# AC Separation Grade III Recovery



## Nim (Jan 2, 2004)

Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


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## merlin (Jan 20, 2004)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


Grade III...thats nothing I had a grade 5  Just kidding, I feel your pain Bro, it sucks. I did have a grade 5, 8 years ago. I had to cancel my MTB trip to crested butte  . The good news is it will heel. After a couple weeks i started to go to spin class and ride the trainer then after about 5-6 weeks went on the road bike. When i finally did go on my first MTB ride I had kept a lot of my fitness. Iwould follow you MD instructions and take thing VERY slow. Do not do any push ups etc till MD says it's ok. Good luck


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## roadiegonebad (Jan 31, 2004)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


3 words- range of motion... and no, that bump will not go away


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## Squash (Jul 20, 2003)

*DO NOT, I REPEAT, DO NOT push it....*

take your time and do EXACTLY what your Doctor tells you! Pushing an injury like an AC Sep can cause it to take much longer to heal, and should you fall, crash, or whatever that you did to cause the initial injury, you could EASILY make the injury worse. Or again prolong the recovery by re-injuring the shoulder. Another problem with AC Sep recovery is over use. It'll take a while to recover, but it will be well worth it. Spin classes and the use of the trainer can help you stay in shape. But DON'T ride until your doctor says it is okay to do so. And if he says light riding the TAKE IT LIGHT!!! Don't head off to your favorite DH run the second the MD says you can ride. Do it his way! That way you shouldn't have any problems.

Good Dirt


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## OneGearGuy (Jun 15, 2004)

I will have to agree with the above arguments for letting things heal...
I have been suffering since summer with a grade III AC sep as well. My problem was that I did it right before 90% of my big races were coming up, and 36 hours before a 12 hour race that I stubbornly rode to a 3rd place finish on my rigid SS in the solo class.
I have tried to take it easy, but have raced on it all season long. Now, I am finally giving in and taking it easy for the winter. It doesn't help that my Chrome bag goes across my injured shoulder, so I am not commuting either. Just road riding, some trail running and hiking, and of course the trainer (snore). But I want to heal up already!

My .02
OGG


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## glenboro (Oct 31, 2005)

*Three time for me *

I just seperated mine in July for the third time. They were level 3, 2 and 3 respectively. Problem is, this time it is not reconnecting. It might someday but for now it just floats around inside. It feels mostly healed; that is, no more pain etc... but it is completely disconnected. I can't ride because when I pull on my bars it pulls away. Lucky for me I'm living in Chicago temporarily, otherwise the Colorado mountains (I'm from Colorado Springs) would lure me into certain handicappedness. Fact is, had I undergone proper rehab with the first injury I prolly wouldn't be in this predicament now. (The army isn't the best medical environment.) I would push for therapy and adhere to it strictly.


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## JAK (Jan 6, 2004)

*Fully separated in '89 and...*

The doc said to quit climbing and MTBing. So I did. I experienced shoulder pain and stiffness. I did the 'light' therapy the doc recommended. It continued to hurt. They were concerned with me never doing anything that would stress the area. It continued to hurt. I went out and belayed a friend telling myself I wouldn't climb, I would just hang out. Well, it was a little SportClimbing area that had a thuggy 5.9. I gave 'er and have not felt the same stiffness since...15 years later!!...I still have crepitus, soreness and weird feelings of seperation...Maybe my slow going in the beginning helped? Like others said take it easy early...My doc still hadn't cleared me for physical activity when I went climbing  . At the time there was no effective surgery and he said I wouldn't climb or bike again without great discomfort. WRONG! Be careful who you listen to and make sure they understand the 'actual', not theoretical mechanics of the MTB. FYI, I put DirtDrops on my rig and with the different hand position, I experience way less fatigue in my left, separated shoulder. I am a bit slower on the DH, but when I get to the bottom, my shouldewr feels solid and virtually pain free. After you get back on the bike you might want to check out some different handlebars if you get any weirdness in your shoulder. Get a good Sports Therapist and be vigilant in your therapy. Those surgical tube exercises did wonders for me. I have lightweight barbells I do military presses with and it strengthens the surrounding muscles. Also if you swim, hit that pool! It seemed to be an activity that helped to stabalize my shoulder.

Hope that helps and Hang(pun intended) In There!!


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## zon (Nov 4, 2004)

Been there, doing that. I seperated mine (grade 3) in September, 8 1/2 weeks ago. Doc told me the same thing. 6 - 8 weeks. Well I couldnt sit still so I went for an easy ride around the hood after 1 week. Big mistake. Hurt like hell fo a couple of days so I decided to lay off it for the suggested time. I tried to keep the range of motion going by just moving my arm as much and as far as I could several times a day. Seemed to help as I dont experience any limitations now.
At 7 weeks I started riding again, nothing to technical, didnt want to chance a crash and agrivate the injury. Still did about 22 miles the first ride and felt real good afterwords. I have ridden about 6 times so far with lots of climbing and carefull downhill. I also started back at the gym. Cut the weight in half of what I was previously lifting and am doing OK. It kinda "pops" every now and then and feels tender with certain movements but it is definetly getting stronger. Still cant sleep on that side though. I'm 51 so my "heal time" may be different than yours.


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## Jdub (Jan 12, 2004)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


 Yep it pretty much sucks. I blew out a front tire on a downhill run this May and smashed mine up 3rd degree too. I was off the bike for about 6-8 weeks, and for a lot of that time I couldn't do simple things (like lift a gallon of milk, etc). It slowly gets better, but you basically have to build the strength of the shoulder up over time, it doesn't happen overnight.

I was putting in miles on the trainer, but even that proved to be too much too early. Ice is certainly your friend as well is Naproxen or Ibuprofen to help the inflamation.

Take it slow, even when it starts to feel better it will still be weak and easily subjected to injury again. Belive me I know all too well....

And yeah that bump isn't ever going away. My Doc said that he could get rid of the bump via surgery, but I'd be trading the bump for a scar. Plus the recovery of both options (surgery vs no surgery) was pretty much the same. Surgery (in my case) would be strictly for cosmetic reasons.


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## X-rider (Jul 25, 2004)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


I had a class 3 separation in 2000 and 2001...same shoulder. The first time it healed great and I was back riding in six weeks. Road riding at first, then easy trails untill I felt I could take the pounding of harder trails.

The second time wasn't so good. It took 9 weeks just to get on the bike and ride the road... I knew something wasn't right, but I left it go untill 2004.

I ended up having a bone spur ground off that was tearing into my rotator cuff. I also had my clavical ( probably not the right name) surgically tied back down in the position it is supposed to be in. This was done because I had severe impingement. I literally couldn't swing a golf club without my shoulder catching and making a loud cracking sound. It is one and a half years since surgery... I wouldn't get cut again. It is different, but not really better. I guess I'll just live with it... at least it's an injury that I can brag about!


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## BetterRide (Apr 6, 2004)

X-rider said:


> I had a class 3 separation in 2000 and 2001...same shoulder. The first time it healed great and I was back riding in six weeks. Road riding at first, then easy trails untill I felt I could take the pounding of harder trails.


I have separated both of my shoulders and both were third degree seperations. You are the second poster who says he has has done it twice to the same shoulder. I am confused how this could be done. I am under the impression that once you do a thrid degree it is done (thats what both my doctors said) since you have basically snapped the ligaments that hold the shoulder together. The shoulder never heals like it was before (the ligaments never re-attach) so how could you do it again?

Please explain what happened. I am curious, not trying to start an arguement.


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## X-rider (Jul 25, 2004)

BetterRide said:


> I have separated both of my shoulders and both were third degree seperations. You are the second poster who says he has has done it twice to the same shoulder. I am confused how this could be done. I am under the impression that once you do a thrid degree it is done (thats what both my doctors said) since you have basically snapped the ligaments that hold the shoulder together. The shoulder never heals like it was before (the ligaments never re-attach) so how could you do it again?
> 
> Please explain what happened. I am curious, not trying to start an arguement.


The first time, the doc said it was borderline class 3... more like a class 2 3/4. The second time was class 3 all the way.

When I was in recovery from surgery, the opertating room nurse that checked on me told me it was the worst separation she had seen in her 12 year career.


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## Mike T. (Dec 30, 2003)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


Mine was almost 30 years ago so it's a bit hazy. I wasn't off the bike (road) for long but limited the out-of-saddle stuff. I was back on the bike when the pain had gone. I remember it aching for months and months after and the worst time for me was when driving the car.

I never did bench press more than 125lbs after that and had the feeling that something wasn't connected. The separation gave me more grief than the (year earlier) broken clavicle on the same side.


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## elguamo (Jan 24, 2005)

roadiegonebad said:


> 3 words- range of motion... and no, that bump will not go away


Range of motion???? What's that? You mean you should be able to lift your hand above your shoulder??

Don't push it, trust me, take the time to let it heal.


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## xray_ed (Oct 9, 2004)

*Mine looked like this*

It took months to heal but I also had a broken wrist on the same side. I couldn't do any therapy on it for at least 6 weeks. That put me behind and made the range of motion harder to get back.

The AC (acromio-clavicular) joint is where the clavical (collar bone) meets the acromian process of the scapula (that little piece of bone on the shoulder blade that points towards the clavical) Notice on the xray how the end of the clavical is raised. Definately take it slowly and work on range of motion. Lots of painful stretching.


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## xcguy (Apr 18, 2004)

*Working on your shoulder's range of motion is*

very important. Waiting for the pain to subside, trying to maintain your strength and fitness, not trying to come back too soon...these are all components of the healing process. BUT one of the most important things is making sure you keep the range of motion in all your working parts. For instance, if you can't lift your hand above your head using your muscles you can get next to a wall and walk your fingers up the wall to elevate your hand higher and higher as the weeks progress. Something you probably wouldn't think about on your own.

I'm certainly no doc or physical therapist but I've PTd my way out of rotator cuff surgery so I've done a lot of "range of motion" exercises. These exercises don't really use the muscles in the affected area to move your arm/shoulder (gotta let those connections heal without stress) but your ligaments, tendons and muscles are all gonna permanently shorten up if they're not worked. If you don't have a physical therapist, get one, even if just for one session. They will enlighten you better than I can. You'll walk away from that first session with much needed knowledge about the ENTIRE healing process. Good luck.


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## wrongway (Jul 26, 2005)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


I had an accident at the 2001 Big Bear Norba nationals where I had not only a grade 3 AC separation, but also a fractured scapula, five broken ribs, and a collapsed lung, which immediately started to fill with fluid. I had to be airlifted. At the hospital I had a 1/2" plastic tube through my rib cage for three days attached to a suction device to suck out all the fluid.

I did my first slow and easy 30 minute road ride on my mtb by end of the second week. I could not ride my regular road bike at the time because of the stretched out position. Did my first easy mtb ride after 5 weeks or so. The docs said that I could do as much exercise I could tolerate, that it was good for my circulation. I had trouble pulling up on the bars for more than two months.


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## TripleSteve (Jun 28, 2005)

I did a grade 3 a little over a year ago. It's still not 100% and I'm sure it never will be. I followed the PT religiously and didn't ride for probably 6-8 weeks. It still feels like it's going to pop out whenever I get knocked forward on the bike or over 300 lbs on the bench etc. All of my workout symmetry is out of whack. 

At this point I'm really thinking I should have went against the ortho's recommendation and did the surgery...I'd take a scar and 95% over a big bump and 80%. I don't see how a Dr can say you'll be 100% when your whole shoulder geometry is out of line...
Of course, drilling a couple of holes in my shoulder and tying it together with a peice of my hamstring didn't sound that great either  

I saw one negative reply about the surgery as well...anyone else go through with the surgery? What were your results?


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## zon (Nov 4, 2004)

NoWake said:


> I did a grade 3 a little over a year ago. It's still not 100% and I'm sure it never will be. I followed the PT religiously and didn't ride for probably 6-8 weeks. It still feels like it's going to pop out whenever I get knocked forward on the bike or over 300 lbs on the bench etc. All of my workout symmetry is out of whack.
> 
> At this point I'm really thinking I should have went against the ortho's recommendation and did the surgery...I'd take a scar and 95% over a big bump and 80%. I don't see how a Dr can say you'll be 100% when your whole shoulder geometry is out of line...
> Of course, drilling a couple of holes in my shoulder and tying it together with a peice of my hamstring didn't sound that great either
> ...


So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?

Good Links on AC seperation: eOrthopod 
and Sports Medicine


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## BetterRide (Apr 6, 2004)

NoWake said:


> I saw one negative reply about the surgery as well...anyone else go through with the surgery? What were your results?


I had a "Weaver-Dunn?" surgery in 1999 and it has held up well so far, knock on wood. Seven seasons racing downhill and it still feels good. My doctor also recommended no surgery but after 4 months it was still hurting so I had the surgery.


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## xcguy (Apr 18, 2004)

*100% after surgery? Well...*



zon said:


> So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?
> 
> Good Links on AC seperation: eOrthopod
> and Sports Medicine


that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.
You know, getting dinged bigtime results in unwanted changes in your body. We like to think we're invincible but gravity teaches us otherwise!

Rotator cuff tears and seperated shoulders are two different animals. Maybe surgery is the better way to go in your case, I don't know. My point is: do a lot of research on your own (the internet will provide a ton of info for you--I did my research at a medical school library) and see what percentage of folks who had the surgery that you need actually said, f!ckin' ay, I'm glad I had that surgery! Weigh up the cost of surgery, the recovery time and the chances that the end result will be better than just PT alone.


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## TripleSteve (Jun 28, 2005)

xcguy said:


> that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.


I think it's really a case by case basis...probably a lot depends on how bad the separation was. And then you have to take into consideration what you expect after the injury...I mean most of us here didn't get our injuries from rolling off the couch while grabbing another beer! I know I asked my Ortho that I needed to be close to 100% just to fit my lifestyle. Unfortunately the PT only got me to 75-80% after a year.

Mine was a "100% Grade 3 separation", which depending on what you read, is the worse you can get with out breaking the skin. I had also had a grade 2 from football, so I'm sure that did not help my recovery just due to the scar tissue already in there.

On the superficial side I think I would go with the scar instead of a big protruding bump that you can even see under a tight shirt.

Cons are you never know what you're going to get when someone starts cutting you open!

I would get a couple of opinions and get some realistic advice about what kind of recovery you can expect with your particular injury.
Good Luck!


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## StrangeLuv (Nov 17, 2005)

*Grade 5 Here*

Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck


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## TripleSteve (Jun 28, 2005)

zon said:


> So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?


My ortho said there are two types of surgery; 
The first is where they put a screw in. He said this type has a high rate of failure, limits range of motion and has common impingment problems.
The second was the one I described where they take a peice of hamstring (I later found out you can opt for a "cadaver" donor) drill holes in your clavicle and scapula and basically "tie" them back toegether.


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## TripleSteve (Jun 28, 2005)

StrangeLuv said:


> Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.
> 
> I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.
> 
> Good Luck


Wish I had found your second guy...Which surgery did you have? The Weaver-Dunn drill and tie one?


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## nonoy_d (Jun 27, 2005)

StrangeLuv said:


> Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.
> 
> I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.
> 
> Good Luck


_______________________________________
You have a good ortho surgeon...bottom line don't curse the pain... respect the pain...


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## X-rider (Jul 25, 2004)

I had the Weaver-Dunn surgery. My shoulder works fine, with full range of motion. I only have about 90% of the strength I used to have. It has been a year and a half since surgery. I still experience some pain when doing certain things.

I gave up lifting weights because my shoulder fatigues too fast and throws everything out of wack when benching, doing lateral raises, push-ups, etc... I have no problem at all with riding and doing what needs done on the bike.


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## zon (Nov 4, 2004)

NoWake said:


> My ortho said there are two types of surgery;
> The first is where they put a screw in. He said this type has a high rate of failure, limits range of motion and has common impingment problems.
> The second was the one I described where they take a peice of hamstring (I later found out you can opt for a "cadaver" donor) drill holes in your clavicle and scapula and basically "tie" them back toegether.


Don't like the idea of weakening the hamstring. Are there rejection issues with a cadaver part? Are there any rejection drugs involved?


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## Mike Brown (Mar 12, 2004)

I have a grade 3 AC separation that's a little different as it's secondary to an extremely severe "crushing blow" fracture of the last 2 inches of my clavicle as the result of a car cutting me off on the road bike. Had to have a plate put in to restore clavicle, that's good, on my 3rd month of PT, been fully released to activity. 

Here's what I've found. The shoulder works great for any ride of easy to moderate effort including 10-plus hour days doing a 2-day MTB race with my girlfriend at an easy pace. When I put forth my full effort for the first time in a 38 mile technical MTB race in early November, it hurt- a lot- for the next 4 days. It just couldn't handle the 4 hours or so of hard effort and rock gardens. I've got an appointment next week with my doc that's to determine if I'm going to get the second surgery- if there's any chance it going to give me back that 10% to be able to go all-out, I'm going for it. 

Don't know if any of that helps, Mike


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## X-rider (Jul 25, 2004)

zon said:


> Don't like the idea of weakening the hamstring. Are there rejection issues with a cadaver part? Are there any rejection drugs involved?


I had a variation of the Weaver-Dunn. The doc used all synthetic material to tie me back together. From what I can understand, any surgery that uses the same basic technique to tie things back togheter is generaly called a Weaver-Dunn. I don't know if that's true or not, just my take on it. I do know that when I went back for check ups, the assistent would talk into a recorder and say he was checking patient # so and so's progress on Weaver-Dunn shoulder surgery.


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## StrangeLuv (Nov 17, 2005)

*Surgery*

I think I had the Weaver Dunn. I can't remember. The second guy didn't give me the surgery. It was a third guy. I'm in the Air Force and they sent me to a specialist who only did shoulders. The first guy wanted to do it, but he said he only had done three of these type of surgeries in two years. The specialist said he did about 25 surgeries a month, but only 5 of those would be ac separations. I told him "your'e the man". He did a great job. I didn't really do any physical therapy. The doc told me to use it normally for awhile. 6 weeks later (I think, maybe 9), he cleared me to lift weights. I started out light and slowly worked my way up. The only time I notice any soreness out of my shoulder is when I lay off the weights and come back, but even that seems to be dissapating.

The sooner you can get the surgery done the better. There are three ligments in there. Two are small and one is big. It must be left over from our tree swingin' days. The two little ones had been torn all the way through and had reabsorbed due to the fact there was too much time between the accident and surgery. The big one was still good. The doc said the shoulder would be as strong as it ever was, so don't worry about it.

Keep the faith


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## Bostonian1976 (Dec 9, 2005)

So I just had a screw removed after having it in for 3 months to heal my Grade 5 injury. I still have a bump...you can see a lot of my clavicle, in fact. Will this go away with increased muscle up there? I feel like the surgery wasn't done well. Check out the picture and see my before and after shots. Incidentally I was road biking when this happened...got clobbered by an out of control biker that sent me into shock and knocked out a couple of teeth. I'd be really curious to hear what people thought of how it looks, because I don't see why you couldn't fully fix this injury.


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## namaSSte (Dec 19, 2003)

I can't believe how many of us there are. 

Im in the midst of all of this right now too. Grade III AC sep. I have to admit that Im a terrible patient. I injured the shoulder in 8/04 (yes, a year and a half ago). I tried anitinflammatories at first with no result. Kept riding. As time went on the pain increased so we went to cortisone shots (3 this year), results lasted approx 5 wks on each) then back to the pain. Kept riding. Its gotten so painful now that I began getting serious about surgery (I didnt want to be off the bike before so I said no). Well, the MRI revealed some unpleasant news. The arthritis (swelling and inflamation) in the AC joint has caused enough impingement that I have caused a nearly full thickness tear in the rotator cuff. Im sure riding contributed a lot to that as well. I know have numbness and tingling in the arm and hand and have only been able to ride light xc (normally I ride a lot of skatepark and urban as well as light FR). The pain is constant, I dont sleep well and I can't do many everyday things. I am on prednisone and PT and will be having surgery very soon.

The point to all of this rambling is....listen to the doc. Take things easy and get better. Surgery is a very reasonable alternative if you can't get thigns calmed down in a more conservative manner. Just don't follow my course of action. In hindsight, I wish I'd have been a better patient. Hopefully, the recovery won't be terribly long for me (although Im not really that optimistic). Im sure the bump will remain and that's okay since it will remind me of what I should have done (my wife and kids already do!).

Good luck man, take care and get well. Keep us posted on your progress.


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## Mike Brown (Mar 12, 2004)

I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you. 

Given this will be my second and third surgeries (second to get plate removed, see previous post and third to tie it all back together) I'm feeling a bit down, but hopefully the overall picture will be good in the end. 

Mike


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## Bostonian1976 (Dec 9, 2005)

Mike Brown said:


> I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you.
> 
> Given this will be my second and third surgeries (second to get plate removed, see previous post and third to tie it all back together) I'm feeling a bit down, but hopefully the overall picture will be good in the end.
> 
> Mike


shouldn't my bump be gone though? I'm guessing you're an expert in all of this after 3 surgeries and it just seems really simple to me, looking at my X ray that the screw could have gone down further and made me heal better. I'm really wondering why they didn't. My doc is really lax with this stuff too (Harvard doc at MGH so he knows what he's doing)...he didn't even think I needed physical therapy after the screw came out last week (??)


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## Mike Brown (Mar 12, 2004)

Your repaired Grade 5 looks just like my unrepaired Grade 3. So yes, I would think the lump should be gone. Get a second opinion. 

Mike


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## Bostonian1976 (Dec 9, 2005)

Mike Brown said:


> Your repaired Grade 5 looks just like my unrepaired Grade 3. So yes, I would think the lump should be gone. Get a second opinion.
> 
> Mike


Thanks very much. Man this bums me out. I've been through so, so much with this.....and to think he may not have done it as well as he could have really kills me.....


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## zon (Nov 4, 2004)

Mike Brown said:


> I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you.
> 
> Mike


Will you have to take any anti-rejection drugs?


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## Nim (Jan 2, 2004)

*Late update*

Ok, 9 months later. Shoulder, well it will never be the same, but pretty good considering. Pain/random pain pretty much gone. Riding well, but the more techy stuff was physically difficult for a few months with the injury. Road (yes) riding helped get me back. Took a while to get the strength back for pulling up, drops, jumps, etc. Definitely ride a tad bit more cautious/sane these days. And heck, I think my golf swing has improved from the injury, but I don't have time for that - MUST RIDE!


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## Anonymous (Mar 3, 2005)

Just be glad button fly jeans went out of style.  
I did the same thing skiing back in the 80's. The first Q the doc asked was,. "Does it hurt to button your pants?". When I said that it did, and added "like hell", he correctly diagnosed it, before the xrays or MRI.


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## nuttymtbr (Apr 7, 2006)

*Complete seperation*

1 year of therapy SUCKED!!! :madman: But I elected to not have surgery and I'm SOOO happy with the results. When riding if I fall I try to remember not to catch myself with my right arm cause jamming the shoulder up into the scapula(sp?) hurts like heck. But besides that the shoulder works like it did before the accident. and my wife does not mind how the scapula protrudes up where my shoulder should be. If I have a good year of weight lifting the bump will go down considerably but now I prefer to ride instead of hitting the gym.:thumbsup:


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## k-stein (Jan 5, 2005)

I had a grade three seperation after launching a kicker about 6 weeks ago. I decided not to go through with the surgery and laid off the bike for about 3 weeks. Things were healing up pretty fast. After about 3 weeks i took some short ´"laid back" tours and did experience shoulder fatigue fairly quickly, so id stop and take off the camel back and kind of stretch it a little. Anyways 2 weeks later im back rockin the full face and ridin the rough stuff. It still gets fatigued at times and im still not able to touch my elbows together in front of my chest without pain but im glad i chose not to go under the knife. Ive got a doc appointment monday and hell probably hook me up with a PT schedule. Ive still got the crazy protrusion on my left shoulder but ill get used to it. I think everyone recovers differently from stuff though. By the way whats a grade 5??? I went to a german doctor and he made it sound like grade 3 was as bad as it gets...i mean once the tendons/ligaments are all torn whats left to damage?


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## AlliKat (Apr 28, 2006)

I did a grade 1 or 2 so hard to compare to some of your injuries. Swimming was the best rehab for me. I was teaching swimming so I used very low load full range motion and things got better quickly.


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## k-stein (Jan 5, 2005)

Doctor appointment went well. Said it was healing nicely and the stability is definitely improved. Said i should be able to lift weights in about two weeks. So all in all, 2 weeks pretty much light restricted movement. 3rd week dropped the sling, no more pain. 4th week started biking again safe n sane style. 5th and 6th couldnt hold it back anymore safe n sane pretty much out the window however still keeping the rubber for the most part on the dirt. next week we'll see how it feels. Overall thats about the time line i experienced. As of today im very pleased with the results and glad i chose not to operate.


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## conradm (Aug 15, 2007)

I suffered a shoulder dislocation and 3rd degree AC separation on July 20th in a training accident and 2 days later rode a 7 day, 500 mile touring event on a road bike. The guys I was riding with pulled the dislocation back in place at the accident site. I then went to the ER as we felt that I had fractured the collarbone. Xrays showed the AC separation. Consulting with the orthopedic doc in the emergency room, he said I could do whatever I wanted as long as I could handle the pain. After the first day, the pain subsided. I never took any pain meds during this whole episode. I actually found that the most comfortable positioning for the shoulder was on the bike as it forced the shoulder back up and in. After returning, I went to an orthopedic surgeon who recommended no surgery. He encouraged me to continue doing what I doing and said that in three months, the results will be comparable to surgery. I was happy to take the conservative route, but will see what happens. The separation is quite pronounced and I don't understand how those ligaments will repair themselves given the weight of the arm maintaining the separation.


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## monocognizant (Jul 10, 2007)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


I seperated mine last september so, I feel you pain. I was off the bike 4 weeks. Going back to riding didn't cause any shoulder pain but, now, a year later, I am just starting to get back my range of motion. It's going to take a long long time to get back to normal. Be patient and start of slow.


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## dwnhlldav (Feb 2, 2006)

I did a grade 1 or 2 seperation in February in a skiing accident. Because of all the other injuries I sustained I was pretyt much couch bound for several weeks, then just walking. When I started physical therapy it was all range of motion stretching and what not. The were really conservative with any strengthening which I found very annoying. The pain ended up at a manageable level and when I started riding 6 weeks out it only took a few rides before it stopped feeling like my arm was falling off when I pulled up on the bars.

I started light lifting after 3 months and got a little heavier and mixed in pushups and pull ups at about 4 months that is when I noticed the pain really subside. I'm not just past the 6 month mark. up untill recently I just thought I was going to have to live with some pain for ever, but I started taking a glucosamine supplement and with in a week pretty much all my shoulder pain is gone, it will just be achy for day if I sleep on it the wrong way or ride my cross bike instead of my MTB.


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## jcaino (May 26, 2007)

i have/had type 3 acromia (still have in my left shoulder) and had an operation to correct the condition in my right shoulder after severing my tendon.

the fused the tendon back together, cut out bone and had my shoulder strapped to my side for about 6 months. after that, i was supposed to do physical therapy, but i didnt have time for it - i did take it easy, but made sure to follow most of what the PT program had outlined - gentle stretches, dont push through range of motion, etc.

well, about a year after that, i needed to go back for a final check for insurance purposes - i hadnt gone to PT for pretty much the whole year and the doc was amazed at the recovery i had made - i gained 100% of my motion back and my shoulder is still nice and solid in the socket - no problems with dislocations like i had previously.

now, even though i regained my motion, i know i still have to take it easy, even more so on my other shoulder since i could still possibly tear that tendon. i had to stop swimming 2 times a day, everyday - but i can still do most anything.

i stay the f*** away from bench pressing and such though - thats just asking for a problem.

oh yea, the operation was able to be performed using arthroscopy instead of the formal 7 inch incision.


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## leer13 (Apr 27, 2007)

My wife crashed her road bike and fell full weight onto her shoulder. Separation and dislocation. I reduced the dislocation on the spot and we went to ER. They hemmed and hawed and basically said - Yup, it's dislocated. Our family physician was a first class idiot, said - you, it's dislocated. At this time her shoulder was about 2 inches lower than the other one. 

Long story short - after about 18 months she FINALLY got to see a great ortho - he ended up shaving the end of the clavicle off and shaving down the underlying bursa because of the wicked impingement she was getting. She is now about 8 weeks post-op and feeling a lot better. Good news was the AC joint was healed up and no damage to the rotator cuff. The significant scar tissue that had built up is nearly gone too. 

She now does physio and massage therapy and is nearly back to normal.

The moral - get a GOOD diagnosis the first time around, follow the instructions, do the exrecises and do not overdo things. Good luck on a speedy recovery.


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## pimpbot (Dec 31, 2003)

*Dang....*



Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


Grade III sounds nasty. Like your arm was severed and put back on.


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## rural (Jun 14, 2006)

Wow - I wish I found this thread 5 months ago. My story is very similar.

First doc said it was grade 3 and I should put it in a sling and take it easy for 3 weeks.
I couldn't help but notice the jagged bone end trying to rupture through my skin - so I found another doc..... I ended up in the hands of a really good Ortho that just does shoulders. I had done the ligaments, but I'd also smashed the end of my clavicle into lots of little bits. So surgery was the go.
My ortho did 7 shoulder surgeries on the day he did mine. If you're living in a location that has specialists - I think you are way better trying to find a doc that does 7 shoulder opps a day rather than 1 every 3 months!! 
I had the Weaver-Dunn thing with some anchors and minor hardware (located further down the clavicle to get to a solid non smashed bone).
The advice I got was that the big screw through the shoulder was not the way to go and had a high incidence of failure and problems.

So 5 months....
2 months of it really SUCKED - I mean depressing, intruded into work, ability to sleep, drive, etc. it SUCKED!!!
I did no PT or any real movement for the first 2 months. Muscle wastage and all that sort of nasty stuff.
Then 2 more months of recovery and PT.

I've now been back on the bike for a month and fitness levels are returning.
It's only been in the last 2 weeks where I've been having great rides where everything just feels great and the ride comes together.

The arm/shoulder is 99.9% good now, with a full range of movement and only slight discomfort if I stretch it way up. My PT guy was blown away with how fast I managed to get my range of movement and strength back. I hit the PT exercises pretty hard as I was determined to get back on the bike.

I'm so happy I found a good ortho and got the surgery.
Post surgery I still had a bit of a bump, but that's gone away now.
Now all I have is a cool looking scar.
The memory of 4 months of pain and suffering washes away when you get back on the bike and have one of those rides where you're just in the zone.


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## k-stein (Jan 5, 2005)

Well, its been now over a year with mine as well and i have no problems with the shoulder anymore. Back to jumping, dropping whatever. Strength and movement is good to go. Ive done PT on it continously since I was able to. I'll always have the lump, but i find it endearing.


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## jcaino (May 26, 2007)

oh yea - my surgery was just a lil over 9 years ago - april of 1998.


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## Jah Jah Man (Jul 17, 2008)

Hmmm, well, since it seems there haven't been any 2008 entries regarding AC separations, I guess I'm going to have to be the one to post. Did mine on 11-09-2008. Passed out on a buddy a couple of minutes afterwards from the pain. Thought I dislocated my shoulder, but I could still move my arm. Had the "bump" immediately afterward, so I knew something wasn't right. Eventually went to the emergency department, got x-rays, received a sling and prescription for percocets that I didn't fill, and was told to follow up with the Core Institute (PHX). "AC separation" they said. Put off the follow-up for a couple of days, went and picked up my copies of the x-rays on disk along with the diagnostic report. Looked at the pics on my computer and saw the damage done. Did extensive research and learned about the grading of separations. Entertained the idea that mine wasn't that serious. Found myself freaking out from the lack of pain late the following Friday. (Mind you, I had been riding nearly everyday up until the time of my accident.) I had been taking ibuprofen as instructed since visiting the E.D., but boy, was I starting to wonder about my pain receptors and nerve endings. Range of movement? Check. Not all I had before the wreck, but damn near. I could move my arm above my head, behind my back, and across my chest. Feeling in my hands, arms, and shoulders? Check. I actually pinched myself with my fingernails atop my hurt (right) shoulder to confirm. Started thinking about "Unbreakable"... Wondered if I could do pull-ups? I know, I know. You are probably thinking, "Is he insane?" Well, maybe. So, I walk down to the spare bedroom housing my Soloflex, which was left setup for pull-ups. I grab the bars and begin to do pull-ups. Not just a couple, but more than I had been doing before. I actually stopped before I tired my muscles out. Man, something is wrong. Should I be able to do pull-ups with a separated shoulder? The next day I talked to a buddy who is basically a physical therapist and told him what I had done. He started laughing before I even finished telling him. Especially, when I told him the part about "Unbreakable." Then, he says that I have probably created scare tissue very quickly as a result of metabolism and being fit. I end the conversation still in disbelief. Today, on the 18th of November, I finally got my follow-up with Dr. Marcus at the Core Institute. After he is allowed to view my x-rays, he puts me through some simple range of motion/resistance tests. I ask him if I should be where I am for the injury sustained? His reply is no. He tells me that I am definitely a grade 3+. With some doctors, he says that I would probably be a grade 5. He weighs my age against whether or not he would consider surgery. (I'm 37 with about 5% body fat. I'm actually underfat from dedicating so much time to riding. I rarely do more than this actively, I swear.) I mention "Unbreakable", during the course of our conversation, but I couldn't bring myself to tell him about the pull-ups. He's familiar with the movie. He then proceeds to tell me that if it were him comtemplating the decision, nobody would be touching him surgically. At 44, he has 7 years on me. He honestly tells me that he could actually put me in a worse position than I currently am in. I would definitely be in some sort of pain following surgery. My range of motion might not recover as quickly or be as good. I could possibly develop complications from the materials used in the surgery. I would be taking a huge step back as far as progress is concerned. And, other than aesthetics, I probably wouldn't benefit from surgery at this point, and that he couldn't guarantee that there wouldn't be some form of movement upwards with the clavicle forming a bump on top of my shoulder. Basically, it's a preventative maintenance gamble for me. He ultimately leaves the choice up to me, but in his mind it's a no brainer. I could possibly be a candidate for reconstruction with cadaver ligaments at some point down the road after problems arise, or I could have him perform an acute operation to tie down my clavicle to the coracoid process so long as it is within 3 weeks of the episode (a small window). I'd flip a coin, but I think I'll take it easy for a bit instead and gamble with the hope that I never meet Dr. Marcus again. You might not be so lucky.


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## Crawfishy (Jun 17, 2004)

*15 years later*

Jah Jah Man, I don't usually post here but I saw the word separation in the title and had to look. In June of '93 I was riding Walker Ranch outside of Boulder when I went over the handle bars and separated my shoulder. Still don't know if I hit a boulder or pulled on the front brakes.

When I sat up and luckly avoided being hit by my best friend who was trailing behind, I too could tell I had messed up my shoulder. The doc in the ER, a orthopedic surgeon checking on another patient, told me I had a third degree sep. He said that he did not recommend surgery and that the sep. would close back up. He prescribed a certain sling. The place was closed so I could not get it that night.

The next day when I went to see him in his office he started to look at it again. He had me stand up and he started pushing on the clavical. I soon asked him if I could sit because I did not feel so hot. He had me sit and went and got me water because he said I was turning green. He soon told me that the clavical had slipped behind the shoulder blade and he could not get it back up because it was being held down by a muscle. He said surgery was no longer an option.

A few days later I was put back together with a big S on my shoulder. I was able to make it stronger than before. Later that year I had a slight sep. in my other shoulder from playing flag football and hit hurt worse.

I think you will be alright without the surgery, maybe stronger.

Good luck!


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## nubcake (Nov 16, 2007)

another ac sep for 08. Mine happened 2 days ago, went to the hospital yesterday and found out the news. In researching this it seems like recovery time is really based on the quality of your doc. It also sounds like alot of docs dont take into account how serious alot of us are about our riding and think 90% is a great recovery, and then hearing from those with that 90% recovery mention alot of complications when riding that make it sound more like 70%

Im needing to set up an appointment with a specialist and am currios what i need to look for. Sounds like i need someone who also specializes in sports medicine but i dont know. Im ready to do whatever it takes to get on the bike quickly (at least the roadie) im just worried about a shitty doc that doesnt consider the fact i ride almost every day, race etc.. and hope he doesnt treat me "good enough" like he would for alot of seditary people that would never really notice the diff.


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## jro75 (Aug 17, 2006)

Just did this last night. Riding the road bike home in the evening and took a corner while going at a decent speed and BAM before I knew it I was on the ground. Front wheel washed out on something I didn't see.

Stood up and immediatly knew something was wrong. I actually thought I had broken my collarbone the way it was sticking up. Turns out it is seperated AC.

So much for my trip to S.Utah I had planned for sunday-wednesday.

Anyhow, just happened to notice this thread. I'll update later on how the recovery went.



Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


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## nhanus09 (Dec 1, 2008)

*a c sep grade III*



Jah Jah Man said:


> Hmmm, well, since it seems there haven't been any 2008 entries regarding AC separations, I guess I'm going to have to be the one to post. Did mine on 11-09-2008. Passed out on a buddy a couple of minutes afterwards from the pain. Thought I dislocated my shoulder, but I could still move my arm. Had the "bump" immediately afterward, so I knew something wasn't right. Eventually went to the emergency department, got x-rays, received a sling and prescription for percocets that I didn't fill, and was told to follow up with the Core Institute (PHX). "AC separation" they said. Put off the follow-up for a couple of days, went and picked up my copies of the x-rays on disk along with the diagnostic report. Looked at the pics on my computer and saw the damage done. Did extensive research and learned about the grading of separations. Entertained the idea that mine wasn't that serious. Found myself freaking out from the lack of pain late the following Friday. (Mind you, I had been riding nearly everyday up until the time of my accident.) I had been taking ibuprofen as instructed since visiting the E.D., but boy, was I starting to wonder about my pain receptors and nerve endings. Range of movement? Check. Not all I had before the wreck, but damn near. I could move my arm above my head, behind my back, and across my chest. Feeling in my hands, arms, and shoulders? Check. I actually pinched myself with my fingernails atop my hurt (right) shoulder to confirm. Started thinking about "Unbreakable"... Wondered if I could do pull-ups? I know, I know. You are probably thinking, "Is he insane?" Well, maybe. So, I walk down to the spare bedroom housing my Soloflex, which was left setup for pull-ups. I grab the bars and begin to do pull-ups. Not just a couple, but more than I had been doing before. I actually stopped before I tired my muscles out. Man, something is wrong. Should I be able to do pull-ups with a separated shoulder? The next day I talked to a buddy who is basically a physical therapist and told him what I had done. He started laughing before I even finished telling him. Especially, when I told him the part about "Unbreakable." Then, he says that I have probably created scare tissue very quickly as a result of metabolism and being fit. I end the conversation still in disbelief. Today, on the 18th of November, I finally got my follow-up with Dr. Marcus at the Core Institute. After he is allowed to view my x-rays, he puts me through some simple range of motion/resistance tests. I ask him if I should be where I am for the injury sustained? His reply is no. He tells me that I am definitely a grade 3+. With some doctors, he says that I would probably be a grade 5. He weighs my age against whether or not he would consider surgery. (I'm 37 with about 5% body fat. I'm actually underfat from dedicating so much time to riding. I rarely do more than this actively, I swear.) I mention "Unbreakable", during the course of our conversation, but I couldn't bring myself to tell him about the pull-ups. He's familiar with the movie. He then proceeds to tell me that if it were him comtemplating the decision, nobody would be touching him surgically. At 44, he has 7 years on me. He honestly tells me that he could actually put me in a worse position than I currently am in. I would definitely be in some sort of pain following surgery. My range of motion might not recover as quickly or be as good. I could possibly develop complications from the materials used in the surgery. I would be taking a huge step back as far as progress is concerned. And, other than aesthetics, I probably wouldn't benefit from surgery at this point, and that he couldn't guarantee that there wouldn't be some form of movement upwards with the clavicle forming a bump on top of my shoulder. Basically, it's a preventative maintenance gamble for me. He ultimately leaves the choice up to me, but in his mind it's a no brainer. I could possibly be a candidate for reconstruction with cadaver ligaments at some point down the road after problems arise, or I could have him perform an acute operation to tie down my clavicle to the coracoid process so long as it is within 3 weeks of the episode (a small window). I'd flip a coin, but I think I'll take it easy for a bit instead and gamble with the hope that I never meet Dr. Marcus again. You might not be so lucky.


WOW amazing recovery time.. I got a grade III sep. on the same day u did lol 11-09-2008 - fell off the bike during a jump... 1st doc said surgery.. I did not like that answer.. saw a 2nd doc and he said PT and left the choice for surgery up to me... Its now 3 weeks I have full range of motion (with some pain and popping) and can ride on the road went hiking yesterday but had some pain after 3 miles or so... I wont get on the trails for 2 months, i want to heal right.


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## nhanus09 (Dec 1, 2008)

*a c sep grade III*

got mine on 11-09-2008 its great!


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## OnyRS (Dec 17, 2007)

Got mine in March, 2008. Looks pretty much like that X-Ray above.
I had a little bit of pain for maybe 5 days and was off the bike for only 10 days.


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## kahiwa (Nov 8, 2007)

When i did my grade III, I went on my first ride on the 5th week. no trails. just slow fireroads. There was no discomfort but I still slowly got back into it and my first hard ride was after 2 months...


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## BC (Jan 11, 2006)

Don't Know what "grade" mine is, but it's basically not connected at all. My collar bone just floats around in space where it's not connected anymore. Six weeks sounds about right but like the doctors always tell me.."Let pain be your guide". Thereapy will help the muscles perform what the ligaments can't anymore. Other looking nasty with that bump on my shoulder, it does not affect my riding. It only gets sore from lots of windsurfing from the constant pulling motion.


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## G-reg (Jan 12, 2004)

I'm 8 weeks from mine, it's sitting at about 90%. I was able to ride gingerly at week 4. Lifting the front wheel to get up curbs hurt a bit. I posted the full report in the other AC thread:http://forums.mtbr.com/showthread.php?t=300318


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## Lawson Raider (Jul 24, 2006)

I had a level 1 separation back in July 2006 and it was about 5 weeks off the bike for me. Like everyone said, follow the doc's advice (It's hard because you want to be back on the bike so bad!) and with the Level 3 you definetly want to as soon as the doctor clears you to start working the range of motion exercises. With my level 1, the doc told me to work it ASAP.

I pray you recover quickly!


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## HurtShoulder (Dec 5, 2008)

Well I sustained what was first diagnosed as a Level 3 separation and after 4 months of PT with no improvement, while I went scuba diving 4 weeks after I did it with no problems at 4 months I still couldn't lift my children, push or pull on anything and had 24/7 pain, I went for a second opinion to learn it was Level 5 spearation. If I could figure out how to post my xray I would - my clavicle shot up and tented my skin and my arm fell a couple of inches. I did this in July 2007 tripping over a bump I never saw. I went up in the air and came down with the full weight of my 5'10", 140 lb body (I'm a female) on the tip of my right shoulder in the back. I still have the scar from the impact. I had no choice but to undergo the surgery - my arm was not going to realign itself. I had the surgery in November 2007. Cadaver graft, distal end of my clavicle cut off so that my clavicle could be put back where it belonged. I traded a huge bump for a 3 inch band scar. My problem now is at 12 months post op (of which I spent 2 months totally immobilized and 9 months in PT - and I'm fit) I still have pain and lack of function. I have full ROM but I can't throw a ball, lift more then 20 pounts, hang from anything (never mind a pull up), push, or hold weight in my hands and move my arms around. It just hurts too much (and I have a pretty high tolerance for pain) and it "clicks", "clicks", "clicks". I just went to my surgeon and he said that my biceps tendon is inflammed and I have a lot of scar tissue in the joint (and in my actual shoulder joint). I now need my 4th MRI of the year. Has anyone out there had such a severe separation and the surgery? If so, does any of this sound familiar? I just want to get on with my life and enjoy my 2 small children. I haven't been able to pick up my 4 year old since I did this. Thanks for any input.


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## BetterRide (Apr 6, 2004)

I am sorry to hear about your long road to no recovery. I had a similar surgery in 1998 (I believe it was called a "Weaver Dunn" after the two doctors who invented it) and it took a lot of pt but after a 2 months it was close to 100% but with some pain (not near what you are experiencing).

Here is the interesting part. On new years day 2006 I re-separated the shoulder and blew the surgery up in a crash. Other than looking like a freak with my shirt off it has felt fine ever since. Not that I recommend you "fix" the surgery by crashing on it but, it is an option.


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## HurtShoulder (Dec 5, 2008)

You actually made me laugh, thank you. When I hit and did this it was on asphalt. They had to pick asphalt embedded in my skin out in the ER and give me a tetanus shot. I've been told that I hit basically as hard as you can. In addition, I'm a female and apparently us girls don't have as much "padding" around our shoulders so an impact like that is devastating. My surgeon now says he wouldn't be surprised if I messed something else up in my shoulder at the same time. What pisses me off is the fact that I've been complaining about this since 6 months post op when I realized I got back my full ROM but was still have problems with daily living, never mind sports. I went to an anatomy book and determined that my pain was emanating from the area of my biceps tendon. I actually put "Xs" on my shoulder where the pain was coming from - which went from the upper biceps tendon to the area right under my scar where the graft is located. He looked at me like I was crazy and now he's saying "maybe it's your biceps tendon". I really don't know what to do. Hopefully, it's mainly scar tissue impinging on stuff in there and if they go in arthroscopically (I had open shoulder surgery the first time) they can scrap away the scar tissue and things will be better. I can't seem to find too many people with as severe a case as I had - I went to the top shoulder doctors in NYC - the ones who work on the famous people  

Maybe another fall would do the trick instead!


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## BetterRide (Apr 6, 2004)

Glad to make you laugh. 

Have you seen a surgeon here in Colorado? Famous people rarely hit the ground hard where as a lot of skiers, snowboarders and mountain bikers do (I left out skaters because they don't have insurance). I believe (and have been told) the best orthopedists are in Aspen, Vail and Steamboat.


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## GPRider08 (Aug 22, 2008)

I feel the pain along with you. in '98 I did something to my right shoulder playing football my freshman year of high school. I didn't see the ortho about it until it started really bothering me in December when I started wrestling. He said it was a grade 1 rotator cuff tear, and that I needed therapy. Long story short, I was cleared to wrestle on the day of my last therapy session, and that night, I tore it again. I went back and the doc said it was a grade 3, but that I didn't need surgery. Just no more wrestling and football. To this day, it still bothers me.
Then in '02 I separated my right shoulder, though I don't remember to what degree. That came from playing tackle without pads against a guy who was easily over 300lbs (I'm about 165lbs). At least I took him down! It took about 5-6 weeks before I was able to actually use it for everyday tasks, and even longer before the pain completely went away. I had the option of surgery, but the doc said it would mostly be for cosmetic purposes. Fortunately, it healed to nearly 100% on its own. It just looks deformed now.


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## acctnut (Dec 1, 2008)

*had surgery*

I had a grade 5, where you could stick your finger under the clavicle. I'd really freak people out before the surgery when I showed them how screwed up it was.

I had the dunn weaver done and a couple years later it looks really good. The scar is almost gone and there is no hump.

Problem with the injury is I was an avid surfer for 20+ years and after the injury I really don't have the same kind of snap in the shoulder to get into waves and out of critical situations while paddling. I only ride longboards in head high and under surf now, which I'm not always into, and have kind of left a sport and lifestyle I cherished behind.

Anyways, get the surgery if you look like a freak. I don't think it does much for your strength though.


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## OnyRS (Dec 17, 2007)

My orthopedic surgeon friend told me that, unless you NEED the surgery, to not go for it. He said that it's a pain in the butt to do as a surgery and it's pretty much for cosmetic reasons or to prevent the bones from hooking each other in the wrong position.
I don't know anything about the subject, but he's an expert in the field, so I just wear my bump with pride.


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## acctnut (Dec 1, 2008)

I wouldn't get the surgery done just to reduce just a bump. This is heavy duty surgery, where you're knocked out and wake up in major pain. The pain lasts well over a week and it is almost impossible to get out of bed the first couple nights to pee. Recovery sucks, vicodin won't help with the pain and you'll be off the bike for about 3 months, maybe more. In my case there was a huge void and a big step from the clavicle to the scapula. It was pretty nasty looking. I also feel as if the surgery helped to tie the shouler back together in order to prevent more scaring, arthritis, bone spurs,etc. I did it, it looks good and I'm pleased. I have no idea if I'd be stronger or not if I didn't do the surgery. At least I was able to go on disability and chill for a bit


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## pstaff15 (Jan 9, 2008)

i've got one of these. EARNED it on Sunday morning . . . saw an ortho today, he said a lot of the same things about surgery not always being the best option. I'm waiting for two weeks to see him again, Jan. 5th to be exact. I want to do whatever it takes to ride ASAP.


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## Zen_Turtle (Sep 22, 2005)

BetterRide said:


> Glad to make you laugh.
> 
> Have you seen a surgeon here in Colorado? Famous people rarely hit the ground hard where as a lot of skiers, snowboarders and mountain bikers do (I left out skaters because they don't have insurance). I believe (and have been told) the best orthopedists are in Aspen, Vail and Steamboat.


You're a funny guy Gene :thumbsup: 
I didn't have a surgery, but I'm always wondering what would happen if I crashed again on my already separated shoulder. Is the collar bone going to cut thru the skin?
At that point I'd have it really sticking out and look like a freak :eekster:

Do you think the wever Dunn was worth it?

ZT


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## outsideforever (Dec 10, 2007)

I am 16 months out from a type-V AC separation (which boils down to a very severe type-III) and just wrote about my experience on my blog. It's pretty long, so I won't repeat it here. If you are interested in hearing how it went for me to recover without surgery, you can read about it here. I went over the handlebars near the end of the Great Divide Mountain Bike Route. Some day I'll go back and ride the last seven days...

I did not opt for surgery and did rehab in the weight room on my own. I don't necessarily advocate this option because every injury is different and every person is different - but it is an option. I'm a woman, 35, a multi-sport athlete, and have been a weight lifter since I was 19. This obviously helped me in my recovery. I'm probably at 95% now, and anticipate being at 100% before I hit the two year mark.

I hope to be able to give some ideas to other people in the same situation.

cheers,
Michelle


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## SC Slugger (Jun 9, 2009)

Hey Michelle,
I am a week into a third degree separation. Most of that time was spent researching surgical vs. non--surgical approaches. Originally, all the pain and the look of the x-ray made me think that surgery was the only viable option. That's what the ER doc's when they saw it. The thought of surgery scared the hell out of me, but I thought it was necessary in order to maintain my strength. Apparently this is not so.








The journal of the American Academy of Orthopaedic Surgeons had an interesting article in April 2009 entitled "Acromioclavicular Joint Injuries: Diagnosis and Management." It seems that recently more and more doctors are recommending the conservative treatment (not usually for a grade 5 like yours!). That, in combination with your detailed log, (and my doctors advice) has helped me in making the decision to take control of my situation and rehab it myself. 
Anyways, just wanted to thank you for posting here and linking to your log. 
Thanks!!


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## G-reg (Jan 12, 2004)

Slugger, that could be my X-ray. As I've said previously in this thread I didn't get surgery. I'm 8 months out now and I'm really glad I didn't get surgery. The only time I notice is trying to do wide grip pull-ups. There is some scapula/clavicle interference in cases like that. Otherwise I'm 100%. I do get an odd look when someone sees the bump.


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## raid (Sep 18, 2005)

How can you live without any surgery after this accident ? I had this too, AC 3, and i´m very happy that i had a operation. My shoulder looks better,i feel better and i think that i´m in balance with my shoulder.The doc told me that i can live with this accident without surgery, but i have to workout my shoulder until the rest of my life to get no osteoarthritis ?


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## dennisadhs (Aug 8, 2007)

I had a grade II AC seperation last riding season. It happened after a really looooong 35 ride with 80% climbing. Anyways, I was going down a rocky section and was so tired that I somehow went off trail and there was a nice stump waiting for me. I endo'd off the bike landing on my shoulder. At the time I thought it dislocated and popped back in but found out later the my clavicle was sticking out. 

I'm a surgery tech so I had one of the local ortho docs give it a look over. Like most of you, surgery wasn't recommended since the turnout usually isn't worth it. The area was sore for about two weeks but didn't really hinder me in any way. However, I the area can sound a little like rice crispies every now and then, snap! Crackle! POP! I'm only 22, I am hoping arthritis cripple me one day.


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## Borealtrail (Jul 19, 2009)

Has anyone had experience with arthroscopic surgery for a type III as an alternative to the Weaver-Dunn procedure. A doc in WY is describing it as "the way to go" but has only done one of these procedures.


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## chrismindless (Jul 28, 2009)

*Grade 5 here*

Hey everyone thought Id chime in. My situation is a bit different. I race motorcycles and on 7-10-09, a drunk driver hit my on the highway. My helmet saved my life but i was wearing jeans and tee shirt. I donated 31% of my skin to the asphalt gods but hey, what can you do?

I discovered a bump on my right shoulder and went back to the hospital. 2 weeks after the initial accident, I was told I had an extreme type III or even type 5. The doctor told me i needed surgery. I am a skinny guy. We tend to be as lightweight as possible for racing. I am 6-1, 185 lbs and mid 20's. I am having all sorts of problems moving my arm and it is SOOO weak.

I am also uninsured. Turns out full coverage on a motorcycle doesnt include medical and the a-hole that hit me, well they never stopped. I was left for dead on the side of the road. So I am stuck raising funds for this operation AND I start law school on Aug 17th ...

So, Im thinking of going through surgery in December. The doc told me I could wait a long time for the surgery since all three tendons are torn. He told me to use the shoulder as much as I could tolerate. He said take it easy but that surgery was needed. He also said there would be a bump but nothing like what I have now. He also said I could regain full ROM on my own without surgery but I had a better chance with surgery. He was going to do the WeaverDunn and I would have a 5" scar.

Being that I am not as fit as the rest of you, I wonder how this will effect me. Any suggestions or advice on HOW TO recover?


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## chrismindless (Jul 28, 2009)

^^^ Also I would like to add Im almost 3 weeks into this injury and it still hurts and is very sore. Im better than before as I am able to do things and move my arm but just about everything I do hurts a ton.


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## jcufari (Jun 20, 2008)

Separated my right shoulder, grade II spring of 2005 playing lacrosse. Had to miss 2 weeks of practice could hardly throw righty for a while after that and my arm would fatigue very fast. Fast forward to the present and arm still hurts sometimes, grinds occasionally, don't sleep on my right side(if i do my arm kills me when i wake up). I have come to the conclusion that it is always going to hurt to some degree and that i will probably get arthritis in the joint.


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## BetterRide (Apr 6, 2004)

Having separated both of my shoulders 3rd degree (what the heck is 4th and 5th?, my doctors said what I did was the worst kind of separation. How can you get more separated than that?) one when I was 21 the other at 32 I will say the pain lasts longer than any other injury I have ever had except broken ribs (which hurt just as long but not as much). So pain three weeks later is normal.

I had the Weaver Dunn surgery done and about 6 years later I wrecked and un-dunn it. Most doctors don't recommend surgery unless it is still painful or has movement issues months after the initial injury. The Weaver Dunn would probably be fine for someone who isn't likely to take multiple hard hits to the shoulder again but in my case I abused it a little too much.

My advice is to wait a few more weeks and see how you feel. The WeaverDunn takes as long to recover from as the separation itself. The WD always calls for a lot of painful rehab work.


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## chrismindless (Jul 28, 2009)

thx for the info. 

There are 6 types of seperations. type 1-3 refer to the level of seperation. Type 4 and 6 are unique deformities and the Type 5 is the most severe often mixed with an extreme type 3. Point being that surgery ... surgery, what really is the big deal? Im honestly scared to go under the knife, but why is that?

Why are people so much against surgery? Im just curious. I have my speculations but Im curious because I think I dont have a choice in my case. I have to undergo surgery so Im just wanting to get ready for the big op.

thx


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## Rick K. (Jul 29, 2009)

Sustained a Grade 5 shoulder separation on 6/7/2009 with about 40mm displacement. I had surgery on 6/24/2009. The surgeon said that the ligaments were completely shredded and installed a hook plate to reduce the separation. The plan is to leave the plate in for 6 months and allow everything to fuse into a scar mass. It has been about 5 weeks and I have been on hydrocodone 7.5/550 which has helped with the pain. Just recently the doc reduce the hydrocodone to 5/325 which cause some withdrawal pangs lasting about 2 days. I decided not to even screw with pain meds the last two days, just to see where the pain was at. It has been a tough two days with very little sleep and obvious depression, but the pain appears to be lessening. Pain varies throughout the day so it is really hard to gauge day to day.

I have not found anyone having this "fusion" type surgery on the ac and was wondering if anyone else has had this type of correction.


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## Rick K. (Jul 29, 2009)

*Follow-up from Surgery for Type 5 ac separation*

After 5.5 months of having the hook plate, I had my surgery to remove the plate yesterday.
During the last 5 months, I only felt pain when I slept on the side of the injury. When lifting.
The hook plate itself lets its presence be known all the time. Not so much pain, just the feeling that something is there. Over the last month, this presence feeling has increased and there are twinges of dull pain every now and then, making it easy to decide that it was time to come out.

There is localized pain from the incision that I am treating with Tylenol3. According to the surgeon, there remains a slight dislocation of about a 1/4", which is significantly better than the 1-1/2" separation after the accident. This was done using only the hook plate without any tethering. Time will tell to see how the shoulder will be, but it looks very promising. I am really hoping to heal quickly so I can get into some mountain biking this coming spring.


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## Lawson Raider (Jul 24, 2006)

Nim said:


> Separated my shoulder. Doc says it is a grade III ac separation. Does not recommend surgery. Said it's a common MTB injury. Doc said 6 to 8 weeks recovery time. Web info suggests up to 12 weeks. So for you who suffered the same, how long did it take for you to get back on the bike? Road riding first? Can getting back on the bike early cause healing problems? That is, don't push it and wait until no pain or suck it up and start riding? Recommendations/info on your experience? Thanks.


I had a grade 1 a few year back, it was 4 1/2 weeks before I was healed up enough to get the sling off and 30 days after that to get back on the bike.

The main thing is don't go outside of your doctors recommendations for physical activity. He or she will let you know what you can and cannot do and how well you follow their advice determines the speed of recovery and the reduces the likelihood of long term effects from the injury.

When the doctor says to stretch and move your arms in range of motion exercises and at the right time, they will tell you to start doing this. Do it religiously. Failure to do this might make your arm stiff and less mobile than before the injury.

Do expect from time to time your shoulder will ache even years after it has healed up. It's been 3 1/2 years since mine and it still once in a while ache up for a little bit. Also, realize that once you separate your shoulder, it is prone to reinjury. Of course, healthy or not, crashing on it at the crazy MTB speeds and such probalby don't make much difference anyways.

Once you are healed up, if the doc gives you a full clear, you can go back to mt biking. You don't have to start out road for a while then go to off road.


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## Jah Jah Man (Jul 17, 2008)

*Level III/V AC Separation without surgery follow-up*

Thought I'd follow-up after a little more than a year. To those that it's happened to, I can only tell you to do your research. It is a fairly common injury in the sport. Much is available on the 'net. Educate yourself and know your options. Write down any questions and ask your orthopedic surgeon when you see them. Things like: How many AC separation surgeries have you performed/do you perform in a year? Which technique do you use? What is the success rate like? What can I realistically expect as far as recovery?, etc. While it has probably worked fine for those that have had it done, I would elect for the "tightrope" procedure over the "Weaver-Dunn" if surgery absolutely has to be done. Dont' think that you HAVE to have surgery, though. I can tell you firsthand that you can function with this separation.
I took 2 months off to be safe and I was back riding with little loss in stamina. Sure, that first ride was sort of scary from a nervousness standpoint, but does one quit riding horses when falling off the first time? Okay, well maybe, but that damn horse stands a bit taller than your bicycle.
Surgery is a gamble. There are no guarantees and complications can arise no matter what. Every person is different and what works for one may not work for the next. Oftentimes, after surgery, one is never what they were like beforehand. A complete reconstruction can always be performed down the road should you develop pain or limitations later. Why not see how you get along?


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## Rick K. (Jul 29, 2009)

Appreciate the input.

I won't know what the residual pain will be for sometime. I suspect that there is the possibility that there may always be some discomfort. Also, of concern is that in reducing the dislocation, you could end up doing too good a job and put the ends of the joint in contact with one another which could lead to a severe arthritic condition. A little dislocation might actually be helpful in this regard. My surgeon indicated that he could not see the scarring directly, but would be evidenced by how well the joint aligned after removal of the hook.

At least the joint didn't spring back open when the hookplate was removed. If it had, then the surgeon would have had to tether it or install a permanent hook plate. So right now, being in somewhat unexplored territory, I am still hopeful. 

I will try to get back every now and then to remark on how it is working out in hopes that someone might find the information helpful.


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## feelmjawlk (Aug 11, 2009)

Rick K. thank you for posting on your progress. I too have had a hook plate intalled, it has now been a bit over a month and it's planned to come out in three months. I too will get back with information on my recovery as time passes. Best wishes to your and everyone else's recovery from AC-separations!


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## Dr willy (Dec 22, 2008)

6-8 weeks is no time bro. That's where I was on my 1st total dislocation. Now I'm 1 month fresh out of surgery from my second dislocation and I'm not supposed to kayak or mtn bike until May. That's right, 6 months of down time!

Do yourself a favor now and do everything the Doc says! Its a good idea to stay on top of the rotator cuff exercises afterwards too because most likely, your shoulder will never be the same again. Good luck bro!

BTW- my injury was a Hill-Sachs lesion and a large Glenoid Labrum Tear.


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## morsetaper2 (May 22, 2005)

I didn't read through all the posts.... Your injury sounds way worse than mine, mine was not a shoulder seperation so you might want to ignore my post.

I was working under a PU truck and it rolled and pinned my head and shoulder to the ground under the engine & suspension. After getting out from under it I knew my shoulder was F-ed up, and collarbone broken. After all said and done I was lucky, broken & dislocated collarbone, cuts, bruises, and lacerations. If I was a bigger guy I'd be....maybe dead?

Dr & PT guy encouraged going to the gym about week 4. Working weight machines w/ no weight at first to see how it went, work the range of motion. let pain be your guide, if it hurt, stop. reduce weight, make some adjustment so no pain. Low weight barbells & dumbells at high rep #'s were preferred. If all is good, have a focus on stretching. Only increase weights after I could do 15 reps they said. At 4 weeks I was riding a bike around the neighborhood. At week #10 I went out on a MTB w/ no issue other than my reduced endurance.

It is now week 12 and I still have a few issues w/ stiffness. I've been so focused on getting back, I feel I am in really good shape. I have a feeling your timeline will be a bit longer than mine if you are 50 yrs old like me. If you are younger hopefully you will bounce back quicker.


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## Rick K. (Jul 29, 2009)

Just a follow-up 3 weeks after the hook plate removal surgery. I only had to take the pain meds for 3 days, then I took my sutures out after 5. Its a good looking scar!
The shoulder has a minimum bump, if any, so I am pleased about that. 

All in all, I am pleased with the surgery. I have pretty good range of motion, although there are points of weakness which seem to be diminishing as time goes on.

My instructions from the doc were to use the shoulder (arm) as much as I can tolerate. So I am gradually increasing using the arm to lift things, especially, like putting things up on a shelf. Also, I occasionally do stretching exercises to keep it loose. If I were younger, I would probably be doing more exercises, but at 58, I am just going to take things moderately.

The shoulder feels a little weird like it has a weight on it, but that was to be expected since the joint is held together with scar tissue instead of ligaments.


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## Caffeine Powered (Mar 31, 2005)

I skimmed the post and I'm feeling pretty fortunate. While I've broken both clavicles I suffered a Grade 1 separation just before Thanksgiving. Nothing spectacular about the crash, riding at night with a group and the front wheel found treachery under some leafs. I thought I'd broken the clavicle again but xrays said otherwise. I'm 5 weeks out now and I'm possibly at 80% normal strength.I find I have reduced strength lifting tools at work (commercial electrical construction) and I tried pulling the string of a compound bow before Christmas and couldn't without a fair amount of pain. 

I don't feel any pain riding and I skate skied for 30 minutes today and there was no pain pushing the poles up hill. 

I guess I'm fortunate.


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## prsman27 (Aug 16, 2006)

I had a grade 3 separation two summers ago from biking. The doc said 9 to 10 weeks recovery time. I was back on the trails in 7 1/2 to 8- though, I was pushing it. I rode VERY easy and made an extra effort not to fall. It took a little while longer (total of 14 or 15 weeks) for me to be able to ride at my normal intensity again. 
As far as surgery, I skipped and just did physical therapy. Today, my shoulder is 99%. The 1% difference is when I do weights, especially incline press, where my shoulder seems to eek a little at the extremes of my range of motion.


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## Simonns (Mar 25, 2004)

Im on my 2nd 3rd degree AC seperation, both from snowboarding. Did my left shoulder first about 4 years ago. Its 100% back to normal. I just did my right shoulder a week ago. It is seeming to heal faster than the last one as I did my 10 mile commute on the bike this morning, it felt fine. I have a bump on both shoulders now. I didn't do any surgery for either of them, I didn't even go to the doc for the second one. Im going to start lifting light weights soon to get the strength back.

-Simon


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## xcguy (Apr 18, 2004)

Simonns said:


> Im on my 2nd 3rd degree AC seperation, both from snowboarding. Did my left shoulder first about 4 years ago. Its 100% back to normal. I just did my right shoulder a week ago. It is seeming to heal faster than the last one as I did my 10 mile commute on the bike this morning, it felt fine. I have a bump on both shoulders now. I didn't do any surgery for either of them, I didn't even go to the doc for the second one. Im going to start lifting light weights soon to get the strength back.
> 
> I'm not doubting what you say but still, no problems with your _second_ third degree separation? Are there different gradations of a third degree separation, like, you've got a minor third degree separation, like the collarbone didn't get ripped completely up off your shoulder? X rays I've seen of others' third degree separations look pretty dam painful and look to entail a long recovery. One week and your right shoulder feels fine? If only all of our injuries would heal so fast.


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## Simonns (Mar 25, 2004)

xcguy said:


> Simonns said:
> 
> 
> > Im on my 2nd 3rd degree AC seperation, both from snowboarding. Did my left shoulder first about 4 years ago. Its 100% back to normal. I just did my right shoulder a week ago. It is seeming to heal faster than the last one as I did my 10 mile commute on the bike this morning, it felt fine. I have a bump on both shoulders now. I didn't do any surgery for either of them, I didn't even go to the doc for the second one. Im going to start lifting light weights soon to get the strength back.
> ...


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## killing_it (Jan 28, 2010)

*2010 Grade III Seperation*

Thank god I've found a forum that actually has people who've done this... I'm not actually a mountain biker but die hard snowboarder but had a lack of luck finding one with snowboarders and this injury.

Well I guess its officially 3 weeks today, first time doing this. Did it snowboarding falling full impact onto my shoulder on some stupid S box that was more sticky than it should have been... After it happened I realized something wasn't quite right. It looked like a regular fall but I felt like vomiting as I was sitting there clutching my shoulder. Rode down to the bottom and the meds there told me to go to the hospital.

At the hospital they told me I had a grade 3 ac separation, 22.5mm on the xray. I've been doing lazer treatement, chriopracture, and some minor acupuncture along with PT (however they haven't been much help). I opt out of getting surgery but from reading this thread I feel like it may be a viable option.

Most of my pain has gone away, I've only noticed the bump this week and have been frantically trying to push it back down so itll heal properly but I'm doubting it. I still have the sling on, but I feel like I can do without it, guess I'll see what they say tomorrow at PT.

Was really into working out, I play rugby as well, not sure how thats all gonna work out, let alone going into another rail jam snowboarding with the chances of landing on my shoulder... Does anyone know of a shoulder brace or something that you can wear for some more stability? I've found some but they're mostly in the UK and I'm not sure how effective they are cuz no ones really reviewed them or anything.

I guess I'll keep whoever reads this posted on how it goes.


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## bgfthntr (May 18, 2009)

I had a Grade 4 in 1998 and had two surgery's to fix it. I popped out the screw from the first time around because of my own impatience and started using my arm. Second time around the Dr. put a band to hold the clavical is place. It's still there and the shoulder works great. Considering my degree of separation I was able to get 99% motion out the shoulder. I can even throw a baseball still. It took some time to feel comfortable on the trails again.... I was a bit spooked from getting hurt again.


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## Blurr (Dec 7, 2009)

lol well **** long as it is revived I may as well pipe in now, I dislocated my left shoulder nearly 20 years ago now, I decided not to have surgery, and lived with quit a bit of pain and a shoulder that popped out constantly, so much so that when I was fighting (did some kickboxing) I could not jab with my left or it would pop out, finally now, it still pops out somewhat, but I have always had full use and still do some pretty heavy lifting with weights. 
Just ate **** two weeks ago and probably strained my clavicle on my right shoulder, first day really sucked, things were moving around and you could feel it, second day it was not so much pain so I merely limited my mobility and dealt with it, two weeks later it is only sore when I am laying on my side, seems to be working alright so no doctors yet. Im old school, if possible I think a person is better off working through things. lol now I know after reading this thread what that bump on my shoulder is, oh well, its going down.


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## killing_it (Jan 28, 2010)

*Ugh week 3 and I'm still using a sling...*

Went to physio this morning.. they're really seeming like the most pointless people ever.. they do a little lazer and tell me the EASIEST exercises which span from rotating my elbow to applying a little pressure on my shoulder.. Tells me I should finish them in a week.. I literally have gotten it half hour ago and I can do them all without any pain...

2 things I've been wondering...

1. Is it that easy to re separate it? Alota people here have said this hasn't been their first time doing it.

2. When has everyone else stopped using their sling for a grade 3? Like its been 3 weeks and a day and I'm pretty sure I can cope without the sling but apparently my physio wants it on for ANOTHER 3 weeks cuz he rathers it be stiff then work on stretching it rather than letting it get loose and having no way of stiffening it... It really seems pointless though... this sling feels like something I'm wearing but to no point. Like a silly hat but on 24/7.


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## Blurr (Dec 7, 2009)

killing_it said:


> Went to physio this morning.. they're really seeming like the most pointless people ever.. they do a little lazer and tell me the EASIEST exercises which span from rotating my elbow to applying a little pressure on my shoulder.. Tells me I should finish them in a week.. I literally have gotten it half hour ago and I can do them all without any pain...
> 
> 2 things I've been wondering...
> 
> ...


I have no Idea what mine was at all, but and I never used a sling, I just minimized movement with it, but yea, I still used it. 
Doctors and the like will always go a bit extra on the careful side do to insurance reasons as well as just to be careful.
these are some very good exercises to strengthen your shoulder, Im not going to be so arrogant however as to say it should be something you should do right away. 
anyhow, hold your arms out straight, palms up, do slow rotations forward and backwards. Also just doing shoulder shrugs helps as well.
edit
IM also going to step out here and while the separation of my left shoulder I never did anything with it, I was still able to build it back up and bench my max 350, at that point you could feel it moving out again. 
Lateral press was close to 300 as well since then. Not saying that is something you want to go for, just saying its possible to build yourself back up.


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## dysfunction (Aug 15, 2009)

I've re-separated mine (both left and right have done it). I'm gonna hazard a thesis that since they're pretty easy to damage the fist time, once you've done damage it'll be easier to separate.. depending on how bad your damage was in the first place..

I've always gotten mine out of the sling as soon as I could stand it comfortably, course that will also be situationally dependent.


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## Simonns (Mar 25, 2004)

dysfunction said:


> I've re-separated mine (both left and right have done it). I'm gonna hazard a thesis that since they're pretty easy to damage the fist time, once you've done damage it'll be easier to separate.. depending on how bad your damage was in the first place..
> 
> I've always gotten mine out of the sling as soon as I could stand it comfortably, course that will also be situationally dependent.


I didn't think you could re-separate an AC separation since once you tear your ligaments they don't grow back. Hence the bump on the shoulder. I would think that you might be more at risk of breaking your collar bone after already separating your AC.

Unless you guys are talking about actually dislocating your shoulders.


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## Burtonrider250 (Aug 31, 2006)

Separated my shoulder back when I was 16. Required surgery.

It's never been the same  

I can no longer weight lift how I used too. Real drag, but I guess it could be much much worse.


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## dysfunction (Aug 15, 2009)

Simonns said:


> I didn't think you could re-separate an AC separation since once you tear your ligaments they don't grow back. Hence the bump on the shoulder. I would think that you might be more at risk of breaking your collar bone after already separating your AC.
> 
> Unless you guys are talking about actually dislocating your shoulders.


It'll depend on the severity of the injury. You haven't completely torn a grade 1, 2 you've only torn the AC, not CC ligaments etc.

I've dislocated the shoulder as well.. I'll take an AC separation any day


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## bgfthntr (May 18, 2009)

killing_it said:


> Went to physio this morning.. they're really seeming like the most pointless people ever.. they do a little lazer and tell me the EASIEST exercises which span from rotating my elbow to applying a little pressure on my shoulder.. Tells me I should finish them in a week.. I literally have gotten it half hour ago and I can do them all without any pain...
> 
> 2 things I've been wondering...
> 
> ...


Keep the sling on! You want to immobilize the shoulder for at least 6 weeks. This is how I popped the crew out out mine and had to have a 2nd surgery. Take your time and do it right. It will be stiff for awhile unitl you go to PT and they work it free.


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## urban16 (Feb 1, 2010)

*Snowboarding Grade III*

I just separated my right shoulder this past Saturday, Grade 3. Snowboarding. Glad I found this post, it really helped reading about other people's experiences.

My two cents:

1) You can't re-separate if you've had a grade 3. Once you rip the tendons they're done for. they do not grow back.

2) I just got back from my ortho appointment, I went to a very top notch doctor in Manhattan. He is supposedly one of the best in the country, and all the signed photographs from professional football/baseball people on his wall made me believe it. He told me to ditch the sling already (this is day three), you are only hurting recovery by keeping it immobilized. He also said he doubts I will need surgery, and that he only recommends it for people who really need full use (like baseball players). I pressed him about this and said I didn't like the idea of living the next 50 years having detached parts. He said after 4 weeks of PT I will barely notice a difference. Surgery is always an option, but I don't hurt anything by waiting. I have a follow up in a month, he assured me that at that time I will be fine. Reading other posts here I am beginning to believe it.

I guess I'll have a hump for the rest of my life. Oh well


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## FutureMD11 (Feb 3, 2010)

Although I'm not a MTB, I am an avid snowboarder and I needed to find a forum about AC grade 3 separations. On Christmas just a month ago I had a nasty fall off a 15ft cliff, which resulted in an ac grade 3 separation. I remember feeling dazed and nauseous after the accident. Luckily, I had enough energy and coordination to get down to the first building at the base of the mountain. I was taken by the ski patrol to the clinic where I was driven to the ortho 40 minutes away by my father and brother. I was warned about the controversy surrounding surgery, but still opted for it. I was told by many that I had the best shoulder ortho surgeon in the valley and was in good hands. Its been a month since the surgery and I've been out of the sling for a week now. It is starting to feel great besides the bitter cold of winter that cools the metal in my shoulder. Otherwise, recovery is going well! I will take the metal out in May will be eager to work out again! Here is a pic of the shoulder before and after surgery.


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## JJ_n_Houston (Feb 15, 2010)

*3rd Degree AC separation*

I tripped and fell at Christmas time in Puerto Vallarta ( ya, so I had had a few two many margaritas ) not exactly the way I would plan this, but I had it x rayed when I got back home. Family practitioner said x rays showed 3rd degree and put me in a sling. Two days later I saw the orthopedic surgeon. He said "get of out the sling and start using it". I asked how much and he said, "your body will let you know when you have gone too far". As for surgery, I opted to have it, the bump seemed enormous, and I feared being limited in workouts and actually, at anything I did. But I didn't like this surgeon, so got a second opinion from a surgeon who specializes in sports medicine and shoulders. He also said I could live with it, but I said no, cut me open. Surgery was two weeks ago, I am in a sling for 6 weeks, and the screw that is connecting things will be removed in a second surgery in 3 months. Cadaver hamstring was used saving me getting cut on twice. After the screw is removed, I cannot workout for 5 months. I can hardly tell where the incision is, the suture job ( all underneath the skin) was done so well. I know I have a long way to go, but I have never doubted my decision to have surgery.


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## jkad (Dec 29, 2005)

I separated my right shoulder oner the bars a few years ago, still have a cool bump, then this happen Kayaking this Oct. The Dislocation was way more painful.:thumbsup:


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## killing_it (Jan 28, 2010)

Lol holy s***, I never knew your arm could drop that low with a dislocation.

Just keeping people up to date. Its now officially been 6 weeks, my physio said I could slowly start taking it off today in intervals.. however... I took it out of the sling 3 days earlier thinking there wouldn't be much harm, there was no pain whatsoever for me but now theres a giiiiiiannnnt bump, like defiantly bigger than it was before, on my shoulder now. I suppose if thats it its not too bad, it just feels really awkward more than anything. Still range of motion is limited, and certain exercises like rotator cuff exercises are REALLY painful. Its like the joint freezes up all together. 

Who knows if it would have made a difference if I kept it in a sling for the full 3 days but I guess its something ill live with.

I ended up buying a "rugby ac joint' brace near where I live which specializes in sports injuries. Its just a neoprine material that wraps around the one shoulder applying some pressure on the ac. I dunno how much it actually pushes down, I suppose its more for padding and confidence than anything else, but when I have it on it practically feels like my shoulders pretty normal. I guess I'm gonna wear that under my shirt till I feel like its unnecessary, then only when I'm playing sports.


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## Mr. Hecklerr (May 14, 2009)

*Grade 3 Shoulder Separation*



JJ_n_Houston said:


> I tripped and fell at Christmas time in Puerto Vallarta ( ya, so I had had a few two many margaritas ) not exactly the way I would plan this, but I had it x rayed when I got back home. Family practitioner said x rays showed 3rd degree and put me in a sling. Two days later I saw the orthopedic surgeon. He said "get of out the sling and start using it". I asked how much and he said, "your body will let you know when you have gone too far". As for surgery, I opted to have it, the bump seemed enormous, and I feared being limited in workouts and actually, at anything I did. But I didn't like this surgeon, so got a second opinion from a surgeon who specializes in sports medicine and shoulders. He also said I could live with it, but I said no, cut me open. Surgery was two weeks ago, I am in a sling for 6 weeks, and the screw that is connecting things will be removed in a second surgery in 3 months. Cadaver hamstring was used saving me getting cut on twice. After the screw is removed, I cannot workout for 5 months. I can hardly tell where the incision is, the suture job ( all underneath the skin) was done so well. I know I have a long way to go, but I have never doubted my decision to have surgery.


I also suffered a grade 3 shoulder separation going over the bars trying to get around a n00b on the trail during a race and high sided my pedal on a root. pitched over and separated the right shoulder. That was 3 yrs ago. Like you I was in a sling to see how it would heal. Wasn't getting the range of motion and strenght back after 3 months and opted for surgery. Had one of the best docs in ATL. do a modified weaver dunn procedure on it. He specializes in shoulder injuries and works on a lot of the pro athletes in ATL. He had the autographed photos on his wall also. Besides mtn biking I am also a competitive 2-man sand v'ball player. (Used to play semi-pro back in the day) Still play open and A level. It took a full year of rehab, working out and rebuilding the strength but I'm a 100% with what I have left in my right shoulder. Pushing the same weight I was in the gym prior to the separation. Playing v'ball again. Back on the bike and raced last yr. in the 12 hr series on a 4-man team. (we won the point series) Shoulder aches on occassion from playing v'ball but that could be overuse to.


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## mjake4479 (Mar 1, 2010)

*well*

this is becoming a theme. don't mean to overrun this biking board with snowboarders, but it appears we suffer common injuries. i actually registered for this board today because i was interested in reading about mountain biking and i stumbled across this thread. i actually just suffered a Grade III AC joint separation 9 days ago at Windham in the Catskills trying to do a rail grind. not a smart idea. my x-ray looks nasty as well, just take my word for it.

the replies on this post really say it all, some do well with surgery, some don't. this is the first injury of this type that i've ever suffered and to be honest...i expected worse. i'm now 9 days removed from a Grade III and i don't need my sling at all. the doctor at the mountain gave me some medieval-looking harness to wear, but when i had my shoulder re-examined by a doctor in Manhattan, he told me i didn't need it (thank god).

i can move my shoulder through most of my pre-injury range of motion with some stiffness and pain. sleeping is annoying. i snore like a freight train when i sleep on my back, yet that seems to be the only comfortable position. my poor wife - she has been trying to shove those pain meds down my throat all week so i can sleep well (and, in turn, she'll be able to sleep well), but i have no interest in narcotics.

i'm due back to my orthopedist in about 10 days. i hope to be ready to start PT at that time. i don't really care about the bump (after all, i'm not a runway model), but i DO care about loss of function. if i'm not able to gain full range of motion and strength back, i'll have to consider some other options. but after reading this thread, i'm even more optimistic that full recovery can be achieved without the knife.


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## Simonns (Mar 25, 2004)

mjake4479 said:


> this is becoming a theme. don't mean to overrun this biking board with snowboarders, but it appears we suffer common injuries. i actually registered for this board today because i was interested in reading about mountain biking and i stumbled across this thread. i actually just suffered a Grade III AC joint separation 9 days ago at Windham in the Catskills trying to do a rail grind. not a smart idea. my x-ray looks nasty as well, just take my word for it.
> 
> the replies on this post really say it all, some do well with surgery, some don't. this is the first injury of this type that i've ever suffered and to be honest...i expected worse. i'm now 9 days removed from a Grade III and i don't need my sling at all. the doctor at the mountain gave me some medieval-looking harness to wear, but when i had my shoulder re-examined by a doctor in Manhattan, he told me i didn't need it (thank god).
> 
> ...


I did both of my shoulders snowboarding. Both grade III. I'm about 8 weeks in on my second one. Its still sore when I lift things and reach across my body. However, in the last couple days if feels like things are moving a lot more inside. When I move my shoulder you can see the collar bone moving and popping. It hurts a little and feels really strange. I'm wondering if there is some scar tissue building up or something. I don't remember if my left shoulder did this when I tore that one. Thanks.

-Simon


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## outdoornut (Aug 13, 2005)

6 to 8 weeks is about right, however you won't be 100% for several months. I would notice some pain 3 to 4 months later when doing a bunny hop or after several hours of riding. But it's back to normal now. The bump will be there unless you get surgery. My specialist advised they have more trouble with arthritis down the road after surgery and recommended I just leave it alone.

I feel for ya, just follow the docs orders.

ODN


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## jkad (Dec 29, 2005)

*graphic pic.*

Here is my arm 24hrs after surgery. Very sore, on the road to recovery!


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## Craw (Feb 10, 2004)

I haven't posted on MTBR in ages, but I caught this thread and wanted to chime in. I suffered a Grade 5 AC separation last year, right about this time. March. I was in a moto accident, swerving to avoid a truck that turned in front of me. I was lucky. The accident happened a few blocks from home. I pushed my bike back home, and my roommate took me to the hospital, down the street. I was totally fine, save for my messed up shoulder.

Went to see an ortho soon after, who gave me the option to have surgery or not. I was informed that in my case, I could wait and see before deciding on surgery. Taking into account all of my activities: Climbing/bouldering, MTB, Snowboarding. 

That was a year ago, almost to the day actually. I have not had the surgery. During the first few weeks I was in a sling, but able to go to work and do normal things, just one handed. After about three weeks or so, I started doing physical therapy to get my range of motion back etc. Pain was manageable, nothing too bad. I pushed it though, within a safe range. I figured, more effort and pain endured during physical therapy would mean better results for me later. 

So, here I am, one year later. I'm mountain biking, and bouldering. Carrying on with my normal activities. I do experience soreness at times, but for the most part my activity now is pretty much the same as it was before the injury. I have the bump, but it's not horrific, at least to me. 

I am able to do pushups, pullups etc. Haven't really lifted weights or anything like that, but I didn't really do any of that before the injury anyway so that's fine.


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## meowracer (Mar 12, 2010)

I jointed this forum just to post on this thread! I don't have a shoulder injury but rather a shoulder deformity that I have had all of my life (but just discovered when my shoulder hurt so bad I thought I would puke) - there is a hook on the AC bone/joint, and that hook will press into my rotator cuff at times, causing pain. The more I use it, the worse it gets. The doctor said to just be careful, that it will not cause harm to the rotator cuff, but I need my shoulder! Anybody dealt with this issue? Thoughts on what to do aside from not using it too much?? I do swim and am very careful with the shoulder and form.


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## Rick K. (Jul 29, 2009)

Well, it has been some time since my last post. I had a grade V separation in June '09. I was 57 at the time. After consulting an ortho-surgeon I opted to have surgery. The separation was about 1-1/4" and all 3 ligaments were shredded, the end of the clavicle was poking through the muscle tissue.

A hook plate was installed to hold the joint in place. Due to the trauma involved in maneuvering the joint back together, there was a considerable amount of pain after the surgery. I was up and about in two weeks for easy rides. After about a month, the swelling in the shoulder went away, but the joint became more susceptible to pain in use. As time went on, the presence of the plate became more and more noticeable.

After the allotted 6 months, I had the plate removed and the recovery from that surgery was just a matter of a few days. The joint is now held together with scar tissue. The shoulder dropped a little with the removal of the plate, but I have no noticeable bump. 

Today, 4 months, after having the plate removed the shoulder feels OK. I have full range of motion and the shoulder feels stronger everyday. The only ache I get is when I sleep directly on the shoulder, but even that is becoming less as time goes on. I have not done any physical therapy other than to just use it as much as I can tolerate, per the doctor.

It was an easy choice for me to have the surgery. A bump is one thing, the sharp end of the clavicle messing with poking through the skin is another. Also, the joint is now separated with scar tissue and so that should prevent any future arthritic conditions of bones of the joint coming in direct contact with another.


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## killing_it (Jan 28, 2010)

Hey so its me again, haven't posted in awilllllllee, but just to say how my shoulders been after a grade 3 separation. So however long its been from my last post (at least over 5 months-ish) my shoulder literally feels totally normal again. Minus the bump on it, I don't notice it at all. (If you wanna be pickly theres a small 'clicking' sound when I rotate my right shoulder fully but thats about it.) There was some pain when I got my sling off whenever I worked out for the first couple weeks but that went away, now that I'm out of school for the spring/summer I work out practically everyday minus the days when I have rugby practices. (yeah I play rugby too and it doesn't bother me at all taking a hit, or giving one, on it or anything). So basically its back to normal again! This was just to sum up my experience with the injury, I never got any surgery just weekly physio and I'm glad that I did!


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## Rickhopper (Aug 8, 2010)

Ok, first time poster. What's up?
Got surgery tomorrow morning to put my shoulder back together.
Yes I mountain bike AND snowboard, but my grade III sep happened on my 22mph electric skateboard, I'm 45 and have been ripping around on this thing for 9 years with zero falls. I broke two of just three rules on Wednesday. Rule #1 Helmet(always), rule 
#2 No flip flops(broke that one), and rule #3 keep your eye on the next 30 feet of road(Oops). False confidence in a smooth familiar stretch of road that grew a new pot-hole. 

Thanks to everyone who has taken the time to toot thier experiences. I have opted for the surgery and I'm gonna be somewhat of a guinnypig with some new technology. I guess they drill holes through the clavical and the acromi, thread this synthetic material through both, attach to a button underneath, draw them together like rethreading a broken baseball mit, and put a button on top. This method requires no second surgery to remove hardware and is done out-patient. I will keep all you crazies posted on the result.
Wish me luck, never been under the knife.


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## sooner518 (Aug 1, 2007)

Rickhopper said:


> Thanks to everyone who has taken the time to toot thier experiences. I have opted for the surgery and I'm gonna be somewhat of a guinnypig with some new technology. I guess they drill holes through the clavical and the acromi, thread this synthetic material through both, attach to a button underneath, draw them together like rethreading a broken baseball mit, and put a button on top. This method requires no second surgery to remove hardware and is done out-patient. I will keep all you crazies posted on the result.
> Wish me luck, never been under the knife.


That sounds really familiar to the surgery my friend had for an AC seperation about 2 years ago. Not to freak you out, but it was unsucessful (I think the material tore or something) and he ended up having to have a 2nd surgery with a plate and screws about 2 months later. After the first surgery, his doc seemed kind of ambivalent about him riding and told him he could ride a road bike like 2-3 weeks after surgery and if he coul stand the pain, mountain a few weeks after that, which he only did once, although he did ride his road bike alot around town.

long story short, he had to have the 2nd surgery and went through alot more extensive rehab and this time, the doc said absolutely no bikes for like 3 months. im not really sure what exactly went wrong the first time.... anyhow, good luck and dont push it too soon!


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## Noclutch (Jun 20, 2010)

25 years ago I went OTB big time on a dirt bike, grade 3 A-C I think. Had a sx where they tighened everything up with suture materials, cut the end of the clavicle off, ran basically a big ole lag screw through a hole drilled in the acromion and into the cut end of the clavicle. THE POST OP PAIN WAS AWFUL for the first couple of weeks :eekster: It was much better for the following couple of months and even the GF had to be on top for this period, and even that was sorta uncomfortable, but I was OK with that LOL :thumbsup: 
So after 2 or 3 months? the screw was removed, a short period of light home unstructured rehab, and was back to racing HS within a couple of months. Everything is hunkey dory at this juncture, racing all this time and take my share of get-offs and no further pain. Got a lump- who cares- no pain and only very minor decreased range of motion( can't reach my left shoulder blade with my right hand like the other side)

Part of my decision to have sx when I maybe could have avoided it- and this is the take home message- as my doctor explained, is that you can not have arthritis if there is no "arth", no joint= no arthritis, which I have none of. Something to consider for those on the fence about sx.... YMMV


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## mo0se (Jul 31, 2006)

Those suck... had my share.. twice!!


__
Sensitive content, not recommended for those under 18
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## RollerCoasterVictim (Aug 27, 2010)

I just wanted to say thank you so much for sharing your experiences guys! Joined for this thread only. Had a grade 3 on my left shoulder about a month ago at Hafjell Bikepark here in Norway. I thought "Oh well, they´ll fix me up" but my to my surprise the doctors took a bunch of x-rays and sent me home. With less than no information I´m sitting here contemplating having to sell my Intense M6 and dropping out of twin-tip skiing because of this injury.

I don´t have much pain, but I do get some lightening bolts through my shoulder from time to time when I stretch or when I try to open/close the car door. Had some really bad cramps in my shoulder muscles that hurt like Hell, but thankfully they´re gone now.

I am amazed that this is it.... That the doctors go "Well, that´s life, we don´t advice you to operate but to make the best out of it..." After all the garish accidents I´ve seen my friends go through, with broken bones and crap like that ... I wasn´t expecting to be told that I was going to have a bone pushing against the skin on my shoulder for the rest of my life. It´s not the cosmetic part that is my issue, but the fact that I have a "rogue" bone in my body and that anything I wear rubs against it and keep it sore. I´m a skinny guy so the bump is pretty visual. Showed it to a female co-worker and she had to sit down 

But what do you guys recon. Is a AC degree 3 damage a career ender or what? Did you just recover and jump back on the horse?

Thanks again for all the good info!


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## Blurr (Dec 7, 2009)

almost 9 mos since I had My accident, have no Idea the grade as after reading this thread i never bothered to go to the doctor until a month later, I had the classic bump and it felt loose, but it just stayed sore, I nursed it and used it a bit more and more, month later when I went in the doc said it looked good and to let pain be my guide, No bump any longer and Seems fine so far *knocking on wood*


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## Rickhopper (Aug 8, 2010)

Hey Roller Coaster,
My grade III separation happened on 8/4/10, my surgeon went in and cabled me back together on 8/9/10. The pain prior to the surgery was manageable with some ibuprofin, but the post operation pain was indescribable for 4-5 days, today all I do is ice it a couple times a day. 
My shoulder is right back where it was before my accident. Doctor says everything will re-attach if I follow through with his orders.
Doctors orders after reconstruction: Keep shoulder strapped to side of body, let gravity make it fall away from your body only to dry after shower and to apply deoderant, no lifting, reaching or swinging that arm for 6 weeks. After which I can start therapy. Don't know what that entails yet, my six weeks aren't up till the begining of Oct.
The repair itself included a four inch/15 staple opening on top of my shoulder, a couple holes in bones, a cable with a hook on bottom and a button on top. Pretty cool.
Any body that says they had anything worse than a grade III, have your doctor call my surgeon who has been doing this for decades. 
I will let you know how things are progressing, I can't wait to get back in my kayak and on my surfboard. Yippy Kayay!!


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## Scrub (Feb 3, 2004)

Well I had my surgery in March but it didn't end up as well as the Dr. said it would. The wires came loose and the rods ended up coming loose and didn't hold anything in place. Total waste of 6 months, now doing PT. My county hospital sucks, thats what happens when you don't have insurance.:madman:

I only had the x-rays done at Sierra the closest ER near downieville, surgery back in the bay area


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## jcufari (Jun 20, 2008)

i had a stage II separation in 05 and my shoulder aches a lot. Probably because I was playing college lacrosse at the time and did not let it heal right. I am pretty sure there is some arthritis going on in there now. I still don't sleep on the injured shoulder as it will ache in the am. The shoulder also tires very slowly when throwing objects for a period of time.


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## acctnut (Dec 1, 2008)

*picture of my step pre op*

This was 5 years ago. General practitioner called it a grade 2 and the surgeon called it a definite 5. Looks normal now, but will always be kinda "crusty", especially when a low pressure system moves into town. This is road rash and I got thrown head on into a car while going downhill. Hence, it is pretty ugly. Paid for my masters degree, tax free, and I got a couple bottles of vicodin. Fun times! Biggest bummer is I'll never surf like I used to. Way to crusty and awkward paddling, kinda burns. Doesn't affect riding a bike at all though.


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## Rickhopper (Aug 8, 2010)

Looks like that damn tape tearing your skin from the bandage was the worst part, just kidding. I will keep you all posted. I have a feeling that if my surgery works out, my doctor is going to get a lot of business. Keeping my fingers crossed and my arm strapped down.
By the way, that could be my x-ray, my incision, and I will be praying for all of us.


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## dm1333 (Jun 27, 2010)

> How can you live without any surgery after this accident ? I had this too, AC 3, and i´m very happy that i had a operation. My shoulder looks better,i feel better and i think that i´m in balance with my shoulder.The doc told me that i can live with this accident without surgery, but i have to workout my shoulder until the rest of my life to get no osteoarthritis ?


I had my ACIII back in 1988, surgically speaking they were still dancing around fires and painting on cave walls. Faced with a huge scar on my shoulder from a Navy doc or taking my chances with just physical therapy I took the PT and never regretted it. I do have arthritis and I don't bench press much (push ups and dips instead) and I still don't sleep on my left side but everything else is good. If I hurt it again today I would probably opt for surgery. A co worker had it, tiny little scar, good drugs and much better surgical techiques sort of made it a no brainer.


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## Minimalist (Apr 14, 2006)

About 4 years ago I had a type III separation. The doctor told me, surgery may or may not be successful. He also told me that there is no conclusive evidence that arthritis (if developed) is coming from the bone rubbing against skin or the actual accident. Finally the doc said, if I develop any problems that there are ways to resolve any issues even after years. I opted against surgery and am fine. I can do everything without any issues today.


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## waterdogs (Jun 18, 2010)

Man, there is a lot of this going around. Here's my wife's Grade 4 from Aug 19, fixed on Aug 26. I don't have pics of the staples as it's under the bandage. I'll take a pic of it on Fri when she gets them pulled.


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## BetterRide (Apr 6, 2004)

RollerCoasterVictim said:


> I
> 
> But what do you guys recon. Is a AC degree 3 damage a career ender or what? Did you just recover and jump back on the horse?
> 
> Thanks again for all the good info!


No! Both my shoulders have 3rd Degree AC separations and I still race downhill at 44! They do take a while to feel good though.


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## waterdogs (Jun 18, 2010)

BetterRide said:


> They do take a while to feel good though.


@ BetterRide.... How long is that? So my wife knows what to expect.


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## mdwamp (Jun 10, 2010)

NoWake said:


> I did a grade 3 a little over a year ago. It's still not 100% and I'm sure it never will be. I followed the PT religiously and didn't ride for probably 6-8 weeks. It still feels like it's going to pop out whenever I get knocked forward on the bike or over 300 lbs on the bench etc. All of my workout symmetry is out of whack.
> 
> At this point I'm really thinking I should have went against the ortho's recommendation and did the surgery...I'd take a scar and 95% over a big bump and 80%. I don't see how a Dr can say you'll be 100% when your whole shoulder geometry is out of line...
> Of course, drilling a couple of holes in my shoulder and tying it together with a peice of my hamstring didn't sound that great either
> ...


I smashed my shoulder on July 20th of this year. Here is the xray:










I had surgery on August 10th. My doc feels that with this type of repair, I will have a better chance at a full recovery. I start therapy in two weeks. Here is a xray of the repair:










I have to return in approximately 6 months to have the plate/hook removed.

I haven't been on my bike since and it's killing me. He talked like the recovery time is considerable, but wouldn't give an estimate. I'm surprised that it's taking so long for the pain to subside.


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## BetterRide (Apr 6, 2004)

waterdogs said:


> @ BetterRide.... How long is that? So my wife knows what to expect.


 I think it depends on your age, how healthy you are and your pain threshold. I was 21 when I separated my left shoulder and I was snowboarding 5 days later (but in pain) I was 32 when I separated my right (dominate arm) shoulder and it took 2 months before I could ride mellow trails comfortably. Hopefully yours starts to feel better in less time.


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## Simonns (Mar 25, 2004)

RollerCoasterVictim said:


> I just wanted to say thank you so much for sharing your experiences guys! Joined for this thread only. Had a grade 3 on my left shoulder about a month ago at Hafjell Bikepark here in Norway. I thought "Oh well, they´ll fix me up" but my to my surprise the doctors took a bunch of x-rays and sent me home. With less than no information I´m sitting here contemplating having to sell my Intense M6 and dropping out of twin-tip skiing because of this injury.
> 
> I don´t have much pain, but I do get some lightening bolts through my shoulder from time to time when I stretch or when I try to open/close the car door. Had some really bad cramps in my shoulder muscles that hurt like Hell, but thankfully they´re gone now.
> 
> ...


Two grade III here as well, no surgery on either of them.. I'm riding more than ever, no pain, a little popping here and there.


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## waterdogs (Jun 18, 2010)

Just from my wife's personal experience, be a little careful on the Grade 3 decision not to do anything. The Doc said that the Xray told him that it was a 3 and gave us the option of doing nothing or fixing it properly. She decided to let him work his magic. When she came out of surgery, I told me it was actually a 4 in his opinion as the clavical (sp?) was pushed back in to the muscle and would have caused more problems long term. Just food for thought based on our experience.


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## NotQuiteClimbing (Jul 26, 2010)

I had a grade 3 about 4 years ago from a skiing accident. They said it was a "classic" example of a grade 3 that didn't require surgery. I ended up doing some PT and I was back rock climbing in 50-60 days. It was before I rode. I don't have any long term pain or anything else besides the bump of pride/shame. My wife and daughter both call it the alien that lives on my shoulder.


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## dagmz6s (Sep 25, 2007)

Ok I guess I will play this game. I am just under 2 weeks into my injury time out, suffered a Grade III AC Separation on my left shoulder practicing for a DH race. Pain at the time was incredible but I somehow managed to drive myself 60 miles home and then to the ER. Xray didnt look good at all, first they thought my collarbone was broken then someone said my AC was separated. Orthopoedist confirmed a Grade III about 3 days later.

The doc I saw is the team ortho doc for the 76ers. We went through the option of tightrope surgery or no surgery. I had already done a significant amount of reading prior to my appointment so I knew that if surgery wasnt necessary I wasnt going down that road. He said I could do either but that he has only had one tightrope where the clavical didnt move at all afterward and that studies have shown that Grade III's have just as much a chance of full recovery with or without the surgery. Since its my left arm and I am right handed, he agreed with me that he wouldnt do it unless I wanted to for cosmetic reasons. I can live with a bump on my shoulder, I named it Kuatto. I am seeing him in about 2 weeks, at that time he'll assign me to PT. He told me to get out of the sling as soon as I could handle it.

About a week into the injury, I was able to take my arm out of the sling. Today I have the sling with me but I am not wearing it at work. The pain is gone, certain movements do feel uncomfortable but not painful. My shoulder feels weak but I can tell the strength is coming back every day, ROM will take a while since I can tell there is some decent scar tissue buildup already that will have to get broken down. I am hopeful that I'll make a full recovery and be back on the DH bike in about 5-6 weeks, just in time to race the last race of the season and try to hold my top spot in the series overall.


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## charging_rhinos (Jul 29, 2008)

just did mine two weeks ago. Grade 3 and my collarbone was sticking up a full 2 inches above the rest of my shoulder. It's a bit gross to have to push your won bones back into place, but it felt a lot better after I did. 

Anyway, it's healing surprisingly fast, although I'm sure it feels better than it actually is internally. Going to get in the pool next week for some very light stretching and a bit of muscle work, but overall, things are going rather well. 

just ordered an EVS SB04 shoulder brace to help things along a bit too. Should be here soon


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## dagmz6s (Sep 25, 2007)

charging_rhinos said:


> just ordered an EVS SB04 shoulder brace to help things along a bit too. Should be here soon


Let me know what you think of the SB04. I have been researching tons of different products and need to pick something that I will run for DH. The SB04 looks good but I am concerned that it'll need a supplemental pad for the AC area.


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## chas_martel (May 14, 2006)

zon said:


> So I will never be 100%. That sucks.


Yes it does suck. I had an Grade III AC Separation 2.5 years ago and my shoulder has never been the same. 4 months after the injury it felt fine, fast forward a couple of years and
the pain is back as well as this funny disconnected feeling in my shoulder.

Crap, I sure don't want surgery. Hope you get better soon.


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## RollerCoasterVictim (Aug 27, 2010)

Same here! The SB04 looks very interesting. But the thing is that I have no idea how this brace+shoulder bump will work with my Dainese armor. Just the thought of the armour rubbing against the bump gives me the chills.

Still it looks way more promising than the other "Robocop" versions. 

Please do give us your thoughts on the SB04 if you can 

Regards


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## Scottwax (Jan 18, 2009)

Thought I'd share my grade 3 AC separation story, which occured on May 9th this year. I'm a roadie, not an MTB'er (found your forum while searching for lights for night riding) and was involved in a head on collision with another cyclist at a local park. I was pulling off the front of a paceline when a guy on an cruiser type bike came around a curve wide left towards me, leaning on his handlebars, not paying attention. Several of us yelled and I hit the brakes, he never seemed to see us until he nearly hit the guy in front of me, then slammed into me handlebar to handlebar. I had slowed from 23 to maybe 15 or so, he was probably going the same speed. The impact was hard enough to completely break the top tube of my aluminum bike and severely bend my downtube and I fell over on my right shoulder. The other guy kind of laid there for a few minutes muttering something about not riding without a helmet again, then while everyone was tending to me and the huge lump in my shoulder, he got on his bike and road off. 

Anyway, my son meets me at the park and loads my broken bike and me into his car and takes me to the emergency room. The doctor comes in after the x-rays to tell me I have a grade 3 shoulder separation and gives me a sling. Prescribes hydrocodone for the pain and ibuprofen and ice packs for the swelling. First few days (especially the day after) were pretty uncomfortable. I was able to drive my car (6 speed manual) after two days but had to use my left hand to put it in reverse. Decided to wait longer to do that again. I kept my arm in the sling (and developed a nasty under arm rash...) and the ibuprofen/ice pack regiment up. At the ER doctor's recommendation, I made an appointment with an orthopedic sports specialist in Irving (TX) at a center that treats many of the Dallas area pro athletes. 

I went this past Tuesday (May 17) and met with the specialist. He took some x-rays and noted my range of motion (I was able to raise my arm level with my shoulder) and my grip to access muscle strength. I'm not the typical 130 pound zero upper body mass roadie, I did a lot of lifting when I was younger and he said that helped limit the severity of the bone movement. His x-rays showed the collar bone had dropped significantly in relation to the x-rays on the evening of the accident. He then said it would be best for me to simply to ditch the sling and go back to my normal routine as the pain allows. While he would love to do the surgery on my shoulder (says it is his favorite operation), he didn't feel I would gain any additional strength or mobility with surgery and my recovery would take longer. 3 days now since that appointment and my range of motion has definitely improved and the pain has noticeably lessened. My son said the bump is barely noticeable now and both shoulders are at the same height. 

I hope to be back working on Monday (I have a detailing business, hence my user name) and I think the motions of washing, buffing and waxing cars will provide some pretty good PT for my shoulder. I already have a new frame for my bike and plan on swapping everything off my old bike to the new frame sometime late next week-don't want to put it together too quick because then I know I will be riding it then  

I go back for a follow up in the middle of June, I'll post how that appointment goes and what my progress is. FWIW, I'll be 50 in a few weeks.


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## Scottwax (Jan 18, 2009)

Just an update. I haven't been back to the specialist yet (next week, I guess) but my range of motion almost 5 weeks after the injury is pretty good. No problems raising my arm over my head or supporting my weight as I lean across cars (like I said, I'm a car detailer) or using my buffers. Still have some pain that mostly occurs when sitting down, typing, using the mouse or eating right handed. It is lessened if I maintain good posture and slumping over a bit makes it worse. Has anyone else experienced this? Otherwise I am about 95% pain free at this point.


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## RollerCoasterVictim (Aug 27, 2010)

Thanks for the update Scottwax! I smashed my shoulder in august 2010 and suffered a grade three. Now I have no pain, but it feels like my shoulder/arm is slightly tired like after the first day of skiing. I haven´t touched my downhill bike since my accident. It is all in my head, I know that, but I have to trust my own body before I drop in again. I get some pain now and then. It feels like when you have used your ok arm and carried a heavy bag of groceries. The bump on my shoulder is highly visible, but it looks worse after heavy carrying. But the summary is: Mor or less no pain, 90% power, visible bump, phsycological issues regarding the accident. Else everything is ok. 

I have been told NOT to do surgery, BUT I was told that if I started to experience pain there was a spanking new procedure they could do. It was all about harvesting ligaments from the back of the knees and using them to tie the shoulder back down... Not sure about that one... happy for now!

Oh! And also, my insurance payed out 8060 usd  Told my girlfriend I was going to buy a new downhill bike. She told me to go to Hell and stay there... 

The best of luck with your shoulder! I guess the best thing is that we are not suffering from too much pain as this is for life or untill they start harvesting ligaments from stem cells or something 

Happy trails!


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## Scottwax (Jan 18, 2009)

Good to hear you are doing better. I still have some occasional soreness, usually if I buff more than 1 car in a day but it is more of a temporary dull ache than anything really bothersome. No problems on my road bike. Got back on my bike on June 14th, put 2500 miles on my bike since.


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## PretendGentleman (May 24, 2011)

I have a grade 3 separated right and grade 2 separated left. I've had no surgeries and I feel fine. I can say that its important to stay in good shape so your muscles compensate where the ligaments left off.


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## caskifun1230 (Oct 2, 2011)

ScottWax, I have the soreness/knots in neck to back of shoulder when sitting at computer. Did this diminsh over time with you?


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## caskifun1230 (Oct 2, 2011)

Waterdogs, How long did your wife wait before deciding to do surgery? Did she do PT at first?


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## Admiral97 (Dec 31, 2011)

Scottwax,
Did you have numbness and tingling in your hand? Did it ever go away? I have a grade two i think.


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## givati (Dec 5, 2011)

I had a grade 2 in Oct. 2010 I was feeling fine after the initial healing process and then last week without doing anything I started having pain and way less mobility. The pain feels like a nerve. I'm a bit worried. I don't want surgery! Anyone try massage? 

What the hell? Anyone?


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## Scottwax (Jan 18, 2009)

No numbness or tingling that I remember. 

Still have some minor soreness if I sleep in my right side or lift something heavy with my right arm. However, bench pressing, rows, lat pulldowns, flys and triceps extensions don't cause me any pain.


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## trouble0613 (Jan 8, 2012)

If your injury is anything like mine was, you're going to be hurting from it for a long time. I was back on my bike after 7 weeks but wasn't able to do hard riding for 12. 9 months later, if I push too hard, I hurt for days- that includes non-biking activities. I didn't have the $$$ to do what was recommended to me by the surgeon which was massage therapy on the area after the initial healing phase. Good luck to you and your healing!


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## Scottwax (Jan 18, 2009)

I don't hurt for days when I overwork my shoulder, more like a few minutes. What is weird is about the 15-20 mile mark on my road bike I feel some soreness in the shoulder, but after 20 miles or so, it goes away. Just that 5 mile window. Go figure. The specialist didn't mention any need for massage therapy, he just said to get my arm out of the sling and use it as much as the level of pain would allow. Hard part was sleeping upright for about a month and on my back for another few months. Now as long as I keep a pillow under my right arm, I can sleep on my stomach. Sucks that it seems I will have to make at least some allowances for my shoulder for quite some time. 

I'm just glad I was able to get more or less back to work after a couple weeks. I have a mobile detailing business and when I don't work, I don't make money. That was part of the reason I didn't opt for surgery, probably would have missed 4-6 weeks of work instead of about 15 days. Cosmetically, the lump isn't too noticeable, I did a lot of weightlifting when I was younger so I have enough muscle mass to mostly hide it.


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## Scottwax (Jan 18, 2009)

Yes, haven't noticed it in a long time.


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## PretendGentleman (May 24, 2011)

trouble0613 said:


> If your injury is anything like mine was, you're going to be hurting from it for a long time. I was back on my bike after 7 weeks but wasn't able to do hard riding for 12. 9 months later, if I push too hard, I hurt for days- that includes non-biking activities. I didn't have the $$$ to do what was recommended to me by the surgeon which was massage therapy on the area after the initial healing phase. Good luck to you and your healing!


wow, that's terrible and totally different from my experience. I won a pull-up contest(~20) while drunk at my buddy's wedding reception no more than a month after my own grade 3. Full bunny hops were possible within 6 weeks of the injury. Pretty much the same recovery time was required for my grade 2 a year later.

The only thing that persisted is minor weakness doing dips (i.e. the triceps exercise).


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## Scottwax (Jan 18, 2009)

Its been a year and 7 months now. Seems to be close to 100% recovered. No problems throwing a baseball or football, can swing a bat at full speed without any issues. Slight decrease in range of motion when reaching across my body (compared to my other arm), but nothing that remotely inhibits me. I can now sleep in any position, no longer have to keep a pillow under my right arm. Still some occasional tightness but no pain. Really glad so far I didn't have surgery.


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## Joe-it-all (Apr 6, 2004)

^this
I did mine early Aug '12, was back on the mt bike mid sept. Extending the front end for drops or rollers was dicey the first week or two. It's all good now and generally wouldn't even know I did anything except for the nub sticking up.


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## Coleman87 (Jan 21, 2013)

Scottwax said:


> Its been a year and 7 months now. Seems to be close to 100% recovered. No problems throwing a baseball or football, can swing a bat at full speed without any issues. Slight decrease in range of motion when reaching across my body (compared to my other arm), but nothing that remotely inhibits me. I can now sleep in any position, no longer have to keep a pillow under my right arm. Still some occasional tightness but no pain. Really glad so far I didn't have surgery.


Hello Scottwax/all,

I write to you from Spain and the thing is that a couple of weeks ago I made and AC dislocation grade 3. Out of 6 traumatologist 4 recommended conservative treatment so thats what I am doing. I am quite scared because the gym is my world. I cant stand the idea of not being able of lifting as before. From what I see Scottwax, now you are 100% recovered and can lift with the same intensity and strenght as before. What was your recovery process? Would you recommend me surgery? Do you think I will be able to lift as before? How long were you out of the gym?

Thank you everyone


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## Coleman87 (Jan 21, 2013)

Sorry I wanted to send a PM


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## Scottwax (Jan 18, 2009)

Coleman87 said:


> Hello Scottwax/all,
> 
> I write to you from Spain and the thing is that a couple of weeks ago I made and AC dislocation grade 3. Out of 6 traumatologist 4 recommended conservative treatment so thats what I am doing. I am quite scared because the gym is my world. I cant stand the idea of not being able of lifting as before. From what I see Scottwax, now you are 100% recovered and can lift with the same intensity and strenght as before. What was your recovery process? Would you recommend me surgery? Do you think I will be able to lift as before? How long were you out of the gym?
> 
> Thank you everyone


Really late reply, I road bike so I don't check this forum too often...although that will be changing as I plan on getting an MTB to ride in the winter, need to mix things up. All my roadie friends switch to MTBs in the winter and riding solo when its in the 40s and 50s sucks when you're alone.

I didn't really do anything, just went back to my normal activities as the pain would allow. It was 6 months or so before I did any lifting, biggest issue was when I was holding something heavy in my right hand, I could feel a pulling sensation in my shoulder, so I made it a point to carry heavy groceries (go through a ton of Powerade Zero this time of year) in my right hand, after a few more months, no problems carrying really heavy stuff now. I don't do that much lifting, got a lot of size left over from when I did and on the bike, bulk is the enemy so most of my upper body workout is detailing cars in my business.

At the point, I am glad I didn't have surgery. I have the same range of motion on both shoulders now, strength seems equal in both. Even after several months, I felt something like bar dips would be out of the question but I've tried a few, no pain at all, no unusual movement in the shoulder. Even without a shirt on, its very hard to tell I had the separation the lump is so small. The size of my traps help too.


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## generate (Jun 20, 2009)

Gonna add to this...
I injured myself just last week. Today I had my follow up with an orthopedist. He said that I have a higher end grade 3 separation. He said that I am in a grey area and that I need to decide whether or not to get the surgery. As soon as I mentioned that I race bikes, he recommended the surgery. 

Its weird because I'm not in all that much pain. I can rotate my arm but certain movements or lifting anything will aggravate it. I hope I'm making the right choice. He also said that if I decide to do surgery, we need to do it asap. I'm going in tomorrow! I just want to be back on the bike without any issues after recovery.


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## PretendGentleman (May 24, 2011)

generate said:


> Gonna add to this...
> I injured myself just last week. Today I had my follow up with an orthopedist. He said that I have a higher end grade 3 separation. He said that I am in a grey area and that I need to decide whether or not to get the surgery. As soon as I mentioned that I race bikes, he recommended the surgery.
> 
> Its weird because I'm not in all that much pain. I can rotate my arm but certain movements or lifting anything will aggravate it. I hope I'm making the right choice. He also said that if I decide to do surgery, we need to do it asap. I'm going in tomorrow! I just want to be back on the bike without any issues after recovery.


higher end means it's about to cost you more. It sounds like a crock to me. Is he the one who will benefit financially from the surgery or is he sending you to someone with whom he's unlikely to have a substantial affiliation?

Higher grades of AC separation typically include severe deformations such as your clavicle being displaced. If you just have the usual notch in your shoulder (both of mine are separated) though it may be too swollen still to really tell, then the majority of current medical advice is that you don't get surgery. I would ice it and do ample physical therapy and you'll be back riding soon.


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## Scottwax (Jan 18, 2009)

Agree completely. 2 years out and I'm fully back to normal without surgery. And I was in a lot of pain the first few weeks, couldn't even reach down to tie my shoes for about 3 weeks. I was also told by the specialist I saw that incidents of arthritis are lower without the surgery than with. 

I'm not a doctor and have no idea what a more severe grade 3 would be, but I was told most insurance companies consider it an aggressive form of treatment.


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## desertred (Jun 9, 2010)

I suffered a high grade II separation in June on my road bike (that will teach me to stay on the dirt). Doc stated that it usually takes 3 months to heel and about three months to get back to full strength. I seemed to complete the healing process a bit more quickly, as I had full movement and rotation by the end of two months. Strengthening the shoulder is taking longer than I would like, but work has kept me from exercising it as consistently as I would like. I have a pronounced bump on my shoulder from the protruding end of my clavicle.

As far as addressing the OP's original question, I was back on my mtb at the end of the second month, sticking to the easiest trails to keep fall potential to a minimum. I still haven't started to ride the most difficult trails yet, still fearing a fall on the shoulder, as I know its not strong enough yet to take another hit. Still have yet to get back on the road bike.


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## generate (Jun 20, 2009)

In regards to my original post, by saying "high grade 3", he basically meant that it was almost a grade 4. He said that if it were a grade 4 then surgery would be necessary but it my case I could still make a decision.

I did go through with the surgery a week ago. Doc also found that I had tore my labrum as well and he fixed that. First couple days were hell, but I am currently off pain meds and starting to get a full nights sleep. Overall I feel really good. When I take the sling off just to stretch my arm out and do pendulum exercises, it feels solid. I can move around without pain. I'm taking it really easy on it until my follow up appointment next week.

Typically I heal up quicker than normal, even at 37. I've been riding my trainer (no handed and gingerly) since the day I got out of surgery. I'm glad this happened now instead if the middle of spring or summer, but it sucks either way. I race all year (road, track, mtb and CX) so I'm hoping to be able to recover enough to start winter training in a couple months. 

Another thing is supplementation. Not sure what you guys are into but I've always believed in the supplements I use. I've gone through a lot of trial and error over the years. Some of the things I have been taking to aid recovery are Vit d, fish oil, Protein powder, Collagen protein, and L-glutamine. Also eating higher fat/protein and cutting back my carbs a lot since I'm not training. I'm trying not to be 20lbs heavier when I get back on the bike!

I'll try to update here as things progress.


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## Dr Wade (Feb 11, 2015)

First of all, Very thankful to everyone who contributed to this thread. It has been really helpful to me. I am a Chiropractor working in Veitnam, and an avid mountain Biker. LatelyI have started training for an ironman. Bought my first road bike, carbon Cannonade, on Saturday, 4 days ago. at 51 years old, have never ridden a road bike, but figured since i was an expert mountain biker, Road bike would be a peace of cake. Wow was i wrong. Long story short, I also now have a grade 3 AC dislocation on my left shoulder, and some poor Vientiane fellow has a large dent in the rear Panel of his
white Mercedes. 

have talked to three orthopedic surgeons, who i trust, and after reading this post, I am going to try to manage the injury conservatively. My other Chiropractor has been K taping it several times a day, and have been getting Class 4 laser treatment and gentle physiotherapy an chiropractic care in my clinic hourly. after 3 days, i don’t seem to need the sling, and full passive range of motion, but can only lift a little in any direction using my own Strength. Laser seems to really help remarkably with the pain. I have spent 10 hours reading case studies and journals on the net, and even being a doctor myself, it has taken a few days to get my head around what would be the best course of action. 

Two of the surgeons offered various procedures, but also gave the opinion that It was probably just as good of an idea to avoid the surgery. all three recommended against the tight rope procedure in an active athlete. I will post my outcome in a few weeks, in case it is useful to anyone. 

thanks again.


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## Mike123456 (May 14, 2013)

I had a grade 3. Rested for 12 weeks and am fine. Fell last week and landed on same shoulder again, but luckily to repeat injury. Rest. Always avoid surgery if that's an option.


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## Mr.Wizard (Feb 4, 2015)

Hooked a root last night and went down hard.
After a long night in ER, found out I have a grade 3 separation.
Dang, it was really an epic ride.
I'm in my 60's, appointment with Doctors Monday.....:madman:


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## Burt4x4 (Feb 21, 2013)

^^Whiskey & Time is all you need! Welcome to the "bump" club!
RIDE!!!!!!!!!!!!!!!!


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## Mr.Wizard (Feb 4, 2015)

Burt4x4 said:


> ^^Whiskey & Time is all you need! Welcome to the "bump" club!
> RIDE!!!!!!!!!!!!!!!!


Amen...


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## BeanMan (Jul 6, 2006)

Grade 3 here. Use it to your advantage. I told my Wife I couldn't scrub my back in the shower because of it and got her in the shower with me  6 to 8 weeks for recovery.


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## Burt4x4 (Feb 21, 2013)

^^ Brilliant LOL


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## GaryPitts (Feb 23, 2011)

*Ugly*

Great thread and good read for those subsequently injured (like me ). Post crash 4 months, the worst thing is how it looks. My separation is a full bone width from its original position. If my arm is held back, it looks like a bump. If held forward, the whole freaking bone sticks up and looks gnarly. It catches on the seat belt all of the time (left shoulder). I'm holding off on any surgery until next spring which will be a year from the crash. I've heard both negative and positive surgery experiences, so I'm a bit leery. You can't undo surgery  I don't know why the pic is sideways or how to fix it. Sorry...

__
Sensitive content, not recommended for those under 18
Show Content


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## GaryPitts (Feb 23, 2011)

P.S. Those that say it takes 3 months to heal are wrong. I'm at 5+ months now. Sleeping on that side is still a problem. Even moderate activity with my left arm can result in significant pain the day and 2nd day after. I'm still wanting to wait a year before deciding on surgery, although it seems my shoulder is dropping making the bone stick up further looking worse than a couple of months ago. I sure wish this had never happened


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## roadracerX (Apr 21, 2011)

Hang in there, it gets better. I got my grade 3 back in 2002. It was rough for a while but I was racing my motorcycle again months later without surgery. As soon as the doc told me it was ok to resume normal activities I started to work on building up the muscle around it. The first pushup almost made me cry but I kept at it.

I had the same problem years later that I couldnt sleep on that shoulder but it barely sticks up now and never bothers me anymore.


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## GaryPitts (Feb 23, 2011)

I appreciate your words on encouragement roadracerX. I'm in my 60s and 14 years from now I'll likely be dead  I didn't take real good care of myself in my younger years. Ha! My slogan has become, 'it could always be worse' and that is so true. 

On a non-related note, I've not been able to ride much at all for the last 3 years. I went from 600 miles a month average to 20 due to neck pain. After chasing that problem for the last 3 years and having all kinds of treatments that did nothing, I went to an infectious disease doctor last week to be tested for Lyme. I'm really, really, really hoping I have it so it can be fixed and I can get back in the saddle. I miss how I felt riding 4-5k a year. If I can get over that hump, the shoulder will be minor. Like I mentioned earlier, the worst thing is how it looks. Here's hoping!


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