# AC shoulder seperation Grade 3



## Jimmywalsh56 (5 mo ago)

56 year old.

Did mine 10 days ago on a road bike (clipped my mates back wheel, lost control and ended up in a ditch - Shoulder took the full force).

Saw rhe Ortho yesterday and his initial replsponse was to operate but I said I wanted to wait so he given me 6 weeks.

R.O.M slowly getting better but still painful when pushing up out of a seat or reaching out.

I already had a clavicle resection 10 years ago (they cut a good bit off the end of the clavical at that point apparently?) and some major shoulder surgery on the same (dominant arm)

Anybody else recover from this?? - I'm an avid Tennis player as well and have always enjoyed the gym/weight's etc - Are those days over now ?
Thanks in advance for any advice.


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## Carl Mega (Jan 17, 2004)

I suspect you'll heal up and (without surgery) have nice & interesting shoulder area bump where not everything lines up nicely anymore. Fun conversation piece at pool parties.


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## Jimmywalsh56 (5 mo ago)

Thanks Carl.

Yes that seems to be the case with most people but some saying to go for the Op ??


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## brex17 (Jan 31, 2019)

I did mine with a road bike crash as well. Landed on head/shoulder.
It's been ~10 years now. It is occasionally a nuisance and can hear annoying noises, but was all back to normal fairly quickly. I actually did a sprint triathlon 5 weeks after the crash. Lopsided swim strokes, but biked and ran fine.


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## Jimmywalsh56 (5 mo ago)

That's good to hear brex17


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## brex17 (Jan 31, 2019)

And to follow up, Carl is correct on the "fun conversation piece" bit as well. For a while I would show people how I could push on the clavicle and manipulate where my shoulder sat, then they would want to push it as well and say how gross it is. At the time I tore mine up, the doc said really only people that cared about the look did the surgery where they anchor the clavicle to the scapula. It isn't anything structural, it is more about not having the telltale bump and the shoulder sitting slightly lower.
I'm not the kind to care much about that, rather I like my scars, lol.
In the end, don't worry too much about it, you will be fine and learn to adjust for it relatively quickly. I do still lift - bicep curls, triceps extensions, bench, etc. Again, it isn't a real issue.


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## Carl Mega (Jan 17, 2004)

I'd listen to my ortho regarding surgery and the pro/con on the decision. But many, many (most, if not virtually all) people have a full recovery regardless of approach - so feel good about that. Similar to above, my ortho was like 'mostly cosmetic' regarding surgery for mine. I can't recall if it had an impact on time to recovery/heal.


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## DGUSMC (Jan 29, 2021)

Carl Mega said:


> I'd listen to my ortho regarding surgery and the pro/con on the decision. But many, many (most, if not virtually all) people have a full recovery regardless of approach - so feel good about that. Similar to above, my ortho was like 'mostly cosmetic' regarding surgery for mine. I can't recall if it had an impact on time to recovery/heal.


Same from my guy, “you can operate if you don’t like the bump or if it gives you other problems down the road.” 

I’m 53 and had nagging issues since chronic dislocation in high school before the AC “slip” caused by a hooked pedal OTB so hard to eval exactly what’s what these days. No surgery though and no issues generally with riding.


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## JKA (Jul 26, 2006)

Think long and hard about having surgery. I had the same grade 3 AC separation 30 years ago and went to an ortho that was the team doc for our triple A baseball team and sports medicine specialist. He did surgery...cut off the head of the clavicle and sewed the shoulder back together with merciline tape. About ten years later, almost all orthos had abandoned AC separation repair due to the surgery causing greater incidence of arthritis in the joint later on. I can personally attest to this. I definitely have significant arthritis in that shoulder only now. I can't sleep laying on that side, I throw a baseball like a girl now. You'll have a nice bump on your shoulder but no big scar like I have and hopefully not worse arthritis later. Get a second and third opinion before any surgery.


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## Stonerider (Feb 25, 2008)

I'm 54 now and had a grade 3 separation in 2008...so 14 years ago. I did not have surgery and I have full range of motion and lift weights 2 days per week and ride 4 days per week.


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## EugWanker (5 mo ago)

I'm in my early 50s too. I had a full AC separation over 20 years ago. The academic orthopaedic surgeons at the university's sports medicine clinic didn't offer the surgery as an option. It wasn't even a discussion. They just said they wouldn't recommend it.

Anyhow, if I were you, I'd consider getting a second opinion from another ortho. A mountain biking forum isn't exactly the best place to get medical advice. 

FWIW, as an anecdote, I have full range of motion and no pain, but when it comes to holding up that arm for long periods it will get more tired than the other side. My situation is different though as I was about 30 when this happened, not in my 50s. Healing to the point of being pain free with full ROM did take a very long time though even at that young age. Also, I hadn't had a prior shoulder injury like you.


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## Dkayak (12 mo ago)

Carl Mega said:


> I'd listen to my ortho regarding surgery and the pro/con on the decision. But many, many (most, if not virtually all) people have a full recovery regardless of approach - so feel good about that. Similar to above, my ortho was like 'mostly cosmetic' regarding surgery for mine. I can't recall if it had an impact on time to recovery/heal.


My wife had a grade 3 separation from a high speed OTB in 2020. Her orthopedic surgeon advised against surgery, saying doing nothing is now known to give better results. She had full range of motion in two weeks and was back on her bike quickly after that. Now we learn many of our friends have “the bump” too. Pretty common it turns out. If your Doc recommends surgery, you might want to get a second opinion.


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## Canssago (9 mo ago)

I have a Class 3 separation on both shoulders. Now I look symmetrical! Surgery, AFAIK, is only for cosmetic reasons. You can also see a chiropractor and they hammer the collar bone back into place, no need for surgery. My left shoulder took almost a year to heal and still can barely get it straight above my head, but is pain free. I do weights every week, including pull ups without any issues. Very common cycling and football injury.


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## Dkayak (12 mo ago)

Canssago said:


> I have a Class 3 separation on both shoulders. Now I look symmetrical! Surgery, AFAIK, is only for cosmetic reasons. *You can also see a chiropractor and they hammer the collar bone back into place, no need for surgery. *My left shoulder took almost a year to heal and still can barely get it straight above my head, but is pain free. I do weights every week, including pull ups without any issues. Very common cycling and football injury.


Seems doubtful. Chiropractors adjust each other all the time. My wife is a Chiropractor and the colleague she sees also has a grade 3 separation (his from college football). Neither of them has done anything except compare shoulder experiences. You can press that floating bump down but there’s nothing left to hold it in place.


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## Carl Mega (Jan 17, 2004)

Dkayak said:


> If your Doc recommends surgery, you might want to get a second opinion.


For the record, I didn't get the surgery nor did my ortho recommend it. I'm in the bump club and proud.


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## Ripbird (Jun 25, 2020)

I had a grade 3 separation in 2002 from a hard snow board accident at age 27 from catching an edge. No surgery, but had it immobilized in a sling for 8 weeks and damn it was painful. After 8 weeks my shoulder was frozen and I had no muscle as you can imagine. I got my shoulder working with physical therapy and then weights to build back the muscle. 
After a few months I started my next adventure into racing Go Karts that lasted 10 years and I've never had a hint of pain or an issue with the shoulder and racing karts used a lot of upper body strength. My clavicle is still lifted, but had full range of motion without issue, until I dislocated it on a MTN Bike in 2017. I was a lot younger and we know the body heals much quicker, so it's a tough call. I was told that nothing can be repaired once the ligaments are torn, just time to let the trauma heal. Good luck.


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## netaron (12 mo ago)

Grade 3+ if there is such a thing about 5 years ago at motobike track, crash landed/high-sided on my shoulder. Pain went away in about 2 weeks, but I had weakness/lack of strength especially while pressing downward, like sanding, for over 2 years. Pain came back after I re-tore whatever managed to put itself back together up there about a year ago. I've had pain since off and on, but mainly when working around the house. Went to a couple of doctors, PT, more PT and no one recommended surgery due to, well there isn't much to put back together, what do they attach the ligament to?? And as mentioned above, the consensus was that more damage results from the actual surgery process than what is put back together. PT helped tremendously, but only the 2nd time, so do your homework before going there.

If I had to do it over again, I would keep it in a sling for as long as possible, from my own research, it is the most critical step you can take after a grade 3, which I did not follow. IMHO, even if surgery was an option, you are at least 6 months to a year away from facing that decision and only when all other options have been exhausted. Oh, and get that vision checked 😁.


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## MTB_Underdog (Jul 8, 2020)

I was 50 when I did my shoulder (grade 3 as well) and I opted for the surgery. My Ortho said I could go either way, but the research I did said a percentage of people who just did PT had to have surgery later. I'm a mechanic, and I didn't think work would be very happy with me if I did 6 weeks of PT then told them I would be out another 12 for surgery (no light duty available where I work).
.

Very happy with the results, no pain, loss of range, or instability in the shoulder. I think my job was actually an advantage in terms.of rehab, once I was released for full duty I made sure I used the injured shoulder more than the good one to build it back up.


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## Dkayak (12 mo ago)

Ripbird said:


> I had a grade 3 separation in 2002 from a hard snow board accident at age 27 from catching an edge. No surgery, but had it immobilized in a sling for 8 weeks and damn it was painful. After 8 weeks my shoulder was frozen and I had no muscle as you can imagine. I got my shoulder working with physical therapy and then weights to build back the muscle.


My wife saw the Orthopedic surgeon the next day, after an ER visit in which the ER Doc had already told her they don’t do surgery any longer. The Orthopedic Guy advised no surgery, keep using the sling, offered Rx pain med (no thanks, but could I have ibuprofen Rx though), and said come back in two week for follow-up and a physical therapy referral. You’ll be on your bike gently in 4-6 weeks. He was very encouraging, saying he’d had a college quarterback go back to playing after the same grade 3 separation.

She wore the sling but did range of motion work on her own several times each day, relying on her knowledge of anatomy. She’s a very muscular, athletic gal and as a Chiropractor was determined to maintain her range of motion, without compromising what needed to heal of course.

At two weeks the Ortho Doc asked her to remove the sling so he could gingerly test range of motion in different directions. He was stunned that she could smoothly move through just about everything and could push back with force against him as requested. He said I don’t need to see you again. She asked about the PR referral and he replied I don’t see what else they could do for you.

She did a 5-mile paved bike trail ride at 4 weeks and then slowly ramped up road riding to 10, 20, . . . 40 miles, then at 61 days rode 8 miles of green MTB trails.

Patience. YMMV but you’ll be back on your bike. Don’t get discouraged. She struggled a *lot* emotionally with going back into the woods. We could have stuck with road and gravel, but it’s all risky business. I had a buddy get a terrible shoulder injury, requiring intensive surgery, from skiing icy moguls. A crash could have worse consequences than a grade 3 separation.


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## kosmo (Oct 27, 2004)

Carl Mega said:


> I suspect you'll heal up and (without surgery) have nice & interesting shoulder area bump where not everything lines up nicely anymore. Fun conversation piece at pool parties.


That worked for me 3 times, but all during the "better healing" years of life between 30 and 45.

100% now, with matching bumps!

Maybe see another ortho for a second opinion?

For me, surgery is a last resort, but that's a very personal decision.


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## RickBullottaPA (Mar 4, 2015)

I've separated both, broke both clavicles, and had (have) rotator cuff tears in both from MTB and moto (I've since sold the moto since that was the major offender). I've been able to get back to 95% function, ROM and strength just through physical therapy and continuing a strength and ROM regimen forever (a couple times a week). I've stopped doing heavy lifts above my head and heavy bench presses - focusing on pushups and flys and rows to keep the chest and back muscles solid. About the only major restriction is limitations in one or two sleeping positions.

Last time through this was a year ago, and I'm 60 now. I would definitely avoid surgery if you can.


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## Rod (Oct 17, 2007)

I'm in the same club as everyone else. It took a few weeks or a month before my range of motion and pain lessened. Just avoid weights above your head. Push ups were a great exercise. The other exercise which built a lot of strength was using a 25,35, or 45 pound plate. Hold this plate with both arms fully extended directly in front of your chest. Rotate the plate right and left or pretend it's a very heavy steering wheel. 

It's been years since I've torn my AC and every now and then it will just get a little sore depending on weather. My strength has fully returned, I can go to the weight room, play basketball, and lift heavy objects above my head. 

Good luck to you.


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## Dkayak (12 mo ago)

Planks are a great all around exercise. They seem to help my rotator cuff but that might be my imagination. No equipment required.


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## jackshack (May 11, 2011)

I tore mine when I was in my early twenties - landed on it and tore it clean off. Went to Dr. Distefano (Main doc for the Eagles at the time) and I remember him having me hold a sandbag and when he saw the separation he called over several other Dr.s to see how far it was torn. I wasn't insured at the time and decided to just let it go. I'm 54 now and have enjoyed a pretty normal life other than the comments at the pool or beach. It's nice to finally hear how others have had the same experience! My nieces and nephews loved it when I would lift my arm to show them my strange-looking joint. I can throw a baseball hard but it will always trail up to my right. I can also still walk on my hands so recovery is possible. It may take longer to heal up at 56 but you should be good like the others have said. Do yourself a favor and go through some PT to strengthen around the area once there is no pain. Don't go lifting that 45 lb weight any time soon. Build up to it by starting out with Therabands. Good luck!


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## NorCalTaz (Nov 12, 2013)

I've been dealing with shoulder issues for years, mostly due to HS Football and a couple of OTBs, had my right one unfrozen one time, not fun. Last spring my left shoulder really started hurting for no apparenkt reasons, tests revealed a tear in the rotator cuff and some arthritis. The usual course is to do some PT before Ortho will move forward, though I was heading for surgery and more time off the bike. I got lucky and ended up with a good therapist and with a few months of work, my shoulder is back to 95% good thus dodging the surgery bullet for now. Now a firm believer in physical therapy, although it won't solve all problems. Good luck and wishes for a speedy recovery.


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## Dkayak (12 mo ago)

NorCalTaz said:


> I've been dealing with shoulder issues for years, mostly due to HS Football and a couple of OTBs, had my right one unfrozen one time, not fun. Last spring my left shoulder really started hurting for no apparenkt reasons, tests revealed a tear in the rotator cuff and some arthritis. The usual course is to do some PT before Ortho will move forward, though I was heading for surgery and more time off the bike. I got lucky and ended up with a good therapist and with a few months of work, my shoulder is back to 95% good thus dodging the surgery bullet for now. Now a firm believer in physical therapy, although it won't solve all problems. Good luck and wishes for a speedy recovery.


I’ve found these helped a lot with my rotator cuff, but can’t say which specifically did the most good. It’s improved greatly, to the point no can resume weight training, including things that were impossible originally. Healing often takes time.








10 Rotator Cuff Exercises for Managing Pain without Surgery


If you've torn your rotator cuff, surgery isn't the only option. Read on for 10 rotator cuff exercises you can do to relieve pain and build strength.




www.ptprogress.com


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## jackshack (May 11, 2011)

Dkayak - this is awesome. These are all of the moves that my PT person put me through and made me a believer in PT.


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## Dkayak (12 mo ago)

jackshack said:


> Dkayak - this is awesome. These are all of the moves that my PT person put me through and made me a believer in PT.


They sure worked for me over several months. After reviewing several sets of exercises online, this one seemed the most comprehensive. Now if my shoulder ever bothers me I can run through these ten and the pain is gone. Wish I knew which ones were working the quick miracle. Inclined planks seem good.


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## Canssago (9 mo ago)

Dkayak said:


> Seems doubtful. Chiropractors adjust each other all the time. My wife is a Chiropractor and the colleague she sees also has a grade 3 separation (his from college football). Neither of them has done anything except compare shoulder experiences. You can press that floating bump down but there’s nothing left to hold it in place.


Well tell that to my chiro, after the 3rd whack with a hammer and wedge I stopped. It felt like I was injuring the shoulder all over again and told them I will live with the bump!


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## mtnbeer (Jul 2, 2007)

Thee are some newer techniques with physio tape that can move the joint back into place better and reduce the size of the lump. Also a sling helps push the joint back together.


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## Ripbird (Jun 25, 2020)

mtnbeer said:


> Thee are some newer techniques with physio tape that can move the joint back into place better and reduce the size of the lump. Also a sling helps push the joint back together.


I would tighten my sling down thinking it would help the joint heal closer together and after the fact I realized it really did nothing except cause more pain at the time. You quickly forget about the lump and my shoulder movement didn't change once healed.


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## RickBullottaPA (Mar 4, 2015)

NorCalTaz said:


> I've been dealing with shoulder issues for years, mostly due to HS Football and a couple of OTBs, had my right one unfrozen one time, not fun. Last spring my left shoulder really started hurting for no apparenkt reasons, tests revealed a tear in the rotator cuff and some arthritis. The usual course is to do some PT before Ortho will move forward, though I was heading for surgery and more time off the bike. I got lucky and ended up with a good therapist and with a few months of work, my shoulder is back to 95% good thus dodging the surgery bullet for now. Now a firm believer in physical therapy, although it won't solve all problems. Good luck and wishes for a speedy recovery.


And definitely keep doing your PT exercises - at least occasionally - forever! I try to do mine as part of my gym routine 2X a week.


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## mtnbeer (Jul 2, 2007)

A few years ago I read a detailed account of a guy that used extensive taping procedures to heal his AC joint injury without a bump. If I remember correctly He was re-taped by a PT every day or more. Aside from the aesthetics of losing the lump the joint will probably be stronger if the bones are in the correct position. It seems my AC joints are weaker after injury.


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## erusnak322 (9 mo ago)

after a MTB jump gone wrong, I did a grade 3 this spring at the age of 53. Was told by my OS that I would be out for 12 weeks and that surgery was for women who wanted to look good in tank tops. 
Did one session of PT and after watching 100 you tube videos put my own recovery exercise program together at home with bands and light weights. 
Was back on the mountain bike and motorcycle after 3 weeks and now I really don't notice it except that I always wake up with shoulder pain in the morning. Lifting weights is back to normal, but I have issues with push-ups, but not bench pressing. Not sure why.


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## jackshack (May 11, 2011)

Wow - you moved incredibly fast at 3 weeks. How long has it been since the injury? Just curious. I'm able to do pushups without issue but it's been many years since the injury.


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## Rusnak_322 (Dec 6, 2009)

jackshack said:


> Wow - you moved incredibly fast at 3 weeks. How long has it been since the injury? Just curious. I'm able to do pushups without issue but it's been many years since the injury.


June 5th was the accident. By day 3 I had full range of motion without pain which was great compared to the guys I was watching on you tube


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## .WestCoastHucker. (Jan 14, 2004)

Carl Mega said:


> For the record, I didn't get the surgery nor did my ortho recommend it. I'm in the bump club and proud.


same here. my ortho said he only would only recommend surgery in extreme cases and if you're like a professional baseball pitcher or your livelihood depends on your shoulder.
i was back riding in about 3 weeks and back at the jumps in 6...


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## dysfunction (Aug 15, 2009)

.WestCoastHucker. said:


> same here. my ortho said he only would only recommend surgery in extreme cases and if you're like a professional baseball pitcher or your livelihood depends on your shoulder.
> i was back riding in about 3 weeks and back at the jumps in 6...


Same advice I got. Same results, pretty much.


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## Mikes70 (Oct 24, 2016)

good read.
Separted my left shoulder (I'm right handed) on Tuesday eve's ride. Hardest hit I've ever taken on a mountain bike. Seat went into my gut and pedal took lots of shin skin away.

I see the OS on Wednesday Sept 7, and I suspect he'll recommend the MRI and possibly the surgery route. I'm opting for the PT. I went through a 7 tear surgery in '12 that took away my career of being a glazier. I'm office and sales boy now and its frustrating, but after going balls to the wall for 25 years thats the price the body pays.

My left shoulder (same) kissed a tree on my Sunday ride a week ago, at apprx 15 mph on a single track down hill, took the skin with it through the jersey. I'm wondering if weakened it during that initial kiss/smack.

In a sling now and I imagine I'll be in one for the better part of 4 weeks

So, brings me to my question: does anybody here wear like shoulder protection (like a chest protector in Moto) while mountain biking to help absorb the energy from the next hit/impact? cause ya know its coming.....

56 years young and stupid (at times lol)....
Dam, just got the Turbo Levo and was loving it....


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## Rusnak_322 (Dec 6, 2009)

I had just bought this, first time wearing it and I crashed and f’d up my shoulder. Not a hard “roost protector” like motocross guys wear.


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## Rusnak_322 (Dec 6, 2009)

Demon Pro Fit Top


Demon Pro Fit Top




demon-united.com


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## Xylx (Mar 18, 2005)

I've broken my right clavicle twice and separated that shoulder once in my late 40s. Give me the broken clavicle any day. Took me 18 months to rehab the separation. One third that time to recover from the last clavicle break even at age 65. I would avoid surgery if at all humanly possible.


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