Grade 3 shoulder separation, questions for Dr Mark

[1st4stroke41]

I took a fall off a hill climb last night, when I hit i knew something broke. ER says separated shoulder grade 3 I can't get in to a doc until Tuesday.

I have big bump on top of my shoulder and a lot of pain.

What's the treatment?

Recovery time?

I have the X-rays on a disk I can email them.

[Datz a DRZ]

Been there done that. Grade 3 at 45 years old two years ago. The bump is the only thing noticable anymore. Full range of motion and strength. Dr is going to tell you to strat rehab right away. (That's what he told me). So that's what I did. Maybe I was just a lucky one but I got back to shape pretty quick. My ortho did not recommend surgery unless there was persistant pain and trouble. He said it would be about a year total recovery time after surgery. Of course that would be more or less depending on your age IMHO.

Edited June 6, 2011 by Datz a DRZ
More information

[DrMark]

I can give you more information looking at the X-rays. Many ER docs confuse the gradings, so I make my own judgement.

[Kx_Ryan21]

You won't be able to sleep on that side of your body for about 4 to 5 weeks.

I did this same thing about 2 years ago while riding at the track. High sided myself and flew a good 15ft with the bike still between my legs. Tried to tuck and roll but it was just too much force.

Despite the pain I went back out and rode another 15 laps that day. Doctor will probably recommend abot 5 to 6 weeks off. I know this what you should do but I was back on my bike about a week and a half later but I'm not a good listener lol.

Most of the pain will be gone after about 4 to 5 days. Certain things like throwing a football will hurt for at least 3 to 4 weeks as will trying to sleep on that side of the body.

[1st4stroke41]

[Kx_Ryan21]

Oh wow.

This image may help for explanation.

[DrMark]

That is a grade 5 AC seperation and needs surgical repair. A grade three is 100 percent displaced. This one is greater than 100% and is overlapping the acromion. No good will come of this unless a competent person fixes it.

[1st4stroke41]

How will I know if the doc here is any good?

What time frame to use my arm at say 50%?

Thanks for the help.

[DrMark]

I dont know how to evaluate someone I know nothing about. My patients start full range of motion the day after surgery, and to functional activities without a sling. Return to sports occurs at 12 weeks.

[1st4stroke41]

Would I need an MRI in addition to the xrays?

[DrMark]

If you have $1000 dollars to burn, then you need an MRI

[1st4stroke41]

Nope, no money to burn.

My doc wanted to do nothing, ice and rest.

How would you fix it? Hardware, graft, sew it up?

Just trying to understand

[DrMark]

http://www.sandersclinic.net/shlder_acjoint.html

Rehab is slingless and functional. Return to sport occurs at six weeks to three months.

[1st4stroke41]

Local doc says do nothing and live with the bump from the collar Bone sticking up. He thought repaired or not won't make much difference other than the bump.

That doesn't seem like a good plan, I'm thinking something is torn and needs fixed. Like a torn ACL, not fixing it causes issues later, is this the same way??

I still want to race my bike, I'm not ready for the rocking chair.

Edited June 9, 2011 by 1st4stroke41

[1st4stroke41]

All right I'm sick of this shoulder already. I have some questions and we I can call IM or just ask here. I'll start with here and if you want I can call.

I fly in the night before and surgery the next day I assume, fly home the day after surgery?

When can I return to work, I don't mind a limit on weight. I'm working now so what kind of restrictions will I have?

I'll check on if your in my PPO plan, what is the approx cost of the surgery?

How long before I can get on the schedule?

[DrMark]

Most folks fly in the first thing in the morning before the surgery. We visit in the office, and you undergo the requisite poking and prodding necessary before a surgery. Surgery is the next day. PT is the next morniing and then you go home.

You can use your arm for anything except lifting anything heavier than a Bud lite. At six weeks, you can start some resistive exercises, and at 12 weeks return to sports.

Since, I am probably on your PPO, your costs include the cryocuff (if not covered), your deductable, and copay.

Here is where I want you to go. Call them, and speak with MIchelle, my Nurse

North Texas Medical Center

1902 Hospital Blvd., Suite A

Gainesville, Texas 76240

Phone: 940.612.3100

Fax: 940.612.3103

[1st4stroke41]

For some reason my account stopped working, finally found how to fix it.

My shoulder has got so much better so fast I can't believe it.

It has stopped popping into and out of it's normal position. I can lift light things and even scratch my opposite side ear without any pain.

I am waiting on what my work says about 6 weeks of light duty but at this point it all seems to be working out very well. I even rode my bike some in the yard today.

I do have a large bump on my shoulder but otherwise it's just weak and feels heavy.

[nvas]

Dear Shoulder Gurus,

I took an impact during a rugby game 3 weeks ago (I'm 28). It wasn't a fall, my coach ran at me and hit me. Immediate pain, no disability or loss of range of motion but it was painful when I raised my left arm. There is a slight bump of course. I treated it with cold patch, and a few days of voltaren painkillers but the pain eventually subsided, the only discomfort is that I still can't sleep on that side. I tried lifting some weights (biceps, and lateralus pulldowns) and had some pain afterwards so I thought I better have it checked. The doc said he has to do an x-ray because of the muscle mass. The x ray shows a slight elevation (hence the bump I guess) but said it's gonna be fine and we don't have to do anything about it. If I do a circular motion with my shoulder I hear a slight pop sometimes.

The x ray was taken with weights, and the doctor tried pushing my shoulder to see if it moves or whatnot and it was alright.

Now I'm seeking other opinions, especially regarding the grade and how should I proceed. I plan to seek PT and scheduled an another ortho visit but it's a bit too far as I'm abroad.

My main concern is my hobby, very amateur body building. compared to my weight I bench press only 80-90% of it so not much but I love it.

Many thanks!

Edited June 28, 2011 by nvas

[DougBi]

nvas-You may have more responses if you start your own thread instead of tagging on to this one. Ask Dr. Mark for his professional opinion. Compared to what we usually see on here your injury looks pretty minor. Time and PT and you'll be fine IMHO.

Good luck....

[1st4stroke41]

From what I've seen most should heal on there own.

I've got a pretty big bump but my shoulder gets much better every day,

I might have to get it fixed but for now it's fine I'm riding and have 50% strength and 90% range. I've heard benching is a trouble spot with ac separation.