Grade III shoulder dislocation of AC joint

[Rod Whiteley]

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.

[Gareth]

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)

[plucs]

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?

Regards

[kaushik]

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

[kaushik]

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>?

[Nicko1981]

Hi there injured ones. I thought I might share my experience for the benefit of those debating surgery.

I had a type 3 dislocation having stacked my mountain bike. I had surgery 6 weeks later. The surgery used the hooked clavicular plate.

It is 9 weeks post surgery now and I am back to the gym (thank christ), running and playing some non contact. I still have constant low level pain in the shoulder. Especially after a workout. I may start using anti inflammatory's for this.

I have pain lifting weights above my head, have had to cut out related excercises at the gym and can't ride my bike offroad untill the plate comes out in about three months.

Despite the pain I do not regret surgery. My shoulder looked pretty deformed with the bump. I doubt I will ever be 100% again but at the same time I think I would have struggled later on having to deal with arthritis and the deformity. I had the surgery at the Melbourne Orthopaedic Surgery in Windsor. They are excellent.

Good luck to anyone with this injury.

Nick

[hopeful]

Hi Nick, thanx for that info. How does the shoulder look now? is there still a small bump? do you find your shoulder clicks, grinds more than the good shoulder?

thx,

[Nicko1981]

The shoulder looks great now besides the scar. There is almost no difference in the outline of the shoulder - no bumps or corners. My shoulder doesn't click or grind either.

I would add that I am now benching 80% of my previous best. What is holding me back is that two small tendons on the posterior deltiod (back of the shoulder) have been cut (deliberately during surgery) and so the shoulder is a little less stable when pushing big weights. I am told that in a couple of years they will heal up.

In the mean time I am strengthening the whole shoulder (and the rest of my body) as much as I can.

I would seriously recomend that anyone who has this surgery also go to the gym. I have found that weight training helps bring back some of the confidence that you inevitably lose when your body has been seriously injured.

[hopeful]

you know, that is really amazing. very rare. I have heard of horror stories about this surgery. even from the top surgeons. some things go wrong like the clavicles pops up for no reason several weeks or even years after the surgery is one. and i have seen that there is stil a small bump on most people who had the surgery.

consider yourself a lucky shoulder man.

[Ekkawat]

Hey guys, I've injured myself and suffered a grade 3 AC joint separation around in early Feb 2007. The doctor advised me its better to treat it non-surgically but its been 4 months plus and I feel I could not get back much to lifting and I could feel pain when I do push-ups. I feel my shoulder wasnt as flexible as before.

So I went to see another doctor would recommended strengthening is all I could do as surgery is quite late and he wouldnt risk it for me. Its been about 16-18 weeks now, is it really too late for surgery now? I really hope you guys would advice and answer me asap. Thanks a million!