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AC joint separation
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isobars



Joined: 12 Dec 1999
Posts: 19325

PostPosted: Tue Jan 01, 2019 4:51 pm    Post subject: Reply with quote

I would absolutely see a sports orthopedic specialist, but I've even had to fire (i.e., ignore and walk away from) at least four highly credentialed orthopedists and at least 20 doctors in other fields. In informed hindsight, I'm very glad I did in every case and wish I had fired a few more.

My sources of orthopedist evaluation include other orthopedic surgeons, PTs I trust, friends with similar injuries, professional gym trainers, and my own literature research. There's a LOT at stake, so I don't stop until I'm satisfied that I've chosen the right doctor(s) and the right course of action for any treatment or problem.

Some medical issues are worth second -- even 8th or 10th -- opinions. If I hadn't done that with my cancer, I'd be deathly ill or dead by now by the admission of the Mayo Clinic and their west coast competition and according to federal Standard of Care mandates and data, rather than still buying WSing gear in anticipation of the next season.

One thing I'd recommend -- despite and because of the fact that every such injury and shoulder is unique -- is asking everyone you consult with whether taking the time to do your research, decide, and evaluate your progress will do any harm. The last orthopedist I chose insisted that we wait at least three months before surgery (my knee blowout and fractures) to let nature heal what it can with the help of many hours every day of PT, continually evaluate my status, and operate only if and when he and I agreed surgery was necessary and timely.

My shoulders both hang low and display a bony prominence, but as long as I keep them strong and maintain proper form (e.g., retract my scapulas during overhead work or play), the knots are just cosmetic.
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hitech



Joined: 13 Aug 2000
Posts: 77

PostPosted: Tue Jan 01, 2019 10:40 pm    Post subject: Reply with quote

I understand your concern. When I had my AC separation several as a result of a mountain bike slam, I fully expected them to rush me into surgery straight from the ER.They strapped it up and told me to see an orthopedist when I could get an appointment. Diagnosis was a Grade 3 separation which evidently was on the cusp between surgery and watchful waiting. Recommendation was to wait and see knowing that surgery was months of recovery/P&T. I reluctantly followed the advice of my ortho knowing that the damage would get no worse if ultimately surgery was necessary. I went off to the Virgin Islands on a sailing vacation about 10 days later. After a few days I discovered I could swim with my shoulder and within a few days I was swimming about a mile with fins. I could work the winch and foredeck on the boat without issues.
Recovery was remarkable and I have no issues with range of motion or strength as a result. It has never been an issue windsurfing and the only downside is a significant bump on y right shoulder.
Hope your results are just as good.
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grantmac017



Joined: 04 Aug 2016
Posts: 844

PostPosted: Wed Jan 02, 2019 3:05 pm    Post subject: Reply with quote

Saw another ortho and he figures it's more a Grade 4. He said I could choose either option but that surgery would not be a bad choice for a very active person needing overhead strength.
He uses one of the more modern techniques plus a tendon graft.

He said either do it now or wait 5-6 months. Likely I could recover enough to sail 4-5 months after the surgery.

I'd hate to PT for the next 6 months only to find I need surgery to get the mobility I need to sail, then lose another 5-6 months.

Needless to say I'm spending my time reading journal articles and research papers.
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AG80



Joined: 04 Mar 2014
Posts: 35

PostPosted: Fri Jan 04, 2019 2:32 pm    Post subject: Reply with quote

I would suggest that your rib and sternum injuries are more significant than your AC injury and would wait to evaluate your shoulder function after your other injuries have healed. From the description of your injuries, you are lucky not to have a head injury as well. Start some easy range of motion exercises now. Your AC injury could be treated either conservatively or surgically. If you are a competitive pitcher, wt lifter, tennis player, etc; then surgery is more clear cut. Or, if you need to fix the cosmetic deformity, then surgery would be a consideration. Otherwise, taking the non-surgical approach makes sense. Most AC injuries can return to full motion and function without surgery. Remember, having surgical repair of your AC joint does not guarantee return to full motion and function of the shoulder.
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grantmac017



Joined: 04 Aug 2016
Posts: 844

PostPosted: Fri Jan 04, 2019 4:04 pm    Post subject: Reply with quote

I've got nearly full range of motion right now, it's the stability and load bearing capability which concerns me long term. I can barely support the weight of the arm at 90 degrees and overhead pushing is not possible.

The other injuries are not bad enough to prevent me sailing on mild days although they sound spectacular when described. I've sailed/lofted weight with damaged ribs before. Although I would want to hit the boom with my sternum right now.
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