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Grade III shoulder dislocation of AC joint

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  • Grade III shoulder dislocation of AC joint

    hello, on the friday the 10th june, i was playing football and i fell awkardly, and managed to dislocate my shoulder,i went to the hospital and they informed me that i have a grade III shoulder dislocation of the AC joint, the doctors advised me not to have surgery and said that it will heal without surgery, but right now there is a really big lump on my shoulder where i can see the collar bone really sticking out, because i am aware of the bump, i am considering having surgery on my shoulder, but that is if it wont even go down a little bit. but id prefer it to recover non-surgically, but my main concern is the bump and the AC ball and socket joint, i was wondering if the ball and socket will ever come bak into place, and if so great, if not i am considering having surgery, as i also do a lot of weight lifting
    i am concerned that if i keep playing football after recovery and it is still popping out, wouldnt i be prone to more shoulder dislocations?
    and the other question is, will the ball and socket joint ever go bak in place or will the collar bone just sit on top?
    and will the lump go down on my shoulder in time?
    please reply
    many thanks in advance guys!

  • #2
    Mate I've had the same injury on both shoulders and all I can say is there is very little chance of that bump ever going away.
    When I first did my left shoulder the bump was huge and the physio told me surgery "wouldn't do much" so I did a big of rehab but (because I was lazy) there is still a pretty bad lump there to this day.. My shoulder is also far weaker and clicks around a fair bit.
    When I did my right shoulder last year, I again sought advice on possible surgery but the (different) physio said it would do nothing to strenghthen the injury -- however it could help asthetically (as in, make it look better, get rid of the bump).
    Needless to say I didn't have enough money to have surgery and don't like the idea of it anyway, so I just worked harder on rehab and it has recovered better than my other shoulder. Although I'll add its still weaker than before the injury and there is still a slight bump - especially after a big night out or if I've slept on it.
    I'd seriously consider surgery if I were you, especially if you want to keep playing football and lifting.
    I can't play anymore because any impact on those 'bumps' equals a lot of pain and it literally moves the collarbone around dangerously in my shoulder.
    If I do want to go back and play (with pain) then I have to use really tough shields that I strap to the bumps. The physio can hook you up with those sorts of things but it gets bloody annoying to have to strap that stuff to you every training session.

    So overall, recovery from AC joint injuries takes quite a while and there's no guarantee the bump will go away. It's up to you whether you think you need surgery or not. The advice I got (from a former Canberra Raiders physio) was that surgery will do nothing for the actual injury, just make it look better.

    Cheers, good luck.


    • #3
      thanks for reply

      hey thanks again for the reply mate, wat ime really worried abt is if the collar bone will ever go bak into its socket in time? relly gutted this has happened because i was really into my weight lifting lol. i am not bothered abt the bump to be honest, my main concern is if my collarbone will ever go bak into its socket. thanks in advance for reply, other opinions from others i would be really grateful


      • #4
        You need to educate yourself on what the injury actually is. There is heaps of information on the internet and this site.


        • #5
          hey, i have looked on the internet a lot, trust me, i just dont know for a fact if the collar bone will ever fall in place given time, if i dont have surgery, please could you give me a definitive answer, thank you very much, because the collar bone will be relocated in the socket, then i may not have surgery, vice versa, then surgey may be an option, please reply folks


          • #6
            You still have got the injury wrong, it has nothing to do with your collarbone and a socket. It has got to do with your ac joint and the ligaments that held the ac joint together. If you really have a grade III dislocation you should have heard a few cracks when you landed on your shoulder, that noise was ligaments rupturing. Fact, your collarbone will never go back in place since those ligaments who did that job for you are gone forever.


            • #7
              hey, ok , so what are teh advantages and disadvantages of surgery compared to non-surgery


              • #8
                The advantages of surgery:
                - stability in the shoulder
                - better protection against the development of arthritis
                - relief from arthritis if you are a sufferer
                - allow you to return to activities that involve heavy lifting of objects over your head

                The disadvantages of surgery
                - even with private health cover you are looking at around $5000 for the whole process, this does not include lost wages.
                - your arm will be in a sling at all times for 6 weeks.
                - rehab takes around 3 months, return to contact sport at 4 months, your shoulder will start to feel better after about 6 months.
                - scarring above the ac joint, there is nothing that can be done about this. Scar revision will only be possible where your sutures split. A plastic surgeon can do this in day surgery and won't charge a gap.
                - there are the typical risks involved with any surgery.
                - extra risk with an ac joint reconstruction - they can fail though though this is a risk with any operation. Make sure you get the best shoulder specialist you can find to do an ac joint reconstruction for you, make sure he has done thousands of them.

                I was a long time sufferer of arthritis due to my injury and after the operation my shoulder has improved and continues to do so. The rewards were worth the risk for me in my case.


                • #9
                  hey this thread has been really helpful, could you also point out the advantages and disadvantages of the conservative method?
                  thanks very much
                  greatly appreciated


                  • #10
                    A fairly recent paper would have you stay conservative as the longer term results match or exceed those for surgical reconstruction. In contrast to one of the earlier posters, the incidence of late OA is higher for surgical reconstruction (Calvo et al, Journal of Shoulder and Elbow Surgery, v15, no. 3, 2006). From the last line of the abstract: "Because operative and conservative treatments achieve equally good clinical results and surgery carries a higher risk of osteoarthritis, we recommend managing this injury conservatively".
                    I should point out that they only looked at the modified Phemister technique.


                    • #11
                      The last post was written in haste, and I neglected to mention the downsides of conservative management. The short answer is that they are primarily cosmetic (an ugly lump on your shoulder).
                      I should also point out that there is a reasonable amount of evidence that a-c joint injuries are not nearly as benign as we had thought, and while I don't want to scare you, a lot of people have ongoing symptoms for quite some time. the upshot of this is whatever treatment you choose, there's a fair chance you'll think that it's not 'ideal' as it's unlikely to completely abolish all of your pain and restore all of your function and appearance.


                      • #12
                        Hey guys,

                        As some of you may know from a previous thread I had a grade 3 seperation on March 4th this year, I managed conservetively for approximately 9 weeks and like u had a large bump on my shoulder. I too am very into weight lifting and when I did this injury playin rugby it really hit me hard and I was really depressed that I could not train. Over these 9 weeks I had also lost about 1/2 a stone of muscle which went no way to helping the situation. I did not really care all that much about the asthetic qualities (or lack there of) of the bump but in my 9 weeks post injury after returning to light training I was struggling lifting the bar 20kg when 9 weeks earlier I was doing sets on 100kg +.

                        After consulting a good specialist we decided (although I had decided long b4) to have an operation. On May 6 I had my operation which was to have a false ligament pinned in between the colar bone and shoulder and to have the colar bone excised causing scar tissue to form as well. There are many variations on the shoulder operations and many surgeons will approach it in different ways using a variaty of pins plates false ligaments or whatever their preference. There is debate about which is better but I know of success cases for many and some who have returned to full strength and activivty with conservative treatment.

                        Four weeks + post operation I had made remarkable recovery according to my surgeon and physio and was even allowed to start strengthening around the joint after working successfully on flexibality in the previous week. After six weeks I was allowed back in the gym and along with my strengthening exercises I was allowed to return to my normal routine only on low weights to start with( the specialist had told me that the joint was pretty solid now and I could do what I liked but to stay clear of extream weights 1 rep max or max sets till week 12).

                        I left it one more week b4 returning to my beloved bench press and after seven weeks I was back under the bar. I managed to start back with sets of 55kg which in comparrison to the 20kg after 9 weeks of conservative was a vast improvement and I was not pushing it fully, my physios have also told me that muscle and strength will fly back on over the next three months. (My bad side is also noticably weeker than my good side at the moment.)

                        Overall so far I am delighted with the results of my operation because although I am a lot weaker than b4 the injury, my joint although feeling a little disimular to b4 seems stable and was reletively painless when traning. I am not scared of hard work getting my muscle/strength back but the fact that the joint feels good is the most important, and I have got to build all the muscle up around the joint (which has suffered extreme atrophy) which will make it imeasurably stronger as well (physios will tell u to do thid however it is treated). As for cosmetically I have got a three inche scar on my shoulder and still an ever so slight bump but to be honest who cares as long as I can get back to doin what I love then Im happy, if it bothers me that much I will get a tatoo over it but to be honest it is not that much of an eye saw anyway.

                        The main thing is dont worry there will be imrovement either way but if you love training consult a specialist who can point u in the right direction operation or otherwise. I am on here from time to time so if there is anythin u wanna ask then fire away I am no expert but am more than willing to share what I know. (Also sorry about the spelling and grammer)


                        • #13
                          Hi Gareth,

                          I'm 8 months post operation. I limit myself to 3 days a week for heavy weights - squats 100kg, rows 60kg, bench 90kg. I find that if I go consecutive days I can get inflammation and will need to take anti-inflammatories for that day. How are you going with lifting heavy weights? Do you suffer inflammation any more with your shoulder?

                          My shoulder also does not feel as normal as my uninjured shoulder. I think it is my fault because I have not spent enough time in the last 5 months reintroducing it to doing normal tasks. In the first 3 months I was extremely dedicated to getting back my ROM and getting back to judo so I worked on my rehab a few hours a day on the shoulder joint exercises from the physio, theraband, and very light work in the gym. It also has not helped that I am a software engineer so I sit at a desk all day, and have worked very long hours and weekends for the last 5 months, although this goes back to normal mid August. How does your shoulder feel? Does it feel normal when compared to your uninjured shoulder yet? Are there any kinds of activities that have made a difference to return your shoulder to normalacy?



                          • #14
                            hey i am going to leave it a while see how the conservative mathod goes, and hopefully i will be able to do my normal routine, 4 weeks after injury, i am able to go press ups, and light lifting, but not tried the bench yet, but just wondering if i wanted surgery can i have it in like a year or so , if i feel its appropriate, going to a physio at the gym, see what he says abt all this, but i seem to be moving it remarkably well after 2-3 weeks, better than expected, ime hoping it will get better. surgery is an option in the future, when i gain a bit of money, thanks for your help guys, you been excellent


                            • #15
                              hey i was just wondering, that if in a year i wanted surgery on my shoulder to get rid of lump, would it be possible>?



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