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AC Separation Grade III Recovery

130K views 183 replies 107 participants last post by  GaryPitts 
#1 ·
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
 
#2 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
Grade III...thats nothing I had a grade 5 ;) Just kidding, I feel your pain Bro, it sucks. I did have a grade 5, 8 years ago. I had to cancel my MTB trip to crested butte :( . The good news is it will heel. After a couple weeks i started to go to spin class and ride the trainer then after about 5-6 weeks went on the road bike. When i finally did go on my first MTB ride I had kept a lot of my fitness. Iwould follow you MD instructions and take thing VERY slow. Do not do any push ups etc till MD says it's ok. Good luck
 
#3 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
3 words- range of motion... and no, that bump will not go away
 
#4 ·
DO NOT, I REPEAT, DO NOT push it....

take your time and do EXACTLY what your Doctor tells you! Pushing an injury like an AC Sep can cause it to take much longer to heal, and should you fall, crash, or whatever that you did to cause the initial injury, you could EASILY make the injury worse. Or again prolong the recovery by re-injuring the shoulder. Another problem with AC Sep recovery is over use. It'll take a while to recover, but it will be well worth it. Spin classes and the use of the trainer can help you stay in shape. But DON'T ride until your doctor says it is okay to do so. And if he says light riding the TAKE IT LIGHT!!! Don't head off to your favorite DH run the second the MD says you can ride. Do it his way! That way you shouldn't have any problems.

Good Dirt
 
#5 ·
I will have to agree with the above arguments for letting things heal...
I have been suffering since summer with a grade III AC sep as well. My problem was that I did it right before 90% of my big races were coming up, and 36 hours before a 12 hour race that I stubbornly rode to a 3rd place finish on my rigid SS in the solo class.
I have tried to take it easy, but have raced on it all season long. Now, I am finally giving in and taking it easy for the winter. It doesn't help that my Chrome bag goes across my injured shoulder, so I am not commuting either. Just road riding, some trail running and hiking, and of course the trainer (snore). But I want to heal up already!

My .02
OGG
 
#6 ·
Three time for me :(

I just seperated mine in July for the third time. They were level 3, 2 and 3 respectively. Problem is, this time it is not reconnecting. It might someday but for now it just floats around inside. It feels mostly healed; that is, no more pain etc... but it is completely disconnected. I can't ride because when I pull on my bars it pulls away. Lucky for me I'm living in Chicago temporarily, otherwise the Colorado mountains (I'm from Colorado Springs) would lure me into certain handicappedness. Fact is, had I undergone proper rehab with the first injury I prolly wouldn't be in this predicament now. (The army isn't the best medical environment.) I would push for therapy and adhere to it strictly.
 
#7 ·
Fully separated in '89 and...

The doc said to quit climbing and MTBing. So I did. I experienced shoulder pain and stiffness. I did the 'light' therapy the doc recommended. It continued to hurt. They were concerned with me never doing anything that would stress the area. It continued to hurt. I went out and belayed a friend telling myself I wouldn't climb, I would just hang out. Well, it was a little SportClimbing area that had a thuggy 5.9. I gave 'er and have not felt the same stiffness since...15 years later!!...I still have crepitus, soreness and weird feelings of seperation...Maybe my slow going in the beginning helped? Like others said take it easy early...My doc still hadn't cleared me for physical activity when I went climbing :eek: . At the time there was no effective surgery and he said I wouldn't climb or bike again without great discomfort. WRONG! Be careful who you listen to and make sure they understand the 'actual', not theoretical mechanics of the MTB. FYI, I put DirtDrops on my rig and with the different hand position, I experience way less fatigue in my left, separated shoulder. I am a bit slower on the DH, but when I get to the bottom, my shouldewr feels solid and virtually pain free. After you get back on the bike you might want to check out some different handlebars if you get any weirdness in your shoulder. Get a good Sports Therapist and be vigilant in your therapy. Those surgical tube exercises did wonders for me. I have lightweight barbells I do military presses with and it strengthens the surrounding muscles. Also if you swim, hit that pool! It seemed to be an activity that helped to stabalize my shoulder.

Hope that helps and Hang(pun intended) In There!!
 
#8 ·
Been there, doing that. I seperated mine (grade 3) in September, 8 1/2 weeks ago. Doc told me the same thing. 6 - 8 weeks. Well I couldnt sit still so I went for an easy ride around the hood after 1 week. Big mistake. Hurt like hell fo a couple of days so I decided to lay off it for the suggested time. I tried to keep the range of motion going by just moving my arm as much and as far as I could several times a day. Seemed to help as I dont experience any limitations now.
At 7 weeks I started riding again, nothing to technical, didnt want to chance a crash and agrivate the injury. Still did about 22 miles the first ride and felt real good afterwords. I have ridden about 6 times so far with lots of climbing and carefull downhill. I also started back at the gym. Cut the weight in half of what I was previously lifting and am doing OK. It kinda "pops" every now and then and feels tender with certain movements but it is definetly getting stronger. Still cant sleep on that side though. I'm 51 so my "heal time" may be different than yours.
 
#9 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
Yep it pretty much sucks. I blew out a front tire on a downhill run this May and smashed mine up 3rd degree too. I was off the bike for about 6-8 weeks, and for a lot of that time I couldn't do simple things (like lift a gallon of milk, etc). It slowly gets better, but you basically have to build the strength of the shoulder up over time, it doesn't happen overnight.

I was putting in miles on the trainer, but even that proved to be too much too early. Ice is certainly your friend as well is Naproxen or Ibuprofen to help the inflamation.

Take it slow, even when it starts to feel better it will still be weak and easily subjected to injury again. Belive me I know all too well....

And yeah that bump isn't ever going away. My Doc said that he could get rid of the bump via surgery, but I'd be trading the bump for a scar. Plus the recovery of both options (surgery vs no surgery) was pretty much the same. Surgery (in my case) would be strictly for cosmetic reasons.
 
#10 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
I had a class 3 separation in 2000 and 2001...same shoulder. The first time it healed great and I was back riding in six weeks. Road riding at first, then easy trails untill I felt I could take the pounding of harder trails.

The second time wasn't so good. It took 9 weeks just to get on the bike and ride the road... I knew something wasn't right, but I left it go untill 2004.

I ended up having a bone spur ground off that was tearing into my rotator cuff. I also had my clavical ( probably not the right name) surgically tied back down in the position it is supposed to be in. This was done because I had severe impingement. I literally couldn't swing a golf club without my shoulder catching and making a loud cracking sound. It is one and a half years since surgery... I wouldn't get cut again. It is different, but not really better. I guess I'll just live with it... at least it's an injury that I can brag about! :D
 
#11 ·
X-rider said:
I had a class 3 separation in 2000 and 2001...same shoulder. The first time it healed great and I was back riding in six weeks. Road riding at first, then easy trails untill I felt I could take the pounding of harder trails.
I have separated both of my shoulders and both were third degree seperations. You are the second poster who says he has has done it twice to the same shoulder. I am confused how this could be done. I am under the impression that once you do a thrid degree it is done (thats what both my doctors said) since you have basically snapped the ligaments that hold the shoulder together. The shoulder never heals like it was before (the ligaments never re-attach) so how could you do it again?

Please explain what happened. I am curious, not trying to start an arguement.
 
#12 ·
BetterRide said:
I have separated both of my shoulders and both were third degree seperations. You are the second poster who says he has has done it twice to the same shoulder. I am confused how this could be done. I am under the impression that once you do a thrid degree it is done (thats what both my doctors said) since you have basically snapped the ligaments that hold the shoulder together. The shoulder never heals like it was before (the ligaments never re-attach) so how could you do it again?

Please explain what happened. I am curious, not trying to start an arguement.
The first time, the doc said it was borderline class 3... more like a class 2 3/4. The second time was class 3 all the way.

When I was in recovery from surgery, the opertating room nurse that checked on me told me it was the worst separation she had seen in her 12 year career.
 
#13 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
Mine was almost 30 years ago so it's a bit hazy. I wasn't off the bike (road) for long but limited the out-of-saddle stuff. I was back on the bike when the pain had gone. I remember it aching for months and months after and the worst time for me was when driving the car.

I never did bench press more than 125lbs after that and had the feeling that something wasn't connected. The separation gave me more grief than the (year earlier) broken clavicle on the same side.
 
#15 ·
Mine looked like this

It took months to heal but I also had a broken wrist on the same side. I couldn't do any therapy on it for at least 6 weeks. That put me behind and made the range of motion harder to get back.

The AC (acromio-clavicular) joint is where the clavical (collar bone) meets the acromian process of the scapula (that little piece of bone on the shoulder blade that points towards the clavical) Notice on the xray how the end of the clavical is raised. Definately take it slowly and work on range of motion. Lots of painful stretching.
 

Attachments

#16 ·
Working on your shoulder's range of motion is

very important. Waiting for the pain to subside, trying to maintain your strength and fitness, not trying to come back too soon...these are all components of the healing process. BUT one of the most important things is making sure you keep the range of motion in all your working parts. For instance, if you can't lift your hand above your head using your muscles you can get next to a wall and walk your fingers up the wall to elevate your hand higher and higher as the weeks progress. Something you probably wouldn't think about on your own.

I'm certainly no doc or physical therapist but I've PTd my way out of rotator cuff surgery so I've done a lot of "range of motion" exercises. These exercises don't really use the muscles in the affected area to move your arm/shoulder (gotta let those connections heal without stress) but your ligaments, tendons and muscles are all gonna permanently shorten up if they're not worked. If you don't have a physical therapist, get one, even if just for one session. They will enlighten you better than I can. You'll walk away from that first session with much needed knowledge about the ENTIRE healing process. Good luck.
 
#17 ·
Nim said:
Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.
I had an accident at the 2001 Big Bear Norba nationals where I had not only a grade 3 AC separation, but also a fractured scapula, five broken ribs, and a collapsed lung, which immediately started to fill with fluid. I had to be airlifted. At the hospital I had a 1/2" plastic tube through my rib cage for three days attached to a suction device to suck out all the fluid.

I did my first slow and easy 30 minute road ride on my mtb by end of the second week. I could not ride my regular road bike at the time because of the stretched out position. Did my first easy mtb ride after 5 weeks or so. The docs said that I could do as much exercise I could tolerate, that it was good for my circulation. I had trouble pulling up on the bars for more than two months.
 
#18 ·
I did a grade 3 a little over a year ago. It's still not 100% and I'm sure it never will be. I followed the PT religiously and didn't ride for probably 6-8 weeks. It still feels like it's going to pop out whenever I get knocked forward on the bike or over 300 lbs on the bench etc. All of my workout symmetry is out of whack.

At this point I'm really thinking I should have went against the ortho's recommendation and did the surgery...I'd take a scar and 95% over a big bump and 80%. I don't see how a Dr can say you'll be 100% when your whole shoulder geometry is out of line...
Of course, drilling a couple of holes in my shoulder and tying it together with a peice of my hamstring didn't sound that great either :eek:

I saw one negative reply about the surgery as well...anyone else go through with the surgery? What were your results?
 
#19 · (Edited)
NoWake said:
I did a grade 3 a little over a year ago. It's still not 100% and I'm sure it never will be. I followed the PT religiously and didn't ride for probably 6-8 weeks. It still feels like it's going to pop out whenever I get knocked forward on the bike or over 300 lbs on the bench etc. All of my workout symmetry is out of whack.

At this point I'm really thinking I should have went against the ortho's recommendation and did the surgery...I'd take a scar and 95% over a big bump and 80%. I don't see how a Dr can say you'll be 100% when your whole shoulder geometry is out of line...
Of course, drilling a couple of holes in my shoulder and tying it together with a peice of my hamstring didn't sound that great either :eek:

I saw one negative reply about the surgery as well...anyone else go through with the surgery? What were your results?
So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?

Good Links on AC seperation: eOrthopod
and Sports Medicine
 
#20 ·
NoWake said:
I saw one negative reply about the surgery as well...anyone else go through with the surgery? What were your results?
I had a "Weaver-Dunn?" surgery in 1999 and it has held up well so far, knock on wood. Seven seasons racing downhill and it still feels good. My doctor also recommended no surgery but after 4 months it was still hurting so I had the surgery.
 
#21 ·
100% after surgery? Well...

zon said:
So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?

Good Links on AC seperation: eOrthopod
and Sports Medicine
that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.
You know, getting dinged bigtime results in unwanted changes in your body. We like to think we're invincible but gravity teaches us otherwise!

Rotator cuff tears and seperated shoulders are two different animals. Maybe surgery is the better way to go in your case, I don't know. My point is: do a lot of research on your own (the internet will provide a ton of info for you--I did my research at a medical school library) and see what percentage of folks who had the surgery that you need actually said, f!ckin' ay, I'm glad I had that surgery! Weigh up the cost of surgery, the recovery time and the chances that the end result will be better than just PT alone.
 
#22 ·
xcguy said:
that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.
I think it's really a case by case basis...probably a lot depends on how bad the separation was. And then you have to take into consideration what you expect after the injury...I mean most of us here didn't get our injuries from rolling off the couch while grabbing another beer! I know I asked my Ortho that I needed to be close to 100% just to fit my lifestyle. Unfortunately the PT only got me to 75-80% after a year.

Mine was a "100% Grade 3 separation", which depending on what you read, is the worse you can get with out breaking the skin. I had also had a grade 2 from football, so I'm sure that did not help my recovery just due to the scar tissue already in there.

On the superficial side I think I would go with the scar instead of a big protruding bump that you can even see under a tight shirt.

Cons are you never know what you're going to get when someone starts cutting you open!

I would get a couple of opinions and get some realistic advice about what kind of recovery you can expect with your particular injury.
Good Luck!
 
#23 ·
Grade 5 Here

Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
 
#24 ·
zon said:
So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?
My ortho said there are two types of surgery;
The first is where they put a screw in. He said this type has a high rate of failure, limits range of motion and has common impingment problems.
The second was the one I described where they take a peice of hamstring (I later found out you can opt for a "cadaver" donor) drill holes in your clavicle and scapula and basically "tie" them back toegether.
 
#25 ·
StrangeLuv said:
Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
Wish I had found your second guy...Which surgery did you have? The Weaver-Dunn drill and tie one?
 
#26 ·
StrangeLuv said:
Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
_______________________________________
You have a good ortho surgeon...bottom line don't curse the pain... respect the pain...
 
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