Greetings Sho,
First, bummer on the injury. I too had a 3deg separation of the AC 15 yr ago.

It's a weird injury prognosis if I remember--not enough to definitely operate, but also long recovery for PT. I went no-surgery, and it did work out ok. Each injury in this grade is a bit unique. My recollection is it took about 6 mo of PT before I really trusted it again, though *for me* the instability lasted for a good year as I'd tweak it occasionally. I PT'd throughout and it did make continuous improvement stabilizing the joint. Definitely, YMMV.
I wasn't SBRing then, it was mostly ball sports, so I imagine swimming could have been a problem. I would ask this ? to your doctor, if you'd be risking damage or if it's just a pain-tolerance issue. Now, after 10 years of multisport I never ever worry about it and it's never popped up again--no pain, erosion, or impingement on that side.

Don't know if this is advice/wisdom as much as just experience. Heal up fast! -J

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Life is tough. But it's tougher when you're stupid. -John Wayne

Hey, that sucks - I went OTB on Memorial Day this year and got a 3rd degree separation in my left ACL. I think the recovery depends on any other related injury, especially to your rotator cuff. I was lucky, my injury seemed to be "only" the torn ACL. No rotator cuff injury. I had full range of motion with no pain. I was riding (road) 5 days later and swimming 3 weeks later. Within about 5~6 weeks I was close to 100% but like I said, there was no other injury except the torn ACL. My only issue is that I have a big "bump" sticking out now where the bone isn't held down by the ligament anymore. At this point it's just cosmetic but still kind of weird/gross. The Dr said if I have no pain or issues, then there is no need to do any surgery. I haven't had the feeling of being able to pull my arm out of it's socket or any pain if I press down on it or anything. Really it was "fine" within a few weeks. Hope that helps.

Concur with orange curtain. Complete grade 3 February 2008 training for IMAZ (April at that time). I was back on it pretty quick with lots of PT. Was doing 3000 yds in the pool within a month I think, rode outside two weeks later. Made the start line in April

Doc said I'd done all the damage I could do, just don't crash again but if I could stand the pain go for it

Just a big bump I never notice until someone says "what the hell is that? ". Had a doc look at it last year, said he had a good technique to fix it but 3 month recovery, no thanks (had a plate oh the in the other shoulder last year and already took 6 months off)

My wife separated her shoulder in 2012 (3rd deg ac joint as well). She chose to have the surgery (hook plate). I just asked her if she would recommend someone in your situation have the surgery. Her response "hell no, it was the most miserable experience I've ever been through". She suffered a lot during the 7 months the plate was in place (almost instant relief when it came out.)

That said, her clavicle (which she broke in another bike crash this summer and needed a plate for) doesn't stick up. :)

I had a grade 2-3 A/C separation and it took a good year for the clicking and instability to 'go away.' I didn't have surgery, but was in PT as soon as I was allowed. Good news was that I got lots of time to work on my weak upper back!

I also had a 3rd degree, although you are getting better much quicker than I managed.

As regards the instability; the 3rd degree normally means all of the ligaments connecting the ACJ joint are gone and are never coming back. You can get full range of motion though. Stability no; try pointing arms forward - you'll have different and variable length arms now.

In my case the bones partially slipped in relative position each time I took a stroke in front crawl and completely in butterfly. Less of a click and more of a clunk wwith each stroke. I also had to do decline bench press, as on the flat it ached. I don't do big weights anyway, so this was silly. In the end I had it surgically repaired and regret not doing so sooner. But, you are already doing much better than I did.

What they didn't tell me before the operation was that they were going to chop the end of the collar bone off. I think it reduces the chance of arthritis and is good, but it was still a surprise. The longest OWS I've done since is 5.25 miles and it didn't ache in the slightest.

From what I've read there seems to be a huge variety in how people do & no set path that you will definitely follow.

Don't do surgery - that would be last resort for me - I too separated my ACL took a while to heal - but apart from my shoulder clunking when it moves certain ways its all good.

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"PAIN is nothing compared to what it feels like to QUIT"

I had a grade 4 dislocation and had to have an op (screw and anchor), back playing rugby 6 months later. It will never be 100%, but it's pretty good. Not sure about non-surgery options though.

I have the same big bump after a grade 2 - 3 about 18 months ago. I went OTB, landed on my forearm which rolled up underneath me and pulled my shoulder out. I just assume the bump is never going away. Kinda weird because I'm fine now, it just looks funny.

6 months before I was comfortable using the arm, 12 before I could trust it, 18 before I felt normal and didn't avoid using it.

Still don't have *complete* range of motion/strength. But enough so I only notice when playing basketball. Don't notice doing anything else.

I separated mine back in 2007 and opted not to go for surgery. The ortho and others said they would do surgery if I wanted, but also said I may do just as well without it. I have 30+ years in strength training for myself and training others so I went my own route for rehab. It went something like this......

Phase 1 - waited for inflammation to reduce and road rash to heal. Couldn't lift my hand for the first couple of weeks. Used ice packs and anti-inflammatory daily.
Phase 2 - Started daily limited motion without weight or resistance. Just front and side lateral motion. This started about week 4 until week 6.
Phase 3 - Started with ultra light resistance band front, side lateral motion and pressing motion. About week 7. A lot of discomfort.
Phase 4 - Started with 5 lb db's. and resistance bands. Week 8. A lot of discomfort.
Phase 5 - Back into normal shoulder, chest and back training routines with ultra light weight. Discomfort is starting to suppress. (Edit: About 6 months after the accident)
Phase 6 - Start rebuilding strength. About a year later I was about 50% back to previous strength. (Edit: as noted below I was never able to get back to full strength.)

Strength markers before the accident as examples.

Before Accident (Summer 2007) - Seated shoulder bar press 175 lbs x 5, Seated db press 70 lbs x 5
1 year after (Summer 2008)- Seated shoulder bar press 100 lbs x 5, Seated db press 40 lbs x 5
Current day - Seated shoulder bar press 135 lbs x 5, Seated db press 60 lbs x 5

I will never be as strong as I was, but not just because of the accident. I am also at 53 now and strength was already declining, but I am not too unhappy with current strength levels and generally feel like most lifts in the gym and in life (like building a block retaining wall with 80 lb blocks this past summer) are pretty good considering.

Of course I am not suggesting to follow what I did, but in some cases one can rebuild fair strength and stability levels without surgery. If this gives some encouragement. It just took a lot of patience on my part to take it slow and not try to rush a comeback.

3rd degree separation on April 1st while snowboarding this spring. I decided to go without surgery and couldn't be happier. Trainer rides and light running after about 3 weeks. It took me about 8 weeks before I could swim at all.

I am now about 95% but not sure if it ever gets fully back.

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TEAM ZOOT 2020

This

I have a marked "bump" but rarely have any discomfort. The first 6 weeks was pretty painful, but after that, I could complete short workouts. Its been three years and I have had a couple good IM's, but still can't sleep on my Left side ;-)

I did the exact same thing in Jan 2006, it was nasty. The surgeon gave me a super conservative prognosis, said Lake Placid was highly unlikely. I was on the trainer(on the sly from the wife with the bars turned upwards) and on the TM at 15% 3 days after surgery. Swimming with fins in 8 weeks. Did Eagleman and LP and both went very well. It took a year or two before I would throw right, or serve in tennis-two things I could not give a crap about.

It is a straightforward surgery. Just go get it done and start training asamfp afterwards. It will hurt obviously but not so terrible.

I will say that I did not keep taking the pain medication the day after the surgery like they suggested because it was making nauseated. That was a big mistake. The pain when the nerve block wore off was other-worldly, for 4-6 hours.

Not sure why some here are against surgery. I pulled off a 4th degree back in the late '80s and had it repaired in '90. I'm glad I did since it doesn't look funny any more and chicks dig the scar.

So sorry to hear of your injury.

I have had 3rd degree (on the 3 scale . . . there is also a 5 scale) separations on both shoulders with no surgery.

First thing that strikes me is if you really have a 3rd degree(on a 3 scale) the is no way on earth you could "jump" into a pool 2 weeks after the injury . . . the pain would simply be too much. Now, I did get in the 1st couple of weeks and very easy and lightly kick with fins while on my back and the arm at my side. If you have a 3 on a 5 scale you may possibly be able to "jump" but you certainly would not need surgery in that case.

My personal experience is having a good friend who is Harvard trained and a renowned shoulder surgeon advise me. He advised against surgery as long as I could be diligent in my rehab and understand the outcomes. With both shoulders I was back full blast in 12 weeks or so and now I certainly know they aren't perfect but I have no perception of being limited either. Separated the left in 1992 at 32 years old, and the right in 2004. Many, many triathlons and IMs since then. Really doing very well now.

Best wishes,

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David
* Ironman for Life! (Blog) * IM Everyday Hero Video * Daggett Shuler Law *
Disclaimer: I have personal and professional relationships with many athletes, vendors, and organizations in the triathlon world.

Thank you all for your stories and wisdom. It was three weeks today and my range of motion is definitely improving. Just for clarification my trip should to the pool have just been to kick and scull - no way could I swim. Frustration is starting to set in however, I tried to help carry a dresser into the house yesterday - BIG mistake.

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http://theworldthroumyeyes.tumblr.com/

I had a third degree AC separation of my right clavicle in 2003. I was back to easy swimming after three weeks of kicking drills. It took about four weeks all of the pain to go away when standing up pulling on the handle bars. Shoulder rides about a half inch lower than previously but seems alright otherwise even though I didn't have any PT.

I had a second degree AC separation of the left clavicle in 2011. I had long since quit daily swimming but was back on my bike three days later. Again, pulling on the bars was painful for a few weeks. Shoulder seems to be about a quarter inch lower than previously and it seems okay even though I didn't have any PT.

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I have a personality disorder, I don't drink coffee...

Sorry to hear that.

I have experience in both shoulders. Separated right shoulder in 1.991 in an off-road motorcycle race. Grade III AC shoulder separation. Went through surgery within 2 days and was immobilized for 1 month. Then went through 1 month of rehab and was in perfect condition after that. Mind you, it was 5 hours a day of rehab. I was treated as a pro.

Back to 2.005, I fell in a steep descent in my MTB and separated the left shoulder, again grade III AC. No surgery, DIY rehab following some guidance and within a month was OK for normal life, but not sports. I can't remember exactly, but it took me months to feel OK. Since then I have a bump in my shoulder showing the clavicle end, and can't sleep in certain positions without the help of a pillow.

My conclusion is that my right shoulder received much better treatment. It was before insurance companies in Spain put profitability way above health. Nowadays I am very skeptic about all recommendations I receive and try to think what is best for the insurance company's bottom line.

One good way to deal with this is to go to the doctor and say you will pay out of your pocket, many times the recommendation changes.

Good luck whichever way you go.

I know this is kind of a old post along with a few other threads about this subject. I just got grade 3 separation ( which seems to be the most popular ) during a sprint last Saturday. What I have noticed about reading others experience with it is that everyone heals differently. Some fast, some slow and some never the same. I've already seen 2 doctors and decided no surgery. I'm a month out from HIM gulfcoast. I still plan to do it. even with one arm if I have too. I don't think that will be my case though. My symptoms seem to be less than some others that have a 3. I have pretty good range of mobility already just after a few days. I ditched the sling also and just have been taping it. I don't mind my new souvenir bump, although I am having trouble naming it.