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You can live with Type III AC joint separation, but I want more

It’s been three weeks or so since the AC joint and supporting ligaments in my left shoulder were completely torn apart.

My recent visit to the orthopedics doc left me kind of annoyed. I waited for about an hour and when the doc finally came in, the first thing he asked me was what I did for a living. I replied with my typical “I’m an IT guy”, to which he replied “Well, you can have surgery, but you’ll be fine without it.”

At that point he was ready to wrap up the visit only 60 seconds in. I asked if the ligaments would ever grow back, and was told they wouldn’t unless I got the surgery. He went on to explain that the muscles in the shoulder would grow to compensate for the lack of support, and unless I was a pro tennis player or something like that, then I shouldn’t worry about it. I asked him if there were any limitations or loss of structural integrity and was told “nothing significant.”

Well I’m sorry, but it seemed to me that a proper shoulder should be supported by the very ligaments I tore. Yes, being an IT guy, the likelihood of me taking up a pro tennis career is practically nil. However, I still felt that any loss of structural support like that couldn’t be good, especially when I get older. After getting my hands on some orthopedics texts while visiting a doctor friend of mine today, I found that indeed a 5% to 10% loss of strength can be expected with a type III separation. What bothers me most isn’t the permanent bump on my left shoulder, or the fact that the ortho doc I saw was basically saying “you’re a fat IT guy, you won’t miss what you don’t use”… what really bothers me is the thought of being broken, especially when I have the option to fix it.

As of today, amazingly I can move my left arm around pretty good and I’m gaining some strength back. I still can’t lift my arm up to raise my hand or anything, and I have no hope of doing things like reaching around to scratch my back. The pain in the AC joint itself is still very real, and it lets me know when I go too far, but all in all I’m impressed with my body’s ability to cope. All the muscles around my scapula still cramp up like nobody’s business, and I have to take frequent rests to help calm those puppies down… but things are progressing.

So with all this progress and not much in the way of lost function to look forward to, why am I considering surgery? Aside from the fixer in me that is bothered as hell that one thing that is supposed to be connected to another just isn’t, and will never be without surgery… the fact is I have an opportunity to take a small risk to fix the problem while I’m young enough to recover as quickly and as thoroughly as possible. No amount of muscle building or physical therapy can get my body to a state as structurally sound as how I’m naturally supposed to be put together.

Still, the argument for just letting it recover without surgery and live with the separated shoulder is a good one, particularly when my physical activity level is currently so low and the foreseeable future doesn’t assume any increase. The real bottom line is; I want my limitations to be entirely of my choosing. I know that sounds kind of funny, but let me explain it this way; When I was a kid growing up, I liked keys. I began collecting them because I knew they would let me into something or somewhere. Eventually that collection became known as “the forbidden key chain”, and held such gems as the mater key to all the doors in my high school, the key to a mountain top communications relay station, and several others. I never used any of these keys… well, ok rarely did I ever use only a couple keys from the forbidden key chain a couple times, but my point is I had the option to use them, but chose not to. The important thing was that I had the choice… and really that’s all anyone wants. I see it all the time.

Let’s say a someone is looking over a clearance table in a local store. They stand and look over the items with other people. As they look over the various things, they are making judgments about usefulness, value, etc. but ultimately nothing from the table interests them. Then this casual browser overhears a couple standing on the other side of the table talking about an item sitting next to the casual browser. Immediately the mind races… the browser instantly becomes an aggressive shopper, rechecking the table, reassessing the item in question. The browser may even be prodded into action by pretending they didn’t hear the couple talking as they pick the item up… staking a claim to it by simply holding it, and at the same time reserving the option, the choice, to purchase it. Whether or not the casual browser decides to buy the item or not is irrelevant. Action was taken because of the pressure generated by the knowledge that soon, if they didn’t act fast, the choice to buy it would be gone. The knowledge that the item itself would be gone is not the affecting issue, the browser had already determined that it was of no interest. Action was taken due to the potential loss of choice.

So here I sit with my broken shoulder. No matter what the doc told me, I know there will be limitations. For example, with my shoulder the way it is I don’t have the choice to take up professional tennis. I know I’ve had and will have a lot more situations come up in my life where I have no choices at all, but in this case I do have one. I can choose to get the surgery.

I’ll give it a month, let things settle down with my shoulder and my day job projects, then I will revisit this decision. Luckily, the doc told me this is a choice that can wait.

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457 Responses to “You can live with Type III AC joint separation, but I want more”

  1. Amal says:

    Hahah I just read his age (65), I AM half his age almost exactly!

  2. Amal says:

    Man, I should coordinate my thoughts before posting. Anyway, I just wanted to say that this is what I really am afraid of when I get older. Not necessarily the bump, but the lack of support as my muscles get weaker with age. I may look into getting the surgery around 45 or 50.

  3. Joe says:

    Amal

    Does your shoulder move around when you push or pull on the collarbone or scapula?

  4. Amal says:

    Hmm, not really. I get the same movement with my right shoulder as I do with my left, but the muscles around my left (torn) shoulder are pretty tight… they might be doing a good job of holding things together. The only time I can get any strange motion is if I lay on the hard ground, flat on my back, relax everything, and someone else manipulates my left arm. Then I can see some odd movement. Other than that, things are pretty tight considering the total loss of ligamental support.

    When I lift any weight, I can feel the strain on my left shoulder and all the connective muscles. If I try to hold any weight over my head, it feels “saggy”, like the muscles are slowly losing the battle, and my shoulder starts sagging lower and lower away from my collar bone. Visually you can’t really notice the difference as its happening, but I can sure feel it. Eventually things give out completely and any attempt to lift any weight results in a pronounced weakness on my left side.

    I’m trying to increase the endurance of those muscles by repetitively lifting light weights above my head and holding them for at least 10 seconds. It is very tedious sometimes, and while I don’t lift anything more than a pen while at work, this effort coincides with my overall plan to lose the gut and get healthier.

  5. Jeff says:

    Well I guess I will continue the thread.

    I have hurt my shoulder a few times skiing, but never enough to see a doctor. A week ago today I dove forward to catch a ball and landed directly on my right shoulder. I knew something was wrong after a few minutes when my shoulder felt loose and weak. I told my friend to check it out and he told me about the “bump”. I went to the ER, got x-rays (they weren’t sure if I broke my collar bone at first), told me it was an AC joint injury, gave me a prescription, gave me a phone number, and sent me home.

    Today I saw an orthopedic specialist and got more x-rays; this time I was standing up and holding weights to see how far everything separates. He determined it was a type III. After a very brief discussion of what that means, he told me surgery is possible but to try to go without especially since I am not in “heavy labor” and work in IT. He said to wear the sling for one more week, without it the next, and he will see me in two weeks.

    My injury is only a week old, but it seems so strange to just let something like this fix itself. I can’t really tell if it is getting better or if I am just learning how to deal with particular motions that cause some pain. Putting on a T-Shirt is terrible and I still have trouble trying to find a comfortable sleeping position. However, all the comments here have assured me that trying to go without surgery is the normal way to go. I consider myself an active person; running, mountain biking, skate boarding, lifting, and skiing. I guess my biggest concerns are with lifting and skiing. How long before I can start lifting again, and will I have the stability in my arm to be comfortable with lifting weights over my head/body? Are the chances of me re-injuring myself greater with or without surgery?

    I guess these are just questions in my head I want to get out, I really don’t expect anyone to answer specifically. Thanks for all the info.

  6. Amal says:

    Nice link! From looking at the images on that link it looks like that is a much more severe separation than mine. The digital x-ray I have of my shoulder has a sweet feature which lets me measure distances in the image itself, and my right shoulder AC joint only covers a 1.5mm span, while my left shoulder AC joint has a 9mm span between the clavicle and scapula. So it definitely is torn up, but maybe I have less of a severe separation of those two bones and therefore I have less of a prominent bump.

  7. Amal says:

    I too did the weights, but I had no deviation between the two images, but both my family doc and the ortho said it was definitely a type III tear where both the AC joint and all three supporting ligaments were completely torn.

    I’ve not been doing any real serious physio and I’m close to 5 months since the tear and I can once again lift weights above my head. It is definately weaker, but if I cared enough to actually work it out and push the limits I’m sure I could get it back to close to 100%, especially considering I didn’t start with much strength in that shoulder anyway… sets the bar kinda low ya know?

    One thing I wanted to comment on though is you saying “let something like this fix itself.” because the one thing that should be clear by now is that your AC joint and those ligaments are never going to heal back together without a successful surgery. What will happen is your body will create scar tissue and the muscles surrounding your clavicle and scapula will try to compensate and hold things together for you. You should soon notice as you start to get up and around that the right side of your back will start cramping up. That will eventually pass as your muscles get stronger on that side.

    The state I’m in right now, I don’t notice much in my daily life, but I do notice weakness on my left side if I’m lifting serious weight, or if I do something repetitive… then my left shoulder and left side of my back get soar much more quickly than my right. All in all, not so bad. I don’t know if risking surgery would have been worth it at this point, which is why the doctor and ortho guy both told me not to worry about it.

  8. Eric says:

    I have made a few entries on this blog before; I got a Type III separation while snowboarding on March 14, 2009.

    I would take it easy on the weights. I started lifting my arms (biceps, triceps) only at the end of May and then in June proceeded to lift arms and then back in one week and sort of re-injured my shoulder.

    It went back (almost) to the pain of when I did it. Now, a month later after not lifting weights, it is back to just feeling awkward once in a while. I run, bike and swim but I am going to hold off on weights for a while.

  9. Joe says:

    I am approaching 10 weeks on mine and shoulder always feels like a tight muscle right at the AC joint (like it needs to be stretched, but will not stretch out). Who else has this? I don’t really have pain, just this awkward feeling of tightness all the time.

  10. Joe says:

    Anyone been lucky and have this stupid bump reduce in size at all? I’m hoping mine will reduce just a bit…I hate it but don’t want surgery 🙁

  11. redbikejohn says:

    hi there, i posted earlier about my type III. no sure if this will come out but this is my x-ray

    [IMG]http://i92.photobucket.com/albums/l33/redbikejohn/28042009046.jpg[/IMG]

    if not then this is a direct link to it

    http://i92.photobucket.com/albums/l33/redbikejohn/28042009046.jpg

    so my bump hasn’t gone away at all. looks like i’m stuck with it but it doesn’t hurt when i race any more. hurt a tendon in the frontof my shoulder again on the weekend while out trail riding but a week of rest should cure that. building strength up on the gym now as well. Looks like hell but at least i can still race!

  12. Joe says:

    John…nice Type III….you have made good progress…mine still hurts after 11 weeks which sucks. I’m not sure I would trail ride even now!

  13. mike says:

    I obtained a grade 3 separation on May 24. Doc said to live with it. Here it is in august and it hurts like all get out.
    With that in mind plus the grinding in the joint, I sought out a better Orthopedic doctor in a bigger city. One look at the MRI and Xray and he says we can fix this. “would have been better is done 3 weeks or less after injury”.
    So now I am in for another 2 months in a sling and then therapy. The prognosis is good and should get full recovery.
    You have to shop around for a GOOD DOCTOR. plus check them out.

  14. Amal says:

    Having pain that long after, and grinding, it sounds like you had a either a type II or type IV separation. A type III is a clean tear and will scar over within a month or two. When the AC joint is only torn or damaged, it will continue to grind around and cause pain, and surgery is the only real option. Many people with a type II get misdiagnosed as having a type III and end up having pain for months before seeking a second opinion.

  15. Lilly Neal says:

    my family & I were in a wreck this past weekend where my husband was the only one seriously injured. Our primary doc set him up an appt for him to see an orthopedic surgeon today & was told that he has a type 3 AC shoulder separation & that without the surgery he will have abt 70% mobility out of it but with the surgery he may have 90% but his concerns that with the surgery & them having to drill holes through the bone that he’ll have problems out of it later on. The surgeon has given him abt 2 weeks to decide & he says it’s gonna be a tough decision to make. He is a very active person for his age & the type of work he does he has to have good mobility – he’s an aircraft mechanic & is always crawling around in the tank/wing areas of the planes he works on. When he’s not working he likes to swim, hike, travel & do things with the family.

  16. Amal says:

    Glad everyone is pretty much ok from that accident!

    From every medical text I’ve read (which is 2 by the way) and most ortho reports I’ve heard, you gain about 90% without the surgery. I chose not to get surgery and it took 3 months to get my full range of motion back, and I did get it all back, but my shoulder is weaker. I can still do push-ups, and military presses, but my left shoulder just doesn’t have the endurance it used to. I need to rest it much more often. I’d say strength wise I’m at about 85% and range of motion wise I’m at 99%… but I didn’t do any strength training either. I’m sure if I did physical therapy and strength training I could have gotten my shoulder strength up to at least 90%.

    With surgery, you are out for a cool 6 weeks and cannot move your shoulder, or you will re-tear everything that is trying to heal. You get holes drilled in bone and screws put in, then after a long period of time, the screws can come out. The bone will heal and the holes will close… but the risks of surgery and low probability that you will regain a higher level of over-all mobility from getting the surgery make it an unpopular option… which is why most doctors don’t bother recommending it in the first place.

    It feels to me like things are being rushed with your husband. You might consider using that two weeks to get a second opinion from another orthopedic surgeon. Don’t bother talking to another general practice doc… find a second ortho to talk to. Unless he is lifting heavy things directly over his head all day, surgery might not be as necessary as your current care providers are making it out to be.

  17. Lilly Neal says:

    thank you Amal,
    sorry for getting back with you a little late on this. He saw the ortho doc today & has made the decision to go ahead & go thru the surgery which will be on the 23rd this month. So far this ortho doc seems to know what he’s talking about, he saw him once before for another injury on the same shoulder & his prognosis on that was correct. Then this happens with the wreck & all, it really seems like for us here when it rains it pours!
    when he came home he said something about the doc said that they would be using parts of a cadaver (dead body) for the ligaments I guess & a few screws & he said that surgery on a shoulder like that was the worst as far as pain wise & he’s gonna be out of work for 6 mos recovering afterward.

  18. matt says:

    Thank you all for posting; very informative. Reading through above addresses nearly all my questions – I achieved Type 3 playing softball (turns out the body ages while the mind does not) a week ago. Golf and jogging are my main passions.

    One question I have that is alluded to above is whether timing of surgery is important. Seems to me that doing so before any “healing” takes place is better than after.

    I have seen two good ortho docs and both say same thing – my choice. One of them had had the surgery and was happy.

  19. Amal says:

    From what I’ve heard from my doc and others is that it does not matter how long after the injury until you get the surgery. I know it doesn’t seem to make sense, but that’s what I’ve heard.

  20. Joe says:

    Matt

    How much pain are in? My initial injury was just hell for at least 3 weeks not being functional to even put my hand on steering wheel. Does your shoulder have a bump yet or is it still swollen. Mine swelled up and I couldnt tell I had a bump for about a month. Now right on top at the joint it still hurts at 4 months.

  21. matt says:

    The pain is tolerable, unless I do something stupid, and then it brings me to my knees. Sneezing is one of the worst things I can do. I am only at about 10 days out from the injury so I guess I should be pleased. Someone above wrote about muscles cramping and that is me. I can watch the bump grow and shrink throughout the day.

    I think most of my swelling is gone and have a sizable bump.

  22. Mike says:

    I have grade 3 no doc collar bone moves around something awful pain has gone but any extended work and I’m a hurting pup. This is the most suck ass injury I ever had large bump on shoulder. I did go to emergency after it happen total waste you need a specialist for this injury. When I do work its like this pain that just won’t stop. My injury happen June 13 2009 that was 125 days ago I really hoped by now I could at least work

  23. Mike says:

    I think if I had the money and knew what I know now I would not screw around I get into surgery ASAP get the fucken thing back in alignment and at least a chance of normal life

  24. Joe says:

    I’m at 5 months and mine still hurts right on top at the AC joint. If I work it with weights…hurts like a bitch for a week…I hate this it does not want to heal plus have stupid bump cant get used to.

  25. Amal says:

    Dude, it seriously sounds like you have a type II separation. Type II means the AC joint is ripped but not necessarily the supporting ligaments, which means the AC joint will continue to hurt… it hurts because the joint tries to actually heal instead of scar over, and with daily use it keeps tearing. The pain will stay with you until you get surgery to fix it.

  26. Joe says:

    Amal…must be…damn thing never heals. Must be severly torn (have bump) but not completely. Do ligaments heal? I thought I heard they just scar and never “heal”. Anyone know?

  27. Amal says:

    Hi Joe,

    I dunno man, but if you want to test that theory without getting surgery, and you have 6 weeks to kill, then you can put your arm in a tight wrap and basically do nothing for 6 weeks to see if it will heal.

    The ligaments, if torn, will not heal. Nor will the AC joint. The only way to get them to heal is to get surgery. When you get surgery, the docs put a screw into the bones in your shoulder to cinch things up and hold the bones together, kind of like a metal ligament. Then they loosely sew the ligaments back together. Over the next 6-12 weeks, the screw holds stuff together so the ligaments can properly heal. If you don’t go super light duty on that arm/shoulder, the screw will break and you’ll re-tear everything. One things are healed up, you go in again and they take the screw out of your bones and you’re “healed”.

    Without the screw in place to hold everything together, there is no possible way for your ligaments or AC joint to properly heal. Gravity and normal activity will keep the torn ends of the ligaments from even touching, let alone keeping them stable enough to heal.

    However, the bottom line is; if you are still in pain after 5 months, I’d get the surgery.

  28. Eric says:

    I have written on this blog a few times over the last six months – I got a type III on March 14th snowboarding. I noticed the last couple of entries from Mike and Joe and you must have a type II. I am 6 months from my injury and it has gotten much better, just as my Dr. had said. I work in an office and never even notice it. I have re-started lifting weights (more lightly than I used to) and although it does move around and has a “crunchy” sound sometimes, it has stopped hurting.

    What I’m saying is, if you have a type III it will get better over time with no surgery! You will of course still have a stupid looking bump but that’s just the way it goes I guess.

    Also, listen to Amal; everything he says is right on the money; he sounds like my Dr.!

  29. Dave says:

    Hi folks,

    Just thought I’d add my few cents worth, since this seems to be the only AC separation support group on the net. I blew out my shoulder in a motorcycle crash in May, as longer readers might recall. Like everyone else says, the pain goes away and you get full function back without surgery. It looks stupid, particularly if you crank the arm around to scare small children (I occasionally do that), but it doesn’t hurt apart from maybe a dull pain if you leave it unsupported for too long. I ride again, this time a Triumph, and that works just fine. My doctor also insisted that you can always get the surgery later if you want, it doesn’t seem to matter how long you leave it. For what it’s worth, I’d see how you go without it.

  30. Amal says:

    I’d say that about sums it up. That’s exactly where I’m at, but I still ride my ‘busa 🙂 My doctor also said I could choose to have the surgery at any time if I wanted… which I may do actually. The one thing I noticed I have a hard time with is weight lifting, which I just got into recently. I get a sore muscle burning sensation all down the upper left side of my back (tore my left AC) and I have to stop. Apart from that though, no issues in my daily life.

    Now when I get into old age and my muscles start to go, then I think I’d have a real problem… but for now I’ll do without the surgery. Maybe in 20 years when I’m 55 I’ll get it done.

  31. Sandy62 says:

    Wow this is such a great site. I have a Grade 3 AC joint sep and SLAP injury Grade 2 on my right side and fractured scaphoid on my left wrist. Happened 5 weeks ago. I do enduro dirt bike riding and my suspension stuffed up landing a jump and I hit a post. I thank God this is all that happened. I am still sore. Seeing a hand surgeon next week and shoulder surgeon next month. The worst part for me is I am a very active person and love camping, 4WDriving and scuba diving and now I am totally bored and depressed that I will never ride again. I have been told surgery is a possibility but I am not keen. So pleased to read that some of you are doing well without it.
    By the way guys be grateful that you don’t have to wear a bra or makeup. That sucks when you have an AC joint injury. Actually, thinking about the bra strap acts a good support mechanism. I see a pt and have my shoulder strapped and my wrist is in a cast.

  32. Amal says:

    Are you not ever going to ride again because you don’t want to, or because the doctors are telling you that you won’t be able to? If the latter is true, I wouldn’t count yourself out that easy… will power has gone a long way in healing people… especially when it comes to physical recovery!

    Yeah, I’m glad I’m not the bra and makeup wearing kinda guy 😉

  33. Sandy62 says:

    Hi Amal, I have been told I cannot ride for 12 months. Then I should be able to. I think my confidence has taken a beating as I have never been this hurt before. My female friends are saying to give up, my male friends tell me to go for it as I love it so much. I am finding at the moment I am even scared to ride in a car in case I am involved in an accident. I hate the thought of having something broken in me. I guess I just feel really broken and sore and that I will never return to normal. I don’t know any other females that have had these injuries. so I guess I am feeling rather alone at the moment. I am not the type prone to self pity and usually just on with it, but this has really affected me. My back muscles are cramping up all the time. that is worse than the pain from my injuries. Does this impove. I am 5 weeks tomorrow.
    Thanks Sandy

  34. Amal says:

    Hi Sandy,

    With the extent of your injuries, it’s probably a safe call. The pain in your back is normal, and can take up to 3 months to sort itself out. The fact is, your back is compensating for the torn ligaments, so it’s as if you are working those muscles out all day long each and every day… they will be sore until they get strong enough and develop enough endurance to handle their new job.

    I know what you mean by feeling broken… I’ve never even broken a bone. This AC tear is the biggest injury I’ve ever had, and it’s definitely an odd feeling knowing something in my body is not connected to what it’s supposed to be connected to. I kept being reminded of that old childhood song “The leg bone’s connected to the… hip bone” and thinking “my bones are no longer connected!”

    That feeling passes as muscles get stronger and flesh heals. Today I still feel bothered by knowing I can never physically fulfill my potential (unless I venture into surgery)… but ultimately I don’t really have any limitations in my daily life, so that feeling only comes up when I get all philosophical on myself.

    You have additional injuries which may enhance this feeling, but the good news is; bones heal back STRONGER than before they broke. That’s why I was really hoping I broke my collar bone when I realized I couldn’t use my left arm to pick my bike up off the pavement. However, like I said, even though my AC joint and supporting ligaments are torn and will not heal back, I always have the surgery option if I want… we both have a way to fix it later if we continue to feel incomplete. I can say I no longer feel that surgery is an absolute necessity at my current age. I may look into it as I crest into old age, but for the next 20 years or so I’m good.

    As for giving up something you love, consider this a really big learning opportunity. I know I will never ride a bike off the lot after putting on a new back tire without inspecting it. I also learned I’m not as invincible as I once thought, but I’m not so fearful that my riding style has become more dangerous by being paralyzed by fear. I guess what I’m saying is, don’t give up something you love simply because you may be afraid of it. Simply use that experience to adjust your riding style.

    When I got on to my first 50cc dirtbike at age 8, my grandfather gave me the best advice; “if you ever get to thinking you’re the master of this machine, it will teach you very quickly how wrong you are.” I count my experience as a quick reminder of who’s in charge when I’m riding.

  35. Joe says:

    Sandy–Thumpertalk.com Health and Fitness section. Sign up and post Consult Dr. Mark and other riders advice. Scaphoid injury is a difficult one from what I have read from other riders.

  36. Sandy62 says:

    Hi Amal
    Thanks for the words of wisdom. I remember my father saying the same thing when I started riding at 5. I have managed to get to 47 without any serious injury. I think I was becoming complacent. It’s hard as I still feel young, but the body is not keeping up with the mind. I will go back to riding but not at the level I was doing. I think this has made me realise that I am not exempt from serious injury. How long before you could sleep on your shoulder. Mine hurt like crap when I did it. So much so I did not realise I had a break in my wrist until a few hours later. The swelling is starting to go down now and I can feel a large bump. The pt straps it once a week and this helps a lot. Today was the first day out of the sling and I think that is a good thing.

  37. Sandy62 says:

    Hi Joe,
    Thanks for that I am going to have a look now. How is your injury going?

  38. Amal says:

    Hi Sandy, it took me around 3 months to be able to start to sleeping on it. However I was starting out flat and waking up sleeping on it (in pain) much earlier than that 🙂

  39. Joe says:

    Sandy…Mine hurts still after 6 months more after working out and when I wake up. It is becoming routine to just live with it and rub my shoulder often. Mine hurts right at the joint. I does get better but so so slow healing!

  40. Sandy62 says:

    Hi guys. Had a hell of a day with the shoulder. I felt pretty good yesterday and caught up on a lot of work. Today I can barely move because of pain. I saw the hand OS today. He thinks it will be okay however he reckons my ac may take 18months. He is not a shoulder specialist though. I see that one next month. I think because the swelling is coming down I am getting some clunking when I move a certain way and my shoulder does not feel as stable. Have any of you heard about DMSO being used with any success?
    I hope I will be able to sleep on my shoulder as early as 3 months. I understand Joe about the slow healing. Time goes very slowly when you are waiting to heal. I am worried about losing muscle tone around the shoulder as I am not using it much.
    Thanks for telling me about Thumper Talk. I spent hours on there last night reading posts. It’s got something for everyone.

  41. Jay says:

    Hi, I thought I would add my personal observations after living with a Grade III separation for the past 12 years. I was working out with my son recently and he was asking about it and I thought I’d check the internet on any new breakthroughs that may have occurred since my injury but it seems the advice is the same.

    My injury occurred during a judo tournament when I was about 29 yrs old. At the time, I obtained three different opinions on what to do. The first Dr suggested if I wanted to continue Judo tournaments that surgery could be an option (this was just a hobby so that wasn’t a concern), the surgery would involve inserting a screw in the shoulder along with using I believe he said a gore-tex vein to also help hold the collar bone in place, which would require more surgery later to remove the screw. I got two other opinions, which included an orthopaedic surgeon for a professional football team, his opinion was that if I was a million dollar quarterback and it was my throwing arm, then “maybe” he would recommend surgery.

    I opted not to go with surgery. It took about 4-6 weeks of being in a sling followed by about 6 months of physical therapy to get my shoulder back to “normal”.

    Over the past 12 years I have been able to do most things I had done before the injury with just a few exceptions. I always have to be careful with any type of lifting of weights or heavier objects over my head and be cognizant not overdo things, gradual increases work if I want to lift heavier weighs and trying to attempt any type of “max” effort usually results in pain. Lifting weight below the shoulder is fine. I do still participate in Judo, but I have to make sure when I have “randori” or free practice with someone my size or heavier that I am careful about any fast and sudden stresses against the joint as I know I will be in pain once the practice is over. I stay fairly active with exercising and rock climbing weekly and routine day to day things don’t bother my shoulder, whether I am working outside in the yard, lifting boxes or moving furniture around. On occasion I may have some brief pain in the shoulder after sleeping with my arm above my head.

    Based on my experiences I think not having surgery was a good idea. I still have the bump from my collar bone at the shoulder joint but it has diminished significantly when compared to how it looked when it was first injured. So if you are thinking of getting surgery I’d suggest waiting a few months before making any kind of decision.

  42. Amal says:

    Hi Jay,

    Thanks for you in-depth comment!

  43. Sandy62 says:

    Thanks Jay,

    That’s really positive. I really don’t want surgery and am not in a profession where I need it. I am feeling much better coming up to six weeks since the accident. I am really geting into the pt and have almost ditched the sling. Some days are better than others but overall I am starting to feel positive again. I was talking to a guy the other day and he said pretty much the same thing. He did his 2 years ago and was back landscape gardening at 6 months. The only time his hurts is if he over extendes above his head or wakes up with his arm above his head. He also said for the first month he could only move from his bed to the lounge and was in horrific pain. He did not get any follow up work done as he was told at the hosp he would heal just go home and rest. He feels if he had it srapped or at least saw a pt he recovery would have been faster. He showed me his bump and it is still huge but does not bother him.

  44. Joe says:

    How’s everyone hanging in there???

  45. Sandy62 says:

    Hi All,
    I am doing much better now. Saw the surgeon last week and he said he wouldn’t touch my shoulder. He only operates on grade 4 to 6 and also grade 2 as the bone can rub in muscle and cause ongoing pain and discomfort. He was amazed at the range of movement I have. He agreed that wearing a bra would help as much, if not more, than strapping. The swelling has come down now and I have a very obvious bump. The pain is worse in the morning. I always wake up sore. I am starting to sleep on that side now which is great.
    Have changed physios and can see a big difference. I go twice a week and get massaged, ultrasound,TENS and exercises. The wrist is still painful but the cast is off and it is unlikely I will need surgery on that. I got on my son’s TTR 125 on the week-end and went for a slow ride. could only manage 15 minutes. I guess I am not as good as I thought but certainly a hell of a lot better than I was.
    How are things with you Joe?

  46. Joe says:

    Hi Sandy

    I am at 8 months now and shoulder still aches, like you have, in morning, and after I workout. I have good strength. Once in while I just feel it right at the AC joint during the day which I hate. I have the small bump but getting used to it now. Hope this thing gets better where I dont feel it all. The body does heal…just very very slowly!

  47. Jose says:

    This is a great site and would like to add my experience. I’ m a 54 year master cyclist who rides around 7,000 miles a year a race 30 times a year.

    I came down very hard off my bycicle three weeks ago and landed on my right shoulder, grade III but close to V seperation. My upper back muscle pain is worst than the actual injury but is slowly getting better. I will not go for the surgery, even though my doctor was 50/50 because my gap is approximately 15mm, which puts it close to a grade V , but I talked him out of it after researching the injury and reading post on sites like this one. I can feel improvement already.He just wants to keep seeing me to see how stable it becomes given the severe gap seperation.

    My first concern was arthritis 10 to 15 years from now. However, at work a colleague just went thru surgery to clean the joint from arthritis buit up due to a grade III from a fall 12 years ago.He said it was done by laser with a quick recovery. I will take my chanses since this sounds like a better alternative to a painfull surgery with long recovery.

  48. Amal says:

    Thanks for sharing Jose! Please keep us updated as things progress 🙂

    I’d also be interested to hear how people handle strength and muscle deterioration issues as they age, as muscles are the only thing holding stuff together in there after a grade III separation. If anyone else knows of someone over 65 who has had this injury for at least a few years, please comment!

  49. John Honey says:

    I’m glad I stumbled on this site while googling “ac shoulder separation.” 🙂 A couple weeks ago, on januray 10 (my birthday actually), I was playing on a frozen lake with friends, slid, and fell directly on my shoulder. We all heard a popping sound, I was in intense pain then (nauseated, even). ER said AC shoulder separation, confirmed by an ortho the next day. This ortho said “we’re not doing surgery, wear a sling, come see me in a month.” I didn’t have a good sense about him or that treatment, so I went to another ortho. He gave a much more thorough exam and new x rays and better explanation, and asked more questions about my life and work. I run a ropes course as my job, my hobby is rock climbing. My life….work and play…is all outdoors and very strength-related. He said he predicts then I will elect to have surgery. I believe he his right.

    I have one more appointment with another ortho…I guess you’d say a third opinion…and this one does lacroscopic surgery. I read though that lacroscopic surgery for AC separation is either very new or not available at all. Has any one had it or have any details on it?

    Thanks for sharing. My goal like all of ours I suspect is nothing short of 100% range and strength. That will have to happen.

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