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To the OP - I'd say swatdoc has provided some excellent information. I suggest you see a doc and consider following his advice. Usually, a prescription is necessary to get PT covered by insurance and he can provide that along with recommendation of where to go.. If you don't like what he says, I suggest getting a second and maybe even a third opinion. 3 is what it took for me to find the right guy to fix my wrists. Good luck!
ROM was 75 - 80 % for a couple of years and occasionally it would feel loose, as if it was about to pop out of socket but it hasn't. ROM has increased over time although never 100% but I have had good luck with it for all these years.
The bump is permanent, every moto person I know that has any time on a motocross bike has a bump, some are minor and some are terrible but we all manage to find our way back to the bike.
Therapy afterward is important and cannot be over emphasized, do not go back early, do not look for short cuts. The shoulder is a complicated system and if it's jacked can make your life miserable both on and off the track.
have surgery, but the Doc says it would only be for cosmetic reasons, rehab is
longer, & most likely rom would be worse. I didn't go through with it, did my pt
religiously, & it came back just fine. I have a pretty big lump, but who gives a
shit....it's one of mx's badges of honor....The only problem is I'm a Contractor,
& it's kind of rough carrying lumber on that shoulder, but other than that, it's
been great-
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As for the clicking that a few have mentioned - the medical term is crepitus. As with the bump, it's not really a big deal, other than being a little annoying to some. Crepitus is very common with any joint injury, and for many of us, it never goes away completely. It's harmless though - doesn't mean your shoulder is getting more damaged or anything.
I will mention this however - probably not what you guys wanna hear, but again with ANY significant soft tissue (muscles, ligaments, tendons), you run about a 7 times greater chance of developing some degree of arthritis in that joint later in life. Hard tissue (bones) heal just as good as they once were, as long as they are lined up properly and allowed to heal with immobility (cast). With soft tissue, though, it's never the same. You can drastically improve your outcome and decrease the chances of future problems though via a few different things: number one, reduce the inflammation as much and as soon as possible. Inflammation leads directly to scar tissue formation, which is bad. scar tissue is weaker, less elastic, and has more pain receptors than regular tissue. You will always have some scar tissue after an injury, but the goal is to make it as little as possible, and what is there as healthy and as normal as possible. How do you do that? Ice, anti-inflammatory medication, physiotherapy like ultrasound and E-stim, and physical therapy like ROM exercises, and eventually strengthening exercising. I cannot stress strongly enough how important movement is to soft tissue injuries. The absolute worse thing you could do with you shoulder is put it in a sling for 2-3 months. You have to move it and get back the ROM. It might take months, but moving even some every day is critical. So the second part of optimal healing is the movement. The third phase of healing is strengthening all the muscles surrounding the joint to make the joint as strong as possible, and even more importantly to stabilize the joint. Think of the guy-wires on a tall tower. If the wires are loose and weak, the tower will be unstable and sway all over the place. But if they are strong and tight, the tower will be solid. Prob not the best analogy but hopefully you get the idea.
I'm 5 weeks into recovery now. The ortho surgeon was really close to calling mine a grade 4. I quickly started regaining basic usage of my shoulder and ROM is nearly 100%. I don't feel like it is fully stable though. I can feel it moving around and clicking during certain movements.
The surgeon is a well know shoulder guy in the area (Dr John Edwards in Bountiful). He said exactly what the experts in the post here have said, see if I can rehab it without surgery. I've been in PT for a few weeks now.
I really knew nothing about this injury before suffering it. It sure sucks knowing I more-less maimed myself. The bump is big, and my shoulder absolutely hangs more than the other. I feel like the displacement of the joint it causing part of the pain and discomfort I'm experiencing.
I'm going to see the doc again on the 10th of Jan. I think I'm going to call and request an MRI. I really like to completely understand the extent of the injury so I can decide more informed whether or not to have surgery.
With your second injury - that was a bad one - you really damaged the shoulder internally on that one. I really don't think having your collar bone sitting 3/4" lower and rigidly attached to you shoulder blade would have made much difference on your second injury when you damaged the OTHER parts of you shoulder.That sounds like such a bad injury that your shoulder would have been toast even with no previous injuries at all. COULD it have made a small difference? Yea, sure, but I don't think a significant one.
Not sure if guys have ever hear of impingement syndrome - it's another shoulder condition. But one of the treatments is to surgically REMOVE the outer 1/3 or so of the clavicle. they simply just cut it away. People go on to recover completely without even having all of their collarbone any more. Again guys - having the end of the collarbone re-attached where it should be is not that big of a deal - people do just fine with the whole end completely cut off!!!
Remember guys, here's a general rule about surgeons - surgery is what they do. Most surgeons are going to recommend it - it's what they do and how they make their living. Not that there's not many who are more conservative, but quite a few will tend toward surgery if surgery is an option. There's an old saying - "if all you have is a hammer, everything starts looking like nails"
Josh - If you're back to almost 100% ROM after only 5 weeks, you are doing great!!! Especially if you've only been doing PT a few weeks. It's a painful injury for sure - I remember vividly, and it has been over 35 years ago for me. PT and recover takes time. Don't get discouraged. see how you're doing after about 4 months of PT. Don't worry about the clicking - you might always have that. Don't worry about your shoulder "hanging down" - you have a lot of muscles in spasm right now, and as your body recovers and things stabilize and normalize, that feeling and look will diminish. You'll always have the bump - but as you continue exercising, it will diminish some. Mine is hardly noticeable now. Mine was a grade 3-4 initially, and even years later, I could grab the end of my collar bone and move it around.
Keep up with your rehab - don't quit. I think one of the biggest mistakes people make is to go thru rehab, get the shoulder (or whatever) doing better, then quit. What happens is they lose all the strength and stability they gained from all the hard work. My shoulder was "OK" for many years, but really got better when I took up wt lifting. It got much better over the years from the increased strength and stability. What I came to believe and then recommend to all my patients is this - for the best possible recovery and long term functionality - don't ever stop your rehab. Make wt lifting a part of your life from now on. You don't have to be a fanatic or go at it like a bodybuilder - just stay consistent with it and make it part of your weekly routine. You will thank yourself later in life.
I wanted to have my shoulder back to 'normal' as I have limited skills so being able to still throw a football above the average person was something that was important to me.
When I went to the hospital I got the typical 'You'll always have a lump' response.
That just seemed ridiculous. So I decided to do my own research and obviously went the surgery route.
Didn't do rehab at a clinic I did it all myself after reading the recommended processes. After all the rehab people learned it from a book so that meant I could as well.
Other than not being able to use my right hand for anything {which sucked because I can't use the left
I was able to get back to my pre-crash push up count 50 in a row.
So a year later I couldn't be any happier with my decision. I'm a car salesman so I had to only take 2 days off.
It takes twice as long to warm up before I can throw 100% but I can still get 45 yards out of my 36 year old arm.
Just do YOUR OWN research its your body so do what the F you want not what anyone tells you.
Side note I killed my ACL in 2002 and haven't gotten that fixed as with a knee brace I'm good.
If anyone has any questions contact me at: mikebellaire@me.com
Not bragging about throwing or push ups but I feel that its a good water mark you know?
Now days with most of these AC separations, they do much more than "reattach the collar bone to the shoulder blade" as they used to via plates and screws. For mine they strapped my clavicle down to my coracoid process, cut off the end of my clavicle and in my case reattached my deltoid. Had I not done surgery on mine, I would have lost most basic function with my right arm for good. Had no idea that was the case until after they cut me open and found the disrupted deltoid. I'm only 2 months post op right now but I'm happy everyday that I opted for surgery. It may take longer to recover but with the strap, my injured shoulder will now be even more durable than my non injured one and Ii will regain 100%rom etc.
Medicine in general is not an exact science. Even for someone who has had a heart attack, and it's discovered that they have narrowed coronary arteries, some doctors will suggest CABG surgery, some will suggest angioplasty (stents), and still others would suggest IV chelation therapy.
In your case Skyler, your injury was obviously pretty bad if you had a detached deltoid. So in YOUR case surgery was preferred. YOUR case was not a typical AC separation, however. The typical AC separation does NOT involve the deltoid muscle tearing completely off the bone.
The OP has already said he is making progress and almost 100% ROM has returned - he obviously does not have a detached deltoid then like YOUR injury. The OP is asking for advice from others with the same or similar injuries as his. Again, YOUR injury was much worse, so the treatment required for YOUR injury doesn't really apply here.
People with typical AC separations will absolutely not lose basic function of their arm for good. Not even remotely. Again, in my case, with a typical AC separation like most have, I recovered just fine with no surgery and no rehab at all. I didn't start exercising until about 15 years after my injury. Thousands and thousands of people have had AC separations and have done just fine without surgery. And remember, again for a typical AC separation, which YOURS was not, there really is no risk trying PT first. If it doesn't work as good as you like, you can always have surgery later. A few months of PT would make your shoulder stronger and your recover after surgery would that much easier.
But hey, obviously you think you know more than me. Everyone is entitled to their opinion. I wish you all the best Dr. Skyler
Thanks for your professional advice/insight. The skinny, beat up kid appreciates it :D
Pit Row
2nd shoulder went in got a clean up and the dr found a few things more wrong with it that didn't show up on mri
These are two very different injuries.
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