# Shoulder AC separation...how long 'til I ride again?



## BenWA (Aug 11, 2004)

So I separated my shoulder skiing over the weekend...went to the ER and they gave me a very fuzzy diagnosis/prognosis (there were srsly 5 doctors circled around my bed arguing about whether or not my shoulder had dislocated..!?!). Xrays showed no fractures.

I left with the diagnosis that I had *probably* strained or separated the AC joint (possibly/probably torn 1 or 2 out of the three ligaments in there), and that I would need to wear an immobilizer/sling for 2 weeks, then gradually return to normal use over the course of several weeks after that (with probable PT rehab involved).

Does anyone know much about shoulder injuries like this? I.e., how long can I expect it to be before I'm riding again? Also, if I tore ligaments, isn't that kind of bad? They said I wouldn't need surgery or anything but...how does one go about being an active type like myself if they have blown ligaments in there?

Also, I've been lifting a good amount over the past couple of months, I'm surprised that I got injured so easily. It wasn't an impact, it was a very slow, soft roll onto my side in deep, soft snow...I just fell on my arm in just the right (err, wrong) way and heard/felt a distinct "pop". :mad2:


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## Creakyknees (Sep 21, 2003)

Just go by feel. Both of my AC's are permanently separated - 2 separate horrific crashes, years ago. Doc sais "well, you'll never be able to dig ditches for a living"

But, as I recall, the pain didn't last long, and I know I was back on the bike quick because back then I had no car.

Look up the anatomy, it's an odd little joint and the angle is such that muscles don't support it very well.

Creak.


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## I am The Edge (Jul 27, 2004)

BenWA said:


> So I separated my shoulder skiing over the weekend...went to the ER and they gave me a very fuzzy diagnosis/prognosis (there were srsly 5 doctors circled around my bed arguing about whether or not my shoulder had dislocated..!?!). Xrays showed no fractures.
> 
> I left with the diagnosis that I had *probably* strained or separated the AC joint (possibly/probably torn 1 or 2 out of the three ligaments in there), and that I would need to wear an immobilizer/sling for 2 weeks, then gradually return to normal use over the course of several weeks after that (with probable PT rehab involved).
> 
> ...



go to an orthopaedic surgeon as soon as possible and get an evaluation by him. after his diagnosis, ask him what your options are.....do some research and go to one who specializes in shoulders. it is time and money well spent.


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## uzziefly (Jul 15, 2006)

What edge said. See an orthopedic surgeon asap. 

Good luck and recover fast.


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## Armchair Spaceman (Jun 21, 2003)

uzziefly said:


> What edge said. See an orthopedic surgeon asap.
> 
> Good luck and recover fast.


Ditto,
I left mine for almost 2 years and the surgical repair needed to be much more extensive than if I had seen an ortho straight away. See an ortho - look for one that does a lot of shoulder work - they're a finicky joint and need to be done 'just so'.


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## MarkS (Feb 3, 2004)

Armchair Spaceman said:


> Ditto,
> I left mine for almost 2 years and the surgical repair needed to be much more extensive than if I had seen an ortho straight away. See an ortho - look for one that does a lot of shoulder work - they're a finicky joint and need to be done 'just so'.



Get yourself to an ortho/sports med doc ASAP. I usually recommend seeking a doc who cycles or knows something about cycling. But, shoulder injuries are common among football players. Find out who the local football types go to. When I broke my shoulder in 2003, my bike-riding sports med doc had his former football-star colleague look me over. There definitely are shoulder specialists among the orthos. It is worth spending a little time on research to find a good one. Sometimes it is hard to get an appointment on short notice. If you have any friends in local athletic programs like coaches or players, you may have to pull a few strings or drop a few names to get a quick appointment with a renown shoulder doc. This is not a time to be bashful about using any connections that you have.

My injury did not require surgery and although I was told not to ride for two months, I was doing some limited riding outside within two weeks. I spent a lot of time on the indoor trainer during the two months that I largely was off of the bike. I was determined to do a century that was nine weeks after my injury. I did it in driving rain notwithstanding my doc's admonition that if I fell on the shoulder during the ride, I would be out of luck. 

I did not have to do formal PT, but my sports med doc, in conjunction with the football-star doc, gave me exercises to do during the four-five month period in which he was monitoring my condition (initially I was going to the doc every two weeks, then after that I went every month). I have no residual effects of which I am aware. Although, if your experience with the docs is anything like mine, you will start to wonder whether you will glow in the dark. You know that you have had a lot of x-rays when the x-ray techs know your name without looking at your chart.

Good luck.


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## GScot (Feb 7, 2005)

I had one along with a 'severely displaced clavicle fracture'. After some really 1/2 assed care from the HMO (so bad my employer switched providers within a week) I got in to an ortho. She got a new set of xrays and put me through a range of motion test (this was 4 days after the accident I was hit from behind by a car the ground strike did the shoulder damage). After watching me move she thought it looked like I had a high tolerance for pain and would therefore be fine without surgery or PT. No surgery because it wouldn't help and no PT because I would move it on my own. She was right. It hurt a lot for about a year, a little for about 3 years. 9 years later I still have a couple of knots and the scars but absolutely no pain or limitations. It did take over a month to ride again but I was pretty screwed up.


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## uzziefly (Jul 15, 2006)

Armchair Spaceman said:


> Ditto,
> I left mine for almost 2 years and the surgical repair needed to be much more extensive than if I had seen an ortho straight away. See an ortho - look for one that does a lot of shoulder work - they're a finicky joint and need to be done 'just so'.


I actually had an arthroscopic bankart repair done on my left shoulder and I did not separate it actually. I just fell on it some 2 years prior to that but it still troubled me a decent bit and since the surgery in December 04, it's doing good for me now. Slightly less range of motion vs. my right arm but it's not hampering me in any way.

But, I'm feeling some pain and am having some trouble with my left shoulder again. Just had an MRI done last Friday and will be seeing my surgeon tomorrow to get a diagnosis.


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## Wookiebiker (Sep 5, 2005)

It took me about 1.5 months to really start riding, though I had a pretty sever separation. In fact it's still separated, but the soft tissue has healed up around the joint (I can pop it out at will).

Now, I don't suffer any pain or discomfort when riding and it doesn't cause any problems.

If you want to ride a little, put your bike on a trainer and set your bars really high to reduce the weight bearing on your shoulder. That will allow you to do some minor riding until you can put weight on it. Your riding will likely be limited due to butt soreness having so much weight on your posterior, but you will still be getting some riding in.


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## physasst (Oct 1, 2005)

*You*

need to see an Orthopedist. Preferably someone who specializes in Sports or upper extremity. There are 5 grades to an AC separation, and they vary from very mild to quite severe requiring surgical intervention. Without seeing you and your xrays, no one can tell you for sure. Consequently, it is impossible to inform you on a return to cycling time, as that will also be variable depending on the grade of the separation. Hope that helps. BTW- it stands for the acromioclavicular joint.

Here's a link...

http://www.wheelessonline.com/ortho/ac_joint_separation


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## theBreeze (Jan 7, 2002)

*Ditto on the orthopedic surgeon.*

I had a complete separation in '04, tore everything. I went from the ER on Sunday to the surgeon on Monday and had surgery on Wed. Because the injury was so fresh he could do some ligament repair in addition to the standard fix. He didn't actually tell me I COULDN'T ride, but I sure didn't want to for about 2 weeks after surgery. Within a month tho the pain was much reduced. Rode a trainer a few times, but it made me nuts. The surgeon's restrictions were no lifting from the shoulder (as opposed to the elbow) for three months. That when I bought a Saris Bones trunk rack because I could lift the bike with my good arm and put it on the rack. Just under 6 weeks after surgery I rode a week long bike tour in Colorado. Didn't need the sag wagon at all, but carting my gear around at the overnights was a pain.

Now days my shoulder is stable and as strong as the other side. It looks a little weird and sometimes feels odd, but no pain.


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## Argentius (Aug 26, 2004)

*Ouch!*

I got nuthin' on the remedy for it, but I just wanted to say: sucks, man, hope to see you back on two wheels soon.

Doesn't it always seem like the littlest things that hurt the most?


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## BenWA (Aug 11, 2004)

Thanks, all, for the info/suggestions and the healing wishes. I have an appointment with my PCP (no, not the drug) to have a second look and give a referral to an OS.

In the meantime, I have a couple of questions: these guys at the ER were seriously weird (UW Medical Center, for the Seattlites on here), and I dunno how much faith I have in their treatment instructions. 

For one thing, out of 5 different docs, NONE of them instructed me to ice the injury as part of the treatment. Isn't that like rule #1? 

The other thing is that they told me to keep it in an immobilizer for a couple of weeks to let it rest/heal, but also told me to take it out of the immobilizer 3 times a day and force myself to work thru the joint's range-of-motion, despite any pain. Doesn't that seem sort of counter productive? It seems to me either it should be in a sling resting or it shouldn't. What's the point of having it in a sling if you are just gonna wreak havoc on it by forcing it thru its ROM every few hours?

It's been a few days (and sleepless nites), and it still hurts like a &#%[email protected]%@&%$


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## MarkS (Feb 3, 2004)

BenWA said:


> Thanks, all, for the info/suggestions and the healing wishes. I have an appointment with my PCP (no, not the drug) to have a second look and give a referral to an OS.
> 
> In the meantime, I have a couple of questions: these guys at the ER were seriously weird (UW Medical Center, for the Seattlites on here), and I dunno how much faith I have in their treatment instructions.
> 
> ...


The advice you got at the ER is very similar to the advice that I received from the shoulder specialist OP when I broke my shoulder. No ice ever was mentioned. I was told to keep it in a sling EXCEPT for when I did some range of motion exercises (for the first week I could not really do anything and the OP gave me very strict limits on what I could do).


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## physasst (Oct 1, 2005)

*That's*



MarkS said:


> The advice you got at the ER is very similar to the advice that I received from the shoulder specialist OP when I broke my shoulder. No ice ever was mentioned. I was told to keep it in a sling EXCEPT for when I did some range of motion exercises (for the first week I could not really do anything and the OP gave me very strict limits on what I could do).



because ice has never been really proven to do anything besides reduce a little soft tissue swelling...if you have significant swelling in your shoulder the ice will help, otherwise ice and heat are strictly comfort measures, and which ever one feels better you can do. You should be taking it out of the sling to do some VERY gentle ROM exercises...DO NOT FORCE it through significant pain. It will be sore, and some mild soreness is okay. 

Here's a link describing how to do the ROM:

Pay particular attention to the active MPEG at the bottom.

http://www.nismat.org/ptcor/shoulder/


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## BenWA (Aug 11, 2004)

Thanks for that link, phys. I've been doing that "stretch" for the past couple of days and it def helps relax the muscles.


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## Ed Leahy (Aug 10, 2004)

*It depends on the degree of separation*

I had a mountain bike vs tree incident resulting in a mild but painful shoulder separation about 12 years ago. For the first week the only exercise I could tolerate was biking on a trainer. It was pretty much back to normal after 6-8 weeks. Usually separations are not that big a deal, but get it checked out to make sure it isn't a high grade injury.


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