Grade 5 AC (shoulder) separation. Anybody had one?

DYE
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Edited Date/Time 9/21/2021 6:51am
I've held off on making this topic but decided to go ahead because each day is up and down and I'm tired of wondering if I will ever get back to normal. Closing in on the 4 month mark since my accident. I had the hook plate surgery 11 days after and meet with the surgeon in a few days to decide when we are going to take it out. In 4 months I'm still no where near full range of motion. At my one month progress report in PT I had gained about 50% back from my starting point (that was last week). I just recently was able to start sleeping in a bed again, but it still F's with my sleep and I'm in pain every day. Every time I ask the surgeon or PT I get the ol "I think you'll get it back but everybody is different bla bla bla" I'm so in the dark on if I'll ever recover fully from this. I made a couple good leaps in progress over the last few weeks. Yesterday the PT said "I'm going to level with you, this is the worst AC separation I've ever seen, we are in uncharted waters here". He said this after me hounding him to give me an estimation as to when I could get back to physical activity lol. As of now its nothing over 10lbs and nothing where I could risk taking a fall.

I've read about some 3/4's but if anybody has had a grade 5 please chime in on how recovery is going long term. And did you feel the same as me during the process?
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Forty
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9/17/2021 9:14am
Holy Smokes! Didn’t even know they went to 5.
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murph783
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9/17/2021 9:14am
Jesus I had a grade 3 years back and I thought that was bad. Does grade 5 actually involve your arm being torn off and sewn back on?
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DYE
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9/17/2021 9:23am Edited Date/Time 9/20/2021 8:46am
murph783 wrote:
Jesus I had a grade 3 years back and I thought that was bad. Does grade 5 actually involve your arm being torn off and sewn...
Jesus I had a grade 3 years back and I thought that was bad. Does grade 5 actually involve your arm being torn off and sewn back on?
Pretty much except with a metal plate lol. It's when there's more than 100% separation.
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T-MAC
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9/17/2021 9:50am
I had a grade 5 AC separation. I had the "ac tightrope" procedure done. They drill a hole in your clavicle and one in your coracoid process (bone protrusion off chest plate). Then they basically anchor down the clavicle with a tension wire and some washers to align it in correct position. The wire stays in there forever unless it causes issues. I was lightly riding mountain bikes within 6 weeks and have had no other issues since. Got full range of motion back. I didn't go to PT but was given exercises to work on at home (mostly ROM stuff) and did it daily.

I did mine in a mountain bike crash on a Sunday. Had surgery the following Tuesday. Then I was on a plane Thursday from CA to MI for my sisters wedding (which I was in) with a fresh shoulder surgery, staples, a couple broken ribs, and was in the wedding on Saturday with no sling. My family was not pumped but shit happens haha.

The Shop

swordfish
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9/17/2021 9:54am
Not a grade 5 but I had a 4th degree separation and opted to not go for surgery after the surgeon told me it was an invasive procedure with a high 2 year failure rate. I’m used to living with it now.
9/17/2021 10:18am
I did the same thing 16 years ago. It will eventually stop hurting, strengthen the muscles around it, the clicking and popping will become normal. The only fix is to just replace the ligament with ties. You’ll be just fine buttercup.
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DYE
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9/17/2021 10:19am
T-MAC wrote:
I had a grade 5 AC separation. I had the "ac tightrope" procedure done. They drill a hole in your clavicle and one in your coracoid...
I had a grade 5 AC separation. I had the "ac tightrope" procedure done. They drill a hole in your clavicle and one in your coracoid process (bone protrusion off chest plate). Then they basically anchor down the clavicle with a tension wire and some washers to align it in correct position. The wire stays in there forever unless it causes issues. I was lightly riding mountain bikes within 6 weeks and have had no other issues since. Got full range of motion back. I didn't go to PT but was given exercises to work on at home (mostly ROM stuff) and did it daily.

I did mine in a mountain bike crash on a Sunday. Had surgery the following Tuesday. Then I was on a plane Thursday from CA to MI for my sisters wedding (which I was in) with a fresh shoulder surgery, staples, a couple broken ribs, and was in the wedding on Saturday with no sling. My family was not pumped but shit happens haha.
Damn dude, sounds like yours went a lot better than mine. I was in a sling for 4 weeks and needed every bit of it. The first 5 days after surgery I was miserable. The pain blocker wore off too fast and I got behind with my pain meds. He said if I got behind I'd never catch up. He was correct.

I was offered that same procedure. I told the doc I just wanted the best recovery possible and he said the hook plate was more stable and less chance of damaging anything further during recovery, but the drawback was it required 2 surgeries. I have good insurance so I told him to send it.
DYE
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9/17/2021 10:22am
swordfish wrote:
Not a grade 5 but I had a 4th degree separation and opted to not go for surgery after the surgeon told me it was an...
Not a grade 5 but I had a 4th degree separation and opted to not go for surgery after the surgeon told me it was an invasive procedure with a high 2 year failure rate. I’m used to living with it now.
Does living with it mean still some pain or less range of motion or?
DYE
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9/17/2021 10:28am Edited Date/Time 9/17/2021 10:29am
I did the same thing 16 years ago. It will eventually stop hurting, strengthen the muscles around it, the clicking and popping will become normal. The...
I did the same thing 16 years ago. It will eventually stop hurting, strengthen the muscles around it, the clicking and popping will become normal. The only fix is to just replace the ligament with ties. You’ll be just fine buttercup.
It's easy to play it off 16 years post injury when you already know what will be. When your in it and wondering what the future holds its a little different. I even said in a year or 2 I will look back and think what was the big deal was. But when you're in the middle of it, no sleep, pain every day, it wears on you a little different.

But I do appreciate the info.
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Forty
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9/17/2021 11:57am
I took a level 3 back in 1982 at the old lakewood track. They said surgery or compression brace for 6 months, I took the brace and its been ok ever since....bone sticks up and some crackling but no pain.

I thought level 4 was automatic surgery...level 5....yikes

langhammx
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9/17/2021 12:04pm
I had a level 3 and also had surgery. 7 anchors on bicep tendon and labrum. I took the PT very serious. It still aches in the winter, but the Dr that did it, did a very good job and I have a very good range of motion.
It will get better and you’ll have less pain as the time goes by. Hang in there…
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Boomslang
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9/17/2021 12:24pm
Yes, happened in 1993 and been operated twice since and i still have trouble. Sometimes my pain gets real bad then I'm off to the specialist. He uses Ultrasound to locate where to jab the Cortisone.

I got an inversion table and hang upside down with arms stretched out. 5 min in the morning and 5 min before bed. It helps both my back and shoulders.
Shredder
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9/17/2021 12:40pm
T-MAC wrote:
I had a grade 5 AC separation. I had the "ac tightrope" procedure done. They drill a hole in your clavicle and one in your coracoid...
I had a grade 5 AC separation. I had the "ac tightrope" procedure done. They drill a hole in your clavicle and one in your coracoid process (bone protrusion off chest plate). Then they basically anchor down the clavicle with a tension wire and some washers to align it in correct position. The wire stays in there forever unless it causes issues. I was lightly riding mountain bikes within 6 weeks and have had no other issues since. Got full range of motion back. I didn't go to PT but was given exercises to work on at home (mostly ROM stuff) and did it daily.

I did mine in a mountain bike crash on a Sunday. Had surgery the following Tuesday. Then I was on a plane Thursday from CA to MI for my sisters wedding (which I was in) with a fresh shoulder surgery, staples, a couple broken ribs, and was in the wedding on Saturday with no sling. My family was not pumped but shit happens haha.
I had basically this same scenario roughly 30 years ago. Mine was almost through the skin. Got the wire surgery and was back working in a week. Had no choice since I had no insurance. Took me some time to pay that one off. Recovery wise went pretty well. Without the insurance I had no access to PT, so the doc hooked me up with some home stuff and being young and smart, I followed it to a T and was back to normal in less than 6 months. I hated feeling the wire up there, I was always playing with it, and when I had to have that same bone plated 15 years later they took the wire out. So now I have a plate to play with instead of a wire...
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9/17/2021 7:21pm
I did mine about 18 years ago. I can still grab my collar bone and move it around if I take pressure off the "joint". It did take a long time, but once I wasn't in danger of reinjury I just went back to living. I let life bring back my range of motion instead of the other way around.

Mine came with a few other shoulder injuries (nerve and muscle) but other muscles learned to compensate.

At about the 15 year mark I went in for stem cell injections with PRP and about a year after that I noticed actual growth in my deltoid which had previously been atrophied down to shoe string size.

Like I said it still isn't "normal". But it does not keep me from doing anything at all. Well may shoulder presses...
nch209
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9/18/2021 1:43am
Grade 3 left and surgery fixed it and it’s awesome. Grade 3 on right and was doing good for about a year after surgery and decide to land on it again via a bmx crash and ended up with a 3/4ish and broken clavicle. Chopped it and doing better now- but it looks all jacked up and still hurts. Moto at 40 is becoming less fun…

To the op. Ouch. Mine were nothing like that! Lol
dmm698
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9/18/2021 6:51am Edited Date/Time 9/18/2021 6:53am
Grade 5 is what I was told I had. It was always confusing because it seems like it’s 1 to 3 or some people use 1-6.

Broke 3 ribs front right, 2 rear right, 1 front left, collapsed right lung at same time. The shoulder was what bothered me the most, hospital kept saying it was inferred pain from the ribs. Got home after my 4 day hotel stay at a lousy hospital, looked at my own x rays and they looked like the ones posted above. Went to an ortho next day, they said grade 5 ac separation. They were kind of all steering me to PT “because you’re going to ride again”. PT also discovered torn peck.

I started PT about 3 weeks post crash. Rode my Harley at 4 .5 weeks, rode moto again around 6.5 with some KT tape. Raced at 7.5 weeks. Have the nice lump someone also posted above, no real range of motion issues I’ve ever really noticed I guess. Only time I remember I did it is when I use that arm to open a door. Open door knob and then that rotation while pushing to open door while holding knob if the door knob was near your stomach when you twisted it.
Overall glad I went with the PT as opposed to surgery

Hang in there it effing sucks how bothersome that injury is when it’s fresh.
CR92
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9/18/2021 7:12am
Grade 5 in March of 2020 here.
Honest question, not meant to be rude at all, but have you been doing all the exercises the PT told you to do?
Also, have you seen any other PT's?
As a person who's worked as a trainer/rehab specialist for the past 10 years, and as someone who has worked with a lot of PT's both for my self and work, what he said isn't exactly something normal. Have you thought about meeting with a different physical therapist? Even just for a consultation?


swordfish
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9/18/2021 7:19am
swordfish wrote:
Not a grade 5 but I had a 4th degree separation and opted to not go for surgery after the surgeon told me it was an...
Not a grade 5 but I had a 4th degree separation and opted to not go for surgery after the surgeon told me it was an invasive procedure with a high 2 year failure rate. I’m used to living with it now.
DYE wrote:
Does living with it mean still some pain or less range of motion or?
No major issues with ROM, I have some occasional soreness and pain. Depends on temperature outside. Sometimes it will fatigue slightly faster riding or feel sore the first 15 min. I have no issues doing military press with a plate or any other movements in gym. I had shoulder issues previous to the the accident. My right shoulder is a grade 3 as well. Surgeon was very honest with me. Said he had no issue doing it but suggested if I could live with it to not go surgical. I’m 48 yr old. Been living with it for 8 years. Did it on my 40th BD. I do a lot of shoulder stretches and hang from the bar at the gym a lot for as long as is tolerable.
the kid 857
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9/20/2021 6:30pm
DYE wrote:
I've held off on making this topic but decided to go ahead because each day is up and down and I'm tired of wondering if I...
I've held off on making this topic but decided to go ahead because each day is up and down and I'm tired of wondering if I will ever get back to normal. Closing in on the 4 month mark since my accident. I had the hook plate surgery 11 days after and meet with the surgeon in a few days to decide when we are going to take it out. In 4 months I'm still no where near full range of motion. At my one month progress report in PT I had gained about 50% back from my starting point (that was last week). I just recently was able to start sleeping in a bed again, but it still F's with my sleep and I'm in pain every day. Every time I ask the surgeon or PT I get the ol "I think you'll get it back but everybody is different bla bla bla" I'm so in the dark on if I'll ever recover fully from this. I made a couple good leaps in progress over the last few weeks. Yesterday the PT said "I'm going to level with you, this is the worst AC separation I've ever seen, we are in uncharted waters here". He said this after me hounding him to give me an estimation as to when I could get back to physical activity lol. As of now its nothing over 10lbs and nothing where I could risk taking a fall.

I've read about some 3/4's but if anybody has had a grade 5 please chime in on how recovery is going long term. And did you feel the same as me during the process?
I had a grade 5 couple years ago and I feel your pain. The doctors where telling me the same thing. Luckily for me I had a awesome pt. Kicked my ass 5 days a week. I stretched multiple times a day and did what I could to help with range of motion. I was very discouraged with my range of motio and strength . After 16 weeks I got the hook plate out and had instant range of motion and was almost pain free. I continued with PT for about a month after surgery till I was comfortable and gained some strength and mobility back. I was back on the bike about 6 months after my injury. I’d say it took a year for it to feel 100%. I still have some minor pains with bench press and certain positions with weighs but over it feels great. I have crashed on it a few times now with no issues. Feel free to reach out if you have any questions.
1
DYE
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9/21/2021 5:27am
DYE wrote:
I've held off on making this topic but decided to go ahead because each day is up and down and I'm tired of wondering if I...
I've held off on making this topic but decided to go ahead because each day is up and down and I'm tired of wondering if I will ever get back to normal. Closing in on the 4 month mark since my accident. I had the hook plate surgery 11 days after and meet with the surgeon in a few days to decide when we are going to take it out. In 4 months I'm still no where near full range of motion. At my one month progress report in PT I had gained about 50% back from my starting point (that was last week). I just recently was able to start sleeping in a bed again, but it still F's with my sleep and I'm in pain every day. Every time I ask the surgeon or PT I get the ol "I think you'll get it back but everybody is different bla bla bla" I'm so in the dark on if I'll ever recover fully from this. I made a couple good leaps in progress over the last few weeks. Yesterday the PT said "I'm going to level with you, this is the worst AC separation I've ever seen, we are in uncharted waters here". He said this after me hounding him to give me an estimation as to when I could get back to physical activity lol. As of now its nothing over 10lbs and nothing where I could risk taking a fall.

I've read about some 3/4's but if anybody has had a grade 5 please chime in on how recovery is going long term. And did you feel the same as me during the process?
I had a grade 5 couple years ago and I feel your pain. The doctors where telling me the same thing. Luckily for me I had...
I had a grade 5 couple years ago and I feel your pain. The doctors where telling me the same thing. Luckily for me I had a awesome pt. Kicked my ass 5 days a week. I stretched multiple times a day and did what I could to help with range of motion. I was very discouraged with my range of motio and strength . After 16 weeks I got the hook plate out and had instant range of motion and was almost pain free. I continued with PT for about a month after surgery till I was comfortable and gained some strength and mobility back. I was back on the bike about 6 months after my injury. I’d say it took a year for it to feel 100%. I still have some minor pains with bench press and certain positions with weighs but over it feels great. I have crashed on it a few times now with no issues. Feel free to reach out if you have any questions.
I appreciate the input big time man. It's good to hear from someone with the same surgery that the process was about the same. I've been getting discouraged lately with so much time passed and still in pain and limited ROM. I meet with the surgeon today to decide when we will take the plate out. It's looking like next month sometime. Hoping I have the same result when it comes out.
RDnutz
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9/21/2021 6:49am Edited Date/Time 9/21/2021 6:51am
CR92 wrote:
Grade 5 in March of 2020 here. Honest question, not meant to be rude at all, but have you been doing all the exercises the PT...
Grade 5 in March of 2020 here.
Honest question, not meant to be rude at all, but have you been doing all the exercises the PT told you to do?
Also, have you seen any other PT's?
As a person who's worked as a trainer/rehab specialist for the past 10 years, and as someone who has worked with a lot of PT's both for my self and work, what he said isn't exactly something normal. Have you thought about meeting with a different physical therapist? Even just for a consultation?


that X-ray is what mine looked like in Fall of 2008. They Didn't give me a grade but was told it was "complete separation of AC joint" that snapped both ligaments. Also that collarbone had made hard contact with shoulder blade leaving a divit in shoulder blade and snapped off last ~1/2" of collarbone. Rotator cuff was shredded and needed repair at some point. By February 2009 I found the right surgeon to rebuild everything. He re-attached the ligaments with holes through collarbone and stitched up labrum and tightened biceps and triceps tendons. Smoothed rough end of collarbone. Then put a set screw connecting collarbone and shoulder blade at same distance as my other shoulder.

I had to keep the screw in for 3 months, wear a sling day & night and sleep in a chair at 1st, then upright on pillows in bed. Only allowed to let my arm hang down and rotate my hand in small circles couple times a day throughout. When he finally took the screw out I had full range of motion within minutes. Started PT 2 days later and they put me through a a couple ROM exercises and sent me home to do on my own daily until Dr. said it was enough. I was cleared for strength building at about 6 weeks, then cleared for full activity including riding. I haven't had a day of pain or most importantly, any Arthritis ever since.

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