Seperated Shoulder - how was your recovery?

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Ignoto
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Seperated Shoulder - how was your recovery?

Postby Ignoto » Tue Sep 23, 2014 10:39 am

So I came down pretty badly on the weekend during a race (yay for people not checking over their shoulder before claiming a new lane and sprinting), grade 3 separation of my shoulder along with a lot of road rash across the body and a sore pelvis.

Anyway, had several x-rays, seen a specialist who's a keen cyclist himself and said surgery for me isn't needed unless; A) I have pain, B) Don't want the clicking noise or C) Cosmetic reasons. But if I decide on surgery, there's no opportunity lost, so I can delay for a year and the outcome will be the same.

So, I'm tempted not to worry about the surgery, everyone I've spoken to says I will recover 90-95% of my shoulder functionality back which is sufficient for me. I don't plan on lifting anything heavy or go rock climbing so the 6 weeks in a sling + full rehab seems like a lot of pain to go through for 5% extra functionality. I do find it slightly depressing that I'll always have a couple of broken ligaments in the shoulder, being a young fellow I'm curious to know if it'll have a knock on effect throwing a rugby ball around with any potential children.

But, for those who have separated their shoulder and didn't opt for surgery, how's riding the bike for you? I've pretty much been told I can get back on as soon as the pain goes away/road rash lets me. But I was going to hit up the trainer for two - three weeks and then I'm on holidays for another 3. So total recovery time would just be shy of 8 weeks since the injury, after which I'd like to start rebuilding. Mentally I can see the shoulder always being in the back of my mind as I go down a hill or potentially race again so I may speak to a psychologist about how to best proceed with that.

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MattyK
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Re: Seperated Shoulder - how was your recovery?

Postby MattyK » Mon Oct 06, 2014 1:15 pm

I've popped both my shoulders (not simultaneously). The need for surgery really depends on whether the ligaments have separated from the bone. That involves a painful scan (actually the dye injections are the painful bit).

I ended up not getting the surgery done after one of them recurred and I ended up in ER because it wouldn't go back in on its own. I haven't had any further problems though (that was about 12 years ago?). I tend to be a bit cautious pivoting my right arm in certain ways though (baseball/boomerang throw action can make it twinge).

Like any accident it will fade from your memory and you (should) eventually not worry about it.

Best of luck with the recovery!

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find_bruce
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Re: Seperated Shoulder - how was your recovery?

Postby find_bruce » Mon Oct 06, 2014 10:01 pm

Stretched the ac joint in my left shoulder 20+ years ago. That & different injury to my right shoulder ruined my golf game- no smooth swing from me any more. Eventually caused me to give up rugby.

No surgery & no problems I can't live with - no regular overhead work or arm rotation are the main ones. I can still swim comfortably but have to stop around 3km.

All depends on your particular injury & recovery though.

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jules21
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Re: Seperated Shoulder - how was your recovery?

Postby jules21 » Wed Oct 08, 2014 11:19 am

as noted, it depends on the severity of damage.

mine would virtually fall out of its socket when i raised my arm above my shoulder. back then the public health system worked on a 3 strikes policy - after the third time it popped out the outpatient doctor informed me i'd won a surgery.

i'm not a surgeon, but my experience was enough to be able to say that you can make a pretty decent self-assessment. if the joint feels like it has recovered 6-8 weeks afterwards, and you need to do the rehab (strength) work, then you may not need surgery and a doctor is unlikely to opt for it anyway. but if your socket feels like a stone rattling around in a coke can (like mine) - that means it will fall out again, when provoked. surgery is the only solution then - unless you consider having it pushed back in every time it falls out a solution.

the surgery was great - arm is almost like new again (mildly restricted movement, but nothing like the old days when they virtually tied it down). i had surgery in late 90s so it's probably even better now.

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trailgumby
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Re: Seperated Shoulder - how was your recovery?

Postby trailgumby » Wed Oct 08, 2014 12:09 pm

Depends on who you get to do it. The guy who did mine was an ex-NSW Blues player and did it up quite tight, probably because that's what is needed for his usual clientelle. Took a long time and a lot of work to get range of movement back, and it is still restricted in some planes. But it doesn't affect me in everyday life, so no further intervention proposed.

I've fallen on it a couple of times on the mtb since and no issues, probably more roust than the other shoulder.

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Re: Seperated Shoulder - how was your recovery?

Postby petie » Wed Oct 08, 2014 12:31 pm

Separated shoulder is different to dislocation everyone. I haven't done it, but have looked after a few people who have. From my anecdotal experience, that advice is pretty spot on. Unless you are really having issues after 6 weeks or so, no surgery is fine. I would thoroughly recommend a physio though, the one issue some people have is the slight muscle mismatch having not properly used their arm for a little while and also having changed the dynamics of the joint slightly through injury.

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jules21
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Re: Seperated Shoulder - how was your recovery?

Postby jules21 » Wed Oct 08, 2014 12:32 pm

petie wrote:Separated shoulder is different to dislocation everyone.
it is?

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Re: Seperated Shoulder - how was your recovery?

Postby petie » Wed Oct 08, 2014 12:36 pm

jules21 wrote:
petie wrote:Separated shoulder is different to dislocation everyone.
it is?
Dislocation involves the humeral head moving out/away from the socket, shoulder separation is more correctly called AC joint disruption and is the joint between your collar bone (clavicle) and acromion (the top part of your scapula). Primarily held together by ligaments and has much less movement that the extremely complex shoulder.

CKinnard
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Re: Seperated Shoulder - how was your recovery?

Postby CKinnard » Wed Oct 08, 2014 12:47 pm

Ignoto, you need to clarify whether it was a separated AC joint, or an actual shoulder joint sprain/subluxation.
Usually separation is reserved for AC jt sprains, in which ongoing clicking is common.

I've got a cient right now who has reinjured an old AC sprain, and he won't be going back to his previous job requiring regular lifting. Scans show ligamentous support is totally ruptured now, as opposed to Grade 2 before, and the joint is unstable as hell. My challenge is to convince the surgeon to do the surgery he should have done the first time.

Only time will tell in your case how instability will impact your regular activities.

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sogood
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Re: Seperated Shoulder - how was your recovery?

Postby sogood » Wed Oct 08, 2014 12:58 pm

Ignoto wrote:5% extra functionality...
It's easy to dismiss "5%" until that 5% is what you need to feel normal for the rest of your life. Some are more accepting and will live with the disability while others are not. Don't forget also that when moving into the more senior years, every small percentage of loss is magnified when compensatory mechanisms have receded.
Bianchi, Ridley, Tern, Montague and All things Apple :)
RK wrote:And that is Wikipedia - I can write my own definition.

petie
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Re: Seperated Shoulder - how was your recovery?

Postby petie » Wed Oct 08, 2014 1:37 pm

sogood wrote:
Ignoto wrote:5% extra functionality...
It's easy to dismiss "5%" until that 5% is what you need to feel normal for the rest of your life. Some are more accepting and will live with the disability while others are not. Don't forget also that when moving into the more senior years, every small percentage of loss is magnified when compensatory mechanisms have receded.
Very, very true, and it may not be advancing age that compromise your adaptability.

However, to bank on the fact that 100% function can be restored through surgery is a dangerous game ;) the reality is that there has been an injury, and your future from here on in is totally what you make it. Do the rehab and be aware that things are never going to be exactly the same and you are well on the way to your host level of function.

Ignoto
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Re: Seperated Shoulder - how was your recovery?

Postby Ignoto » Wed Oct 08, 2014 3:02 pm

Since my initial post, the shoulder has come along in leaps and bounds. I now have most of my range of movement back, overhead isn't a problem nor is general waving etc. The only time I'm encountering soreness is bringing the left shoulder across the body. The physio has had me doing a couple of exercises to improve the range of movement (seeing him for the second time tomorrow) and I'm trying to increase the movement across the body by pushing in the shoulder muscle?

Anyway, I was back on the bike last week (or 10 days after the crash, I could have gotten on earlier, but the road rash on the shin didn't allow for it). No noticeable discomfort other than some stiffness dropping from the hoods to the drops or vice versa. But that's getting progressively better.

Sleeping wise, I'm able to sleep on my left side, but I need the weight to go on the shoulder blade and not the shoulder directly, so a half roll.

Clicking and general discomfort is quite minimal, but lifting wise causes some issues deep in the shoulder. For example, lifting the bike up a couple of stairs isn't too pleasant, but I'm hoping over the next couple of weeks through physio exercises that the strength will return.
CKinnard wrote:Ignoto, you need to clarify whether it was a separated AC joint, or an actual shoulder joint sprain/subluxation.
Usually separation is reserved for AC jt sprains, in which ongoing clicking is common.
Ahhh I believe it's the former. We believe the acromioclavicular ligament is completely ruptured, but the coracoclavicular ligaments may be stretched. The reason being, the collarbone is still partially in line with the joint and not floating by itself completely.
CKinnard wrote: Only time will tell in your case how instability will impact your regular activities.
Yeah one of the first thing the Doc asked was my regular lifestyle. Between sitting on my butt at work, on the bike or on the couch I don't do too much lifting. If my strength returns in the shoulder I'll be quite happy with the recovery. I'm heading overseas in a couple weeks so I've gotta be able to put the carry on bag into the overhead locker as the missus is too short to reach :lol:

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Re: Seperated Shoulder - how was your recovery?

Postby lunar_c » Sat Jan 24, 2015 12:56 pm

I'm 3 days post op from an acromioplasty .. If you have recovered well and don't have any ongoing discomfort/ac joint instability then your indications for any surgical interventions are pretty much zilch.

I definitely recommend seeing a physio and getting some treatment if you find it starts becoming uncomfortable again with your cycling - instability in the joint can make a lot of the tendons (and there are many in the shoulder!) overcompensate and become pretty painful and they can advise you on some exercises to strengthen the area also.

My left ac was full of cysts, had significant bursitis and osteolysis (eroded bone) on my distal clavicle but my tendons were all intact - even so my ac joint was very unstable and clicked and popped, and was quite painful and prevented me from doing weights and swimming.

The idea is that in shaving the distal clavicle and removing the ac bursa the gap that remains between the end of the clavicle and the opposing articular surface of the acromion will fill in with fibrous tissue and form a fibrous joint (think pubic symphysis) eliminating the pain and instability and arthritis later on.

Hopefully in a few weeks the pain will settle down and I'll be able to get on the bike again, even if it's on a wind trainer. I'll let you know what the end result is regarding return of function/mobility long term.

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