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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!!!
 
#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!
 
#915 ·
DAY 6

No riding today, so I went out for some parts to refresh my daughter's old Trek 820 Mountain Track. New wheelset, RD, cassette, and chain. about an hour in I shed the $3 sling. About another hour in, my new A/C brace arrived via FedEx. Goofed around another hour or so, and now I think I'm going to pay for it. I can feel swelling right at the a/c joint and it's as uncomfortable as it's been. I'm in the new brace, which I think I'm going to like, with ice on me and Motrin in me...
 
#916 · (Edited)
Easily my best night of sleep last night. I've been sleeping on my back. I hadn't done a full night in the bed until last night. The couch has been more comfortable. I put my arm straight out to the side, which seemed to reduce the end of the clavicle. I was going to stay in this position only a few minutes, but wound up waking up a couple hours later. I then went on my right side, which has been uncomfortable for the injured shoulder, and woke up in that position. It was only minimally sore. I think taping my shoulder and the new brace have really helped. My wife put three strips of Kinesiotape (KT) tape, over the acromion last night, but I think Leukotape works better. It's a little less elastic. Little riding to get the blood flowing later!
 
#917 ·
Had a wee tumble on my last ride - impacted rear of right shoulder (luckily on a rotten log i.e. semi soft landing)... have put my AC back 6-8 weeks =( going to quick on a night ride >.<

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#1 resolution... Ride it like I stole it!!
 
#918 ·
I separated my shoulder (grade 3) a week ago snowboarding. This thread has been good for learning more about this. Planning on getting a second opinion soon, but right now I'm leaning towards no surgery.

A couple questions though:

I've been taping the shoulder which makes it feel less creepy, but do you think it helps speed recovery or could reduce that bump if I stick with it?

Does that "creepy" my arms hanging by a thread, and the clavicle is poking out feeling ever go away? Not just get used to it, but go away?

and finally, how long should I keep using the sling?
 
#919 ·
I'm doing the sling for two weeks. I got a specific acromioclavicular sling on the internet. Search Kenny Howard sling. I can get much more support than from a regular shoulder sling. The taping sure makes my shoulder feel better, but I don't know if there is any evidence showing it improves the deformity long term. There is less of that unstable feeling at one week post injury, but it doesn't take long out of the sling to tire the shoulder and get that sensation of instability with the collarbone poking up into the trapezius. Then I return to the sling and ice it. Rode 17.5 miles today, mostly flat path and about 2 miles of light trail, with just a couple twinges. Can't yet use the left arm to help lift the bike.
 
#920 ·
This was a great Forum to visit to after such an injury. It all seems so tragic ... mine was caused fromover rotating on tabletop and landing hard on dominant right shoulder.
Not very much pain just discomfort and floppy arm. I went to the Emergency ward and discovered a 21 mm separation of CC joint (vs 8mm on good side). All the worries about what have I done and options of surgery.
MRI indicates grade 3+ with sprain to deltoid and a near full thickness tear to supraspinatus (a rotator cuff). The rest all good.
That was on the 22 February .. So 4.5 weeks ago.
I have seen 5 physios and all seem to push towards PT. I went to the Public hospital orthopedic unit ... That was bad ... they had a model of the shoulder joint that was wrong.
So basic Timeline has been:
First week rest and sling
Second week rest and started pendulum swings and a little use
Third week basic ROM exercises
Fourth week. More whole body ROM exercises. Started a few light weights and theraband.
Overall I am lucky as I haven't experienced much Pain.
I already had a bit of scapula winging on that shoulder ... so I thing that makes it worse.
I try to set and hold the shoulder AC joint together from muscle setting. I sleep on back at night. In the end it may scar up ... at the moment I am just trying to keep things aligned under the false hope scar tissue may form.
I was in NZ when I did it and traveled around a little after the injury. Overall I have seen 5 physios. They all seem positive with my progress so far. Just light ROM. I have kept it taped most of the time as that keeps me aware of proprioception. Really having to work on scapula control and correct movement of it. and then strengthen all the muscles. Just take some time and plenty of conscious PT...
 
#922 ·
Day 8

Found out what it feels like to roll to the injured left side last night. I will call that pain. Woke the wife when I yelped. Kinda bummed to wake up to a stiff, sore shoulder this morning, and bummed again after removing the tape and taking a look in the mirror. The deformity isn't changing.

On the flip side, I got in the pool, primarily for maintenance, but found I could breast stroke a few laps without pain before fatigue set in, and I could weight bear enough on that arm to lift myself out of the pool. I also did some light buoyancy assisted shoulder range of motion. I won't be trying any freestyle for another week. It felt very good after the first pool session.

Up and down...
 
#924 ·
Thanks for that link! That was encouraging to read, especially as his separation looks as though it was a bit worse than mine. I think I'll be using Hypafix under Leukotape for the next application. The Kinesiotape did not irritate my skin as much as Leukotape, but it is not quite as supportive.

The markings down the left side of my back are nearly identical to his abrasions.
 
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