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Ac Separation (shoulder Separation)

495K views 1K replies 376 participants last post by  weevie 
#1 ·
I Recently Went Down Hard And Suffered A Grade 3 Shoulder Separation. I Am 5 Weeks Into This Injury And I Am Treating It Conservitively (non-surgical). It Is Very Frustrating Being That You Would Think This Injury Should Be Repaired Through Surgery But All The Doctors Are Telling Me To Leave It Alone And Physical Therapy It. I Am Also An Active Weight Lifter. I Used To Bench Press 340lbs And Now I A Struggle With 50lbs. I Know It's Only 5 Weeks Into The Injury But I Am Not Sure Where I Should Be At As Far As Lifting Weights And What's The Road Ahaed Of Me Going To Be Like Being That Is Being Treated Non-surgical. Any Info Would Be Greatly Appreciated!!!
 
#886 ·
If it's any consolation surfing was pretty hard for me too. What really helped (not just surfing but everything about making my shoulder feel better) was slow progression in the pool....first time 5 minutes super slow, then 10 etc. after about a week and a half added some 75% sprints and on and on. Everyone's different but there was something about the swim motion that works both full range of motion and strength that really got me feeling better. Riding single track is fun, and it's great for mental health, but there's nothing about all that jarring and bouncing that's inherently good for a healing shoulder.

Long story short pool=crazy boring. But in my experience worth it for 4 weeks. Wish I would have started few weeks sooner.
 
#887 ·
Shoulder been a lil sore post Monday ride...

So, I'm heading out again tonight...

Tag along with the slow bunch on a group ride ^^

Then, it's beers n bangers!!

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Ho, Ho, Ho... now you're broke!!
 
#888 ·
After about 4 months since a Grade 2
Aches after riding, lifting the front wheel causes some pain on the trails, as does 3 foot + drops, puts a jar through the joint which causes pain, overall tho back riding and hoping i'm not doing more damage
Rock climbing is still out tho
 
#889 ·
4 months!?

Holy, hand down the wide fronts and finding something missing... Batman!!

I'm going to need therapy if my AC takes that long to fully mend =(

________________________________________________
Ho, Ho, Ho!! And now you're broke...
 
#890 ·
First really techy ride today... gnarly rock gardens for Africa!! Shoulder only squealed once, when I thought I was going to manual my front wheel on to the top of a rocky out crop... and instead I slammed into it and my shoulders/chest had to take the G-force. Icing it now >.<

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Ho, Ho, Ho... now you're broke!!
 
#893 ·
Considering the Arthrex Dog Bone procedure. zero85ZEN, any further recovery trajectory? Anyone else gone through it?

thanks!
5 and a half months post-surgery for Gr. 5 AC sep using the Arthrex fiber and button technology to get things back where they belong. Seems to have worked so far. At least no stretching or other failure of the materials. After 3 months, scarring in had stabilized the shoulder enough to be cleared for normal activity. Just finished PT and am at maybe 90% of previous range of motion and strength. Still exercising and stretching on my own per therapist's advice. I can mountain bike with no problems but surfing is coming more slowly. Have some pain still paddling and getting the elbow up high enough on the forward part of the stroke for my hand to clear the water. But is definitely improving and should be OK with continued effort. All in all, I'd have to rate it a success so far.
 
#894 ·
Medical radiography Text Joint X-ray Bone


Also glad to find this forum. I separated mine two weeks ago snowboarding. Finally saw an Ortho Sports Surgeon that treats the LA Kings who has me down as GR 2. I was surprised since the xrays look like GR 3. Anyway he recommends to rest shoulder for 4 more weeks with PT starting then and a follow up in 6 weeks. I can't keep still so starting my own PT after researching the web. I don't have much pain if I keep my movements ~75%. I do feel things moving around and will have pain with anything beyond that. Does anyone feel things moving around while doing PT? Has anyone tried shoulder braces?
Thanks!
 
#895 ·
Just thought I'd post a 10 week update, Grade 5 separation, AC joint reconstructed using hamstring.

Basically I'm super happy at this stage with how things are gone. The first six weeks were tough, but I really got stuck into rehab. ROM & strength have seriously really kicked on since then, and the level of background pain now is quite low.

It's a relief in a way as both the physio and surgeon mentioned that what you have at 3-4 months recovery is pretty much what you'll have from that point on. Ealier on it was a bit like, damn I'm going to be stuck with this sh*t shoulder. Thankfully not the case.

I started back on the MTB at 4 weeks, and have slowly been getting back up to speed. I'm just at the point now where I can begin to ride aggressively, still a long way from pre-injury but pretty cool none the less. Critical thing in the short-mid term remains not to crash and re-injure shoulder.

Other cool things: I can now sleep on my side, injured shoulder down, which has really helped the quality of sleep. I've also been able to return to work in a fairly physical job. I can pretty much do most day to day things with that side of my body, which is also my dominant side. The surgeon encouraged a fairly aggressive approach to rehab, and touchwood that seems to have worked well for me.

Still working away on rehab exercises. Strength both away from my body and above shoulder height is going to take a while yet.
 
#964 ·
Just thought I'd post a 10 week update, Grade 5 separation, AC joint reconstructed using hamstring.

Basically I'm super happy at this stage with how things are gone. The first six weeks were tough, but I really got stuck into rehab. ROM & strength have seriously really kicked on since then, and the level of background pain now is quite low.

It's a relief in a way as both the physio and surgeon mentioned that what you have at 3-4 months recovery is pretty much what you'll have from that point on. Ealier on it was a bit like, damn I'm going to be stuck with this sh*t shoulder. Thankfully not the case.

I started back on the MTB at 4 weeks, and have slowly been getting back up to speed. I'm just at the point now where I can begin to ride aggressively, still a long way from pre-injury but pretty cool none the less. Critical thing in the short-mid term remains not to crash and re-injure shoulder.

Other cool things: I can now sleep on my side, injured shoulder down, which has really helped the quality of sleep. I've also been able to return to work in a fairly physical job. I can pretty much do most day to day things with that side of my body, which is also my dominant side. The surgeon encouraged a fairly aggressive approach to rehab, and touchwood that seems to have worked well for me.

Still working away on rehab exercises. Strength both away from my body and above shoulder height is going to take a while yet.
What surgery did you have done? Going in for mine on Wednesday. Desperately trying to get back to road riding in two months. Having bouts of anxiety right now thinking about recovery.
Oddly enough my grade 5 is feeling pretty normal. Logged 120 easyish miles this weekend. I have two huge races first week of October that I'm trying to get ready for.
 
#896 ·
Grade 3 here 2 years ago this coming may.... I never had surgery.. Wore a shoulder brace for a few months though I still feel an annoying type of pain If I lay on that shoulder for more than an hour and I still feel things moving around though when riding I never notice anything other than a fear to not crash and then stick out my right arm to break my fall --- Ive trained myself to fall left now ;)
 
#898 ·
Been 2 months (almost to the day) since grade 3 separation... Had my first ride yesterday where I forgot about shoulder and just rode. Anytime I lift front wheel I get a twinge and also when weight is taken by arms on HB's i.e. quick deceleration etc. Seeing clinician this morning, final visit.

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#1 resolution... Ride it like I stole it!!
 
#899 ·
Been 2 months (almost to the day) since grade 3 separation... Had my first ride yesterday where I forgot about shoulder and just rode. Anytime I lift front wheel I get a twinge and also when weight is taken by arms on HB's i.e. quick deceleration etc. Seeing clinician this morning, final visit.

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#1 resolution... Ride it like I stole it!!
I'm almost to 3 months for a grade 2. I had that same thing when lifting, and now it's finally completely gone. Went surfing this past Sunday, and it was the first time the shoulder didn't really bother me paddling either.

I can still feel the rib injuries. Pressure of the front rib cage from laying on my board, gives mild pain to the rear rib cage where the injury was, but not bad at this point.
 
#900 ·
Its been 5 months since repairing a Grade 3 with the AC Tightrope procedure. Recovery has been more gradual than I expected. 95% range of motion and strength but still feel a bit sore at times and don't trust it in a fall yet. That may be psychological though. Don't feel it at all riding.

Happy with the surgery route, still a small bump but nothing like the major bump and disconnected feeling I had before.

The surgery itself was easy, or I should say both surgeries were easy as they had to go back in and repair the first one as the knot on the top button came undone. The most difficult part was fighting off frozen shoulder from being in a sling for an extended period of time.
 
#901 ·
Hey guys, 3 months ago I was in a motorcycle crash which gave me a grade 2 Ac seperation. I have the bump on my shoulder, with lots of popping.I have been getting back into the gym noticed a lot of pain in the joint so went back to the Ortho. He said I had weightlifter shoulder gave me a cortisone shot and said come back in a month if it's not better to discuss surgery. Does anyone know if I get the surgery which shaves the bone, will this help to reduce the bump? I hate having the bump, it's been really depressing.
 
#903 · (Edited)
Im really trying to decide wether or not to get this surgery to reconstruct my Ac joint. Going to the gym and strength training is something I don't want to live without. I am really wanting to get back into lifting heavy weights some day. It been almost 4 months now and still holds me back. It doesn't feel like it could take any kind of serious load. Like a 500lb deadlift, and benching 315. I can't imagine doing that with the way my shoulder is. Has anyone had success after the surgery with lifting heavy? My doctor told me I would have to stay out of the weight room for 6 months after the surgery to make sure it is fully healed before stressing it. Any advice on surgery or no surgery would be appreciated.
 
#904 ·
Earchel, I'm 6 months out from AC tightrope surgery and spend a lot of time strength training. My pre injury best bench was 315 (3 plates was enough). I'm working my way back carefully. I'm doing reps with 135 now. I'm going to be real patient with it. Especially with lifts that stress the joint. It feels stable but I hate the bump as well and don't want to risk it coming back. I do think I will get there though.

The good news is that the dramatic atrophy I experienced after surgery (it was shocking) came back quickly after I got back into the gym. Every day it feels stronger and less of an issue. That was one issue I had before surgery, looking at how bad my shoulder looked just zapped my motivation to train.
 
#905 ·
I had surgery last May to correct a grade 3 separation. Prior to my accident I worked out a lot, roughly 4-5 times a week. At first I contemplated surgery, I actually waited a month before I decided to have the surgery. I had a lot of pain and didn't see any improvement with in the month so I opted for the surgery. My main reason for the surgery was to eliminate the pain. I asked the Ortho specifically how long would it be before I would be able to work out heavy again. His answer was well it depends, like your Dr. said at least 6 month before I can start lifting. Its been nearly 9 months since my surgery and and I'm not 100% to where I was before the surgery. The Dr. told me 6-18 months as did my PT. Both said it would be a while. I can do pull ups again but for some reason lat pull downs are uncomfortable. Push ups still bother me some. I feel popping when I do certain activities and certain movements. I don't regret having the surgery one bit. The pain I felt was gone after surgery besides the pain that comes along with the surgery. It sucks a lot, I lost weight from not being able to hit the gym. I have altered my workouts to accomadate my shoulder. It's taken me longer to get back into the gym because I also broke my heel in my accident. I hope all goes well with what ever decision you make. Good luck.
 
#906 ·
My martial arts master advises against getting surgery...

I've done pull ups, bench press, lateral raises, triceps ext. (seated/lying down), bicep curls... w/o too much issue.

Of course the weight is down a bit (apart from chins) o_0

Holding the kick shields really aggravates the old AC...

Will be 3 months since injury in 10 days. Thinking it'll be be good 6-8 months before I'm back to normal.

Know another fella, that did his a year ago. It's still giving him grief.

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#1 resolution... Ride it like I stole it!!
 
#907 ·
Earchel, just noticed you say you have a grade 2 separation. Very surprised you were offered surgery for that. For Grade 3 it's a highly debated topic, but seemed pretty settled that "no surgery" was the route for Grade 1 and 2.

If your just talking about the distal clavicle excision (shaving the end of the clavicle) I don't think that's really going to give you anymore stability in the joint. It will just deal with any impingement issues you have and make it look a bit better.

There are several surgeries that are designed to address stability issues but they all are focused on reconnecting the clavicle to the coracoid. Grade 2 would imply you still have a connection there.

If the bump is significant though it might be worth getting a second opinion on the grade. The docs sometimes get it wrong.
 
#908 ·
Earchel, just noticed you say you have a grade 2 separation. Very surprised you were offered surgery for that. For Grade 3 it's a highly debated topic, but seemed pretty settled that "no surgery" was the route for Grade 1 and 2.

If your just talking about the distal clavicle excision (shaving the end of the clavicle) I don't think that's really going to give you anymore stability in the joint. It will just deal with any impingement issues you have and make it look a bit better.

There are several surgeries that are designed to address stability issues but they all are focused on reconnecting the clavicle to the coracoid. Grade 2 would imply you still have a connection there.

If the bump is significant though it might be worth getting a second opinion on the grade. The docs sometimes get it wrong.
Yes I was told that is a grade 2 but said it was as bad as a 2 could get. The doctor wants to shave off the end of the clavicle. I think if I was someone who didn't lift that would be fine. He did however say that it could leave my joint more unstable for weight lifting and if it creates and issue then he might have to do a tightrope surgery. The main reason I want to try and get it fixed is because I want to lift heavy again. It's been almost 4 months and I tried to set up to do a dip and didn't even try because I could feel my shoulder couldn't handle it. It is all just very confusing. I don't want to get the surgery and end up worse, but if surgery could give me a normal functioning shoulder it would be worth the 6-12 month waiting period to me. Thx for the responses guys, this has been hard to deal with on my own.
 
#909 ·
Ac separation grade 1 or 2 ?

Hi guys! I suffered a shoulder injury 7 weeks ago, falling on my right shoulder dancing. Went to MRI and Xray, doctors confirmed the acromioclavicular joint is normal, BUT I feel a bump on my shoulder much prominent than the left shoulder. I took an Xray for both shoulders to compare and I see a slight difference in spaces. I will upload pictures here to see. Also i still feel pain in my shoulder, i have full range of motion but not pain free.

left shoulder (normal) https://i64.tinypic.com/spg7yc.png

Right shoulder (injured)
https://i66.tinypic.com/svkl09.png
 
#911 ·
St. Patrick's Day 2016. Won't ever forget it! Headed out to the local off road park by myself after work, anticipating a fast run before a Guinness for the holiday. Beautiful Florida day! Put on my lightest biking shirt and went out on a fairly fast and level section and made it only 3/10 of a mile out before tires washed out coming out of a left berm. Never fell at such a speed on such a hard surface. Knew it was happening and turned the back of my shoulder to the clay and expected to roll right out of it like I had many times before. At impact I knew my left AC joint was cooked. Put my hand atop my shoulder and felt my collarbone jutting over the acromion. Called my wife, then called the orthopedist, before leaving the park. It was a ***** trying to put my bike on the rack one handed.

I went to urgent care to verify no fractures. Looks like a Grade 3 to me. Heading to the orthopedist in an hour or so.

I am a physical therapist and pretty much know how this is going to go down, but reading all of the stories here has lifted my spirits so much. The initial thought after falling was that I spoiled a great day to ride. The second thought, reinforced after looking at my deformed shoulder in the urgent care, was that I have irreparably changed the anatomy and biomechanics of my shoulder.

However, after seeing how you guys have willed yourself back to the activities you live for, I am much more upbeat. I especially am thrilled to read about returns to swimming and surfing. Thanks for posting your experiences.

A blurry iPhone pic, but you get the idea...

 
#912 ·
First thing the orthopedist said after looking at the x-ray? "What a clean shoulder..." Seems I trashed a perfectly good shoulder. :-(

Off work and in the sling 2 weeks with no elevation past 90 degrees or shoulder height. He asked to see how high I could elevate my arm. Earlier this morning I could go just short of shoulder height, about 80 degrees, with some scapular elevation, or shoulder shrugging. In his office I went about 150 with a little better mechanics. It's improving daily.

But it needs rest for a little longer. I have ordered an off the shelf (off the internet!) acromioclavicular sling as he suggested. Should be here in 2 days. My daughter taped me up with Leukotape which really feels as though it has helped the stability. My two chief complaints at this point are the feeling of instability when I try to flex or abduct the shoulder, and the trapezius fatigue/tightening that I have felt when out walking a few miles. I have very little soreness there. I've turned down narcotics twice now, and I'm only using Ibuprofen and ice to manage discomfort.

I'll be back on a bike soon. Weight bearing lightly on that arm makes it feel better. I'll also be elevating to shoulder height in the pool soon.

Gotta get ready for a 27 mile ride in the woods in CT May 15th! Not missing Tour de Lyme!
 
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