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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!!!
 
#867 ·
Not given to me...

Just negotiating w/ boss via email on what constitutes 'light duties' and not using right arm...

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-=snifff!!=- What's that you say?
 
#869 ·
One day shy of 4 weeks on my grade 2 with fractured ribs....

Back to sleeping in bed this week rather than recliner. Can ride the bike on road and rail trails without discomfort. Sneezed yesterday, and although it's still quite painful, it wasn't nearly as horrible as it was in the beginning.

I get more pain out of my shoulder when I pull, like if I try to pull the front end of the bike up. I also get pain when I bring my arm behind me. I wanted to try surfing yesterday, but the paddling motion is still too painful.

Plan to ride 10 miles plus today. so far I've only done shorter rides so will see how it goes.
 
#870 · (Edited)
Update: Grade 1.5-2.0

Sunday morning (day 3) and some ROM is returning ^^ see how it is once out of bed...

Update-to-update:

Using range of motion causes prolonged suffering!! i.e. I'm pretty sore right now o_0
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-=snifff!!=- What's that you say?
 
#872 ·
How's everyone's manualing technique going? Just a few days into recovery and I can see lifting the front end will be trickiest part of getting back on steed... which if riding gnarly trails is pretty important.

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-=snifff!!=- What's that you say?
 
#873 ·
That manual motion of yanking something heavy in front is still the worst movement for my shoulder, now that I'm 95% better. I have an Outback, so I pick my bike up and slide it in back. That motion hurts more than riding my bike. Just a strange injury compared to everything else I've done. I can make it through most of my wife's Insanity videos, surf, lift heavier weights at the gym....but if I reach down to put on a shoe with my arm fully extended I get a little shot of pain. And none of my post recovery pain has ever been in the actual shoulder where the joint was damaged. It's always a dull ache up my Trapezius.

Which out of curiosity......what movements or strange everyday things still bother you guys now that you're more or less better?
 
#874 ·
I believe I'm right at 5 weeks past my injury. The yanking/lifting is still the worst to me, but it continues to get better slowly. I also tend to get more pain with any motion where my hand is somewhat behind me. I'm nervous about trying surfing because when I simulate the paddle motion, I get pain in the whole portion of the stroke from when I would pull my hand out of the water until it goes back into the water, since that part of the stroke has my hand behind me. Also weird movements have caught me offguard. For example a smoke alarm went of yesterday. I jumped up to press the hush button instinctively with my injured arm, and that motion hurt.

My pain is mainly in the the head of my shoulder, and towards the rear portion. Not really where I visualize the separation is.
 
#875 ·
5 months post-surgery for grade 5 AC sep. I found paddling my board to be good therapy. In fact, it seems to be the only therapy for getting back surfing. Like you, in the beginning I couldn't get my arm up high enough on the recovery part of the stroke but had no problem with the pull, other than being weak. Had to dog paddle at first with the left arm. A few sessions in it started to get better and now at times the stroke almost looks normal although it still hurts at that lifting the elbow spot. It also hurts to push to the sitting position and still can't push all the way to standing yet. Am going out in an hour or so (hoping the sun clears the clouds a bit) for my now regular 2 a week session. Am up to an hour out in the water mostly paddling alternated with 15-20 reps of sitting from prone. It doesn't hurt as much now. Hope to be back standing soon! Haven't found any exercises that replicate surfing and being out in the water really helps the soul.
 
#876 · (Edited)
About 4 1/2 weeks since surgery on grade 5 and pretty much any movement that includes extended reach is tough. A good example would be leaning over to wind down the car window on the passenger side from the drivers seat - almost impossible ATM and super painful.

I've been back on the MTB since last week, early days but gradually increasing intensity, moving from sealed roads to smooth paths. ATM with the shoulder I'm not able to lift/pull the front of the bike up at all, and absorbing large impacts is tough too.

That said I did several shuttle runs while working in the mountains on the weekend and loved being out on the bike. Definitely had to concentrate on staying relaxed and just riding vs protecting the shoulder, plus took it relatively easy of course. Main issue for me is building confidence in what the shoulder can do, while at the same time continuing to strengthen it up. In my case gotta be on the bike to make it happen in sync.
 
#877 · (Edited)
I'm kind of amazed at how different the rehab protocols given by different doctors are! My doc has me in a sling for 12 weeks after an anatomic allograft reconstruction of a grade 5, not riding road until week 12, certainly not mountain biking before then. Other docs let people out of their slings at week 4-6 and allow biking again at that point. Blows me away how much variation there is!
 
#879 ·
I would say it just depends on the individual injury and how it was repaired.

My AC joint grade 5 was reconstructed using a hamstring harvested from my leg - there was no graft etc. In my situation there was no benefit or need to immobilize the shoulder/arm in a sling following surgery. In fact you're encouraged to start moving the arm ASAP i.e. the next day, and stop wearing the sling altogether as soon as you can tolerate the discomfort, which for me was 1-2 weeks. From then on it's all about regaining movement and building strength especially during the first few months, and learning how the shoulder behaves. From all the options described by the surgeons this one seemed to be the one that best addressed the injury and my needs, lifestyle etc going forward. I'd probably describe it as brutal and effective.

I should say that while they OK'd smooth path riding ATM, neither the surgeon or physio recommended I go out trail riding just yet, but ya know sometimes you've got to find out where things are at, and I was relatively careful. The reason for their riding recommendation is that main risk in my case is crashing/bumping into something and fracturing the bones around where they were drilled to thread the hamstring - and crashing is obviously way more likely when you're shoulder isn't fully functional yet. The other risk is prematurely stretching the hamstring excessively which could lead to a sloppy shoulder later on.

For me the discomfort can still be intense in a searing kinda way (95% off all pain medication), but the trade off is each day the shoulder improves. Anyways that's what ya left with, on the outside at least!

Lip Cheek Mouth Chin Forehead
 
#878 ·
Can't imagine the pain associated with a grade 5...

my 2-2.5 (75% separation) is pretty sore in the morning i.e. 10-12hrs w/o pain relief. Still struggling to feed myself (right hand - injury side) have to move mouth/head down to hand. Looking like a homeless man i.e. can't shave or not brave enough to try left handed (man slits own throat shaving!?) Still finding if I try and do anything particularly heavy with left arm, it will transfer to right side. Tried rolling on bike yesterday (asphalt) and handlebars felt crooked. Thinking full recovery is some weeks off yet... smooth trails in a couple weeks (hopefully), then some moderate single track after that... no rush to be bombing stuff yet. Just getting back out on bike will be nice. Martial Arts I'm thinking is done for the year.

NB, 10 days post injury...

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-=snifff!!=- What's that you say?
 
#880 ·
Sat on whip yesterday and pedaled around garage w/o any major pain (tight turns were meh)... Getting excited I'll be able to ride soon (even if it's only on flat stuff)

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-=snifff!!=- What's that you say?
 
#881 ·
3 weeks post injury today...
Would say I've got 50-60% rom back... lacking strength at mo.
Have planned in my minds eye a midweek ride (next Wednesday) w/ kids - just paved stuff to dip the toes.

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-=2011, 2015... 3-peat?=-
 
#882 ·
10km ride not long ago... asphalt only w/ my 6 year old ^^ wish I was as hardy as him. He did an endo/scorpion... on the flat!? Don't know what he was trying to do ^^ couple of tears and he was off again. I would've been back in hospital >.<

Anyway, ride went fine. Hands took a wee bit to get used to weight/pressure again. Got adventurous and rode over a wooden carpark barrier (1/4 of a railway sleeper) shoulder not so keen on that... but, a little step down didn't faze at all!?

Planning another ride tomorrow with son again... this time on a little loop I do with the kids on hard packed trail. Will be a bit more challenging. Should be epic! If I come through unscathed o_0

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No skool... like old skool!
 
#883 ·
Stage 2 separation 10/25 with bruising and what turned out to be fractured ribs.

I've been riding single track again, for a few weeks. Each ride a little better. Last week I felt much better pulling the front end up, and even threw in some bunny hops. Was very happy with progression. Well, until today.

Today was my first attempt at surfing. Waves were about chest high. I really thought I was going to be relatively fine, but I was wrong. Everything hurt...paddling out, duck diving, popping up to my feet, really everything. The worst part was I couldn't paddle hard, so catching waves was very difficult. The whole session was essentially a wash. The shoulder got more achy as I went, and I even started feeling the ribs; even though they are in back, the pressure on the front of my rib cage made them hurt.

Pretty depressed with the whole thing. Hoping I just tried too soon, and in a few weeks it will be a lot better, but worried I may have damaged my shoulder in some other way. At least I can ride. Still haven't tried rear wheel hops or any trials you type moves, but XC riding has been great.

I did buy an armored vest though, in case I fell on the ribs. Gave me a sense of security (false perhaps) that helped me ride a bit harder. I also bought a fatbike about 1-2 wks after my crash thinking it would be a "softer" way to get back out there. Basically just an excuse to buy anger bike :)
 
#884 ·
Woohoo!! First ride on dirt this afternoon ^^

Managed a wooden ramp and seesaw... wasn't going particularly quick (wasn't blazing when I injured shoulder either), only problem is up & overs i.e
up and over large roots. Small wheelies were fine as they're initiated by leaning back.

Think I'll do a solo (today's ride was with boy again) ride tomorrow... bit of asphalt, couple of good off road climbs then one more road climb home.

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No skool... like old skool!
 
#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 =(

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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 ;)
 
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