Separated Shoulder - AC joint. Your experiences please

ben306

Hi

I have managed to sustain a grade 3 shoulder separation following a crash at LLangollen 2 and a half weeks ago. I've had very little info from the NHS and Im back for my follow up appointment in a weeks time. I've been trying to do lots of research on line to try and find info of my own and there seems to be a massive mix of how people have recovered from it. There seems to be such a range of people who have different experiences, some who have been back riding within weeks, and other having years of problems and surgery. A lad I ride with had 18 months out and surgery following bad advise from NHS and having to go private.

Mines happened just as Ive started to get some real pace and getting to a decent level on the DH bike. Out til at least the new year now following the advise of the NHS, but they seem to believe it will heal, yet my understanding that once a ligament is completely torn, that it, and there a few that have gone in my shoulder that now leave the end of the collar bone unfixed and a very unstable/weak shoulder.

For those of you wanting to know how I did it, front wheel blasted through a loose berm at Llangollen on a steep but one of the slowest sections, so quick I didnt get chance to get my hands off the bars and an arm out.

Full edit
http://www.youtube.com/watch?v=WfdaNn2RfHY

Crash edit (what you are all only really interested in)
http://www.youtube.com/watch?v=bnYPZzphDIA

And my xray


After doing some searching online I came across this image which is a good at explaining what the injury actually is



This week has been the first time not using the sling during the day, and I have 90% range of motion back, but its painful. The NHS approach it rest and they appear to be happy if you get satisfactory strength and RoM back, however Im 31 and want to continue riding/being active so satisfactory for me is near 100% again. I have private health cover through work so going to ask for a referral to BUPA when Im next back at the Hospital for my follow up next week . I've got a constant deep ache within the joint of the shoulder, and keep getting shape stabbing pains when it move certain ways etc.

Plus Im right handed and its my right shoulder so thats been fun.

Been a shit year for me for a number of other reasons as well so will be glad to see the end to 2014 now.

So, have any of you guys had the same injury, your experiences? Left the lump in to shoulder and managed OK or had to go the route of surgery?

Nairnster

This happened to me over a year ago, no op, but lots of physio. Bloody thing hurts in cold weather, if i lie on my side, cant hold the arm up or out for very long without thr shoulder hurting. Nightmare.

Need to try and see what can be done for it now, as i only expect it to be worse when i get older.

reformedfatty

Not really the same injury, but I fractured the neck of my humerus in the first week of August and ruined quite a few muscles in the shoulder in the process. This was then followed by 6 weeks in a sling which caused those muscles to all tighten up.

As of today I have maybe ~150 degrees of forward motion, maybe a smidge over 90 to the side, and am not told that going out on the bike, road or mtb, or running is a no-no as if I fell I wouldn't be able to break my fall using that arm.

The NHS were... keen but limited in budget, even simple things like theraband (which ebay says costs less than a fiver for a complete set) were not available via them and they don't think I'll get back full motion.

I'm also having physio via the army (injury happened on army time), and they have done these extra bits - e.g. theraband, acupuncture, weekly sessions vs fortnightly on nhs, and say they can get back full motion albeit it's going to take a long while. They also seem to be a bit better in tailoring their treatment to get me back to pre-injury status versus the nhs focus on getting to a functional level of mobility, and indeed communicated with my nhs physio to get the two treatments working together as such.

In short, go private as well as nhs if you can.

buccal

I'm 5 months in to recovery from an anterior dislocation and fractured head of humerus.

Been tough going but now making progress. Been back in the bike for 3 weeks.

I think the physio is the most important part and now that I have about 80% range of motion, the rest is going to depend on how diligent I am at doing the exercises.

Again, slightly different injury to yours but the consistent opinion I had was to avoid surgery if at all possible.

Interestingly, I got all of the previous posters treatment (including acupuncture) on the nhs, albeit through my occupation health.

buccal

Oh yeah and it hurts like hell.

I would concentrate your efforts on finding an excellent physio. Regardless of whether they are nhs/private or both.

Heal quick!

johnas7

i had shoulder surgery 3 years ago but was for a suprasinitus tear around the back of the shoulder. I know this is different but i would say the main thing is keep the physio up and do it all the time. My shoulders fine now, get a few pains everynow and then but im back at the gym and into my mountain biking. I still even do the physio exercise now with the therabands to keep my rotor cuffs strong.
Physio should give you one of them, a yellow one to start off with and do them religiously. I was having to do physio just a few hours after coming out of surgery, just by moving my arm up and down in the sling.
Hope this is some help and that it recovers.

sofaboy73

did exactly the same thing c 7 year ago now on my bike (wheel failed at 30 mph in the alps!)

best advice i was given was to keep it mobile as soon as you can. if it's painful, don't push it too hard, but don't let the soreness and aching stop you. i think the theory being the more you let it seize up and the muscles atrophy, the more physio you'll have to go through. i never put my arm in a sling / had it strapped up etc and tried to use it as normal (with varying degrees of success) from the 2nd or 3 rd day from the accident. within a few weeks i had a near full range of movement with the pain being much reduced.

obviously different for everyone, but i found after about a 6-8 weeks the pain was very minimal the majority of the time, although would go through periods of a deep dull ache.

7 years on, it aches when it's cold and damp, if i've slept on it badly or i'll get a couple of random days pain from it once or twice a year. have a full range of movement back and only a slight weakness in it. however it still makes a weird and wonderful selection of clicks, grinding and crunching noises when i move it! for me, it hasn't interfered with my biking at all in the long term, so hopefully you should make a full recovery.

as other have said, get a good physio and keep doing the exercises, even when you think it's all better or you can't be arsed.

as to whether to have an operation or not, different in each case and personal choice i guess. i elected not to after seeing a shoulder specialist. as he was based in Sheffield he said he saw these injuries all the time as it's a classic climbers / bikers injury. his advice to me was, if it was stable, then there was little benefit to the operation. apparently the injury doesn't often deteriorate over time / as you get older, and if it does, just have the operation then. I was also concerned if i had a crash on it again it would do it further damage. His view was that this was unlikely, having since tested this proposition a number of times (including a couple of very heavy crashes on the damaged shoulder) he was right, it hasn't worsened the injury. i do however ride with 661 sub gear shoulder pad all the time to protect it.

as ever get medical advice and don't listen to people on the internet, but hopefully of some use. good luck with the recovery, i'm sure you'll be good

ben306

Well im just over 8 weeks on, been doing the physio exercises that they gave me, having to have the odd day off the physio tho as there are days its really sore.

Found recently I've been really struggling with my sleep, keep sleeping on it (use to be that side/shoulder I would sleep on) and that gives me a really pain come morning.

Still finding the odd weird thing painful, like wiping the windscreen of the car in a morning has me in agony!

Still not even looked at the bike yet, tempted to maybe have a go at swimming over the Christmas break but will see how Im feeling once I've finished work in a few day

lostboysaint

Mine was still like that after 8 weeks. I used a turbo or gym exercise bike to keep a little bit of fitness. Had the same sleep issues as well! Keep going with the physio as after about 12 weeks I found it much more comfortable although still a bit "droopy" (oooooerrrrr Missus). The shoulder continued to tighten up again over the 12-16 week period and I started cycling again - got a very occasional shock or pain through the bars that transferred rather nastily to the shoulder but generally ok. After 6 months it was back to normal in every way.

I'm now a couple of years down the line and it's fine. Not affected by the cold, full strength and range of movement.

itboffin

I had the same injury a couple of years ago and just struggled on for 18 months taking even stronger drugs until I gave in and went private and had it fixed in that time I'd also grown a bone spur in the gap, even now years afterwards long periods sat in the same position hurt, such as a few hours flying or driving.

I'd suggest going to your gp for a recommended and I would assume a referral to a specialist after that its up to you, plus you're young so more chance of a speedy full recovery.

Don't ignore it.

EBEB

I had exactly that injury (Rockwell grade three).

Driving and wearing lead clothes for work was the main problem. Ended up having an operation (reconstruction with a LARS ligament). That was at the start of last year; subsequently did a 5K swim, half-ironman, full Ironman, Velothon Wales, another half and have a 5.25mile swim in September. It did ache on the TT bars at first, but can't say I notice it while cycling anymore.

Swimming wise, I started with breast stroke and then later crawl. I can even do a bit of butterfly now, although it is not overly keen.

Main thing is the two screw heads under the skin that rub on seat belts and lead clothing. May need them removed when it has all settled down. Other operations don't use the same screws.

If I lie down on my side I lie of the other arm. If I fall I make sure I fall on the other side. Before the operation it looked weird, even through t-shirts, and my arms were different lengths. The end of the collar bone has actually be chopped off, so it'll never be as good as before, but it'll do.

Main difficulty is that grade 1&2 are not surgical whilst 4 & 5 are, but it is not at all clear for grade 3. Overall I am think it is better that it would have been now without it, but I did have to wear a sling for 10 weeks after the operation - which really drags on.

One thing I would say is, if you go for the operation, put your bike on the turbo and get it setup so you can be ok sitting upright on the bike so you can use it while in the sling. Trying to adjust the saddle with one arm is farcicle. Been there.

Bassworm

I popped my right ACJ in an over-the-handlebars crash. After initial treatment/diagnosis I was offered physio at my local hospital but was told there would be a waiting list. By good fortune, at the bottom of the hill where I lived at the time was a sports injury clinic. So I wandered in there the day after the accident. The physio lady recommended keeping the shoulder mobile as much as possible, not letting the joint have the chance to seize up due to inaction. The first thing she did was make me ditch the sling I had been given at the A&E. She also bombed it with heat, and ultrasound (I think - it was a long time ago). Using it, and sleeping on it were both painful at first. I think it took about eight weeks before I got back on the bike, but constant gentle exercise and increasing effort during that time I found that it wasn't a problem returning to racing a couple of months after that. It still occasionally aches, twenty years on (Usually in cold weather) but is otherwise healed fine, although there's a noticeable lump on the top of the joint which isn't on the opposite undamaged one. Listen to your doc, and your physio are the most important things I can suggest. And if possible, see a sports injury specialist, they'll have insights that others may not have. They'll also understand your desire to get riding again quickly. Good luck.

jakey226

I got the same injury on holiday in greece (quad, monsoon, aqua plane and storm drain) docs just wrote me a sick note and was generally fobbed off until i finally saw a consultant 6 months down the line who said it can be brought back in place with a plate and 6-8 screws, this wouldnt change my mobility in the shoulder or make it hurt less so I decided that was a pointless surgery. I had physio which didnt really amount to much, its grade 2/3 according to that photo. I naturally focus more pressure on my good side now and am no where near as strong with my bad side, cant hold my hand straight up and cant hold it high for very long but unless i aggravate it or It is particularly cold I dont really notice it now day to day. just aches a lot easier than would normally.

once the initial pain is improved jsut get using it and keep exercising this will definitely help.