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ridethespiral
Dec 14, 2003, 5:53 PM
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I recently seperated my AC joint in my shoulder snowboarding. Tore the three ligaments that connect the clavical to the shoulder. Just wondering if anyone knows much about this injury and how to make sure i recover completely to climb again. The big question right now i guess is whether or not to have surgery. thanks for any help
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reno
Dec 14, 2003, 6:15 PM
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Surgery depends on the degree of the seperation.
There are, if you'll pardon the bad pun, Six Degrees of (AC) Seperation.
Types I, II, and III all involve superior displacement of the clavicle on the acromion process. Type IV is posterior displacement of the clavicle. Type V is inferior displacement. Type VI is extreme superior displacement.
I and II generally don't require surgery. III might. IV, V, and VI usually do.
Hard to tell which one you have without being able to see your shoulder. Unless the orthopedic doctor tells you "We'll need to do surgery," you have a good chance of healing fine without it. Rest, ice, more rest, and time. Then some physical therapy/rehab to strengthen the muscles around the shoulder.
If you can, send me a jpg of the X-ray via e-mail at medic245@mindspring.com and I'll offer you more info.
Good luck.
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ridethespiral
Dec 15, 2003, 5:02 PM
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Thanks for the info, my injury is a 3rd grade seperation, i don't have the x ray, but i do have an obvious bump on the shoulder where the clavical sticks up. On the xray it looked to be displaced about an inch. My dr. said that it should heal ok, but that to regain the ROM that I want for climbing it may require surgery. I'm seeing him again tomorrow so I should get a better idea of the recovery process then. Thanks again
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reno
Dec 15, 2003, 5:10 PM
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In reply to: Thanks for the info. My dr. said that it should heal ok, but that to regain the ROM that I want for climbing it may require surgery.
That sounds like pretty solid advice. The decision of surgery or no surgery often depends on what you want to do after the injury. I know lots of folks who had ACL tears, for example, and did fine without surgery, as their level of activity didn't require the presence of a solid ACL (swimming, etc.) Others with the same injury decided to have the surgery, since they needed the stability for their activity (skiiers, volleyball players, etc.) It all depends.
And where the hell is Sharpsburg, GA? I was in the ATL metro area for the past 6 years...
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roadguy
Dec 15, 2003, 5:33 PM
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just to add a bit of personal experience into this thread, I've had three 3rd degree AC separations (w/ no surgery) and only did the last one (impacted the pavement at 35mph) do anything that made me lose any real range of motion. I'm not sure if it was due to impacting an already separated shoulder but my doc said it was pretty locked up. But with the first two I was able to climb again without to many problems for years. That being said, full range of motion and strength was only regained through lots of physical rehab. I did lots of pullups, light dumbbell flys etc. The more you develop your shoulder muscles, the more stable it will feel. If you opt not to have surgery, your clavicle, in certain positions like sleeping on your side, will feel like it wants to pop up/thru the skin. Carry packs can be a bit of a pain too because your clavicle tends to push against the pack straps more then it used to. If you need anymore anecdotal info pm me
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ridethespiral
Dec 16, 2003, 6:08 PM
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Saw the doc today. He said that if I do need the surgery, I don't necessarily need it right now. So I'm gonna do a lot of physical therapy and see how it heals without surgery. Thanks for the info. Roadguy, did you do formal PT with a phyical therapist, or just work out on your own? Sharpsburg is a little city about 40 miles south of Atl near Newnan and Peachtree City. I actually live in Leadville, CO now though.
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boulderin
Dec 16, 2003, 8:26 PM
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Hey man, sorry to hear about the shoulder. I just wanted to let you know that if you are careful and do some good stretches and train the shoulder you should be fine. I never had surgery on my shoulder and i climb just fine, however, you will always have the bump on the shoulder if you dont get it fixed...so again its all up too you...but good luck!
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wigglestick
Dec 16, 2003, 8:38 PM
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I separated my shoulder in May and posted this topic. Might be some useful information in it for you http://www.rockclimbing.com/forums/viewtopic.php?t=31431
It has been 7 months since my injury and I am still having trouble with my shoulder. I can climb alright (pulling motions don't seem to give me any problem) but pushing motions are difficult. It was only about 2 month ago that I was finally able to do a real pushup. I missed the entire season of kayaking and had to call off a trip to Costa Rica because my shoulder isn't up to stress yet. I am contemplating seeing another doctor to see if there is something wrong with my shoulder and what I can do about it. Is it normal for there to be a ~1 year recovery process for this injury? My doctor seemed to think that within 6 months I would be back 100% but yet here I am at about 75%.
lifting weights seems to help and doing some PT was really beneficial in the beginning to get the range of motion back to where i can still function in everyday life.
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roadguy
Dec 16, 2003, 10:27 PM
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In reply to: Roadguy, did you do formal PT with a phyical therapist, or just work out on your own?
all of my thearpy was on my own. It takes time. Don't expect huge gains in your comeback soon. Mine were caused in bike riding/racing accidents and I was not climbing that much at the times these happened. Another poster to this thread noted that pull down motions didn't affect him to much, and I agree there, but as soon as your arms drop below your shoulders, the effects from the separation become much more noticable, like manteling or undercling, you will feel the float more then. You probably already have noticed this when you try to pick up anything with weight in it, your clavicle feels like it wants to pushup thru the shoulder skin.
But, if you aren't going to have surgery at this time, then make sure the sling they put you in, is not the doughnut or figure 8 style. All these do is pull your shoulders back and reduce the pressure on the clavicle. they don't keep your clavicle in place to allow the muscles to reclaim their lost tension on the shoulder, locking in place what your acromonial joint once gave you. They make one where your arm is in a 90 degree sling type of rig with a strap going over the shoulder, holding it firmly in place. Of my three separations, I had the best long term luck with the results from this type of sling. I mean I was riding my bike within a week from my last injury, but climbing took me a lot longer cause of how much stress is put on your shoulders from yarding on holds. YMMV
good luck dude.
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nafod
Jan 8, 2004, 7:21 PM
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In reply to: I recently seperated my AC joint in my shoulder snowboarding. Tore the three ligaments that connect the clavical to the shoulder. Just wondering if anyone knows much about this injury and how to make sure i recover completely to climb again. The big question right now i guess is whether or not to have surgery. thanks for any help
I'll throw my experience into the stew, for you to chew on...
Had a Grade III separation, with the big bump on the shoulder, etc. Did you get the nasty discoloration of your shoulder too? Looked like someone dumped egg yolk on me. Localized jaundice.
After testing me to see if there were any major muscle injuries that would mess with my range of motion (there weren't) he stuck me in a sling and said essentially, "let pain be your guide". I used the sling lots the first week, then started weaning myself. Goodbye sling by second week. I was doing pushups by the second week.
Sleeping on that side was impossible the first 6 weeks, and is doable now if I sleep on the couch and have the support behind me, and put the arm up so I can rest my head on my hand. Otherwise, I roll in my sleep and immediately wake up from the pain.
I've been very aggressive on rehabbing it, and in fact have gotten stronger than I was prior. My theory is strong muscles will help make up for loss of structure there. Lots of bodyweight exercises...pullups, pushups, dips. I do the http://www.crossfit.com workout of the day, and one of the things they have you do is handstands and handstand pushups. Plus lots of pressing type exercises. Just go light at first, and do reps.
Can't do a full handstand yet, but the pain is decreasing (or my tolerance is increasing), range of motion improves daily, and I figure this week I'll do it.
I ski patrol, and I will tell you it hurts like a *mother* to fall on that side, particularly on the elbow. You will feel your new joint move. Beware.
Oh, my injury was in mid-November.
As for surgery, I'd choose it as an absolute last resort. There's a reason the good lord didn't put holes all over your body, that's to keep your innards inwards. Very unnatural.
Good luck!
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