# Grade 4 shoulder separation: Advise re surgery/no surgery



## Paranoid_Android (Oct 11, 2006)

4 weeks ago I crashed heavily on my right shoulder riding DH and damaged my AC joint. X-rays etc revealed a grade 4 separation. Lots of pain initially but after 2 weeks my pain, strength and range of motion were surprisingly good. I'm at 4 weeks now and I don't have much pain (I haven't done anything too strenuous) but it doesn't feel very stable. Certain movements, especially circular moments give me a pretty horrible sensation of how unstable the joint is; but not much pain. The bump on my shoulder is pretty damn massive and my shoulder looks/feels like it's dropped a _long_ way. I wasn't advised to use a sling any longer than I needed it so I only wore it for 4 or 5 days on and off. On advise from the hospital I tried to use my shoulder as much as I could. I've since been told that's probably not good advise. I suspect I haven't given it much of a chance to heal in the normal position.

I saw an orthopedic surgeon today. He confirmed what I'd read, that surgery isn't seen as necessity these days. He said surgery would most likely help to stabilize the joint, but it's not guaranteed. In my eyes the cosmetic advance of not having the bump is negated by the big scar, so I'm not looking at that as a reason to go ahead.

I asked as many questions as I could think of but still didn't get a feeling either way as to what to do. He seemed to be saying it's totally up to me. But I really don't know. I like to look at things very scientifically before I make a decision.

Now that I've had time to think about it I have some more specific questions and I'm interested in the opinions of people who've gone through it themselves. I'm especially interested to hear from people who've had the same injury more recently, as I know surgery has become less common these days. Even better from downhill riders or people that use their shoulder for _very_ strenuous riding and/or crash on it a lot 

I want to keep riding DH so it's a guarantee that I'll be crashing on the shoulder again.

- Am I more likely to re-injure the shoulder if I don't have the surgery?
- Am I likely to cause _other_ shoulder injuries if I don't have the surgery?
- Will the shoulder continue to get more stable in the coming weeks/months without the surgery? Keep in mind it seems to have healed very low and spaced out.

The surgery is going to mean a long rehab but I'm willing to do that if it's the only way I'll have a shoulder that's as strong, stable and crash-proof as it originally was.

Thanks!


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## diott3113 (Apr 25, 2012)

Hi sorry to read about your injury. Hopefully things turned out good for you and you're riding again and having fun.

The reason a came upon your post was that I recently took a bad spill while mountain biking. The Dr. said that I sustain a Grade 4 level injury and that the only real option if I want to get back on the trail is to have the surgery to repair my shoulder.

I didn't see any subsequent post and am wondering how things turned out for you?

Take care, hope you're back to riding!


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