Has anybody any experience with recovery time for a stage 3 AC separation. I crashed last Saturday riding the California Man course and jacked up my shoulder pretty good. When I tell the doctors I am doing an Ironman in 16 weeks they look at me like I am on drugs. They will not give me any answer as to when I can expect to be able ride or swim again. I just get take it easy and time will tell crap. I am signed up for CDA in 110 days and I don’t know if I should withdraw or go for it. I already have a lot of movement and most of the pain is gone. All of the rehab time tables I have found deal with post op recovery.
I did the same thing 7 years ago and still have trouble if I push my swim workouts to hard or workout with heavy free weights. My swim times are now worse. Plus I have a very deformed shoulder now too (big bump on top). I asked about corrective surgery and the surgeons say it is a 50/50 chance of being better or maybe even worse. Good luck. I know that is not the answer you wanted to hear.
I used to be an orthopaedic technition years ago and if I remember right there where four stages of shoulder separation. Stage 3 will show some partial separation on x-ray while holding weights but is non surgical.
Don’t know why the docs are playing silent sam with you. I’d just play it by your symptoms. Just don’t do too much too soon.
I did the same thing last year, 5 weeks before Muskoka Long Course, 7 weeks before Tupper Lake Half and 11 weeks before Ironman LP. I was actually able to start swimming 10 days before Muskoka, but could not apply much pressure with my left arm and swam around 5 min slow for 2K. Same thing at Tupper, but by LP, I was within 1 min of my normal lame Ironman swim split. Initially biking was very painful and running was a real disaster ! Both those came around quickly though.
That being said, it was not till I started lifting weights in the fall that I realized, how weak my shoulder was and how much “recovery” I had left. After a winter of XC skiing, it seems almost normal, but still “weak” at some angles.
I fell while trail running a few years ago, and I think I had mild separations in both shoulders. Within 6 months, I could not sleep on my right side, and within another 4-5 months, I could not sleep on my right side either. I could barely even get my wallet out of my pocket without excruciating pain. What happened is that scar tissue built in around the injured areas, and I was down to 60-80% ROM in both shoulders. Some very painful PT later, I am up to 100% ROM in the left and 90% in the right.
I guess what I am saying is–don’t screw around with your shoulders! You may get through an IM, but you may have pain and disability for the rest of your life.
I had a serious rotator cuff injury November '02. I was out of work (I’m a police officer) for just under 4 months and recovery took nearly a year. i worked with an orthopedist (specializing in athletes) and a physical therapist for 3 months. I then continued rehabing on my own … literally til today. I have not recovered full range of motion (I probably won’t) or strength. My bench press plummitted by almost 50%. In fact, I don’t do freeweight benches anymore because of the stress it places on my shoulder.
There was no way I would have been able to even contemplate an Ironman 4 months out from the injury. And, I chose a non-surgical route. I was told that I would not be cleared to return to work for 6 months to a year had I gone with a surgical repair.
Both my doc and the PT told me that my injury was a classic football players rotator cuff injury. They each commented that it could have been, and should have been, much worse that it actually was. What saved me (and probably you to) was a comparatively high level of fitness. Rather than completely tearing and separating, my shoulder was able to absorb a lot of the impact.
As an aside, this was the most painful thing I’ve ever endured. I’ve been told by others that I have a pretty high tolerance for pain and discomfort. But, this hurt so bad I became noxious and thought I might pass out. Wicked wicked pain.
My advice: take it easy and listen to your docs. Maybe try to find one with an athletic background or clientele. Most importantly, don’t rush your recovery. If you do, you could end up with an even more serious injury that might haunt you for the rest of your life.
I crashed my mountain bike and suffered the same grade AC injury four years ago. I found the stationary bike ridable in about a week (sling still on)and was able to manage my road bike within a few weeks. The separation caused a large, cosmetically bothersome lump on my shoulder but the orthopedic surgeon was reluctant to operate at the time. He gave me good advice as I rarely think about the injury anymore. I can’t speculate how long your recovery will take but mine went pretty quickly and I don’t have any residual pain or discomfort at this time.
If you don’t have much pain, and you’ve got good motion, you’re fine. You don’t have to keep it still - the ligaments are torn and not going to heal back to where they used to be anyway. The proviso is that this is actually a grade 3 and not higher.
I don’t think you need to withdraw by the sound of things but that’s just my internet opinion. Good luck.
BTW the injuries described above, particularly the rotator cuff one, are mostly not like yours. Sometimes low grade AC separations end up with AC osteoarthritis, but rarely in grade 3s unless they’re fixed.
I separated my AC in November while playing hockey. I don’t recall the grade but in Emerg they suggested that the specialist may recommend surgery (he didn’t).
I was off running three weeks and the first week back I ran with the sling. I wasn’t/am not swimming or cycling. I was off hockey 13 weeks, but so far so good.
I am still not 100% for strength but my mobility is good and I’m not concerned playing hockey (playoffs start this week!).
I think one key to my recovery was having Fiona (who works at Enduro Sport/Athletes First as a bike fitter and athletic therapist) compress the step deformity that occurs with AC separation. By pulling the collarbone back down immediately post-injury it helps the joint heal with a minimal deformity and allows the ligaments to heal with a minimum of stretching. I now have a relatively small step deformity.
Fiona, as an AT, worked with the university hockey team and had a player who returned to play very quickly after AC separation by having it taped before every game.
On a related note, one of my customers separated her AC less than a month before IM Florida and still qualified for IMH. Her injury was less severe.
Don’t give up hope, but see a therapist who understands athletes and AC separations (try and find a AT who works with contact sports) and get on it early.
Just to be ornery and contradictory, although taping of shoulder separations is a common practice (and probably does make it feel better), there is little (no?) real evidence that it actually helps the joint heal in a better position. This is demonstrated by the fact that despite the many NHL trainers taping separated shoulders, there are a whole whack of pro hockey players who have big steps in their AC joints (and functioning well).
There is actually some evidence that you don’t really want a grade 3 separation to heal back in place. There has been at least one randomised controlled trial of fixing these vs leaving them alone, and the group left alone did better in the long run. This is thought to be because the joint is sometimes damaged in the separation, so if you put it back together, it can become arthritic. If you leave the ends apart, they don’t rub together enough to be arthritic.
What I would take out of this is: do what you need to do to make it feel comfortable, and don’t worry too much about the step.
Thanks for all the information. I know time is the only true way to know if I can make the race. I was just looking for some first hand experiences which you all provided. I have Kaiser health insurance and I can’t get in to see a specialist for another week. The lack of specific information is killing me. I have become so used to following a training plan that I expect one for my recovery.
It is amazing when you realize that the one thing you have been so focused on and spent countless hours training for may be gone. So far I have been on the spin bike and I did the elliptical trainer tonight without much pain. I attempted a run on the treadmill and that didn’t go well. I guess the lump on my shoulder will be with me forever. They say chicks dig scars but do they dig lumps?
I have a 3rd degree shoulder separation as well. It happen in a crash 2 1/2 years ago. The clavical is connected to the humerus and the clavical by a couple sets of ligaments. Shoulder separation is injury (disruption) of the connecting structures. A third degree seperation means all the ligaments are disrupted. They don’t heal. A third degree shoulder separation, unless fixed surgically, is forever. The bones are held close together by the muscle of the shoulder girdle (I know this stuff because I am a doctor with the same injury). Treatment for 1st and 2nd degree injuries is nonsurgical. In the past 3rd degree with treated with surgery. As mentioned above, surgery dosen’t seem to be much if any better than nonsurgical treatment. Any body remember Burt Jones? He and bilateral 3rd degree injuries in the middle of his career. The good news is that: 1) you can’t make it worse, 2) you can expect near complete functional recovery, 3) the hump in my case has become less noticable over time (I am pretty skinny). I am a cyclist not a triaguy so I do know when you will be back to baseline performance. I raced Iowa games TT 5 wks after my injury (and won). Good luck.
“Can you provide an update on how your IM turned out?”
Wow, this was a really old post Marcos.
IM CDA turned out as best as I could expect. The movement returned slowly and I was able to do the Californiaman 1/2 as a test 6 weeks before. For the swim at CDA I started 2/3 of the way to the back of the pack to avoid the banging and to more closely align with a my now even slower pace. The first lap was good but the damaged left shoulder became weaker on the second lap causing my left side pull to diminish. This caused me to migrate to the left on a course with all right turns. I finished the swim in about 8-10 minutes over my original goal time but I felt fairly good.
The shoulder wasn’t much of a problem on the bike other than I left T2 pushing way to fast trying to make up for the lost time on the swim. Rookie mistake that would cause me a lot of problems later in the day.
On the run the shoulder was sore but not a big concern on the first 10 miles. After 10 the cumulative fatigue caught up and it really got painful. I had brought some ibuprofen but I knew I was quite dehydrated so I chose not to take it. I took my HRM strap and made it into a sling and that really helped. The pain continued for the whole day but the sling made it tolerable. If I had it to do over again I would have brought a real sling for my T2 gear bag and or my special needs bag on the run.
You have almost a year until AZ so I wouldn’t be too concerned. Train your ass off with what you can do with your shoulder and add back what you can as the recovery allows.
Good luck and let me know how how it all works out.
“do you still have residual pain or restrictions? have you done any IMs since then”
My shoulder got progressively worse after CDA with my range of motion getting really bad. Then one day on a plane I tried to hand my son a heavy backpack by lifting it over and around my head. I heard a ripping noise and saw stars the pain was so bad. But that was the tearing of the adhesions and I have had 95% range of motion from that day on. Not how they say to remove adhesions in the medical books but it worked.
The only long term issues I have had are some weakness and it gets fatigued well before the other shoulder. I have done a bunch of 1/2’s and the full Vineman in 2007 without any issues other than it getting tired sooner than before.