Member Case Study: Separated Shoulder

author : AMSSM

comments : 0

I was in a bicycle accident that left me with a separated shoulder. I went to an orthopedic who said that it had been too long to do surgery because the ligaments would not repair themselves.

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Member Question from Tri2improve

In early April I was in a bicycle accident that left me with a concussion and a separated shoulder. The ER doc said that the ligaments that hold the clavicle to the scapula were probably stretched, that it would take some time to heal and that the clavicle would return to it's normal position. After 5 weeks with minor changes I went to an orthopedic who said that it had been too long to do surgery because the ligaments would not repair themselves. Is this a repairable injury and is there a time frame in which this has to be done? I was under the impression that new ligaments can be grafted and in time will repair themselves. Is this true?
 

Answer from Douglas McDonald, MD

Member AMSSM

First, hopefully the concussion symptoms have resolved as that would be our bigger concern. Second, it sounds like your shoulder injury was what we call an acromioclavicular (AC) separation. The ligaments between the acromium (the bony projection from the scapula that extends forward to the top of the shoulder) connect to the clavicle (collarbone) are sprained when put under traumatic stress such as your fall. The separation that occurs is often worsened by the muscles (the trapezius in particular) pulling the clavicle further away from the acromium.

Deformities of the AC joint that occur when sprained can reduce some over time but do not usually return to their pre-injury position. Ligaments, in general, have poor healing and will do very little repairing on their own. Surgery is not normally done unless function of the shoulder is disrupted which is not usually evident if separation was the only injury. Your injury sounds like a classic separated shoulder which should respond nicely to physical therapy and time. However, you may have to live with the bump at the end of your clavicle. Good riding. Wear your helmet.

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date: July 24, 2009