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Shoulder separation - recovery time?
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I suffered a 2nd degree shoulder shoulder on May 7th. I have fairly normal range of motion and am pain free. There is mild discomfort, mostly feels like stiffness, but it is quite weak. Am I being foolhardy in thinking I can hop on a bike and start riding on the road in the next few days in relation to long term damage? Basically, should I be taking it easy for the next 2 more weeks of the 4 week recovery time the doctor originally gave me?

EDIT: Since people are getting kind of pissy about this question; I did have a follow-up with an orthopedic surgeon 9 days after the accident. He had me lift my arm over my head, asked if I was still using the sling, had me stand up straight while looking back and forth between my shoulders. He said, "Looks good, you don't need to come back for a 30 day" and left the room. I had to ask the nurse if I was done.

2nd EDIT: Also why I'm asking is because I'm hearing everything between "Oh my god, you'll be deformed, never be normal again, why aren't you wearing a sling for the next month?!" to "Don't worry about it, it's not a big deal".
Last edited by: hidaniel: May 19, 11 7:55
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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Quite weak to me says you will favour the other side, leading to imbalance, leading to problems. Your doc said 4 weeks recovery time. What did he or she say about when it would be suitable for getting on the bike or running etc.... without causing extra damage?

Ian
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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Rub some dirt on it. You'll be fine.

What I do: http://app.strava.com/athletes/345699
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Re: Shoulder separation - recovery time? [Printer86] [ In reply to ]
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You're probably ok on a trainer, if you sit upright and ride hands free. I'm envious...I separated my shoulder a year ago and I'm still not pain free....sigh.
Last edited by: RedLizard: May 23, 11 8:40
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had a grade three seperation 5 or 6 years ago. I had pain for about a year, when I tried to play catch with my son/daughter's. I saw the KC Royals Dr. and he asked if I was worried about the look (my collar bone sticks up 1/2"). I stated that I didn't; but, I wanted to be able to play catch with my kids. One cortisone shot and I was done. Never went back. I only have issues if I throw a lot or if I swim....which I don't do a lot of. Everynow and then, I will tear the scar tissue (I assume that is what is happened) and my shoulder will audibly crunch for a few weeks. Other than that, I am good.

If I were you, I would take some short rides and see how it feels. As the Dr told me, do not push through the pain as you are only going to hurt yourself worse. It is not something you can push through. I still use this advice today. If I am throwing and my AC joint starts to feel it; I immediately stop. My kid's get frustrated now and then when I tell them I am done in the middle of BP or playing catch; but, I know my limits really well.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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This seems to be an unfortunate recurring theme on ST, doctors not really addressing the needs of their patients. As a sports doc I'm sorry to hear this. Maybe this is for another thread.
With respect to your question, I am assuming you are referring to an AC (acromio-clavicular) separation. A grade 2 injury is relatively mild. I will put someone in a sling initially but tell them to come out of the sling as soon as they are comfortable enough to do so. I will usually let people go back to activity as soon as they are comfortable. This usually takes about 2-3 weeks but can vary from person to person. You will likely have pain sleeping on that side for much longer, typically 6 weeks. Pain should be your guide for return to activity. You should be able to run pretty quickly but getting down in the aerobars may be hard for a few weeks.
If at 2 weeks you are not noticing a significant improvement I would have some re-examine your shoulder and look closer at the rotator cuff to make sure you don't have a significant tear. I would suggest going to a different physician given your initial experience. I have put this in another thread, but go to AMSSM.org and find the name of a primary care sports medicine doctor in your area if you need more assistance.
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Re: Shoulder separation - recovery time? [docjock] [ In reply to ]
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Docjock: Thank you sir. If you're ever in Toronto, I owe you a beer.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had a shoulder separation playing rugby when I was 14, in 1962. I swam competitively for years after, lifted weights, everything you can think of. It can be good, it will work fine, but it will never be the same. (of course that was English medicare, 50 years ago, so a little stone age by todays standards)

My son also separated his shoulder a couple of years ago, took current medical advice, went back to what he was doing too early, pushed it, separated it again, had surgery. It will never be the same.

Don't want to or mean to be negative, it just means you have to work with it, you are the best judge, and this is pain you take notice of.

Good luck
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had the joy of dislocating both shoulders at the same time, tearing my rotator cuffs in Feb, 2010 due to a very violent epileptic seizure. It was NOT pleasant, and I spent a long time recovering and regaining flexibility. Even now I can't sleep on my side and swimming... well, swimming is coming along, but it aches after a long set. I did not have surgery, but I spent a good long time in physio. It took about 2-3 months before I could raise my arms above my head. With a lot of physio, determination and boring walking up and down the walls with my fingers tips... I was able to get back to local bike racing by June. Fast forward to present day and I am now feeling pretty good about IMLP in July. I notice my arms fatigue a lot faster than they used to though, so the swim is my main concern.

Eventually, after getting a little more flexibility, I started doing really light resistance training. I think it helped as well. As it was described to me, the risk is that you will start using your shoulder in a way you had not before to compensate for the loss of strength and flexibility. That will lead to long term troubles. I'm not a doctor, but I would really suggest doing the physio, even when it feels like a waste of time. It pays off.
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Re: Shoulder separation - recovery time? [docjock] [ In reply to ]
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docjock wrote:
This seems to be an unfortunate recurring theme on ST, doctors not really addressing the needs of their patients. As a sports doc I'm sorry to hear this. Maybe this is for another thread.
With respect to your question, I am assuming you are referring to an AC (acromio-clavicular) separation. A grade 2 injury is relatively mild. I will put someone in a sling initially but tell them to come out of the sling as soon as they are comfortable enough to do so. I will usually let people go back to activity as soon as they are comfortable. This usually takes about 2-3 weeks but can vary from person to person. You will likely have pain sleeping on that side for much longer, typically 6 weeks. Pain should be your guide for return to activity. You should be able to run pretty quickly but getting down in the aerobars may be hard for a few weeks.
If at 2 weeks you are not noticing a significant improvement I would have some re-examine your shoulder and look closer at the rotator cuff to make sure you don't have a significant tear. I would suggest going to a different physician given your initial experience. I have put this in another thread, but go to AMSSM.org and find the name of a primary care sports medicine doctor in your area if you need more assistance.

I have a grade 3 separation...happened back in 2001. It took a long time to feel "normal" again, at least two years. Just out of curiosity, how often do you recommend immediate surgery for a grade 3?? The reason I am asking is because my shoulder imbalance is causing some upper back issues (at least that's what I think it is).
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Re: Shoulder separation - recovery time? [JGerbodeGrant] [ In reply to ]
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Its rare that grade 3 separations require sugery unless you are a competitive throwing athlete.
That being said, I have had a feew people that end up with surgery after a grade 3 AC separation. This is usually after they have failed aggressive conservative treatment with physical therapy for rotator cuff strengthening. Its just hard to dertermine ahead of time who is going to end up with surgery.
I think 2 years is more than enough time for conservative therapy.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had AC separation in June 2007 it was either 2 or 3 don't recall...tore some ligaments and have a bump plus scars from road rash.

Are you going to PT? I started after a week and they helped me strengthen muscles around my shoulder and make sure I had the correct movement patterns.

I was on the trainer the next week, riding easy about 2 weeks after. July was tough as my shoulder hurt swimming at times and I didn't know if it was I can swim through it pain or I should stop pain. Running also bothered my shoulder.

I was able to do a HIM in early Oct but was under trained on the run and the swim. I told my coach I'd do the race even if it meant I swam whole thing with one arm.

My shoulder bothered me some off and on in 2008 and less in 2009. Mostly when I started upping my swim volume building towards IM. For a year did it bother me occasionally on long runs.

From other triathletes I know with similar AC separation recovery time varies quite a bit from person to person and perhaps if you are a man or women based on your strength prior to the injury. Now Almost 4 years out it rarely bothers me, but my movement pattern when lifting is a bit off.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had a Grade 3+ (complete tear) in Feb 2008 training for IMAZ April 08. My ortho said it was completely torn, the only limiter was my pain since I couldn't really do any more damage to it. Crash on a grade 2 however and you could turn it into a 3.

I was on the trainer within 4-5 days, riding outside within 10 (those bumps HURT). I was swimming 3K/workout within a month. I started slowly with just kicking, hurt even to put my arm out front on the board. Then slowly added the bad arm, still kicking with fins so I wasn't "pullling," then progressed to pulling. The longer workouts hurt at the end, but I iced afterward. I was diligent with PT and range of motion work. Made it to the IMAZ starting line.

Honestly, running was the worst, the ligaments holding the shoulder blade up were gone so it would sag and get very uncomfortable around 7-8 miles. Did a lot of complementary strengthening of the surrounding area

Today I just have a nasty bump that I only notice when people comment on it. Ortho said surgery was not a guaranteed fix since there are several methods, not all of them great. And I'd be adding recovery time and trading a bump for a scar. He said unless I had a job where I had to throw or lift heavy objects over my head, best to let it sit. Plus, it didn't matter when I had the surgery, now, later, whenever, if I decided to have it.

I will occasionally get a crunching sound in there, sometimes I wonder what it will be like when I am 70....
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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you can ride and run just fine.
Go for it.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I had a grade 3+....complete rupture of the AC joint--collar bone sticking way up...back in June 2005

I rode my bike the next day (very flat where I was) 32 miles out to the Police Station to thank folks who helped me.

Running and swimming were off the table for the first week.

9 days after the bike crash I entered a triathlon with my wife--she swam and I biked and ran.

5 weeks after the crash I competed in the ITU LC worlds in Denmark (3000 meters/120 KM/30 KM)--slow swim but otherwise I was competitive--top American in my AG

In December of 2005 I had it surgically repaired--frankly more cosmetic than anything. Recovery from that was brutal and talk a full 6 weeks before I coulr really run or swim again.

My repaired shoulder feels stronger than my normal one.

You should be able to get back after everything in short order (less than 4 weeks for sure). let the pain guide you....lot's of indoor trainer time would be good for sure

Randy Christofferson(http://www.rcmioga.blogspot.com

Insert Doubt. Erase Hope. Crush Dreams.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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2nd Degree separation after mountain biking crash. No surgery but it took a good 6 months before I was able to throw a ball again. No problems now besides one shoulder being noticeably lower than the other - maybe that's affecting my aeroness on the bike and causing my slow bike times!
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I did a grade 3 and did an sprint race exactly 1 month after the injury, it was a bit stupid and if it wasnt a wetsuit swim (the compresion really helped) I wouldnt of done it. GIve it time, I still have a dislocated collabone 18months on, only cosmetic. It will probably take a couple of months to get to 100%, as the loss of strength will be quite high. Also it will feel a little stiffer and could be a little tender over the long-term.

You wont be deformed nor will it harm your athletic performance, although the bump (depending on its size) can be a little intimidating for some people.

__________________________________________________
http://twitter.com/willrc91 --- instragram.com/willrc91
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Re: Shoulder separation - recovery time? [cannastar] [ In reply to ]
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I am not sure what grade seperation I have but it's nasty. I did it a few years ago while mountain biking. It sticks up probably close to an inch or so and my collar bone is shoved forward to the point it sticks out some(you can see it through my t-shirt). I have been to the doc several times but told me that it functions fine and is pretty much cosmetic. It only bothers me when the seasons change. I can't really do a push up any more but it doesn't bother me swimming unless I put in a serious effort and then it's only sore for a few hours.

I do worry about falling because the doc said that the bone will go through the skin on the next fall. So I am very careful or atleast try to be.
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Re: Shoulder separation - recovery time? [hidaniel] [ In reply to ]
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I have some experience with AC separations. A grade 2 on the left and a grade 5 on the right. The grade 2 I took some time off and with some good PT I was back on track in no time. Grade 5 however took me two years and two operations to correct. And its still not right. A different kettle of fish.
Good luck with it and look after it.
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Re: Shoulder separation - recovery time? [docjock] [ In reply to ]
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docjock wrote:
This seems to be an unfortunate recurring theme on ST, doctors not really addressing the needs of their patients. As a sports doc I'm sorry to hear this. Maybe this is for another thread.
With respect to your question, I am assuming you are referring to an AC (acromio-clavicular) separation. A grade 2 injury is relatively mild. I will put someone in a sling initially but tell them to come out of the sling as soon as they are comfortable enough to do so. I will usually let people go back to activity as soon as they are comfortable. This usually takes about 2-3 weeks but can vary from person to person. You will likely have pain sleeping on that side for much longer, typically 6 weeks. Pain should be your guide for return to activity. You should be able to run pretty quickly but getting down in the aerobars may be hard for a few weeks.
If at 2 weeks you are not noticing a significant improvement I would have some re-examine your shoulder and look closer at the rotator cuff to make sure you don't have a significant tear. I would suggest going to a different physician given your initial experience. I have put this in another thread, but go to AMSSM.org and find the name of a primary care sports medicine doctor in your area if you need more assistance.

This post is almost 10 years old to the day but was extremely helpful- I've had difficulty getting ortho specialists to commit to the best course of action and your post has more relevant direction and info than they've provided, so THANK YOU!
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Re: Shoulder separation - recovery time? [J1mmyleg] [ In reply to ]
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J1mmyleg wrote:
2nd Degree separation after mountain biking crash. No surgery but it took a good 6 months before I was able to throw a ball again. No problems now besides one shoulder being noticeably lower than the other - maybe that's affecting my aeroness on the bike and causing my slow bike times!

I'll have to use excuse. It is on the internet so it must be true.

I had a car accident separation. Spouse forced me to go to immediate care. They touched it, I passed out. No surgery, no drugs or sling. I was 25 at the time.

24 years later I still have the hump, but it hasn't really affected anything in my life other than a slight shoulder drop on the separation side while swimming. It was on my stronger side and it is still stronger than the uninjured side.

Swim - Bike - Run the rest is just clothing changes.
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