AC ligament shoulder separation

[Fishman]

Took a dive in Tokai on Saturday and ended up with a Grade 3 AC ligament injury. Its one of those where its a toss up whether to go for surgery or passive treatment to get the collar bone to re-attach to the shoulder.

I'm keen to know if there are any Hubbers who have gone the non-surgery route on a grade 3 and what their experience was like as well as the final result.

[The Guy in Pink]

When I seperated mine I went and saw a surgeon who also rides a bike.

He told me to seach the internet for surgical fixes for this problem: "You will find 50 ways to fix it. If any actually worked there would only be 2 or 3 ways to fix it on the internet"

[El Saltemontes]

Hi, Bad luck with your shoulder, I had the identical injury some 4 years back,I had the surgery, which involved disc like washers and wiring. Problem was that it all pulled through the ligaments with in a week or two and i am now left with a colar bone protruding out the top of my shoulder, all as if I hadn't had the surgery. Haven said this, I do have normal movement of my arms and shoulders, it took a while to be able to get into gym and start some strength training, also takes ages to be able to sleep on that side. I am able to ride all and sundry as if nothing had happened.

[Taps]

Don't know what grade mine was, never saw a sawbones. Shoulder lower than the other one and I can feel the bones grate against each other, but no pain. Will probably become arthritic with time.

 

Mine happened about 12 years ago.

[Fitbull]

I had a grade 3 tear just over 1 year ago. Saw 3 surgeons, 2 said to leave it and see what happens and 1 wanted to operate. I decided to leave it.

 

It takes a while to strengthen but my shoulder is now back to 90% of where it was. It doesnt hold me back anymore. I would suggest leaving it as TGP says, there is currently no reliable way of fixing it and unless it is causing you a real problem I wouldnt go the surgery route.

 

When the pain has subsided then start doing strengthening exercises and you will be well on your way to recovery.

[niterider]

I had a grade 3 about 8 years ago. I had lots of physio, but I'm not sure that it did much of anything. It ached for about a year after the injury, and my one shoulder still hangs a tiny bit lower than the other. I had full strength after about 2 years I think.

[King_Crispy]

I had it, twice.

Don't do the op, it's a waste of time.

Rehabilitation will take a while, but you always have surgery to fall back on the next time you buy the farm.

If you're in jhb I can give you Megan's number.

She will make it good again.

A few of the Spruit rats have used her to put their shoulders back together when they ran out of talent on their jumps

[TALUS]

Injured 3 times (rugby). Operated x2. Done the op myself - endless times. Dont do it now. Wait - if you get AC arthritis- have the end of the clavicle excised arthroscopically. Could still bench 135kg afterwards..

[M L]

Also had a grade 3 seperation a week before the holidays, was still writing exams and it was my writing arm, wore the sling but not nearly enough. After a week I took the sling off, tried to just rest the arm as much as possible, never wore the sling while sleeping though. Then began using the arm after 2-3 weeks.

 

Drank the painkillers for the first 2 days and anti-inflamatories for 3 weeks.

 

After 3 weeks I started exercises with a rubber thing, arm was still a bit sore with some movements and it tired very quickly. After 4 weeks I got thicker rubber and started riding again. Don't do flats, just hills and downhills on jeeptrack.

 

After 5 weeks I was back to normal with slight pain when I put too much force on the arm. After 6 weeks I forgot I seperated the shoulder.

 

Apart from a big bump and scars my shoulder is almost back to normal (8 weeks now). Started doing very light bench pressing. Don't think I can do pull ups yet.

 

Was amazed at how quickly the recovery process went. Good luck!

 

Tips:

Keep the arm in the sling for the first 2 weeks ( the muscles tore and has to grow back)

Take in extra protein

Get excercises off youtube and start them about 4 weeks in. Don't push into pain.

Dont take the AI's for more than 2 weeks, otherwise you will slow the healing.

Drink lots of water, green tea and rooibos tea

[BarHugger]

From the replies you will see most went the conservative route by focussing on strengthening the muscles surrounding the shoulder girdle (scapula and clavicle). Also injured my AC joint (16 years back) through a drunk driver T-bone vehicle accident. Impact was so big that I was flung out of the vehicle (VW Beetle). In the process completely bent driver's door and ripped whole door-lock mechanism from vehicle's bodywork.

 

The main purpose of clavicle with its two joints (AC and SC) is to act as a stable attachment for the shoulderblade (scapula), which in turns rotates and glide across your body as you make use of your arm. With a separated AC joint this gets compromised and because there is now more movement in the joint itself, you experience pain (swelling and inflammation). This will however pass, similar to a sprained finger joint.

 

The main aim must be to strengthen all the primary muscles attaching onto the scapula, but also muscles that attach to the clavicle. Although youtube might have some good (and sometimes very unique) exercises, I suggest you go and see a professional that can assist you with the correct exercises. Flat bench press puts more strain on the AC joint than for instance an incline bench press. Also keeping your elbow close to your body for the next few weeks will aid in recovery because the moment you start moving your elbow away from the body, the scapula starts moving and affects the AC joint. Narrow grip pull- ups with palms facing towards you (supinated grip) and elbows in can also help with strengthening the necessary muscles.

 

In short, get professional advice on rehabing that shoulder and you won't regret it. Kept the muscle strength intact on mine and so far no problems, not even the arthritis (osteo) being referred to (and going strong to 50).

 

All the best with your AC and hope you recover quickly.

[HeyYou]

+1 ... surgery should be the last resort, always.

[Kozin]

Don't do it

I have had two operations on same shoulder using different methods

The last op the doc promised I would never break what he did...

They don't last, my collar bone still protrudes

 

[Fishman]

Thanks so much for the replies and input. It really does help hearing about other experiences. I'm not to keen on the surgery route and with some TLC and rehab it looks like I can sort this out. Seeing a specialist today and will take it from there.

 

Not to worried about a bump as it will match my other shoulder which had a grade 2 from a previous skateboard injury.

[Dawdle]

Hi! Did the Ac joint fall about 11-12 years ago.I think it was grade 2. Great orthopod who said surgery and be cool in a few weeks, or no surgery, no activity for 9 -12 weeks, and you will look unbalanced at the beach because of the bump on your shoulder> chose the latter option. No problems at all. My 2 cents worth is do not get cut and try the non surgical option but this takes more time to heal (very important is the patience) maybe some physio or massage to reduce the scar tissue and you'll be fine! Cheaper too!!

[Fishman]

Went to a shoulder specialist and the low down so far is that my shoulder has been upgaded from a 3 to 5 (SLX to XTR). Basically it is a bad grade 3 where the collar bone sticks up quite a bit more.

 

Remarkably I'm not in a lot of pain and have a fair bit of motion, quite a lot more motion than I should have for this type of injury. The ortho has advised against surgery for the time being as I seem to be doing well bar the hectic knob on my shoulder. I'm off pain killers and anti inflamitory drugs.

 

I have been doing daily 3-4hr cold treatments with this machine that pumps icy water through a blanket that surrounds the shoulder. My arm is in a sling and I try keep good posture with my shoulder in a good position. The advise is to stick with this if I think its working and then start passive treatment when I'm ready. Who knows, healing with belief is a powerful thing.

 

Thanks for all the advice.

[Dawdle]

Good Luck! I remember that to keep in form I went and spun on a stationery bike. It also helps with your mental state as you at least are doing a cycling like activity. Be well