

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

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

    Good luck with your injury

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

  16. #516
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    Quote Originally Posted by giantfox View Post
    this is the great dilema.

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

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

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

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

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

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

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

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

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

  19. #519
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    No PT?

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

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

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

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

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

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

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

  21. #521
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    Quote Originally Posted by Teh Smith View Post
    I'm 47. Went OTB 9 days ago and received a level 3. Ortho Doc recommended non-surgery, but when I asked him about PT, he said not to worry about it, just let it heal naturally.

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

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

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

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

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

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

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

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

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

  24. #524
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    Hi All,

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

  25. #525
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    The Weakest Link!

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

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

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

    JMHO

    R

  26. #526
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    hi guys. this could be a very long post but i will try to keep it short.

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

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

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

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

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

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

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

  27. #527
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    Had surgery yesterday. Not too bad yet good drugs help. Dr said everything went good.

  28. #528
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    more physio

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

  30. #530
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    Quote Originally Posted by TranceX View Post
    For those of you considering surgery for a Grade 3 separation for cosmetic reasons here's what it looks like without the surgery.

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



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



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

  31. #531
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    I posted awhile back in this thread, but I can't remember what I said and I don't feel like looking through 22 pages to find out.

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

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

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

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

    So, I went under the knife just over 5 weeks ago. I was released from my immobilizer sling on Wednesday and started therapy on Thursday. Right now it's just stretching to restore range of motion lost from being immobilized for 5 weeks. I'm still in a decent amount of pain. Still popping percocet two or three nights a week. I'm limited to no lifting over 5 pounds for another 5 weeks, but I can already tell that all the popping and clicking is gone. Each day I feel much better. I'm optimistic that I'll be better off than prior to surgery. I think that having attempted the conservative approach with good results until I made things worse by crashing again puts me in a unique position to be able to assess the outcome of the surgical route vs physical therapy. I'll let you all know how things progress.
    Disclaimer: I no longer fix bikes for a living.
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  32. #532
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    that is an interesting post.

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

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

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

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

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

  33. #533
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    I did just fine without surgery for 5 years and would have gone many more had I not made things works.

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

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

    Riding was fine.

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

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

    Look for a a surgeon who specializes in athletes. My surgeon specializes in the shoulders of athletes. He also knows that being able to ride, ski and play with my kids are much higher up my list of priorities than work. I couldn't have found a more qualified doctor.
    Disclaimer: I no longer fix bikes for a living.
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  34. #534
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    One Year Later, I'm 95%

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

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

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

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

  35. #535
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    Quote Originally Posted by dwnhlldav View Post

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

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

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


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

  36. #536
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    Quote Originally Posted by G-reg View Post
    Please share the links if you find them. It sound like you are implying that a shoulder repaired via surgery will not have any arthritis problems.

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


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

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

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

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

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

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

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

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

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

    Disclaimer: I'm not a medical professional. This is a synopsis of my own personal research into AC joint reconstruction. I'd like to link all of my sources, but I replaced my computer since doing the research and lost many of the links. Should have switched to google chrome earlier...
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  37. #537
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    Quote Originally Posted by dwnhlldav View Post
    ... the latest technique is to remove 1cm from the end of the clavicle, and then use a hamstring tendon to rebuilt the ligament from the clavicle to the coracoid process. The tendon can either be from a cadaver, or your own. It's the same tendon used in ACL reconstruction....
    This is the technique I had done April 2011.
    I have fallen with my bike, as well as gone straight up over the bars, since then.
    I can say honestly that as I travel up and over, my thoughts do center around my shoulder and trying not to land on it.

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

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

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

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

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

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

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

  38. #538
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    Good info!
    Slowly slipping to retrogrouchyness

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    Quote Originally Posted by G-reg View Post
    Please share the links if you find them. It sound like you are implying that a shoulder repaired via surgery will not have any arthritis problems.

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


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

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    i'm still no further forward in forming a definitive opinion..

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

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

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

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

    I am 37 btw.

    Good luck and speedy recovery to everybody.

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    Oh and btw: My dr said that the ligament will indeed "fuse" back together on a grade 2. He didnt like the term regrow.

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  47. #547
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    Quote Originally Posted by Andy17 View Post
    Looks like mine.. Sorry your here. I'm 3 week since surgery now going to doctor tomorrow for 3 week check up.
    Thanks Andy! Let us know how the appointment goes/went.

  48. #548
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    Quote Originally Posted by wsmac View Post
    It's a long read but this whole thread is full of info on rehab and such.
    I started my story on page 12.

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

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

  50. #550
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    I got the go-ahead to start riding on the trainer. My doctor doesn't want me to risk falling for another few weeks so nothing outside.

    Now, I just need to find my trainer. I think I may have loaned it to someone...
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  51. #551
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    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..

  52. #552
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    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...
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  53. #553
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    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.
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  54. #554
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    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.

  55. #555
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    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.

  56. #556
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    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.
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  57. #557
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    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.
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    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!

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    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!

  60. #560
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    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.
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    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.
    Last edited by TranceX; 01-13-2013 at 12:40 PM.

  62. #562
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    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.
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    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.

  64. #564
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    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.

  65. #565
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    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!!!!

  66. #566
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    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.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  67. #567
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    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

  68. #568
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    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?

  69. #569
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    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

  70. #570
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    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?

  71. #571
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    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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  72. #572
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    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

  73. #573
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    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.

    Ac Separation (shoulder Separation)-arm.jpg
    Last edited by shredjunkie; 02-18-2013 at 11:10 PM.
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  74. #574
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    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

  75. #575
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    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.
    "He seems quite arrogant and ignores quite some valid points." -Millfox
    "I don't like you" -ne_dan

  76. #576
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    Well yesterday I endo'd pretty hard, the front wheel was completely pinned so it happened very fast. I was going about 15 mph at the time, and didn't even realise I crashed until I was on my back. Apparently I landed squarely on my right shoulder (glad I'm a lefty).

    Anyway after I rode home and very painfully removed my shirt(s!), I noticed my shoulder was hanging low, and my collarbone was sticking out, so obviously my shoulder was separated. Since it was Saturday, I went to the Urgent Care. They x-rayed me and referred me to an orthopedic surgeon. The doctor thought it was a grade 4 separation and would definitely require surgery, but obviously I will need the ortho's diagnosis and recommendation. I will schedule an appointment with an ortho ASAP on Monday morning.

    I am 31 and want to regain as much of my shoulder function if possible. Really bummed about missing spring/summer activities. Also, my mtb race schedule is totally thrown out. I just hope I'll be able to race Iceman on Nov 2. Also was hoping to do the Lumberjack 100 again, but that is now totally out of question.

    I have attached the x-rays I got at urgent care. They are not terribly clear, but if anyone has any comments on them please provide. Thanks to everyone else for providing their experiences, I'll be reading through them. I'll update my progress for the benefit of others who experience this common injury.

    Ac Separation (shoulder Separation)-separated_shoulder.jpgAc Separation (shoulder Separation)-separated_shoulder_2.jpg

  77. #577
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    Quote Originally Posted by WillTheGreat View Post
    Well yesterday I endo'd pretty hard, the front wheel was completely pinned so it happened very fast. I was going about 15 mph at the time, and didn't even realise I crashed until I was on my back. Apparently I landed squarely on my right shoulder (glad I'm a lefty).

    Anyway after I rode home and very painfully removed my shirt(s!), I noticed my shoulder was hanging low, and my collarbone was sticking out, so obviously my shoulder was separated. Since it was Saturday, I went to the Urgent Care. They x-rayed me and referred me to an orthopedic surgeon. The doctor thought it was a grade 4 separation and would definitely require surgery, but obviously I will need the ortho's diagnosis and recommendation. I will schedule an appointment with an ortho ASAP on Monday morning.

    I am 31 and want to regain as much of my shoulder function if possible. Really bummed about missing spring/summer activities. Also, my mtb race schedule is totally thrown out. I just hope I'll be able to race Iceman on Nov 2. Also was hoping to do the Lumberjack 100 again, but that is now totally out of question.

    I have attached the x-rays I got at urgent care. They are not terribly clear, but if anyone has any comments on them please provide. Thanks to everyone else for providing their experiences, I'll be reading through them. I'll update my progress for the benefit of others who experience this common injury.

    Sorry to read about your injury. If the Orthopedic Surgeon suggests a Weaver-Dunn or any version of the procedure, walk out and find a different doctor who is more up to date on the current fixes for AC separation. Refer back to my most recent post (prior to this one). What you want is a Anatomic Coracoclavicular Reconstruction using Semitendinosus tendon using either an allograft or autograft. The modified Weaver-Dunn is a success if it produces a joint that is 30% as strong as the original joint. The newer procedure, using a hamstring tendon to rebuilt the Coracoclavicular Ligament has been shown to reliably produce a joint with 85% to 95% of the strength of the original joint.

    I've had a lot of injuries. I hate to say it, but recovering from this surgery has been one of my longest recoveries to date. I had surgery on October 25th of 2012 and it's just in the last month that I feel I'm better than before surgery. So, 3.5 to 4 months. It is very important to be conservative for as long as the doctor recommends. There has also been a shift to a longer, conservative period. Previous thinking was that the rebuilt joint would be mostly healed in the 10-12 week post surgery period. More recent studies as pushing that out to the 14-16 week time frame. As the newer surgery uses a tendon to replace a ligament, it actually undergoes changes on the molecular level. Even though you will be feeling much better, the new ligament will be weakest in the 12-14 week period. It is a well understood phenomena as this is the same tendon used to rebuild injured ACLs.

    It's been a tough recovery, but I'm confident enough to say I'm glad I went under the knife. If you read my previous post, I lived with a grade 3 separation for 5 years, but a subsequent fall made it a grade 5 and there really wasn't much question that I needed surgery. Having gone through it, I would like to have had surgery much earlier, but if I'd done it after the initial grade 3, I would have had the less successful, older procedure, the Weaver-Dunn.

    PM me if you have any questions, or ask them here.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  78. #578
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    As I've mentioned here before, if a full-thickness tear of a connective tissue component is not the case, few surgeons these days would recommend surgery prior to a period where non=invasive therapy is tried. You'll find out soon enough what category your shoulder is in. Until then don't do anything to aggravate it. A sling might be in order, but you will find out son enough.
    I agree with downhlldav.........shoulder surgery is a serious thing to rehab from. You have age on your side, so you gopt that going for you. Best of luck with whatever you decide to go with.

    And I'd add that you should not be shy about seeking a 2nd, or even 3rd completely independent opinion, from another Ortho Doc, or from a Physical Medicine Doc, as well. So many cases. in our rather "unique" for-profit health care system, are driven by financial incentive and/or what that patient's health care coverage will pay out for, and not necessarily by what evidence-based case studies might indicate.

    Keep a positive attitude, and an open mind.

  79. #579
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    Good points from Ray. The doctor who did my surgery was the third surgeon I had seen, fourth doctor if I count the ER doctor I saw right after the injury. He was recommended to me by my physical therapist when I started having issues a few years after the grade 3 separation. He convinced me to keep doing physical therapy instead of surgery the first time I saw him, and even the second time when I was in for a different injury so I trusted him when he said surgery was the best, only real solution when I injured myself further last summer.

    Surgery is generally indicated for grade 4 or above. The prevailing consensus is to pursue non-surgical treatment for acute grade 3. Only when grade 3 becomes chronic is surgery indicated by consensus.

    There was recently a study published (I'm still trying to track it down again) that looked at long term results of the modified Weaver-Dunn procedure performed shortly after initial injury versus non-surgical treatment. It concluded that for both types of treatment, in the long term, you are very likely to develop osteoarthritis that will eventually require at least arthroscopic debridement. This is one of the reasons for the controversy about surgery vs. non-surgery. I would very much like for this type of comparison to be made between the newer repair and non-surgery.

    Unfortunately the long term results of the newer procedure that I had performed have not been compared to non-surgical treatment in this way (as far as I've been able to find at least), though it's been shown to produce results that far surpass the modified Weaver-Dunn in joint stability and strength. From this, I've inferred that it should at least take longer to develop osteoarthritis compared to the non-surgical treatment of a grade 3 separation.

    Surgery was not a decision I came to lightly. I'd been researching it since very shortly after I injured my self initially, over 5 years, and discussing it with a doctor I trusted for over 2 years. Prior to injuring it worse last year I was getting close to seeking out a surgical solution as I was beginning to have minor, though constant discomfort, was treating with ice at least once per day and resorting to pain killers more than 3 times a week. Sleep was also becoming difficult due to pain.

    Good luck with whatever you decide.
    Disclaimer: I no longer fix bikes for a living.
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  80. #580
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    Here's a dissenting opinion disguised as an update on my shoulder. In short 4 years ago I got 4 opinions from or those, all gave different opinions. My full story is in here somewhere, but I didn't have surgery.

    Things like wide grip pull ups hurt a bit and sleeping on that side will leave it sore when I wake up. I've fell on the shoulder hard enough I'm pretty sure that I'd have broken my clavicle or blown up any of the AC surgeries, had my AC joint still been healthy or "repaired."

    That impact hurt, but not too much more than when I sleep on that side. The real danger is if you hit hard enough or just right a healed cat 3 could become a 5.
    Slowly slipping to retrogrouchyness

  81. #581
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    I fought surgery for years. While you can strengthen the other 17 muscles and tendons that cross the shoulder, you can not do much for a full thickness hole or tear.
    I agree w/person: 30% surgon vs. 70% rehab!

    No improvement over a year is a condition for surgery.

    R

  82. #582
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    I appreciate everybody's advice and shared experiences. I had follow-up x-rays performed yesterday, and they showed that the end of my collarbone is also broken off. The doctors said that I will definitely need surgery.

    There is a chance that some of my ligaments are still in tact and attached to the broken-off piece of collarbone. It is possible that I may have less ligament damage than I originally thought. At this point, though, it is uncertain.

    I live in a university town, and went to the university hospital. It is a top ranked medical school, and I have an appointment with the orthopaedic surgeon for the football, hockey, etc teams. He is also a professor. I have to assume that he will be able to provide good advice based on modern procedures. I think it is a plus that he is used to working with athletes as well. I will also seek alternate opinions, of course. I don't want to name the institution in this space, but it is obvious based on where I live.

    It's been 3 days now since the injury, and my shoulder is feeling better. I was able to put on a button down shirt today for work, so that is progress! I have been wearing a sling since the injury, applying ice, and taking Ibuprofen for pain/inflammation. I have been sleeping well, but only on my back of course. I sleep in my sling because sometime I jump or move suddenly in my sleep. I've been trying to maintain my normal schedule and life because I know that things will get much harder after the surgery.

    Here are the newer better x-rays:

    Ac Separation (shoulder Separation)-busted_shoulder_1.jpgAc Separation (shoulder Separation)-busted_shoulder_2.jpg

  83. #583
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    Grade 3 AC checking in here. Clean separation of the shoulder, with no breaks or fractures, and 2 days out, already hitting about 50% of my range of motion. The doc recommended a wait-and-see. Said about 4 weeks from the pictures.

    All told, I'm pretty happy, considering I came down from 6 feet on top of it.

  84. #584
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    Hi All

    Here's an 8-month follow-up report to my grade 3 - operated with the double tightrope procedure acutely.

    In my first post I was saying I wanted to be get back to surfing - mission accomplished. No worries. Super weak on the injured side to start off with, but that disappears within a week or so of hard paddling (I have to say that I spent a session or two in the local pool for about 8 weeks before I started surfing again).

    As for daily things - carrying around bags can be a bit annoying when the straps go right on top of the tightrope button that sits on top of the clavicle. My AC also clicks occasionally now - when reaching across the body or putting arm far up behind the back. But in comparison to what I hear from guys who haven't had the OP - there's no "crunching", just a bit of what they call "crepitis". Doc said I will/might have arthiritis in 10 - 15 years time. I don't think that's a problem as long as it's just the AC - they usually just do the clavicle resection OP.

    There's still a little lump, but I think I'm the only one who notices it...According to the literature the tightropes give a little over time and the gap increases.

    Here's some exercises that I found to be good (on advice from Physio):
    * Y's, T's and I's
    * Lateral raises with small weights and big reps

    Cheers

    Greg

  85. #585
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    Hey all, I've been reading these forums since I did my own grade three separation at the end of July '12 (almost 8 months ago) and found them helpful so I figured I'd add my two bits.

    Separated my right (dominant) shoulder bailing on a way too steep BMX jump at a jump park. I had just finished a ride with a friend and was feeling good on my trail bike with clipless pedals. What was I thinking?

    Anyway was diagnosed with a separation by emergency room doc. Made an appointment with my own doctor about 10 days later who confirmed a grade three. Told me to live with it and that I'd still make my planned trip to Moab two months after the injury.

    My wife is a nurse and she told me that I should avoid the surgery if it wasn't required because of all the things that can go wrong when they cut you open and start messing around.

    First while after the injury was brutal. Had to sleep on my back. I was in a sling for about 2.5 weeks. My shoulder fatigued from just having my shoulder out of the sling.

    Saw a physio who gave me some really basic exercises that I did with a two-pound sack of coins (tied into an old sock). Five pound weights were too much. One thing that helped was leaning forward and using a table for support and then gently letting my injured arm hang down and very gently swinging it like a pendulum in circles and back and forth, side to side. You can find pics/vids on the web I'm sure.

    So I really took it easy the rest of the summer. I did physio daily but sat on my duff most of the time. Slowly the strength returned and the pain subsided.

    By the time the Moab trip came around I was a bit nervous of getting out on the bike. I went for a few timid rides near my place and figured I was good enough. Gotta get back into it.

    I went down with a handful of guys for the Outerbike show in the fall. I'm glad I went, I rode 8 days hard riding. It was the first real riding I'd done since the injury and actually I have to say that my saddle was more in agony than my shoulder. Although by the end of day eight, going from zero riding to eight days straight my shoulder felt like it was going to fall off. This went away with rest though.

    I keep generally active and over the winter I did about a month of the P90X workout program. That helped with strength and I didn't have any shoulder discomfort at all during this time as the increased strength helped. I have since fallen off the 1.5 hrs a day six days a week wagon.

    I had to modify some of the exercises a little but overall I was fine. The only exercise that gave me problems was a side raise where I'd lie on my side, tuck my left arm/hand up on my right shoulder and lift myself up with my right (injured) arm/shoulder. My clavicle would move around in there and even make some "shloop, shloop" kinda sounds. hearing those made me a bit queasy and I stopped doing that exercise.

    Fast forward and a couple of weeks ago I was doing a pushup -- I'm lucky pushups haven't been too much of a problem for me, same for sleeping on my side. I heard a tearing sound and my shoulder popped a little bit. It was really weird, I was tender and a little sore, but my shoulder (especially my clavicle) felt much more solidly attached.

    I told my wife the good news and she told me to call it a "readjustment" instead of a tear followed by a pop.

    Has anyone else experienced anything like that?

    Overall shoulder is definitely getting more solid. I have some discomfort in my right trapezius, associated with weakness I think -- I really should get back on the workout program but it's nice out now and I want to ride.

    Riding has been fine. I can ride anything I used to bunnying and pulling up on the bars is no problem.

    I do have a lump on my right side. It's not so bad, I tell myself. And only one person has pointed it out to me so really nobody's looking at it but me (which I seem to do a lot).

    I'm hopeful that the weakness/discomfort goes away. I think that going no surgery was better for me. Got me healed more quickly for sure. Good luck to anyone out there with this injury.

  86. #586
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    Update time.. I went to the doctor monday and got good news.... I don't have to go back! 18 weeks post op and I was released from care. I can finailly get into the wood again although he said slow and easy for another 6 weeks and careful after that. He wants the allograph to fully strengthen and says 6 months it should be there. I feel great ROM is almost 100% in every test. Strenght is getting better every week. At this point I feel great and I'm really glad I had the surgery.
    As someone has stated here already everyone is different and every injury is too. There for take my posts as you will for what every its worth to you.

    I'm ready to put the new Tallboy LTc in the woods for sure! I will tell you it won't be hard to take it easy as I really dont want to travel this road again!!!

  87. #587
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    New to the forum and guess what AC SEP stage 4. due to my occupation surgery was a must. cant ride, cant golf, cant do anything. having Surgery April 8th and was wondering what i should exspect and if there are any MUST HAVES prior to the cutting. ie recliner, plenty of pain meds

    any help would be great.

    happy trails

  88. #588
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    Separated shoulder at about 13 never x-rayed it, just toughed it out. 4 months ago hit some rocks on motorcycle, had x-rays, a good grade III sep. Oh by the way I'm 55 now. Just had Anatomic Coracoclavicular Reconstruction 11mar2013. Hoping for the best, being very careful to use sling.

  89. #589
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    A recliner is great for the first few days. I only spent 3-4 nights in it then sofa and then the bed. Get an extra sling to take shower in the first 2 weeks I had to wear te sling 24/7! After that I could take off the shower and dress and thats was it!! 6 weeks is a really long time! Your should (orat least mine) will freeze up and grow to be very weak. Don't push it, if you read this thread completely there has been a couple of guys that have and had to go back under the knife for a re-repair. I'm not going there if at all possible! As far as pain meds I took them for about 3 days and stopped all together, I really hate the way they make me feel and the pain was not too bad. Don't get me wrong I was sore. I have had a good result with the surgery. My ROM was very slow and strength is still not 100% but I feel very close to normal now. Good luck guys its a long road but not too bad other wise.

    Andy

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    Almost at 4 weeks after injuring the shoulder, and I have, generously, 95% of my RoM back. My strength isn't where I would like it, but I started riding on the road last week, and it has helped in that area tremendously. I still have a little bit of a pulling sensation when I reach down to the left, but most of the pain subsided around the same time that I gashed my fingertip with a rotor! After the tetanus shot that I got just about two weeks ago, my other shoulder has been giving me the majority of my pain. It would appear, as they say, that I cannot win.

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    Andy

    Thanks for the reply, you may have said previously but did you have anatomic reconstruction with tendon grafts or another procedure.
    Thanks again

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    Andy thanks for the heads up. i hate painkillers as well. how long did you go from injury to surgery? and what kind of surgery

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    When I first went to the doctor he checked me out and told me to come back in 2 weeks so surgery was about 3 weeks after injury. I was injured on sept. 24 and had surgery on nov. 20. I did have teh anatomic repair with a allograph (donor tendon). Pain wasn't too bad really, I was sore and your not going to move it period. I froze up really bad in the shoulder after being in a sling for 6 weeks. The last 2 weeks are tough you are not sore from surgery and want to move it and get the show on the road so to speak.
    ccrecon your half way thru the sling and well on your way. You guys be careful and wear the sling!
    My new tendon hasn't streched at all, I have no bump and I am getting to where I can sleep on that shoulder again with my arm over my head it has taken a while for that.

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    Ac sep

    Andy

    Thanks

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    I fell a year ago - level 2/3 seperation. I couldnt lift my arm for a month and it was three before it was pain free & stronger. Broke a lot of things....but this was the worst. Went to PT and did the exercises on my own since then. Lots of light weights and reps 2x a week. It felt as good as new after 4-5 months - until I fell on the same shoulder last month!

    No pain this time - worked OK vs. 1st time - but now its closer to a four...ripped evertying off - a big bump and very lose. I can move the collarbone about a half inch back and forth - shoulder too. Going to rehab myself it again.

    I wouldn't reccomend surgery to anyone - I think it hurts more / takes a lot longer.....(unless your a pitcher). Check with a sports ortho guy - get a few oppinions. Remember they only get paid when they do surgery.

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    seem to be a touchy subject Surgery vs Non surgery. after 4 consultations with 4 different surgeons, i feel that in my case surgery is a no-brainier. after reading this entire blog it seems to me that people with a grade 3 or higher that chose not to have surgery noticed a drop in there range of motion, and for some mild discomfort longer down the road. as a PGA golf professional i cant take that risk. Surgery bound and cant wait.

    i think you (chief muckymuck) should possible talk to a orthopedist to see if your injury could be recurring due to NOT having surgery. Either way this Forum is a really good testimonial for anyone having to weigh the options for surgical/non surgical treatment. im really happy its here for people.

    i hope your Shoulder Heals up soon.

    see yah on the trails
    NV-Nelly

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    Ok - no surgery unless your a pitcher... or a PGA golf professional. A little lose....not quite as strong for awhile. A little lose & sloppy is your problem...not relevant to 99.98% of the population.

    Recurring because I flipped over the handlbars and flew 10 ft. and landed directly on my bad shoulder on a big jump / downhill....nothing to do with not having surgery. As a matter of fact it would have been worse if I hadn't built up all the muscles for the last year - thats why it wasn't as bad this time even though the injury was much worse.

    Good luck you you -and given your profession it is a no brainer...but most of the other people i've read about on this site DONT need surgery...just time and the correct exercises. I'd suggest everyone else who doesnt need 100% accuracy try the no surgery option for at least a year. If it doesn't work you can always do it later.... I've had no loss of range of motion either time - Make it move and it does.(12 yrs. of Yoga...welcome to CA) Sloppy is different. Busted AC's are a bit sloppy...esp. 3+

  98. #598
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    Quote Originally Posted by chief muckymuck View Post
    Ok - no surgery unless your a pitcher... or a PGA golf professional. A little lose....not quite as strong for awhile. A little lose & sloppy is your problem...not relevant to 99.98% of the population.

    Recurring because I flipped over the handlbars and flew 10 ft. and landed directly on my bad shoulder on a big jump / downhill....nothing to do with not having surgery. As a matter of fact it would have been worse if I hadn't built up all the muscles for the last year - thats why it wasn't as bad this time even though the injury was much worse.

    Good luck you you -and given your profession it is a no brainer...but most of the other people i've read about on this site DONT need surgery...just time and the correct exercises. I'd suggest everyone else who doesnt need 100% accuracy try the no surgery option for at least a year. If it doesn't work you can always do it later.... I've had no loss of range of motion either time - Make it move and it does.(12 yrs. of Yoga...welcome to CA) Sloppy is different. Busted AC's are a bit sloppy...esp. 3+
    There is little debate about grade 1/2, no surgery. Grade 4 and above indicate surgery. Again, almost all parties involved agree with that. The only time it's debated is for grade 3. Speaking in absolutes is not helpful. Every person is different, every injury affects people differently. For some people, surgery is the better option. Others live the rest of their lives without surgery or problems. I do agree that it's best to try rehab for a year before getting surgery on a grade 3.

    I tried no surgery for 5 years. I went 6 months after making it a grade 5 before surgery. I wish I hadn't waited so long to get it done. I'm much better off than before surgery, better than before making my grade 3 into a grade 5. It's been so long, I don't remember what 100% (pre-injury) feels like, but I'd say I'm there.

    Also, not all surgeons suggest surgery just to make money. Mine kept me from doing surgery for several years. It wasn't until I made things worse by falling again that he said surgery was the better option.

    My other shoulder (not the one I had surgery on) has a grade 2 separation. It's been 6 years since that injury. The only time I notice it is doing push ups. I wouldn't even consider surgery for that.
    Last edited by dwnhlldav; 04-06-2013 at 05:57 AM.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

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    Andy made some great points. I bought a second, cheap sling for wearing in the shower. Sling was on 24/7. If I was sitting in a recliner with my elbow supported to keep weight off my shoulder, I was allowed to take my arm out of the sling and move at the elbow. My shoulder didn't freeze up completely, but it did take a a few months after getting out of the sling to get my ROM back to normal. I swim in addition to riding. I'm now back in the pool, and I notice that my repaired shoulder is still much tighter than my injury free shoulder. Swimming takes a lot of shoulder flexibility so even thought the doctor and pt say my ROM is back to 100% against their standards, I don't think I'm back to my 100%, but it's coming.

    I took pain meds for 3-4 days then stopped. I started taking them again a few days later, but only at night so I could sleep.

    It's been almost 6 months since surgery. I still can't lay on my repaired side for more than 20 minutes before it gets irritated, but I couldn't lay on it at all before surgery.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

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    I picked up an EVS SB03 (shoulder brace) today. I'll have a review in a week, after using it for a while, but my first impressions are quite nice. After about 20 minutes of getting used to how it feels (and apart from it being made of neoprene, ie: breathable as a rubber suit) it has my shoulder bump fairly smoothed out, but still obvious.

    More to come as it gets used more.

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