Thread: Shoulder separation

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

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

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.

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.

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.

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.

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.

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

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.

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.

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.

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!

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!

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.

...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.

Originally Posted by 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.

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.

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

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....

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

Originally Posted by 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

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.

Originally Posted by 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

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.

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.

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

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.

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.