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.
Tags: health, psychology
Hi Amal. I just spoke with my surgeon’s nurse who clarified a bit for me.
I asked her about the ligaments growing back on their own and this was her response:
“The doctor is going to go into the joint, re-set everything to where it should be, and make it as though it never happened.”
This obviously doesn’t answer the question, BUT I SINCERELY hope she’s right. (I will ask the suregeon when I speak to him after my insurance clears this procedure). She DID say that I was a ‘rush job’ when I originally went in to see them 2 weeks ago but she could tell that I was hesitant about the procedure. Now that the swelling has gone down and it’s a little later she called it a ‘RUSH-RUSH job’ since it’s important I get in to re-attach it.
In my situation, the reality is that I have a Class 5 separation. As Richy said, I don’t have a choice at this point and after speaking to my family and friends… I have insurance so I should bite the bullet. I am starting to see that NO amount of PT will help my condition. It’s painful to the touch and when I simply move a smidge in any direction.
I’ll keep this blog updated with my personal experience in the hopes of helping someone else out if they ever unfortunately find themselves in this situation.
Getting old and hurt sucks.:(
In my opinion.. after talking with hundreds of people about this:
Class 1 & 2.. suck it up and ice and sling it. Class 3.. give it 2-3 weeks to see what you’re really dealing with.
If you are in the situation of being class 4-6 (class 6 BTW is when the clavicle gets inverted DOWNWARD… VERY rare)… you’ll know it. IF you can get the surgery in this situation… Well… I’m doing it. My surgeon says he doesn’t see a lot of this.
Best wishes and healing to everyone and as always.. IF you need/want to discuss feel free to post or reach out.
Scott
mckid814@aol.com
hi , 4 weeks since surgery , done on the uks nhs service so free at point of use
tight rope procedure, 2 hours in surgery, done open rather than key hole, saw the doc on monday this week who said i should continue with sling for 2 more weeks
not wearing it all the time now but as they gave me physio exercises to do 3 times per day it not like it needs to be held rigid all the time and i just prop my elbow on my lap or table top if im not wearing it
i also found that the sling was making my uppr arm muscles cramped and sore
collar bone back in place at once , doc says use sling for 2 more weeks and no heavy lifting , but cup of tea and tv remote ok!
cant wait to chuck the sling – looking at it now causes me to have a physical ‘hate you’ response
http://www.privatehealth.co.uk/articles/april-2007/shoulder-surgery/
interesting article at link above
grade 5 fellow Scott, knowing what my shoulder was like , my non-medically qualified advice is to get the surgery asap, you’ll e back to normal in 3 months and having a bone sticking out the top of your shoulder isn’t a long term strategy and according to this article ur ligaments heal if done fast enough
Hi Richy. Thanks a LOT for that article. It’s one of the most thorough, concise and clear ones I’ve read, and yes… I’m now sold on the fact that I don’t have a choice.
My injury will be 3 weeks on Friday, so I’m hoping the doctor rushes me in next week at the latest. Pain and the size of the bump is increasing daily, so it’s time to get to done ASAP.
My doctor isn’t doing any ‘screwing’ into bone which is cool, and will do the orthoscopic procedure. (mostly).
Thanks for the info and advice… waiting impatiently to get in there now…
Glad to be of use
my shoulder feeling pretty good today , can’t wait for physio next week and to CHUCK THE SLING
let me know if you get booked in for your op
all the best
Right on Richy. My doctor just scheduled me for for surgery 1 week from tomorrow. Friday the 27th. I asked him if he was confident that this was within the window to do the ‘quick surgery’ and avoid using the cadaver ligament and he said, yes. I’d like to do it TOMORROW but this is the soonest he can get me in.
My injury took place just under 3 weeks ago and I was REALLY swollen up until a few days ago. That swelling protected the bump and I had full ROM and not much pain, BUT… NOW… the swelling has gone down and it hurts like HELL. My bump is massive and VERY sensitive. I don’t have a choice of surgery or no surgery. I can barely move. Even when I’m just standing around I’ll get periodic SHARP pains that immobilize me. I’m basically in the hell stage for 8 more days. There is no doubt in my mind that this is a class 5 separation. Doctor prescribed an anti-inflamatory and some synthetic pain medication and said to sling it and ice it and deal for 8 days.
I spoke to his nurse who said that he has performed several of these surgeries and it’s a ‘cool’ procedure. I asked what the heck that meant and she explained to me that he performed this on another patient who was injured on a motorcycle and the guy’s back to normal and good. That’s what I’m praying for. I’m REALLY freaked out about surgery (this is only the 2nd in my life) and I feel like I’m in good hands which makes me a little more at ease. I was totally up for doing conservative therapy and rehabilitation but it’s simply not an option. As someone else said on this site, ‘class 4-6.. you don’t have a choice’… yeah… I get that now.
I thank God that I have pretty good insurance and live in an area with some pretty bad ass doctors. I joked with my surgeon that in another week I could probably perform this procedure myself with as much as I’ve read about it and ALL the people I’ve spoken to. One thing people should know is that (here in the states anyway) the doctors seem to be doing more orthoscopic surgeries. My surgeon is doing a little half and half and I’ve spoken to other people who have experienced the same. A little less invasive, smaller scars and avoiding the screwing into bones and clavicles and such… which I was VERY happy about.
So… there it is. Going to be a LONG, IMMOBILE week for me, but I’m looking forward to getting this taken care of and starting the healing process.
Congrats on almost being done with the sling Richy and good luck with the physio!
Hi Scott
I know when I did mine at first many movements were too painful which was why I was surprised that you would even consider not having surgery.
It was my first time under a general anesthetic which was a worry but these people know what they are doing
Sorry to hear you will be suffering for another week though….
R
I’ve been reading a lot of posts from Amal’s site. (VERY helpful) Love to hear how people have come out the other side of this thing.
I’m firmly convinced you’ll know the difference between a class 3 and 5….
I’m going in for surgery in 5 days from now… bump isn’t a bump… it’s a TUMOR and is about to rip through my shoulder skin… anyone else feeling this?
sc
things must be a bit different in the states – my surgeon told me it needed surgery – I did mine on saturday and the operation happened 4 days later – I didn’t argue as 1) a bone was sticking out of my shoulder and 2) the surgeon is an expert – the guy I got especially so on shoulders – its a bit like trusting the pilot when you are on a plane
get the impression that in the states you are given your options and asked to pick one or not
http://www.bmihealthcare.co.uk/consultant/consultantdetails?p_name=Keshav-Mathur&p_id=44121
5 weeks on shoulder feels sore (muscles growing back hopefully) and clicks a lot but I have read that you lose 1% of muscle each day you don’t use muscles so am hopefull muscle rebuild will help with clicking
Hey Richy. When I initially saw my doctor, I think he didn’t necessarily want to force surgery on me and knew that the swelling had to come down still and all that. After seeing him last Tuesday, he said it’s a no brainer and scheduled me for this coming Friday. I like my surgeon, he owns 5 patents on braces apparently and as I mentioned before, he’s performed this procedure several times and I like that he isn’t cutting part of the clavicle off or screwing into bones or using a cadaver ligament. What procedure did you have by the way Richy? Tightrope, Weaver-Dunn, etc.? Just curious as it sounds like we have the same diagnosis and grade.
Here’s one thing I haven’t been able to figure out: It’s my understanding that Class 1-2 denotes a partial tear of either the upper or lower ligaments and surgery is NOT recommended, right? Class 3 is a COMPLETE tear of both sets of ligaments and people are 50-50 as to treatment. I know class 6 (the highest) is when all the ligaments are torn and the clavicle is actually pushed DOWNWARD (as opposed to popping up in class 3-5). My surgeon said Class 6 would usually occur in some sort of crazy car accident. So… what escalates a class 3 into a class 4 or 5? IF all those ligaments are simply torn… well… they can’t get MORE torn. They’re gone, right? It is my understanding that the clavicle pops up because the ligaments aren’t there to hold it down, so it’s not like the degree or intensity of your injury is going to push it up more, is it? I can’t really figure that out. If anyone has any thoughts, I’d love to hear em.
As far as post-op, I’m assuming you have to live in that sling and treat your shoulder like a glass vase, right? Be SUPER gentle and careful and cover it up for showering and such?
Now that my swelling has gone down, the bump is huge and there’s obviously no choice for me. It’s not even the look of the thing. Can’t even ride the bike at the gym cuz of the shooting pains. Wish it were Friday already:)
Happy healing people.
scott
mckid814@aol.com
Hi Scott,
You’re pretty close… I have a grade/class 3 and it means the AC joint and supporting ligaments are torn. I was presented with a 50/50 either or approach to surgery, but didn’t ask nearly enough questions when it first happened (hence my blog posts about the subject). Class 1 means the AC joint is completely separated (torn), class 2 means the AC is torn and the ligaments are stressed or partially torn. Beyond class 3, it’s just how far the scapula has fallen away from the clavicle (collar bone).
That brings me to my second point. The clavicle does not “pop up” or float up, it stays exactly where it should be. The scapula and the rest of the shoulder sink down away from the clavicle, producing a bump. You can test this by putting a level across your back that’s long enough to span both of your shoulders, or simply have someone grab your elbow and push your shoulder up into place… bump gone!
So, to recap; classes 4 and 5 are simply an indication of how far the scapula has fallen, while 6 indicates a total clusterf*ck in the shoulder region.
Glad you guys are able to connect and share your stories here. I’m read every comment and appreciate everyone who shares their experiences here.
class 6 look really bad! can only imagine high speed bike or car crash to cause that
i had a tightrope procedure
treating shoulder like glass vase – yes and no – but take ur own docs advice – from day 1was given exercises to do that were hand, wrist, elbow related but also allowing the arm to hang down like a pendulum and swing it back forward 20 times and side to side 20 times , all 3 times per da
about 2weeks in my physio showed me an exercise to do on a table top, a bit like polishing it , making circular motions in both directions
so not (in my case) held rigid for 5 weeks in sling
nearly five weeks in now , 4 weeks , 5 days – seeing pt tomorrow
showering – i had water proof dressing – but ur wounds will be tiny if ur having key hole, key hole sized in fact teehee
sling will be destroyed in 6 days and counting
good luck
Thanks Amal and Richy. Thanks for the clarification on the grades Amal. Makes sense. I go in for my pre-op tomorrow and am compiling a list of questions for the surgeon. Scheduled for surgery Friday morning at 9am. Expensive procedure and it sucks that this is my 2nd surgery in 2012 but whatever. Gotta do it.
I was in an arm cast for my elbow for about 5 weeks this year. From what you said Richy, I might have a bit more mobility with this surgery. I’m realizing that no matter what route you go, the PT is VERY IMPORTANT!
Keep the site posted with how it all goes. Chomping at the bit to get in there and start on the road to getting back to ‘normal’.. hopefully…
scott
well they put me in sling not a cast so would guess same for you – first week the worst in terms of pain
pain free now just want to get on with pt and rebuild some muscles
PTist told me to ditch the sling (wayhay)
done some of the recommended exercises – shoulder really sore now but I’m glad to be on the road to recovery
Right on Richy! Congrats on being rid of the sling!!
T minus 3 days for me…
Just left pre-op with my surgeon. Really digging him as he seems to REALLY know his stuff and I guess I’m about as comfortable as I could be going in for something like this. Surgery will last 3 hours. He said the bump will be gone immediately after surgery as he is re-attaching the collar bone with these little ‘shoelace’ type fasteners. Amal… I asked him about the ligaments and he explained that they’re ripped apart right now. Once he puts the clavicle back in place, the ligaments will be in their original place and will basically just begin the scar tissue re-growth.
I take the bandage off in 2 days and then wash with soap and water and use neosporin and band aids. I see him a week later and then 3 weeks after that. Take the sling off to shower and I can do MINOR motion. Bending the elbow, Pendulum hang of the arm and BABY shoulder shrugs. He showed me the motions and they can’t even be considered anything other than gravity taking a second to do it’s thing. I think I’ll wait until 1 week later when I see him to try ANY of that. A full 8 weeks in the sling and still beginning PT after 4 weeks.
He recommended this ‘icing machine’ for pain and swelling. (my insurance of course doesn’t cover it). Basically keeps a constant application of cold to combat the swelling and pain that he said can get bad for some folks that first week. I’m leaning toward just using the ice pack and medicating. He said that he pumps me with some fluid for the procedure (I think to expand the area while he works on it) and that can cause residual pain as well.
Anyway… off to the pharmacy and then to chat with insurance folks and fill out a mountain of paperwork.
Keep us posted with the PT Richy and hope it gets back to 100% in the near future!
scott
http://www.youtube.com/watch?v=lrOFwXbQd4A
I think if you are having key hole they pump saline under the skin to that the surgeon can see what he’s about
first week was the worst, but having the surgery was a relief as the bump was gone!
Hey Richy. Yeah, you’re right. I guess ‘keyhole’ is another word for arthroscopy.
http://www.shoulderdoc.co.uk/article.asp?article=45
Yes – like operating by poking the instruments through a key hole – I have a 5 inch scar on my shoulder as not done key hole – but hey us rugby players needs a few scars!
think I’ll be hanging up my boots now though, the prospect of having another 6 weeks like the ones I’ve had leaves me pretty cold, Im 41 , too old for it any way , not sure of my golf prospects though! always had a slice , maybe a tightroped shoulder will fix it
just been doing my rehab exercises – the most painful being putting your hands behind you back , grasping them together and moving them upwards – managed to do it 3 times about 3 inches before I’d had enough of that one
another “favourite” is placing both hands just above waist height against a wall and sliding them upwards as far as possible – that smarts!!
Good luck re your op – I will say a prayer for you. I guess that you will be off work for a while ? (4 weeks or so)
Not so bad sitting up but getting to sleep a little awkward – need to put a pillow down so that you arm shoulder is supported and you sleep on your back – this causes me to snore, hence she who must be obeyed (the wife) has been rather short of sleep recently
first week the worst , after that (hopefully) more inconvenient than painful
R
Surgery completed!
Thanks for the prayer and good vibes Richy. Appreciated.
Surgeon, anasthesiologist and all the nurses and staff were VERY cool. Surgery lasted 2 hours (one less than they had predicted). I was COMPLETELY out so still don’t know how it all went but will go in for my first post op in 5 days on Thursday. Pain was pretty bad the first night and just laid on the couch, iced and took meds. Have feeling back in my arm from the block wearing off now and just feel the pain in the incision. I’m blown away that I take the bandage off tomorrow (48 hours after surgery) and commence to washing it with soap and water daily and using bandaids and neosporin. I’m supposed to remove the sling for showering, clean and dress the wound and the live in the sling the whole time.
They gave me photos of my separation showing a clear class 5 and a dvd of the operation/procedure. Nice to have for the holidays and bringing the family together.
Pain goes in and out and the meds and ice and elevating it help a lot. Looking forward to seeing the doctor Thursday to hear how it all went.
Happy healing
Scott
Hi
my own experience suggests that you are over the worst of it and can get on with getting better.
Ha ha , the DVD will be a wow at parties – I didn’t get one of those!
I’m 5 days now into rehabing my shoulder now with various loosening exercises – range of movement is getting better but shoulder a bit sore – using muscles not used for 5 weeks – shoulder is a bit clicky too but I’m hoping once muscles improve that this will tighten the whole thing up
Good luck with your shoulder – just take it easy
R
1 week post surgery.
Well… the pain from before the surgery, stemming from my collar bone being out of place, is basically gone. It’s been replaced with post surgery pain from the doctor getting in there and tying it down with the ‘shoelace’. Saw the surgeon today who said to stay in the sling for another 3 weeks and then I will start ROM physical therapy. 3 more months until I start the strengthening. I’m a little bummed as there appears to still be a bit of a bump. Not anywhere near what it was, but it’s there. I spoke to the surgeon and his staff and it could possibly be from the swelling. I also haven’t done ANY muscle training for 5 months (because of my elbow injury) so I’m hoping that through therapy and eventual weight training, I can build up the area and it will go away. A lot of posts on this site mention that through conservative therapy and hard work, people were able to minimize the bump, so I’m hoping that that’s what happens. Going to be optimistic.
The shoelace that the surgeon used to tie my clavicle in place is there forever. He explained that now all the tissue will grow back around it and scar over and that’s what my new shoulder will be. I’ve learned that whether you go the surgery route OR non-surgery, this injury is a long recovery and you have to put in the work. One day at a time, right?
I do actually start little exercises already. Bending my elbow so it doesn’t stiffen up, bending over and letting my arm hang like a pendulum, and small shoulder shrugs. Going to try and stay ahead of the recovery and be completely healed in 3 months time. We shall see though…
Scott
Hi mate
glad to hear that you are making some progress – I’ve been doing PT for 2 weeks now trying to build up the muscles a bit – biggest weight used so far is a tin of beans!
muscles feel sore and tight but not too much so and I do think that the muscles are starting to come back a bit now.
I found after 5 weeks that the muscle wastage was pretty severe , but feel like I’m on the road to recovery –
as you say a day at a time, good luck
Ok… I’m 3 weeks post op.
I had a CLASS 5. HUGE bump and it was painful and sucked and it was COMPLETELY noticeable. Doc did the arthoscopic thing and tied my collar bone down.
I’m 3 weeks post op, still in a sling. Barely a bump. Starting PT in a week. NO pain at all. Hoping to build the muscle now.
I’d recommend surgery at this point.
Best wishes with the healing…
sc
Hi, I’m sort of an unusual case because I’m a 49-yr.-old female and this injury is much more common in young, athletic men. My orthopedic surgeon has been doing AC joint repairs for years and has never even seen a woman with grade III to V AC separation. I fell off (not down) a set of stairs (from the top step) and all my weight landed on my acromion (point of the shoulder). The ER docs didn’t seem concerned since there were no broken bones sticking out through the skin and my neck was intact so they sent me home in a sling with some pain meds. I saw my doc a week later and she sent me to the orthopedic doc. Two CT scans, X-rays, and an MRI later, I was told I had a severe grade III to grade V separation. I could have told them this just from the huge bump, the pain, and the useless arm – and the fact that I’m an RN. In spite of the fact that I ride a bike, sail, ski, and need the use of my arm in order to work as a nurse, I was told to give it six months to heal since I wasn’t an “athlete”. I did the exercises and waited patiently, but had to take time off of work and of course couldn’t do any of my sports because of pain and fear of falling again. At five months I couldn’t take it anymore – the pain, the financial strain of not being able to work – and saw the ortho surgeon. I had a modified Weaver-Dunn procedure with a Biomet Zip-Loop fixation of the clavicle to the coracoid. I am now 3 months post-op and am making good progress strength-wise but still have range-of-motion limitations and biceps cramping and pain with sudden movements. The problem is that I have smaller bones and less “space” for the implants, which impinges on the short head of the biceps tendon. The surgeon says this will lessen over the next few months as the contractures break up and the tendons and ligaments heal with physical therapy. This week, finally, I was able to tolerate fifteen minutes on my bike, and am going back to work next month. To anyone with this grade of injury, I personally would recommend surgery if you have continuous pain and motion limitations after the initial recovery period ( the 4 to six weeks it takes for the swelling to go down after the injury).
Oh, and no more bump! My shoulder looks normal, except for a little muscle-wasting. You can feel the top “button” of the Zip-Loop device on top of the clavicle, but it’s not visible. I had an open procedure which left me with a five-inch scar but that will be covered by a bra strap. I was in a sling for six weeks. There are other issues, being a woman, with this injury – I couldn’t wear a bra for months, couldn’t style my hair – that sort of thing. Now I can do all this, and the sports, though I’m still afraid of falling.
Hi again
its slow going for me, have been out of the sling for several weeks and my collar bone is in the correct place at least but my shoulder feels pretty weak and stiff and prone to clicking a lot, hopefully as the muscles return this should improve but its taking longer than I had hoped!
good luck
Hey Richy. Sorry to hear it’s slow going. I’m about 4 weeks post op and just started PT. My ROM is pretty solid. I’m going VERY slow, NO lifting, and following doctor’s orders. From everyone I’ve spoken to, this rehab time just takes awhile. Do you still have any sort of bump? From swelling, scar tissue or otherwise? Just curious. Happy healing my man!
Scott
Hi Scott – no bumps, just sore muscles am trying to build back up slowly without risking doing too much.
Range of movement pretty good but shoulder joint seems prone to clicking – can hold my arm straight up in the air and rotate the shoulder fully without pain , clasping hands together behind my back pretty painful though – am hoping hole shoulder will tighten up as I get some muscles back – am seeing the surgeon again soon – so will see what he says
I’ve read that ful recovery could take a year , but the last few days I have seemed to feel its improving
Hope you continue to well ! good luck , keep me posted
Hi Scott
no I have no bump at all but shoulder muscles still rather sore and weedy – trying to build them up with some light PT – overall I am making progress but slower than I had hoped
How you getting on?
Rich
Hi All,
I have a grade 3 separation from a mountain bike accident were I also broke 4 ribs and punctured my lung, cause of the lung they wouldnt operate till it healed, this took about 5 weeks to recover, then I was told it may be best not to have the surgey as I have full range of motion.
The bump on my shoulder is huge and feels like someone is poking me from the inside with a sharp stick, the whole shoulder aches most of the time and the arm has dropped to a point where I look lopsided.
It has been 9 weeks since I did it now and my ribs still hurt a lot. I am presuming they haven’t healed fully from being broken yet but sometimes get the feeling the shoulder blade having dropped is irritating my ribs, has anyone else had this?
I see the shoulder specialist in 4 weeks for a review, he said from the out set I can choose to have the op any time if I am not comfortable with it.
I am 42 and used to being very active and am very much in 2 minds on what to do? Any advise would be greatfully recieved.
Dave
Hi Dave,
Thanks for commenting. The rule of thumb seems to be; if you are in pain, particularly sharp pain, then seriously consider surgery.
Hi Richy. Sorry you’re sore. That sucks but hopefully it’s getting better with time. Hang in there.
This is for Dave too.
I’m 40 and had the arthroscopic surgery done about 7 weeks ago in southern California. I was in a sling for 4 weeks and then went to see my PT guy to start on 4 weeks of getting the range of motion back. I was basically at 95% range of motion when I saw him. I’m just doing isometric exercises at home (holding a squishy volleyball size ball under my arm and squeezing… stuff like that). I’ve had ZERO pain basically from about a week post surgery. When I wake up in the morning or push my right shoulder forward, the bump is a bit more noticeable. NOTHING like before the surgery. My whole right arm/shoulder area has been in atrophy since the beginning of the year (I had elbow surgery in January and was immobile) so I have NO muscle tone in that area. I go in next week and will hopefully get the go ahead to start strengthening and do SUPER LIGHT overhead presses and stuff. Overall I’m SO GLAD I had surgery (class 5 and all) and am hopeful that by years end my muscles will be back and it’ll be like it never happened.
Dave… Amal is right. If you’re in pain, I’d say do it. Why go through life with pain and a monster bump on your shoulder if you don’t have to? Not sure where you live and what your insurance situation is, but I’d HIGHLY recommend getting a doctor who does the less invasive arthroscopic procedure. It doesn’t involve any drilling holes into bone or sawing the end of the collar bone down. I just have this synthetic shoelace thing tying my collar bone down in place and as time goes by I am hoping that everything will just grow around it accordingly.
Take a cue from Amal (and this was confirmed by my surgeon as well who was awesome) Some doctors say you can have it ANYTIME down the road, however that procedure will often require a cadaver ligament instead of a synthetic fiber. After researching the hell out of this injury myself, it also just make sense: after and injury occurs the body is in trauma and will start to rebuild around the new configuration of what exists. IF you get it done earlier, it just makes sense (to me anyway) that BEFORE the body has a chance to ‘rebuild’, a good doctor can get in there and tie things in place. If a person waits, it just makes sense that the body will have already grown scar tissue around the injury and then your body has all that in place. Then again… I’m NOT a doctor… just going off my personal experience.
Best of luck healing gentlemen and hang in there! I can already see the light at the end of the tunnel, and while I don’t forsee a major league pitching career in my future, I’m confident this will be in the rear view in a few months of sticking with the exercises and having patience in the healing process..
scott
mckid814@aol.com
I have a type 3+ and have been reading your comments. I am 35 it happened 4 weeks ago now and I have a full range of motion in my shoulder with very little pain have got to see the surgeon in 2 weeks have not made my mind up yet to have the op done or not but I am a very active person and like to go to the gym and go mountian biking which I am going to give a try this weekend and I play golf to any ideas if I will be able to continue all this without the surgery and for the first week I wore a sling which I couldn’t wait to get rid of and after that I wear an ac joint shoulder strap whilst at work and home have still been able to do some light duties at work not that I have to I am lucky I don’t have to do that kind of work I am pushing my self a lot just to prove I can do something, I heal very well with most injury,s but just need some feed back of some people who have the experience in this injury.
Hi Scott and everyone,
I’m 3 weeks post cycling accident at high speed. Ortho diagnosed Grade V separation of AC joint and I have the big bump on my shoulder. I have other injuries which are delaying my progress towards AC surgery – 9 fractured ribs, 3 cracked transverse vertebrae and a punctured lung. I’m over in Singapore for work so haven’t been able to fly back to the states until my pneumothorax (punctured lung) is cleared. My concern is that I have maximum opportunity to get back to full use of the arm. I do a lot of swimming with triathlons. Also rock climb and do crossfit. At this point I appear to be lucky as I don’t have any significant pain in the shoulder and can lift it above my head. It is stiff though and I do have a lot of cramping in the scapula area from weight of the shoulder pulling down. Doc says I would have more pain if I had a torn tendon versus a completely ruptured one. Any input would be great. I have two appointments with shoulder surgeons next week when I return. I’ve read a lot and heard of a technique called Lars Ligament which has what appears to be a high success rate. Also heard it hasn’t been approved in the states. It also sound kind of like a modified weaver dunn procedure? I do already have holes drilled in my bone with a plate and 9 screws in the displaced clavicle from a 2008 accident. Figured I could go under the knife, remove the plate and get the shoulder surgery done at one time. Thanks advance to anyone that can give me their thoughts. Before seeing this thread I sent you an email Scott. I saw you on the Shoulder1 thread and you seem to know a lot.
Dave
djlundberg64@gmail.com
Hi guys
not blogged here for ages – having had a tight rope surgery to pull my clavicle into place I was struggling a bit a few back and was worried that the surgery had not worked properly.
Saw my surgeon a few weeks back and had x-rays to demonstrate that all OK
few weeks further on with ongoing PT shoulder is thank god returning to normal – working on building muscle back up
much happier today than I was a month ago
Hi Guys,
I had the same problems as the original post. I’m and active duty military member and the doc basically just tried to talk me out of the surgery. But, I had the surgery right away and after a lot of PT I finally got back to my tip-top shape. I always prided myself on being very, very fit. It was a crushing blow to thing that I would never be 100%, so I just had to give it a go. Fast forward to three weeks ago and the sucker popped loose. The amount of pain I’ve been having in the shoulder has been ridiculous…mostly at night after a long day. My bump is huge, and my range of motion is cut in half. 18 months; that’s all i got out of it. Granted, I’m a Crossfitter and doing all of my Army training, etc. but I just don’t think I can do this every 2 years. What do y’all think? Should I give it another go? What to do, what to do…..
Hi,
how are you all doing that had surgery? Had my double tightrope (no cadaver) surgery 4 weeks ago and am in a sling for 2 more weeks. I had the surgery 2 weeks after a mt bike accident and seems to be going well so far. muscle are gone since i babied it for the 2 weeks before surgery. no real pain, a bit achey at night, but otherwise fine.
Hey About 2 months ago had a class iv separation, Went to doctor and he offered me surgery but I refused it (Canada its free) Even though it was free I still refused it. I have a bump sticking outta my shoulder went to physio only twice and was way ahead of the exercises she was giving me. Now 2 months after the injury I have no pain what soever and my range of motion is near perfect with no pain or anything. I can reach as high up on my back as my other arm and most of all my strength and muscle is back. Just saying surgery isnt always the only option. It does heal after a few weeks of pain it does get better
Hey Guys and Galls,
I’m debating joining the surgery club or not. I have two weeks to make the call and have a couple questions/ other issues that I would love your feedback on. First like you guys I have a stage 5 separation and have a pretty large bump. The swelling has pretty much gone down now and I’m not in terrible pain. I’ll be turning 29 in a week so I have a lot of my life ahead of me to heal this and a lot of my life ahead of me for this to get worst. My concern is that I am buying a house and settling at the end of September so my funds are tied up and limited at that. I have insurance but still need to find out what this is going to cost me. If I don’t get the surgery I might be able to heal enough to assist with the move and if I do get the surgery then I will probably have to hire movers or at the least buy cases of beer for some friends, provided they can help. How have things been now that you guys received the surgery, what kind of collateral damage either financially or physically do you think I’m looking at if I do or don’t. I’m in sales and don’t really have to do any physical labor but I would like to be active and be able to toss the ball with my kids should I ever have some.
Hi. Scott here. I haven’t checked in in a LONG while. I’m 4 months post op. At the risk of repeating myself, I had a joint reconstruction on a class 5. NO screwing into clavicles or shoulder blades or anything.
My ROM is 99.9% and I have absolutely NO pain. Been back in the gym, BUT I haven’t being as diligent with the precise exercises as I should. Been doing overhead presses and triceps, but last week started with the isometric band exercises to build up the whole shoulder. As we all know it’s a tricky joint, so I’m going balls out this month.
In the morning when I wake up my bump is most noticeable. It dissipates throughout the day with activity. Is it freakishly HUGE? No. Do I want it to go back EXACTLY the way it was before my accident? Yes. Will it? I don’t really know. I think over time (and speaking to 100’s of people who have had this injury) they all say it goes down with time as the muscles grow back to compensate for the shredded ligaments. My doctor said there will always be a little difference, just because I tore the hell out of it.
Anyway, I’m going back into the gym tonight to seriously work this thing over. Whether you get the surgery or not, it take a LOT of tedious PT and patience and time.
Good luck to everyone!!
scott
mckid814@aol.com
Hey everyone..im a 23 year old crossfitter from toronto. On sept 13 i wiped out on my fixed gear bike and suffered a grade 3 ac seperation. I saw the orthipedic surgeon the day after injury and was told the arthrex tightrope procedure/operation would be his recommendation due to my highly active lifestyle. He said that if i didnt get this done there was a chance i would never get 100% of my strength/ROM back. I have decided to go for the sugery on sept 21 as i would rather fix the problem now instead of wait and see if it bugs me later in life. I have done tons of research into this and hope i ammaking the right choice.
Il keep this thread updated coming up to and following the surgery..and many thanks to richy and scott for their input on this…your posts answered many of my questions.
So I’m 10 weeks post op my tightrope operation and getting my range of motion back. I’m 46 yrs old in good shape and keeping fit on the exercise bike. Its a slow tedious process but i can feel it coming back every day. I am also doing some isometric exercises with bands and using a 2 lb weight. Went to the doc on Friday and he said all looks good. Muscles are springing back ever so slightly but looking forward to getting some real mass back next month. So far I am happy about going ahead with the operation and am being optimistic about a full recovery.
Hi
Just found this site and would like advice. Am 49, cyclist riding 4k miles a year with a grade 3/4 ac separation that happened 9 years ago. Wasn’t offered surgery at the time, just the conservative option. Until recently been mostly pain free with full ROM but it has been getting more and more uncomfortable of late. Have often wondered about surgery but now think that maybe its too late to do anything?
Hi Chris,
If you have gone 9 years without pain and now you’re having issues with both pain and ROM? Without much more than that to go on, my thought is arthritis… and I don’t believe surgery will help with that. Your best bet is to talk to an arthritis specialist first, then talk to an osteopath about having surgery.
Can you describe the pain? Is it an issue of your muscles not being able to keep things together and now the shoulder is coming apart and causing pain, or is it more “grindy” and “gritty” in the shoulder joint itself like arthritis?
Hi Amal,
Thanks for the response. It’s hard to define but not gritty. More a general discomfort, aching and low level pain throughout the various parts of the joint. Tension in the shoulder muscles generally and the upper arm as if the dislocation is no longer being coped with.
Think it best I ask for a referral to the osteopath.
Hi I also could use advise. I’m 3 + months out from my grade 3 seperation I’ve been to three different doctors the first told me up front after diagnosing me a grade 3 that he thinks I need to see a different Dr. One that does more shoulders. So then I go to the second Dr. a week after the injury and she says no surgery which I was very happy to hear at the time. She scheduled me to see her a month out from the injury at that point I was not much better if at all I told her how frustrating I was and she recommended physical therapy after three weeks of PT I realized that it didn’t seem to be helping and depending on what I was doing I would be more sore the next day. So I decided that maybe I needed to see another Dr because of the lack of progress and the second Dr didn’t seem to be concerned at all. So I went to the third Dr three months after the injury and he said the same thing as the second Dr. no surgery and he gave me a time frame of 6 -12 months which is much longer than the 3 months that the second Dr said. Both Dr.s are telling me that the tight rope surgery is cosmetic. I have no idea what to do I haven’t had much experience with medical stuff before. I know my body and I know how I feel and I will not feel right until my shoulder is put back together or at least stabelizes somehow. Is tightrope a real solution or is it for cosmetic? And if it is a solution why is it not being offered to me? It seems I fit the bill I’m 30 years old athletic and my job requires that I lift heavy objects over my head which I read might be very difficult without surgery and most importantly I’m still in pain 3+ months out. How does insurance handle this injury? Can I just tell the Dr to fix me and have it be covered? If I can it seems like that’s what I’ll have to do. If anyone can help with any of my questions I would appreciate it very much.
hi guys, an update on my story
i had grade 3/4 seperation and was givin option of surgery or no surgery. i am now 3 weeks post Tight-rope ac surgery and am still in a sling. i had the operation done by an experienced surgeon that had done more than 20 of these procedures before. first week post op was pretty painful i have to say, constantly uncomfortable and virtually unable to do anything for myself eg, shower, make dinner, get up , get dressed etc…
3 weeks later and i feel better every day. as i mentioned i am still in a sling however i feel i am just able to move my shoulder the slightest bit ( few inches ) comfortably and pain free. i had the arthroscopic procedure done and it looks as though the scarring will be minimal ( about 13 stitches all together in 4 places ). i have an appointment with my surgeon at the 6 week post op mark where i think i will get out of the sling and begin physiotherapy, I CANT WAIT!
overall i am very happy with the outcome of surgery SO FAR…it has been difficult wearing the sling and just after the surgery was like hell however i can really feel the improvements everyday.
as for you Matt S. from my understanding the ac tightrope is not a “cosmetic” procedure, however it is also not permanent. what the ac tightrope does is pull you collarbone back down into its right position and allows for the teared muscles tendons and ligaments to heal at the appropriate length in order to hold and support the ac joint for the rest of your life. the actual tightrope will not support the load on the ac joint forever and the nylon sutures will stretch out and even break eventually if your bodies own ligaments tendons and muscles do not take over or do not heal correctly. therefore the ac tightrope is not a guarenteed fix. everybodies chances are different depending on age, activity level, injury, and amount of time between injury and surgery.
i am a 23 year old highly active male, thats why i received the operation, my chances of a good recovery were high. also i got the surgery just 2 weeks after injuring which also increased my chances, the longer you wait, the longer your body will heal your tendons and ligaments incorrectly.
3 months post injury seems like way to long to get the operation. my doc told me 4 weeks is the danger zone of ineffective surgery. my advice….research a specialist in your area and talk to them to see what they say.
good luck with your injury hope you get well soon!
we feel your pain and we know it sucks 🙂
hospital: St. Josephs Toronto Ontario Canada
MD/ortho surgeon: Dr. Amr Elmaraghy
I’m now 16 weeks out of surgery. ROM is getting much better and the tight spots seem to be reaching over my other shoulder and behind my back, although these are improving too. I have been running for the last 4 weeks and I went for my first swim yesterday. It was more a stretching exercise than cardio workout. Pecs are still very weak and will be going very slow over the coming 2 months. I do lots of stretching during the day (4-5 times) and lift some light free weights (twice a day) to strengthen my back muscles. These are all done on my stomach on the kitchen counter and involve lifting a 3-6 lb weight in various configurations. Still have a ways to go but can feel and see the work is paying off. I will continue with PT to work on my ROM and strength. I had a check up/xray a few days ago again and all looked good. I feel more and more back to normal each day and am happy I went for the surgery. Being in the sling was the hardest part and I was pretty down about 5 weeks in. The atrophy was significant and I would look in the mirror and feel like I was wasting away. It does get better with time and if focus on the long term goal and not on the day to day it helps with the anxiety.
I just stumbled upon this site and experienced a 3rd degree separation roughly 4weeks ago. I have the lump on my shoulder and the first 2 weeks were really painful. I saw the Orthopedic Surgeon and he advised against the surgery even citing himself as an example of this injury and stating that he did not go forward with it. He advised that if I did elect to have surgery the tightrope or shoelace method would be used and that I would be in a sling for 6 weeks with 6 weeks of PT after that. He also, referred to the surgery as more of a cosmetic surgery. I had ankle surgery last year to clean out bone spurs so I know surgery is no joke, but my ankle is feeling pretty good almost 1 year later. He recommended a surgeon that specializes in the surgery but I am also seeing another specialist next week for a 2nd opinion. I am 29yrs old and play hockey regularly so being active is a big part of life. I will update once I get the 2nd opinion but ROM and pain has improved, but the lump definitely remains.
i am now 5 1/2 weeks post injury for a grade 2-3 sepation to my right ac joint. i am 50 years old and want to know if anybody at my age has had the tightrope surgery with good results as far as ROM and reduction of the insightly lump…have i waited to long to have this surgery with good results?