Shoulder injury people...

**tintin5** · 06-03-2022, 09:36 PM

Originally Posted by Whiteroom_Guardian

Surgeon still thinks my shoulder is too stiff to entertain surgery now. Wants me to keep doing heavy PT and even get on the bike "later this summer".

He might be right. It just feels to me like I will waste all summer doing PT, still have a fucked up shoulder in the Fall, finally get surgery in November and then wreck my entire ski season too. Ughhhh.

Waiting/Pre-hab is frustrating, but it might work out in your favour.
If you have a stiff shoulder going into a stabilization surgery, it’s going to be really stiff after surgery and several weeks wearing a sling.
Get your shoulder moving as best you can, get stronger, and then go for surgery. You might have a better long term outcome.

**tintin5** · 06-03-2022, 09:41 PM

Originally Posted by Whiteroom_Guardian

Surgeon still thinks my shoulder is too stiff to entertain surgery now. Wants me to keep doing heavy PT and even get on the bike "later this summer".

He might be right. It just feels to me like I will waste all summer doing PT, still have a fucked up shoulder in the Fall, finally get surgery in November and then wreck my entire ski season too. Ughhhh.

Waiting/Pre-hab is frustrating, but it might work out in your favour.
If you have a stiff shoulder going into stabilization surgery, it’s going to be even more restricted after surgery, and wearing a sling for several weeks. Get the shoulder moving now, and you might have a better long term recovery. Good luck with your recovery!

**Whiteroom_Guardian** · 06-06-2022, 06:22 PM

Finally got the CT images. See the nice chunk at the bottom of the socket. In theory enough of the socket plane is intact and I don't need this fixed. IDK, seems like a big piece.

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**MagnificentUnicorn** · 06-06-2022, 06:40 PM

Originally Posted by Whiteroom_Guardian

Finally got the CT images. See the nice chunk at the bottom of the socket. In theory enough of the socket plane is intact and I don't need this fixed. IDK, seems like a big piece.

That’s not a big piece. It would be really difficult to fix that securely. Most of your instability is from soft tissue, the labrum and capsule. Having assisted on hundreds of arthroscopic and open shoulder reconstructions, I would say that would be a very sketchy repair. Listen to the docs advising you to be conservative. Are any of them suggesting labral and/or capsular shift without addressing the fracture? That seems like a reasonable option.

I had a fx of a 1/3 of my glenoid posteriorly and opted to be conservative

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**Whiteroom_Guardian** · 06-06-2022, 06:44 PM

3 out of 4 surgeons say I need that fixed if I plan to keep racing bikes. Still going with the conservative approach for now with PT. The only way to really know will be riding and eventually crashing again.

**Whiteroom_Guardian** · 06-20-2022, 05:26 PM

It's like some sick joke at this point. Girlfriend fractured her acromion 7 weeks ago. Very rare fracture. I was shocked when they said it was a non surgical fix back in May. She went in for her checkup today. It's not healing at all. She said the fracture looked even "wider" now than it did 7 weeks ago. Brand new young ortho on the case. Radiologist who's been at it for like 25 years told my GF she had never seen that fracture before. Ortho said she could ride her MTB though if she wanted, "But don't fall!"

**Dantheman** · 06-21-2022, 08:59 AM

Good guidelines for acromion fx treatment don't seem to exist, but no callous formation and more displacement at 7 weeks would seem to indicate surgery:

https://link.springer.com/article/10...02-019-03126-6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602832/

This quote from the second article would freak me out a little:

"Early surgical intervention to the patient can have a positive effect on fracture healing. Kim et al. [16] compared early and late treated acromion fractures and found out that while all the early surgically treated patients came back to their pre-fracture activities, the rate for late treated patients is 44%."

**Whiteroom_Guardian** · 06-21-2022, 12:17 PM

Originally Posted by Dantheman

Good guidelines for acromion fx treatment don't seem to exist, but no callous formation and more displacement at 7 weeks would seem to indicate surgery:

https://link.springer.com/article/10...02-019-03126-6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602832/

This quote from the second article would freak me out a little:

"Early surgical intervention to the patient can have a positive effect on fracture healing. Kim et al. [16] compared early and late treated acromion fractures and found out that while all the early surgically treated patients came back to their pre-fracture activities, the rate for late treated patients is 44%."

Thank you. I'm convincing her to go see my new ortho ASAP. I'm not totally sold on him yet, but he has garnered the most praise from other docs and nurses in the valley so....

She's like, "Well it feels fine." I'm just concerned it's a case where it may cause problems later. Same with mine I suppose.

**Dantheman** · 06-21-2022, 01:41 PM

Originally Posted by Whiteroom_Guardian

She's like, "Well it feels fine." I'm just concerned it's a case where it may cause problems later. Same with mine I suppose.

If the fx is non-symptomatic that muddies the waters even more. I'd definitely get at least one more opinion. I'd lean toward surgery for a young active person who participates in sports with a propensity for shoulder injuries, but I'd also be hesitant to have one fixed by an ortho without previous acromion fx experience. She seems to be in a tough situation with no easy answer.

**Whiteroom_Guardian** · 06-22-2022, 11:48 AM

I'm going to try riding my bike this afternoon. On pavement. Maybe on super mellow in town trails. Still total grey area if I need surgery. I've gained a ton of ROM but not all the way there. Posterior Capsule is keeping humeral head from dropping back and away. Scapula area wants to ride along when I do anything overhead. No major glide in the joint, but occasionally when my muscles relax for a moment I get some weird shifting in the socket.

This is just an epic mental battle. Can't ride. Work is stressful. Literally might not have anywhere to live soon. Ski season may also be fucked if this thing ends up getting surgery in the fall.

**TBS** · 06-22-2022, 11:53 AM

A road ride on a rigid bike will tell you a lot
Vibes mang. Always tough decisions - do I kill a ski season or kill a bike season?

**motopsycha** · 06-22-2022, 12:23 PM

I’ve got surgery scheduled for mid September. Doc thinks bicep tendon is causing my problem so likely bicep tendonesis and cleanup of anything else he finds

Timing is tough. Hoping to get some biking in while avoiding heavy coat season while in a sling. (I’m in MN). We will see how the recovery goes. Not ruling out some skiing

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**Whiteroom_Guardian** · 06-22-2022, 02:54 PM

Originally Posted by motopsycha

I’ve got surgery scheduled for mid September. Doc thinks bicep tendon is causing my problem so likely bicep tendonesis and cleanup of anything else he finds

Timing is tough. Hoping to get some biking in while avoiding heavy coat season while in a sling. (I’m in MN). We will see how the recovery goes. Not ruling out some skiing

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Good luck dude. I'm contemplating just being in pain all summer trying to work and then lose my ski season with surgery in the fall. I already bought a non refundable super expensive ski pass. Fuck.

**yeahman** · 06-22-2022, 06:29 PM

Originally Posted by Whiteroom_Guardian

Good luck dude. I'm contemplating just being in pain all summer trying to work and then lose my ski season with surgery in the fall. I already bought a non refundable super expensive ski pass. Fuck.

Big Sky will refund your money due to injury if you make the request before the season starts.

**altacoup** · 06-22-2022, 09:50 PM

Honestly the situation with orthos up there in Montana sounds horrible. I’d seriously recommend looking at doctors with more experience for both you and your lady.

**Whiteroom_Guardian** · 06-23-2022, 09:12 AM

Originally Posted by yeahman

Big Sky will refund your money due to injury if you make the request before the season starts.

Ok good to know thanks. Didn't see that anywhere on the website FAQs. Figured I would be fucked.

Originally Posted by altacoup

Honestly the situation with orthos up there in Montana sounds horrible. I’d seriously recommend looking at doctors with more experience for both you and your lady.

Yeah I need to research SLC docs again and see if anyone is in my network.

I did ride my MTB very slowly for like 5 miles yesterday. Mostly on pavement and about 1 mile up and over the little in town singletrack hill. Didn't feel super sketchy but I knew if I fell I would be fucked. More sore from lifting the heavy enduro bike onto my hitch rack. Kinda regretting selling my XC bike now.

**Whiteroom_Guardian** · 06-27-2022, 12:00 PM

Rode another 8-10 miles over the weekend. Some very fun and smooth singletrack south of Butte. Kept it super slow for the most part. Pain in the armpit from climbing. Feels a little sketch on downhills. Any little bit of jank trail/fork bounce and my shoulder feels somewhat sketchy still. Over 10 weeks out. I would think it wouldn't feel that fucked up still, but what the hell do I know.

**VTskibum** · 07-02-2022, 12:22 PM

May be joining this club. Riding Wissahickon park in Philly this am, tail end of ride, hit a built up rock kicker that bucked guy in front and then me right after. He barely pulled it together and me on his wheel did the same, riding a 20mph nose manual which I had pulled back to control until I hit a loose rock and front wheel disappeared. With 3 others and they helped me walk out and then through some neighborhoods while other go to fetch car.

Sitting in ER post x-rays, knee likely needs some stitches, slightly labored breathing so may have broken rib and my shoulder is almost certainly some kind of AC separation. Edit - broken scapula and 3 ribs. Summer rides done

Worst part of it is my 9 y/o crying on the phone as I called home. Worried we won’t be able to ride together and that I’m hurt.

**Dantheman** · 07-02-2022, 08:38 PM

Originally Posted by Whiteroom_Guardian

Rode another 8-10 miles over the weekend. Some very fun and smooth singletrack south of Butte. Kept it super slow for the most part. Pain in the armpit from climbing. Feels a little sketch on downhills. Any little bit of jank trail/fork bounce and my shoulder feels somewhat sketchy still. Over 10 weeks out. I would think it wouldn't feel that fucked up still, but what the hell do I know.

12 weeks is pretty standard for a basic grade 2 AC separation. Yours was much worse so 6-12 months seems like a reasonable expectation.

**Whiteroom_Guardian** · 07-02-2022, 08:51 PM

Originally Posted by VTskibum

May be joining this club. Riding Wissahickon park in Philly this am, tail end of ride, hit a built up rock kicker that bucked guy in front and then me right after. He barely pulled it together and me on his wheel did the same, riding a 20mph nose manual which I had pulled back to control until I hit a loose rock and front wheel disappeared. With 3 others and they helped me walk out and then through some neighborhoods while other go to fetch car.

Sitting in ER post x-rays, knee likely needs some stitches, slightly labored breathing so may have broken rib and my shoulder is almost certainly some kind of AC separation. Edit - broken scapula and 3 ribs. Summer rides done

Worst part of it is my 9 y/o crying on the phone as I called home. Worried we won’t be able to ride together and that I’m hurt.

Vibes dude. As much as ribs hurt they heal. The scapula is hopefully more straight forward for you as well. Friend of mine did the same thing (ribs/scapula/collapsed lung) skiing last year. They were only down for a couple months.

**Dantheman** · 07-03-2022, 06:50 AM

Scapular body is no big deal at all. Painful and sucky but they heal up great. When I did my clavicle and scapula together my ortho didn't even bother with follow up x-rays on the scapula.

**VTskibum** · 07-03-2022, 12:08 PM

Discharged today, Ortho said same thing Dan and WRG. Check back in 2 weeks to see if I did some rotary cuff damage which they couldn’t tell, but rest and then work w PT. Getting up and out of bed/chair is most painful part. Seems like I’ll be planted on the couch for Netflix and the tour.

No collapsed lung it seems, can take deep breath with only last little bit painful.

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**Whiteroom_Guardian** · 07-20-2022, 05:04 PM

How are you feelin VTskibum?

Fucking clown world down here. My girlfriend just went in for her 11 week post injury checkup. Acromion still not healed. Looks more displaced than it did in May after the initial injury. When I saw the xray in May I couldn't believe they just sent her on her way. I'm not a doc but super wide gap in the middle of a clean break screams fixation IMO. "Yeah, go ride your mountain bike!" Fucking clowns. I'm pissed. They want the whole CT scan run around now. I'm having her get a second opinion with my guy now.

I see him next week anyway. I've made progress with PT but still missing ROM especially with humeral head twisting/dropping. It's like it's stuck. IDK if there is scar tissue in the way or what now.

**VTskibum** · 07-20-2022, 06:33 PM

Ugh sorry to hear W_G!!

Was pinging w Summit about his a bit as well.

I’m lucky that I’m recovering pretty easily. Scapula fracture is hairline and ribs are healing, knee took about 10 days to get to normal. No PT and have full range of motion of the shoulder, with decreasing pain daily. 2 week Ortho appt told me I’ll be pretty close to 100% at 6 weeks, almost 3 weeks now.

Back on the trainer this week already, ~16 days off the bike. Now getting itchy to get back out for a ride, but so far held off the urge. Having backyard pumptrack has made that harder, especially when my kids are riding. 1st world problem I know.

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**Roxtar** · 07-21-2022, 04:16 PM

Spring of 2021 I got bucked right before a drop, lost all momentum, and lame ducked off the kicker, Augured in on the rocks.
Full frontal tear of the supa-whatever (rotator cuff) and grade 5 AC separation (Clavicle is basically a branch sticking out attached to nothing).
At 61 years old.
I finally got the rotator and bicep tendon done last March (leaving the AC as is). Just back riding this month. Thing are doing pretty well. ROM still sucks but pretty much pain free (just general soreness)
At 38, I'd get the labrum fixed. No question.

Oh one other thing. I will NEVER get another nerve block. Yes, it cuts down on opiate needs but 4 months later, I still have numbness in my hand with no idea of when/if it will get better.
I'm told, "it's not uncommon"