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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!!!
 
#52 ·
I talked to another Ortho today, and he said that absolutely under no circumstances should I go with the cadaver tendon type surgery.

It will come down to what the Flight Surgeon thinks(I'm an Air Force Pilot) of the three opinions I've got...More to follow.
 
#54 ·
I had a level 3 separation my freshman year in highschool from snowboarding. Totally blew it apart, after 1 trip to the PT, he recomended the surgery (granted, this was about 9 years ago). was a long recovery, can't remember the timeline, but i still have a big bump on the shoulder and about a 7 inch scar across the top. I think the overall strength is better having it fixed, but its hard to say. i've seperated the other shoulder to a level two and it feels fine now. I still have some pain when i put pressure on it in odd angles, but it doesn't slow me down at all, no problem at all for biking, but i get some pain when i do judo...Good luck to everyone and they're healing!

i'm just coming off a bad bone bruise in my heel, but nursing it for a few months now, been on and off crutchs, in a walking cast, and now i'm doing a series of cortisone injections, seems to be the first thing to help...
 
#56 ·
I gathered another opinion, from another guy in a Sports Medicine facility. He was adamant about not doing the surgery. When he looked at the X-rays and did the physical inspection he gave me a cat 2, which was about 1.5 weeks after the injury. At the rate I was healing and the X-rays he was pretty sure the other Dr jumped the gun. He also mentioned that they can really repair things if it's within 24 hrs. After that time having the surgery done today or in 6mo is no different. So the extended down time is the only crappy part about trying to let it heal before trying surgery. Especially as the surgery's are less than proven. My Flight Surgeon thought the same thing, but the USAF's regulations don't really care how I heal, just as long as the end results are acceptable. So for now I'm going with the advice of, "ditch the sling when you are able, don't pick up anything heavy, and come back in 4weeks." At the moment I'm pretty much pain free, poppin Alive for swelling but no "happy pills." I get a reminder things are not right when picking up or placing torque on the shoulder with my arm out in front of me. I'll update as everything comes along.
 
#57 ·
I gained one of those on my 1st run down Livewire @ Northstar this year, left shoulder. My doc said it was a class 2 seperation and that it would just be up to me as to how much pain I could handle. Not worth the surgery. The same doc that reapired my torn rotator cuff last year. Ny wife says I need a new sport.
 
#58 ·
So for now I'm going with the advice of, "ditch the sling when you are able, don't pick up anything heavy, and come back in 4weeks." At the moment I'm pretty much pain free, poppin Alive for swelling but no "happy pills." I get a reminder things are not right when picking up or placing torque on the shoulder with my arm out in front of me. I'll update as everything comes along.
That sounds a lot like mine. I'm doing well with a bit of supportive taping that seems to keep everything together even when I'm not wearing a sling. I'm pretty sure mine is a grade 2. The AC joint itself is completely nuked but I know from having done ligament damage previously to my other shoulder (skiing accident) that I've not ruptured anything other than the AC.

I'm really surprised by the absence of pain... except when I forget and flip my collarbone out of position. Then it hurts.

I still guess it is a long road to recovery. I'm 39 years old and have been riding with much younger, strong riders and holding my own. I'm not looking forward to losing that hard won fitness, but I've figured I just need to get this over with and not try to do anything too fast, too soon.
 
#62 ·
I did mine 2 1/2 weeks ago. I went to the ortho yesterday and he told me that I had a mild grade 1 seperation on the ac. I was feeling really good until I went to the Chiropractor. The ER doc said that I had only inflamed the tendon so I figured a good adjustment would get me back on track faster. I have had really bad pain since the chiro. I told her to stay away from my shoulder but I guess she new more about my body and what pain level I had then I did. Thanks to her she upgraded my inflamed tendon to a grade 1 seperation thus sayeth the doctor. Oh well. I am starting all over with the healing process....:madman:
 
#63 ·
Hey folks,
Just got back from my Ortho follow up. He was impressed with how much I've healed in 4 weeks. At the moment I've got full range of motion, and 70% strength. And I wasn't exactly a powerlifter prior to the injury. The Doc said I'll continue getting better for 6 weeks or so. I already forget about it. It will never be 100%, but I'll probably only notice the injury when I look in the mirror. The best part is I'm cleared to ride and work out, and get back to flying!
 
#64 ·
Me too

About 4 1/2 weeks ago i did a nasty endo on my head. The Doc in Urgent car said I had just pulled the ligaments in my back. Sent me home with muscle relaxants and a pat on the head.

I started PT about 2 weeks later. The PT said, your left shoulder is higher than you right. He said must be muscle spasm. I went along with that diagnoses until this week when i said BS. I want another opinion. The pain was too great after 4 weeks just to be a muscle spasm. :nono:

Sure enough, I see a new Doc today and he says it's an obvious AC separation. Now I get to start over with a sling and more PT in two weeks. :thumbsup:
 
#65 ·
I'm one month on from my Grade 2. Everything is feeling quite good in terms of healing and day to day activity. Riding off-road is still a long way off. I tried yesterday and it was hopeless. The first gentle dip tugged at the shoulder - nothing to undo any of the healing but the promise that one false move could set me back weeks.

It seems mountain biking needs shoulders to be at pretty close to full strength.:( I pretty much figured this was going to be ~3 months before I'm going to be back in action properly.

More information from GPS logs on the accident itself shows that it all happened at 40kmh (25mph). After the pedal strike I was airborne to the point of impact. The more I think of it the more I realise I was lucky to get away with just an AC injury. It is going to take a while for my confidence to come back.
 
#66 ·
I am about 6-7 weeks into mine. I have very little pain but my range of motion sucks. I cannot raise my left shoulder high enough to get stuff out of my jersey pockets. I have the strength back I just cant move very well. I have been riding but I have been taking it really easy. I hope I dont fall on my shoulder again. Does anyone where any sort of shoulder protection? I wear a chest protector when I ride my dirtbikes but there doesnt seem to be anything out there for the bicycle crowd.
 
#68 ·
G-reg said:
Well the verdict was level 3-4, with the dead guy ligament surgery as the recommendation. He only thought it would add a few weeks to recovery compared to leaving it alone. Being an active person was a big part of them suggesting surgery, and this was from a respected Ortho from a sports medicine clinic. He implied that doing nothing and just leaving it there, especially with grade 3, was more for folks who don't plan on hitting the gym after re-hab. The dead guy ligament is to reconstruct the inner ligaments and then they can repair the outer one, eventually giving a 100 percent joint without the crazy bump and equal length arms.
Thanks for posting on this AC joint problem. I have one from a single track fall and it really prevents some activities. I've been looking at various options. My concern has been that some of the stuff I read on the surgery is that there can be problems down the road from making the joint too stiff. Has anyone heard of this new Regenexx procedure? Sounds interesting as they place your own stem cells into the shoulder to heal the ligament tear (see www.regenexx.com). I'm also considering prolotherapy, but have seen pros and cons on the web. Have any of you had either of these?
 
#70 ·
I endo'd on my bike a week ago and suffered a Type III AC Separation. The acromioclavicular and coraclavicular ligaments are completely torn from the collarbone. I went to the ortho and he recommended that I don't initially receive the surgery. He said considering that it was my left arm (my non-dominant arm), the fact that surgery has the potential to cause arthritis problems down the road, and that recovery can be 6-8 months it would be best to see what happens without surgery. The first week sucked. I couldn't do anything with my arm and it felt like it was hanging differently (because it was). The pain has subsided but I can still feel the collarbone loose in my shoulder (feels pretty weird). I bought a shoulder brace and wore it through the weekend. I can't do much with the arm (it is stiff to move and hurts as I raise my arm above shoulder level from the joint rubbing) but the brace supports it. I can put a little weight on it now, but not much. I hope to be able to ride at least a bit by next weekend. We'll see...
 
#72 ·
jesse.futrell said:
I endo'd on my bike a week ago and suffered a Type III AC Separation. The acromioclavicular and coraclavicular ligaments are completely torn from the collarbone. I went to the ortho and he recommended that I don't initially receive the surgery. He said considering that it was my left arm (my non-dominant arm), the fact that surgery has the potential to cause arthritis problems down the road, and that recovery can be 6-8 months it would be best to see what happens without surgery. The first week sucked. I couldn't do anything with my arm and it felt like it was hanging differently (because it was). The pain has subsided but I can still feel the collarbone loose in my shoulder (feels pretty weird). I bought a shoulder brace and wore it through the weekend. I can't do much with the arm (it is stiff to move and hurts as I raise my arm above shoulder level from the joint rubbing) but the brace supports it. I can put a little weight on it now, but not much. I hope to be able to ride at least a bit by next weekend. We'll see...
I feel for you, sounds like my situation a couple of years ago at this same time of year. Non-dominant arm and doc said about the same thing. I was riding again in about two to three weeks. Didn't really bother the injury to ride for some reason. There were a lot of other things that I could not do though if they involved weight bearing or lifting. Lots of those things just take time.

Try stretching/lifting the arm upward by using a wall to walk your hand up and back down. I found this really helped to get the range of motion back. Best thing is to start physical therapy ASAP if you possibly can. If not available then at least start using rubber resistance bands to start building strength back. Search the net for physical therapy for the shoulder and you will find a lot.

Yes it will feel weird probably from here on out. Mine still pops and moves around strangely even after two years. The bump is still there and it does still feel like my arm hangs lower than it should unless I concentrate on holding it up in position. Strengthening exercises do help though. Your shoulder position will now depend 100% on muscle strength and tone since you no longer have the joint to bear the load.

Also see my post #32 above if you are concerned about crashing again.
Good luck :thumbsup: .
 
#73 ·
Just to check in again, 8 months later. Cliffs notes: Class 2, 3 or 4 depending on who I asked. Ended up not getting surgery. Strength is nearly 100%, the strange situations where it's less than 100%, my uninjured shoulder is pissed too. Looking back, I'm REALLY happy I didn't have surgery. My understanding was that unless the injury was operated on within 24hrs, the main joint will never be repaired. Very few of the surgery options did anything more than trade the goofy bump for a scar. The ones that repaired the joint didn't give me a warm fuzzy about the actual usefulness of the joint after all is said and done. Looking toward drinking less and training more for next season, I'm not scared about re-injuring that joint......it doesn't exist anymore.
 
#74 ·
kmacon said:
I feel for you, sounds like my situation a couple of years ago at this same time of year. Non-dominant arm and doc said about the same thing. I was riding again in about two to three weeks. Didn't really bother the injury to ride for some reason. There were a lot of other things that I could not do though if they involved weight bearing or lifting. Lots of those things just take time.

Try stretching/lifting the arm upward by using a wall to walk your hand up and back down. I found this really helped to get the range of motion back. Best thing is to start physical therapy ASAP if you possibly can. If not available then at least start using rubber resistance bands to start building strength back. Search the net for physical therapy for the shoulder and you will find a lot.

Yes it will feel weird probably from here on out. Mine still pops and moves around strangely even after two years. The bump is still there and it does still feel like my arm hangs lower than it should unless I concentrate on holding it up in position. Strengthening exercises do help though. Your shoulder position will now depend 100% on muscle strength and tone since you no longer have the joint to bear the load.

Also see my post #32 above if you are concerned about crashing again.
Good luck :thumbsup: .
Thanks bro, the shoulder is already feeling better. I'll post back after my first ride. For now it's work on the stationary bike
 
#75 ·
ok guys its been 10 weeks, It was doing good and pain free untill a day ago. I tried to do a push up and it hurt a little so I didn't to any more, then today it's been hurting just about all day. Did I really re hurt it by doing a push up? How long did it take you guys before you could do push ups pain free?
 
#76 ·
Dude,

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