Separated shoulder advice

I've had two AC separations. First was in college football and I didn't miss one practice thanks to a special pad they had to move forces away from the separation. Second, was 1.5 months ago in a race bike crash. I couldn't swim for a month due to pain but I rode and ran just fine and didn't need to lower my volume or intensity. IMO, you can "let pain be your guide" with this injury but you do not want to crash or fall again until that ligament has healed. If it tears completely, your collarbone pops completely off your shoulder and surgery becomes mandatory. After a month out of the pool, I was able to swim for two weeks at an easy effort before my HIM on Sunday but it hurt bad in the race at a harder swim effort.

The good news for me is that I now have two matching shoulders and so I no longer look deformed.

ETA: I didn't go to a doc about this because I didn't think I'd done it. But the separation was hidden by swelling. Once the swelling went down it became very obvious. Secondly, this injury is so common in the football/skiing/cycling world from which I came, that I knew an ortho doc would give the exact advice you stated above.

Edited by breckview 2009-08-11 10:15 AM

I don't really want to crash or fall again at all (grin)...the road rash is still oozing from my last one! Thanks for the input- really appreciate it. Time to get back in the saddle again! I tried a on-land swim stroke this morning to see what that felt like and I think it will take a few more days until I am ready to swim (that, plus the still-oozing road rash) but good to know I can run/bike again.

I have to disagree somewhat with this. My understanding is that a grade 3 separation is where the collar bone is completely detached from the Scapula. It does not always require surgery. In fact with a grade 3, the consensus seems to be that the out come of surgery is not much better then just PT to strengthen the shoulder without surgery. Only if it's a grade 4-5 where the clavicle becomes displaced do you require surgery.

I have a grade 2 on my right side and a grade 3 on the left. 2 is a partial tear. I'm almost inclined to beleive I'd be better off with a 3. The partial tear causes me more discomfort on a regular basis. The grade 3 side never bothers me.

With the grade 2 separation I was mostly bed ridden for about a month because of other injuries but still had to nurse the shoulder for about 8 weeks.

With the grade 3 I was riding and went over the bars and tumbled down a hill while mountain biking 6 days later. Went over the bars and need stitches 7 days after. I shouldn't have been mountain biking so soon because I wasn't mentally prepared to be back on the bike, but the shoulder wasn't a problem. I wasn't swimming at the time, I hadn't taken up triathlon. I did start swimming about 10 weeks after the separation. I had to be a little careful with how hard I swam and how long, but I feel that swimming has been the best rehab for both shoulders.

What grade separation do you have?

Graceful Dave: I think it is a Grade 1 (doc never said) but I think it is just a Grade 1 separation. None of the signs of a more severe separation are present.

With my second separation, the ER doc said I just had a bad bruise and the large lump that turned out to be my clavicle was just tight muscles. Apparently I didn't complain about pain enough to be taken seriously.

I did it 2 days before moving to Tennessee for 8 weeks training before finally ending up in WI so I didn't have time to get a second opinion. I self diagnosed and just did the same PT as my first separation. When I finally got in to see an ortho 10 weeks later he just said "Yup it's separated, but since you're back to normal, just keep doing what you are doing."

Yeah, you're probably totally correct. I was just going off what some local ortho told me at a party years ago and my recollection of a friend who had the surgery due to a football injury but that was a long time ago.

I don't know anything about "grades" and wouldn't even know I was injured except that my collarbone is now about an 3/4 inch higher at my shoulder than before my crash. (I know because it used to look so different from my other shoulder that I separated as a kid in college and now they look the same except for the bruising still there after 1.5 months.) As I said, I didn't go to a doc about my recent sep.