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AC Joint Reconstructive surgery

Chris Graham · · Bartlett, NH · Joined Jun 2008 · Points: 545
tonyre31 wrote:hi all, had surgery 3 weeks ago for a stage 4+ separation after downhill mountain bike crash how long before the pain stops? its worse in the morning many thanks tony
Tough to say Tony, but it takes a couple of months anyway. Make sure you take your meds and ice it constantly. I was given a cryocuff...it was fantastic. I slept sitting up in a recliner with pillows stuffed under my arms for several weeks. But my surgery was on Feb 22, 2012 and by the end of May I was back out rock climbing. I am moving up on a year here this month...so far so good. I am feeling strong and am less aware of the shoulder. It will take a good year or more to get it back to 100%. IT has only been this past month or so that I have kind of forgotten that I had the surgery...less aware of the surgical site...so I am happy with that. Keep up with the PT...do it religiously and you will be happy you had the procedure.
JoshuaP84 Perkins · · Pensacola FL · Joined Feb 2013 · Points: 45

I was mountain biking porcupine rim in Moab UT 4 weeks ago today and was within the last 2 miles of the trail and hit a steep section and flipped my bike. I now have a type 3 tear in my Left AC. (Shown in the PICS). I have been to 3 different Docs, 1 in Moab and the other 2 here in my home city. The first doc said that I probably would not need the surgery and the second doc said I prob would not need the surgery either but he sent me to another doc who specializes more in this type of injury. The third doc recommends that I have the surgery. I work as a firefighter and I am also a rock climber so given what I do for a living and my active lifestyle I am choosing to go threw with the surgery. I know there is a lot of controversy on Type 3 AC tears so I really do not know what the best option would be in the long run but I think I have decided to go threw with the surgery on JUNE 16th. I have noticed that most people that have this type of injury do not go threw with the surgery but I think I might follow Chris on this and OPT for the surgery even tho the recovery time will be long and rough. If anybody has any other suggestions or experiences I would like to hear them...

Thanks Chris for your post...this is what helped me lean more toward having the surgery

AC tear 1

AC tear 2

AC tear 3

Chris Graham · · Bartlett, NH · Joined Jun 2008 · Points: 545

Hi Joshua!

I tore all the ligaments, fractured the clavical, tore the rotator cuff and labrum. For me, surgery really wasn't an option as I guide and climb personally. I shopped around like you have done and that is the smart thing to do. I too was told by several Doctors that I could forgo the surgery...they were the ones that started the conversation with "At your Age...". I basically checked the doctors off the list that started the conversation with that line...pissed me off.

I had the graft done in Littleton on Feb 22 and was back climbing easy rock by early May. It was exceptional, I did a very aggressive PT protocol (I would recommend this approach for you too). I was going to PT 2-3 times per week. I had climbed rock right up until the day before surgery much to my Dr's dismay. Doing that was dangerous and risky, but when they got into the shoulder there was little to no scar tissue, I had good range of motion and the muscles had not atrophied. I believe staying active aided me in my recovery post Op.

If I can stress anything Josh, do the PT...do it religiously, take the meds...work on range of motion...push it and push hard. Typically just the labrum or the rotator cuff surgery can take 6-9 months. I had the whole show done...including new ligaments and screws...clavicular reduction, etc...and was back climbing three months later. It can be done and if you are willing to fight through some pain, get high quality sports focused PT folks that know how to push you...you will be back in no time.

I still feel the shoulder. I am aware of the injury every day, it will never be 100% but I was back to climbing hard in 6 months and continue to push it at 49 years old. Good luck with your procedure and keep us posted on your progress.

Grammy

Evan Riley · · San Francisco, CA · Joined Jun 2009 · Points: 45

Chris, thanks for this awesome thread! It's a godsend. I'm 4 weeks out from the surgery to repair a grade 3 ac seperation. A taxi clipped me (illegal lane change and no signal) on my bike commute and I went flying. I thought I did a good job of rolling over my shoulder, but I guess it wasn't good enough. I have the bonus of having a broken right hand and left wrist too.

Question: did you run at all with your sling on during the first 6 weeks? God knows we all love approaches (hiking) but running is way more interesting. My doc gave me the ok so long as I keep my sling on but something tells me his number of patients that ask that question is low.

My thoughts are to just suck it up for 2 more weeks but hot damn I miss running, or cycling, or climbing, or tying my shoes, or not having to use my feet to open a beer.

Chris Graham · · Bartlett, NH · Joined Jun 2008 · Points: 545

Hi Evan!
Get out there and run. I sure did...I'm not a runner..don't realky like it but it helped keep my sanity and a few pounds off. Lace them up an go!

JoshuaP84 Perkins · · Pensacola FL · Joined Feb 2013 · Points: 45

Well I am 2 weeks out of surgery and not feeling good! I woke up out of surgery not only with a sore shoulder but with a paralyzed left arm. Apparently the doctor either placed the clamps over my nerves during the surgery and put them to sleep or it might have something to do with the anesthesiologists...I am not sure and neither is my doctor...so basically I have a left arm that I cannot use as of right now. The doc failed to mention that this surgery could result in nerve damage. So now not only is my shoulder recovering but I have to wait and see if I get any feeling back in my left arm over the next few weeks. My shoulder is actually doing better than my arm. I have pain that shoots down from my shoulder to my finger tips because of the nerves and it sux. Makes me kinda regret getting the surgery. Apparently this is a rare thing so it only makes sense that it would happen to me.

Chris Graham · · Bartlett, NH · Joined Jun 2008 · Points: 545

Holt shit Josh, that is awful news. Any time you go under the knife you take a risk, but this sounds like somebody screwed up. Never heard of this happening. Do you have any recourse? I hope you recover from this bro

Evan Riley · · San Francisco, CA · Joined Jun 2009 · Points: 45

Josh,

Give it some time. I had no movement for 2-3 weeks but by week 4 I could do 5lb curls and by week 5 I had 25% range of motion.

AGFW · · Colorado · Joined Nov 2008 · Points: 0

Well I am 2 weeks out of surgery and not feeling good! I woke up out of surgery not only with a sore shoulder but with a paralyzed left arm. Apparently the doctor either placed the clamps over my nerves during the surgery and put them to sleep or it might have something to do with the anesthesiologists...

Josh,
If something goes wrong with surgery, the first knee-jerk response of any surgeon is to blame the anesthesiologist. Surgeons can do no wrong in their mind. The only way your anesthesiologist could possibly hold some blame for your persistent nerve injury is if you had a nerve block for postop pain. And even then, the nerve block might not be to blame. Just remember who it was cutting, retracting, and generally mucking around near your nerves in there - the surgeon. Sorry to hear about your injury. You should inquire about taking pregabalin (Lyrica) and be diligent about your PT.

JoshuaP84 Perkins · · Pensacola FL · Joined Feb 2013 · Points: 45

I got a MRI and I did a EMG nerve test the other day and they say that it is my radial nerve that is damaged and that it was probably caused by improper positioning during the surgery or they said the blood pressure cuff might have been to tight around my arm. So I am basically stuck waiting to see if the nerve will recover on its own. They say it could take 2-6 months. U know doctors spend all of their time in books and learning new ways of doing things in our advanced society that it just amazes me how little common sense they have so now I have to suffer for who knows how long because the doctor and his medical staff were to smart to realize a simple mistake. Very Frustrating!

Patrick Sundahl · · Unknown Hometown · Joined Jan 2014 · Points: 0

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.

JohnG62 · · Unknown Hometown · Joined Jul 2014 · Points: 0

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.

Evan Riley · · San Francisco, CA · Joined Jun 2009 · Points: 45

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 · · San Francisco, CA · Joined Jun 2009 · Points: 45

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.

DaveSampson · · Unknown Hometown · Joined Sep 2014 · Points: 0

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.

JoshuaP84 Perkins · · Pensacola FL · Joined Feb 2013 · Points: 45

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.

Scar

mt37 · · Unknown Hometown · Joined May 2015 · Points: 0

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.

Kathy Sanders · · San Jose, CA · Joined Feb 2016 · Points: 5
Chris Graham · · Bartlett, NH · Joined Jun 2008 · Points: 545

Looks familiar...sadly Kathy!
good luck with your recovery.
Chris

CraigK · · Unknown Hometown · Joined Mar 2016 · Points: 0

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?

Guideline #1: Don't be a jerk.

Injuries and Accidents
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