AC Separation

[sequoiashan]

Had a good crash a few months back on the single track. Ever since my right shoulder has been tender and sore, it was much worse in the first few days. I still have a good deal of tenderness right on my ac joint but everything seems to work okay. So WWMD? I'm leaning toward run it until I can't...bad idea or worth it for winter?

[systemoverblow'd]

Just deal with it. AC separation is for life, it will continue to be sore now and then but will get better. I was stupid enough to try to 'have it fixed'. 2 operations, much infection, way too much pain, a giant scar and it looks worse than it did before. Laying on it or stressing it for a longer duration still hurts and causes stiffness but it is fine in day-to-day activity and doesn't hold me back. This was 8 years ago when I was injured.

One of the best orthopedic surgeon's in my state (works with pro athletes) sat with me after my multiple surgeries and continued soreness. He said I never should have had surgery. He said any ortho worth a damn refuses to operate on AC Separations unless it is absolutely necessary. They tend to fail again and don't do anything special for you except maybe get rid of the lump on your shoulder. Wish I went and saw him the first time instead of my local ortho.

[sequoiashan]

Just what I was thinking. I've been sleeping on my left shoulder for a while now and have opted out of surgery for a torn UCL in my left hand for the same reason. I'll stick to building strength and flexibility to help prevent a total blowout.

[Vinman]

I suggest bringing some liquid co-pay to the upper parking lot as soon as possible and I'll have a look. Assuming we ever get snow enough to ski down from the upper lot that is....

[sequoiashan]

I think I can manage that. What do we do about the snow problem now? Either way I'll be there Sat morning.

[Vinman]

I'm on kid duty Saturday. Sunday is my day this weekend. Monday probably also. I have mondays off now.

[L7]

I've done both shoulders and one of them twice. grade 2's or thereabouts for all of them I think. I would have suggested having it looked at and wear the sling for the full duration (I didn't). That being said my first one was about 35 years ago and the last one about 20. I have no real problems but do have a big lump sticking up on each shoulder where the clavicle ends. The last one I was on skis again in a couple of days with a sling and very pussy skiing. Skied the season but don't really remember how much time I had to go easy.... not that long I think.

Vinman should get you sorted pretty quick. Just giving you some firsthand experience that it shouldn't give you too much grief long term.

[splat]

I've done both shoulders and one of them twice. grade 2's or thereabouts for all of them I think. I would have suggested having it looked at and wear the sling for the full duration (I didn't). That being said my first one was about 35 years ago and the last one about 20. I have no real problems but do have a big lump sticking up on each shoulder where the clavicle ends. The last one I was on skis again in a couple of days with a sling and very pussy skiing. Skied the season but don't really remember how much time I had to go easy.... not that long I think.

Vinman should get you sorted pretty quick. Just giving you some firsthand experience that it shouldn't give you too much grief long term.

I wasted mine eating a beach while bodysurfing. I'll go with L7s sling suggestion. I went with trying to exercise through it and further wasted it. I couldn't pick up a glass of water off a table for three years, didn't sleep on that shoulder for ten years and it took a grand total of 17 years to heal on it's own. It's truly amazing how stuff like that can heal - and how long it can take.

[sequoiashan]

Thanks. I'm hoping it's just a sore spot but most likely just fooling myself. Strength and mobility are fine, just hurts to lay on my shoulder or touch near my ac joint and my right shoulder is sitting a bit lower than my left. But I can't recall ever really looking very close. As per usuall I tend to just ignore until I can't but now that I'm getting older got to think about skiing and mtb for the long term. Losing skis and bikes might just mean losing my mind.

[systemoverblow'd]

Take your shirt off, look in the mirror and lift your shoulders like you are shrugging. If the bone isn't sticking out of your shoulder it will be fine. Mine sticks up a good 2 inches AFTER my surgeries and like I said it does nothing to hamper me. Just keep it loose by working it and you'll be fine. Strength won't be an issue but soreness will.

[auvgeek]

Bumping this thread.

I fell running yesterday (from a potential mugger—incredibly stupid, I know, but I hadn't slept in a while and fight/flight response kicked in), landed on my elbow, and noticed my shoulder hurting until a few hours later. Went to bed and woke up this morning to a very tender AC joint. Quite a lot of pain with upward motion, especially cross motion, but no bump at the end of the clavicle and minimal clicking with movement. Full ROM but pretty painful. Pain all appears to be at the acromioclavicular ligament so I'm assuming/hoping it's a Grade 1 sprain. Fortunately, I sit at a desk all day, and I have minimal pain while working. No prior injuries to this shoulder—it was one of my few "good" joints left.

So WWMD? I desperately don't want this to become a long-term issue so I'll do everything and anything to make it heal quickly and permanently. I have decent insurance. The closest sports med clinic can't get me in until Monday. Should I go buy a sling and wear it when I'm not working at the keyboard? Or wear a sling all the time for the next few days and do my best to type one-handed? Or go to the ER and get seen today? That seems a bit extreme and a huge time suck. Or should I just suck it up, work as usual, and do my best to keep it down at my side for a while? I don't want to blow this out of proportion, but I have the ability to do whatever it takes to let it heal properly.

[billyk]

Go to the ER and get the X-rays done. Take anti-inflammatory and ice the joint until you get better instructions from a doctor.

[Meadow Skipper]

…So WWMD? …

Not much you can do besides NSAIDs - or surgery, which if you read the thread can be a bitch.

[plugboots]

I had the full tear. 4th degree? Surgery worked for me. Very good Orthopedic surgeon at Palo Alto medical foundation, when I went in said, "when do you want to schedule surgery?" Anyway, billyk has the best advice, since the doc is booked, get the x-ray.

[auvgeek]

Not much you can do besides NSAIDs - or surgery, which if you read the thread can be a bitch.

I get that. But I meant: would you throw it in a sling for a week, or is there any harm in keeping it by my side instead of in a sling? Should I take a few days off work and lay in bed? Typing with my elbow at my side seems like the pain is like a 1-2 while laying in bed is closer to 0-1. Will going to the ER tell me anything I don't already know?

Figured I'd ask here before wasting any time dealing with the ER.

[Meadow Skipper]

If it hurts when you do something, don't do that. Pain on movement will tell you what sort of movement to avoid.

But I don't think you'll damage it any further by not slinging it. If the sling provides relief, then by all means. Seek a position of comfort.

Instead of the ER, I'd go see an orthopedist if you want medical attention. It's not a medical emergency.

[billyk]

The X-ray may tell you whether or not you have a fracture, like a crack but not a complete break (which you would definitely know if you had). If you have a stress fracture, I'd be leaning towards using the sling, and resting up until you can see the specialist.

[Peruvian]

I had a full thickness AC and CC joint dislocation. I have an obvious deformity but never required surgery.

[GoldMember]

I've had Type II AC separation and didn't use a sling, although an ortho told me later he would have prescribed it to help lower the stress on the joint for pain. It can't hurt to use a sling until you see an ortho. I have about a 1/2" bump on the shoulder but no pain or restricted movement. I wouldn't go to the ER but, that's me.

Rub some dirt on it and get back in the game!

[Schemeboat]

5 AC's. 3 in the left, 2 in the right. Take it easy and sling for a while. Then, its no problem at all... except for sleeping, and expect poor sleeping.

[Dantheman]

Anyone have a link to a good PT/rehab program for a Grade II AC separation?

Two weeks ago I fell backwards downhill onto a rock right on my right scapula. Crippling pain immediately afterwards and I strongly suspected a fractured scapula (BT; DT), but x-rays were negative. Scapula and surrounding musculature is improved but still painful, and it's become clear that my AC joint is messed up as well. Minimal bump/tenting (sub-quarter inch, not really obvious unless you really look close), but there's vertical play in my clavicle when I push down on the distal end. Combined with my pain level a full tear of the AC ligament seems likely. Certainly nothing that needs surgery, but I need a PT program just to have something to do while I wait this out.

[Dantheman]

Oh so close to being done with this nonsense.

[BS720]

How bad was your pain, and your grade?

[rideit]

Hey DTM, how is your shoulder now that it has been a few years?
I smashed myself in México, type II separation. (On the same side as my recently reconstructed shoulder, no less).
Just curious!

[Dantheman]

Being religious about PT I was doing mellow MTB within 4 weeks, 95% in 3 months and 100% in 6 months, though I didn't fully trust it for more like 12 months. Feels great these days. I do very occasionally get a weird click or pop but there's no pain with it. I do a lot of muscle-ups, HSPUs and other shoulder-intensive exercises without issue.