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  1. #1101
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    You're right Humpty, very limited information for anything to do with this injury except the anecdotal from places like this. One thing is for sure, if PT doesn't produce satisfactory results there is the surgery which is a bitch from the recovery standpoint. I don't need to tell you, if you go that way - find the best surgeon you can. Good luck to you and hope the PT can be adjusted to address the issue you are having right now.
    Last edited by savoi; 12-08-2017 at 05:50 PM.

  2. #1102
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    Finally getting around to posting some photos of what my shoulder can look like with good posture and when I let it get sloppy. I had a Grade III separation 03/17/2016. I can do anything with my R arm. My main activities are surfing and training for sprint triathlons, and I have no issue paddling or swimming. You can tell which photo is which...

    ...If they were there. Guess I can't use photobucket anymore. Anyway, if I put my scapula in it's normal position, the distal end of the clavicle reduces, next to the acromion. If I'm slouching, the acromion drops away from the end of the collarbone and the lump appears.
    Last edited by FL mtb; 12-09-2017 at 10:25 AM.

  3. #1103
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    Quote Originally Posted by FL mtb View Post
    Finally getting around to posting some photos of what my shoulder can look like with good posture and when I let it get sloppy. I had a Grade III separation 03/17/2016. I can do anything with my R arm. My main activities are surfing and training for sprint triathlons, and I have no issue paddling or swimming. You can tell which photo is which...
    That's amazing, keep that good posture!

  4. #1104
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    Quote Originally Posted by savoi View Post
    You're right Humpty, very limited information for anything to do with this injury except the anecdotal from places like this. One thing is for sure, if PT doesn't produce satisfactory results there is the surgery which is a bitch from the recovery standpoint. I don't need to tell you, if you go that way - find the best surgeon you can. Good luck to you and hope the PT can be adjusted to address the issue you are having right now.
    Thought I'd give a little update on my AC separation.

    First, I had a bit of a breakthrough in physio with some deep massage techniques which freed up my shoulder and allow me to put my hands on my hips again. I followed up with a full hr massage therapist appointment after that since it had such a dramatic effect on that weird range of motion that seems specific to hands on hips. So just throwing it out there that after prolonged physio some of the muscles can get tight and may start restricting motion in weird ways that can be addressed through massage. My injured shoulder is more heavily muscled than my good one at this point.

    With respect to scapular winging things have not improved, actually ever so slowly it's getting worse and I've been noticing a very gradual increase in pain as the months go by.

    I did have a consultation with a surgeon a week ago. I have to admit I was kind of hoping that he'd look at it and say suck it up, the instability is not really abnormal for the injury and you don't need surgery. That is not what he said. Basically he confirmed what my sport med doctor said, which is that the instability isn't usual and is characteristic of failed conservative management and that I'm a candidate for surgery at this point. Obviously it's up to me whether I want to go that route or not.

    Because a surgery would take out the entire next cycling season if I go that route I will plan it for this coming September. I see the surgeon again in June and we will assess where things are at with the shoulder and make a decision then whether to book a surgery for the fall. This gives me lots of time to continue to work on the shoulder and it's a relief to have a plan of action in place.

    The surgery would be an arthroscopic procedure to reconstruct a replacement for the CC ligament with donor/cadaver tissue as well as remove the last 1cm or so of the clavicle. The recovery period is very long, with an extended period immobilized in a sling as one of the common ways this surgery fails is for the reconstruction to give out and the clavicle to pop up again requiring another surgery. He did say I'd be able to ride an indoor trainer sitting upright with no hands on bars, or on a recumbent exercise bike, very quickly after surgery - a week or two - but I'd be in that mode for ~3-4 months.

    Anyway for now I'm just sticking with indoor training and lamenting that my fat bike isn't leaving the basement this winter.

    I plan on trying taping again for outdoor riding this summer. I'd taped during the first couple months of recovery but found over time that it irritated my skin, but that was wearing tape several days at a time. What I plan to try is taping only for my rides and then removing the tape right after.

  5. #1105
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    Sounds as though you are going to do the surgery, I didn't wait to see if PT would help. It was just too wrong for me. Still happy I did it although it is so slow to come back from. Good luck in whatever you do!

  6. #1106
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    hi

    I'm just popping in with an update.
    5.5 years after my grade3 separation and there are no issues (no surgery)
    Sure it pops and klicks etc.

    But it works just fine

  7. #1107
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    Quote Originally Posted by giantfox View Post
    hi

    I'm just popping in with an update.
    5.5 years after my grade3 separation and there are no issues (no surgery)
    Sure it pops and klicks etc.

    But it works just fine
    Ditto. Started lifting weights, which has helped a lot. Dead lifts, bench, no problem...
    If your not wreckin', your not ridin'.

  8. #1108
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    Had my first Grade 3 three weeks ago. Went OTB and bounced on CT perma-frost. No surgery required...rehab only. I've got 'the bump' and it had some good color after a couple of days. It was pretty touchy the first week or so and I did my share of ibuprofen. Tough to get dressed, shower, can't carry anything, or sleep on that side, etc. After 2 weeks it was feeling better and I started mellow rehab exercises.

    Week 3 I've stepped up the exercises as hard as I dare and it has gained mobility in the last week. It's going so well I decided to brave a 'moderate' night ride last night to test it out. I did about 10 miles without any problems. I took it easy and did the first mile or so on fire roads. As I gained confidence, I dipped into some of the more technical singletrack loops and before I was done I was able to ride almost everything but much less aggressively than normal.

    Great to be on the way back!
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  9. #1109
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    Wanted to share a little bit of hope with a success story going without surgery. I am very active and am in the gym 5 days a week. I am 37 years old and still play hockey, mountain bike, and am on a SWAT team. Last May I suffered a 3/5 AC seperation. I opted on the wait and see option, but I could not put on a shirt or wash my hair without terrible pain. I could not even lift the sheets of my body without pain when getting out of bed. The doctors said it could go either way and insurance was not an issue. I never really took it easy and whatever I could take I would do at the gym. At about 8 weeks I was able to do many things at the gym, albeit lighter weights. Dips and bench were out of the question but shoulder press and pull ups came back quick. Things really slowed down after that. They progressed, but not at the rate they did for the first 8 weeks. Over the next 3 months my strength came back a lot, but the first sets of bench hurt a lot and then I would be fine for the rest of chest day. Incline bench came back the quickest. Believe it or not my shoulder would ache regularly when driving, or shaving, or doing everyday things, but if I worked out chest or shoulders I would be OK for at least 2-3 days. Dips were still out of the question.

    Then out of nowhere, at about the 7 month mark, if really stopped hurting. I would still notice it here and there, but I could even bench press 95 lb dumbbells with almost no discomfort. At about 8 months I could even do dips but I still feel that a bit. I can sleep on it with not issues and really only lossy about 5% strength and only in some excersizes. I still have the huge lump and it's obvious it is not connected, but I have no issues doing Anything I used to do.

    Side note, from compensating while trying to maintain, I may have inflamed arthritis in my neck, but that may have happened anyways.

    Good luck to everyone with thier decisions, but if you can live with the lump, this is something that can be overcome on its own. I only missed 1 day of work., but 3 months of SWAT.

  10. #1110
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    This thread was useful to me so I thought I would put my story up quick. I crashed in a crit race in August of 2014 that left me with a grade 5 separation on my right shoulder, all ligaments gone. I saw four different docs in the SLC area for an eval, 3 wanted to do nothing. One took one look at me trying to take my t shirt off and said, you're going to want to have that fixed.

    Three weeks later surgery, it was starting to feel a lot better by the time of the surgery which made me start to question the decision a little. I went thought with it and have no regrets. Doc completely reconstructed the AC ligaments with a donor hamstring tendon.

    Surgery took almost four hours. Two keys for recovery post op for me, one I had a nerve block. My right arm was paralyzed for almost 48 hours after surgery. It was a little nerve racking but feeling and movement came back in full exactly when they said it would. The second key was an ice machine that pumps cold water around the shoulder. I used it all the time, even while I slept.

    With these two things I was able to completely avoid using any painkillers. After a week I went back to work in a sling, no real pain. I took the arm out of the sling a few times a day and just walked my hand around a desk or table to move it a bit.

    Three weeks after surgery I started PT. I went twice a week, but did additional exercises as prescribed everyday. I was cleared from PT the week before Thanksgiving.

    I did wear a hardshell brace on that shoulder during the next year for riding and skiing. More just to make sure I was thinking about it than actual protection.

    It took almost 8 months for full strength to come around and almost two years for the size the muscles in the injured area to look normal again.

    Today, my shoulder is as strong as ever and very stable, no clicking or cracking noises. I have no problem suggesting surgery but do understand that everyone of these injuries is different. Today I also try to ride in such a way as to (hopefully) never have this happen again.

  11. #1111
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    5 months post grade 3+ AC separation. No surgery, no PT. Never had any loss of range of motion. Just ibuprofren and light duty to not further hurt the shoulder.

    I have a bump. I'm not 100% what I was, but not less than 95% I would say. A little cracking and popping every now and then and maybe a little sore after a few hours of heavy hitting repetitive motion (i.e. chopping roots or digging with a mattock or trail tool). I can still feel that one shoulder is different from the other, but rarely think of it.

    I was riding paved trails and Zwift the week after injury and single track again within 6 weeks.

    I think these injuries are different between individuals. My decision to not have surgery was mostly based on the fact that there is no time limit. If it ever loses stability or changes, I can then opt for the surgery. And who knows, maybe then there will be better technology with less invasive options and shorter recoveries.

  12. #1112
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    Hi all, on April 8 2017 (29 years old) I made a nasty fall on a trail with the mtb. Result, grade III AC separation.

    The emergence room doctor told me I would not need surgery, only a little bump will remain. They gave me a sling and sent me home. I already felt: this ainít right. Whenever I wanted to tie my shoe lace, the clavicle would pop out of its socket. The days after I was doing a lot of google searching and found this forum and started reading.

    14 days later I had an appointment with an ortho surgeon: he operated me immediately (next day) with a single tightrope and stitched the AC ligament.

    I knew from the start of the injury that I am not the person who can deal with a loose clavicle as I am a very active individual (regular gym, mtb, running) I guess that is a personal decision.

    Now, one year later I am fully healed and going to the gym since January. Heck, I can sleep on the shoulder I would like to encourage you all to do the surgery, the results are fantastic!! sidenote: I did let it heal from april 23rd until January 2018, did nothing in the meantime.

    I wrote this text, because I was very depressed during the time of the injury and first month post-op and want to share that with you. I hope some of you can benefit from this!

    Greetings
    Last edited by YDrx; 05-02-2018 at 01:36 PM.

  13. #1113
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    I separated my shoulder badly 5-6 years ago if I recall correctly. It was a grade 5. It was a dumb accident and I was stubborn riding without insurance at the time. I didn't even see a doctor at the time and did a lot of research and diagnosed myself (of course I would not advise this nor would I be dumb to take the chance and diagnose myself again)with a separated shoulder. Also from reading forums, I learned there were a quite a few people who actually chose not to do surgery and they turned out fine.

    Years later, I saw an orthopedist for a different mtb injury and I was curious about my shoulder. He had it x-rayed and confirmed it was a separated shoulder and told me that it is a grade 5 and he would have recommended surgery at the time. Since it has been years since the injury and there is no pain and have full rotation, he did not recommend doing surgery.

    My shoulder is fine but definitely not 100%. Can't really explain how it feels, but you would be able to tell it's not quite right.There is no pain and is fully rotational. I can lay on it, run, shadow box, and lift weights, etc. Pull ups are hard on the shoulder and I lift very light for shoulder workouts.There is a permanent bump.

    There are those who choose not to do surgery even with bad separations. There is always a risk with complications from surgery even if it is routine. If I had insurance at the time, I don't know if I would choose surgery or not. My feeling is that my shoulder will get worse with age and will eventually need surgery. The older you are the more complications there can be from surgery and healing time would take much longer. But who knows, maybe I will never need surgery even at an older age.

    If you don't have insurance, take it easy on the bike. If you can't take it easy and are easily tempted to ride aggressively, don't bike at all. See you all on the trails.
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  14. #1114
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    I went over the bars a week ago with a grade III AC separation. I work in Philly and went to UPenn, right out the gate said no surgery.(after viewing the X-ray)
    Hoping it heeals like many others here! Getting better every day, first couple days very limited now ROM is improving
    I'm not in great shape and not a great rider. Will take it easy when I return still have trouble with steeper downgrades which is how I got injured.
    Thanks for all of the stories is very helpful!

  15. #1115
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    I am six week past a grade 3 and did a mountain bike ride today. I took it easy. The worst part is pulling up on the bars to clear roots, etc, It is hard to replicate that moment despite lots of rehab on the shoulder. I did not elect for surgery. The orthopedic did not recommend it, but said he could do it 6 months or a year later if there were lingering issues. I found some of the comments about inability to do bench press and dips interesting. I have the same issue. I am glad to hear people did get strength back after 8 months. My one concern is the greater susceptibility of the collar bone to future injuries. I am looking at some of the shirts with some padding in the shoulder. It is a set-back, but at 55 every injury is a set-back.

  16. #1116
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    BB3 and dcr1 I can relate. I'm 58 and all is well since my grade 3 late Jan 2018 (see post #1108). I've been riding 3X/week since mid March and also did a fair amount of spring skiing thru end of April. I'm pretty much all the way back regarding how aggressive I can ride but my shoulder will never be what it used to be. It's not really limiting me and I have no pain...just feels different from a properly attached shoulder!
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  17. #1117
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    padded shirts

    . I am looking at some of the shirts with some padding in the shoulder. It is a set-back, but at 55 every injury is a set-back.[/QUOTE]

    I purchased a padded football shirt, has shoulder, rib and middle of back protection. Not sure of fit although meant to be snug- can't get my arm through maybe in a couple weeks. I saw a rugby shirt that looked good but i don't think they had my size.
    Any others wearing padded shirts just to protect the shoulder?

  18. #1118
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    Good to hear that Sturge! Can't wait to get back on the bike. I hope it only takes a couple months although that feels like forever!
    I feel like a slug not doing much without being able to ride...

  19. #1119
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    Check out the Pro-X Compression Shirt by G-Form. Maybe it's something you (and or others) will like...

    It was exactly what I was looking for once I was cleared to ride after my ac joint surgery. I wear it every time I ride a trail (3/4x weekly), and now have been wearing it for several months. Still holding up strong...
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  20. #1120
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    Padded gear is nice but after years of testing and careful analysis of previous incidents, my data indicates the most effective strategy to combat future injury is....DON'T CRASH!

    Example...Rain from Sat night made our Sun morning ride a bit slick with dampness on rocks, roots, etc. Even though it was not super slick I did a number of 'go arounds' on some of the more advanced obstacles I typically hit...that's called 'experience'!
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  21. #1121
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    nice option

    Quote Originally Posted by woodchips View Post
    Check out the Pro-X Compression Shirt by G-Form. Maybe it's something you (and or others) will like...

    It was exactly what I was looking for once I was cleared to ride after my ac joint surgery. I wear it every time I ride a trail (3/4x weekly), and now have been wearing it for several months. Still holding up strong...
    Looks like a nice option thanks

  22. #1122
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    Experience helps a ton!
    I'm pretty sure my fall occurred from poor experience or not thinking about what I was doing. Pretty sure I was not in a good position to descend and over I went!

  23. #1123
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    Quote Originally Posted by dcr1 View Post
    I am six week past a grade 3 and did a mountain bike ride today. I took it easy. The worst part is pulling up on the bars to clear roots, etc, It is hard to replicate that moment despite lots of rehab on the shoulder. I did not elect for surgery. The orthopedic did not recommend it, but said he could do it 6 months or a year later if there were lingering issues. I found some of the comments about inability to do bench press and dips interesting. I have the same issue. I am glad to hear people did get strength back after 8 months. My one concern is the greater susceptibility of the collar bone to future injuries. I am looking at some of the shirts with some padding in the shoulder. It is a set-back, but at 55 every injury is a set-back.
    2 years post grd3 and torn pectoral muscles. I explained in detail what I do to my PT and he tailored my program around that. 6 weeks post injury I was riding bike park again. He had me doing things like resistance band rows seated using handlebars at home and rows in the gym specifically to do that motion. Break down the motion that isn't good to its basic movement and work on that. I really don't notice my shoulder now but the first few months I was aware of it at all times.
    I like to fart when I'm in front of you on a climb

  24. #1124
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    Quote Originally Posted by dirtrider76 View Post
    2 years post grd3 and torn pectoral muscles. I explained in detail what I do to my PT and he tailored my program around that. 6 weeks post injury I was riding bike park again. He had me doing things like resistance band rows seated using handlebars at home and rows in the gym specifically to do that motion. Break down the motion that isn't good to its basic movement and work on that. I really don't notice my shoulder now but the first few months I was aware of it at all times.
    What's the average time post injury people are doing PT or stretches at home? Any good YouTube vids to share?

  25. #1125
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    I did every day for like 3 months from my injury, I stretch every day still. I plan on starting to do some again here soon as my right shoulder is a bit rolled forward and it helps my posture a lot(I have tech neck from work).
    I like to fart when I'm in front of you on a climb

  26. #1126
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    What Do you do for the rolled shoulder?

  27. #1127
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    I've got to say, this is about the most comprehensive ac separation thread on the internet. Thanks to everyone that's taken part so far, a real wealth of information here.
    So, my contribution....

    Ac Separation (shoulder Separation)-1.jpg
    Ac Separation (shoulder Separation)-2.jpg
    Ac Separation (shoulder Separation)-3.jpg

    A grade 4 I picked up 25 days ago.
    Like many of you I did a lot of reading, everything I could find on pub med and shoulder Doc. Much of the studies (Beitzel being one of the most reliable) suggest conservative treatment for grade 3, and surgery for anything above. Their conclusion was that in grades 4/5 conservative treatment only had a 20% success rate, where as surgical had an over 70% success rate, higher still if surgery was performed in the acute phase.

    So my question is; Why am I having to battle for surgery! I have seen a Doctor who recommended conservative treatment, then a physio, then a surgeon, all suggesting the same thing. "Try physio for 6 months, then consider surgery if you don't like the results".

    My issue is, if physio has an 80% chance of not working, then why blow 6 months just to have surgery and start my recovery process all over again?

    Have any of you guys been in a similar position?

  28. #1128
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    ^^^ Have you researched a shoulder specialist you want to have work on you? I bet one look, and he would say you need to get it operated on.

    This is what I did. I researched, found one, and told him I was an extreme athlete. He told me that I would not be happy leaving the injury untreated surgically. Bam, scheduled surgery right then and there.
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  29. #1129
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    Quote Originally Posted by woodchips View Post
    ^^^ Have you researched a shoulder specialist you want to have work on you? I bet one look, and he would say you need to get it operated on.
    Thanks for the reply mate.

    I'm in the UK so doing my best to get fixed up through the NHS.
    So far i've seen a doctor and a surgeon, both of them trying to take me down the "give it 6 months" road. Seeing the shoulder specialist Monday, apparently he is on point, so i'm hoping he'll be my guy

    I want to be prepared so i've spent an hour trying to find out which procedure has the best success rate. There's so much conflicting info out there. Which method got you shredding again?

  30. #1130
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    Good to hear, man - I hope he's the guy for you, and takes care of ya!

    Using just FiberWire (no hardware), my doc utilizes his own securing technique to keep the clavicle in its proper place. Unfortunately, I don't have any details regarding his method, and I haven't seen his technique anywhere on the web. In any case, he impressed upon me that no matter what I did to my shoulder going forward, there's no way I could "undo" his work.

    Other than that, he removed scar tissue and put my blood into a centrifuge to use platelet-rich plasma in the shredded ligament areas to promote healing. He also shaved a little off the end of the clavicle to hopefully delay arthritis as long as possible.
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  31. #1131
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    Quote Originally Posted by woodchips View Post
    Using just FiberWire (no hardware), my doc utilizes his own securing technique to keep the clavicle in its proper place. Unfortunately, I don't have any details regarding his method, and I haven't seen his technique anywhere on the web. In any case, he impressed upon me that no matter what I did to my shoulder going forward, there's no way I could "undo" his work.
    Sounds like you found yourself a master, great work.
    Thanks for all the info mate, very much appreciated.
    Joel

  32. #1132
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    Not a problem, and, yeah, he's known as the King of Shoulders in the Raleigh area, and I think I was fortunate to have found him. He's been utilizing his clavicle securing technique for 10yrs, and has been 100% successful.

    I'm sorry I couldn't have been more helpful regarding the technique details, but if you have any other questions, feel free to hit me up anytime.
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  33. #1133
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    Quote Originally Posted by joel.dunsdon View Post
    Thanks for the reply mate.

    I'm in the UK so doing my best to get fixed up through the NHS.
    So far i've seen a doctor and a surgeon, both of them trying to take me down the "give it 6 months" road. Seeing the shoulder specialist Monday, apparently he is on point, so i'm hoping he'll be my guy

    I want to be prepared so i've spent an hour trying to find out which procedure has the best success rate. There's so much conflicting info out there. Which method got you shredding again?
    I'm no expert, but from the Xray that looks like Grade V. With a Grade IV, the clavicle is more displaced, kind of poking into the trapezius. Either IV or V should be repaired surgically I believe. Mine was done in a fashion similar to what woodchips describes, using what's called a tightrope to hold the clavicle in place while scar tissue forms to permanently secure the joint. Such a procedure is best done within 2 weeks of the acute episode. If you end up doing something down the road, they will likely want to use a grafting technique, which is more complicated. Make sure they are checking your sternocavicular joint as well though. With a severe separation like yours, there is often dislocation of the clavicle at the sternocavicular as well. My doctor didn't really address that and now when I rotate my shoulder my clavicle pops out from my sternum. It doesn't hurt, but it feels funny. I'm not sure there is really anything they could have done for that anyway, but good to ask. I think that I have pictures of my before and after posted somewhere several months back on this thread.

  34. #1134
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    Hello Everyone,

    Hello all,

    Guys I have a grade 2-3 Separation of my AC Joint. This is not something I want to live with. I can't train and do what I really love and I am 24 years old. The entire shoulder is unstable and I have no function it is totally impossible to train. The Collarbone is moving when I press on it. It is higher up than the other one. Not the big separation like other people but there is certainly a difference compared to the other one. My entire right side has no muscles. Could you guys please tell me who is the best surgeon for the AC Joint repair if you want you can tell me about the surgey you had and the results you got from it and who the surgeon that repaired your AC Joint is. I would also appreciate and be thankful if you could tell me the best procedure for this injury. Please I am in need for the best surgeon for my injury to help me repair it.

    I would be really thankful for your help.

    With Love
    Last edited by workout2; 07-31-2018 at 07:16 PM. Reason: I didn't spell it properly

  35. #1135
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    ^^^ Try researching Shoulder Specialists in and around your area to schedule an appt for an evaluation.
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  36. #1136
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    Quote Originally Posted by throet View Post
    I'm no expert, but from the Xray that looks like Grade V. With a Grade IV, the clavicle is more displaced, kind of poking into the trapezius. Either IV or V should be repaired surgically I believe. Mine was done in a fashion similar to what woodchips describes, using what's called a tightrope to hold the clavicle in place while scar tissue forms to permanently secure the joint. Such a procedure is best done within 2 weeks of the acute episode. If you end up doing something down the road, they will likely want to use a grafting technique, which is more complicated. Make sure they are checking your sternocavicular joint as well though. With a severe separation like yours, there is often dislocation of the clavicle at the sternocavicular as well. My doctor didn't really address that and now when I rotate my shoulder my clavicle pops out from my sternum. It doesn't hurt, but it feels funny. I'm not sure there is really anything they could have done for that anyway, but good to ask. I think that I have pictures of my before and after posted somewhere several months back on this thread.
    Thanks for the post throet, that's solid info.
    I saw the local shoulder specialist on Monday and he too advised against surgery. He is the second-second opinion too, the first doctor and surgeon I spoke to were also against surgery.
    The specialist says i'm making good progress and (like the others) seems to be more concerned with the potential risk of surgery than the reward. We spoke for a little while and his choice of method is the "surglig" procedure. We agreed that i'd see him again in 2 weeks.
    I'm really torn (pun intended) as if I can make a full recovery without surgery, then that's fantastic. But the thought of spending 6 months "fake" healing just to need surgery down the line is a tough pill to swallow.
    Oh and today marks 5 weeks out for the crash. Apparently to get an operation in the "acute" phase under the NHS is pretty much unheard of unless your clavicle is displaced 4600%

  37. #1137
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    Just a quick update on my gr. 3 separation which I'd suffered on my right (dominant) shoulder in Aug. 2017. I decided to go the surgical route after the scapula wouldn't stabilize, went with an allograft reconstruction on Sept 12 of this year, a little more than a year after the original injury. The surgery was pretty uneventful, I was sedated but conscious for the procedure. The first four days afterward were not a lot of fun (mainly for sleeping) but not terrible, had some pain meds to help which I stopped taking after that point. Pain was easily manageable. I've been in a sling full time except for bathing and exercises since then; full time sling use ends as of tomorrow (6wk point). I started physio at 4 wks per surgeon's protocol, with passive and active-assist exercises for range of motion. Now's when it gets real since while it's pain free in a sling regaining range of motion with exercises particularly using the muscles in the shoulder definitely leads to some soreness. In terms of outcome it's still TBD, the reasons for going with surgery are functional not cosmetic so it's a long process to regain full range of motion and strength.

    The scapula stayed winged somewhat after the surgery and my affected shoulder has been riding high compared to the other, but both things seem to be settling down and without the sling I can now sit comfortably in a chair or car seat again without my scapula sticking out and bugging me which is great. I'd returned to work 2wks post-surgery (desk job), getting more adept at doing things with my left hand. I was back on the bike trainer on day 5 post-surgery and have been doing that and a lot of walking to maintain some fitness.

    Other functional things like stability when pulling up on handlebars etc I won't know until next summer. I'm supposed to not start any strength training until 12wks post-surgery which will be mid-December.

    Cosmetically the surgery was brilliant, if that's all I was after I'd be thrilled there were just two small incisions for the arthroscopic reconstruction and a larger incision right on top for removing a bit from the clavicle which was open surgery. All this is nearly invisible unless you look for it and the shoulder looks normal.

    Overall the surgery has been no worse than the original recovery other than the first four days, which would have been worse were it not for pain meds and cryotherapy.

    I've been advised that it's a good idea to continue using a sling for riding the trainer to avoid stressing the shoulder, until wk 12. I won't be able to drive a car for some time yet (I drive standard, ), probably another 3-4 weeks.

    Anyway, so far so good and no regrets. Knock on wood!

  38. #1138
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    See post #1108 describing my Grade 3 which occurred in Jan 2018. I was able to do my first ride after about 4 weeks and ramped it up from there. Also did a fair amount of spring skiing in March/April.

    Been almost 10 months and it has responded well to 3 rides/week during that time but it's never going to be the same. There are times I wonder if I should look into surgery because it still crunches and feels kind of loose. I have had periods where it aches and feels 'overworked' so I have to back off and skip a ride or so. Then I remind myself that at 59 I should probably leave well enough alone and be thankful I can still get out and rip. I just add it to the list of aching joints that bark from time to time.

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  39. #1139
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    Quote Originally Posted by sturge View Post
    See post #1108 describing my Grade 3 which occurred in Jan 2018. I was able to do my first ride after about 4 weeks and ramped it up from there. Also did a fair amount of spring skiing in March/April.

    Been almost 10 months and it has responded well to 3 rides/week during that time but it's never going to be the same. There are times I wonder if I should look into surgery because it still crunches and feels kind of loose. I have had periods where it aches and feels 'overworked' so I have to back off and skip a ride or so. Then I remind myself that at 59 I should probably leave well enough alone and be thankful I can still get out and rip. I just add it to the list of aching joints that bark from time to time.

    Ibuprofin before the ride...IPA after!
    Reading your post it looks like you did too much too soon. Iíve had two Grade 3 separations (left and right) and both have healed to 100% without any limitations. Other than the bumps, I would have never known I injured my shoulders. That being said, I took PT and recovery very seriously and meticulously.

    First 3 weeks in a sling. Weeks 4-10 physical therapy and no weight in the affected arm over 5 lbs. Only road and trainer riding until 2 months post injury. The ligaments are still healing during this time and any jarring or weight will affect already comprised attachments, possibly inhibitting their ability to fully heal.

    Many people often get back on the trail when pain has subsided. True, pain may be gone but the shoulder is probably only about 60% healed. Itís getting it to that full 100% that takes patience and persistence.

    Iíd also be careful with regular ibuprofen use or you may run into a whole new set of issues.
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  40. #1140
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    Quote Originally Posted by sturge View Post
    See post #1108 describing my Grade 3 which occurred in Jan 2018. I was able to do my first ride after about 4 weeks and ramped it up from there. Also did a fair amount of spring skiing in March/April.

    Been almost 10 months and it has responded well to 3 rides/week during that time but it's never going to be the same. There are times I wonder if I should look into surgery because it still crunches and feels kind of loose. I have had periods where it aches and feels 'overworked' so I have to back off and skip a ride or so. Then I remind myself that at 59 I should probably leave well enough alone and be thankful I can still get out and rip. I just add it to the list of aching joints that bark from time to time.

    Ibuprofin before the ride...IPA after!
    I'm 2 years post separation in my right shoulder. I took rehab way serious and was released back to work in 4 weeks as a auto tech. Continued rehab for another 2 months after. I caught the last day at the local bike park before the closed for winter then just took it easy rehabbing and riding through winter. Took about a year till it felt good. I don't mind it all now.


    Odd this came up, I'm going to get my left shoulder checked tomorrow.
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  41. #1141
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    Good to hear people are making progress.

    Update from original post #1127

    Four and a half months from separation. Shoulder is better but still not right. Still being advised against surgery by my shoulder specialist but I have had an MRI (not fun) and nerve conduction check, which both came back ok.

    Sleeping - I still tend to favour my right (non injured side) for most of the night but can sleep on my left (original sleeping side) for some of the night, which is nice.

    Riding - I can ride pretty much as before except for a few specific things. I ride BMX and airing, manuals, jumps etc are fine, the only challenge is bunnyhopping which is gradually starting to feel comfortable again.

    Resistance training - Scapula retractions and stretching at various points throughout the day. Training back, shoulders and arms every few days. I do have trouble with pressing movements. I have tried working back up to press ups a few times but always seem to aggrevate the injury, right under the collarbone every time. I was never a fan of press ups anyway so might not be too much of a concern, can do wall presses and dumbell presses with light weight so may just build those up.

    Bump - Definitely less visible, as the trap and deltoid muscles has found its place again, but it is still quite prominent. Especially in the morning. I certainly wouldn't call myself a vain person but it does annoy me.

    Pain - Depends on the day. It's at the point now where I forget about it some days, other days it aches a little. Occasionally I push it a little hard and it lets me know.

    Plan - In the early days I wanted surgery and would have had it if any of the doctors/surgeons I saw (NHS) would have done it for me. Now I'm not so sure. I certainly don't want to go back to zero again and the recovery is better than i'd expected after 4.5 months, I can technically do everything I did before (with some modifications) and while i'm in good shape i'd feel like an idiot if I pushed surgery and suffered complications.
    The shoulder specialist in my area told me about a patient he has who basically forced his hand to perform surgery and ended up suffering a complication and losing proper use of his arm, probably for good. A very high percentage of the surgeries have great results, but I guess you don't want to be the one in a hundred or so where it goes sour.

    Stay strong fellas.

  42. #1142
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    Quote Originally Posted by joel.dunsdon View Post
    Good to hear people are making progress.

    Update from original post #1127

    Four and a half months from separation. Shoulder is better but still not right. Still being advised against surgery by my shoulder specialist but I have had an MRI (not fun) and nerve conduction check, which both came back ok.

    Sleeping - I still tend to favour my right (non injured side) for most of the night but can sleep on my left (original sleeping side) for some of the night, which is nice.

    Riding - I can ride pretty much as before except for a few specific things. I ride BMX and airing, manuals, jumps etc are fine, the only challenge is bunnyhopping which is gradually starting to feel comfortable again.

    Resistance training - Scapula retractions and stretching at various points throughout the day. Training back, shoulders and arms every few days. I do have trouble with pressing movements. I have tried working back up to press ups a few times but always seem to aggrevate the injury, right under the collarbone every time. I was never a fan of press ups anyway so might not be too much of a concern, can do wall presses and dumbell presses with light weight so may just build those up.

    Bump - Definitely less visible, as the trap and deltoid muscles has found its place again, but it is still quite prominent. Especially in the morning. I certainly wouldn't call myself a vain person but it does annoy me.

    Pain - Depends on the day. It's at the point now where I forget about it some days, other days it aches a little. Occasionally I push it a little hard and it lets me know.

    Plan - In the early days I wanted surgery and would have had it if any of the doctors/surgeons I saw (NHS) would have done it for me. Now I'm not so sure. I certainly don't want to go back to zero again and the recovery is better than i'd expected after 4.5 months, I can technically do everything I did before (with some modifications) and while i'm in good shape i'd feel like an idiot if I pushed surgery and suffered complications.
    The shoulder specialist in my area told me about a patient he has who basically forced his hand to perform surgery and ended up suffering a complication and losing proper use of his arm, probably for good. A very high percentage of the surgeries have great results, but I guess you don't want to be the one in a hundred or so where it goes sour.

    Stay strong fellas.
    It took me 2 years to regain full "pushing" strength after my injury. The ability to do overhead shoulder presses at full strength returned first, but it took longer to regain forward pushing strength, i.e. chest presses. I think that may have been partially due to me tearing my pectoral muscles at the same time I separated my shoulder.

  43. #1143
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    Quote Originally Posted by throet View Post
    It took me 2 years to regain full "pushing" strength after my injury. The ability to do overhead shoulder presses at full strength returned first, but it took longer to regain forward pushing strength, i.e. chest presses. I think that may have been partially due to me tearing my pectoral muscles at the same time I separated my shoulder.
    That would certainly make sense. One of the main areas of pain that has only just started to (mostly) subside was in my front deltoid muscle, I do wonder if I did some damage to that in the crash too. Any specific pressing excercises that helped you in the early days?

    I'm in a similar boat, overhead stability seems to have been largely unaffected and aside from some working around the joint I can overhead press just fine. But yes, push ups are a no go. Even "girly" from the knee push ups feel horrible, as if my collarbone is being torn through my chest. But then I never liked press ups, even before the injury they have always felt weird to me and given me trouble. Bench press feels fine. Weird. I would like to be able to do dips again, in my mind once you can bust out a set of full dips and pull ups with good form you can pretty much take your shoulders anywhere!

  44. #1144
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    Quote Originally Posted by joel.dunsdon View Post
    That would certainly make sense. One of the main areas of pain that has only just started to (mostly) subside was in my front deltoid muscle, I do wonder if I did some damage to that in the crash too. Any specific pressing excercises that helped you in the early days?

    I'm in a similar boat, overhead stability seems to have been largely unaffected and aside from some working around the joint I can overhead press just fine. But yes, push ups are a no go. Even "girly" from the knee push ups feel horrible, as if my collarbone is being torn through my chest. But then I never liked press ups, even before the injury they have always felt weird to me and given me trouble. Bench press feels fine. Weird. I would like to be able to do dips again, in my mind once you can bust out a set of full dips and pull ups with good form you can pretty much take your shoulders anywhere!
    For me the key was doing as many different exercises as I could to hit the chest and shoulders from multiple angles, but using low weight and high reps. In addition to the typical overhead and chest press movements, I did a lot of standing, single-arm cable movements.

    Also, if you can find a weight-assisted or belt-assisted dip / pull-up machine, those are great for getting range of motion and building strength over time without putting too much strain on the recovering joint. I bought a Gold's Gym branded machine for under $200 (US) that came with a few different belts that supported your weight on a knee board through the complete motion. That was a great investment!

  45. #1145
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    Quote Originally Posted by joel.dunsdon View Post
    That would certainly make sense. One of the main areas of pain that has only just started to (mostly) subside was in my front deltoid muscle, I do wonder if I did some damage to that in the crash too. Any specific pressing excercises that helped you in the early days?

    I'm in a similar boat, overhead stability seems to have been largely unaffected and aside from some working around the joint I can overhead press just fine. But yes, push ups are a no go. Even "girly" from the knee push ups feel horrible, as if my collarbone is being torn through my chest. But then I never liked press ups, even before the injury they have always felt weird to me and given me trouble. Bench press feels fine. Weird. I would like to be able to do dips again, in my mind once you can bust out a set of full dips and pull ups with good form you can pretty much take your shoulders anywhere!
    Pretty common to tear other stuff. Did you see a physical trainer? They should have checked for that in the initial evaluation. I had a torn pec as well and they worked everything else till that healed enough to work on strengthening it.


    Outside from the rowing machine I used at PT visits I didn't use any equipment. A few resistance bands, small weights and kettle bells and body weight. I actually went yesterday to the same guy to have my other shoulder looked at. In a hour he had me setup on a plan to get it sorted. A good PT is worth seeing, if your driven you will recover pretty quickly. I was set on 2 times a day doing my excercises and stretching a few times a day.
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  46. #1146
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    Quote Originally Posted by MI-XC View Post
    Reading your post it looks like you did too much too soon. Iíve had two Grade 3 separations (left and right) and both have healed to 100% without any limitations. Other than the bumps, I would have never known I injured my shoulders. That being said, I took PT and recovery very seriously and meticulously.

    First 3 weeks in a sling. Weeks 4-10 physical therapy and no weight in the affected arm over 5 lbs. Only road and trainer riding until 2 months post injury. The ligaments are still healing during this time and any jarring or weight will affect already comprised attachments, possibly inhibitting their ability to fully heal.

    Many people often get back on the trail when pain has subsided. True, pain may be gone but the shoulder is probably only about 60% healed. Itís getting it to that full 100% that takes patience and persistence.

    Iíd also be careful with regular ibuprofen use or you may run into a whole new set of issues.
    I had a similar recovery to yours; grade 3 separation on dominant shoulder.

    about 3 weeks up to 10 was rehab physio then I jumped back on MTB but wore a support brace for about 4 weeks.

    Am now 4.5 years post injury (no surgery) and feeling pretty good I am riding harder than I did before I injured the shoulder, my only limitation being can't lift too heavy weights during shoulder press and benchpress.

    Shoulder feels a little tired after a big ride or carrying a heavy backpack all day.

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