# Separated shoulder (Acromioclavicular joint)



## GazMac (31 Jan 2009)

Hi All, found this forum for all the wrong reasons . I had a fall 12 days ago going to fast in thick fog (muppet ) and xrays proved I had a Grade 3 shoulder separation ( thats bad apparently ) .It was all taped and strapped up and yesterday this was all removed . I looked in the mirror and I look a right freak, my shoulder has dropped and leans forward and my clavicle sticks up . Dr said it should go back to normal and try to use my arm but I have read stories of people having to have surgery months later to correct initial mis diagnosis. I'm not sleeping through worry, any one heard of similar experiance and how do joints go back to normal.
Thanks
Gaz


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## cheadle hulme (31 Jan 2009)

Erm, If you're losing sleep, then best look away now!

I had a car pull out on me from a side road on the left. i hit the car where the drivers door hinge is. My arm went under the mirror and as I went over the bonnet, my shoulder seperated as it got trapped under the mirror.

I had NHS physio to try and correct the damage that the torn ligaments had caused, but no surgery was possible. I ended up having private physio which built the strength of the shoulder back up (I had subconsciously not been using it to its full extent)

It's better now, but still clicks and gives me pain on longer rides. The CV joint sticks out about an inch further than the othet side. The shoulder always sits higher than the other side too. I'm bony anyway which makes you more susceptible to this kind of damage. 

Make sure you trust your physio and ask for a different one if you feel you're not getting along.

Get well soon.


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## GazMac (31 Jan 2009)

cheers for the reply, how long after the accident was the photo taken ,you look like a similar build to me but compared to my shoulder yours looks better. The nhs doc said he would arrange physio in 8 weeks, this seems a long way off, in the mean time I have found this http://www.ssoc.co.za/seperated-shoulder.html with some decent exercises. I am trying to arrange a second opinion on monday ( private ). I am concerned I might not ever look more normal. ( shoulder , not generally )
Gaz


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## cheadle hulme (31 Jan 2009)

Thats 2 years later, after all the physio had finished. It did sit higher than that.

Its still much weaker than the other side and will fail early if I'm doing dumbell raises for instance. If makes clicking and scraping noises when I move the joint, though my GP says not to worry about this.

That link looks good, though wait a bit before you try any. The shoulder flexion against a wall is the one I have trouble with.


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## Chrisz (31 Jan 2009)

If it's any consolation I did the sternoclavicular joint (the other end) about 10 years ago. It took me 5 years before I could bench press or throw properly (throwing still feels awkward!). However, I was back on the bike within a couple of weeks.

Mine is still odd looking - because it's not worth a surgical procedure to place it back into the correct position they almost always end up looking a little deformed. If the clavicle is broken rather than dislocated there's more likelihood of them fixing it properly.

On the bright side - it's great for grossing out the kids  

(I also have 5 popped lower ribs - 2 one side and 3 the other + 2 on my sternum - cool for showing the kids what can happen sometimes )


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## fossyant (31 Jan 2009)

My AC joint was injured in a RTA just before Christmas. Nothing as bad as yours sounds - everything still in place, but the tendons have been damaged.

I get a clunking in my shoulder if I extend my arm out, or swim with it..... Seeing a physio currently, but he reccons it's a shoulder specialist at some point. Had the problem for 6 weeks now...fortunately riding the bike is OK, but not gym or swimming.

All going through the solicitor.


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## GazMac (1 Feb 2009)

Cheers for replies, had a housefull today not sure if its because its my b'day or everyone came round to laugh at me. I kept having sneaky looks in the mirror and i'm sure as are some of my "friends" that something isn't right. The doc who took the strapping off didn't look at the xrays so I'm thinking maybe he should of. I'm gonna phone him up tomorrow and get another app'tment. Also phoning the local Nuffield for their advice. I've done supermoto racing for a while so I've had a fair share of getting battered but this injury is worrying me.
Gaz


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## fossyant (1 Feb 2009)

Mine is only a Grade 1 at worse...so yes go back. 

Xrays may show broken bones, if not then it's a scan. My xrays came back clear - both shoulders 'normal'. Think I'll be looking at a scan.

Even a mild injury like mine is a bugger, at least it doesn't stop me riding (well no long distance stuff, but that's the time of year.

Cheadle Hulme had a nasy one by the looks of it.

Get it re-checked.


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## benborp (1 Feb 2009)

After a badly managed collarbone injury I had to have the damaged collarbone and my ACJ removed. I now have a band running from the stump of my collarbone to the acromion instead. After surgery the shoulder was quite unstable and tended to slump forward and droop but with physio my shoulder position and function quickly improved and are now near normal and appearance isn't too unusual. Even with the appalling management of my injury the outcome hasn't been too bad. The only issue I have is that the range of movement in the shoulder is too large.


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## craigwend (5 Feb 2009)

it seems to be a cycling (& rugby side effect), I’ve personally got a : torn 'blah blah blah' tendon and a partially dislocated 'blah blah blah' muscle in my left shoulder from last July, did not see a physio properly for 6 weeks but luckily saw one for basic advice early on

Importance of keeping movement in arm - but if it causes pain DO NOT DO IT! so literally 3 separate simple exercises a day form me at the time, a cortisone injection helped massively a long & gradual build up of movement and strength via physio was very helpful, unfortunately it has all ( and it can just happen) gone a bit wrong & I've now been referred to a surgeon.

Also I was also recommended ibuprofen both to help with the swelling and pain management, tend to use gel as I'm not a massive fan of tablets.

Be prepared for the long haul but it does get better, even if only 95% better.


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## cheadle hulme (5 Feb 2009)

Would you recommend the cortisone injection Craig?

I did 45 miles yesterday (longest ride this year - must get out more) and then went to the gym in the evening. 

I can't get my arm much above head high today due to the pain. It will subside in a few days, but when I start to up the mileage I might find a "permanent" painkiller useful.


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## Chrisz (5 Feb 2009)

Pain killers (cortisone etc.) are great for hiding the symptoms but you really need to treat the cause!!


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## craigwend (5 Feb 2009)

cheadle hulme said:


> Would you recommend the cortisone injection Craig?
> 
> I did 45 miles yesterday (longest ride this year - must get out more) and then went to the gym in the evening.
> 
> I can't get my arm much above head high today due to the pain. It will subside in a few days, but when I start to up the mileage I might find a "permanent" painkiller useful.




I agree they hide the symptoms, however they also relieve the *bloody pain* like nothing else had, if 'luck' had gone with me and i had not had a 'one of those setbacks' i believe the cortisone injection helped with progressing my physio over the months, nearly worked too

I did ask for another injection at the last consultant visit, but as after 6 months physio i was actually loosing movement again & the prospect of an operation looks the best long term bet it was decided against it (correct decision) 

But if it helps go for it, but I'm aware for some people it does little or nothing for me it went from 5/10% free movement, to 90% movement in days.


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## GazMac (6 Feb 2009)

I managed to see a private shoulder specialist and he recommended not having surgery yet and having phsyio for a while but starting it on monday . He said it may not , like yours Craig , entirly fix it but theres 85% it may. So I'll give physio a go.

Cheadle, what kind of handle bars do you have and do you do mainly tarmac riding ? I have flatish straight bars and I'm thinking I might get similar problems.

Gaz


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## cheadle hulme (6 Feb 2009)

Drop bars. I may have to bite the bullet and get one of those riser stems so I'm not so stretched out.


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## fossyant (11 Feb 2009)

Not done any long rides myself yet on my injury - although 36 miles with rucksack on commuting and business miles made it ache somewhat last week. Physio want's me to see a specialist as the pain is going, but the clunks are there.

Checked it out with my solicitor as she is speaking to the third party's insurers to see if they will allow it privately (not yet admitted liability) - but off to see the doc on monday to see what's a realistic time before I could get a NHS appointment. I just want to see what's wrong, as one of the tendons certainly catches something.....


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## GazMac (12 Feb 2009)

My shoulder makes some strange sounds but the physio has got good range of motion from it and is optomistic it should get back to almost normal, if not the specialist may consider a " modified weaver dunn procedure " . Physio said to keep off the bike for a while and also showed me this http://www.shoulderdoc.co.uk/ which might be usefull to you fossyant as its in manchester.


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## Renard (12 Feb 2009)

Mine is permanently ****ed in that the tendons have snapped completely (grade 4). It gives me pain but I have the full range of movement. No amount of physio has made any difference. I have been offered an op which involves taking a tendon from my leg and hooking it over the collar bone to pull the whole thing up but I am reluctant to try it incase my leg ends up ****ed as well. Likewise if anyone has any experience I would love to know?


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## benborp (12 Feb 2009)

Can you ask if an artificial ligament can be used? I have one doing the job at the moment, the only reservation I have is that the surgeon said it would be good for somewhere between two and twenty years.


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## cheadle hulme (12 Feb 2009)

GazMac said:


> My shoulder makes some strange sounds but the physio has got good range of motion from it and is optomistic it should get back to almost normal, if not the specialist may consider a " modified weaver dunn procedure " . Physio said to keep off the bike for a while and also showed me this http://www.shoulderdoc.co.uk/ which might be usefull to you fossyant as its in manchester.



Good site that Gaz, cheers


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## fossyant (15 Feb 2009)

Progress report.... 90 or so mins on the bike - mainly flat...shoulder has been aching for the last 24 hours.... great !

Off to docs tomorrow to see about referral, and back to physio tomorrow PM - so far I've only done upto an hour on the bike, including hilly rides - so I think 90 mins is a bit much at the moment (and mine is a minor injury)


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## fossyant (15 Feb 2009)

I will say this stuff affects day to day life.....even a minor one like mine....

I can't swim with the kids as it's uncomfortable to say the least (crunch clunk), I can't go lifting any weights, dig the garden etc..... and today I had to get a 73lb box into the car from Ikea.... flipping great (wife says I'll take you as I can't lift it....) - yeh I can carry it - but what damage is it going to do  - so far it's in the car boot - I'll remove it bit by bit when I need to build it.... (chest of drawers) - and the wife has some plans for the wardrobe.....flippin great !


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## Tynan (19 Feb 2009)

bloody hell you lot, you've made me feel a whole lot better about mine!

sympathies and best wishes to all of you


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## fossyant (7 Mar 2009)

Shoulder's been a bit better over the last week, still clicks and clunks, but I've got the NHS Specialist booked for early April - that'll be 5 weeks from asking for the referral - not bad - still no news from the solicitor about an independent assessment.


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## craigwend (9 Mar 2009)

went to see specialist today...

operation in the next twelve weeks... (repair or re-attach tendon)

sling for 6 weeks post op! - argh just when I thought I could escape the turbo!

hopefully sort things out long term


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## fossyant (12 Mar 2009)

Good luck !!


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## Hugo15 (13 Mar 2009)

I dislocated my shoulder playing rugby. Did is another 4 times over the next 5 years, twice while sleeping!! Finally went to see a specialist and he nailed it back together with a couple of bits of titanium. Best thing I ever did, should have got it operated on much sooner than I did. Was on the turbo within a couple of weeks and back out on the road after about 12 weeks.


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