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  1. #1
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    Ac Separation (shoulder Separation)

    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!!!

  2. #2
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    Had the same grade shoulder seperation as a result of getting slammed to the ground in a rugby match. I went to a sports ortho who said they don't do surgery on that type of injury any more. Studies showed that 5 years down the road there was a higher onset of arthritis.
    I bypassed rehab as the doc said all the injury really need was time for the ligaments to heal. At about the 3 week mark I started light weights and I couldn't even bench press the bar. At about 8 weeks I went from 35 lbs to 135 to 150 over the course of 2 weeks. 12 week mark I was back to about normal. You'll know when it is healed. You can feel it. Don't rush it as you don't want to tear the ligaments and start over again. When it was all said and done - w/out surgey my shoulder is as strong as ever and I've got an enourmous lump on shoulder as a keep sake - which is actually the collar bone sticking up. But every other person I ride with has one of those.

  3. #3
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    Rugger, Thanks For The Reply. You Put My Mind At Ease. Just Don't Understand One Thing. You Said You Don't Want To Tear The Ligaments Again. I Thought With A Grade The 3 That The Ligaments Are Completely Torn And They Don't Repair. Your Body Just Adapts To It.

  4. #4
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    You are right. I should have used the word "healed". I am still not sure what that means but the doc said I would be healed in 12 weeks. I guess I never asked him what he meant by that.
    I do know that at 6 weeks I couldn't do anything and at 8 I could do the bar and at 12 I was feeling fine. I am 7 years out now and the only thing that still bothers me is the clicking of the tendons when I do shoulder presses. Otherwise there is no residual pain or weakness.
    On the other hand my wife thinks I look like a freak because my collar bone sticks up a good inch. And it is good for scaring the kids at the pool.

  5. #5
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    Quote Originally Posted by JB800
    Rugger, Thanks For The Reply. You Put My Mind At Ease. Just Don't Understand One Thing. You Said You Don't Want To Tear The Ligaments Again. I Thought With A Grade The 3 That The Ligaments Are Completely Torn And They Don't Repair. Your Body Just Adapts To It.
    JB800. Hope you heal fast. Just a suggestion ... don't capitalize each word in your posts. It's a little hard to read. Welcome to the forum.
    2005 Specialized Sirrus Comp, 2006 Specialized Roubaix, 2007 Specialized FSR XC Pro

  6. #6
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    Thanks! I greatly appreciate the info. This injury has been very frustrating to me but I am now much at eased hearing the outcome of someone else. Thanks again!!!

  7. #7
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    I believe the AC joint is a pretty 'average' design left over from when we ran around on fours, hence why when the ligiments tear they don't stress too much about surgical fixes. Its a joint with a really really small range of motion but the whole shooting match of joint bits ie. cartilege and ligiments. If it realy packs it in later they just remove the whole joint and the end of the clavicle (saw a piece of the the bone off) and let it fill with scar tissue which makes a flexible connection, and apparently that works good.
    My shoulder sticks up on one side for the same reason, seems real common.

  8. #8
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    Hey JB, another AC joint cripple here.

    Both of them actually. My right shoulder was a very serious grade 3 and my left shoulder a mild tear/strain. My Ortho Doc told me he would not recommend surgery unless I wanted it badly due to constant pain and also aesthetic reasons, mainly that the shoulder now hangs down and there is a significant bump on my shoulder. Also, when I have my arms hanging down one arm is slightly longer than the other.

    If you can deal with the slight hunchback look and aren't in significant pain or have arthritis in 12 weeks or so, just let it be. If your young and take your shirt off at the beach and flex for the ladies...its your call. You will have that bump forever. If you get the surgery you will have a scar across the front of your shoulder. Take your pick.

    BTW, my ortho Dr. is a pretty good doc. He fixes some major figures from pro sports. ACL and shoulder surgery are his big things that he does. I saw a WNBA player in the office when I was there so he knows his stuff. If he says skip the surgery, I listen. Peace.

  9. #9
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    grade 2 separation here

    I'm about 4 weeks since the injury and not doing much except resting (partly due to the bilateral radial head fractures I got with it ). I got the same story - rest for a few weeks, less pain after 6-8 weeks with return to activity. I seem to have lucked out in the arm length/shoulder bump area because I'm not really seeing either one.

    I'd be careful with the bench (or overhead) presses because it can put a fair amount of load on the shoulder, depending on your form. I'm focusing on regaining range of motion and flexibility before worrying about strength, otherwise you risk letting too much scar tissue build up and not returning to full use of the joint (important for my throwing arm).

    Good luck!

  10. #10
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    Quote Originally Posted by Rower_CPU
    I'm about 4 weeks since the injury and not doing much except resting (partly due to the bilateral radial head fractures I got with it ). I got the same story - rest for a few weeks, less pain after 6-8 weeks with return to activity. I seem to have lucked out in the arm length/shoulder bump area because I'm not really seeing either one.

    I'd be careful with the bench (or overhead) presses because it can put a fair amount of load on the shoulder, depending on your form. I'm focusing on regaining range of motion and flexibility before worrying about strength, otherwise you risk letting too much scar tissue build up and not returning to full use of the joint (important for my throwing arm).
    Good luck!
    Good point about the presses, overhead stuff BB is not at all good for my AC joint, bench is OK, but dumbell presses put a lot less strain on that joint so I mainly do those myself.

  11. #11
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    Smile

    Sufferred the same injury about a year ago but I don't remember what grade it was. Anyway, just wanted to say that some months later, and a bit of physio and excercises, it is like I never had it. I couldn't even tell you now which shoulder it was. Time is a great healer, so have patience.

    All the best!

  12. #12
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    Thanks for all the feedback! greatly appreciate it!!!

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    Listen to your Dr. and do the PT as they suggest. I didn't really do any PT and it took a very long time to get the shoulder back to feeling normal. I never really fully regained the strength, but eventually got to a point where I could crash on the shoulder without it feeling any different than crashing on the other one. That is until I broke the collar bone a month ago. Now I get to go thorough the whole ordeal again. This time I will spend the time and PT.

  14. #14
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    Had a type 3 AC separation two years ago and had surgery to fix. The very same operation and also the same surgeon as Steve Peat earlier that year.In simple terms they put a piece of tape around the collar bone and bone spur on the shoulder blade and in the doctor's own words "pull on both ends as you would fastening shoe laces" although this is meant to be the cutting edge method of fixing this injury. Convalescence was awful, two weeks with the shoulder completely immobile and no physio for 2 months. It took me 4 or 5 months to get back to riding to work and 6 or 7 months before I got back to using my shoulder as I used to.




    Shoulder only hurts now as I got knocked off my bike by a bus the day before Xmas and landed on the same shoulder although this is being dealt with by my solicitor not my surgeon!!!!!
    Last edited by sic_nick; 06-30-2007 at 07:05 AM.

  15. #15
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    I suffered a third degree shoulder separation last November after crashing into a tree after a great ride and clearing some crazy ****.

    I opted for the surgery, modified weaver dunn, had it done December 28 2006. Today I was just released from Physical Therapy. Yes I have a scar on my shoulder, but very little lump and shoulder is almost as high up as before.

    Progressing well, mostly core and bodyweight exercises. Was in a sling for the first four weeks (sucked) then out of it. Initially PT was a *****, very painful. Right now I have almost all my range of motion back and some of my strength. Doc says 9 months (will be september for me) until it fully heals and a full year or more before it feels mostly normal. Cleared for biking this September.

    I know it sounds like a lot but I am glad I did it. Google Weaver Dunn Procedure. I would go for it!

  16. #16
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    oh wow.... i myself experienced a type II tear DHing this week. was told it would be a 4-6 week recovery. from what imreading here, i may be too optimistic

  17. #17
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    I'm 10 weeks out from my 2nd degree separation and here's a basic timeline of my healing:

    2 weeks - out of sling, range of motion (ROM) OK but still some pain/weakness with lifting
    4 weeks - almost full ROM, little pain with light lifting/reaching across body
    4-8 weeks - slowly regaining strength/mobility

    I considered myself "healed" by 8 weeks, but I still have a little ways to go to get back to full strength and flexibility in my shoulder. I still can't lie on my injured side without experiencing a dull ache.

  18. #18
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    I seem to be in somewhat of a dilemma. Apparently I damaged my scapula and a nerve that covers it when my 2nd degree seperation occured. My doctor says that I cannot do any PT because I risk damaging things worse witht the nerve and shoulder situation. So apparently I just have to let it heal with time. I'm at 4 weeks and I have full ROM but it still hurts to reach across to the other shoulder and if I push against something with my right arm my shoulder blade pops out of my back a bit. I'm concerned that not doing any PT at all is really going to make healing a ***** and take forever. Anyone else in the same boat? Should I get a second oppinion?
    Last edited by patch-rik; 07-17-2007 at 01:06 AM.

  19. #19
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    Grade 2 seperation here.

    I'm thinking once we all heal, we should start the "Team Pointy Shoulder" and we'll get custom fit jerseys.

    I seperated mine last week on a night ride. (I'm gonna get that punk that put the stick in the trail) When I woke up the next morning and I noticed the high collar bone and droopy arm; I went to the urgent care. Doc diagnosed it at first sight but couldn't understand how I could have full range of motion with very little pain. I think he was just looking for an excuse to take more xrays. He explained what it was and said no surgery and that it will heal itself and I'll always have the bump. He didn't say anything about a timeline.

    I can go all day with no pain but sleeping hurts (still hurts to wipe my arse). Rolling out of bed is quite difficult.

    We'll live.

    Caz

  20. #20
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    I was amazed at how long it took to be able to sleep on my shoulder after my grade 2 separation. I'm a little past 3 months now and it's only in the last couple of weeks that I can lie on that side without any issues - I had full range of motion in the joint and was able to start lifting weights again after 2 months, but there was still some deep tightness/soreness that reared its head when I tried lying down on it.

  21. #21
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    I've separated both of mine and I also had the problem of having pain when trying to sleep - took about two months before I could sleep through the night without waking myself up by rolling over on it.

    My right shoulder is the grade III and I did it about 12 years ago in a road biking accident. Anyway, I had a really bad wreck last weekend and fell on - you guessed it- my right shoulder. I felt my shoulder giving way as I slammed into the ground and I was having flashbacks about pain. Funny thing was it didn't hurt as bad to slam my already separated shoulder into the ground. I know it moved enough that it would have separated had it still been attached. I've definitely had some pain but nothing like before. I guess the point is once the bone is ripped free you don't have to worry about the pain of having it ripped free anymore!

  22. #22
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    I had a type 3 seperation in spring last year. My doc told as long as I don't experience any pain I can do whatever I wanted. After 10 days I was back on the road bike and after 6 weeks I did some easy trails. About 3 more weeks and I could ride everything I did before. Today I have no pain or any issues, just a lovely cycling lump.

  23. #23
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    I also separated my AC joint. I am not sure what grade, but not bad enough to warrant a sling. I never had an xray. A guy on his motorcycle was riding illegally on the trails. I came around a bend and we were face-to-face. I slammed on my brakes to avoid hitting him and flew over the bars. It hurt terribly. My arm/shoulder were weak for weeks. I rehabbed myself...started lifting light weights. To this day, the shoulder hangs different than the uninvolved shoulder.
    I dont think surgery is recommended unless the injury remains painful.

  24. #24
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    Over ten years ago, I separated my shoulder pretty badly in a hockey injury. It took over a year to fully heal, but now its 100% and has been for years, never gives me any problems whatsoever.
    Wanted: broken Titec 2 bolt seatpost, any size

  25. #25
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    Good job! broken....but healing

    I've read the reviews on this thread. Lots of good advise, just Bcareful w/2nd hand doctoral advise. all injuries are person specific.

    I hopped on looking for time lines for shoulder separation. I've got 4 collar bone, 1 shoulder blade, 1 broken hand and several ribs injuries for experience but the separation is a 1st. I likely have to multiply the time by 1.5 since i' i'm old.as in 41. Class ll is going to keep me from grp ride @ Gooseberry in Utah on 10/ 7.

    Anyway....My additional advise for those early in the healing stage and esp for the guy
    having trouble sleeping. I hate to say it as much as I hate to do it, but TAKE THE MEDS.
    You are likely too active in the day like me..so bedtime can be good healing time....but
    not if you keep re-injuring yourself.

    The true muscle relaxers (in addtion to the anti-inflamitories, not to be confused with) help immobilize your injury for a good 6-8hrs. So get in a good "resting your injury position" before you nod off. When out of codine type drugs...I use 2 glasses of wine....almost as good. Obviously not good advise if you have addictive personality! (disclaimer)

  26. #26
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    I have grade I AC Separation maybe more

    Happened last Sat 9-1, haven't been to the doc yet but it really hurts to move my arm across my chest and rest my palm on the opposite shoulder.
    Also had some pulling/tightness in the muscle on the side of my neck and in my back and lats, but that's subsided quite a bit after a week; however the shoulder tighntess,pain is not.

    I think I got REALLY lucky, actually, since riding group videod this particular descent and crash on DH section and it was pretty violent. My buddy rode the whole section and made a mistake at the end (a drop into a berm) and broke his collarbone. Buds said my crash looked way more violent than his, yet I get away with AC separation and he breaks a bone!

    My advise for those who still want a cardio workout but can't get on the bike yet, if you can, ride road or use the recumbant bike in the gym - I've gotten 3 pretty good cardio workouts this week on it and it puts minimal load on the shoulder- up right bike might be better. Not sure about the road bike but going to try that tomorrow.

    There sure are a lot of shoulder injuries on here and I didn't think about googling "AC Separation" or "Shoulder Injury" until tonight, when a friend mentioned it.

    FAst healing everyone, and try to as active as you can (if you can at all) in the meantime.

  27. #27
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    Had a type 3 seperation a few years back. Opted for the surgery route for several reasons. Def. slows the recovery process, but I'm glad I did. (2 times under the knife actually, had to go back to get a pin removed.) Have a nice huge battle scar to show for it now too. Now I'm laid up again with some huge gashes on my arm from a slide down some rocks today.

    Def stick with the PT and training though, but don't over do it. It's easy to set yourself back when you start getting overzealous.

  28. #28
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    Oh wow. I am 4 weeks into a AC separation. Doc told me same story about
    the wait and let it heal strategy taken these days.

    Sleeping has been a real pain, as has removing shirts.

    He told me to give it a solid 8 weeks before I worry about the pain aspect.

    He did say to try riding on flatter ground. The visit before when I saw him
    was for a broken thumb, messed up wrist ligament and messed up nerve in my elbow.

  29. #29
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    I too, am a member of the "lumpy shoulder club"

    Did my right one 13 years ago playing judo....took a long time to get right, but anymore the only reminder is the lump on my shoulder and an occasional twinge when I overdo the push ups, or if I lay off the PT for a while and pick it up again. No surgery and no arthritis so far, still follow up with my ortho doc and he says not doing the surgery probably saved me a lot of pain in the long run. On the other hand the knees have been in the body and fender shop a couple times and the initial injury to my shoulder was far and away more painful than they were.

  30. #30
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    Four weeks out on a 3rd degree separation. Classic over the bars fall. God bless my brand new Bell Sweep that saved my melon. I second the pain being terrible, I'm not the toughest guy, but ouch.
    How soon did some of you with 3rd degree injuries get back on your bike? I rode some slow single track yesturday, with no pain. Really scanned the trail like never before, and the trees seemed VERY close to my shoulder. I probably shouldn't be riding, but couldn't resist.

  31. #31
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    I'm glad I saw this post. I feel a bunch better after just receiving a grade 3
    separation a week and 1/2 ago. I blasted down a 4 foot drop and the front
    wheel hit something in the leaves and just stopped. I did a bad body slam
    causing the separation. I've been a bit worried about it, as many of you, the
    doctors, even a 2nd opinion opted no surgery.

    Thanks for all your input. I feel a lot better knowing it will come around. The
    doctor said to take it out of the sling as soon as I could do so without much
    pain. I took if off this past Thursday and seem to be getting some use out of
    it now. It will be two weeks into it the day after tomorrow so I guess I'll just
    keep counting.

    Thanks again, everyone.

    ODN
    Caffeine ! "Do stupid things faster and with more energy" ! !

  32. #32
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    I am 5 months out on a AC 3 separation (no treatment) and have been riding since the third week. Funny thing is that the position while riding since the separation has always seemed stable and not induced any pain. My problems have been laying on my side to sleep and also pushing straight up with the affected shoulder from a laying/sitting position on the floor.

    Went OTB again 2 weeks ago and landed on the same shoulder. Heard all the same crunching and scratched my arm and leg up pretty badly and had some deep bruising on my leg. With the exception of my bump sticking up a little more for a few days the shoulder though was OK. I am glad that I did not do the surgery. Would have probably messed it up real bad.

  33. #33
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    Grade 4 separation

    Its been about four years ago now, did mine snowboarding. I opted for the non surgical route, no PT and no drugs. I still cant lift as much as before and rock climbing is a lot less stable but I dont notice it in daily life other than the big lump. I would recommend letting the injury heal on its own unless the bone is sticking out of your skin, but thats just me. Be patient with your bodies healing process and seek out some myofascial bodywork to keep the shoulder girdle opened up things stop working.

  34. #34
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    My AC seperation has a little twist

    About 3 years or so ago I was working out on a shoulder press machine at the local Y. Pressing the weight back up I felt a pop by my right shoulder blade and dropped the plates. I was in a lot of pain and went to my Doc. I obviously strained myself and "rest and never lift that much weight again" was my doctors response. For the longest time I had a tough time with my right shoulder and my range of motion was quite limited. I could not for the life of me grab the back of the collar of my shirt to pull it over my head with my right hand. Due to my limited strength and flexibility working out became quite annoying and I stopped.

    As a result of a trip OTB last year I received a class 2 separation on that shoulder. Within 4 months I could not believe how much better my shoulder was feeling. I regained much of my range of motion and was able to exercise that shoulder without pain. It's been a little over a year now since the separation and I've been back in the gym for about 3 months. I'm taking it slow but all of my strength is finally starting to come back.

  35. #35
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    Update:
    I am now 11 months out, coming up soon on the anniversary of my crash and my surgery (modified weaver dunn, read my previous post). Crash was on 12/26/06 and surgery on 12/28/06.

    I have been religious about working out, mostly core exercises and power cal's (pushups of all kinds, pullups, etc. I can recommend books) and I am feeling strong and so is the shoulder. Occasionally it might feel a little sore if I push hard, but this is progressively reducing in what it takes to make it sore. I feel I am better off with the surgery, and it looks almost as before.

    I have lifted weights heavy for 25 years. After the accident I had to learn new workout techniques and also learned how bad the bench press is for you (google bench press and paul chek), I would recommend you guys who are obsessing over the bench press (how much ya bench) to stop doing it and change your focus. My workouts leave me much more wiped out and I feel stronger, more of the entire body is worked out at once, has more real world applications for skiiing, biking, etc than isolated weight lifting, and this is coming from a former hard core weightlifter!

    If you can find a good surgeon I would recommend it. Arthritis isn't an issue since they trim off a bit of the clavicle in the modified weaver dunn procedure. I would also recommend you thoroughly research that procedure first so you understand what they will be doing. Plenty of info on the net. I have heard guys have gone back to playing rugby after the surgery.

    I went biking two weeks ago, played it real cautiously as I wanted the shoulder to be close to 100%. I think its about 98% right now.

    Anyhow, thought I owed it to those who are looking for feedback. I know I was when I was contemplating surgery. I scoured the net and read everything I could.
    The Trick to carrying on is not to get carried away

  36. #36
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    Wow, good thread. I'm about 4 months out from a level 2 separation on my left shoulder. I too have the big bump now. My sports specialist said surgery was really for cosmetics and that in the long run, I'd heal up just fine, albeit with the "lump." If I chose surgery, the recovery time would be significantly longer.

    I've also got a really bum rotator cuff that I'm going in for surgery on in January. My ortho said the same thing about the A/C separation - surgery would be more for cosmetics and would really increase recovery time. Although when I saw him last week, he said that he could shave off a little of the end of the clavical (about a 1/2") to reduce the bump and allow for better rotational movement.

    Race season starts in April, so I think I'll just stick to the arthroscopic surgery for the rotator cuff and be back in shape for Sea Otter.

    In the meantime, I think I'll do some more research on the Weaver Dunn procedure.

    Last edited by Surfinguru; 11-19-2007 at 09:54 PM.



  37. #37
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    Quick info update for those interested. Here's a really good overview of the modified Weaver-Dunn procedure.

    http://www.shoulderdoc.co.uk/educati...sp?article=525



  38. #38
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    Surfinguru,

    You are correct you will incur a much longer recovery, however, my ortho said I would achieve more strength then without the surgery and from everything I have experienced myself and read; replies, studies, etc I think he is right. Look at some of the people who have replied on this thread. I don't experience the same issues as they do after the surgery. Not trying to push this on anyone just trying to provide a response by someone who has had the surgery as it seems I am in the minority on this thread.

    Your link was a good one also, I read that one when I was researching my procedure. The only difference was that they used a fastener rather than a piece of string or twine of some sort to anchor the clavicle down. I have after pics but unfortunately no before pics.
    The Trick to carrying on is not to get carried away

  39. #39
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    SkiBikeMan, sent you a PM, but I want to ask if anyone else here knows a surgeon in the California Bay Area that does the arthroscopic modified Weaver Dunn procedure?



  40. #40
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    This thread has been a great resource. I dislocated and fractured my shoulder just over 3 weeks ago and had no idea what to expect as far as recovery besides the standard stuff from the doc. Thanks everyone for sharing your experiences. Looking forward to getting back on my bike ASAP!

    xray.jpg

  41. #41
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    Hey nice x-ray. So what procedure did they do there for your clavical? Looks like they've done a Weaver-Dunn?


    edit: Oh yeah, meant to ask if any of that stuff will be coming out?
    Last edited by Surfinguru; 11-28-2007 at 02:18 PM.



  42. #42
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    I crashed in September went to the ER and the doc said I had a bad bruise. When I asked about the huge lump on my shoulder she said it was tight muscles if I was still in pain I should go see an Ortho doc. Because we were in the middle of moving I didn't get into see the Orthopod untill late Novemeber. Did a grade 3 of my left shoulder. I also did a grade 1 to my right last february.

    I'm kind of glad I didn't know about the second one. I was riding 6 days later. Crashed on the 7th day. And kept riding. Riding really didn't aggrevate the injury. Bunny hopping/pulling up on the bars did.

    As far as the healing thing goes. I asked the Ortho Doc because of this thread. He said that what they find if they go in for surgery a couple years down the line is that the scar tissue develops into a cartilage type substance that helps to stabilize the join. That is what they mean by healing.

    No surgery here as I was basically back to normal in 6 weeks. Just some pain if I lift things over 30 pounds, or hold lighter items for extended periods (think squirming 1 year old) but it's getting better.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

  43. #43
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    Just a quick update for those interested, I went to get a second opinion from a guy named Tim McAdams yesterday since I was starting to get that "no so good" feeling from my other ortho. Dr. McAdams is the current team physician for the San Francisco 49ers and used to be the team physician for the Stanford basketball team.

    They took a fresh x-ray and he prescribed a new MRI which I'm getting done tonight. I asked him about the arthroscopic Weaver-Dunn and he point blank said it's still VERY experimental and that he wouldn't do it. (Case studies have revealed alot of complications.) He said he can do the AC reconstruction with at the most a two inch incision to implant a cadiver hamstring tendon, so that's not very invasive at all. He'll also do the arthroscopy proceedure for the labral, supraspinata tear etc. when he's in there and feels confidant I'll be back and ready for race season in three months.

    I'll continue to post follow up on events as they occur since it sounds like it could be useful for others on the board.



  44. #44
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    I have a twist too

    I have an AC grade 3. Big bump. I can actually grabg the end of the clavicle and move it around. It happened in 1990. FWIW, I was in pretty good upper body shape when it occurred. I was recommended at the time against surgery and for PT, unless I wanted it ground down for cosmetic purposes...I went to the Jobe Clinic...Lakers docs. I did PT and still do...in the gym, I do some minor/fun exercises now and it is all it takes. Riding my bike seems to make it feel better. I ride regular one gear type of bikes and I think b/c I mix up my technique so much that it has had a positive effect on my shoulder...standing and reefing up and out vs. seated spinning pulling back, etc. etc. I climbed through it and I think that was some great PT as well. I was in the Valley for a couple years and I gotta say I think I had this minor advantage in offwidths and squeeze chimneys…the Steck-Salathe comes to mind, but anyway….

    No under the knife for me...not when just a minor change in lifestyle would do it...you know like going to the gym, stretching and whatnot. this little change has benefited me in many other ways as well....think of the whole.
    The AC separation is a weird thing…I have spoken with folks who have had exactly the opposite experience of me…I forget I have one most of the time. After a couple years I could sleep on that shoulder again. I have been MTBing since ’84. I have full range of motion.
    Night has fallen.
    And there's nothin' we can do about it.

  45. #45
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    Body Armor

    About 10 years back I had my AC joint removed due to a bad skiing fall. Haven't been able to body build since because of the pain afterwords. Started MTB over the summer and it does'nt bother it.

    Can someone recommend some type of shoulder protection for aggresive trial riding, something you can move and feel somewhat lively in? I don't want to break or separate another shoulder.

    David

  46. #46
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    Another update. I started swimming laps 10 weeks after the grade 3. I had some pain at first but on the whole my shoulders feel better then before my first separation. I can sleep on it no problem. Basically the only time I remember it is when I move my shoulder in such away that the bone sticks out to it's farthest. It just feels weird.
    Disclaimer: I no longer fix bikes for a living.
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  47. #47
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    Quote Originally Posted by MTB'n Louie
    About 10 years back I had my AC joint removed due to a bad skiing fall. Haven't been able to body build since because of the pain afterwords. Started MTB over the summer and it does'nt bother it.

    Can someone recommend some type of shoulder protection for aggresive trial riding, something you can move and feel somewhat lively in? I don't want to break or separate another shoulder.

    David
    Hey David, I separated mine while wearing a 661 Pro Pressure suit. I don't think there is anything one can do to completely eliminate the possibility of injury. There are only degrees of mitigation.



  48. #48
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    Well for anybody that might still be following this thread and my situation in particular, I had surgery on Friday the 11th. Doc said they did ALOT of work, but said it went exceptionally well. He took care of the bone spur, fixed the rotator cuff, bursa sack tear and the supraspinata tear. Then he went on to do the distal a/c reconstruction. (cadiver tendon graft slight clipping the last 1/8" of the bone to get the clavical back in place.)

    I woke up from anesthesia with the worst pain I've ever experienced. As a result, they decided to keep me overnight and hooked me up with the PCA machine (morphine drip) and a bunch of vicodin. About 6hrs later came one of the worst sicknesses I've had. (I'll never take that again - I'll sack up and writhe in pain before going through that nightmare.) Got discharged about 3pm the next day. Staying overnight in the hospital is one of worst experiences to be sure.

    I'm home now with strict orders to ice and not do anything with the arm for two weeks to ensure the tendon graft doesn't get screwed up. (Basically immobilization and lot's of percocet and darvocet - yeah!) Sleeping is a bit tough as I have to sit upright and sleep in the bolster/sling.

    I've got a follow up appointment next thursday to have the stitches removed and then it's physical therapy. I'm really stoked so far despite the pain. Only got one stitch for each of the three arthroscopy entry points and the incision for the tendon graft was only like 1-1/2" long.

    The goal is to be back in the saddle for Sea Otter. Keep you posted!



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    Me Too!

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mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> Long story short…I’m in the club.
    The Details: I crashed out at mi 25 or so of the Chequamegon40. Spent some time in the Hayward ER, got some X-rays. And then was told that I probably dislocated something but it popped back into place and I will be sore for a while. Here is you sling and ice pack, have a nice day. I then pointed out the giant bump on my shoulder that the old ass Dr missed while yanking my arm around in his earlier inspection. He replies, “Oh, I missed that….that’s an AC separation, here’s a prescription.” Really? Ya didn’t see that? Any ways I’ve got an appointment with a Ortho later today to get a good check out.
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    Slowly slipping to retrogrouchyness

  50. #50
    Harrumph
    Reputation: G-reg's Avatar
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mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:10.0pt; line-height:115%;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> 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.
    Slowly slipping to retrogrouchyness

  51. #51
    I'd rather be riding!
    Reputation: kmacon's Avatar
    Join Date
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    253
    Quote Originally Posted by G-reg
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mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:10.0pt; line-height:115%;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> 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.
    Hey G-reg I am 1.5 years out on a grade 3 and at this point I think I would concur with your ortho guy. While I have no pain and do absolutely anything I want to do there are still times when the shoulder is annoying. For example water skiing and wakeboarding with the torque that they place on your shoulder still takes a toll on the separated shoulder. Pushing up with that arm from a sitting or laying position is still bothersome too to a certain extent and yes people still sometimes ask what is wrong with my shoulder due to the bump. Thank god though, riding my bike has not been any problem at all. Also, and this is something to consider, I went OTB again 6 months ago and landed on that shoulder again and guess what, my separated shoulder probably helped absorb the impact and was non the worse for the wear.

    Can't speak for those who have had the surgery since I have not had it, but if I had it to do over again, and surgery was an option, I think I would choose to get it done and be done with it.

  52. #52
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    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.
    Slowly slipping to retrogrouchyness

  53. #53
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    just did mine 5 days ago am waiting to see the specialist in 6 days but already its noticably better first ride today since and not too much pain so im thinking it might be grade .5 not very serious at all.

  54. #54
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    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...

  55. #55
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    Did mine today. my pic looks like your pic, G-reg. I've been injury free for a few years now. Only took one pedal strike to fix that.

  56. #56
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mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> 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.
    Slowly slipping to retrogrouchyness

  57. #57
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    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.
    "You don't stop playing because you get old, you get old because you stop playing!" - Unigeezer

  58. #58
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    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.

  59. #59
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    How are you taping things, I'm used to ankles and knees...but this is my first blown up shoulder.
    Slowly slipping to retrogrouchyness

  60. #60
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    I've basically got what's shown on pages84-85: http://books.google.co.uk/books?id=4...esult#PPA84,M1

  61. #61
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    Did mine 3 years ago, completely blown and had a Weaver Dunn procedure with an allograft. The rehab wasn't easy, but returned to normal activity after 5 months. Now 3 years out it feels great, if anything stronger than the other one.

  62. #62
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    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....

  63. #63
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    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!
    Slowly slipping to retrogrouchyness

  64. #64
    I got nothin'
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    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.

    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.
    I ride at ludicrous speed

  65. #65
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    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. #66
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    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.

  67. #67
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    I've had a couple more goes and I'm now able to ride gently. I'm using a SixSixOne neoprene shoulder support and a small amount of physio taping.

  68. #68
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    Quote Originally Posted by G-reg
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mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> 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?

  69. #69
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    tomorrow I will be 2 weeks into mine. The doc said I tore one of the three ligaments so I'm not sure if its a stage 2 or 3? I'm glad I found this thread, a lot more helpful then my doctor. Hopefully I'm getting out of the sling and starting pt next week.

  70. #70
    Acromioclavicular Free!
    Reputation: jesse.futrell's Avatar
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    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...

  71. #71
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    Hang in there it will get better, just this last week I have improved a tun, its now been about 6 weeks and I have full range of motion back w/ a little pain at the very top. I hoping to start riding trails and park by summer

  72. #72
    I'd rather be riding!
    Reputation: kmacon's Avatar
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    Quote Originally Posted by jesse.futrell
    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 .

  73. #73
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    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.
    Slowly slipping to retrogrouchyness

  74. #74
    Acromioclavicular Free!
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    Good job!

    Quote Originally Posted by kmacon
    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 .
    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. #75
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    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. #76
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    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!

  77. #77
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    Here is my shoulder story. Last August (08) I dislocated my shoulder, it was out of the socket for a couple minutes and slid back in on its own. Being the stubborn (stupid) man that I am I chose not to go to the doctor. Basically just rested and worked on range of motion for a couple months. I tried lifting weights again this winter only to reaggrevate something in there, laid up for another few weeks.

    A couple days ago I took a pretty mild spill, arms outstretched to brace for impact. I felt the shoulder pop out a couple inches (out the front side) and as I was getting back up it it slid back into place. Not really much pain, I contemplated to keep riding. Now the rear of my shoulder is sore, and am kinda back to square 1.

    Does anyone have a link of exercises I can do to strengthen the entire shoulder. I travel a lot for work (months at a time) so its not the easist to get into a doctor or a regular PT program. Thanks for any insight given!

  78. #78
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    BTDT... Type 3 separation after flying over the handlebars going downhill in a race.

    I researched the hell out of this injury and read every article I could on it. Visited three orthopedic docs, all told me to let it heal on its own and see how I do. Six weeks of PT, and about 6 months later it was 90% of the way back to normal (normal being full range of motion and strength), a year later I was probably 98%.

    Will always have that hideous bump though. There goes my modeling career.




  79. #79
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    Shoulder Separation is different from Dislocations

    LAXCARP,

    You seem to be suffering from shoulder dislocations and this is a much different problem than a separated shoulder. There is a real limit to how much you can strengthen the shoulder to keep the shoulder socket from popping out, there are ligaments and other structures in the shoulder joint that hold the shoulder in place and these can get stretched and damaged when you pop the shoulder out. The bad news is that while proper PT will make your shoulder feel better it may not make that much of a difference in your shoulder stability. The good news is that there is alot that a good shoulder ortho can do to tighten things up - but it may involve a surgical procedure to do so. Best of Luck!

  80. #80
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    Just did myself a grade 2-3 AC separation yesterday while practicing 4x at the BMX track. You know, dumb crash because of a big round rock that rolled on the track accidently. Doctor said, after the X rays confirmed no fractures, to wear the sling for about 2 weeks and go to PT. Right now, the pain is not to bad, and I have a pretty good range of motion even if I feel limited in a couple of position.

    Any tips on what to do for sleeping, as it seems to be the worst part for me yet. Do you keep the brace on for sleeping?

    Thanks guys and fast healing to everybody.

  81. #81
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    Quote Originally Posted by zoro
    Just did myself a grade 2-3 AC separation yesterday while practicing 4x at the BMX track. You know, dumb crash because of a big round rock that rolled on the track accidently. Doctor said, after the X rays confirmed no fractures, to wear the sling for about 2 weeks and go to PT. Right now, the pain is not to bad, and I have a pretty good range of motion even if I feel limited in a couple of position.

    Any tips on what to do for sleeping, as it seems to be the worst part for me yet. Do you keep the brace on for sleeping?

    Thanks guys and fast healing to everybody.

    By the sound of it you have a fairly low grade separation for 2-3 since you can lift your arm at all at this stage. It took me at least a week to get my arm to shoulder level then I really had to work to lift to the sky. Do the physical therapy. After ripping your tendons/ligaments apart, the only thing that holds your shoulder in position is the strength of the muscles. Strength training for the shoulder became much more important to me after the separation.

    Sleeping was definitely the worst (with the exception of getting up off the floor from a lying position). The first few nights I tried sleeping on my back on some inclined pillows and could at least lean toward the side. After a while I got a really thick (firm) pillow that holds your head and neck up high off the bed. This takes a lot of the pressure off of your shoulder wanting to fold over.

    Two years out and still sometimes I get up and feel that I put too much stress on the shoulder while sleeping.

    Good luck, maybe you will heal fast.

  82. #82
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    Zoro,

    kmacon already gave you some great advice. Some stuff I would add to the mix is this:

    1. Try to get yourself off the sling as soon as you can. Only wear it if you feel discomfort.
    2. Start slow but try to recover your range of motion sooner rather than later.
    3. Be diligent about PT.

    Monitor the progress of your recovery. You should not be in pain after 4 - 8 weeks, you may still have some strength deflicit in the injured shoulder, but you will eventually work this out. If you are experiencing significant discomfort or have not regained your range of motion, you should consult with your doctor again. Also before you start doing strength training, you should get cleared by the PT or Doctor.

    While the shoulder will heal over time, you may have lost some (Grade 2) or all (Grade 3) of the ligaments that hold your shoulder together. Strength training will be key to you being able to return to your sport. You may also need to alter some of the things you do for strength training, i.e. NOT doing the bench press or at least modifying it since this excersize places such stain on the AC joint. Consult with a good sports trainer about how to proceed.

    Good luck.

  83. #83
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    Thanks for the support and tips guys!

    As for the sling, RacerX58, I thought having it stabilize your shoulder was supposed to be an important part of the healing process, as it helps to put everything 'in place' together again. I would feel comfortable to go on with my day without it, but I don't know if it's a good idea yet.

    Right now, (2 full days after the crash), I can move arm shoulder high without pain in most positions, except when moving it backwards. Pain mostly comes when I do a sudden move or try to lift something.

    Last question: when should one start the PT treatment? I know it varies from individual to individual, but what would be a rough guideline??

    Thanks again!

  84. #84
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    Zoro, it is important to use the sling - but if you use it too long - you may get some painful adhesions when you start using your shoulder again. So try to reduce your use of it, key here is that you do not feel discomfort. Another thing to consider is the position of your shoulder, chances are your shoulder is pulling a bit forward because your muscles are trying to support it. You might experience some tightness because of this. A person familiar with muscle release therapy can help you with this and it will really make you feel more comfortable. Just make sure that the person knows how to treat arm and shoulder injuries.

    As for PT, it varies quite a bit and you seem to have medium grade shoulder separation of either a type 2 or 3. If it is a type 2, you could return to activities and begin more active PT at 2-4 weeks, if you really have a type 3 - then it can take 6 - 12 weeks. It really has to do with your level of discomfort and the types of excersizes you can do. Range of motion stuff you can do as soon as you can tolerate it. But in general don't hurry and don't push yourself to get your strength back. The first 6-8 weeks of recovery from an injury is very important, so let your body heal. Here are a couple of links you might find useful:

    This is an excellent source of information about AC separations.
    http://www.uptodate.com/patients/con...8Xm8h.pwl70pNy

    This is a link with rehab excersizes that you may find beneficial
    http://www.med.umich.edu/1libr/sma/sma_shldsep_rex.htm

    This is a recent article about Grade/Type III AC separations and treatment
    http://www6.aaos.org/news/pemr/relea...releasenum=788

    Take care,

  85. #85
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    Thank you very much for the links and the tips (especially the one with the exercices). As for the position of the shoulder, you might have touched a point there. I just don't know if the position I have it in in my sling is the proper position to adopt. Seems to induce more pain when I am in the sling than when I have it loose.

    Will try to consult for that, or call PT maybe to schedule an early appointment in order to have tips for the use of the sling etc...

    Happpy healing to everybody (if there is such a thing...)!

  86. #86
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    Quote Originally Posted by racerx58
    Zoro, it is important to use the sling - but if you use it too long - you may get some painful adhesions when you start using your shoulder again. So try to reduce your use of it, key here is that you do not feel discomfort. Another thing to consider is the position of your shoulder, chances are your shoulder is pulling a bit forward because your muscles are trying to support it. You might experience some tightness because of this. A person familiar with muscle release therapy can help you with this and it will really make you feel more comfortable. Just make sure that the person knows how to treat arm and shoulder injuries.

    As for PT, it varies quite a bit and you seem to have medium grade shoulder separation of either a type 2 or 3. If it is a type 2, you could return to activities and begin more active PT at 2-4 weeks, if you really have a type 3 - then it can take 6 - 12 weeks. It really has to do with your level of discomfort and the types of excersizes you can do. Range of motion stuff you can do as soon as you can tolerate it. But in general don't hurry and don't push yourself to get your strength back. The first 6-8 weeks of recovery from an injury is very important, so let your body heal. Here are a couple of links you might find useful:

    This is an excellent source of information about AC separations.
    http://www.uptodate.com/patients/con...8Xm8h.pwl70pNy

    This is a link with rehab excersizes that you may find beneficial
    http://www.med.umich.edu/1libr/sma/sma_shldsep_rex.htm

    This is a recent article about Grade/Type III AC separations and treatment
    http://www6.aaos.org/news/pemr/relea...releasenum=788

    Take care,
    thanks for this list. very useful after today
    mike

  87. #87
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    Here's one more update at 1 year. I had a Cat 3, did no surgery. About the only type of movement I can't really do is wide grip pull ups. That kind of movement makes the end of my collar bone hit the little process that it used to be attached to on my scapula. Otherwise, full recovery. And I don't have to worry about injuring the joint again...as it does not exist. If you are thinking of surgery, that was the big reason my Ortho recommended against it. If you are likely to injure the shoulder again and it is surgically fixed, you run the risk of blowing up that surgery.
    Slowly slipping to retrogrouchyness

  88. #88
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    I did my shoulder in 3 months ago now, and the worst part it was because I was going too slow while exploring new routes to take some friends on. I hit that root so bad off of that little hop that I even bent my front forks. Sling was on for 5 weeks ( at which point only 60% healed according to the doc)

    Sleeping is still the rough point for me after 3 months. I find that some nights I must be tossing too much and when I wake it feels like my shoulder has shifted a bit out of place. Gonna ask the doc today about it as those days I feel I need to pull on the shoulder to get it to sit right and then I can get full motion. Still could be the healing process as the doc say it was a grade 3 and the only true way to fix it is to put a pin in but like the others above stated he doesn't recomend it.

    At the 3 month mark I am riding (pavement only) again and playing ball ( just can't cannon the ball anymore ). Still have yet to get up the nerve to hit the trails though as I don't want to do my shoulder in worse, as I am not a spring chicken anymore.

    The only good thing was the 5 weeks in a sling was that my wife was actually nice ( as nice as a sarcastic wife can be anyways) and even opened my beer and brought it to me.

    Glad I found this thread though.

  89. #89
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    Quote Originally Posted by Frosti
    I did my shoulder in 3 months ago now, and the worst part it was because I was going too slow while exploring new routes to take some friends on. I hit that root so bad off of that little hop that I even bent my front forks. Sling was on for 5 weeks ( at which point only 60% healed according to the doc)

    Sleeping is still the rough point for me after 3 months. I find that some nights I must be tossing too much and when I wake it feels like my shoulder has shifted a bit out of place. Gonna ask the doc today about it as those days I feel I need to pull on the shoulder to get it to sit right and then I can get full motion. Still could be the healing process as the doc say it was a grade 3 and the only true way to fix it is to put a pin in but like the others above stated he doesn't recomend it.

    At the 3 month mark I am riding (pavement only) again and playing ball ( just can't cannon the ball anymore ). Still have yet to get up the nerve to hit the trails though as I don't want to do my shoulder in worse, as I am not a spring chicken anymore.

    The only good thing was the 5 weeks in a sling was that my wife was actually nice ( as nice as a sarcastic wife can be anyways) and even opened my beer and brought it to me.

    Glad I found this thread though.
    Hey Frosti, I'll give you my opinion, but you know what they say about opinions...

    First, three months in a sling? Ouch, that would really suck. That's a lot to go through to get your wife to open your beers for you.

    With Grade 3 separation what is done is done and its not going back together no matter how long you baby it. All you are waiting for is for torn and bruised muscles to heal after a Grade 3. No ligaments/tendons etc. are going to magically reconnect. The only thing you can do now is to strengthen the shoulder muscles so that they can do the work that the blown joint used to do (ie holding your shoulder in place). If you have not done any physical therapy and been shown what exercises to do then you need to get to it pronto.

    At this point you should be OK to hit the trails again. If not then it is more than likely because you have lost muscle and strength due to using the sling too long.

    Grade 3 management = Exercise, Exercise, and more Exercise

    Good luck and happy trails.

  90. #90
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    I had a completely separated shoulder (not sure the grade; heard from one doc it was a grade 3, from another a grade 6), all to say, it was completely messed up. My neighbor is a Orthopaedic surgical assistant and she took a look at it and sent me to the ER immediately. She got me in a 8 a.m. on Monday morning to see her Ortho. His suggestion was the same; that they just let scar tissue form and surgery is only done if you are a high level athlete. My biggest suggestion is to be patient and let it heal. However, start PT as soon as possible with a certified PT tech. It helped me tremendously and I have all my flexibility and strength back and only have a big lump on my shoulder to show for the injury. Occassionaly I get a little slight pain if the weather is bad. Must be arthritis setting in. Best of luck to you for a speedy recovery.

  91. #91
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    Man I'm glad I found this thread. I just found out yesterday that I have a minor AC separation. The doctor didn't tell me the grade, but it's probably only 1 or maybe 2. I don't have a noticable lump, and I've got pretty good range of motion. We figure it happend about a year ago on a pretty good crash, but it just flared up real good 5 days ago bouldering. Same consensus on no surgery unless it gets much worse. Man I hate taking time off the rocks and even worse is time off the bike, but it sounds like that's what I have to do at this point to keep it from getting worse.

  92. #92
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    Hello everybody, my first post at the MTBR forums although I've been reading around for quite a while.

    Had a grade 3 separation one and a half week ago, I went over the bars from taking an unintended 1 meter drop onto a sidewalk. I have opted for the surgery after having read up alot before my decision and although I'm pretty much trading a lump for a scar (and a couple of additional months of rehabilitation) I still feel it's what I want. I'm 23 years old and having the surgery done on Tuesday. I'm not sure what procedure it will be but I will report back here later since not many of the riders here seem to have chosen the surgical route.

  93. #93
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    Hi all, suffered a grade III AC seperation five days ago.Doctor advises against surgery at this point.I did enjoy doing recreational powerlifting in my spare time and I'm concerned I will have to give this up now. Has anyone been able to resume heavy lifting after this type of injury even after a year or two? Thanks.

  94. #94
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    Separated mine yesterday (grade III), coming up short on a double and goin otb. Glad i found this thread. Thanks for all your stories.

    I gotta say it was one of the most painful injuries i've had. The ortho doc shot me up with some cortozone with novacain today... it's helped the pain a ton. I can actually lift my arm now. The hard part is... i also fractured my wrist . Should be a challenging recovery.

  95. #95
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    urt Collar bone bad in China today. Doctors no help. Need MTBRs advice. Hurts so Bad
    I have been riding my new cobia for 2 weeks now. Like 80 km a day weekdays after not riding for 8 years andbeing out of shape. Someone burglularised my home and stole 8 years of my life work 3 weeks ago I decided I was going to bury ky self in my mountainbiking, get my healthback and now today the worst thing happened.

    First woke up and am scared my youngest child might have the pigflu as he is showing flu symptoms...

    Then I left and rode 35 kilometers on one of my fastest commutes and had an accident. I was in a small back alley street and I saw this guy on the side of the road trying to walk out in front of me it looked like on the shoulder of the road..

    Then blam I hit a speed bump the same color as the street.. totally missed it and indo'd over my front handle pars feet locked in place and slammed head and shoulder into the pavement.

    The Chinese walked around me as if nothing happened. I walked for about a kilometer then felt the most horrific pain I have ever felt.

    Went to the hospital.. and then the doctors tok an exray and said somethinglike two tendons n my collar bone were ripped and I would need a surgery. First they said 10-15000 rmb, then their boss came in and saw I was a foriegner and was like "oh no... thats like 25000 rmb"

    This is some serious cash. I can tell you that this hurts soo bad. They gave me morphine and some other pills Celecoxib.

    That didnt really do anthing that I can tell. I cant stand up and have to hold my arm up and out words of my body in order to not feel any pain... I mean not bad pain. Even when I walk. MY woman has to hel me piss as I cant doi it myself. They put some kind of harness on me and a free hanging splint. I am under the impression they dont know how to make splints because I cant do anything unless Ihold my arm up with my other arm.

    I need You help.

    Can you help me with the following questions?

    1)I can attach a picture of the x-ray and can someone tell me the name of what I have in English?

    2) Whats a good a good painkiller,

    3) how to make the proper splint?

    4)and is an operation necessary?


    And what is it that I have in English?

    The google translation says:

    "The right shoulder is sorrowful place right shoulder lock joint space widened, distal clavicle upward shift"

    I hurt so bad. i need to take care of my two children and 25000 is so much/

    5) Will I ever be able to ride again?

    6) It hurts so bad.. when will it stop hurting?

    Thanks for your help

    Robert ...

    Dead sad. Hurting.
    Attached Images
    Attached Thumbnails Attached Thumbnails Ac Separation (shoulder Separation)-smaller.jpg  

    Ac Separation (shoulder Separation)-img_0002.jpg  

    Ac Separation (shoulder Separation)-img_0001.jpg  


  96. #96
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    Good job! Wow!

    Robert,
    You've had a bad spell.
    First, don't panic about your son. I believe that China has the vaccination for H1N1, as well.? I have known a lot of people that have contracted it and they are all fine now.

    1. Broken Clavicle (collarbone)
    2. Vicodin - Pain Reliever/Anti Inflamitant
    Motrin
    3. How old are you? If you are concerned about the physical appearance you can get surgery and or use a brace. I did this exact break this summer and it just takes time. Put your arm in a sling and leave it there for 2 weeks. Find a good physical therapist.
    4. So, NO! It is not necessary to have an operation.
    5. Absolutley, you'll be riding after 6 weeks. Be careful! IT doesn't completely heal till about 4-6 months.
    6. Yes, it will stop and might be as you are reading this. Get/make a sling, soon!


    The healing that has to occur is the gap you see in your x-ray has to fill with bone. If youu were to go back in 6 weeks you'd see a cloudiness developing between the two bones that used to be one.

    I hope this helps? P.M. me if you have any further questions.

    Things should be brighter for you soon...good healing!
    "You don't stop playing because you get old, you get old because you stop playing!" - Unigeezer

  97. #97
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    Robert,

    Looks like a grade 3 separation. I don't see a fracture. Typically there will be some soft tissue trauma with these and and that is where the pain comes from. There are three ligiments that hold the clavicle down. From the look of the x-ray, you may have ruptured all three. Surgical options for this type of injury for for looks only. Very little gain in function (if any). It will take several weeks (6-8) to be pain free. Start taking Ibuprofen right now. Take 800mg every 8 hours for at least 10 days straight. A little tough on the stomach, but it will control the inflammation and help the rehab. Start doing active range of motion 5-7 days post injury. Sling your arm while sleeping so you don't reinjure in your sleep. Your pain will be your limiting factor while your awake so don't worry about the sling then. I don't reccomend surgical options as there are very little gains for your troubles and you also risk surgical site infection and post surgical arthritis. Many hockey players have this same injury to both shoulders and still keep playing. I had a similar accident about five years ago and was back on the bike in about three months riding hard. I had several broken ribs also and that was what took the time. Hang in there. Tincture of Time will heal this. Do your physical therapy. Good luck.
    A beginner since 1976

    I still have to explain to my wife how a 46 year old likes to get down and play in the mud.

  98. #98
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    Any of you all with type 3 Separations, feel the need to wear any kind of shoulder brace device, now that your back on the trails riding? My doctor said it was a personal preference thing, and didn't think it was needed, unless I felt more comfortable with one on. I'd like to hear other riders opinions/experiences, though.

  99. #99
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    Quote Originally Posted by Dominator13
    Robert,
    You've had a bad spell.
    First, don't panic about your son. I believe that China has the vaccination for H1N1, as well.? I have known a lot of people that have contracted it and they are all fine now.

    1. Broken Clavicle (collarbone)
    2. Vicodin - Pain Reliever/Anti Inflamitant
    Motrin
    3. How old are you? If you are concerned about the physical appearance you can get surgery and or use a brace. I did this exact break this summer and it just takes time. Put your arm in a sling and leave it there for 2 weeks. Find a good physical therapist.
    4. So, NO! It is not necessary to have an operation.
    5. Absolutley, you'll be riding after 6 weeks. Be careful! IT doesn't completely heal till about 4-6 months.
    6. Yes, it will stop and might be as you are reading this. Get/make a sling, soon!


    The healing that has to occur is the gap you see in your x-ray has to fill with bone. If youu were to go back in 6 weeks you'd see a cloudiness developing between the two bones that used to be one.

    I hope this helps? P.M. me if you have any further questions.

    Things should be brighter for you soon...good healing!

    Thanks for your advice...!

    I am happy to say that I dotn think anything is broken... Im not going with the operation for a lot of different reasons.. but most have said it is not necessary. Its not so disfigured... after 2.5 weeks It is still pretty week but I am gettign the feeling Id like to ride a little...


    Took bufferin, and ice... and wrapped it with a horse collar like brace...

    Have to say the brace helped the most.

  100. #100
    mtbr member
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    Oct 2009
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    138
    Quote Originally Posted by guero grande
    Any of you all with type 3 Separations, feel the need to wear any kind of shoulder brace device, now that your back on the trails riding? My doctor said it was a personal preference thing, and didn't think it was needed, unless I felt more comfortable with one on. I'd like to hear other riders opinions/experiences, though.
    I feel much better wearing a brace... I am on 2.5 weeks and have not ridden yet.. I have this brace that wraps around both shoulders and velcros in the back. First I have my woman wrap the shoulder and diagonal across my chest. I take off the brace at night after work and put it on in the morning. Seems to have helped... I feel much mroe invincible with it on.l I can see the strength slowly returning. I ahve rasied my hand up twice since the accident.. once yesterday and once 5 minutes ago.. Couldnt even think about doing that last week. Id say wear the brace to you have full strength.. I definately dont at 2.5 weeks but am feeling like I would like to try riding the bike for 10 miles or so.... but at the same time in the middle of the day' when it aches I can easily realise its too soon to try to ride. I would hate to ride ten miles and be stranded in pain or roll back the clock on the healing process..

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