My injury became apparent in 2011 december. cause - cannot name it. It was not something that appeared all of a sudden but rather smth that evolved in time. But i blaming weightlifting and some martial arts.
I am not a prof athlete but i am fond of sports. Am 22 years old kow and a former obese child. That was what led me to sports. i was 117kg and now i'm 78kg.
I began this way because my story is long.
In dec 2011 an orthopedist said that i should stop all physical activites so i did. He gave meds as well. After 3 months i was better but not great. He said i sjould have surgery but did not mention the grade of the injury ( i live in romania and maybe we are a bit lacking a protocol jn ac separation). So i went to a recuperation doctor.
She said i should to underwater exercises about 2x week and swim if i could.
Notice that until know i have not mentioned anythjng about my symptoms. She asked me a question then:does it hinder my daily activites?i said i guess not. So i was kinda resolved that sports will be tough for me but i kept up my hopes.
7 mpnths have passed. And it hurts. I still cannot go backpacking,turning the driving wheel hurts and cannot rest my elbows on the table. Just saw the recup doc again and i am furious.
She said that i was not a prof athlete so that why she didnt put me to really hard PT and that i should try to enjoy life and not be bothered with my AC separation.
If i would be in the USA i would sue her. Not only did she disconsider my affectipn to sports she nearly openly insulted me suggesting that i am whimpy and just cannot take alittle daily pain.
The pain was okay at the beginning but now it is a rocky dry feeling that i feel. Range of motion i have and that is great. Strength has faded me a bit but it is okay as well. But i cannpt do daily chores cause little things set off a tendinitis inthe biceps.
I am really leaning towards surgery. The tip i leave to others is : speak to multiple doctors and do not have blind faith. I will be seeing an orthopedist soon. My discussion with my recup doc is over. From my point of view she messed up:
-not giving me my adequate PT
-procastinating my operation to 7 or more months (i will see)
-not taling me seriously.
I am 22 and i want to do lots of things but my doc treated me like a 60 year old. I think i will bite the bullet because 7 months have passed with episodes of tendinitis and pain (a tug of war) and i almost am where i started. So a year post-op but with the possibility of regaining normal daily use and possibly even sports seema a good deal to me.
Please write back.

how do you know that you have a ac separation? have you seen x-rays? ac separations are extreme. i am not sure how they can happen without a severe accident.

if you have had x-rays what class is the separation? 1, 2 or 3? there is also class IV and V, which are usually caused by bad car accidents, or extreme sports accidents.

for 1 or 2 class separation, i do believe surgery is optional, but you do need to do PT, and it will never be the same. that's the hardest part of a AC separation. it's basically permanent. it took me years to accept this. i still look like the hunchback of notredame, but i can't complain. i can do all the sports that i like pain free. sleeping still hurts.

B

I had a similar injury 2 years ago along with a broken humerus from the top of the bone. I elected to go without surgery and recovered well. However, I did not do all of the rehab that was involved. The result is a reduction in the ROM of my right shoulder. nothing terrible but it is noticeable.

i saw the x-ray and it is visible also on the echo.
so....imaging wise it doens't look severe but clinically it hurts. plus i cannot to terms with the fact that i'm only 22 years old and was treated like a 60 year old. i am furious with the doctor, she almost didn't tell me to think happy thoughts

- this is my x-ray. what i do not understand is that: if my separation would have been a grade 1 or 2 then it should have healed itself in 6 months time, right ?

I am happy I found this blog discussion – misery loves company! I separated my shoulder (grade 3) 3 months ago. Still very sore with any activity. As is the case with many of you, my doc and physio both advise against surgery and feel that I will recover and have excellent use of the shoulder. My recovery seems to be taking longer than many of you.

But here is the difference…. Only a couple of you have talked about constant clicking.
I have much clunking and clicking in the joint with almost any movement, due to the ligaments not holding the AC joint together. I am not so concerned with bump, but not very keen on the clicking as I am guessing it will continue to cause irritation to the muscles and the bones. It is also kind of freaky.

Do those of you with Grade 3 also have this constant clicking?
Any thoughts from the doctors in the blog?

I had the clicking for quite some time after my Grade III separation occurred. I was pretty aggressive with the rehab exercises and now it rarely occurs. Mostly happens if I try to do pull ups or bench press too much weight. Same as you, I hate to hear that clicking sound.

Yes I have the clicking and in certain positions get numbness down to my pinkie finger. The pull for my swimstroke is weaker and times are defintelty down.

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I had an AC3 separation about 14 years ago. I did not have surgery and went to PT for about four weeks. It took me about 3 months before I could start to swim, but was able to race triathlons within a year. There was a lot of popping and clicking for quite some time (2 years?). For the first couple of years it would fatigue more than the good shoulder . I've participated in over 10 IMs since the accident and the only compensation I've had to do was change the side of my breathing to put less stress on my right shoulder. Over training led to a nerve palsy on that side and the switch to breathing on right side help with reducing fatigue on my right side (I used to breathe to the left).


Long term side affects: very little on a day to day basis. I'm not able to pull ups/chin ups like I was able to do and every once in a while the bone sticking out actually bangs into something and smashes the skin -ouch.

Hi All,

It is comforting to now that you are not alone, so thanks to everyone for posting your experiances.

On the 16th of Decmeber I recieved a Grade III AC joint sepertion for my birthday. I am booked in to see a speciaist next week. Its 2 weeks to the day and the thought of going backwards and having surgery concerns me as I feel im making progress.

I must say I am a little confused with what to do. Lets see what the surgeon says, apparently thre is now key hole surgery that can be performed.
Willkeep you posted.

Grade III this past march - no surgery and full range of motion and swimming like before. Yeah I have a big bump in my shoulder, but its just something to brag about. My ortho dude said that the surgery has low success rate due to the nature of the shoulder. He also said grade III less pain - no bone on bone that grade I or II might.

Meet with the specialist, Its grade 4-5. Had to have surgery quickly. Had the hook plate method. The hook plate holds the bones togethere until the tendons heal. First 2 days after surgery are extremly painful especially the first night once the general wears off! 2 weeks on still need meds to sleep at night, pain during the day is managable without meds. 1 more op in 10 weeks to remove the plate. Looking forward to this as plate is uncomfortable. Doc says I will have 85% movement/function back in 3 months and 95-100% back in 12 months.

Hi people, i had a type 3 shoulder separation in 2012. i went to see my surgeon and she suggested the tight rope surgery, this was the first operation on my shoulder. I went back to work early and one day felt the synthetic band snap inside my shoulder; the bone became more prominent. I went back to my surgeon, this time she suggested the plate and hook procedure, which in her words would then be bomb proof! I went ahead and had the surgery and although the prominent bone has disappeared the recovery has been hell. I have been in so much pain, one evening I had to even go a&e and the doctor told me I had a type 1 infection! As the weeks have gone by it has got a bit easier but the whole process and been very hard to deal with; sleep deprivation couples with severe pain has been a struggle. I go back to hospital and have my plate out in 2weeks, the surgeon said the operation to take the plate out isn't as big as the last one. They have done a fantastic job with the scarring considering its already been opened up twice.

Hola Blu,
Researching this dilemma after a grade 3 separation (crashing on the snowboard on the infamous "last" run a couple of days ago). I'm writing because your situation sounds exactly like mine. Surfer,boarder,biker,etc...everything but the fly fishing,but I'm sure I'll eventually get to that. Just curious as to how you made out in the long run and if you recommend the surgery.Hopefully meeting with the orthopedics this week and leaning towards the surgery. Thanks! Kevin

Hi Kevin,

It's been 2.5 years since my surgery and I still think about my shoulder almost every day to some degree or the other. I don't doubt so much whether I should have had the surgery but rather the exact procedure, and how well the surgeon did, and if I got good guidance on the PT to do or not do. My bump was very pronounced, and it felt too awkward for me, as if it was pulling away from my body and only my skin was keeping it somewhat close. I still have a bump, but depending on my stress level and exercise/stretching it can range from acceptable to fairly pronounced, therefore I often wonder if the donor tendon was accepted by my body, but nevertheless I still have screws and wire in the shoulder holding it together, so I don't worry too much about it. My strength and range of motion are 100%, as far as I can tell. It sounds like you just had your fall so you probably have quite a lot of swelling, and it may be hard to determine just how it will be.

My biggest challenge these days is having my left shoulder hunch up, or "get tight". It seems to be mostly related to the soft tissue and muscles. My surgeon recommended extreme caution after the surgery, and I had to wait months before starting any PT. I literally did almost nothing except wear a sling for 3 months. I believe this caused a lot of excessive tightness in the whole region, and in fact, I have been left with a semi-permanent mega knot in my upper back on the left side underneath the shoulder blade, which seems to radiate through the area and cause neck pain, and tightness. I should have started very basic PT earlier (of course conservative PT) mostly focused on low profile stretching.

If your shoulder feels really awkward to you, and bony point sticks up high, my bottom line recommendation is to do the surgery and do it sooner rather than later. How long ago was your injury, just a few days ago? Another challenge I had was waiting 9 months for the surgery, so I went through the whole process of injury and recuperation twice in a 1 year period, which was brutal.

Hope this helps. Glad to provide any more insights. Every injury is different, and every shoulder is different. I think I will re-start PT focused on stretching out the shoulder/neck region to re-gain the limber.

One more note, you need to think just as much about the mental spiritual side, and staying positive, and accepting it. I fought the injury a lot because I just could not accept the finality of it. I think this may have led to some of the tightness and hunching I experience still today. You need to spend as much time sending good relaxing vibes to your shoulder, and breathing deep. Either way it takes time. It's a nasty bugger. Surgery or not, it will come back, and you will get back into all your favorite sports with very little noticeable effects on your performance.

Peace Out
Blu

Hey Blu,

Thank you so much for your swift,thorough,and eloquent reply.I'm lucky enough to have good insurance and was able to get an appointment this week with an orthopedic surgeon in Boston (Glen Ross) who has worked with the Celtics and comes highly recommended by a friend.The PA at the clinic on the mountain looked at the xray and told me it was "at least" a grade 3 separation and was fairly certain it would warrant surgery but I'm really anxious as to what they'll recommend in Boston on Thursday.It really sounds like the upside of doing the surgery immediately would be worth it to me,particularly because I have a lot of confidence in the skill of the surgeon.I'm also not thrilled with the prospect of walking around with this large bump on my shoulder and the surgery sounds like it may minimize that issue.Most importantly it sounds like the best chance to ultimately regain full functioning.Great advice also on addressing the mental aspect of this injury.I'm dealing with the pain easily without any drugs (although sleeping is a bit of a challenge),but was getting extremely anxious and somewhat depressed about the whole thing. Feeling much better now with somewhat of a plan of attack,even though things are still up in the air,so I thank you for the support! Glad to hear you haven't let this slow you down. I'll keep you posted on my progress (and will blame you if I lose the arm in surgery!) Thanks again, Kevin

Yo Kevin,

Sleeping totally gets better before and after surgery for me. I could not sleep even many months after the initial injury and all the way up to the surgery. But it seemed to only take about 5-6 months after the surgery when i could start sleeping on it some, which was nice. Today it does get a little sore/tight if I sleep hard on it, but it loosens up by mid-morning. Sometimes it doesn't even get sore.

Again good luck on this, but a good plan is peace of mind. One note some surgeons really try to dissuade you from this surgery. That's why I waited 9 months. After 2 visits he said I won't do it until you can't stand it anymore. And thats when I went back to him 9 months later.

Blu

I fell in 2008 and got grade 5 shoulder separation. had surgery with my own recycled ligament and seemed to work great. 8 weeks after the surgery i was still not allowed to make quick movements or lift. i was in a tanning bed (with help with the lid) and the glass fell out on me and i must have jerked to keep it off my face. within minutes the bone was sticking back up. had 2nd surgery 2 months later with cadaver ligament. within 10 days bone was starting to stick up again. gave up but had a lot of pain and also ended up with tears in elbow and was told my elbow was trying to take up the slack that my shoulder couldnt do. also had 2 rotator cuff tears. elected to have it one more time since now i have neck problems and doc said he thought the shoulder bones pulling could make neck worse and it doesnt seem like a lot but my bra strap falling off my shoulder or it in the groove of sensitive nerves under the skin constantly drove me nuts. i am actually still not sure what this doc did but know i have a plate and another cadaver ligament which we were not suppose to try again. as for nerve blocks, NEVER AGAIN. i was one of the people who had the reaction, throat swelled closed, paralized half my diaphram, throat and vocal cords and eye drooped all the way down. breathing was horrible and i couldnt get sound out at all hardly. they had to take it out within hours after surgery. i now am in a sling and cant use arm at all for 4 months!!! then surgery again to remove plate and then pt. at this point since i was not told this long i am VERY aggravated! i will be going from end of jan to end of june before i can use my arm at all, and thats not until the next surgery and then pt which could be july! i just hope this works, that would be the worst after going thru all this. my first surgery was 4.5 hours, 2nd the same and 3rd was 5 hours. i had 42 staples

I'm not a doctor and cannot give you any advice but I can share my experience. I was hesitating about getting a rotater cuff surgery as the option was given to me. My shoulder was bothering me and I took the gamble. My shoulder pain is now worst then before the surgery. I guess it's my fault, as I was warn by the doctor that this might happen. I took a gamble and lost. I'm sure the percentange of failure is really small, so I dont want to scare you.

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Formely stef32

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Hello! I just earned myself a type 3 shoulder separation a couple weeks ago. I had been snowboarding all day up at Mammoth and was tired... hauling ass on my last run to call it a day and basically fell for no reason (poor visibility) right onto my right shoulder.

I just took it out of the sling today and while I am getting some range of motion back, the whole shoulder is extremely tight and painful and lifting my arm up past chest level is impossible. I seem to be running into a 'bone meets bone' issue stopping me from moving it very well. I'm certainly not having the 'no big deal' experience that many on here claim to have had. I am a college student and I can barely write. I can't do my very simple job, taking care of plants at the school. I can kind of drive, but not really safely. I need drugs to sleep. I'm basically crippled. Fortunately, I am meeting with a surgeon next week to discuss options. In my current condition I can't even imagine NOT trying to fix it with surgery. The surgery horror stories I'm seeing here are a little disconcerting... I really hope mine goes smoothly.

Just thought I would share... since I'm still kind of freaking out about it. I'll update once a decision is made.

In the fall of 2006 I went over my handlebars in a hurry thanks to a driver who failed to yield the right away. A very pronounced "bump" (still) and massive amounts of pain for about three weeks if I remember right. Wore boots with long laces as I could tie them with my teeth and the other hand:-)
The surgeon told me that there was no one "recommended solution" due to the relatively high failure rate of the surgery. My physical therapist, who had the surgery himself (with the cadaver ligament) said the same. Also, in my case, given that I'm a little big bigger in the shoulders due to years of weight training, the surgeon said that actually helped to stabilize the joint and so he recommended holding off on surgery and seeing if the resulting scar tissue would work out. It did. My shoulder still clicks a lot when I do pullups and pushups and swim and I definitely lost some power, but I was swimming again in about four months and able to complete my first ironman distance event roughly a year after the accident. I remember doing a lot of rehab, especially with the rubber bands. Anyhow, I'm glad I was patient. I had done all the research as well and read the testimonials about the failed repairs and was not eager to go through all of the pain again. Good luck!

Other then my kids calling me quasi moto :0). Not much main 2 years later but still a little. Plus some nerve damage. When right side is in certain positions. Definetly some power lost in swim stroke also. But right now risks ( infection and failure of surgery) outweighs getting fixed.

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Your post makes me feel so much better. I just separated mine too (Grade 3) doctor told me the same thing about all the damage is done and I thought he was crazy because the shoulder looks so bad. Day 6 now after my snowboard halfpipe accident and I feel like I'm almost completely recovered other then just a little pain did kinda a small test and was able to lift a 400lb weight with both arms and little pain from it. Never would have believed you could live without your clavicle attached to anything until now. The only major concern I have is doing things over hand like throwing a baseball or pull ups. Still in too much pain to try those. I'm a power lineman so I work over my head A LOT.