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  1. #1
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    My AC (Shoulder) Separation Story and Experience

    I am now 4 days post AC Separation and wanted to share my experience. From what I have researched I think it's a type 3 separation. I will know for sure after I see the Orthopedic doctor in two days. Immediately after the accident I went to urgent care. Shout out to my new riding friend Michael for driving me to ugent care since I couldnt drive my car (stick shift). I have been in a sling and doped up on Percocet/Vicodin/Naproxen.

    Who: Me.

    What: 2.5cm AC separation.

    Where: Duthie Hill Bike Park in Issaquah Washington

    When: May 16, 2013

    Why/How: I was just almost to the end of a line and things go weird. I started to notice I was heading right for a tree and jabbed the brakes. This caused me to no dive right off the jump and go sailing. I put two hands down and my right shoulder and head took the blunt impact. I was thankfully wearing my LEATT DBX Comp 4. I don't know if this thing worked but that is the point of wearing these braces. I could definately feel the brace make contact with my helmet and limit the range of motion. See Video and Pic.

    Video:


    Picture:
    My AC (Shoulder) Separation Story and Experience-screen-shot-2013-05-19-11.02.17-am.jpg

    Will have a better clue about recovery time and how bad things really are after I see the Ortho doc. Will post updates.

    Take Care

  2. #2
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    It sucks right now, but you'll likely be fine in a short time.
    The good thing about a Grade 3 separation is that you don't need to worry about doing it again.....
    Do it right the first time and no worries from there on out...
    I've done both of my shoulders.
    Just stay on top of rehab and commit to shoulder exercises for the rest of your riding career and you'll be good.
    Shoulder separation is a DH right of passage.

  3. #3
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    Quote Originally Posted by Norman Clydesdale View Post
    It sucks right now, but you'll likely be fine in a short time.
    The good thing about a Grade 3 separation is that you don't need to worry about doing it again.....
    Do it right the first time and no worries from there on out...
    I've done both of my shoulders.
    Just stay on top of rehab and commit to shoulder exercises for the rest of your riding career and you'll be good.
    Shoulder separation is a DH right of passage.
    Good to hear! The thing I'm worries most about it how EASILY it happened. I feel like if I go OTB again it will happen again no problem! What do you mean I won't have to worry about doing it again? Like, it can't get separated any more??

  4. #4
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    Yeah-snap all those ligaments and you're good to go.
    Once they are gone they are gone!
    I rode for YEARS and had so many horrendous crashes before shoulder separation.
    Very easy to do-casual crash did mine. After how easily it happened, I was amazed that I didn't do it much earlier.
    Don't despair though, you can still snap your collarbones if you want to do more upper body damage.
    The shoulder is an amazing joint.
    Separations are usually no big deal for most people.
    Just keep the full range of motion and flexibility and pack on a bit more muscle and that's all you'll need to do.
    Surgery isn't necessary for most Grade 3s. Many docs will now said avoid surgery and just do rehab.
    Of course, if you're vain and don't want to show off the lumpy shoulder with the piano key collarbone, you can get surgery.

  5. #5
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    Go to know!! Do you have full range of motion and strength back?

  6. #6
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    Yeah, no problem for the most part.
    Was riding soon after but the shoulder wasn't really strong enough for constant DH use for about 3 months.
    For about a year after the injuries I'd notice weakness and lack of stability if landed wrong off of something big or had my balance wrong in rock gardens.
    If I slack on exercise I'll get some clicking and rubbing after 3-4 weeks when the joint gets sloppy.
    Doesn't hurt, but it reminds me that I need to stay on top of things.
    Shoulder feels strong once DH season starts up again and I'm riding almost everyday.
    It's only when I slow down and slack that I feel it.
    BTW, been able to do 40+ park days in the summer and riding 3-4 days a week on average for years with both shoulders separated.
    Use it or lose it.

  7. #7
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    X ray will tell for sure however from the pic looks like at least a 3rd degree injury.

    FWIW: Some orthos will recommend repair some will not.

    I never had mine repaired and suffer no ill effect aside from the bump. Sort of like a badge of honor. Do yourself a favor and check out this article before committing to repair.

    Medscape: Medscape Access

    Point is Grade 3 does not always need repair. Give it time before going under the knife !!

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    Thanks for the link drjay. I'm going to go without the surgery! The bump is huge but i'm not shooting a jockey underwear centerfold anytime soon. :-p

    1 week update:

    Visited the ortho doc and he told me to start getting out of the sling and moving it around a bit. I have been icing religiously and off of all meds other than ibuprofen. Out of the sling not for two days and the shoulder is feeling much better. Let me define better. I can no reach up to touch my face. Do certain things with minimal weight with my right arm. Still needs rehab and time but at least there is light at the end of the tunnel. I'm guessing 2-3 more weeks and I might be riding.....maybe.

    Thanks for the feedback everyone

  9. #9
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    2 week update:

    I am now a lot more mobile with my arm ROM is getting back however things are weak and arm gets sore/painful when lifting weighted objects. The thought of even lifting my MTB to put it on top of my car makes me weep. The bump hasn't gone down at all and I'm fearing now that I don't like it and will want surgery.

    My thoughts on surgery:

    1) Get surgery, bump goes down, play catch with the kids later in life (used to play professional baseball), risk falling on shoulder very easily again biking and do it again....eeek.

    2) Don't get surgery, have bump, never be able to throw baseball overhand, have potential long term pain issues.

    Can anybody share their two cents? I would not even consider surgery if I wasn't such an active individual. I live for the gym, biking, and playing sports.

    My AC (Shoulder) Separation Story and Experience-img_0597.jpg

  10. #10
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    I had a grade three AC separation two years ago. No surgery, lots of rehab, no worries. I threw a football for about 40 minutes with my nephew last week and it felt ok and was not sore the next day.

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    WOW. I have a little relief. I just did that to my shoulder yesterday, was freaking out over the recovery and possible limitations. I was worried about loss of range in motion as with my broken elbow four years ago, but this may not be as bad. Lucky for me I was riding with a nurse practitioner who had me treated as soon as I was off the bike. I have a class 2 seperation, but the weird thing is my bump is not quite as pronounced as OP being it is a 2, but in the pic you can still see his collarbones, on my hurt side my collarbone is completely gone from view, it is deeper now. A little alarming to look at.

  12. #12
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    Quote Originally Posted by BeanMan View Post
    I had a grade three AC separation two years ago. No surgery, lots of rehab, no worries. I threw a football for about 40 minutes with my nephew last week and it felt ok and was not sore the next day.
    Thanks beanman.....how long was your rehab? When did pain go away? How big is ur bump?

    Being an avid weight lifter I feel like it will be a long time until I'm back to where I can go 100% in the gym again.

  13. #13
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    3.5 week update:

    Finally starting to feel "ok". I can now hold things, lift things (lite), wash myself, put deodorant on, etc. Pain is still there but strength is getting good and I don't walk around noticing I have a bum arm. I now just notice it when I go to lift my arm to grab something up high.

  14. #14
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    I went 5 years without needing surgery. I was as good as before the accident, but it took at least 6 months to get there.

    It wasn't until falling on it again and making it worse (a grade 5) that I needed surgery. FYI, it took more than 6 months to get back to pre-surgery condition.
    Disclaimer: I no longer fix bikes for a living.
    National Ski Patroller to feed my winter habit.

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    Thx for sharing dwnhildav.

    5 week update:

    Finally did a pushup. Can lift bike onto roof of car fairly easily. Riding seems to be pretty solid (only around parking lot). Fiance won't let me ride until after the wedding in 2 weeks :-p. Still notice pain when reaching across my body to scratch back of opposite shoulder. That across body movement will be the last part to recover. I have been doing PT and stretching everyday. Light band and light dumbells have been my best friends.

  16. #16
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    not to thread jack, but i took a digger right to the shoulder 10 days ago at winterpark...proud owner of a grade III AC separation. Ive been on a rehab routine like its my job. I have full range of motion, no pain, and gaining strength each day. Just got an EVS shoulder brace to add support as well. Hoping to be back on the bike in the next 2 weeks! Diet, rehab, supplementation, and constant ice/heat has been vital in this progress.

    Winterpark Rainmaker Crash from jakeactkinson on Vimeo.

  17. #17
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    Quote Originally Posted by jmactkinson View Post
    not to thread jack, but i took a digger right to the shoulder 10 days ago at winterpark...proud owner of a grade III AC separation. Ive been on a rehab routine like its my job. I have full range of motion, no pain, and gaining strength each day. Just got an EVS shoulder brace to add support as well. Hoping to be back on the bike in the next 2 weeks! Diet, rehab, supplementation, and constant ice/heat has been vital in this progress.
    You are an animal! 10 days out from a grade III and full ROM and no pain? Crazy! I felt like I was healing mine super fast and getting ROM back. I felt pain for 4 weeks just putting a shirt on. I can only do about 5 girl pushups right now. I can press the 20lb dumbells overhead w/ about 80% ROM :-p. Bench pressing the bar is about where I notice I still have a long path ahead. Will definitely be back on the bike in 2-3 weeks. Can't ride since I have my wedding coming up and my finance would kill me If I didn't get back on my bike and hurt myself.

    Not saying you don't have a grade 3 but your the body physically can't heal itself from a grade 3 in typically 8-12 weeks. When I say "heal" I'm talking doctors definition of pain free and full ROM. Most all of us are going to say we are "healed" because we can go ride but barely lift our bike on the roof of our car.

    Do you have pics? Nice vid btw!

  18. #18
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    I will see if i can get a copy of the xray from the orthopedic surgeon...there is definitely a large gap between the clavicle an scapula. As far as a bump, it was originally extremely noticeable, but seems to have subsided in the past few days. I am a bigger guy (ive lifted religiously since high school and played D1 football) so the size of my traps makes it so that the bone is hardly noticeable, fortunately.

    I am by no means stating that I have healed after 11 days, but the progress thus far has been pretty incredible. After speaking to the orthopedic surgeon yesterday, she advised that even with such great progress, the body biologically takes 4-6 weeks to really make significant recovery with enough scar tissue hold the bones in place so I plan on heeding her advice for at least 4 weeks.

    I hope the recovery is going well for you! ice/heat after exercise, it has done wonders. Also make sure you are on top of taking vitamins and that your diet is on point, it will def help the body with rehabilitation and recovery. Lastly, pound water like its your job and eat constantly! you have to feed your body on the road to recovery

    My AC (Shoulder) Separation Story and Experience-photo.jpg
    My AC (Shoulder) Separation Story and Experience-photo.jpg

  19. #19
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    Thanks for all the input! Good to hear someone else's strategy. I've played professional baseball so have been fortunate enough to be able to perform my own rehab. I know my shoulders and every maintenance exercise out there. Tubing and light dumbells are my best friends right now. Diet and vitamins have been key as well. I even have a personal stim machine I throw in my gym bag for when I'm icing after a workout. Frustrating having a 265x5 bench go to 45x5. It's all a process though

  20. #20
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    for sure man. just stay on top of the rehab and im sure everything will come together.

    This is my 2nd injury to this shoulder. I had it scoped back in college already, and have a torn bicep on that arm as well. Ive made my own rehab program as well, no way in hell am i paying someone to tell me to do some stretches an db/band raises hah.

    I feel your pain, i was benching 385 pre-surgery in college then dropped to the bar for awhile...incredible how fast you lost that strength.

    I have a feeling that i may be looking like this in a month or two after all the leg workouts...

    My AC (Shoulder) Separation Story and Experience-20130212-174308-172-139.jpg

  21. #21
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    Haha great pic! I have just been owning the leg press machine. Pretty much all leg machine for that matter. I can now do a lot of pulling.

    Things I can do without problems: (note: all these are still @ 50-80% weight/intensity)
    Cable Rows
    Bent over rows
    Cable triceps
    Cable biceps
    Curls (up to 35lb dumbbells)
    All core exercises
    Flat bench dips with 80% ROM
    Deadlifts

    Things I can't do:
    Heavy front raises (anything over #5 dumbbells)
    Bench Press (anything over #45)
    Muscle Ups (duh)(used to be able to link 15 bar MU's)(hope I can do them again)
    Heavy back squat *high bar (clavicle protrudes too much)
    Sleep on my right side

    This is all at the 6 week mark. Pain is minimal now unless I try to reach across my body as if I am scratching my opposite shoulder blade. That is the last part to get better apparently since the joint gets pushed together. I will try to put together a 1 minute pieced together vimeo clip of my rehab routine and will post.

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    right on man, thats whats up. id be super interested in seeing what your rehab routine has been. post that video whenever you get a chance

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    just an update to anyone who may be interested:

    i rode for the 1st time this past wednesday (7/3) at Winterpark...I suffered a grade III AC separation 17 days prior. The doctor said not to ride for at least 4-6 weeks. Wellllll...i didnt want to wait that long, so I was on top of rehab like it was my job. I do the arm bike for 10min to warm up the shoulder and then do a series of different exercises, starting with high rep/light weight and gradually increasing weight. I have ridden Winterpark/Keystone 4 out of the last 5 days and my shoulder feels great.

    To anyone thats suffered the same injury: rehab as soon as you can, start with basic arm movements to gain mobility and range of motion back and increase reps/weight as strength comes back. Also, do contrast therapy (ice/heat) as much as possible. I think another thing that has helped me recover quicker that expected was getting in the gym and riding the stationary bike and doing the stair stepper daily. Getting the heart pumping and blood flowing will help draw blood to the injured area and help in the recovery process.

    As far as riding; dont ride until you are pain free and have full range of motion. I ride with an EVS shoulder brace and it helps add some support. I picked one up off of ebay for $38 shipped

    Good luck to anyone going thru this injury...it sucks but stay on top of rehab and youll be back in no time!

    heres a shot riding cruel & unusual at Winterpark on Saturday
    Attached Thumbnails Attached Thumbnails My AC (Shoulder) Separation Story and Experience-screen-shot-2013-07-06-8.07.36-pm.jpg  


  24. #24
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    I had a shoulder separation in December 2012, grade 3. I also dislocated the shoulder at the same time. I have spent a lot of time looking online, and multiple visits to specialists for info on how to heal a separated shoulder. I have had ac tightrope surgery for the injury.

    I finally had to respond to some of the completely inaccurate info I have read on this site pertaining to separated shoulders

    First. Grade 3 is perhaps the WORST grade you can have. And yes, you can make it worse. They are called GRADE 4, 5, and 6. (although it is unlikely that 6 will ever happen as no orthopedic surgeon I have talked to has ever seen one). Since you have completely torn the ligaments, it is MUCH MORE LIKELY that, if you have another accident, you will make it much worse. Trying to get back on your bikes ASAP is the worst thing you can do. You just lost the major supporting structure for your entire shoulder. Get over wanting to be on the trails and realize it will be at a minimum 3-6 months before casual riding. And no, the soft tissue in the shoulder was never meant, or designed, to replace those major supporting ligaments, those soft tissues cannot, and will not, hold the shoulder up as it supposed to be, again, this is a FACT. Those that write "I did lots of rehab now its stronger than before" are simply incorrect (self-confirmation bias, they believe because they want to). Once blown, the shoulder will never be as strong or stable again. FACT. Letting a grade 3 "heal" naturally, will mean most likely a return to 60% of pre-injury condition. And when a doctor says it will "heal", they do not mean like when you cut yourself, that one day it will be as if it never happened. They mean that that the acute phase of pain will subside, but the way it is, is the way it is. Ligaments do not ever heal by themselves once they are torn. Not ever. Only surgery will give you that chance. And even after surgery you will still most likely have some shoulder deformation with some muscle soreness issues. Far better than if you choose no surgery, but it will still be there.

    And to those who like to quote a study that says arthritis comes faster after surgery, are, again, incorrect. In fact, if you spend time researching study's other than those of the ones you want to hear (this is more self-confirmation bias) then you will find that current studies indicate that with the most modern surgery techniques you will experience fewer problems in the future, ie arthritis, etc. There is one study I found currently under way monitoring patients that have ac tightrope done in the acute phase (immediately after injury within a certain time frame) that are showing far better results than leaving it as is (benign neglect), but those are still under way and there won;t be published results for a while yet. Studies stating that arthritis is worse for people who had surgery, are all old studies based on old repair techniques, ie the Weaver-Dunn technique, in fact, that notion of worse arthrits is based on a 1978 study. Besides, look long enough and you will find contradicting studies, all done by very professional people.

    For me, after my injury, after 9 months, my shoulder was at less than 15% recovered. Pain was constant, sometimes dull, sometimes sharp. Immediately after surgery, I felt better. I would do surgery any day over another accident. I was in agonizing pain for 12 weeks. During this time I could do very little.

    All I can say is, if I ever separate the other shoulder, I will not wait for surgery, I will not let doctors tell me "it will heal normally" It will not. I will go for surgery in the acute phase, clavicle hook-plate plus ac tightrope. This is the best bet for as close to a full recovery as is possible, as fast as possible.

    And why is Grade 3 the worst? Because there is really no higher "grade", despite the terms 4, 5, and 6. It is really Grade 3, 3a, 3b, 3c. In other words, after grade 3, there are variations on grade 3 all depending on clavicle position. But they don't like to do surgery on 3's with the older techniques, there was really no statistical difference later if you did or didn't. So get a 4 or 5 and into surgery ASAP you go. Get a 3 and you go home with Advil and life long problems.

    And a note on the Weaver-Dunn: personally I would never get this procedure. You are going to sacrifice another ligament and task it to do a job it was never designed for. As some will know, they cut your coraco-acromial ligament and use it to wrap around your clavicle to pull it down. So now you have lost your coracoclavicular ligaments, and your coraco-acromial ligaments. When studies reference after-surgery results, they almost always are done after this procedure from the pre-60's. I would highly recommend researching the new techniques. Try looking at arthrex's website for some good animations, surgery videos, and information.

    So maybe I went a bit hard on those who choose no surgery, certainly I understand that choice. But after my experience, I wish someone would have laid it out for me a little more completely. During my journey to try repair my shoulder I have found many sites (this one), people, and doctors, etc, with really, really bad information. And if you go to a doctor who tells you "it's normal, go home, it will heal and be fine, lots of guys do this", find another doctor asap.

    Note all this pertains to grade 3 or higher (or a severe 2 where most of the coracoclavicular ligaments are ripped but not 100% ripped).

  25. #25
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    Please advise

    3 ac seperation. Who was your doctor.
    Very helpfull I have been suffering daily for 3 years post grade 3, what was procedure. Got a email address please.
    Quote Originally Posted by ACseparationguy View Post
    I had a shoulder separation in December 2012, grade 3. I also dislocated the shoulder at the same time. I have spent a lot of time looking online, and multiple visits to specialists for info on how to heal a separated shoulder. I have had ac tightrope surgery for the injury.

    I finally had to respond to some of the completely inaccurate info I have read on this site pertaining to separated shoulders

    First. Grade 3 is perhaps the WORST grade you can have. And yes, you can make it worse. They are called GRADE 4, 5, and 6. (although it is unlikely that 6 will ever happen as no orthopedic surgeon I have talked to has ever seen one). Since you have completely torn the ligaments, it is MUCH MORE LIKELY that, if you have another accident, you will make it much worse. Trying to get back on your bikes ASAP is the worst thing you can do. You just lost the major supporting structure for your entire shoulder. Get over wanting to be on the trails and realize it will be at a minimum 3-6 months before casual riding. And no, the soft tissue in the shoulder was never meant, or designed, to replace those major supporting ligaments, those soft tissues cannot, and will not, hold the shoulder up as it supposed to be, again, this is a FACT. Those that write "I did lots of rehab now its stronger than before" are simply incorrect (self-confirmation bias, they believe because they want to). Once blown, the shoulder will never be as strong or stable again. FACT. Letting a grade 3 "heal" naturally, will mean most likely a return to 60% of pre-injury condition. And when a doctor says it will "heal", they do not mean like when you cut yourself, that one day it will be as if it never happened. They mean that that the acute phase of pain will subside, but the way it is, is the way it is. Ligaments do not ever heal by themselves once they are torn. Not ever. Only surgery will give you that chance. And even after surgery you will still most likely have some shoulder deformation with some muscle soreness issues. Far better than if you choose no surgery, but it will still be there.

    And to those who like to quote a study that says arthritis comes faster after surgery, are, again, incorrect. In fact, if you spend time researching study's other than those of the ones you want to hear (this is more self-confirmation bias) then you will find that current studies indicate that with the most modern surgery techniques you will experience fewer problems in the future, ie arthritis, etc. There is one study I found currently under way monitoring patients that have ac tightrope done in the acute phase (immediately after injury within a certain time frame) that are showing far better results than leaving it as is (benign neglect), but those are still under way and there won;t be published results for a while yet. Studies stating that arthritis is worse for people who had surgery, are all old studies based on old repair techniques, ie the Weaver-Dunn technique, in fact, that notion of worse arthrits is based on a 1978 study. Besides, look long enough and you will find contradicting studies, all done by very professional people.

    For me, after my injury, after 9 months, my shoulder was at less than 15% recovered. Pain was constant, sometimes dull, sometimes sharp. Immediately after surgery, I felt better. I would do surgery any day over another accident. I was in agonizing pain for 12 weeks. During this time I could do very little.

    All I can say is, if I ever separate the other shoulder, I will not wait for surgery, I will not let doctors tell me "it will heal normally" It will not. I will go for surgery in the acute phase, clavicle hook-plate plus ac tightrope. This is the best bet for as close to a full recovery as is possible, as fast as possible.

    And why is Grade 3 the worst? Because there is really no higher "grade", despite the terms 4, 5, and 6. It is really Grade 3, 3a, 3b, 3c. In other words, after grade 3, there are variations on grade 3 all depending on clavicle position. But they don't like to do surgery on 3's with the older techniques, there was really no statistical difference later if you did or didn't. So get a 4 or 5 and into surgery ASAP you go. Get a 3 and you go home with Advil and life long problems.

    And a note on the Weaver-Dunn: personally I would never get this procedure. You are going to sacrifice another ligament and task it to do a job it was never designed for. As some will know, they cut your coraco-acromial ligament and use it to wrap around your clavicle to pull it down. So now you have lost your coracoclavicular ligaments, and your coraco-acromial ligaments. When studies reference after-surgery results, they almost always are done after this procedure from the pre-60's. I would highly recommend researching the new techniques. Try looking at arthrex's website for some good animations, surgery videos, and information.

    So maybe I went a bit hard on those who choose no surgery, certainly I understand that choice. But after my experience, I wish someone would have laid it out for me a little more completely. During my journey to try repair my shoulder I have found many sites (this one), people, and doctors, etc, with really, really bad information. And if you go to a doctor who tells you "it's normal, go home, it will heal and be fine, lots of guys do this", find another doctor asap.

    Note all this pertains to grade 3 or higher (or a severe 2 where most of the coracoclavicular ligaments are ripped but not 100% ripped).

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