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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.

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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!

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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!

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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.

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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.

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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!

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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.
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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)

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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.
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  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 fix bikes for a living.

  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 fix bikes for a living.

  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!



  49. #49
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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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    258
    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.
    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.

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    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.
    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

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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!
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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

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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!

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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  

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    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
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    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..

  101. #101
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    Quote Originally Posted by AntiNSA
    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..
    Wearing your brace is good for awhile (I was in what I'd call a sling) but PT, range of motion is your friend. At some point real soon you need to start working your arm through its normal range of motion so your shoulder doesn't freeze up. Use it or lose it, they say.

    Your injury is much worse than my shoulder was/is so others can give you hints about how soon and what kinds of ROM movements you should be doing. Just don't immobilize your shoulder for too long a period. Forget about riding for now.
    The only reply to a fool is silence

  102. #102
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    Like your wells quote btw... I use that in my class whe teaching debate basics....

    I can raise my hand over my head real slowly... I know this is stupid but.. I am thinking Idont ride my bike with my arms raised

    I am feeling almost confident enough that I am internally debating to ride or not..
    I ride about 80-90 km a day going to classes..
    I knoe I cant do that now... but was thinking 26 km in 13 km splits...

    The thing is half of my route is through peasant villages in China.... I am clearly aware that even in my safety zone I can srew up my body for the rest of my life as what got me hear was going over the bars completely unexpected from an unseen speedbumpp... I mean who the hell would have thought.

    The biggest issue to me riding right now is I am thinking I should buy medical insurence as I have two children and one on the way. I naever thought I would get hurt on a bicycle... but all y iuds depend on me and yeah the streets i china are dangerous but I got taken out by a spedbump on a street with no traffic... Freak accidents I guess can happen. I mean going down ski slopes in Germany or coming down out of the mountains in colorado 50 mph on a bike thats too small doesnt kill me... it is the speed bump going 14 kph...

    SO I guess I am going to have to get insurance.. But my bike is chained to my office desk and it is soooooooooo tempting... I seem to get fatter each day and cant stop drinking beer... I want to ride so bad.

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    Grade 3 separation

    I suffered a grade 3 (left side) in a snowboarding accident in early Dec. 2009. Now Feb. 2010, I have regained motion, and strength seems to be returning. I have returned to the slopes. I still do favor it a little. My biggest concern is my arm gets achy when I'm on my feet for a period of time. Example: if I'm at the mall or shopping for an hour, my arm starts to ache. My arm also gets achy when I wear my brace skiing and snowboarding, but it won't ache if I leave the brace at home (always have a backpack on). Sleep is still uncomfortable on the left side.

    My question is, will the the aching go away with time, or is it here to stay? I also have the "bump" and its hideous. Does the self-consciousness go away with time too?

    Thanks, and sorry for thread jacking.

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    Aches and Pains

    I suffered a 4th degree (the AC and CC were completely torn) back in Spring of 09 and I still have the aches and pains. I am now at a point where I can do just about everything I could do before. The only holdups I have is doing heavy resistance stuff like pullups or pushing heavy weights in the gym. When things get heavy I can feel the ligaments pulling and don't wanna risk hurting it. But I still encounter soreness on a regular basis but never any real pain.

    I do remember how wearing a backpack caused minor aches and soreness early on. This went away a few months ago. I would get tightness in my shoulder on the side of the injury. I would guess that will go away for you. Just stretch it out (I twist my back opposite of the injury and it helps).

    I don't wear my brace often but i did just last month when I went snowboarding and while I never felt pain (I fell a lot I did experience soreness. Currently I mountain bike (absolutely 0 issues and I ride pretty hard), do triathlon (sometimes swimming will cause soreness) and run (13+ miles I feel that side fatigue quicker than the other but just soreness). I don't wear my brace through any of this.

    The last two weeks I've started playing basketball which I was really worried about. I play pretty hard and I wasn't sure how my shoulder would hold up because the shoulder moves alot and has some sudden jolts quite often. There are times when a quick jolt will be uncomfortable (not painful) but no lingering pain, just moderate soreness.

    So to answer your question (simply from my experience), the soreness hasn't gone away yet (I'm seeing it subside through time) but the functionality is all there and there is no pain. I just stretch it out and it feels much better. I did get a massage in summer and it was AWESOME! Just play it safe and don't push it too hard, let it heal.

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    Damn... here I am .... 4 months nealry later and I can say it is sore everyday still... not as bad... I got range of motion .. but if I raise my hand straight up... I can do it.. but it hurts. I dont know if I should do it a lot and hopefully the pain will go away? I am sick of the sore ness.. cant wait...
    I can mountain bike.. mainly road bike.... its sore but works

  106. #106
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    i got hit by a car one week ago today and landed directly on the shoulder. i didn't see a doctor because i hate going, it's bad for our companies worker's comp rates, and i knew they would try to make me stay off of it. and i'd rather work if i can. just in the last day or two the swelling in my shoulder went down enough that i could really clearly follow the clavicle and make sure it wasn't broken, but i figured it wasn't because i've had very little pain the whole way through. but i finally with internet research was able to self-diagnose as a level 2 or 3, probably 3 AC separation. i wish i'd known earlier, so i could have taped it for support during that vital first week of healing. i'll still tape it from now on. here are some pictures of the injury, one week after occurence.

    https://i153.photobucket.com/albums/...y/DSC00198.jpg
    https://i153.photobucket.com/albums/...y/DSC00197.jpg
    https://i153.photobucket.com/albums/...y/DSC00196.jpg
    https://i153.photobucket.com/albums/...y/DSC00199.jpg

    but the truth is... the shoulder locked up after about 20 minutes to where i couldn't lift the arm near shoulder length. by one or two days after, i could lift the arm above shoulder height again. of course with pain, but i could do it. the most painful things i've done is pulled up on the handlebars (no curb hops for me this week) and lifted something kind of heavy into the bed of a tall pickup (lifting up was fine, setting it back down in the truck a foot away from the body was what hurt). the second most painful thing i do is to swing my bike chain lock around behind me to catch it with the other hand. it's hard to switch hands with this habit, but switching helps enough to make it worth it. other than those things, i've used it pretty regularly already. so, i don't think i would consider surgery or even consultation because i've worked 9 hour days as a messenger, sometimes with up to 40lbs in the bag weighing on the shoulder, beginning about 30 minutes after the accident and through this whole week.

    SO. with that long bit out, here is my final question though - after the injury does heal, what will a trauma incident to the same area do later? is there increased risk, or is there maybe decreased risk because significant scar tissue has formed and the joint isn't even there to break anymore?

    p.s. the last picture is to show where my bag rests for work.

  107. #107
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    Im not a doctor.. your bone sticks up more than mine. In fact I cand figure out why my bone doesnt stick up as much as others... but I have a little bigger neck muscle so mabe I cant see it sticking up so much because its hidden? I wrapped mine up for like 5 days really hard and kept it immobile.. I couldnt even hardly walk for 4 days the pain was so intents. i kept my forarm bent parralel to my body .. I needed help just goin to the bathroom for 3 days + and taking a shower by myself was almost impossible for a week. I try not to think of myself as a *****, but all I had was some mild muscle relaxers and liike ibubufferin . I sear I thought It would never heal... but 5 months later I am 90-95% back to normal. Some advised the operation, some advised it would be cool to heal normally. Id say go natural. But I had this butterflycolarbone brace thing I wore and wrapped my body up forcing teh bone down for a week-2 weeks. Maybe thats why it is not proturudign now? I wouldnt **** with anything or try to be macho about it it will only keep it from healing and stuff. But I am serious to say I had no ****ing choice.. it was very painful.

    Good luck,

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    that's what is so wierd to me... the bone protrudes up as far as the model/textbook cases i find on medical sites... enough to definitely hint at a level3 separation. but the pain just hasn't been there for me. certain motions cause me to say "ooo" and retract from the movement quick, but nothing constant and nothing unbearable. so i do believe in trusting your body and its signals, and if it really really needed me to lay off it'd tell me so. but my mind simply thinks that i need to let it rest. so i might trade with a coworker biking for driving (he drives usually but would like to get a little time in the sun on the bike), maybe a week or so.

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    Dinsmore, congratulations, your the new owner of a AC seperation. Even though you are starting to regain strength and mobility, you should still get an x-ray to see if it's a grade 2 or 3 seperation.If it's a 3 then all ligaments are torn and you can't really do any more damage, but if it's a grade 2, then another hit to that shoulder could result in an increase in severity which might require surgery.I'm not a doctor, but to me your seperation looks like a grade 2.I injured mine about six months ago (grade 3)and it looks like a golf ball growing out the top of my shoulder and I have alot of upper body mass.You look pretty thin and with the injury being pretty new doesn't look to severe. Good luck brother.

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    thank you for the warning about protecting if it's level 2. for as much info on the injury as there is on the internet, i found nothing at all about the risks of repeat incidents.

    and, yeah, based on the low pain level, only a half day or so of limited range of motion, and the not so bad bump, it's probably level 2 as you say.

    do you think med students do free x-ray clinics like they do for some other procedures? ha.

  111. #111
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    Yeah I dont know how its not painful for you. The **** really really hurt for me. Ratherit hurts or not, be easy on it for the long run. SStrange it doesnt hurt.

  112. #112
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    dinsmore, the real danger to a repeat incident is that you don't know for certain what grade seperation you have. A grade 3, is that all ligaments are torn, a grade 2, to my understanding is not all ligaments are torn.There are 2 group of ligaments that stabilize the AC joint.

  113. #113
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    Well I went OTB yesterday when I hit a root sticking up. I went to Not So Urgent Care last night. After 4 hours they said AC seperation. Now I need to go to an orthopedic Dr. tomorrow. I'll let you know what they say!

  114. #114
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    The AC joint seems a little over rated. I had a grade 3 sep 8 years ago. I ended up having the bone cut and AC repinned that year, so I wouldn't have the bone looking like it would burst through the skin at any moment. I never had any pain. I had some clicking and mashing of the bone through the muscle when doing shoulder presses or rows. I no longer do chin ups.

    I'm happy I had the bone cut and the AC repaired. I brought my shoulder almost all the way back up to normal position. It was limited some my range of movement a little. My shoulder would get pretty sore if I was doing rowing and press type motions. It looked pretty funky to have my shoulder an inch lower on my left side with a protrusion popping up through my shirts. I have paid for a lot of insurance over the years. I'm glad I used it.

    Be glad it was not a rotator cuff injury. Those don't have happy endings near as often.

  115. #115
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    To respond to my last post, I went to the Dr. yesterday. He said it is a minor AC separation. That's good!

    Honestly from me not being able to move it Saturday evening, Sunday all day, it felt like 75% better on monday. Today is feels a little worse than yesterday, but still much better than sat/sunday. I plan on going back to work on monday.

    Mike

  116. #116
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    LuckySomer - how soon after the injury did you have the Weaver-Dunn?

    I did my AC 11 years ago. Level 4, pretty nasty, snowboarding. Hit a quarter wrong, came down on the shoulder. I popped all the ligaments. Had surgery 3 days after the accident but not really sure what was done. I live in Japan and back then my Japanese wasn't good. I know I had a large pin in my shoulder that was removed a month after surgery.

    Anyhow, the surgery did nothing apart from taking me out for 3-4 months. As soon as the pinned was removed I felt the clavicle ping like it was on a spring. I can put a finger between the clavicle and shoulder blade. I can't do heavy weight training as the shoulder gets too sore. I'd love to put some muscle on the shoulder so the clavicle is not so pronounced but it just doesn't seem possible.

    I'm now thinking about corrective surgery as I'm just sick of being deformed. The Weaver-Dunn procedure looks promising but I think finding a willing ortho doc here will be hard plus it is going to be pricey

    I also do a lot of Aikido (I train every day) and some of the throws and locks twist up the shoulder. Sometimes I am simply incapacitated with pain. I'm 37 now and have a lot of active life ahead of and i really feel like the shoulder is holding me back. So I have the jutting out collar bone and nice scar plus vary degrees of pain, soreness and aching. I'd rather do what I do and take the pain though than not do it. But if I could get it fixed by corrective surgery that would be awesome.

    Anyone heard of having this procedure done years after the event? I can also feel the onset of arthritis and heard this procedure can also help with that.

    Oh, also, that "bump" you all got....well, be prepared for it to get BIGGER. Especially if you're active. Weight training definitely widened the gap by a good few millimetres and I'm sure Aikido has added more. Basically after 11 years and surgery the clavicle is 50% higher off the shoulder than it was after that fateful quarter pipe jump.

  117. #117
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    Update:
    I am now 3 years and a few months out from my crash and my surgery using modified weaver dunn, (read my previous post and follow up post). Crash was on 12/26/06 and surgery on 12/28/06 for third degree separation.

    My shoulder feels strong and my range of motion is nearly 100%. I can do most all the things I could do before, I choose not to do bench presses as I just don't think they are as functional as push ups. I am happy with the surgery and would not do anything different. My pin is still in, never had it removed.

    Hope this helps any of you who are wondering what to do and good luck to you! If you have any questions feel free to PM me.
    The Trick to carrying on is not to get carried away

  118. #118
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    update on mine

    Snowboard crash causing separation: 12-5-2009
    Today 5-5-2010

    The last month my shoulder has been getting worse in terms of pain.

    Activity is pretty normal with the effected shoulder. Good range of motion. bump is bouncy and moves around when arm is moved. I am able to work out, but for every hour of working out, there is 3+ days of pain afterwards. Can't be out for multiple hours at a time, Example: denver auto show, after 2 hours of walking around pain was unbearable and had to go home. Normally starts out as a dull ache and escalates the longer I'm on my feet.

    I am actually needing some input of those who have had surgery. I am planning on seeing an orthopedic. I hear surgery puts you out for 6 months. Is there supposed to be pain with conservative healing? will there be this pain after surgery?

    Thanks for any input

  119. #119
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    Post-op surgery was the most paid I've ever felt in my entire life. Way much more pain than the actual separation and more painful than being run over by a car and fracturing my skull as a child. I was shaking with pain for about 12 hours. Excrutiating.

  120. #120
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    I had a 3D+ separation (R) in 1998 and had it repaired. It took about 6 months to heal and get back on the bike. It was a drag but well worth it. My surgeon was able to get to 99% rotation and now I can throw a fastball better with my kids. Go figure. My left shoulder has been bruised a few times (just recently) but seemed to escape any serious injury. The right side has a little bump to match my normaly bumpy shoulders.

  121. #121
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    Ask for a nerve blocker and you will feel no pain until it wears off (12 hours). I am 3 months out from surgery. Still sore but have 90+% range of motion. Really glad I choose surgury, had a grade 4 separation. Clavical was just under the skin.

  122. #122
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    Just separated my shoulder last Wed. going down a chute on mt bike (done it before). Messed up on line and and next thing you know.... Have no insurance cus just got new job so 2 more months to go and hope they keep me. Should have rode conservatively cus could have been worse and no insurance.

    From reading forums and researching web, I have a type 2 separation. Can't lay down on left side. Bump on shoulder is not too noticable. ROM improved from last week. The thing that bothers me is how my injured shoulder is not as wide as the normal one anymore. Looks like it dipped down at the edge so to speak. When I wear T-shirt the sleeve on the injured shoulder appears longer than the sleeve on the normal shoulder.

    I know the bump will stay forever but mine is not that noticable, but will the shoulder ever look broad again or will it always be a 1/2 to an inch lower than normal?

    Also, Do ligaments ever replace themself or once damaged its gone forever? Do the ligaments get replaced by new bone if ligament cant heal itself? What is the disadvantge if support is with other bone vs ligaments.
    A spotless bike is a bored bike.

  123. #123
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    Grade 1, 2, and 3 separation are generally treated without surgery. Once the ligament is torn it stays that way unless surgically repaired. What ever your posture is now will stay that way. A separated shoulder can lead to other problems in the future. Just depends on how severe it is.

    http://www.aafp.org/afp/980215ap/980215a.html

    These are the types of exercises you need to strengthen your Rotator Cuff.

  124. #124
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    Quote Originally Posted by Sonoran_Flyer
    Grade 1, 2, and 3 separation are generally treated without surgery. Once the ligament is torn it stays that way unless surgically repaired. What ever your posture is now will stay that way. A separated shoulder can lead to other problems in the future. Just depends on how severe it is.

    http://www.aafp.org/afp/980215ap/980215a.html

    These are the types of exercises you need to strengthen your Rotator Cuff.
    Thanks. I'll probably wait one more week before I do that. Right now I'm just focusing on shoulder shrugs, raising arm up and down with the natural wait of my arm.

    Just curious when you say problems in the future, do you mean things like arthritis? Can I choose to do surgery later so that ligaments are fixed. I read somewhere that surgery would have to be done with 3 days for ligaments to be fixed.

    When I become permanent at my job and get insurance I will see an ortho just so I can get a better understanding of long term effects.
    A spotless bike is a bored bike.

  125. #125
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    If its grade 1 or 2 probably no or minimal complications. Grade 3 or higher would be of concern. It is just the shoulder is out of its natural position and is using different muscles to support it. This can lead to Rotator Cuff issues 10 to 15 years later. In my case the clavical was just under the skin(punched thru muscle), which can lead to Necrosis (death of skin or infection).

  126. #126
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    I'm 2 weeks into a grade 2 separation that I suffered in the most ridiculous OTB scenario ever.

    Usually I bounce back very quickly but this is different. The recovery process is much slower and I now believe my physio when he says "6 weeks" at least.

    Trying my best not to lose fitness.

    To all the other AC joint injury sufferers out there:

    "GET WELL SOON & CHIN UP"

  127. #127
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    Quote Originally Posted by jathanas
    Trying my best not to lose fitness.
    Thats for sure. I'll continue running treadmill and stationary cycling for the mean time once I feel my arm is a tad better. Right now I'm still too paranoid to be swaying my arm that much from jogging/running or putting wait down on the handle bars of the stationary cycle.

    I'll begin the third week after injury. For now I will continue working my ROM at home with the natural wait of my arm.

    Also hope I can eventually lay down on my left side.Some people say that they still can't lay down on their injured side after months after injury.
    A spotless bike is a bored bike.

  128. #128
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    Quote Originally Posted by pacing08
    Thats for sure. I'll continue running treadmill and stationary cycling for the mean time once I feel my arm is a tad better. Right now I'm still too paranoid to be swaying my arm that much from jogging/running or putting wait down on the handle bars of the stationary cycle.

    I'll begin the third week after injury. For now I will continue working my ROM at home with the natural wait of my arm.

    Also hope I can eventually lay down on my left side.Some people say that they still can't lay down on their injured side after months after injury.
    Been 9 months for me, still can't sleep on my left side. But I can pull a tee shirt over my head using my left arm!
    The only reply to a fool is silence

  129. #129
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    The recovery was going great. 5 weeks from my grade 2 separation I was on the roadie without discomfort...

    On my third ride back I got collected by a car. Diagnosis: Grade 2 AC Separation - Same shoulder. Back to step 1.

    Son of a b#(ch.

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    Glad I found this thread. I am amazed at how many people there are with this type of injury. I suffered a Grade 4 separation a few weeks ago. The first ortho I went to said to just leave it alone and deal with it until scar tissue helped to stabilize the joint. A few days later, I got a second opinion from an ortho who specializes in shoulders and it seems there is a newer procedure out there that must be done within 2 weeks of the injury. It's similar to Weaver-Dunn, but they use metal buttons on top and bottom and very strong sutures to pull the bones back ino place. The ligaments are butted together and reattach and heal, which takes a long time because ligaments are nonvascular. You can be in a sling up to three months and then 9 months of PT. It was put to me that since I was very active to do the surgery, otherwise, just let it scar up. It's been two weeks since the surgery and the joint seems to be quieting down. Coughing and sneezing does not cause much movement anymore and I have confidence that it will heal up completely in time.

    Just wanted to let everyone know that there is another option out there for higher grade separations.

  131. #131
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    Quote Originally Posted by cannonman
    Glad I found this thread. I am amazed at how many people there are with this type of injury. I suffered a Grade 4 separation a few weeks ago. The first ortho I went to said to just leave it alone and deal with it until scar tissue helped to stabilize the joint. A few days later, I got a second opinion from an ortho who specializes in shoulders and it seems there is a newer procedure out there that must be done within 2 weeks of the injury. It's similar to Weaver-Dunn, but they use metal buttons on top and bottom and very strong sutures to pull the bones back ino place. The ligaments are butted together and reattach and heal, which takes a long time because ligaments are nonvascular. You can be in a sling up to three months and then 9 months of PT. It was put to me that since I was very active to do the surgery, otherwise, just let it scar up. It's been two weeks since the surgery and the joint seems to be quieting down. Coughing and sneezing does not cause much movement anymore and I have confidence that it will heal up completely in time.

    Just wanted to let everyone know that there is another option out there for higher grade separations.
    Get well soon mate.

    I'd also have considered surgery if I had suffered a grade 4 AC separation. Luckily, mine wasn't so bad, even the second time around.

    All the literature I've read states that for grade 3 and above you'd be looking at a 12 week recovery period. Chin up!

  132. #132
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    Quote Originally Posted by twistedlizard720
    Snowboard crash causing separation: 12-5-2009
    Today 5-5-2010

    The last month my shoulder has been getting worse in terms of pain.

    Activity is pretty normal with the effected shoulder. Good range of motion. bump is bouncy and moves around when arm is moved. I am able to work out, but for every hour of working out, there is 3+ days of pain afterwards. Can't be out for multiple hours at a time, Example: denver auto show, after 2 hours of walking around pain was unbearable and had to go home. Normally starts out as a dull ache and escalates the longer I'm on my feet.

    I am actually needing some input of those who have had surgery. I am planning on seeing an orthopedic. I hear surgery puts you out for 6 months. Is there supposed to be pain with conservative healing? will there be this pain after surgery?

    Thanks for any input
    Hey, I was in the same boat as you with the throbbing pain that comes up the longer you are up so I thought I would respond. I dealt with healing a Grade III AC Sep for about 3 months without any intervention and then between 3 and 6 months my pain started getting worse and worse to the point of being unbearable just as yours has. I was sure that I was in need of surgery. Finally went back to the Ortho doc and he suggested first to try some physical therapy before moving to surgery. Within one week of starting PT with an actual Physical Therapist the unbearable pain like you are having went totally away and has not been a problem since. Thank god for physical therapy!

  133. #133
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    well I had a grade 3/4 about 10 years ago now. The bump is still there. I have a muscular/lean frame and I still cant get the shoulder built up 100% around it. I have full mobility and maybe a little less strength in left shoulder vs. right. It will always be noticable. I have just learned to love it! It makes for a great story!! You will get past it!

  134. #134
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    Update after 3.5 months:

    The pain never really when away. Dr. worried about rotator cuff tear. He called for a MRI, but for some reason I could not handle it so they did an arthrogram this morning. Rotator cuff is good! He said the scans showed an ac separation. But knew that from the beginning. The weird thing is that the separation is bigger now than it was before. My sister works in the imaging office and said it is 1.5cm apart, which is more than last time.

    I have to go back to my Dr. on Friday. I will ask him if it is a level 2 or 3 and why it got bigger. I think it is only a level 2 because I can't really move it around.

    It's been over 12 weeks. I wonder why I still have pain raising my arm or doing some over head work. Painting and sweeping with a push broom forget about it!

    Biking doesn't bother it, which is great.

  135. #135
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    I guess I get to be a member of team pointy shoulder too. IO went OTB yesterday and sustained a pretty obvious left shoulder separation as verified later on my xrays. Sucks with arm in sling everything is awkward, and as an auto mechanic I am off work for a good while.
    Worst part? I only got to ride on my new Magura Thor fork once, and it was working sooo good! Now I have to stare forlornly at it for awhile....

  136. #136
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    Update 5 weeks after my 2nd degree AC separation. I can crank out 25 push-ups and 7 chin-ups (close grip). The shoulder does not feel normal yet, the physio suggests that's still months away.

    Riding again which is good. Enjoying it too, more importantly.

  137. #137
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    Quote Originally Posted by jathanas
    Update 5 weeks after my 2nd degree AC separation. I can crank out 25 push-ups and 7 chin-ups (close grip). The shoulder does not feel normal yet, the physio suggests that's still months away.

    Riding again which is good. Enjoying it too, more importantly.
    Can you use the affected arm to help put on a tee shirt? How about using that arm to shampoo your head in the shower? These were benchmarks I used. Ten months after my crash I can finally sleep for awhile on my affected shoulder. Woo hoo!
    The only reply to a fool is silence

  138. #138
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    Quote Originally Posted by xcguy
    Can you use the affected arm to help put on a tee shirt? How about using that arm to shampoo your head in the shower? These were benchmarks I used. Ten months after my crash I can finally sleep for awhile on my affected shoulder. Woo hoo!
    As of last week, I can answer YES to both your questions

    You don't know how valuable your right arm is in all hygiene & grooming activity until you must do without... Shave, toilet, shower, dressing up etc

    Still can't sleep on that side though, it still doesn't feel 100%

  139. #139
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    Hi guys - joined the club last monday in an OTB incident I can't remember most of!, saw consultant last night who confirmed grade 3 separation.

    Recommended waiting 2 weeks to see if it was recovering before deciding on surgical route or not, but said that it was too early to start physio in the meantime which didn't sound right to me.

    When did you start physio in your recovery phases?

    Mark

    Ac Separation (shoulder Separation)-xray.jpg
    Last edited by marko1480; 08-10-2010 at 09:14 AM. Reason: Added x-ray

  140. #140
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    I would get a second opinion. Find a doctor would specializes in Sport Medicine and shoulders. From what I know surgery is most successful when done within a couple of weeks of injury.

  141. #141
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    Quote Originally Posted by marko1480
    Hi guys - joined the club last monday in an OTB incident I can't remember most of!, saw consultant last night who confirmed grade 3 separation.

    Recommended waiting 2 weeks to see if it was recovering before deciding on surgical route or not, but said that it was too early to start physio in the meantime which didn't sound right to me.

    When did you start physio in your recovery phases?

    Mark
    Your physio is right. The first 2 weeks of the injury are the inflammation & repair phase. It is important to rest your shoulder, and reduce inflammation during this time (ibuprofen during the first week).

    Usually a physio will recommend a sling or shoulder brace to keep the shoulder still during this period.

    The ultrasound, TENS, and exercises can start later.

  142. #142
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    Well I'm 8 weeks in to healing a type 2 AC seperation in my left shoulder, but the ortho wouldn't address it until the right arm radial head compression fracture healed. So I start PT today for 4-6 weeks 2 time a week. What I want to know is how has the after healing riding been? I currently ride full rigid.
    if you don't feel like riding, that's usually when you need it most

  143. #143
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    I'm 2 months out from a grade 3 AC separation. The doc (his specialty is shoulders) said he normally wouldn't operate but since I do sports 6-7 days per week, he wants to use a cadaver tendon to tie the clavicle and scapula together. I'll get a 2nd opinion in 9 days.

    On the weight machines my pulling (back) strength is about 70%, my pressing strength is only 15%-25% of my uninjured side. The wild card is that I'm 60 which means I should heal more slowly than a young person.

    Most of the posters above seem to recommend against surgery but without shoulder stability, I can't see my strength increasing much at all, especially since I've been lifting weights for 46 years and could do 1 arm chin ups until the injury.

    For the benefit of those injured in the future, I'll update my story when changes occurr..

  144. #144
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    Here is the xray from the day I went OTB on 4-3-10

    Ac Separation (shoulder Separation)-shoulder4-3-10small.jpg

    Here is it 3 months later. See how much further the separation is. I wonder why?
    Ac Separation (shoulder Separation)-shoulder7-12-10small.jpg

  145. #145
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    I'm seeing 2 different orthopedic surgeons next week about my grade 3 AC tear. Feel free to send me questions that you have about grade 3 AC tears. I'll add your questions to my list of questions and then report back on the forum with the doctors answers. My appts are Sept 15 and Sept 17.

    The first doc wants to use a cadaver tendon. I'm going to ask if there isn't a stronger synthetic material available. It will be my first appointment with the 2nd doc.

  146. #146
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    Since this keeps getting bumped up.....I'm a week or so away from two years out on my cat 3/4.

    I did not have surgery, partially because my job frowns on retained hardware/spare parts. But also because after 3-4 second opinions it felt like the Ortho Doc's really just wanted to do an uncommon surgery. Thing is that none of the surgeries actually repairs the ligaments. All going under the knife was trade the odd bump for a scar, and bring the two parts close together so you can have an operation later in life when the joint is terribly arthritic.

    I'm not a Doc, and far be it from me to imply they would rather do 20K worth of surgery rather than just send you home with a sling and a scrip for some narcotics...................

    That said my shoulder is stronger than it was prior. I only notice the separation when I sleep too long on that side or when doing things like wide grip pull ups.
    Slowly slipping to retrogrouchyness

  147. #147
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    G-reg

    You are correct about the ligaments. On a grade 3 the ligaments are completely torn and are useless. The surgical procedure my doc suggests uses a cadaver tendon to tie the clavicle and scapula together. Prior to the grade 3 AC tear, 2 ligaments secured the clavicle to the scapula.

    My doc was opposed to surgery the day after the injury. I was the one who wanted the surgery, not him. Because of the number of sports I do (wakeboard, kiteboard, jui jitsu, surf) he said I was not the usual case and that the surgery would help me.

    My injured side lifts approx. 20% as much as the uninjured side on pressing motions and lifts 70% on pulling motions. The injured area muscles haven't gotten weaker. The muscles are still strong but are not able to exhibit strength now that the bones are no longer tied together to stabilize the shoulder. Any pressing movement, even 10lbs is very herky jerky.

    I haven't made my final decision but surgery seems like the best choice for me.

  148. #148
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    Quote Originally Posted by Old Head
    G-reg

    ..... cadaver tendon to tie the clavicle and scapula together........
    Note that there is a big difference between tie and repair. The surgery won't really gain you the stability back. Surgery or not it is muscles compensating and the scar tissue that encapsulates the blown up ligaments that eventually brings back stability.

    Also think about the forces that popped those ligaments in the first place. Would the surgically repaired shoulder take that hit?

    The one ortho I saw described it like this: "I don't know how religious a man you are so I don't want to offend you.....But the AC joint is more from the swinging from trees section of evolution."

    Just make sure you are getting something beneficial from going under the knife.
    Slowly slipping to retrogrouchyness

  149. #149
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    G-reg thanks for the reply.
    I am 64 days out with no shoulder stability. If I forego surgery, what type of time range do you think before I notice some shoulder stability?

    Does the scar tissue form on each torn ligament to reattach them together and reestablish the connection of scapula to clavicle? I'm lifting every day and I haven't noticed any muscle compensation yet as movements are herky jerky. I'm seeing a 2nd doctor next week. Hopefully I'll be armed with intelligent questions from what I've learned from you and others on the forum. My first doc didn't say much. Thanks again.

  150. #150
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    At two months I was still pretty unstable, no pain anymore but I had to be careful. If I recall correctly one of the surgeries can actually kinda repair one of the ligaments IF done within 24hrs of the injury. Otherwise those three ligaments are toast. The scarring encapsulates the ends of the clavicle and scapula-nubbin, the ligaments doing nothing anymore. Muscles will eventually compensate, as if the clavicle was never there.

    At two months if you are able to work out enough to determine that you are still herky-jerky....you're probably doing pretty well. Give it some more time, maybe get on a dedicated PT program.

    Good luck with the second opinion, make sure to say "this guy on the internet said" as much as possible.
    Slowly slipping to retrogrouchyness

  151. #151
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    I separated mine (Grade 3) 6 weeks ago, after 12 days of that pain we all know!! It was feeling better. After a few visits to the hospital. I was offered the Opp by the surgeon and advised of the complications. After much research, and if I'm honest the thought of that lump on my shoulder forever. I decided to go for the operation (Weaver Dunn), Was done 4 weeks ago today. Recovery was going fine until this week at PT, I informed them that i was getting pins and needles in my little finger and my ring finger and that I had shooting pains at my shoulder and neck. I was given some tests and some new exercises to do. I was told I have some sort of nerve damage/ trapped nerve. and that I need to go to the doctors and get some Amitriptyline. I don't like taking painkillers and have taken the minimum (When waking at night) amount throughout the recovery. I checked them out and don't really want to go down this road.


    http://emedicine.medscape.com/article/1244885-overview

    http://www.google.co.uk/search?clien...Apm8jAeVz_zJBw

    On returning home I researched and found that the nerve in question is the Ulnar Nerve, (from your shoulder around your elbow to your wrist then fingers) And that I may have ulnar nerve entrapment. I was sure this was a consequence of the Opp. (Bugger) After some more digging I found that this could have happened

    Because the elbow was immobilised for a length of time.

    I was not told this by the surgeon or the PT that visited me after the Opp??
    Can't seem to find any similar experiences, Yet I feel this information should be out there. I am hoping to get an appointment the next few days or next week to discus the matter with the surgeon..

    I would say "be careful of the amount of time you immobilise your elbow wouldn't want this to happen to anybody else.....Ask your doc about it".

    Hopefully if its not degenerative, I can sort this with good PT..... Really Not looking forward to another Opp



    Les T Morris Age 43

  152. #152
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    Got my separation a week ago Saturday....OH WHAT FUN...Pain is a LOT better now and I am 10 days in and not wearing the sling all of the time...doctors said use it as needed...sling was driving me nutz! Feels like a migraine in my shoulder now instead of an elephant sitting on it. The first day it happened...I couldn't even get out of a chair without agonizing pain..getting out of the bed was an adventure as it was on an air mattress in a tent...Grade 3...the bone opposite the collar bone isn't totally under the collar bone...so it isn't a full Grade 3...but I do have the bump and it...HURTS

  153. #153
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    Quote Originally Posted by flogger13
    Recovery was going fine until this week at PT, I informed them that i was getting pins and needles in my little finger and my ring finger and that I had shooting pains at my shoulder and neck.
    That's a bummer. Don't feel completely left out though. It seems that my arm falls asleep much fast on the effected arm. I sometimes worry about nerve damage and blood flow. At this point I am 10 months post of the separation, 2 months post PT which made a great difference. At this time I am not getting surgery, but it may be an option in the future if things continue to degrade.

  154. #154
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    lev 4





    just happen, lev 4...doc said no surg and just to tack it ez....really. had mri and e-xray.

  155. #155
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  157. #157
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    2 orthopedic surgeons told me that I had a grade 3 AC tear. I got an MRI.
    Since I had no strength in my arm and couldn't play any sports, I opted for Weaver-Dunn surgery 10 weeks after sustaining the injury. I requested a copy of the surgery report which said that I had a grade 5, not a grade 3. Apparently that wasn't evident to the surgeons by looking at the x-rays and MRI.

    When I see the doctor again (5 weeks after surgery), hopefully he'll tell me to discard the sling and start rehab. The surgery took a lot of energy out of me. I went to the gym 11 days after surgery to lift with my good arm. I wasn't very strong. When I went home I collapsed and slept for 2.5 hours and woke up feeling exhausted. I guess my body has marshalled its resources to heal my shoulder and doesn't have the energy for other physical demands.

  158. #158
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    Did my grade 2 separation in June. Within 6 weeks I was back on the bike. The shoulder was nowhere near 100% but I kept at it, finding satisfaction in the small progress I was making.

    4 months out and I'm much better. I can sleep on it! Pushups and chin-ups are still a little weird. MTBing is fun again and I've nearly regained full confidence on the descents

    Helpful tip: I'm doing kettlebell workouts and they've done wonders for shoulder stabilisation.

  159. #159
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    Type 4

    This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius. This injury is generally acknowledged to require surgery.

  160. #160
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    lol....I came across this thread while researching if my collar bone is going to permanently stick up. Guess I found out the answer is yes!

    My story: August 2010. Won a work trip to Lake Tahoe, took a close friend of mine. We are staying at the Ritz Carlton in Truckee (North Tahoe) and are looking for something to do. We look up the mountain and see a bunch of dudes going up the lift with bikes.

    We talk to the biking guy and he suggests if we want to take it up a notch, we do downhill. This is after a several red bull and vodkas, so it sounds like a good call. Mind you I've never mountain biked before and had limited BMX experience up until I was 16 (10 years ago).

    I figured things were going to turn out bad since I kept on landing on my front wheel and couldn't fix it. I made it down about halfway before I flipped over my handlebars, not sure what happened since I blacked out.

    I somehow made it down the hill and thought I dislocated my shoulder. Had some really nasty road rash all down my back too. Since it was the first day of the vacation, I chose not to go to the hospital and just party it off. It really sucked.

    Finally got back home, went to the doc. Grade 3 separation, borderline grade 4. I still feel it and need to get back into lifting after a few months off. Oh, and I'm never touching a freaking mountain bike again...lol.

  161. #161
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    I never had any physical therapy, and no fancy doctors or doctors I couild understand in China. Thank god, no bump... but even more so seems pretty useable a year later... believe in your body. Hope you guys are ok too,

  162. #162
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    I was in a sling for 5 weeks after surgery for my grade 5. The doc said to throw away the sling and to rehab. He said I could lift light weights like 5lbs. I used to curl 30lbs dumbbells but now 5lbs is too heavy! I'm using 3lbs until I get stronger. A 1st grader could handle more.

    Normally one has about 30% more strength in the eccentric part of the lift vs the concentric part of the lift. That is, if one could curl 100lbs, one should be able to resist while lowering 130lbs. Oddly, I have noticeably more strength in the concentric part of the lift vs. the eccentric. I can curl 3lbs ok but lowering the dumbbell is very shaky.

  163. #163
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    Everyone is giving updates, so I'll give mine.

    Grade 4 - Opted for the surgery. If done within 2 weeks, the surgeon said that there is a good chance that the ligaments will reattach and heal, just like when you get stitches to push the sides of a laceration together. Mine was done 1 week out from the accident. The procedure was the AC Tightrope. You can see the procedure at http://actightrope.orthoillustrated.com.

    Was in a sling for 3 months to allow the ligaments enough time to heal. I'm two months into therapy, this week being my last. Most of my range of motion has returned. The shoulder feels normal now, just that the muscles are still sore as they are rebuilding strength. As for the bump, everything looks great so far. I've been using Mederma on the scars and it does a great job of reducing them. I honestly don't know why everyone is so up in arms about having a scar anyway. Does everyone here have secret modeling contracts?

  164. #164
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    I have a grade 2 A-C separation, just happened last Saturday in Pisgah (ended a long overdue mountain trip early). Went to ER, got the x rays. Spoken with a couple of Dr. friends, they said take it easy for the first couple of weeks, then use it as I can. Not much of a lump yet, but I hear that will come with the scar tissue.
    The part that really sucks is the thought of dragging that damn trainer out of the attic so I can get some pedal time in.
    Good luck to those in my boat. At least cold weather is almost upon us.
    c

  165. #165
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    funny that this is my first post on mtbr......but i joined the club.........1/31 i took a jump on my bike, front wheel hit the mud on the landing, stuck and sent me flying. luckily for me my right shoulder was kind enough to take the fall for me. went to er and then to ortho next day. unbelievable pain - ortho says stage 3 w/no surgery and 6 weeks to recover (not be completely normal by then but really light activity till then). my wife wants me to have the surgery because she is worried that 30 years from now i won't be able to move my shoulder due to the lack of ligaments. what do i tell her?

    enjoy, jason

  166. #166
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    Quote Originally Posted by freemanhoodlum
    funny that this is my first post on mtbr......but i joined the club.........1/31 i took a jump on my bike, front wheel hit the mud on the landing, stuck and sent me flying. luckily for me my right shoulder was kind enough to take the fall for me. went to er and then to ortho next day. unbelievable pain - ortho says stage 3 w/no surgery and 6 weeks to recover (not be completely normal by then but really light activity till then). my wife wants me to have the surgery because she is worried that 30 years from now i won't be able to move my shoulder due to the lack of ligaments. what do i tell her?

    enjoy, jason

    Here is my suggestion. Talk with your ortho again and see what the differences are between surgery now and surgery one year from now or even beyond that. Then make a decision.

    A little input. I saw an ortho two weeks ago and he told me they could have reconstructed the joint within the first 6 weeks (which my ortho 14 months ago failed to mention). Now my only option is the Weaver-Dunn procedure which he explained is more of a patch job. The thing I didn't like was the ortho said surgery may solve my issues completely or just ease the pain a little. It wasn't a firm answer like I was seeking. I am 14 months post injury and if I knew about reconstruction then, I would have had surgery right away.

    I am in a position where I can go either way. I tend to be on a constant rollercoaster. Pain gets worse, I do PT and it bets better. It has really been bugging me lately (again) and plan to start physical therapy (again). I'm going on a short deployment here in a couple weeks. That will give me a good idea if I can hang as is, or need surgery. It really puts a damper on my activities I enjoy.

    I am curious what results everyone else has had long term with their choice, and what kind of pain they have, if any?

    My bump now

    Last edited by twistedlizard720; 02-05-2011 at 10:35 PM.

  167. #167
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    I would go see an Orthopedic Surgeon with a Sports Medicine background.

    My AC was a grade 3/4. The clavicle had penetrated almost thru the skin.

    I had Anatomically correct tight rope procedure.
    It has a long recovery time, but is one of the strongest repairs.

    It will take about 1 year for full recovery.

    I am very happy with the results.

  168. #168
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    I dont know about surgery. I was pretty ****ed up. It was embarrasing and painful. I couldnt **** by my self or even move my arm for like5 days. After the wreck, I had to try to gather my shti so the villigars wouldnt rob me or see my injury as a sign of weakness and rob me.

    I got to the hospital. Seen some poor gu with a broken back. No pain medication , insurance or money. He was in pain. At one point I cried a little ( I should say that at that time I had sleep deprevation, like sleepng 3-4 hours a night for months) shouldnt have been on a 30 krede to work...

    Hells no I didnt want to have an operation on a serious part of my body like that. With all of mankinds so called expertise. I had a serious brace. Kept my arm immobile for about a week. Sometimes would but this horse collar brace on to alleviate the pain. Now, more than a year later... Everything is pretty cool. Sometimes wearing a back pack is not so comforatble as before.. but I cant say for sure.

    I am having thoughts of joining the French foreign Legion. At one point in my life I joinded the US af special forces team, and know that its a good workout. I am wondering if my shoulder could handle the training.

    It sure would be nice to hae a new identity from some country other than the US that would provide social benefits for my children.

  169. #169
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    i thank you guys for the replies...i believe i have an appt w/the ortho in 2 days at which point it will be 2 weeks from the injury. i am progressing pretty well - range of motion coming back but no real strength - except for sleeping which has to be done upright w/pain med. and the achiness! man i went w/out the sling for the most part of yesterday and by the end of the day my entire shoulder was tired and aching. i guess that's just part of the body adapting to no ligaments in the shoulder area?

    thanks for all the info on this thread.

    jason

  170. #170
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    I would advise against operations. MAny sports doctors dont recommend operations, and the specialists I shpwed my exray also recommended healing naturally . I have no bumb. yyou can see my xrays earlier in this thread. The doctors locally in China said I needed them and would never be able to use my arm to reach up. They were wrong.Im good. Save your money. It hurts like hell and will for a while, but youll bounce back.

  171. #171
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    i spoke w/the ortho surgeon's office again today and they advised against surgery as well unless it was absolutely needed. their rationale being that why operate if you can return your shoulder to acceptable levels w/out it. when i asked about 30 - 40 yrs down the road their answer was the same as mine - deal w/that then IF it's a problem

    how long did you guys stay away from other cardio; i.e. running/eliptical/etc

    thanks again,
    jason

  172. #172
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    MAn I dont know how bad yours feels.. Id say like the first 3 days I couldnt move it, It happened on a friday if I remember....For the first day it hurt pretty bad. Ive never broke a bone so I cant compare... on Monday I had to take a day off work as a teacher. I couldnt afford to take off tuesday, it was hell. Had to take the bus instead of my bike. I had this figure 8 collar brace type thing that I wore fora week... and only after when the pain was returning. o had a sling for the first week... but mainly couldnt move my arm. I cant recall how long... read back through these posts. I took it pretty easy for a couple of weeks before getting back into it. Just whatever you do dont push it. I had no therapy, other than life.

  173. #173
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    yeah, mine was probably the worst pain i've ever felt - and i've broken plenty of bones - it nearly made me pass out and throw up several times. the hospital here gave me pain med - i don't know how you made it w/out it! it seems my range of motion is coming back pretty well - i'm actually surprised - but don't wanna screw something up and set myself back! i've had the sling on for the better part of 2 weeks now. heck, i can actually type w/my right hand now (moving the arm around) compared to when it first hapened i couldn't even walk w/out pain for the first 3 days and that was w/pain meds! i guess i'll start slowly here and see how it goes!

    thanks!

  174. #174
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    Yeah I can remember hearing your description. Whatever you do dont push it. I wouldnt try any therapy. When it hurtsm stop moving it. Try to rest it in a position you want it to heal in. Take a lot of some kind of standard pain med... advil like... youll heal. The body is amazing.

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    I got the same advice with my Grade 3 AC separation. In fact I saw three different docs and they all said the same thing - let it go on its own and see how you do. (One of the doctors actually had the same injury on BOTH sides.) Do I like the permanent deformation of my shoulder? Heck no - at times that makes me wish I could have had it fixed. However, almost four years later, it functions at 99% of what it did.

    Took about 3 months of rest/recovery before I got back on the bike. 6 months I was back to 90% of strength/motion. One year later I was at about 98% back to normal. It looks bad, but it works fine.

  176. #176
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    We gave my grade 3 12 weeks of therepy, it didn't heal. Saw the (highly recommended and referred) doctor group yesterday, we're scheduling the surgery today for a couple weeks out. I'm really looking forward to getting this fixed, most painful, annoying, debilitating injury I've ever had.
    c

  177. #177
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    Quote Originally Posted by carter1
    We gave my grade 3 12 weeks of therepy, it didn't heal. Saw the (highly recommended and referred) doctor group yesterday, we're scheduling the surgery today for a couple weeks out. I'm really looking forward to getting this fixed, most painful, annoying, debilitating injury I've ever had.
    c
    i hate to hear that. one way or another it will be good to move past this injury. i would have never thought how much a shoulder injury could affect everything you do until this happened! good luck w/the surgery.

  178. #178
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    well, update, i'm a month out of grade 3 separation and did not have surgery. i can do most things normally, w/about 80 - 90% rom, but my strength is slow to recover. i am doing rehab at home w/the "rubber bands" (which work quite well, btw), have begun riding again on easier trails and felt completely comfortable. i ran for the first time yesterday and was pain free. i can't sleep on the side at all and haven't tried. stillhave the nasty bump on the shoulder, but that's ok.

    i can do most exercises w/very little weight and can do push ups from my knees w/out pain. all in all i'd say God is good to me the clunky shoulder is a bit wierd to get used to but i barely notice it now.

    good luck to all in recovery!

    jason

  179. #179
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    Hi all,

    I'm 6 days into my grade 3 separation, and cant get over the amount of contradictory information out there. It's like opinion on every aspect of it is 50/50 (early rest v active PT, surgery or rehab, sling or no sling, healing ligaments vs non-healing). Even doctors don't seem to agree.

    I think there's some myths about AC separation, the biggest being that AC ligaments can't heal.
    This isn't true. They are just like any other ligament. that's not to sat that they will heal well, or completely in all cases, but they don't just snap and that's the end of it. That's why some say the best time to operate is the first 10-14 days following the injury as this is before the healing process is too far underway.

    The operation itself is designed to move the bones closer together in order to heal better, this is why they usually remove screws post-operatively after about 12 weeks because by this time the ligaments have usually knitted back where they are supposed to be.

    info on ligament repair mechanism here

    For those of us electing to go without surgery, I think we can do a few things to put the odds in our favour. I'm not a doctor, and this is the first AC separation I've had, but this will be my approach based on the idea of allowing the ligaments time to heal in alignment.

    immobilize the shoulder for 3 weeks
    use PT tape to support the joint, and pull the clavicle down into position. Use a sling and spend as much time in a position that reduces the bump. avoid standing as much as possible as the weight of the arm increases the gap between the clavicle and acromion. I find when I lie down and push my elbow up, the bump almost disappears. In this position is where I want to heal and where I want to spend as much time as possible.

    start light physio in weeks 4-8
    Keep the arm immobilised as much as possible but also do some exercises that will keep the joint moving. very light movement. Absolutely no movement above shoulder height. Some light riding may be possible. put the arm in sling when not using it, the ligaments are still knitting together.

    Remove sling increase physio and start light off-road riding week 8-12

    build strength 12 weeks +
    after 8-12 weeks the ligaments will be as good as they are going to get and its time to build strength and get out riding again

    Of course, all may not go to plan, ligaments may not heal properly, or I may still have chronic pain, but I think it helps me to have recovery plan and some milestones.

    I'll keep you posted on whether this works or if I got it all wrong.

    -G
    Last edited by g00mba; 03-22-2011 at 04:00 AM.

  180. #180
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    My Story

    So I injured my shoulder in July 2010. I though I dislocated my shoulder when I drove myself to the hospital. They xrayed my shoulder and said that it wasn't dilocated, it was separated (type 3). The er doc put me in a sling and told me to see an ortho for surgery on Monday.

    I went to the first ortho and the first question she asked me was what I did for a living. She then told me that I didn't need my shoulder for my line of work and that I should let it heal on its own. I wanted a second opinion.

    Went to second doc who also asked me what I did for a living. He also said that he doesn;t rec surgery and I should let it heal on its own. i tried to push for surgery but he convinced me to wait 8 weeks to see how it heals. 8 weeks later I went back and still wanted surgery. He sent me to a third doc.

    Third doc also asked me what I do for a living. I replied, "Why does my vocation dictate my course of treatment? I want my shoulder fixed." This doc performed a modified Weaver-Dunn. He used surgical tape and shaved off a little from my collar bone.

    I am 16 weeks post surgery. No bump, big scar (so what), and full range of motion. I am slowly getting my strength back. I'm at about 60% There is still some movement/instability in my shoulder.

    My advice to anyone in this situation....
    DEMAND surgery immediately. I wasted 16 weeks before I got surgery. I believe I would have been so much better off had they gone in and fixed me immediately.

    DEMAND SURGERY. (screw the scar.)

  181. #181
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    good luck with it is all i can say.. got flipped over the bars on my bike back in april 07... landed square on my shoulder (230lbs of me),,,,,,, collar bone was about an inch high out at the arm (humerous/scapula)... by the time i got to the hospital in the back of the bumpy ambulance it had popped about half way back into place... they put ice on it and by the time the doctor seen me it was pretty normal looking.....
    so anyways got a ride home with my ex at the time, it hurt pretty bad and was really hard to get out of the cushy couches we had at the time....
    so i took that week off work and just kept using it how ever much i could (being nice to it)... had to go back to work the following monday and didnt have a choice but to use the arm.... it got better EVERYDAY i used it.... within a couple weeks it was fully movable and only gave me pain every so often...
    the collar bone is still about a 1/2" high now but works fine w/ no pain .... it took about 6 months or so before i stopped haveing twinges of pain at certain postions of my arm...
    good luck with it and do what ever you think is right...
    oh and this is the MOST PAINFUL INJURY IVE EVER HAD !!!! (head truma, broken cheek bone,concusion x 3,wisdom teeth all at once)
    Last edited by qkenuf4u; 03-22-2011 at 08:13 PM.

  182. #182
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    Well, I just joined this club 3-31-2011. My experience seems a bit different here so far. I am 49 and have been abusing my self for some time now. I took a spill on a paved bike path in a city park. I won a class III full AC separation. It hurt bad the first few hours. What struck me was how familiar the pain was. I realized I have been tearing away at these ligaments for some time. The last time I hit them hard was around 14 months ago when I dismounted from an ATV on an ice covered road. No big crash, just landed right on the shoulder. It hurt like hell for a long time, but no visable separation so I just toughed it out like always. When I had this last bout, I must have been down to a very low percentage of ligament left because the pain is subsiding very fast. I crashed on a Thursday night and was back in the mountains riding with a pack and all on Sunday. Would have been Saturday but it was rainy and cold. Back at work hanging commercial cabinets on Monday. Still some pain but way less than last time. X-ray showed a 40mm or so drop of the shoulder but no broken bones. I know we all talk about the "bump" but it really appears that the clavicle is where it is supposed to be and the rest of the shoulder has dropped, because it is no longer supported by the clavicle. I am working out of town so I have not had a chance to consult an Ortho yet, but will soon just to make sure I know all the options.
    Has any body else had the same result of relatively low pain and quick recovery? If I didn't have the obviuos deformation, I wouldn't have thought twice about this. 25 years of racing through the rocky and steep mountains and I get this in a city park

  183. #183
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    [Has any body else had the same result of relatively low pain and quick recovery? If I didn't have the obviuos deformation, I wouldn't have thought twice about this. 25 years of racing through the rocky and steep mountains and I get this in a city park[/QUOTE]

    i didn't have the cool part of your injury, that being little pain in the beginning - because it was awful. but i have had a bad shoulder for many years. but when the pain started going away, it went away in huge chunks. i'm a little over 3 months out of my injury and have been back to complete normal aside from about 5% reduction in r.o.m. for over a month and a half. strength's back, everything. no surgery here, just simple rest, then rehab, a bunch of prayers, and the doc said i was good to go. he said from the word go that if it didn't hurt i could do it and that sounds like where you're at! good luck!

    jason

  184. #184
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    I caused this same exact injury to my left shoulder about 5 years ago as well. I say caused because my dumbass grabbed too much front brake and went head first over the bars at about 20-25 mph. Luckily my reflexes are quick and instead of hitting my head, I rolled quickly to land on my shoulder.

    I will tell you that I never had any surgery and I was back to "normal" within about 3 months. I still to this day have the "bump" where my clavicle sticks up, but I have no pain, ever, and I military press with 80-85 lb. dumbbells to this very day.

    The pain will be with you for quite some time, but it will go away and you WILL get back to feeling great again.

    In fact, I recommend a supplement called "Osteobolin C" or "Osteosport." Both are made by the same company, and as far as I'm concerned it's a miracle supplement for joints, ligaments and tendons. I used to have tendonitis about and tennis elbow to the extreme when I started lifting again about about 2 years ago. I started taking Osteobolin C and could INSTANTLY feel relief day by day. Now, I don't even take it anymore and I have ZERO pain from tendonitus. I'm not a sales rep for them by any means, but I can assure you the product works. The key ingredient in it is called "cissus." You can find a ton out about it.

    Anyhow...that's my rant...

  185. #185
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    I had a Grade 2 (self diagnosed) separation while doing some gravity riding. Digger into a rock garden at about 15mph, landed right on my left shoulder. Immediate pain, weakness, general nausea. Could get even lift my arm above my belly button. Stopped on the way to get a sling, and rested. Day after hurt even worse, for about 2 weeks I could not use my left arm at all. After the initial inflammation went down, I started doing some diagnostics. There are many resources online to research (although I always recommend talking to licensed medical professionals), and I diagnosed with a Grade 2 with subscapularis tear. I could feel the unstable AC joint when pushing on my scapula, and I used the degree of pain to judge how healed the joint was. When I felt it was strong enough to try some light rehab, I immediately worked in some VERY light rotator cuff rehab. This was about 2 months after my initial injury. I could do light riding at this point, just no serious movements or hard pulls on the bars. I was 95% after 4 months. It is now about 6 months later, and except for another real light reinjury of the same joint, my shoulder is 100%. The labral tear on my right shoulder, however, is another story.

    Bottom line, take it easy, get your diet dialed, and your body will do its thing.
    "If you want to do something ordinary people can't, you have to be willing to do what ordinary people won't"

  186. #186
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    The doctor released from me from the sling today! Still a long way to go, but at least I've shed the last of the "bandaging." Doc says the healing has gone well-the past 6 weeks of misery has paid off and I'm ready to start more movement and strengthening over the next 6 weeks.
    Be careful out there.
    c

  187. #187
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    and now......it squeaks, not an exaggeration-it really squeaks when I move the shoulder back and forth. I guess that's better than not being able to move it!
    c

  188. #188
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    Quote Originally Posted by carter1
    and now......it squeaks, not an exaggeration-it really squeaks when I move the shoulder back and forth. I guess that's better than not being able to move it!
    c
    Get some White Lithium Grease, put it in a syringe, and inject in sockett! LOL!

    No, seriously look into the Osteobolin C supplement I was talking to...it will work wonders for you.

  189. #189
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    Quote Originally Posted by radials
    Get some White Lithium Grease, put it in a syringe, and inject in sockett! LOL!

    No, seriously look into the Osteobolin C supplement I was talking to...it will work wonders for you.

    What does the Osteobolin C supplement do?

  190. #190
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    Quote Originally Posted by tracerprix
    What does the Osteobolin C supplement do?
    I don't want to drop any spam on the forums, but if you'll Google "Osteobolin C by Applied Nutriceuticals" you will find their site. In fact, I advocate just about any product they sell. I am a weight lifter amongst other activities (MTB, longboarding, swimming, etc). I used to have tendonitis VERY bad, and now I no longer have it due to, I believe, taking the Osteobolin C for about 3 months.

    Here is an excerpt from their website:

    "Osteobolin-C approaches joint support from a completely unique angle. The primary ingredient in Osteobolin-C is Cissus Quadrangularis, a powerful Ayurvedic herb that has been proven in published laboratory research to promote bone and connective tissue repair.

    The active phytosterols in Osteobolin-C also promotes healthy muscle tissue due to the pronounced anti-catabolic effects of blocking cortisol. Osteobolin-C users experience dramatic reduction in joint pain and increased mobility, along with accelerated recovery time after rigorous training or injury."



    * Aids in the recuperation and regeneration of cartilage, tendons, and joints
    * Suppresses cortisol and promotes nutrient delivery into connective tissue
    * A potent anti-catabolic that speeds recovery and supports lean muscle

  191. #191
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    I'll try it.

  192. #192
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    I'm back!!!

    My buddy that drug me out of the woods and to the hospital turned 40 Saturday and did a 40 mile all surface ride to celebrate. I got permission from my PT to ride 5 easy miles on the road with the group.

    A little sore, nothing a beer couldn't take care of. Unbelievable how your perspective changes after 6 months off of a bike (after 45 year of riding). One of the best rides of my life. It will be a while before I'm off road, but at least its a start.

    c

  193. #193
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    Mine is minor compared to you guys. Washed out on a corner on a road ride mid-February on some sand/salt and landed on my right shoulder. ER said minor separation, didn't give me a grade. Put me in a sling and basically told me it would be fine in a week or two. No bump, 2 1/2 months later there is a small one and it's very tender. Riding normally doesn't hurt, putting the bike on the truck/wall rack hurts a ton. Limited range of motion; I can't take a shirt off normally. Due to being a poor grad student with state funded health insurance, there was a wait to get into another doctor. Have an appointment in a couple weeks.

    Should a separation that the ER doc said was so minor really not feel any better after 10 weeks?

  194. #194
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    @ ICAsh - You should have good to full range of motion and maybe some minor pain when your arm is extended high over your head. I suffered a Grade 2/Grade 3 separation in a race Feb. 13th of this year. Doc said NO sling - need to keep it moving. Started riding week 3. I now have full range of motion with some minor pain at full extension over my head. Some minor clicking/popping that's not painful just annoying. Nice large bump to scare off the kids. Others I have talked to said it takes a long time before pain goes away, but it will for the most part. Everybody is different. Don't worry and keep moving your shoulder and keep riding! Good luck.

  195. #195
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    Grade V-VI ac separation

    Here is my Xray

    No surgery for now per Dr.Karas, the shoulder Guru of Atlanta. In 3 months IF i am not happy w/ the recovery, he then can perform surgery. We'll see. It's only been 3 weeks and i've ridden on the road and trail. I'm going to PT tomorrow.

  196. #196
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    I tried a lot of taping to the shoulder in the early weeks to reduce the joint after reading this thread:
    http://www.wakeworld.com/forum/showt...ighlight=joint

    I was really hoping I'd get lucky, but It didn't work for me, but it may be worth a try. I still tape it now after 10 weeks in the vain hope that scar tissue will keep the shoulder down. My bump is very prominent. My x-ray looks like the one above. although my bones seem to overlap more.

    I'm able to do pretty much everything now, but with some pain. Riding a bike is pretty good, but pulling up on the bars or braking hard is painful. I started off-road riding after 5 weeks and each ride feels better than the last. I've not taken a tumble yet, and I'm riding on flats just so to give myself a better chance if I go over.

    I've seen 2 surgeons, The first said leave it and see how it goes. 8 weeks post-injury the second surgeon told me it was a pretty bad separation and that he thought that I'd be back at some point to get it fixed. In the UK the waiting list is 6-12 months.

    The recovery after surgery is much longer than the non-surgery route. My surgeon told me 6 months to a year before it feels normal. 4 weeks in a sling, 4 weeks of no movement above shoulder height, then lots and lots of therapy.

    I think I'll go for it though. I hate the bump and so does the wife. It doesn't make me feel tough or cool. It just makes me feel sick

  197. #197
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    Update. Crashed in mid-February directly on my right shoulder. ER doc said minor separation (didn't give a grade), put me in a sling, and told me it would be better in a couple weeks. I felt like it was a "here's a bandaid, quit being a baby" response, but my insurance sucks so I had a wait to visit a primary care doc. I finally had an appointment yesterday.

    They did a new set of xrays and said it was probably tendonitis, and sent me to physical therapy today. The PT told me that Ortho had looked at both new and old xrays, and since the new ones were at a slightly different angle, they could see a collarbone fracture that you can't see in the original ones. So, no wonder I'm still hurting. It's healing, and small enough that they wouldn't have treated it much differently, but it would have been nice to know, and I probably could have started PT sooner. And the separation is still there.

    My insurance lets me do 60 days of PT as often as they want to see me, so I have 3 appointments in the next 2 weeks and we will assess from there. Got a big dose of anti-inflammatory via iontophoresis (2 more next week), and I'm supposed to take 1200mg of ibuprofen a day, plus ice and some stretching exercises. Luckily riding doesn't bother it, so I'm not off the bike. Focus is getting the inflammation down so I can regain some strength and range of motion. I just want to be able to lift my bike up onto the truck again!

  198. #198
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    Sucks

    ICASH...It sucks that you had to wait that long to start PT. My suggestion is to do the PT religiously.

    Update on my condition....I saw the shoulder surgeon this morning and he cleared me to do whatever i want. I started PT a week after i injured my shoulder. So i did three weeks of PT 2x/week and the improvement on my strenght and ROM is obvious. I'm getting stronger and will continue to do PT at home. Good luck to those in the same boat and do your PT.

  199. #199
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    first single track ride yesterday since my injury last November. Longest my bikes have been out of the woods in a long long time-6 months and 2 weeks. Walked stuff I haven't walked in 35 years of riding in the woods! It's ok though, I rode
    be careful out there.
    c

  200. #200
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    Carter... i hear what you're saying bro. I walked stuff that i was like "really?" but at least we r riding in the wood. Yeah, be careful and be safe.

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