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AC Joint Reconstructive surgery
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Jul 17, 2014
Josh I am sorry you are having a bad time with surgery. I hope there is recourse but whats done is done and for now keep a killer mindset. bring yourself back.
I am about 4 weeks out of surgery. After 9 months of increasing pain I had the end of my collarbone excised and while in there one of the rotator muscles had to be sewn, so along with two anchors and the removal of my bursa AND unwelcome arthritis I was sent on my way. I was given the nerve block for my right arm and was told that it can take upwards of a month to regrow nerve endings just an inch, so be patient. PT started 6 days later and I am about to start strengthening. all good so far and I am optimistic. Almost 100% ROM and limited pain. No complaints only that I didn't have it earlier.
Be strict with PT. I do it 3 times a day and never more than they tell me to do. Its a dangerous time for me when I can be active since I tend to push things...so being heads up after the pain is minimal is optimal.
Total recovery is at 9 months but I feel like it will be sooner.
Patrick Sundahl
Joined Jan 28, 2014
0 points
Jul 21, 2014
Hi Josh. Like the poster before me said, done is done. Your new point of departure is where you are right now. If you have recourse for any wrong-doing, pursue it. But don't let that process bog you down in your march to full recovery. Good luck, and keep us posted on your progress.

I'm new to the board but I want to thank all who post here for sharing their stories. I separated my shoulder in May, type 3, and it still feels really unstable. I'm considering surgery and I have benefited from all the insights provided here.
JohnG62
Joined Jul 21, 2014
0 points
Jul 22, 2014
Rock Climbing Photo: A lovely chimney
Six and a half weeks from the surgery. I just washed my right armpit for the first time since the accident. Oh the joy! PT is a godsend. Evan Riley
From San Francisco, CA
Joined Jun 16, 2009
71 points
Aug 1, 2014
Rock Climbing Photo: A lovely chimney
8 weeks post surgery. I lifted my arm over my head! Veeeeerrrryyyyy slowly.....

A still broken wrist on that arm is slowing the rehab though.
Evan Riley
From San Francisco, CA
Joined Jun 16, 2009
71 points
Sep 12, 2014
Evan- How is your recovery coming along now?

I had a similar surgery to yours I'm about 5 1/2 weeks out. I've been doing PT to get back ROM and light strengthening. My shoulder feels super week still, seems like it's a long road to recovery.
DaveSampson
Joined Sep 12, 2014
0 points
Sep 13, 2014
Rock Climbing Photo: Railay Beach West Thailand
Well its been 12 weeks since the surgery. The shoulder has healed nicely. I can move my arm freely without any pain expect for when I cross over my chest and grab my other arm, there is still a little pain. I still cannot sleep on my left side. I used the resistance band to strengthen for 2 weeks and then added 5lb weights to my workout. Its still weak but making progress. I was able to swim laps in the pool the other day so was stoked about that. I am able to move my wrist and fingers again but still not back to normal. I notice small changes over 2-3 week periods so yes its taking a long time for the nerves to heal in my arm but they are slowly healing. I just hope I make a full recovery. Overall I am happy with the shoulder surgery other than the fact that my wrist is fucked but I guess there is always a risk when going under the knife. The scar is not bad and definitely looks better than that big ass deformity that was there. I am still out of work but maybe can get back to it in another 2 weeks or so.
Rock Climbing Photo: Scar
Scar
JoshuaP84
From Pensacola FL
Joined Feb 26, 2013
45 points
May 12, 2015
I had an AC joint separation class 2 about 2 years ago. 6 months after I was ok and starting climbing again.

But now it's back with a vengeance, I have some impingement in my shoulder which grinds the rotator cuff over time. Also I'm in pain most of the time and get weird nerve pinches that sends pain all the way to my thumb.

The doctors I keep seeing all assure me my current problems have nothing to do with my original AC tear and that I should stick with doing more and more PT. I wish I had done surgery when it happened, I feel like I would be in a different place today.
mt37
Joined May 12, 2015
0 points
Feb 24, 2016
Rock Climbing Photo: I can't tell you how thankful I am for this string...
I can't tell you how thankful I am for this string. I had an epic MB crash in the World Cup MB DH course in NZ resulting in a nice AC separation. I see the surgeon tomorrow to discuss surgery or not. I feel much more informed now. THANKS. I just want to make sure I can still do DH Mountain Bike riding.
Kathy Sanders
Joined Feb 24, 2016
5 points
Feb 29, 2016
Rock Climbing Photo: portrait
Looks familiar...sadly Kathy!
good luck with your recovery.
Chris
Chris Graham
From Bartlett, NH
Joined Jun 25, 2008
538 points
Mar 16, 2016
Chris / others- great string of posts…

I separated my shoulder August 31st last year on a MTB ride in Durango…over the bars and landed on the back of my R shoulder while still clipped in to the bike. Initial diagnosis was grade 3+, and I was told that it is somewhat a "wait and see" situation as to whether you do surgery…Pain subsided within ~2 weeks and I was back to exercising after about 5 weeks and have full ROM. Am back to weights, and cycling, but have noticed that longer runs do cause a bit of discomfort due to the lack of support, but no pain and no problems sleeping - just no support and have maybe 80% of pre-accident strength on the right arm (e.g., when bench pressing)…So, as I believe the long-term prospects can not be positive, have decided to go with the surgery…

I currently live overseas, but have a top-notch orthopedic hospital here, so could get it done here or wait until I return to the States permanently in the summer…Surgeon here has talked about a modified Weaver-Dunn procedure - moving the CA ligament over to the clavicle and supporting it with a fiber wire loop - which seems a bit different from what you described. Anyone out there have experience with this particular fix or other options?
CraigK
Joined Mar 16, 2016
0 points
Mar 16, 2016
One and a half years out of a third degree AC step on the left, no surgery just PT. My recovery was slowed a bit by a bicep tendon rupture on the opposite shoulder 8 months ago, more pt.
The lump is still present, although less than originally, I'm pulling harder than I was before the AC injury, probably harder than before the bicep. V6-8 go well depending on style. Harder to judge sport because it's bouldering season and my enduro is piss but I can do all the moves on .12s
Gnarly gastons and weird presses occasionally cause pain, and I refuse to dyno.

I was lucky to see one of the best shoulder docs in the state and for a cutter he's great about suggesting conservative options. A week on pub-Med backed up his initial evaluation that surgery doesn't offer significant improvement over pt alone (other than cosmetic)

Best of luck.
bking7
Joined May 31, 2011
7 points
Mar 17, 2016
Rock Climbing Photo: portrait
Surgeon here has talked about a modified Weaver-Dunn procedure - moving the CA ligament over to the clavicle and supporting it with a fiber wire loop - which seems a bit different from what you described. Anyone out there have experience with this particular fix or other options?

Hi Craig,
I am familiar with the Weaver-Dunn/ac-tighrope procedure. It seems it works for some leaning more toward the "non-athlete". I discussed this procedure as a possible option with my surgeon and he said that it minimally addresses the stability and strength of the joint. Of course it all depends on the severity of the injury and how you intend to use the joint following surgery. My shoulder was about as bad as it can get...nothing left attached in there...fortunately the large muscle groups held things together for the most part...at least until I went under the knife. After some consideration it was decided to go with the graft!

Good luck with everything bro and please keep us posted with your decision and progress!

Chris
Chris Graham
From Bartlett, NH
Joined Jun 25, 2008
538 points
Mar 28, 2016
Awesome thread. Thanks to Chris for updating even years later. I recently had AC reconstruction using the fairly new arthroscopic dog bone technique.( check out arthrex) I also have a donor graft. Smashed my right shoulder snowboarding in the park. The CC ligaments were replaced, but nothing was done for my AC ligament. I'm coming up on 12 weeks post surgery. Things seem pretty good for the most part, but when I attempted a very light (I mean very, very light) cross-body stretch I felt and saw my clavicle protrude posteriorly quite a bit. Otherwise everything seems pretty stable vertically. Young surgeon is giving me mixed information. Said go full ROM at my 6 week checkup and then said no cross-body stretching until at least 12 weeks after reporting the protrusion. Acted like this was a big no-no. He also said he evaluated my AC ligament intraoperatively and that it was stretched and should heal on its own. My separation was type 3. Everything I've read says the AC ligament is torn with a type 3 and even type 2, so naturally I'm starting to question what he's telling me. How do I tear both CC ligaments and leave the AC ligament intact? My clavicle is solid. Has anyone had experience with this surgery or another method that only addresses the CC ligaments? Is it normal to still have instability on the front to back plane? Will it tighten up like he suggests? What's the point in having the surgery if it only stabilizes the clavicle on one axis? Any insights would be much appreciated. If I have to have an additional procedure to correct the AC I want to get that going while I'm still in the mindset of being injured. Thanks a ton! Chris82
Joined Mar 28, 2016
0 points
Mar 29, 2016
Rock Climbing Photo: portrait
Wow Chris!

Sounds like an interesting injury to that joint. Please keep us posted on your recovery/PT specifically the cross body stretching. Good luck with everything my friend and heal quickly!
C
Chris Graham
From Bartlett, NH
Joined Jun 25, 2008
538 points
Apr 2, 2016
Thanks for the response, Chris. I have a follow up with another doctor soon. We'll see what he says. I'm gonna hit rehab hard until then and try to pack some muscle back on. Hopefully that will help with stabilization. Back to climbing ASAP. No cross-overs or serious gaston-ing for now! I'll report back after I've found something out! Chris82
Joined Mar 28, 2016
0 points
Apr 4, 2016
Rock Climbing Photo: portrait
Chris82 wrote:
Thanks for the response, Chris. I have a follow up with another doctor soon. We'll see what he says. I'm gonna hit rehab hard until then and try to pack some muscle back on. Hopefully that will help with stabilization. Back to climbing ASAP. No cross-overs or serious gaston-ing for now! I'll report back after I've found something out!


Right on!!
Good luck and work hard my friend. you'll get it back!
Grammy
Chris Graham
From Bartlett, NH
Joined Jun 25, 2008
538 points
Apr 10, 2016
It's worth mentioning that third and fourth degree separations are generally clinical diagnoses based on degree of displacement. It might be any interesting study to see how many "third degrees" involve full damage to both AC and CC ligaments, now that arthroscopic surgeries are becoming more mainstream.

As for recovery, it sucks but gets better. Nothing against surgeons, but once they're done putting you back together the PT becomes God on what is and isn't encouraged regarding movement.

Rhomboids and serratus anterior will be your best friends in regards to increasing stability, those guys are now your scapula's main support system.
If you happen to be waiting for surgey/docs I'd ask about "pre-hab" it might improve your recovery
bking7
Joined May 31, 2011
7 points
Apr 11, 2016
Thanks for the advice, bking7! I'm staying on top of my rehab. I'll definitely integrate those serratus-anterior exercises into the game plan! Chris82
Joined Mar 28, 2016
0 points


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