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AC Surgery/age

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  • AC Surgery/age

    I have been looking through posts, but have yet to find the answers I seek, so decided on my first post.
    I am a 46 year old female. I crashed my motorcycle going about 45 MPH, landing on my shoulder/head area. I have been diagnosed with a GR III AC separation.
    Accident occurred May 18th. It is now July 5th, and I am considering surgery. I feel really apprehensive about it because I had terrible trouble with acl recon. I have been in therapy, OT feels there might be more than just the AC injury (rotator cuff?)
    My bump is huge... bigger than any pics I have seen on line except one of a gr V. ROM is good, and pain is manageable as long as I am sitting and resting arm. Problem is- when I walk or even stand for 15 minutes my arm gets hurting so bad (just from the weight, I think), that i have to hold my arm above my head or sit to support it.
    in the beginning, i was unable to wear a sling because i had a benign tumor in my proximal humerus that was aggravated from the impact. in fact, the arm pain from that tumor was worse than the AC injury. now that it has settled down, i am able to do much more, but i can't live with this pain in my arm when just standing.
    i do pretty physical work-i am a cable tech and do a lot of work overhead, and climbing, etc...
    i saw my doctor this morning and he said he can't tell me that pain will stop without surgery. like i said, i am real apprehensive but i do need to be able to return to my work.
    he said he would have to do the open weaver-dunn procedure.
    i am not a young athlete like so many on here, and i had a rough recovery from my acl. should i give it more time or just go ahead with the surgery?
    thanks in advance for your input.

  • #2
    With shoulder injuries, they normally say you need to give it at least 4-6 months to heal properly. However, if the pain is getting worse and it is affecting what you are doing then it may be something to consider.

    I have read with AC separations that you can recover without surgery, it just takes time. I think this it is really important to emphasise that each person's injury is very unique.

    If there are other muscles which are involved which may be affecting you moving your arm, I'd say that this requires some further investigation. Have they ruled out any injury to the rotator cuff? It may be worthwhile clarifying if the surgeon said anything about you having an unstable or weak shoulder? If you can't bear weight on your shoulder and it hurts with your arm being in a neutral position, it does sound like you do have some instability. I think this is something which you need to discuss a little more. I have always found when you go and see specialists that their advice is always a blurr when they give it to you, it might be worthwhile following it up with a phone call and clarify your concerns.

    Hopeful, do you have any further insight into this since you've had an AC injury?


    • #3
      Thanks for the reply. my doctor didn't say anything about instability, but my OT sure has. he acted a little aggravated at times. he said my clavicle is not raised, rather my shoulder is hanging. when i told him it is definitely higher, I think it made him a little mad. I can say for sure, it is higher.
      I was wondering that myself, if more time would maybe help. However, if I am going to end up in surgery I would rather get it over with.
      I am able to lift, but I still can't sleep on it. And the pain from the weight of my arm is not really normal according to him.
      The MRI did not show rotator cuff damage, but my knee didn't show cartilage or meniscus damage and had both. The doctors assistant (who around these parts at least, does most of the day to day stuff) said "I don't see how you could NOT have damaged your RT, as hard as you hit".
      I can't really get another opinion, as he is my third- the ER, ons sports doc that sent me right to work 2 days after my crash, and now him. I like this doctor and the staff, but I think maybe you are correct that I need to ask more questions.


      • #4
        I would talk to your doctor and have your OT to talk to them about what he thinks about your shoulder. If you have instability then you need to work with a physio to help with strengthening your shoulder girdle muscles to try to support your shoulder joint. Are you also working with a physio? I have an amazing physio who has developed a rehab program for my unstable shoulder and it has been realy good for my shoulder. I actually have muscle development growing back after my two injuries.

        If you are happy with your doctors thenI wouldn't get a second opinion. Maybe you should just ask some more questions about things like the timeframe you should allow for your shoulder to heal, determine if you have any instability in your shoulder, when you start exercise rehab?



        • #5
          Hi there,

          I wouldn't be worried about getting another opinion. It's your body and need to look after it. Make sure you go to someone that specialises in shoulders, it makes a huge difference.

          It took me a long time to find the right doctors and physios to treat my loose ligaments which often lead to joint instabilities.

          Now I see a sports physician that oversees my overall rehab, a knee physio, shoulder physio, podiatrist, shoulder surgeon and knee surgeon. It has made a big difference in finding the right people.

          If you can I'd find a sports physician/doctor that works with an elite sporting team. That way they are more likely to up with the latest treatments. They would also be able to refer you onto the best specialists for your problem.

          Good luck !!


          • #6
            thanks for the replies. yes, I am working with a sports doctor-he does the Indianapolis Colts and Pacers. He told me Friday if I played for the colts I would have had surgery already. That is why I am questioning my age/recovery if I do opt for surgery.
            I am leaning toward working more on strengthening before I make my surgery date. The problem is I am still unable to perform my normal job functions.


            • #7
              That's great to hear that you're working with a sports doctor.

              I don't think age is a barrier if you're prepared to do the rehab afterwards. If I was you I'd be asking more questions about the surgery and the recovery afterwards.

              Good luck !!


              • #8
                From my experience I don't think any surgeon knows what they are dealing with until they have you under and opened up. My diagnosis before surgery was nothing like the end result of surgery. Like you I have a very physical job with a lot of lifting. pushing and arm movements. I am 47 and have been off work for 5 months now - and dont look like getting back on full duties for quite some time. Its frustrating and the word patience and slowly are not going down well atm. But all I know i am further advanced than 4 weeks ago since surgery. Good Luck