# Separated Shoulder



## 2w4s (Mar 20, 2005)

Last weekend, while going off a 2foot drop to flat, apparently a rock moved and twisted my handlebars. I've never had a crash like this, I never saw it coming. I was going off the drop and the next thing I know I'm on my head and shoulders. Long story short, I managed to separate my A/C joint, I don't think it's too bad. It's been hurting a little, nothing that a couple of advil can't cure, and I have full ROM with only pain in certain areas and no crepitase so i don't thing I damaged any bones, but there's no way I could ride a bike down anything bumpy, and I do have about a 1/2 inch bump on top of my shoulder and some swelling of the trapezius muscle. it's probably a 1st, maybe 2nd degree separation. 

Has anybody had a similar injury and if so, how long were you off the bike? Do i need to see a dr. or should I just let it rest, keep doing stretches and hope it heals fast. I'm pretty sure I'm going to have a lump on top of my shoulder for ever, right?


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## drunkmonckey (Jul 24, 2006)

Sorry to hear about the injury. I'm not sure how much a doctor would help you in this situation. They dont usually do surgery there unless it is completely torn loose or for arthritis, so other than possible injections or expensive MRI's, they won't be able to do much.
Some things you can try - brace or taping to hold it down and ice. Be careful with the stretching - remember this is an issue of hypermobility in a joint. I'd recommend being able to do pushups or getting in pushup position and being able to rapidly alternate putting one hand on top of the other back and forth. When you can do this relatively pain free you should be able to safely mtn bike. Shouldnt be an issue to road or flat ground bike well before that. 
Usually you are looking at a 6-8 week healing time (this differs from the painful time) on a grade 2 sprain, but you might be able to return to riding closer to 2-3 weeks if not as severe. 
The "lump" may decrease a bit, but will probably always be there. Hope that helps a bit.
dm, PT


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## 2w4s (Mar 20, 2005)

Thanks for the response, you're recommending exactly what I thought! Do you think it would be too early to start riding fireroads, as long as just do mellow fireroads and keep in one position would I do any more damage or prolong recovery of the AC?


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## drunkmonckey (Jul 24, 2006)

You might prolong recovery or worse, risk further injury if you were to ride. It all depends on your pain level and how in tune you are with your body. It has been less than a week so far? It'd be better to wait at least another week, and quite possibly more (up to 8) based on the severity. 
Now, if your pain is minimal and you can get into pushup position and at least do a half pushup, you might be able to get by with either an AC brace or a good tape job and get back sooner. Tape/bracing will help stabilize and do what the torn ligament(s) is supposed to do. The athletic trainer I work with wasn't in today, so maybe if one is in the house they can give better advice on the technique as I havent done a lot of it recently. What I do is start a strip just below the mid clavicle and then pull the joint back and down with the tape ending in the back. You'll want it pulled pretty tight unless you are doing it with duct tape  because athletic tape will stretch. Keep moving laterally with strips of tape until a bit past the joint. Additionally, it is a good idea to start a couple strips on the lateral arm and pull up and end over the AC joint. This step can help with the shoulder hanging down and separating it a bit, which is not as much of an issue while loaded on the bike. Then, stick an "anchor" strip laterally across the front and back to stabilize the ends. The tape can help stabilize a bit and help you feel more secure with your shoulder, but will not prevent injury in a serious fall.
One final thought: you have 2 shoulders that need to last you a lot longer. Compared to the time off for a surgery for a completely separated and unstable joint, a bit more time off isnt bad. Listen to your body and when you do get back out there, ice for 15 min or so when you are done regardless if it hurts after or not.


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## 2w4s (Mar 20, 2005)

I'm going to take your advice, I've already done a pretty decent tape job using duct tape, seems to be helping. ; ) I think I'll wait a tad bit longer before getting back on the bike.


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## Endoman1 (Feb 23, 2007)

*Ouch!*

Ooooow! I definitely feel your pain. I was zipping down a trail 4 years ago and kicked up a stick that got jammed between the front wheel spokes and the fork. Got slammed to the ground so fast and hard that I didn't even have time to react and ended up with a 3rd degree AC separation. Hurt like hell for 6 months, and my collarbone still sticks up at the shoulder. It's fine now though but looks weird.

Hopefully, you only have a 1st or 2nd separation because they'll heal with time. I looked into all the conflicting information about surgical repair for 3rd degree separations, even talking with orthopedic surgeons, and found out that surgical repair isn't usually recommended because the recovery is about the same without it. The exception was for throwing athletes and models.

Here's one web site with information about this injury:
http://www.dynomed.com/encyclopedia...ion_(Acromioclavicular_Joint_Separation).html


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## jeffbfox (Apr 20, 2006)

2w4s said:


> Last weekend, while going off a 2foot drop to flat, apparently a rock moved and twisted my handlebars. I've never had a crash like this, I never saw it coming. I was going off the drop and the next thing I know I'm on my head and shoulders. Long story short, I managed to separate my A/C joint, I don't think it's too bad. It's been hurting a little, nothing that a couple of advil can't cure, and I have full ROM with only pain in certain areas and no crepitase so i don't thing I damaged any bones, but there's no way I could ride a bike down anything bumpy, and I do have about a 1/2 inch bump on top of my shoulder and some swelling of the trapezius muscle. it's probably a 1st, maybe 2nd degree separation.
> 
> Has anybody had a similar injury and if so, how long were you off the bike? Do i need to see a dr. or should I just let it rest, keep doing stretches and hope it heals fast. I'm pretty sure I'm going to have a lump on top of my shoulder for ever, right?


Bummer on the wipeout. The ones that you don't see coming always get you the worst. I did the exact same thing at 24 Hrs of Old Pueblo in February. Last lap of the race and I relaxed my grip on the bars on a fast descent. The smallest rock got in my path but it caused my left hand to slip off the handlebar and next thing I knew I was 20 feet from my bike in the rocks. Besides tons of road rash and a split helmet, I suffered a 2nd degree AC seperation in the shoulder.

Anyway to answer your question. It took about 3 weeks to comfortably ride a road bike on smooth surfaces and about 6 weeks to ride the mountain bike moderately. By now I am riding like nothing ever happened and the shoulder seems almost 100%. The orthopedic surgeon I saw recommended that I didn't wear a sling on a daily basis because the joint would become immobile and weaken (he did caution me to be very careful without a sling on). By gradually working the motion back into the shoulder and icing it frequently, recovery was quicker than expected. I hope you can have as good of results.


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## JJGNC (Dec 25, 2006)

I hate to say the obvious but.....

GO TO THE DOCTOR UNLESS YOU WANT TO RISK A LIFELONG INJURY!!!!


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## rural (Jun 14, 2006)

GO AND SEE A GOOD DOCTOR.

4 weeks ago I did a similar quick pile drive into the ground.
Lots of pain and decided to go to the doc. He gave me the separated shoulder story and said the treatment was to put it in a sling for 4 weeks and take it easy as there was not much else that could be done. But to be safe we took an XRay and that’s where the story changed.
The XRay showed that I had not only ruptured the AC/separated the shoulder, but I’d smashed the end of my collar bone/clavicle.
Normally when people break a collar bone the break is in the middle and the treatment is similar to above – sling and wait/hope the bone fuses together straight, sometimes leaving people with a bump.
But I’d managed to smash the end bits of the shoulder and had bits floating around and a really screwed up joint.
This basically means an operation with the Ortho going in and putting in a fake tendon/string to pull the shoulder back together and then screw the bits of bones back into place.

You get about 3 weeks before the bits of bone start to grow together and clag up a bit. So if you do need any Ortho work, you really want to figure it out in the first 3 weeks. If you wait 6 weeks, don’t get better and then discover that you need surgery, it’s a way more traumatic operation as the bones have already started to grow back in the wrong pos.

They had me wait 2 weeks for the gravel rash to heal. So I did the op 2 weeks ago. As I have to wait for the bones to heal and have some bits, too small for screws, being held in by just the muscle flaps, moving the shoulder much is not an option. The doc put it this way – muscle wastage and that sort of stuff can be fixed later with Physio, but if I move any of those bone fragments around or mess the alignment up, the only way to fix it is another surgery. So I have 4 more weeks in a sling and then at least a month of physio.
This sucks so bad, especially as I’m still on the email chains of all my buddies organising rides – But I’m glad that I went to a doc and got an X-Ray as I would have wasted 6 extra weeks otherwise.


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## 2w4s (Mar 20, 2005)

Damn rural, sounds like you did a number on yourself! I hope you heal up quickly and fully. :thumbsup: 

I think i got off lucky. I've been back on the xc bike for two weeks just riding mellow fire roads, still probably another 3-4 weeks before the DH and Dj bikes get ridden. The shoulder has almost no pain, the bump has reduced a bit but is still there but I don't feel any laxity or binding. Next week I plan to do some light stretching and maybe the week after I'll start some light swimming. 

Silver lining to this, I was spending way too much time on the DJ and DH bikes and I was getting out of shape. two weeks of only riding longer xc and I feel so much better and stronger again, I forget how good I feel when I'm in pedaling shape, and how fast that fitness goes away when you're not looking...

Anyhow, hope you guys heal up fast and 100%, so you can pin it again and post more stuff in here... :madman:


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## emptybeer (Apr 22, 2005)

rural said:


> But I'd managed to smash the end bits of the shoulder and had bits floating around and a really screwed up joint.


Ouch...my collar bone shattered in the middle so it was a pretty easy heal despite the idiot doctors (that is not meant to be a stereotypical statement, I just happened to get three idiot doctors). I was riding again 8 weeks later.


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## rural (Jun 14, 2006)

Yea every medico that saw my X-Rays kind of went - normally we would treat this by xxx, but you really did a number on this. It's got me a bit freaked out as the drop I did was pretty small and simple and I've had way worse OTBs before. I think I was a little unlucky with the end of the bone breaking up rather than giving way in the middle.

I can't say enough for the find a good doctor part. I found a surgeon who only does shoulders and knees and it really makes a difference to get somone that knows his stuff. His office was full of sporting personality photos etc. from lots of big stars with thank yous written on them.
I think I have about another 8 weeks of surfing the forums to try and keep myself occupied and motivated. But I might sneak out for a gentle no bump road ride at the 6 week mark. Don't have a road bike so I will just try to blend with the lycra crowd on my Intense.


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## crosley623 (Mar 4, 2006)

I seperated my AC joint last sunday and my doc thinks between 2 and 3rd degree. I have a three week bike trip in a week and a half. Not good! Ive looked into these ac braces, anyone know of a good brand to get or where i can get some more information on these
Thanks,
Andy


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## ferday (Jan 15, 2004)

> Not good! Ive looked into these ac braces, anyone know of a good brand to get or where i can get some more information on these


i use this brace it works good....but the shoulder is a funny joint and a brace only does so much, it's more a confidence thing for me. if you have a trip in such short time...i'd seriously think about not riding IMO or you may do far more permanent damage.


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## Jay04cobra (Dec 6, 2005)

My orto told me a brace wouldn't do much good, beyond comfort. I took a very hard hit on Labor day weekend this past year. Hard rain turned what was the "safe" line into no line at all. I went out the front, about 10' vertical and horizontal, and had the misfortune to land square on a large rock that stuck up. 3rd degree seperation of my right shoulder. My pain tolerance is quite high, and my ortho told me to do whatever I was comfortable with. I did a road ride the following weekend, and was MTB'ing the next, at a easier pace. 9 months later it will still bother me on occasion, especially if I take a hard hit on it, but for the most part it is like nothing ever happened. Just do alot of strengthening exercises.


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## Haggis (Jan 21, 2004)

Currently got a sprung AC joint, but it's not detached completely. (Test is to feel for any movement on the 'lump' while moving the arm through full range of movement). 
Doc says it won't take much to detach it if I have another smack so I'm taking it easy on the fun stuff for 6-8 weeks and chomping glucosomene like a cokehead.


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## SkiBikeMan (Jun 22, 2007)

I posted this originally in the sticky of this section, third degree shoulder separation:

I had just gotten back in the fold of riding with the guys again last November 2006 after having our second child and building a house. Rode on a sunday ride, went to the top of Mount Pleasant on the coast of Maine, overlooking the mighty ATLANTIC ocean, beautiful!.

Cleaned a treacherous downhill, rode all of the ride just fine. In the last 30 minutes of the 3 hour ride, minutes from our vehicles, I crashed HARD. We were flying down a trail with cobble style rocks, one let loose and sent me into a tree. The most pain I have experienced in a long, long time!.

Collarbone torn from scapula (shoulderblade), and front ligaments shredded, shoulder dropped several inches and collarbone stuck up. Had surgery (Modified Weaver Dunn) in December 2006, today (June 27, 2007) was my last day of Physical Therapy and doc has stated that by September I should be able to get back on the ole Turner and give it a try again.

WIll post pics of the after shots of surgery tomorrow. Sucked big time!!!!

As you can see I opted for sugery, I am glad I did, bump greatly reduced. I am training with bodyweight exercises (pushups, pullups, dips) and core training (stability ball). Getting stronger. Do have a scar on the front shoulder, doesn't look to bad though.

Welcome to the group of separated shoulders


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## Bail_Monkey (May 8, 2007)

I concur with others and say, see a doctor... I was in the ER last week, stitches on right forearm... If you have insurance, see him and get things checked out so you will not have issues latter on in life.


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## patch-rik (Aug 28, 2006)

I just got a second opinion on my seperation today and it turns out I may have bruised some nerves behind my shoulder blade (scapula). Whenever I push on something my shoulder blade wings out a little. So that pushes what I thought would be like 3 to 4 weeks of recovery to 6 to 8. 

I seperated mine in Keystone on the first day it was open on the fireroad down to the trailhead. I just went too fast around one of the turns and washed out... after 5 or 6 clean, fast runs with no problems. Its the dumb stuff that'll get you they say.


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