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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. Greg says:

    Hi everyone,

    Wanted to get thoughts on surgery versus no surgery path. I’m 24 and suffered a grade 4 displacement with no other damage aside from full tearing of all ligaments. I was told by an ortho surgeon the clavicle is 100% displaced but no other fractures/collateral damage.

    She advised a conservative approach with 2 weeks in a sling at which point begin ROM PT and 3-6 months of PT about twice a week. Her opinion was that having surgery wouldn’t necessarily provide any added benefit versus a conservative approach. She also said surgery could be done down the road if traditional PT isn’t responding well.

    From what I’ve read it seems that there is a small window to perform surgery that sets the bones correctly (maybe about a month’s time) before the scar tissue begins to form in the area. After that it seems that a cadaver ligament would be used if surgery is needed down the road.

    I was hoping to get some opinions from those who have been through this injury on whether or not to get the surgery. I work in a traditional office job that doesn’t require physical output but I do have an active lifestyle outside of work (cardio and weighlifting about 3-4 days per week as well as golf, biking, etc.)

    My gut is to do try the conservative approach because I don’t really care about the bump or what it looks like but I’m hesitant that I’ll miss this “window” to do the initial surgery that doesn’t seem to be an option down the road (rather just the cadaver ligament is used). I’m currently insured through my employer so my insurance would pick up most of the cost I believe. Also, does anyone have estimates of what the surgery typically costs if the insurance didn’t pick it up?

    Thanks for the information & support!

  2. fahim says:

    hey Greg,

    from my research, a grade 4 separation should be corrected by surgery. i am 23 and suffered a grade 3-4 and had the surgery. i am now about 10 weeks post op and have begun PT. im feeling better everyday. my understanding is that if you dont get surgery you may be fine for years however your chances for developing arthritis in your shoulder in the future greatly increases. you may also have other complications down the road. if you are 24 years old and live a fairly active lifestyle, seriously consider the surgery. having the surgery has a much longer recovery than not having the surgery but it will benefit you in the long run. from people that i have talked to that have not had the surgery, they say that their shoulder was fine but never the same as before. if you are able to have the surgery to fix your shoulder than why not go for it? why live with a messed up shoulder if you dont have to? that was my thinking going into this.

    as for the price, thank god i live in Canada and i didnt have to pay a penny. i was injured and had my operation a week later. i dont know if this helps but usually u are in the hospital for 1 day after your surgery. i had mine done at 11pm monday and was out of the hospital at 6pm tuesday.

    let me know if you have any other questions i will answer them as best i can.

    i feel your pain

  3. Adam says:

    Im now at 22 weeks post surgery and swam 1600 yards the other day. Also got on my bike for the first time last week and rode 10 miles. Been running for a while now and up to 8 miles no problem. Still not 100% but am confident I can and will be able to do the things I want to do. Still tight in the morning and my across the body ROM is only about 75% of my other uninjured side but doc said it would come back. Working hard on getting the muscle back and continuing my weights, pushups, planks and swimming. Working it out leaves me sore sometimes but I guess any hard workout would leave me sore. Good luck to all of you, will chime in again in a few weeks…

  4. Dave Lundberg says:

    Hi everyone,
    Just an update from my previous posting from Dave on July 3rd,
    I had a class III separation (downgraded from class V) along with a ribs and vertebrae fractures on June 7th of this year. I opted to not do surgery as the experts I’ve spoken to say if you can live with the cosmetic bump it’s best to go conservative. At 6 months I am accepting of my shoulder the way it is. I do crossfit, and am into longer distance Ironman triathlons. I have completed an ironman triathlon (Wisconsin) in September of this year which was 3 months out from the separation. Swimming and long distances on the bike in aero positon have caused me to chew Advil like chiclets… I can do weights almost the same as pre-accident (bench, deadlift, curls, etc) except for certain angles. Like others have said presses like military and any angle above the head does not work. Other than that everything else a go. I will say there’s additional ache and discomfort after exercise that involves the shoulder. I believe we all deal with that as we age though. Sort of a rite of passage. I so much appreciate all of you that have posted your experiences on this thread. Though I haven’t updated over the 6 months, I’ve been here reading your situations and how you are meeting the challenges from the injury. Your own accounts give me strength to stay positive and stay focused on my personal fitness goals.

    kind regards,

  5. anthony says:

    my Doctor was against the surgery also, with the same question of what I do for a living and no significance blah blah blah…. i am was adamant about the surgery and am waiting to be scheduled. honestly looking at the joint and how it works it seems like not fixing it could be dangerous as i plan to continue biking (how i separated it) playing b ball and snowboarding. i’ll report back after surgery and as i heal up.

  6. Aaron says:

    Hey y’all,

    I am having surgery on 8 Jan 2012 on a grade III AC separation. The doctors said it’d most likely be a IVd but my skin was holding it up since I am thin. My injury occurred almost 2 years ago and I have been dealing with pain on and off since. I am an active 24 y/o guy and have been limited on what I have been able to do. I have been to a couple orthopedics and have heard the same things y’all have been hearing…”your chances of recovery are the same with or without surgery for grades I-III.” In my case, I am tired of having daily pain and not at least trying the surgery while I am young does not make sense to me. I think it is a case-by-case, personal decision to make.

    Good luck guys and I will update after my surgery and let you know how it goes.

    -Aaron S

  7. Carlo says:

    Hi all

    I had a grade 5 AC joint separation and was operated 12 weeks ago. Made really good progress initially after doing physio and non weight bearing exercises. The last couple of weeks I haven’t felt improvement and the stiffness is still there. Is this normal? I’ve stopped physio in the mean time as I felt I could do it myself. I was told by my surgeon that I can start doing weight bearing exercise at 3 months, which is now. What type of exercise would you recommend? How hard can one push yourself? I’m into triathlons, so the pain threshold is quite high and don’t want to do damage. Can one do damage when your follow up X-ray showed that the shoulder healed nicely?

    Will appreciate your thoughts.


  8. Brenton says:

    Hey guys,

    I came off my motor bike and had a grade 3-4 serparation. Went to hospital and got xrays and scans, the doctors there sent me home for the swelling to go down. They rang me back and explained everything to me, about leaving it or surgery saying again what do you do for a living. I’m a diesel fitter and when I told him, he scheduled the surgery for the next day saying that there will be no way I would ever return to normal duties if I dont have the surgery.
    I had a hook plate installed that they screw to my left clavicle and hooked under my rotor cuff, I think but dont quote me. That was there for 12 weeks, for which I could drive a manual( need my left arm for that I’m in Australia) and it hurt a little, but my ROM was 25% max for tht 12 weeks. Had the plate removed for 2 months now, more weights than I used to to build up strength, man you forget how much you lose when not using it. The clavicle does stick up at the shoulder end by 2-3mm and I have a 200mm scar there, it “crunches” while doing push ups, and aches a little in the morning till I have a shower, but apart from that, I don not regret having the surgery at all.
    When I popped my shoulder, the end of the clavicle that is meant to be on your shoulder was borderline touching my ear and my shoulder dropped 50mm down and looked like I had a birth defect or something similar. My dotors gave me the same story of conservative is better, until he asked what I do, something to think about if it matters.
    Feel free to ask questions guys.

  9. Tyler says:

    23 year old fairly active male here. Suffered a grade 3 separation in September and was told by the surgeon that I could opt for or against surgery, as many of you were also told. After a few months I was still feeling pain during some every day activities, and had significantly lower range of motion. I enjoy playing rec baseball and football, so I bit the bullet and opted for surgery, because i don’t want to regret it later in life. On Jan 18th I was operated on, and while I am only a day removed from surgery, and in a lot of pain (slightly worse than the original injury), I believe I made the right decision. As some have stated, it really depends on what your activity level is, but I would say if you have insurance or can afford surgery, there is no reason not to go for it. I will keep you updated as I progress towards rehab.


  10. Paul says:

    I sustained a Type III AC Joint Separation after falling on an outstretched arm in 10/2007 when I was 58 y. o. I evaluated the treatment options and decided not to pursue surgery. Following previous ACL and Pectoral Tendon ruptures, I went through the same process and opted to be surgically repaired. However, the medical literature for a Type III grade injury indicates a movement toward a conservative approach.


    I have a very high pain tolerance, but have had at least some pain every day since the injury and arthritis has developed in the joint. Usually, the pain intensifies with any movement where my arm is stretched out in front of me, to the side, to the side and back (fly position), and behind my back (trying to touch my shoulder blade). I’m also limited in comfortable sleeping positions.

    The medical literature, Sports Medicine professionals, and Athletic Trainers indicate that one with this type of injury should avoid overhead activities. This means that I would have to omit any kind of pressing movements, but I’m a bit of a relic and have always enjoyed weightlifting as my primary means of staying in shape.

    What I’ve discovered through trial and error is to avoid the following: any kind of forward or lateral raises, flys, bench presses, overhead presses, and dips. Furthermore, I’ve discovered that AC joint pain is intensified through the middle range of shoulder flexion, but very limited or non-existent above or below that range. The following exercises virtually eliminate the impact of that range either because it’s a full body power move or because most of the movement occurs before or after that range as in the Kettlebell snatch or clean and Jerk, handstand pushups, regular pushups, pull-ups, and rowing.

    For what it’s worth, three principles (among others) that I live by are: “Test everything; hold onto what is good” (1 Thess. 5:21; trial and error), “Adapt or Die,” and the principle of Occam’s Razor (basically, the KISS principle: Keep it simple stupid). Even though “professionals,” and I am one, tell you that you can’t do something, the discussion and story doesn’t always end there . . . as Paul Harvey used to say, “And now you know the rest of the story.”

  11. Neil says:

    Hi, I wanted to post an update. It has been roughly 5 months since my injury, a level 5 separation. I opted not to get surgery as at the time I was in the process of buying a house and my money was tied up. I still have a weird bump that is fairly noticeable through my clothes but not very much pain. Sometimes I feel weird or that I going to do damage to it if I sleep on my right side and put weight on the shoulder but it doesn’t hurt. If I lived a more active life I probably would suggest surgery but I am not experiencing pain or any limit to my range of motion. I’m only 29 though and my doctor suggest I get the surgery to prevent any long term damage that could come about if left untreated. I’m a little skeptic to this so if anyone has any suggestions they would be much appreciated.



  12. Stuart says:

    Hi, I just wanted to add my experience.
    I crashed my bicycle in December 2012 and fractured my collarbone and dislocated ac joint. Surgeon didn’t say what grade it was but only that the cc ligament was completely torn.
    I live in the uk and was told by NHS to leave in sling for 6 weeks and see what happens. I wasn’t happy with this so luckily I have health insurance and went to see orthopaedic surgeon. He also said I could see if it would heal in sling but he could do surgery if I wanted.
    I live an active lifestyle, love road cycling and have a job that requires a good level of fitness, ( satellite engineer) so I opted for the surgery which I had 2 weeks later on jan 4th 2013.
    So here I am 3 weeks post op. The pain has reduced and only some movements are sore, but I’m still in the sling until I see surgeon at 5 weeks. Doing physio everyday from day 1 post op where my wife has to move my arm in small movements out to side and front to keep the muscles from seizing up.
    Hopefully when I see surgeon next time I am allowed to start driving again and start on getting muscle strength and rom back with the big elastic bands.
    Would be good to hear how everyone gets on and it’s also useful for others to read when considering their options.


  13. fahim says:

    hey everyone,

    im 4 and a half months post op, had a grade 3 to 4 seperation. i have been posting in this forum regularly and found it very helpful. stopped physio after 10 weeks and now i have been starting to go to the gym again with light weights, legs, cardio and lots of stretching. shoulder has healed nicely, no bump visible and x rays show no stretching of ligaments. everythings where its suppose to be. i am happy i opted for the surgery. i had arthroscopic surgery and scarring is minimal and is visibly fading over time. my shoulder is feeling better and better every passing week.

    my advice…if you are a very active, healthy person and money is not an issue, get the surgery if it is an option given to you.


  14. John says:

    Hi everyone,

    I took a fall in May 2012 and have a grade III ac joint separation to my right shoulder. So my ac and cc ligaments are completely torn. I’m 32, fairly active and enjoy running, cycling and moderate weight lifting.

    Two days after the accident I visited a specialist surgeon who told me I could have surgery or not – it was my choice. He advised that surgery would mainly be cosmetic to reduce the bump and if I didn’t have it I would be fine. I wanted to know more before i made my choice so I’ve been researching like mad for ages and it seems like the argument for surgery vs non operative care is quite even. A year down the line the majority of people are at the same stage and chances are with or without initial surgery now you will need some kind of follow up intervention later in life.

    I chose not to have surgery and I’m doing fine at the moment. Post accident I had physiotherapy for 12 weeks and the physio initially advised surgery but after a few visits he was quite taken back by the strength and range of motion I had so changed his mind and said if he was me he would leave the surgery for now. I’m fairly thick set and have lifted weights since I was 18 and he said that helped as I have strength in my shoulder already.

    Running and cycling are no problem. I think I’ll invest in some kind of shoulder protection soon just in case. With the weights the only thing I notice any difference with is bench press and dips, however everything else is fine. My routine is more or less the same now but I focus a little more on my shoulders and rotator cuff exercises to keep the area strong.

    My shoulder is a little sore when I wake up first thing but after a shower it’s fine. It’s depends on my sleeping position at night mainly. Occasionally my shoulder clicks or crunches but there is no pain. I have a bump and it does bug me but I think it looks worse to me than anybody else. If I had the op it would purely be to get rid of the bump but I’d just be trading it for a scar. My wife doesn’t think it looks bad at all and nobody takes much notice when I’m on my hols which puts my mind at rest. I just try not to reach across my body too much as that’s the worst look. I have a little boy so I will probably leave it for now and get it done later on if I encounter problems.

    I’m not for or against surgery and its very much down to personal preference in my opinion.

    I hope my post is useful.

    Good luck with your recoveries.


  15. Brian says:

    I’m new to this thread and wanted to share my story as I read that several people are questioning the path of surgery.

    10 years ago I had a grade 5 separation of my right AC joint – due to a rugby injury. I was 18 at the time and the orthopedist recommended I wear a sling for a few weeks. I did that but had no follow-up, no PT, nothing. Nobody gave me the option of surgery. They told me my shoulder would heal itself and adapt to the structural changes..

    Well, my shoulder adapted pretty well. Over time I could do just about everything I did before, but there was always soreness afterwards. My clavicle became severely deformed, but I was able to do pull ups, ride bikes, swim, throw, catch, pushups etc… However, after pushing my body to new limits with weight training this past year, I started experiencing sharp pain in that shoulder which prompted me to get it looked at. The tests showed a mildly torn labrum, but the doctor didn’t hesitate to bring up my deformed collar bone.

    After a lot of research and multiple opinions, I went in for a complex reconstructive surgery + the SLAP procedure for my labrum. The recon was a modified Weaver Dunn – performed anatomically with a donor tendon from my hamstring. It lasted three hours. I have a 3.5 inch scar straight down my shoulder towards my chest, and 3 incisions around the AC joint. I was in a sling for 7 long, hopeless weeks. I have since been in rehab for 2 weeks and can easily see how challenging the road ahead will be.

    I chose to do the recon because I wanted to get back to a healthy exercise schedule with pull ups, pushups, swimming, running etc. and this last year had been the most active year of my life up until the re-aggravation of my shoulder. I felt like my body was plateauing much earlier than it should have and then the labrum tear happened. The torn labrum was small and maybe the cause of most of my pain, but while my shoulder was able to cope with the severe separation for an entire decade, I had lost strength and flexibility. I just didn’t know it until I tried to do something more with my body. If I knew that I would never bother weight training again, I probably wouldn’t have done the recon. It’s a major, major surgery and it will test you like you’ve never been tested before. It’s not one of those surgeries where you can get back to work in a couple of weeks. I type 100 WPM and am on the computer a lot! I couldn’t type for 5 weeks…

    This was all spouted out in a stream of consciousness, so forgive me for that. If anybody would like advice from someone who is in post op for a major reconstructive shoulder surgery + labrum stitch please don’t hesitate to reach out. bstrutz@gmail.com


  16. Brian says:

    EDIT –

    I lived for 10 years without surgery after a grade 5 separation. I developed arthritis on the edge of my collar bone (which was removed in surgery) and a deformed collar bone. There was also a small fracture in my collar bone that the initial doctors missed … this fracture inhibited years of calcification that also needed to be cut off of my collar bone.

    I added that so people can see what happened to me 10 years later after choosing not to do surgery. I was also in my 20s for most of this time and my body was quick to adjust.

    All that to say, here I am 10 years later… i got the surgery because I needed it.


  17. Sarah says:

    I have a grade 3 separation from falling on ice. I’m a 35 y/o woman, very active and fit. I landscape, garden, hike etc….everything I do requires all of my limbs to be in correct working order, lol. My doc said surgery is optional. What hooked me was him saying ” I can reline your bones with surgery”…bla, bla, bla….. I thought to myself, relining my bones sounds good, lets do it.
    I am scheduled for surgery tomorrow and am nervous as hell, but I feel better after reading these testimonies. I chose to skip right to surgery and not have the regrets in the future. Here’s to getting back to normal sooner than later….;)

  18. Brian says:

    Good luck with your surgery Sarah! It sounds like your surgery will be different from mine so I can’t speak on what your post op will be like, but I hope it goes well. 35 is still very young. You have a lot of life to live, so i’m sure this will be the best decision for your future.

  19. Stuart says:

    Good Luck Sarah with the surgery.
    Doc said I was grade III and had the ‘Lockdown’ procedure with an artificial polyester braid ligament.
    I’m 6 weeks post op now. Started driving a few days ago and cycled for 40 mins yesterday. Still only about 75% of strength but continuing with physiotherapy for a few more weeks.

  20. Scott says:

    I am a 25 year old Male. I suffered a grade 3 separation in AC join in my left side 4 years ago. After being initially diagnosed as a “bruised shoulder ” by my college’s health clinic, It was almost two months before I realized this was not your typical bruise and the bump was not going away. I went to a Sports PT, got my xrays done, and it was determined that I was border line needing surgery, but therapy would work. I did about 6 weeks of therapy.

    Let’s fast forward to today. I recently have been feeling pain in both my shoulders while doing some pretty rigorous workouts. I have been active in weightlifting and exercise for 8 years or so. I decided to go to a Chiropractor / Licensed ACT therapist who then put me through an hour eval. It has been determined that my left (injured shoulder) has tightened up and pulled forward, due to the injury and scar tissue. This shoulder is also significantly, and visibly higher up than my non-injured shoulder, and looks very funny in the mirror.

    My right, non injured shoulder, is extremely loose, and was told is not as strong as my left – my thoughts of being a lacrosse player has loosened up my throwing shoulder.

    Any similar experiences or ways to losen up the scar tissue to ‘pull’ my shoulder back and to drop it down to being even, or to strengthen/tighten up my loose shoulder?

    Thank you.

  21. Chris says:

    Hi everyone,

    Thanks to all for posting on the thread, it’s really helpful to hear from many who have been through this injury and tried different methods. I’m 36 and I got a grade II or III separation in January 2013 (now I’m about 5 weeks out) while snowboarding. It’s on my dominant left arm. I love racket sports and played a lot of competitive badminton earlier in life, which involves a lot of full overhead shots. Despite the temptation I have opted against surgery for now – not that Kaiser would have let me do it without a big fight, I’m guessing. Instead I’m rehabbing on my own like a maniac, the rule is if the TV is on, I’m doing ROM exercises and lighter weights of 2, 5, and 10 pounds for about 1.5 – 2 hours every night. My range of motion is now very good, and wherever it isn’t, I work the tight/painful area with gentle 2 pound weight exercises until it starts to loosen and strengthen.

    So far I’ve had good success with this approach and I’m able to throw and swing now, thought not at full force. I can also do pushups and some pullups (only about 5 pullups now, as opposed to 10-12 at a time before). Sadly I’ve stopped most other exercise for the time being, I figure it’s more important to spend the time getting the shoulder back as quickly as possible so it doesn’t atrophy.

    Most of you on here have higher grade separations than I did, but for now, nonsurgical approach seems to be working for me, even though I typically tend to be very hard on that shoulder. If that changes I’ll certainly update. Good luck healing to all.

  22. Fahim says:

    whats up guys,

    i have been posting here since i got injured with a grade 4 ac seperation. i opted for surgury and am now 5 months post operation. i had the ac tightrope installed. i am doing great, no visible bump at about 99 percent ROM. shoulder is getting much stronger and i feel very little pain and stiffness.

    i am very happy with the outcome of th surgury and recommend it for anyone who lives a very active lifestyle.

    good luck !

  23. Greg says:

    Hey guys,

    Just wanted to give a follow up to my post several months ago. I suffered a grade 3 ac separation (100% displacement), with complete tears of all ligaments. Ortho said I could do the surgery but would be trading a scar for a bump and recommended giving 1-2 months PT (2x per week) to see how it responds.

    I was in a sling for about 2 weeks, then in and out of it one more week before finally ditching it for good. Once I met with the ortho who told me that I really couldn’t do any more damage, I decided to just do as much as I could (obviously no lifting and using common sense) but just deal with the pain to push ROM as early as possible.

    I started PT on Dec 14 (injured it on Nov 25) and ended first week in Feb (just about 7-8 weeks) with 2 days with the physical therapist and constantly doing ROM/slightly increasing strengthening on my own on off days (occasionally taking some days completely off). In the last month I’ve returned to normal lifting regimen with no difference in strength between my injured (right/dominant) shoulder and my left shoulder. I’ve avoided doing dumbbell shoulder presses and have been using assisted benches to be safe for the time being. I’ve been able to do dips but definitely experience pain afterwards (but nothing too alarming). It definitely still aches/dull pain after lifting but it’s manageable. Also, no major differences between sleeping on my good/bad shoulder but sometimes certain positions just bother a little more than others.

    At this point (3 months out) I’m shocked that I was able to return to normal lifestyle just 2 months removed from the injury. Actually in better shape than before due to being dedicated to PT & re-strengthening the shoulder. I do have concerns that the aches/pains won’t subside completely over time, so this is something that I’ll monitor over the next few months.

    I do feel that every case is probably unique and a personal choice whether or not to do surgery/try conservative first. Just wanted to offer my experience – I had read that the important thing was to stick with the PT and that’s the biggest driver in a successful recovery; having gone through it, I would agree but also hoping that eventually I don’t feel any pain at all. Otherwise, I may need to re-evaluate the surgery route down the road.

    Best of luck to everyone!


  24. Roy says:

    Fell out of bed about 4 months ago and had agonizing pain in my right shoulder. X-rays showed a type 3-4 separation that actually sticks out under my shirt. The surgeon suggested I first try physical therapy as at my age (67) surgery was only recommended as a last resort. Any way 3 months of PT restored my flexibility to the point where I was able to resume playing tennis. I also went to a physical trainer who was able to help me restore strenghth. Can sleep on the shoulder with a pillow under it. Except for the fact that I hate the way my shoulder looks, I’m ok. However — if I were younger I would have the surgery for cosmetic reasons.

  25. Diane says:

    I fell about 10 years ago when I was 40. Insanely painful, horrible swelling resulting in a Type III separation. The doctor I saw told me that unless I was a professional athlete I should just learn to live with it. Went on to say that the surgery would leave a 12″ scar like a bra strap. I opted to live with it.

    I have always been active (weight lifting & cardio) but I was in so much pain, I couldn’t do anything for months. My collar bone sticks up if my shoulder is relaxed but looks sort of normal if I hold it “just so”. I am not so concerned with how it looks as with the pain, which seems to be getting worse. I have almost 100% range of motion, but I avoid lifting weights overhead. Still…it pretty much constantly aches.

    Fast forward 10 years, I just turned 50. I still work out regularly, trying to lift weights to keep my strength up. I just spent a week painting several rooms, very physical work. Now can barely move my arm – numbness and tingling fingers, tightness across both shoulders. Pretty miserable. I can’t afford the surgery (have a huge deductible before insurance kicks in) but wonder if it can be done less invasively these days. Orthoscopically??

    Regardless, I am still not sure surgery is the best idea given everything I’ve read. Especially since it’s been 10 years since the injury. Any thoughts?? Also does anyone have suggestions of exercises that will help? I was never given any PT or direction, just sort of figured it out myself trying to build up the muscles.

    Thanks for the advice.

  26. Brian says:


    Your situation sounds very similar to mine with the exception of age and severity of the initial separation. I was 18 when i separated my right shoulder and am now 28. My surgery was 3 1/2 months ago and I have been in PT for the last 2 months.

    A couple of immediate thoughts on what you said. A 12″ scar going around your shoulder makes me wonder if that doctor knows what he’s talking about. I had a grade 5 separation with a lot of scar tissue and a highly enlarged collar bone (due to calcification over 10 years). My scar is about 3 1/2 inches long down from the top of my clavicle. My doc was very familiar with this surgery (Weaver Dunn) and he did mine anatomically with a donor tendon from my hamstring.

    For me it was a no brainer to get it done because I am only 28. You obviously have a different set of consequences, but you’re not old! If you’re willing to take off work for at least 4 weeks (not knowing what you do) and you’re fine with 6 months to a year of physical therapy, then the decision might not be so hard. The money thing is an issue too. I’m not sure what your co-pay is but the high deductible is a concern.

    As for arthroscopic operations, I don’t know. I doubt it. Not for the Weaver Dunn (assuming that’s what you would get). It’s a major surgery, but it was not as major for me as your doctor is describing. 12 inches! jeez

    Have you had a second opinion?

  27. christy says:

    I’m 16 and have grade 3 with my should, it’s very painful, does anyone have an advice how to stop the pain apart fro. Paracetamol and stuff.?

  28. Paul says:

    Christy, Paracetamol is a weak pain reliever and is, basically, another name for Tylenol. As such, it doesn’t reduce inflammation, like NSAIDs, but it is a safe alternative for children under the age of 12 to avoid Reye’s syndrome and may befit people with minor injuries.
    A grade 3 AC separation is not a minor injury. It’s in the category of “do I or don’t I have surgery.” If you are relatively inactive, you may be able to live with it and have minor discomfort; however, if you are involved in sports or other very physically demanding activities, expect to have chronic irritation, inflammation, and pain.
    I’ve had a grade 3 since 2007, when I was 58, and have had some pain every day since. Even though I have a high pain tolerance and haven’t taken any pain medication, I’ve begun to regret not having the joint surgically repaired because I still like to do things that younger people take for granted and have had to accept the consequences of that behavior.
    If I were your age, and a physically and aggressively active person, I would definitely have the surgery. Your best years are ahead and you don’t want to be limited the rest of your life.

  29. Sal says:

    Hello Fellow AC separation Sufferers,

    I recently crashed on my motorcycle T-boning a car at 40Kph. Prior to the accident I have been very active with a lot of swimming, Weights 5 days a week, motorcycle Racing (Race Tracks), push biking and running. I had the accident on the 28th Of February 2013 and all I remember is seeing stars for about 5 seconds trying to stand up and a massive pain and lump on my left shoulder. I am 33 years old.
    The Ambulance didn’t know what it was and drove me to the Hospital. We did an X-Ray and was diagnosed with a Grade III separation. The Doctor asked me what I did for a living and how active I am. He Asks; is it your dominant hand blah blah blah.. After answering all his questions, he said that it’s not your dominant arm so you don’t need to worry. He gave me a sling and sent me on my merry way.
    Looking into the mirror and seeing the bump was only about 4MM, I was not really worried about the cosmetics but only function. (I UNDERSTAND SOME SHOULDER DROOPING IS FAR MORE EXCESSIVE AND UNDERSTAND YOUR CONCERN) I have a fairly muscular physique and it doesn’t look bad at all, people don’t notice it at the beach after going during my one month off work, So I am happy with the bump.
    Now in my mind, I was not happy with the Docs answer so I went to see an Orthapedic surgeon instead, without a referral which he was pissed about, but I paid big money to see him for a real opinion. He looked at my X-rays and said it’s a grade 3 but was surprised at how small the bump looks and lack of Scapula droop. He mentioned that he believes that a ligament or something is keeping it in place but he can’t say what it is, he sent me home and said you are good, just keep it in a sling for 4 weeks and then start some Therapy. To be honest after so much reading on the internet about this condition, I dropped the sling after 2.5 weeks and at 3.5 weeks can say that I pretty much have full range of motion with slight pain. I have been going to the gym and doing Bench press, 30 Push-ups, Dumbell Curls at 30 Pounds and generally feeling good. Today I also went for a swim and the pain is much better than a few days ago repeating the same activity. I think this is due to the weight training and strengthening my deltoids and chest plus the scapula region. I actually feel great. To be honest the first weeks pain was agony. I couldn’t shower or move that Arm. 3 weeks into the injury and I am able to ride my motorcycle again and Swim. How amazing is that. People that are saying that the conservative treatment will give you arthritis is pure speculation, in fact quite the opposite is true. The surgery will give you the Arthritis due to the bone rubbing again. How can you get arthritis if the bones don’t rub anymore? Make sense?
    I guess what I am trying to say is there is a conservative route for a reason. Surgery involves so many risks including Blood clots, infections, death of the nerves above the shoulder, much longer healing time and on some sights I have actually read loss of limb and death, I think this was enough to scare me out of surgery unless it is totally necessary to do so.
    There is hope for everyone here, the pain gets better everyday and it’s a slow healing process, but I’d love to chat to anyone if they want to talk. email me at selali@live.com.au
    God bless

  30. Brian says:

    re: Sal

    That’s great that you avoided surgery! Congrats — as for your stance on arthritis — i respectfully disagree. 10 years post injury (at 28 years old) I had several signs of arthritis in my shoulder. I did however, have a grade 5 separation. Don’t ask me why the doctors didn’t recommend initial surgery. Sore subject.

    From what I can read about you and your lifestyle — your recovery is very much related to how active you are… you beat the odds so to speak. Most people in the world do not lift weights 5 days a week or race motorcycles or swim regularly. All of this has contributed to your great success. Unfortunately the majority of the world isn’t this active — their results will vary greatly from yours. I’m not PRO surgery or anything, but I think people should understand that if they want to do it ‘on their own’ it’s going to take a commitment unlike anything they have done before.

    But it’s a great motivator for those people who need to know what it takes to heal …so thanks!

  31. dukey says:

    hi everybody!got my grade3 twelve years ago at age 51 (does that make me a veteran)after falling on said shoulder from me motorbike.Because my employment wasnt physical an op was ruled out(didnt wanna put me through the trauma)however he did explain the pros and cons which have already been discussed-and as its not my dominant shoulder i should basically live with it. Well i have for 12 bloody years!
    At 63 now i have arthritis in my hands but not in my shoulder—oh yes it hurts when i hold my arm in a certain position but no pain or aches otherwise.I think over time you learn to position your shoulder or shoulderblade to compensate.Everyday things like putting my coat on hurt or sleeping with my arm forward of my head,youll find the hurtful things as you go along.lifting objects FROM but not TO high positions also pains me but ime okay upto say shoulder height.So the pain of actual movement in said positions has NEVER gone but there is no trauma pain like after the accident-lingering on(ya know wat i mean?)
    Anyhoo i was back on me bike and still am in no time-i recently started back body building and have put on 2 stone solid fat??!! pushing as heavy a weight as possible 5 times a week blah blah—so to cap it all any regrets about not having the op? well no– i just work around things..and here in jolly old England the op is free.Maybe if i had been younger with a heavy job??? Stuff that get a lighter job!!
    p.s.i could have an operation now for a non life threat condition ive acquired but surgeon tells me it could lead to complications if carried out-i.e. its my decision.Talk about passin the buck?

  32. Dan says:

    Hi, I was 14 years old when I got my grade 3 ac separation. Now I am 15 it’s been a whole year. I bmx and went off a jump sideways and fell from 9 feet. I haven’t got surgery and my arm feels great honestly I can do anything. When I bench it aches a lot but I tend to stay away from that. I need someone to tell me if I should get surgery or not because the offer stands, my shoulder doesn’t hurt but it looks very weird.one shoulder (my right one) looks like I was born weird with it. I don’t like it and need someone to let me know if I get surgery will it be like my other shoulder? I just don’t want it to look like this. Thanks

  33. Frank says:

    I came off my push bike last 7 days ago and was diagnosed by the casualty nurse as a grade 4. Looking a various websites, I think mine is more like grade 3 as my clavicle is not very pushed backwards and not going into the trap muscles. Anyway, 1 week in and I am optimistic. Pain is more of a constant ache, like I am wearing a heavy rucksack all day and night. After 2 days I was able to get on a stationary bike trainer and spin my legs whilst holding the bars with one hand. On day 5 I managed to place my bad arm on the bars by using my good arm. I did a 1 hr workout with flat out intervals and completed it ok. I have started gentle rotations of the arm and really slow movements but only with assistance from the good arm. I am a million miles away from feeling strong but can see that healing is progressing. It is hard to believe that I will be able to hit a tennis ball with any power again but reading all the postings above has been very positive. One week in to this experience, I am erring to the side of no surgery.

  34. Pete R says:

    Hi, fell off my Mountain Bike about 9 days ago. Impacted directly onto my right shoulder- looked down to see a large lump through my shirt and pain like I’ve never experienced before. It was intense. I was able to shuffle a few meters to a seat and wait the ambulance. The hospital X rayed me but could offer no advice other than I had an AC joint dislocation- go home, take a few painkillers and see your GP. Anyway, The experience left me shocked as I couldn’t really comprehend that you could be discharged from hospital with out a reasonable outcome- but That’s when I knew nothing about this unfortunate condition. I’ve since seen a specialist and diagnosed with a stage 3 separation. He recommended against surgery- and I must admit when I was doing alot of reading on the net I was almost convinced with the. Surgery option- the surgeon explained a few truths and my mind was made- if I can beat this without surgery then I will. Now 9 days on, the progress is hard to imagine a week ago. I’m out of the sling, did my first ride today (on the turbo trainer indoors) and can raise my arm above my head. Yes, it’s constant pain but I feel every day it’s getting stronger. Honestly in the first few days, the pain and discomfort was nasty- I thought I would never be using my arm again.

    Don’t lose hope. You can beat it- just listen to your body and rest, rest, rest. I’ll update in a while when (fingers crossed) I’m back to close to full use again.

  35. Don says:

    I had a typeIII and was told it would heal and surgery wasn’t needed.That was two years ago so far it hasn’t given me any major problems.I am 53 now and do some construction work as well as ride motorcycles.I have full range of motion and can do overhead work.I snooped around the internet and found info on Rom and rotator cuff exercises.The injury never really pained me much at all but I do have a big bump where the collar bone is not connected.I do uses weights from time to time to keep my muscles up.I had a motorcycle wreck last year colliding with a deer and end up with the other shoulder socket fractured,along with a collar bone and some ribs,so I am still getting myself built back up from that one.On both injuries I tried to follow a good diet and use supplements that would promote healing of damaged tissue and bones.I also do a supplement for joints off and on.I do a multi-vitamin too.It’s just one of those things where everyone is different and injuries even though called the same can very in pain and healing.This last injury to my gleniod Fossa two surgeons advised surgery and I opted to heal it .I have full range of motion but the long term of it is unknown.June I am hoping to get a chance to x-ray it to see if all of the gap in the fracture has filled back in.It’s really a crap shoot with healing or surgery.I was freaked out at first by some of what I read with both injuries,shoulder float,pain and loss of ROM.So far I have had good luck healing and healing may not be the better answer for everyone and it may not be the long term fix but I won’t know that until that day comes.You have to do what you think is the best answer for you,because you are the person who has to live with the results down the road.

  36. Robert says:

    Hi dear brothers and sisters in pain!

    Well I took an idiotic fall doing a drill in Karate class and I decided to flip in the air and roll instead of falling on my wrists and breaking them, except I was falling so fast that I ended up not rolling and more falling so I got a type III.

    I did not have surgery and I have a bump but it is not that bad. I have to sleep on my back or the non injured side and I can manage.

    Range of motion is Ok except when I try to reach my opposite shoulder.

    What makes me mad is that I can’t do the weight lifting circuits I used to do and have noticed atrophy of my right pectoral muscle and my right arm. Dominant side.

    What I would like to know from those who work out and have not had the surgery, what chest exercises can you do? Also, from those who had the surgery, can you work out much better after the surgery than before?

    I am 52 yrs old but I like to stay in shape…

    By the way, great replies and great comments. BEST to all of you!


  37. Pete R says:

    Hi Guys- Just wanted to update on my progress as a reference to anyone else who suffers this injury.

    I had Grade 3 seperation exactly 5 weeks ago today. See my earlier post.

    I opted for non surgical recovery. I am a Marine Pilot- so my job involves frequent climbing of rope ladders up and down the sides of ships (9m long rope ladders up to 8 times a day) When I first did this injury, I seriously felt like I would never do this job again. The pain week 1 was terrible, and movement was severely restricted. However, by ‘listening’ to my body and resting, I have recovered quickly.

    Now 5 weeks post injury, I am close to 98%. Full ROM, close to full strength just hurts a bit some angles and lets me know if I’m over doing it. I do get sore in the muscles of right side upper back and neck, but this is normal as it is the muscles developing in their role of compensation for the loss of support. I am back climbing ladders now and Piloting ships (as of yesterday) and it’s a great feeling.

    After another week or so I’ll start some light resistance training which I’ll build up over time. This will be a commitment for life. The key with this injury is to build the muscles that now have a much bigger roll to play without the collar bone support. When people talk about ‘the bump’ reducing over time, what is actually occurring is the compensating muscles strengthening and reducing the drop in the shoulder- it is not actually the ac joint pulling in- unless you get surgical reconstruction this won’t happen. You will however over time build up scar tissue in the joints where the ligaments used to be, and this will serve to provide some degree of stability- but nothing like it was.

    All I can say is I’m happy so far with non surgical option- yeh the bump is a bit annoying and takes a bit to get psychologically used to but other than that I’m getting there quick- I did 20ks on the mtb trails today (very careful of course!) but that’s after 5 weeks.

    Stick with it- every day should feel slightly better than the last. Good luck

  38. Rich (Uk) says:


    I had a grade 3/4 separation about 12 months ago following a rugby injury, Collar bone was out of its socket – had surgery 3 days later (tight rope procedure)

    ROM 100% now , playing golf (badly) and running etc – have given up the rugby though

    Its an unpleasant injury but just persevere althoug I really don’t understand how anybody would not want surgery to put the bone back in the right place rather than the ‘conservative’ route that many people seem to have opted for?

    I was freaked out by the amount of popping and clicking my shoulder did for a while but that has improved with time too

  39. Chris says:

    I had a grade 3 clavicle separation 11 years ago and just had surgery to fix it 10 weeks ago. I wish I would have had the surgery when it happened, knowing what I know now. Understand something. If you have a complete tear and no support, the body finds support in other ways through more stress on the surrounding muscles, tendons, and ligaments. I had a bicep tendon tear and rotator cuff tear in same shoulder repaired at the same time as the clavicle separation, both believed by my doctor to be caused from wear and tear over the years due to increased stress because of the clavicle separation. Besides the long term physical affects, I also had the mental aspect. People would come behind me and put their hand on my shoulder just being friendly (and not knowing about the injury), one feel of the bone unusually sticking up and they would say “gross! what is wrong with your shoulder?!”. Oh, and hope you don’t live by the beach. Wow, nothing like a clavicle separation to make you feel like everyone on the beach is starring at you, or maybe just me thinking that. Either way, mental stress. Sex, forget about it, one touch by your partner while your arm is in a position (and anyone with the injury knows what I am talking about) where the bone really sticks out and is gross looking and feeling, like you are an alien, and you are absolutely affected mentally. These are just a few examples. Sounds vain and superficial? Listen, growing up as a PK, I know God loves me regardless of clavicle bone status, even knowing this I was still mentally affected in more ways than one and affected most days for 11 years. I guarantee you will be too, 100% no doubt, unless you never use your arm or you are a hermit and come in contact with now one, ever!. 6 hours of surgery, 1 overnight stay at the hospital, and 10 weeks later (I could have did my desk job a week after the surgery), I feel better than I have in 11 years. Go to a sports orthopedic surgeon like I did. I went to the Chrystal Clinic in Akron, Ohio. There are doctors that probably are not skilled enough to do the surgery and those are the ones who will push you off the surgery like my first doctor 11 years ago and then there are awesome doctors like Dr. Dan Myer and his father Dr. Time Myer (they teamed up to perform my surgery)who knows what it is like (Dr. Dan Myer had a major shoulder surgery himself) and have the skill to perform top notch surgery. Greg (and anyone else with a grade 3 separation or worse), I beg you, get the surgery done by a good surgeon and you will be very happy for years to come.

  40. Scott says:

    I am a 41 year old male who is very active in weight loss and weight training. I’ve lost 90lbs in 3 years and have kept it off with around 20 or 25 lbs to go. On January 4th I was wrestling with my son ( who wrestles for his high school) the day before his match and I got a third degree shoulder seperation ( realizing that I am not 18 anymore) we stopped. Its been 5 months and the pain and limitation of almost any activity in the gym or at work has been almost unbearable. I am scheduled for surgery July 9th. I was also told that I didn’t have to have surgery but I felt like trying to be Superman and just dealing with it was not very smart nor productive. I will keep you posted, hope to get better soon to lose the last of my weight………but I won’t be wresting my son anymore.

  41. Eric says:

    Hello everyone I just got news today that it is recommended that I get surgery . I’m 44 yrs old very active lifestyle and 1 week ago I had a nasty spill out the back of a pickup truck. I was taken to the hospital and left with a sling and was told I had a type 2 ac separation everything would be ok in a month. So I was looking in the mirror and said it just doesn’t look right so I went to a highly recommended sports orthopedic dr and was told my injury is a type 5 and would need surgery the technic would be using a band of some sort and ligament repair. If there’s anyone out there please give it to me straight no sugar coating I’m a recently retired army soldier I can take it this ain’t my first rodeo. What am I facing

  42. Amal says:

    Hi Eric,

    A type 5 is a massive separation with bones facing the wrong way. You probably have a type 3 at worst, which is a complete separation of AC joint and supporting ligaments keeping your scapula attached to your clavicle. The sports doc sounds like he’s fishing for cash. All the same, if you have insurance and/or can afford the surgery, get it now. You are still in the injury stage where your own ligaments can be sewn back together. If you wait like I did, you will basically fully recover eventually, but you will never have the endurance on that side of your body because your muscles are constantly doing the work those ligaments used to. Worse, if you wait and then decide to get surgery, they cannot sew your own tissues back together, they will have to use other methods like cadaver ligaments and ropes and screws.

  43. Eric says:

    Thank you Amal my surgery is taking place Friday June 28 @ 08:00 . If anyone is reading this what am I looking at for recovery time after the surgery, bare minimum as to when I will gain some use of my arm and hand. Quick update to my situation I have a type 5 AC separation on my right shoulder and getting it repaired on Friday. And I’m looped right now from the pain med’s LOL

  44. Amal says:

    Recovery time for a type 3 is about the same as if you didn’t get surgery, typically 6-8 weeks. Some say 4-6 weeks, which you might achieve if you take it really easy and don’t re-tear your stuff up by trying to use your arm too soon. Not sure about grade 5, but maybe 8-10 weeks? Obviously your doc would know better, so ask before they put you under 🙂

  45. Tyler says:

    How’s it going everyone.

    Just read through most of the comments and thought i would throw mu 2 cents into this melting pot. In January of this year 2013 i got a grade 3 separation on my right shoulder while snowboarding. Ortho said it was a case of to leave with the bump or not, but my shoulder should be able to do everything it did before. An that is the case so far now in June i have had no pain other than the injury 100% ROM. Also i went to one day of PT and then did the rest myself at a gym, just an independent kinda guy and felt i could do it solo. Overall the situation i was in at the time i opted out of the surgery so i could get to work faster to save and move back to my home state. If i could have, not looking back would have gotten the surgery just because i take pride in my aesthetic’s but a little neck pain every now and again is bearable. In conclusion of this rant would say if its gonna bother you looks wise down the road go for the scar if not im sure with a little bit of training you will be good. Keep in mind I’m a 20 year old male with good genetics and recovered fairly fast.

  46. Coleman87 says:

    Hello Amal,

    I had Modified Weaver Dunn operation 20 weeks ago. I love weightlifting but I am very worried because I think my shoulder will never be the same. I am only 26 years old and I am totally depressed. I just don´t accept the idea of not being able to lift as pre-injury (bench press, pull ups, dips, etc).
    How long did it take you to recover? Is it true that even with the Modified Weaver Dunn operation the shoulder will never be the same?

  47. Bill says:

    Have had an ac3 for 10+ years. I was misdiagnosed in the ER, told shoulder strain. Two weeks later was informed of the separation. Nothing was done to fix it. Back to my manual labor job full time in less then 2 weeks

    Just a few days ago I started getting pain in the area also down my arm and hand. Just saw an Orthopedic Dr.
    Says mine is a 5 or 6 not a 3. Would not advise surgery since the joint is stable. Thinks it is in the muscle not the joint. Going to check with a Sports Dr. outside the HMO. The Capazin cream recommended is doing nothing.
    I am still do manual labor and I am almost 65.

  48. Brett says:

    Hi I am Brett, 60 yrs old and I have a grade 3 AC Dislocation which I did ten weeks ago. I crashed into the tennis post and took my ligaments out and it sticks iPad bit. I can’t decide whether an operation is best. I don’t care about the bump, I just want to serve again at tennis but currently this is too painful, will this be possible in the future without an operation, I am unsure.

  49. Chase says:

    I was just diagnosed with a stage 3 AC separation. I am 24 years old and very active physically. Based on the entries in this thread it seems like the surgery is the best treatment for someone who wants to regain 100% of the strength they had prior to the injury. It seems like there is some loss of range of motion but this can be minimized through physical therapy and PT. Thanks for the posts. I am very nervous and unhappy. They give me hope.

  50. Jamie says:

    Hi all,

    I’m very interested to read these comments. I came off my bike about four weeks ago and injured my AC joint. The doc said it was sprained and to come back in three weeks. Today was my return and he told me I actually sustained a grade 3 injury. Since the injury, I have got back to a full range of motion and have run and cycled. I have not tried weights yet. The shoulder does not hurt and until he pointed out that my “bump” wouldn’t go, I hadn’t noticed that I had “a bump”. I still cannot really identify it. However, I must say here that I used to power-lift. I still press heavy weights and have a muscular frame, so I don’t know if this makes a difference. I live in England and am fortunate to have the NHS which means a free operation if I want it. The doctor asked me what I do and noting my job was fairly inactive said, “you should be okay”. However, I am conscious now having read these posts that I may need surgery if I want to continue heavy weights and an active life (alternatively I could change my training routine). I’m 28 and he has given me three months to see how it goes. I have very little pain (only in the mornings) and full range of movement in every direction without pain. I will start back on light weights next week and let people know how I get on in the coming months. As I see it, I have no noticeable deformity. I have observed where the protruding bone should be on the YouTube posts and I do not seem to have this (if at all a very slight protruding bone and raised shoulder). In fact, I am wondering if part of the tendon is still in-tack. However, I don’t want to regret not going for surgery in the coming years but at the moment I have little reason to opt in I think. The only thing I don’t like is knowing that my AC joint is not attached. That worries me a little.


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