Grade 3 Shoulder Separation

Sorry...no pics! (Actually Jfsh might have some?)
My brother took a bad spill last weekend and suffered a grade 3 SS...and cracked up his full face! Any of you have some medical advice regarding how to proceed? He heads to the specialist next Wednesday. So far we have heard about quick heals (2 weeks or less) and long heals (surgery 2 years out). What's the story? Have you had this injury and what would you have done different in hind sight?:?:
Thanks for the responses
...the little brother

 

Get better soon bud! I don't have any advice but your bro will be in our thoughts and prayers.

 

hit the pool, do some pilates for rehab and don't stress it or try jumping for a month, that's why mine never healed right, straight to weights and a heavy bag.

 

a/c separation or shoulder?

 

Aren't they the same?

From: http://physicaltherapy.about.com/od/orthopedicsandpt/qt/ACSeparation.htm

A shoulder separation injury involves a disruption of the acromioclavicular, AC, joint. This joint is composed of the collar bone, or clavicle, and the highest portion of the shoulder blade, the acromion of the scapula. These two bones meet on top of the shoulder and form the acromioclavicular joint as mentioned above.

The most common cause of shoulder separation, or AC joint disruption, is a direct fall onto the shoulder. This fall injures the tendons that provide stability to the joint. The laxity that results allows a degree of separation between the acromion and clavicular bones. The degree of separation can range from mild to severe with a noticeable deformity.

Treatment of this condition can vary from conservative management with a period of immobility followed by gentle shoulder strengthening, to surgery.

 

Update

Went to see the specialist on Tuesday. He is calling it a grade 3+ shoulder separation, but refers to the AC as well. i think they are generally the same, although if we pressed further there are likely subtle differences.

Surgery is next week...which means I get to take Wed-Fri OFF of work to babysit the poor dude. Little does he know that 5 minutes after I get there I am going to the neighbors house to ride the backyard skills park..then off to ride Just Outstanding!!! Ha Ha!

Actually..I'm glad I'll be able to go up and lend a hand...this is my older brother and he has done more for me than i can ever repay him for.

I'll post some pictures when I get some.
Lagg

 

Are you the one Jeff (jfsh) PMed me about? :?:

Five weeks ago, I separated my shoulder (grade 3) while riding in Quaking Aspens. In fact, Jeff witnessed my crash. Amazingly, I was able to ride Camp Nelson trail less than two days later, albeit painfully.

As of now, my shoulder is feeling better every day, although certain activities are still difficult. The Doc told me that the pain should go away in 10-12 weeks. He also said that surgery would be little more than cosmetic. Me, i'm not willing to have myself cut open unless it will improve the overall function of my shoulder... and I wont know if full strength has returned until I allow a considerable amount of time for healing.

I'd wait on surgery, as you can always get it done later.

 

Yo Art!

It's actually my brother and yeah i heard about your story too! It went like this..."Yeah, this other guy that Jeff knows did the same thing and was riding on it a few days later!"
It's a tough call. The says his is practically a grade 4. We have heard stories that range across the whole spectrum. Insurance is in place today, who knows in a year or more. The injury seems to justify it. We're concerned about arthritis down the road and once that's in place, no surgery will solve. So we are gonna go for it.
We'll see what happens. It certainly sounds like a crappy sx. Lots of pain and slow recovery.

EDIT: Here is a link to the injury: http://www.steadman-hawkins.com/shoulder_acSeperation/overview.asp

Appreciate the thoughts though. Where did you crash on QA?

 

my wife's a pt. she says he'll probably need pinning and expect 6 months for a full recovery. but she's seen clients get through it just getting taped--it just depends on his specifics and how hard he's willing to work. i'd (at least) get a second opinion. lots of people have complications from their surgeries/anasthesia. good luck.
'

 

There are a few friends of mine on this site who have also had shoulder separations. They were all surprised that I was able to ride so soon -maybe i'm just a knucklehead?- ...the Doc was surprised too when he saw the x-ray. He figured it must not be too bad if I was riding, but my clavicle had actually separated by around a half inch.

The problem with surgery -from what i'm told- is that your bro will probably be completely out of action for months, and the early recovery is -I hear- very painful.

We were riding Summit Trail when I crashed... I was about 30 yards up from the big log-ride that crosses over the stream.

 

Post-Op Update

Well...Surgery is done and my brother is on the mend. The actual procedure only took about 45 minutes and he was home the same day. The pain was pretty serious the first day or two after the surgery, but was pretty well managed on Vike's. Although he let the meds dropp off a bit and the pain came shooting back in, so he tightened up the schedule and all was weel. By three days out he was tappering to just anti-inflammitories (and beer).
Thanks again for all the comment s and well wishes. We hope to get him back on the trail next season...with a new helmet of course.
Lagg

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I've had this procedure and it is painful for a quite a few weeks. Access to a heated pool or spa will help ALOT for getting mobility back in the shoulder. It will be much easier and less painful to get that arm up around shoulder height when submerged in water. If he has any questions feel free to send a PM.

 

I've had this done too! It's been a month now doing P.T. daily. Doc, says be out for six months, bummed!!! Did you have a plate or screws in placed? Get well, feel for you!!

 

Been there too, 15 years ago...surgery was the only option... scoped, wasn't that bad. The only thing that continually helps me is lifting weights. Seated flys and over time, seated overhead press using light dumbbells (isolation and separation are a must). When I rebuilt my muscles they held my shoulder together pretty good. When I don't lift my arm goes numb. It's been said, overhead movements are by far the most difficult. I was out 2 months from riding and 6 months from lifting my arm overhead without pain. It's hard work but it can be beat. Good luck to your bro.

 

That's pretty rough man, hope everything turns out okay for you and your bro!

 

Lagg,

You said your bro had a grade 3, did he tear his coracoclavicular ligaments? I am taking a sports rehab class and we consider a grade 3 to be a complete ligament tear of the coracoclavicular and acromioclavicaular ligaments, thus you have a complete shoulder separation of the clavical from the scapula (specifically from the acromion and coracoid process).

Did your bro fall from an outstretched arm/hand? Or was it a direct impact (fall on shoulder)?

From what I've learned, rehab will be a critical factor in recovery to strengthen the soft tissues in the shoulder joint and should be taken seriously so avoid repeat injury. Also, when your bro does go back riding, he should consider wearing a custom molded pad to his shoulder until he feels 100%. They make these pads for football players, and are basically molded plastic (dipped in hot water and then set) and a gel insert that lies underneith. The idea is to help soften blows and prevent further trauma to the shoulder complex.

 

direct impact

He hit the ground hard. Another setback recently is that the wire put in to keep the shoulder in place snapped. It sounds like this will delay recovery but the end result should be similar. The poor dude can't wait to get back on his bike again. I feel bad for him.

 

True! He was behaving like a good rehab patient, doing exactly what he was supposed to. He rolled over in bed, heard a pop and felt movement in his shoulder. Apparently the wire/button system failed and the repair lifted out of place. Now he has to decide if re-surgicating or not is in his future. It's a tough call.

He rides a lot and is very active...he seems pretty depressed and is somewhat of a PITA lately, but hey, he's my brother so I'll give him all the latitude he needs. I couldn't imagine being off the bike from an injury for an extended period of time.
Sucks too because he's my favorite riding partner so I'm solo in KV without him (since JFSH is always out of town!)
~lagg

 

As far as physical therepy goes, does anyone have a link to "work-outs?"

Its been a couple days and i had been taking it out of sling and letting it hang as well as moving slightly. gRADE 2 btw.

Thanks, It lookjs like i got plenty of time to read up...

 

I did a grade three about 7 years ago. Doc told me I needed surgery but I did a bunch of research and found that the surgery success rate was not all that great so I opted out. Glad I did. No real riding for about 2 months (indoor trainer only) and then just got back to things as it would let me. Research said that in general the only folks with grade 3 or less who could really benefit from the surgery (if successful) were folks who used that arm to make a living. Baseball pitchers, quarterbacks, etc. That was not me so I took my chances. Will likely develop arthritis later but none to date. Still hard to raise that arm above my head but weight work and PT helps. Cool hunchback of Notre Dame bump-thing goin' on too!

As always, your mileage may vary...

By the way, have not posted in forever. Moved to Seattle around Thanksgiving and have not found my bikes in the garage yet! Goin' nuts and need to ride soon!! Take care STR and if you get up Seattle way be sure to holler, you got a free place to stay...

Kevin