# Grade 5 AC Separation



## mwayne5 (Apr 4, 2009)

Well. i just got back from the Orthopedist a little bit ago and the two guys that were looking at my injury said that I have a grade five AC separation. All I have right now is an external pic of my shoulder, I'll try to get the x-rays some other time when the roads aren't a solid slab of ice. So, here's what happened:

A little over a week ago I was dirt jumping with my friends and it was a little muddy out. I was hitting them and doing fine, despite the mud, and decided to go over to a series of jumps that had a bit of mud between each of them. Hit the first one fine but I guess I lost too much speed between the first and second jump because I came up a little short on the landing...damn mud slowin me down. My front wheel hit the lip and there I went. The landing started about five feet of the ground so add that to the height of the bike and the angle I was at, I went a ways. Landed straight on my right shoulder and apparently hit something across my face because I had a bruise that stretched my entire brow line over to my right ear. I have to go into surgery here in a week or so then it's about another month in my sling then another four in a brace...bummer dude. The good thing I will be out in time for collegiate race season. I doubt I'll be in shape enough to fully compete, so I'm just going to go have fun, it's my senior year, gotta do it.

Has anyone else been out for awhile due to this type of injury? I'm trying to think of a way to keep my legs. Think it would be safe to buy a spinner and use that while in a sling?

-Mitchell


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## joon64 (Jan 20, 2009)

Had the same injury (moto) a few years back. Spinning will be just fine. I'm sure the doc gave you the options- let it heal and you'll have the bone protruding or get some cosmetic surgery to make it look like the other side (with the risk of arthritis). I chose to have the battle scar (bone) there to remind me to ride more sensibly. Healing vibes to you.


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## Lawson Raider (Jul 24, 2006)

Hope you heal up soon!! I only had a level 1 and it sucked... In my situation, 4 years afterwards I still feel an ache once in a while in the area.


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## nicksstorm (Mar 5, 2009)

I had a pretty gnarly wreck last June riding. The orthopedic I went to grades AC seperations 1-3 and I had a 2. He said he wouldn't do surgery, as living with the seperation is pretty normal. I can feel it "float" when bench pressing but other than that its ok. I have a buddy that did the same and he's fine now. Once the muscle heals around the seperation you should be solid. I wouldn't do surgery unless the surgeon insists. Any time you throw some screws in your shoulder/collar bone things take alot longer to heal.
Speedy recovery to ya man! I feel your pain (or at least I did last summer)


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## mwayne5 (Apr 4, 2009)

Thanks guys. Yeah, the Dr. insists on the surgery which will be on the 22nd. I'm going to go see if I can get my x-rays to keep and post them up. I haven't seen the x-rays myself so curiosity is definitely getting to me.

I don't know how well my body will handle riding after this. I accidentally pulled my backpack off the table today and despite all the pain meds I'm on it still hurt like a major b****, so I could only imagine what a drop to flat would feel like on my shoulder. I've been saving to get a nice full squish DH bike but I may change my mind and get a FS 29er. The cross-country riding I do is way less abusive than the DH I ride. I guess we'll see in several months.


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## mxtrainer (Aug 22, 2009)

After surgery and your doctor gives the ok, continue your cardio program while eating correctly. After the healing process reaches a designated level, start a strength program for the rest of your body (legs, core and given the ok from your doctor your uninjured shoulder). It has been documented that working the opposite side of an injury will allow strength to build slightly in the injured area. Again this is with your doctors permission. Make sure to find a good physical therapist to start you on a rehab program when the doctor oks p/t. 
Note: I would suggest that you talk with your ortho prior to surgery and discuss limiting the trauma of the surgery. Many doctors tend to forget this part when performing surgery on athletes.
You will be back,


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## davep (Mar 11, 2005)

mwayne5 said:


> Thanks guys. Yeah, the Dr. insists on the surgery which will be on the 22nd. I'm going to go see if I can get my x-rays to keep and post them up. I haven't seen the x-rays myself so curiosity is definitely getting to me.
> 
> I don't know how well my body will handle riding after this. I accidentally pulled my backpack off the table today and despite all the pain meds I'm on it still hurt like a major b****, so I could only imagine what a drop to flat would feel like on my shoulder. I've been saving to get a nice full squish DH bike but I may change my mind and get a FS 29er. The cross-country riding I do is way less abusive than the DH I ride. I guess we'll see in several months.


I might ask for a second opinion (or go see someone else to confirm). I say this because I had the same injury a few years ago and I thought _for sure _that I would need to have it fixed. I saw two, well respected, sports orthopedic guys and both told me that corrective surgery for this is 'old thought' and that it really was not done or recomended any more. Apparently research showed no benefit to 'fixing' the AC joint (and several down sides). Both said that the _only_ people they wold recomend surgery for are competetive baseball pitchers....

You situation might be completely different...just though you might want to know.

As for pain, the sling helped me a LOT. Without a sling, I could feel all my muscles pulling all the way up to my ear. It felt like my arm was literally getting pulled off. Ice is very helpful as well!!. Took over a year before I could do bench presses with any weight without pain (although I was riding OK in about 10 weeks or so IIRC...)


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## mwayne5 (Apr 4, 2009)

Saw another orthopedist today, he insisted on the surgery as well. He said it's the greatest separation he's seen in a while. What they'll do is make an incision over the end of the clavicle where it's sticking up. Drill some holes and basically tie it down with dead people parts. From there I get moved into an arm brace and keep it immobilized so my body has time to accept the donor tissue and to also allow my own tendons to start doing their thing. He also said that I should wait a full 5-6 months after the surgery to start mountain biking again. Bleh.


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## dballs (Mar 23, 2013)

How did you ever make out with this? I just went over the bars and did a grade 5 on my right shoulder.


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## andy f (Jan 13, 2004)

dballs said:


> How did you ever make out with this? I just went over the bars and did a grade 5 on my right shoulder.


I'd like to hear as well. I have a grade 3 that I'm hoping will head well enough without surgery. My ortho tells me surgery is pretty much mandatory to regain normal function for grades 4-6 but grades 1-3 pretty much always allow normal function without intervention.


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## NJTransplant (Mar 30, 2012)

andy f said:


> I'd like to hear as well. I have a grade 3 that I'm hoping will head well enough without surgery. My ortho tells me surgery is pretty much mandatory to regain normal function for grades 4-6 but grades 1-3 pretty much always allow normal function without intervention.


On two months after grade 3 no surgery. It's painful still but i was riding a month after it happened. Still missing some strength but full ROM etc was back fairly quickly. Sling for a week then "normal" usage without recreating the pain.

I would go against surgery if at all possible.


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## dwnhlldav (Feb 2, 2006)

joon64 said:


> Had the same injury (moto) a few years back. Spinning will be just fine. I'm sure the doc gave you the options- let it heal and you'll have the bone protruding or get some cosmetic surgery to make it look like the other side (with the risk of arthritis). I chose to have the battle scar (bone) there to remind me to ride more sensibly. Healing vibes to you.


With a grade 3 or less, not getting surgery is an option. It's pretty much universally agreed with grade 4+ that surgery is indicated.

I turned a grade 3 into a grade 5 last summer. Had surgery in October. Recovery sucked, but it has been totally worth it. I'm far better off than before surgery. Better off than before the second injury. Listen to the doctor and don't try to push it before they tell you it's okay.

Pick up a cheap sling to wear in the shower. I was in an immobilzer sling 24/7 for 6 weeks. They only time I didn't have it on was to shower and I needed to keep the weight off so we bought a cheap sling for showering. It was worth it. I slept in a recliner for several weeks. Then built a nest out of pillows to keep my self from rolling over in my sleep. I'm a side or stomach sleeper so sleep was difficult to come by. Truth be told, it took me about 6 months before I could sleep through the night without some sort of sleep aid.


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## andy f (Jan 13, 2004)

dwnhlldav said:


> With a grade 3 or less, not getting surgery is an option. It's pretty much universally agreed with grade 4+ that surgery is indicated.
> 
> I turned a grade 3 into a grade 5 last summer. Had surgery in October. Recovery sucked, but it has been totally worth it. I'm far better off than before surgery. Better off than before the second injury. Listen to the doctor and don't try to push it before they tell you it's okay.
> 
> Pick up a cheap sling to wear in the shower. I was in an immobilzer sling 24/7 for 6 weeks. They only time I didn't have it on was to shower and I needed to keep the weight off so we bought a cheap sling for showering. It was worth it. I slept in a recliner for several weeks. Then built a nest out of pillows to keep my self from rolling over in my sleep. I'm a side or stomach sleeper so sleep was difficult to come by. Truth be told, it took me about 6 months before I could sleep through the night without some sort of sleep aid.


How did you turn a grade 3 into a grade 5? I'd like to avoid doing whatever it is that you did.


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## dballs (Mar 23, 2013)

I was in touch with two people in the last week... One who had surgery on a grade three a year ago and wishes he didn't, He says it is still quite painful and one who did a grade 3-5 twenty years ago and is pain free with zero restrictions, He is an athlete...golf, baseball and basketball. 
Many are recommending surgery for my separation but it sounds like a roll of the dice. I feel excellent at 4 weeks after the injury. About 70 percent normal.

In the meantime I love showing people the bone sticking up, watching them recoil, turn around and throw up in a trash can


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## dwnhlldav (Feb 2, 2006)

andy f said:


> How did you turn a grade 3 into a grade 5? I'd like to avoid doing whatever it is that you did.


Crashed on it again. It seemed like a really minor crash with just a small amount of discomfort in my shoulder, but over the following weeks, the joint started slipping at random times. Like, I'd hold out my arm to hand my wife something as lite as my phone and the clavicle would slip up and over the scapula then pop back into place. Hurt as bad as dislocating my shoulder. It would also randomly do slip out of place while I was riding and I almost crashed on more than one occasion because I lost all strength in my arm when it did that.


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## mwayne5 (Apr 4, 2009)

Well, I'm digging up this old thread. After recovering from my surgery I tried and tried to get back in to mountain biking. My shoulder just couldn't take the abuse and would be throbbing within 30 minutes or so into my ride, so I fell out of biking for years. My bike just sat in the garage and I pondered the idea of selling it, but couldn't because of the passion and memories I had for riding went that deep. Well, I've decided to fix my bike up to trail readiness: new brakes, shifters, derailleurs, and cables. Everything else seems to be functioning fine. I've been in the gym slowly working up the strength in my shoulder to I could cope with the abuse of trail riding again. Season is ending soon, but the parts are on the way. Hopefully I'll get a few rides in. It's damn good to be back.


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## soulshaker (Sep 23, 2013)

I'm about 8 weeks into recovery from surgery to repair a Grade V separation. I started riding on flat, smooth bike paths a couple of days ago and it is tolerable. No way I could be riding off road yet. Still a lot of stiffness and and discomfort. Hope continued PT helps to get back. Good luck with your plan!


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## dballs (Mar 23, 2013)

Following up on a Grade 5 that happened six years ago. I did intense physical therapy at the recommendation of the doc and it is now fine, it was unbelievably hard to do but worth it. Separation started at a 5 and reduced to a 3 after therapy. 

To date I have 0 restrictions and would say the shoulder is at 97%. I am very physically active and have full range of motion. From what I have read and what the doc said, resuming life as usual after the doc clears you helps keep it in working order. Don't go easy on it, push through the pain. Half of it was mental and thinking it was weaker without the ligaments attached. I resumed Biking, splitting fire wood, chainsawing, doing drywall, heavy mechanical work, overhead work and everything you can think of right away. 

The first doc I saw wanted to schedule surgery as soon as I walked in, went for a second opinion and he said no surgery, went for a tie breaker third opinion and he said NO surgery. The last Dr said plow through the pain with physical therapy and you will be good to go.

It took a good 8-12 months before it felt like normal. Couldn't sleep on that side for that long either. Started therapy 2-3 weeks after injury I believe. 

Just looking through old pics to help remember timeline and injury happened 7/6/13. Went on my Honeymoon 7/9/13 in a sling Haha. Completely gutted and remodeled our kitchen by myself starting 8/29/13, that included ripping up 3 layers of floor with a pry-bar, removing cabinets, hanging drywall overhead and all that goes along with a remodel.

Good luck with anyone who has an injury, get a couple or a few opinions and follow docs orders. The body has an insane ability to heal with or without surgery but I believe a lot is mindset.


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## mtbD (Sep 1, 2020)

*did the bump go down as well?*



dballs said:


> Following up on a Grade 5 that happened six years ago. I did intense physical therapy at the recommendation of the doc and it is now fine, it was unbelievably hard to do but worth it. Separation started at a 5 and reduced to a 3 after therapy.
> 
> To date I have 0 restrictions and would say the shoulder is at 97%. I am very physically active and have full range of motion. From what I have read and what the doc said, resuming life as usual after the doc clears you helps keep it in working order. Don't go easy on it, push through the pain. Half of it was mental and thinking it was weaker without the ligaments attached. I resumed Biking, splitting fire wood, chainsawing, doing drywall, heavy mechanical work, overhead work and everything you can think of right away.
> 
> ...


did the bump go down as well?


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## dballs (Mar 23, 2013)

Not really, can still see it.

Sent from my Pixel 3a using Tapatalk


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## mtbD (Sep 1, 2020)

dballs said:


> Not really, can still see it.
> 
> Sent from my Pixel 3a using Tapatalk


how big is your bump? mine sticks out half an inch, it's huge


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## dballs (Mar 23, 2013)

Probably about the same. Still feels good though, it doesn't bother me at all

Sent from my Pixel 3a using Tapatalk


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## oddyba (1 mo ago)

Went over the handlebars on my road bike, grade 5, hook plate, 6 weeks ago. Shoulder is fkud. Seems like the muscles got smashed and flattened. I don't see how the muscles will recover, not to say anything about the ligaments, supposedly reattach since the surgery was within 3 weeks of the injury. I guess, i''ll see when they take the hook plate out. Meanwhile, i cant lift a damd thing with this shoulder.


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