Shoulder separation

[Theodore]

Nother injury for the books. Last thursday I was in the Gold King park at Breck and caught an edge after landing a jump. I spun to my right and went down hard onto my right shoulder. If hurt, but not too bad, finished the day (pole-ing sucked!) and went to the bar that night. Next day it was tight and hurt worse, so I went up to Frisco and had a doc check it out. Right AC separation was the diagnosis. Acromioclavicular Separation for the medi-nerds out there. Basically split my collarbone from my scapula. Doc gave me a perscription for vicodin and PT. I'm not getting the vics, but does anyone have any clue what I'm looking at interms of rest and rehab? I'm hopefully getting my PT referral taken care of tomorrow to go see my good friends that helped me with my knee. Anyone gone through this before? Any ideas on what to expect? Thanks for any info!

Ted

[phUnk]

yeah man, I did my right AC three seasons ago (or was it two?). I'll put up some info sometime in the next couple days. Long story short, you'll be fine in not too too long. Did they tell ya the severity? Class 1/2/3?

-cletus, from phunk's house

[Theodore]

I thought it was weird getting a real no BS answer from phUnk. They didn't give me a definite answer as to the severity, but hinted that if I tore anything, it wasn't much. So I'd say class 1 or 2 at the most. Thanks cleat.

[creaker]

Did a grade 3 on my mtb a few years back and after the pain went away it just felt seperated, still does somewhat. Sounds like yours isn't too bad and should be good to go soon. But be patient. My doc - also the guy I was riding with when it happened- told me that if I did it again before it scarred up I could potentially 'unplug' a cluster of nerves, which didin't sound like anything I wanted to do. Good luck.

[Vinman]

Grade 1: sprained AC lig but not torn, no elevation of the clavicle
Grade2: slight elevation, tearing of AC lig and stretching of CC lig
grade 3: more elvation, completely torn AC and CC ligs
grade 4: tearing of both ligs and injury to the trap and delt fascia (basically the skin is the only thing holding the clavicel down)
grade5 and 6 are dependant on how much separation occurs with 6 being a complate dislocation. (rare)


Most AC separations are 1,2 or 3 but even these usually don't need any thing more than a sling until the pain goes away and themn some easy range of motion and maybe some rotator cuff work.

For now ice and stay in the sling.

[Theodore]

I'd def. say 1 or 2. As for it feeling separated, it does. Every time I move it wrong, or shrug my shoulders it feels just like my shoulder wants to split.

[Theodore]

Cletus, any info to share? I start therapy on tuesday, but it is feel much better already. Tried to avoid the sling at work on tuesday and it was really sore the next day. Whodathunk, the doc was right when they said don't push it.

[Yossarian]

So, the quick run down for me.

I was skiing at Squaw two President's Day weekends ago, two years ago to the day this Monday, wow, huh. Anyway, we had 2 feet of new over boilerplate of Jan-Feb dry spell, and we were ripping around at top speeds over on KT when it happened. To this day, I have NO clue how went down - I didn't fuck up, didn't catch a branch, didn't struggle to maintain balance, didn't hit anything. No clue. All I knew was that I was following Dex and Scott Gaffney down one second, and flying through the air the next second. I landed on my right shoulder, upside down, in the one friggin patch of KT with no new snow on it. Pop, crack.

When I got up it felt funny, weird, kind of numbed, and I was shaky. I don't fall much, and I've never broken anything or done anything permanent like this ever before. I skied slowly down to my other ski, and then skied down to the base semi-cradling the right arm. Mostly I kept feeling the new bump on my shoulder, which I could make dissapear by pushing down on it. It didn't take me long to realize it was bone of some kind, but things just didn't hurt enough or feel weird enough to make think I had totally busted something. I figured that wasn't supposed to be there though, so I went back to the car, got out of my stuff, and wandered over the excellent on mountain clinic there.

They were great. Took about an hour, but after X-rays and some range of motion, etc, they explained to me the whole AC seperation bit, and classified it as somewhere around Class 2 or 3. By this time, it was stiffening up pretty good, and by the end of the day, when I was back in the hotel room with Dex, I couldn't move it. Near immobiliy lasted around 2 weeks for me, which I spent in a figure 8 shoulder brace, much to the amusement of my co-workers, who called it the Bro/Mansiere. After a couple weeks, I could start to move it, and after a couple months in the brace, it started to feel somewhat normal. I actually got it checked out by a top ortho surgeon in Bend where I was living at the time, sheer luck really that she happened to be a US ski team ortho and I was able to see her, but she confirmed the diagnosis, and to my amazement at the time, told me that I just had to wear the brace and perhaps do light rehab, and it'd be 100% in around 6 months or so. Having never in my life experienced an injury that was a break or semi-permanent, that would physically change me and the way I looked, I have to say I was actually pretty appalled at what appeared to me to be a blase response. What the fuck do you mean there isn't anything we can do? I can't raise my goddamned arm, and I have a fucking bone sticking up in my shoulder? You mean that's gonna be there for the rest of my life? It's a small deal, but I do remember struggling a little with the body image thing at first. Turns out that surgery there is somewhat invasive, so they really don't do it unless you're Class 3+, no ligs and nothing else holding it together.

However, after wearing my brace for a couple months, and then easing very easily back into motion, very very light weight training, and eventually, 6 months later, my other sport - rock climbing, which I'd honestly feared I'd never do again - it started to feel pretty normal. By the fall of last year, without ever doing proper PT, it felt as good as it ever had, with only an occasional twinge or soreness after repeated or heavy use. Two years later, I hardly notice it. I still have the bump where the end of the clavicle sticks up, I can still make it go back down by pushing on it (neat party trick!), once every 6 months it feels funny for day or two, but otherwise, I don't really even think about it much. I can't lift super heavy, but that's fine, I don't want man boobs anyway, and I am probably behind on keeping the area strong with light weight training and reps, but basically, it's back to normal, and has been for the last year.

I remember being really, really weirded out mentally when I first began to ski at the end of that season again, last May, and then started to climb that Sept or so, but as with any injury, I think you just build up the mental confidence in your body as you use it more after the repair/rehab.

From what you've said, I think you'll be fine. Be super nice to it for a few weeks, do your rehab, then keep the area strong (and in balance with the rest of your body) with ongoing body work in the future, and you'll be good to go.

Best wishes,
Cletus

[splat]

Did mine bodysurfing off the lip of a break so sweet I forgot about land and caught a piledriver into the beach. It's never fully healed. Your healing is impressive, Cletus. At six months, I still couldn't hold a glass to my mouth to drink.

[gravitylover]

My left shoulder, grade 2/3. It makes a really sweet shelf for a golf bag strap! I can bend over and pick stuff up without holding the bag at all. I actually have better range of motion with that shoulder than the "good" one due to nothing holding it back. It's a little weaker than the other but, oh well.

[Theodore]

Yeah, I'd def. say mine was a grade one after hearing you accounts. I'm what, 2.5 weeks out and mine still hurts, but for all intents and purposes its functional. Therapy starts tuesday, and I'm hoping it'll just be basic ROM exercises. Yeesh, I got off lucky. Cleat, I'd agree with your account of how it happened. Thats the first time I've fallen in 2 seasons and I was in mid-air before I realized I wasn't attached to my skis. Thanks for the write up.

[Theodore]

I'm back from my first day at PT and it looks like I'll only have to go back once or twice more. They taped my shoulder and gave me some exercises to do at home to regain some strength. Looks like its a grade two separation and they even said that my laft(good) shoulder looks like it has a grade one from a long time ago. I'm to avoid my sling as much as I can and resume normal life and lifting as much as pain tolerable. They said the damage is done, so there is no worry of re-injury. So, if I can get West, I can ski whenever I want. Screw this 6 weeks crap... its for the birds. (sorry for any offending any birds).

Splat: Did you see a doc for yours? The only reason I can see it being that bad(knowing what I know now) would be if you were immobile long enough to build up some scar tissue.

Anywho, thats my update, and I'm outta this gimpy biyatch!

[Yossarian]

good for you!

I'd still reccomend working back into ROM and light lifting for strength (high reps, low weight) for a little while, but it sounds like they're telling you to listen to your body and go forward when it feels good.

Good stuff!

[CS]

Just saw this thread. Busted up my shoulder a few years back playing football on the beach. Fell straight on my shoulder with 2 or 3 dudes on top. Snap crackle and pop.

Diagnosis was AC separation. Docs gave me a sling and said don't do anything for a while. Went and saw a "specialist" the next day and they said the same thing, in fact told me I didn't even need the sling.

So I sat around bummed for the next week since the injury cut short my plans for a wall in Yosemite and some backpacking.

Well, a chiropractor friend got wind of it and told me to come and see him. He asked me what the doctors did, nothing, and proceeded to do some chiropractor thing that hurt like hell but later in the day the pain nearly went away and my ROM got better. I was mountain biking in Brianhead a few weeks after that. Still sore, but I was able to ride.

Still have a bump on my shoulder but have felt no ill affects at all.

Glad to here it's feeling better. At this point a chiro visit is probably too late but it sure as hell helped me.

[Theodore]

...and now the bills roll in. Last time I ever go to an ER if I'm not bleeding or having something visibly wrong. Lets see, $293 for 2 therapy visits total of 45min. probably, with a 30% discount for being there so long with my knee. $180 for the xray, and $646.80 for the ER visit. Total= $1119.80 and my insurance which I've been paying into for about 3 months now doesn't kick in til April 1st. This. Fuckin. Sucks. What a waste of a fifth of my paycheck... US health care = teh suck if you aren't covered by your jobby job.

[splat]

Just saw this thread. Busted up my shoulder a few years back playing football on the beach. Fell straight on my shoulder with 2 or 3 dudes on top. Snap crackle and pop.

Diagnosis was AC separation. Docs gave me a sling and said don't do anything for a while. Went and saw a "specialist" the next day and they said the same thing, in fact told me I didn't even need the sling.

So I sat around bummed for the next week since the injury cut short my plans for a wall in Yosemite and some backpacking.

Well, a chiropractor friend got wind of it and told me to come and see him. He asked me what the doctors did, nothing, and proceeded to do some chiropractor thing that hurt like hell but later in the day the pain nearly went away and my ROM got better. I was mountain biking in Brianhead a few weeks after that. Still sore, but I was able to ride.

Still have a bump on my shoulder but have felt no ill affects at all.

Glad to here it's feeling better. At this point a chiro visit is probably too late but it sure as hell helped me.

Funny you should mention that, CS, because it was a move a chiropractor friend did on mine that kickstarted a very slow healing process on mine. One move. He basically bent my arm at the elbow and smacked it upwards from the bottom of the elbow. By the time I went to get rolfed for it, my right arm and side had totally atrophied something horrible. It's taken 20 years for it to feel right.

[wintermittent]

Search and ye shall find.

Add one more separated shoulder to this thread.

I bailed over the bars last night on the local trails. Seemed like a routine crash as it was happening. My tuck-and-roll would have been flawless, if I didn't land squarely on my AC joint. I figured I dislocated my arm, but it only felt partial. LOTS of pain, with that weird achromio-clavicular bump that only made sense when the ER doc saw the X-rays and explained AC separations to me.

I need to see my ortho to get his take before I can grade it or jump to any recovery conclusions. Cletus et al, thanks for sharing the good info RE: your injuries.

ROM is severely compromised. I think I'll be wearing this shirt for a couple of days, as I can't lift my arm over my head.

Cornholio - bring ski porn ASAP

[Theodore]

To change your shirt, get a good stretchy one, put it on your bad arm up to your armpit, then stretch it over your head and put your other arm in. Have fun wipin your ass and brushing your teeth too....

[seldon]

I think I might have done this (twice :() to my shoulder in lacrosse - hit someone with my arm fully extended down :( and heard a pop and my whole arm feels slack. I was thinking partial dislocation that immediately popped back in, but maybe it's seperated? All the muscles around the shoulder hurt, and I have limited ROM without pain. Seeing a doc on friday

[Vinman]

I think I might have done this (twice :() to my shoulder in lacrosse - hit someone with my arm fully extended down :( and heard a pop and my whole arm feels slack. I was thinking partial dislocation that immediately popped back in, but maybe it's seperated? All the muscles around the shoulder hurt, and I have limited ROM without pain. Seeing a doc on friday

Sounds more like a sub-lux (partial dislocation) than a separation. If you aren't in a sling already, go ahead and get one it will be more comfortable for you.

[CS]

Search and ye shall find.

Add one more separated shoulder to this thread.

I bailed over the bars last night on the local trails. Seemed like a routine crash as it was happening. My tuck-and-roll would have been flawless, if I didn't land squarely on my AC joint. I figured I dislocated my arm, but it only felt partial. LOTS of pain, with that weird achromio-clavicular bump that only made sense when the ER doc saw the X-rays and explained AC separations to me.

I need to see my ortho to get his take before I can grade it or jump to any recovery conclusions. Cletus et al, thanks for sharing the good info RE: your injuries.

ROM is severely compromised. I think I'll be wearing this shirt for a couple of days, as I can't lift my arm over my head.

Cornholio - bring ski porn ASAP


Bummer man. Seriously, go see a chiro. I was "taking it easy" mountain biking within 2 or 3 weeks of separating mine. Don't think that would have happened without seeing the chiro.

[assgasorgrass]

I have had two shoulder ops, same shoulder, 3+ separation of the AC joint. That was 18 years ago. I am just starting to feel the arthritis on almost a daily basis, sleeping on it wrong etc. (just like the doc said) Surgery got me back my full range of motion, but it was an pretty intrusive surgery and post surgery pain was incredible the first time around. As far as activities, water skiing causes me the most pain, that and sleeping on the ground during elk season. Good luck on your rehab.

[DCTyler]

I fell of my bike about a week ago and landed on my shoulder hard. I had a type 3 shoulder seaparation but since i am still young the growth plate was still ther which held it together. The question i have is How long is it going to take for me to recover? I kinda think that i screwed up my soccer season becase it hurts to run. I am also wondering if the shouder braces work and which one would be the best for sports? Thanks

[Theodore]

If its an AC seperation then maybe a few weeks, or at least it was for me. THe PT guys told me lose the sling ASAP, otherwise you are just inviting atrophy. Don't brace if you dont need to.

[DCTyler]

Yea my dad ordered me a brace to see if I will be able to play sports more comfortably. It comes in Wednesday and i will post again over the weekend to see how it feels.

[Theodore]

You didn't do an AC sep if you are bracing it. Did you go to the doc?

[MonkeyBear]

Just did my left AC class 2 three days ago.

actually starting to feel pretty good, but some movement hurts like an SOB. I hope for a speedy recovery

[Isis]

if you think you might have a class 1 ac tear, is it even worth it to go see a doc? I caught an edge coming off a groomer onto a cat track last thursday and landed really hard on my right elbow/shoulder. I think its an ac issue based on my internet research, or maybe a really bad muscle bruise of some kind -- it didn't hurt that much initially, but it felt really weird I my whole arm was really shaky. I had reasonable ROM that afternoon, but it tightened up a lot that night and now almost a week later, though, I still can't really lift my arm up at all without a lot of pain.

That said, I don't want to go to a doctor if (1) they are just going to tell me that there's nothing to do but rest, ice and take advil (2) if they are going to tell me I can't ski or (3) it's going to cost a lot or take a lot of time to get either (1) or (2) as advice. It's gotten a little bit better, but not that much better in the last week. If not, any recommendations for shoulder docs in SLC for IHC health insurance?

[Hutch]

I recommend the Bayou for lunch.

[Isis]

that may indeed be the best therapy.

[Hutch]

thanks for lunch, Isis!

[Mountainsurf]

I did mine this summer surfing..well learning how to surf and falling repeatedly on it. Had a bunch of massage, Rolfing was the best. Still in pain in October so I went to a p.t. He was baffled b/c I didn't have one fall, but repeated falls. He didn't think it was seperated although my collar bone was elevated and had point tenderness and swelling. Three weeks of pt , $250 bucks, and it was in more pain. So finally went to see Champa. He wrenches it three different ways...'does that hurt?' Ouch. He giggles at me. Gotta love that man. Grade 2 seperation. Then he gives me a cortisone shot! Hallellujah! Pain gone. $140.00. Then three weeks later at hockey practice, high speed into the boards sliding on my back right on the shoulder. FUCK!! Now it really grinds. Hurts a bit while I'm giving massage. Waiting a bit longer 'til I go back for more cortisone. Advil rocks. 800 mg /4 times a day for ten days helped, too. Don't be afraid to use drugs for this one. Good luck.

[Shepherd Wong]

Both mine are separated. Both from mountain biking. Did the right one with a degree 5-6 separation, had to get the shoulder rebuilt. The other one was probably a degree 2 or 3 and I didn't even go to the doctor for it since I knew all the moves and exercises from the last time around. Both feel great now, and probably stronger than before. My shoulders are nothing but trouble, but I wonder if I'm better off having them separated because they don't rely on strength from my wussy AC joint.
:eek:

[GeNe_]

I separated my shoulder out in northstar at tahoe 3 days before competing in the USASA nationals... Didn't really hurt too bad.. Still have a big ole bump on my shoulder..

[rugbydave]

pretty sure I did my left shouler yesterday, 1st degree separation I'm thinking, or maybe bad muscle bruise?. My ROM is pretty decent, no shoulder drop, going to teh doc's in a bit... Hope I dn't miss too much of this snow...

Goddam!!

[GoNads]

pretty sure I did my left shouler yesterday, 1st degree separation I'm thinking, or maybe bad muscle bruise?. My ROM is pretty decent, no shoulder drop, going to teh doc's in a bit... Hope I dn't miss too much of this snow...

Goddam!!

One of those days that you should've just stayed in bed... One chair running on the mountain, gale force winds, you smoked a tree, I smoked your truck with my truck. What a shitty day.

[gr8fldoug]

After a year or so of shoulder pain (and no insurance) I have finally visited a DR. He recommended a 4 week PT program, he couldn't remember the exact name but it's the "7 levels of .....". He described it as a series of excercises I can do at home with a can of soup and a tennis ball. I have a PT appointment next week but was just wondering if anyone here has ever heard of this series of excercises?

[cascadianwarrior]

Just got back fron the hospital: 3rd degree AC separation.

I hit up Mission Ridge first thing this morning to enjoy some of the 14+ inches of fluff that hadden fallen over the past day-and-a-half in single-digit temps. Sooooooo deeeeeeeeeeep! 3/4 of the way down and after the all the standard 1st run shots, I charged off the side of a run to drop a quick turn in the untrackrd. As soon as I laid on the heelside edge I could feel the rocks. Ended up pitching over the handlebars and took the brunt on my left shoulder. As soon as I hit I knew I was fucked. Cruised down the mountain and straight to the hospital. They hooked me up with painkillers and muscle relaxers.....aaahhh. 4-6 weeks before much can happen. This is the second time for this shoulder; last time was a 1st degree and it was nothing compared to this!

[Blashyrkh]

I got a third degree, two inch AC separation 2 years ago while riding my bike drunk. Smart idea. The ER put me in a sling after waiting for 8 hours unmedicated. The orthopedic surgeon I saw a week later took me out of the sling and told me to try moving and using it if I could. She wouldn't even consider surgery.

Two months later when I went back I had very good ROM, but my shoulder had not gone down at all, and my clavicle is still completely separated from my scapula by about 2 inches. Doc said deal, no PT, nothing.

I look pretty freaky when I take my shirt off (it gets ewwww comments everytime, and it's not just the body hair), it's sometimes uncomfortable to sleep and it gets sore when the weather changes, but it seems to work ok. I do need to support it with something when I sit and hug a pillow in bed.

Do chicks dig AC separations like they dig scars?

I'll post a picture if someone can tell me how/host it for me...

[kidwoo]

Really though.........the worse thing about it is there's a chick in the gym who bench presses more than me........because it still feels like my shoulder is going to rip.

Yeah yeah I'm biking and skiing and all that.........but doood the bench press........the true measure of all that is manliness.......bested by a chick......

I therefore do not recommend this injury. Try another one instead.

[brannen]

um, so which one of these includes a tear? i have dislocated the shoulder a few times in the last year, but only gone to the doctor for the most recent one, about 2 weeks ago. i got an x-ray, negative. then i got an MRI, which showed a ruptured tendon. the doctor said id need surgery, but when i asked him what more damage i could do, it sounded like almost nothing. is this because he spoke austrian, and i couldnt fully understand him? he told me no more skiing, but i have been out on a pretty regular basis since then. no unbearable pain, but i still have no ROM, and yes, wiping, dressing, brushing of the teeth, and sneezing, and showering and eating all cause pain. throwing snowballs isnt a good idea either. just wondering if my arm is going to fall off if i wait another month or two and keep skiing before the surgery?

[kidwoo]

A dislocated shoulder is a different beast. Ball out of socket kind of thing with potential damage to any of the tendons that hold it there.

A separation is a tear of the acromioclavicular joint between your collar bone and your acromion bone or scapula (ac joint in the pic)

http://www.emedx.com/emedx/diagnosis_information/diagnosis_information_image_files/shoulder_images/model_1-shoulder.JPG

But much more important than that is the fact that this picture comes up in google when you just do an image search on shoulder.

http://www.lesterjamesbrandt.com/publications/Shoulder%20Shaping3.jpg

[brannen]

does that mean that im either gonna make it worse, or look as good as that guy in a few months?

[kidwoo]

does that mean that im either gonna make it worse, or look as good as that guy in a few months?

Considering you didn't specify WHICH tendon, the degree of severity or even which particular falling direction stresses it most.........it is my expert medical opinion that you should be fine.:D

[brannen]

Sweet! Yeah, guess i just wanted to know worst case... infections or stuff?

[Smails]

Nother injury for the books. Last thursday I was in the Gold King park at Breck and caught an edge after landing a jump. I spun to my right and went down hard onto my right shoulder. If hurt, but not too bad, finished the day (pole-ing sucked!) and went to the bar that night. Next day it was tight and hurt worse, so I went up to Frisco and had a doc check it out. Right AC separation was the diagnosis. Acromioclavicular Separation for the medi-nerds out there. Basically split my collarbone from my scapula. Doc gave me a perscription for vicodin and PT. I'm not getting the vics, but does anyone have any clue what I'm looking at interms of rest and rehab? I'm hopefully getting my PT referral taken care of tomorrow to go see my good friends that helped me with my knee. Anyone gone through this before? Any ideas on what to expect? Thanks for any info!

Ted

Didn't bother reading the whole thread but I figured I would respond to the original question. I have never been the same since separating my shoulder. I had a class 2/3 separation, borderline operable. I did it playing lacrosse and my right side has never been the same since. I got PT and did everything they told me to do, but even 10 years later it still hurts like a b!tch when I do certain things. For example, when I work out if I try to do dips my right arm feels like it is going to fall after 5. Maybe my experience isn't typical, but of all the injuries I have had in my life this has been one that just never went away . . . Good luck with the PT.

[drmark]

Here is a link on the AC issue. The short story is if it continues to hurt or click it should be fixed.

http://sandersclinic.net/shlder_acjoint.html


http://sandersclinic.net/gallery/shoulder_ac3.html

[Blashyrkh]

Is there a time limit for the ac3 fix? Mine's been fully separated for a year and a half.

[drmark]

There is no time limit. I have fixed some that are 20 years old with results that are the same as if the injury had been fresh.

[Blashyrkh]

So, with my ROM being fine, and only having soreness after activity and with weather changes (it hasn't affected my activities much yet...), but still having a complete separation of the AC joint (my clavicle is completely mobile), what are the implications of having the surgery verus not?

I know, loaded question. It's liveable now, but I'm affraid of what will happen as I get older, with arthritis etc..

[drmark]

There are no consequences to living with it. You can fix it when ever or if ever you want.

[rugbydave]

Is a brace (was looking at EMS type ones) helpful in preventing injury from recurring? I wrecked hucking a 20 or so footer yesterday and my left shoulder, which I separated in january now hurts alot, again... rying to stop another recurrence...

[Huron856]

I happened on to this thread and noted that I had the exact same experience as Yosarrian while skiing in Utah last week. Grade 2-3 they tell me. Iced immediately, and continued to ski the rest of the week. Being highly cynical of the medical profession, I elected to see a chiropractor and go the acupuncture with electrical stim route. It has just been a week, yes it hurts, but I went to a Bikram yoga class today. I think movement is the key. I'm not young either.

Thanks to all. This was a really great help.

[n_buster]

I acquired a type II AC separation 3 years ago wit basically no problems until now. This spring, I was swimming, throwing baseballs, etc. I stopped using it that way because of soreness and stiffness. I tried a little PT, pendulum swing, wall craw, various stretching, soup cans. It just seemed to basically not help and sometimes make it stiffer. However, I have full range of motion and really no acute pain. Just stiff and sore and an occasional twinge when I move it quickly in just the wrong way. I have no hospitalization. It's been going on since April.

I have tried resting it the past couple of days. It has seemed to help, but stiffness is still there. Any suggestions? (Please don't tell me to see a Dr. I am literally broke, no $$!)

[ruhiks]

I'll play too.

Third degree separation four days ago.

Lots of good info on here. Thanks.


Please don't tell me to see a Dr. I am literally broke, no $$!
I love Canada.

[Theodore]

Good to see this thread is helping some folks out. I did a grade 1 (ish, might have been flirting w/2) to my left shoulder over the winter in the gym. Just an odd scramble in ju jitsu, came down on it w/ my weight and the guy on me and pop it went. It felt o so familiar. :) But this time, I knew what to do!

[phatfreeheeler]

Looks like I'm the latest victim. Just last night riding with JoshP. Missed a blind skinny on the back of a 4 foot boulder I was rolling over. Came down on my face and left shoulder. Not yet sure of the severity, but damn the pain is way worse than most of my other injuries. The list is long too. Soonest time with an ortho I've found is next Thurs :( Anyone know a name of a good shoulder guy in SLC?

[80's4eva]

Here is a link on the AC issue. The short story is if it continues to hurt or click it should be fixed.

http://sandersclinic.net/shlder_acjoint.html


http://sandersclinic.net/gallery/shoulder_ac3.html


So here's my question. Is it worth it to get surgury on my shoulder. I have a type 3 separation that happened 2 years ago. I landed on ice from probably 20 ft in the air off a table underotating a backflip. It was pretty bad and I couldn't really use it for about 2 months. At the time the 2 doctors I went to said that getting it fixed might actually make it worse in terms of mobility.

Right now I have full mobility and strength although my right shoulder is about an inch lower than my left.. or it might just be an optical illusion becasue of the bump. The only problem I have is it feels really unstable. Sometimes when I go to spin or land awkwardly I feel a tweak and it is sore around the rotator cuff area for a few days. Would surgury make it less likely for me to have future injuries. Would you reccommend it?

Also I would love to hear from someone on here who has actually had surgury.

[A Dogg]

Looks like I'm the newest gimp on the thread. I jacked up my AC joint real good at Boyne Mountain in Michigan on 12/20/2008. I was there for an entire week over Christmas Break. Of course, my first day out this season, I was on some groomers that had begun to ice up after a busy afternoon when I caught an edge and wiped hard landing on my right shoulder and sliding another 75-100 feet. Yeah it hurt a little, but I didn't think much of it. I've taken my share of spills during my years of skiing, but never any serious injuries, plus I work out regularly and keep in decent shape. Anyway, I shook off the pain and continued skiing into the night with some beers at the bar afterwards.

The next day, however was an entirely different story. I had zero ROM beyond movement at the elbow. I could only raise my right arm above my shoulder by manipulating it with my uninjured left arm. (luckily I'm left handed) However this manipulated movement came with terrible pain. I couldn't even reach get a glass out of the cupboard or ice out of the freezer. Forget about washing your hair or brushing you teeth with that arm. I never bruised, but did notice a slight bony raised area on my shoulder.
After a couple days of ice, Advil, and hot tub jets, I had noticeable improvement and better ROM, but was far from 100%. Determined not to let this ruin my vacation, I skied the rest of the week (wipeout free) and scheduled a visit to the doctor as soon as I got back home.

Doc says I have an AC tear, likely a minor one. He feels it's probably a I or II, maybe a III but doubtful. He gave me the basic PT exercises (pendulum swing, wall crawl, etc.) and wants me to have an MRI if I'm not nearly pain free and 100% ROM within two more weeks. (about 3 weeks from the initial injury)

I'm now 16 days out from the initial injury. I'd say my ROM is about 98%, definitely not pain free, but less every day. Sleeping can be particularly bothersome if you enjoy lying on your side. I resumed my regular exercise routine today. Bench press was horrible as I couldn't even do reps of 135 lbs. I was reduced to warming up with just the bar and then busted out as many 65 lb. reps as possible and did some push-ups too. I also forced my way through some very painful sets of tricep pull downs and lat pull downs. A few pops and clicks from the AC joint, but I think the pain will be worth it. I iced it down immediately after working out and we'll see how it feels tomorrow.

It's hard to be patient with this injury if you’re particularly active. I just want my arm/shoulder pain-free and back to 100% with no permanent damage.

Thanks to everyone for your posts.

[Theodore]

I would ease up up on the weights, especially bench, as that movement is particularly painful. Stay in shape, but I did a few weeks of rubber band exercises before returning to push ups then regular weights.

Don't rush it!

[billybawb]

dude second time on left shoulder pulling a 360 at Stratton, last time was 15 years ago on the hill (first degree that time). Ortho at the hill clinic told me 3rd degree. I'm 5 days in and dont have full ROM. Should I be worried? Any thoughts on what it will do to my golf game without surgery? Thanks

[naguszed]

this is a good thread on shoulder sep's. i found this while looking up recovery from my own injury.

i was skiing at whiteface a week ago. it was a non-stop run. cant remember how long it took, but it was a long run. i get near the bottom, about 50 yrds from the lift area, and there's a steep area and all ice. not a big deal. i had been there for 3 days and seen it 20 times by now.

i was looking ahead at my partner finishing the steep section, and started to cut my skis a little into the ice to slow up. next thing i know, i'm flipping over. land h-a-r-d on my right shoulder. wtf? no warning, no prior loss of balance. i think the ski popped out of the binding and my boot hinged into the ice. straight onto solid ice over frozen ground. no cushion. just pounded the shoulder straight into the ground.

i heard a loud noise when it happened. felt like throwing up. my shoulder felt really hot, and i had a sensation of being lopsided. i was afraid i dislocated it. i got to my knees and figured i'd be in alot more pain if it was dislocated. just felt hot and i couldnt move my arm much. i figured i needed to 'rub some dirt on it' or something, so i stood up, gathered my skis in my good hand, and caught the gondola with my partners. about 10 min later, i get off the gondola and realized that was going to be it for me. i tucked my arm to my stomach and just held it there by gripping my jacket, skied into the lodge for the rest of the day.

i was checked out to leave for sugarbush already and had to get on the road, so i didnt seek out med help at whiteface. i just thought it was a bruise. i get to my digs in VT, looked at the weird bump on my shoulder, and checked out the internet and figured it was a mild shoulder separation. so i popped the ibuprofen and iced it. the worst part was i had a tight shirt on and it hurt like hell to take off. the next day was the last day on the slopes and it was 35 & sunny so i skied all day doing the "modified Bob Dole"..arm in a right angle clutching my jacket, not using poles.

when i got home a couple days later, i got an x-ray and saw the separation. saw great otho doc 2 days later. he called it a class 3. no doubt. did not recommend surgery, and gave me story on that alternative. said in 3 weeks i'll begin exercising it, but for now just keep it in the sling. now im just wondering how long that will take to get back to playing basketball.

[naguszed]

It's been 4 weeks since I separated my shoulder. I thought I would follow up my original post.

My injury was a class 3 shoulder separation, which means i tore the AC ligament that connects my collar bone to my shoulder, as well as the coracoclavicular ligament. In addition, I suffered some serious damage to my rotator cuff and pectoral muscle. I had some light bruising on the bicep which may have been an indication of some pectoral ligament trauma.

For the first two weeks, I was in a sling. Pretty much used it constantly. I couldnt move my arm at the shoulder without causing some serious pain. My chest was incredibly sore. Impossible to wear a non-buttoned shirt. In the third week, I spent some time out of the sling. Initially, the weight of the arm hurt like hell, but that wore off and I was able to move around without the sling.


Week 3, I started some therapy. Electro therapy or something. They hooked some electrodes onto the shoulder and juiced it for about 10-15 min. Made the muscles contract with each cycle. Also did some stretching. After a couple of sessions and a day or so inbetween them , I found myself not noticing the shoulder doing day-to-day simple stuff, including easy lifting. Even at the end of week 2, I couldnt move the arm at the shoulder, but by the end of week three, I could bring the arm up parallel to the injured shoulder. Still have alot of weakness with some motions (such as holding my arm out in front at shoulder height, and trying to rotate it towards my chest- no strength and hurts like hell), which hopefully will improve in the next week. Couldnt have even thought about it two weeks ago. Not much pain associated with the shoulder injury itself. The outside of it feels a little sore, but nothing noticeable.

So at this point, i'm definitely satisfied with the non-surgical approach.

Here's the original xray- the bump is born...

[brobin]

It's been 4 weeks since I separated my shoulder. I thought I would follow up my original post.

My injury was a class 3 shoulder separation, which means i tore the AC ligament that connects my collar bone to my shoulder, as well as the coracoclavicular ligament. In addition, I suffered some serious damage to my rotator cuff and pectoral muscle. I had some light bruising on the bicep which may have been an indication of some pectoral ligament trauma.

For the first two weeks, I was in a sling. Pretty much used it constantly. I couldnt move my arm at the shoulder without causing some serious pain. My chest was incredibly sore. Impossible to wear a non-buttoned shirt. In the third week, I spent some time out of the sling. Initially, the weight of the arm hurt like hell, but that wore off and I was able to move around without the sling.



Week 3, I started some therapy. Electro therapy or something. They hooked some electrodes onto the shoulder and juiced it for about 10-15 min. Made the muscles contract with each cycle. Also did some stretching. After a couple of sessions and a day or so inbetween them , I found myself not noticing the shoulder doing day-to-day simple stuff, including easy lifting. Even at the end of week 2, I couldnt move the arm at the shoulder, but by the end of week three, I could bring the arm up parallel to the injured shoulder. Still have alot of weakness with some motions (such as holding my arm out in front at shoulder height, and trying to rotate it towards my chest- no strength and hurts like hell), which hopefully will improve in the next week. Couldnt have even thought about it two weeks ago. Not much pain associated with the shoulder injury itself. The outside of it feels a little sore, but nothing noticeable.

So at this point, i'm definitely satisfied with the non-surgical approach.

Here's the original xray- the bump is born...


Dude! Your injury sounds just like mine. #3, hurts like hell. Got mine in slopestyle practice at snowboard nationals in Copper last week. Overshot a jump and then the lights went out. The ortho I was referred to didn't give me any suggestions. Only thing he said was that I could have surgery if I wanted to. He said those that do sports like baseball would get the surgery. His office was a mile from the beach and he was clueless about paddling a surfboard. Well I surf "alot" and plan to keep doing it. I'm getting a second opinion and when I'm there I'll show them my paddling style (with my good arm) so I can get appropriate advice.
My bicep has turned an ugly yellow (sounds like yours too) but it doesn't hurt.
Your post has given me alot of encouragement!
What I need to know is what is the best thing I can do to get back into paddling strength as quickly as possible. At one week from accident should I be putting ice on it or heat or taking it out of the sling or gobbling more 800mg IB ???? Any advice would be great.

[naguszed]

My Ortho put the surgery option to me the same way. and my shoulder turned yellow too.

I iced it alot during the first 14 days. Alot more ice early on. Ice gave more relief than anything. You'll want to use heat once you start stretching it out, and heat it up a little before the stretches, and ice afterward if it hurts.

For me, I had as much pain in the back of the shoulder than anywhere else. Minutes after the accident, I could feel something popping like guitar strings around my back shoulder blade when I tried to move. This area hurt alot once I got out of the sling, but the pain went away as the muscles built up in that area.

The strength is coming back. It's not where it used to be, but it's noticeably better than even a week ago. Stills feels weird at times, no doubt. Not painful, just weird. At 4.5 weeks, I couldnt shoot a basketball without pain and couldnt get the ball to the rim. Today at 5.5 weeks, I was making foul shots without pain. Call that 70% of my normal range. I also used that arm to stop a fall in a soccer game and it did feel sore right away, but was ok a few minutes later. I'm optimistic for some more improvement with stretching and light resistance exercises and a full return to sports in a week or two. I expect it to feel weaker for some motions where the forces were at least partially carried by the A/C joint & clavicle. The muscles will have to increase to compensate for it.

My therapist gave me a few stretches to do every day, then added some light resistance exercises using rubber bands. Really simple stuff, but it's working. I'd talk to a PT if I were you. The separation wont heal itself back to normal of course, but the shoulder will encapsulate the damaged area with scar tissue. (so i was told) The stretches wake up the muscles (from the injury & lack of use) and loosen up the scar tissue. I've got the full ROM back at this point, now I just need to get the strength improved.

I'm pleased with the nonsurgical approach, definitely. i should add that if I was in my 20's and very active, I'd consider the surgery if the non-surgical approach wasnt satisfactory after rehabbing. I'm early 40's and the downtime from the surgery is too long for me to wait in general, plus considering the usual surgical risks. 4-6mo downtime from the procedure, plus 3 mo rehab could easily turn into a year or more if there is a problem.

[brobin]

With your separations, did your Dr. do any MRI's or any other diognostics other than x-ray?

[naguszed]

With your separations, did your Dr. do any MRI's or any other diognostics other than x-ray?

No. Just an X-ray.

[shredgnar]

Anyone have any long-term rehab exercises for AC separations and rotator cuff injuries?

Over the years I have injured both of my rotator cuffs (not severely but enought to give that gravely feeling) and had a 1 and 2 separation of both AC's. I'm starting to lift again and have come to the conclusion that I need to build some shoulder strength before I start working on anything else.

Here's the issue, when I lift any kind of weight, my shoulder drops and feels like it's gonna snap off. With larger range of movement exercises, my shoulder snaps and pops, I assume this is scar tissue getting in the way.

If someone could recommend a few exercises that I could do to build up the muscles around my shoulder so it can hold it's self together, that would be great...... Thanks

[naguszed]

Two months later, played basketball. Finished therapy two weeks ago. The shoulder works fine for shooting, passing & dribbling. Feels weak when trying to reach for rebounds above my head. Tried to throw with it just for fun ( it's not my throwing arm to begin with)...that was extremely awkward...Still satisfied with going non-surgical for a class 3 sep... Just know that there are some differences that could effect some motions. My day-to-day use of the injured shoulder is back to normal. Plus the bump...

[tglowik77]

I recently had a cycling accident causing a 5th degree shoulder separation, two fractured wrists, and a displaced bone in my wrist. Pretty severe, but in the end not that bad. The accident happened while I was riding with my girlfriend in SF. We were coming to an intersection when a car coming from the opposite direction tried to cut in between us. When the driver realized she couldn't make it she stopped (just missing my girlfriend's back tire.) Unfortunately she stopped perpendicular to me in the bike lane. I skidded, ended up slamming on my front brakes and went over. As soon as she realized she caused an accident she took off running over my bike light which had flown off into the intersection in the process. If any of you bike in SF you know this is a common occurence. I don't condone the way most cyclist ride in the city, but they're are not nearly as bad as the drivers. That was my third hit and run in a bike lane in two years, by the way.
Back to the injury...I felt like I had a dislocation, so my girlfriend decided we should probably head to the ER. We walked about 20min and I started to get really light-headed. At that point both wrists became swollen and my arm was hanging about 3 inches lower than the opposite. When we finally got to the hospital they gave me the bad news. Shoulder separation and another visit to the doctor in two days. I was working 30hrs a week so my company didn't have to pay health insurance. The great thing is that Healthy SF signed me up and paid for most of my surgery! It's pretty amazing to only pay a few thousand dollars when it would have cost 10x as much in any other city!
The pain wasn't really that bad over the next few days. I was given a perscription for vicadin which helped with sleeping more than anything. Over the next couple of days I saw about ten doctors and finally got the news that the separation and displaced bone were severe enough to need surgery. My left wrist healed from the fracture in about 5 days, but my right wrist wouldn't go back into place. They tried pulling on it, hanging it with weights, etc. but nothing would work!
At this point my shoulder didn't feel too bad, but it sure looked awful. My collar bone had pulled away to the point that it was up over and behind my shoulder blade. It looked crazy! They said it was being held in place only by my skin at that point. Both my collarbone and wrist would need pins and plates placed in them.
A few weeks later I went into surgery. I had the feeling that this would be totally reasonable and I would come out feeling much better. Yeah, I was really wrong about that. The surgery took about 6hrs. I had no idea I was going to be in so long or have a catheter put in me. That was a real surprise when I went to the bathroom for the first time. The anesthesia wore off on the ride home and I started vomitting and having extreme feverish reactions. I couldn't keep anything down for two days, which meant two days of no medication. I had never been in surgery before so I had no idea I would react so poorly to the situation. Those days were by far the most uncomfortable I have ever been. Turns out that I have to go through it again.
So, things get better quickly. I start getting motion, but not strength within a few weeks. I have a bunch of doctors visits and move on to rehab. I'm doing it all at home, mainly because I know my body fairly well and know when to push it and when to lay off. Within a month my stitches are out and my motion is really good. I can't quite sleep on my side yet but I got close during that period. What really turned it around for me was constantly stretching and a good workout every day. Now, after a little over 3 months, I have 80% strength and flexibility. The plate is preventing my movement more than anything. My collarbone just isn't in the same spot as on the left side of my body. I have a naturally high placement. Right now I can sleep on my side, but picking things up over 20lbs is still a little sensitive.
The good and bad news is that they are taking the corrosive plate they put in out of my shoulder. They waited until what was supposed to be my last visit to the doctors to tell me that they were performing another surgery. Pretty sneaky doctors, pretty sneaky. End of August is when I have another surgery. I really hope this is the last one, but you never know. Maybe I'll have more motion and won't have the hitch I'm working around when I play basketball!
I've been keeping up on my rehab pretty much every day. If there's a day where it feels a little worn out I give it a break to let it heal. I'm going into this surgery with the idea that if I get it as strong as I can the healing process will be quicker. I'm hoping by the end of september I'll be 90% and better off than I am now. It seems like such a long time to heal from an injury when I look back on it, but day to day it's not that bad. I can feel how well keeping up on rehab is working and having little, reasonable goals helps a lot. Day to day, weekly, or monthly goals are essential to keeping motivated. My doctors haven't wanted me to work, so I have plenty of time to do a proper exercise and stretching routine during the day. My only real advice to anyone out there with a serious separation is to go slow on your rehab. Listen to your body and don't push it too much at first. You can always up your exercise routine later. With this kind of injury you have nothing but time. Oh, and ask more questions with your doctors. They sometimes forget to tell you things. Things that end up being pretty important. It's just as much our responsibilty to get all the information out of them that we need as it is theirs to tell us. They're busy and have a lot of patients and I'm sure it's easy for things to slip their minds.
Hopefully this helps anyone going through the same injury, or at least warns people about about the dangers of riding a bicycle in SF! And, please drivers be careful around bicyclists, we can't stop as quickly as pedestrians! Just be courteous and stop when you hit someone or cause an accident. Don't assume they're ok because they got up.