Separated shoulder. Operation or no?
 

I came out of a collision with a truck with a separated shoulder (not a bad result all considered..) and did what everyone does. I googled like mad.

It seems they often do not operate. You just have a weird pointy shoulder forever. But two months later mine still hurts and even makes it hard to sleep.

I know the answer is "See your doctor" and I will. But I thought I'd crowd source here first.

If you had separated shoulder, did you get an operation? How long did it take to heal from the injury, and from teh operation? Any advice?

Signed, asymmetrical dude with pointy shoulder.

I had a separated shoulder years ago and had surgery. Screw installed. It initially lifted out and then finally settled in and the shoulder healed when wrapped tightly. Took six months before I could raise my arm enough to turn out the overhead lights in my van. Another buddy didn't have the surgery and his shoulder hangs down and is very unstable. He wishes he had the other surgery. Others I know have left it as is and have had no further problems other than the bump. Very common hockey injury. Good luck with it.

I've separated both of mine many times. I've also separated the AC joint on top of the clavical

No operations, but loads and loads of rehab, which continues to be a part of my workouts.

But, everyone is different. You should find out why it aches, :)

My shoulder took about 9 months to heal.
I always heard that if you leave it alone to heal on it's own it usually takes about the same amount of time to heal after surgery.

It has been almost a year since I injured mine and it is 90+ % normal now. Shoulders heal very slowly, especially with us young guys.

I had tendon transplant surgery on mine in 1988. I'm glad I did it because I didn't like the loose, disconnected feeling in the shoulder. It hurt pretty bad for a year but I got most of the range of motion back after about 10 weeks.

I separated my right shoulder in 2007, right near the end of the last mountain bike race I ever entered. And I was doing pretty well right up to that point. Being that it happened in a mountain bike race, the other riders were most sympathetic. I remember them yelling as I was lying there, "Get the hell off the trail!"

I didn't have surgery, and to be honest, I didn't even do the recommended PT. I was biking 4-6 weeks later. It probably bothered me sleeping for the next 6-9 months. I don't notice it any more.

It still sticks up, and it was an eye opener when I learned they don't usually try to fix these things. It just doesn't seem right - like how can you pick up heavy things when your shoulder is no longer attached?!

My shoulder was a pretty good separation - and I think that is a factor in how much or how little trouble it will give you. More separation = bones not rubbing together, so not as many problems. A friend had separated his, and it was still giving him problems a couple years later. Note: I am not an orthopedic surgeon! But my doc did give me these nice pictures on CD.

http://www.bikeforums.net/attachment...2&d=1454190633

http://bikeforums.net/attachment.php...hmentid=501572

Looking at Wikipedia (which I'm sure you've done), they rate the separated shoulder by the number of tendons and ligaments involved, with non-surgical treatment recommended for the more mild cases, and surgical treatment for the more severe cases.

Actually seeing an orthopedic specialist might help you decide which group you fall in. I'd probably skip the family practitioner/GP, and try to directly get an orthopedic consult. Keeping in mind, of course, that surgeons look for surgical treatments.

My 2¢ worth, if the surgeon feels you will be better off, Curtis, and you are good with this procedure, get the surgery done. I don't advocate willy-nilly cutting, but a skilled surgeon can fix things that you shouldn't have to compensate for. Something else is going to start hurting from your having to adapt to the injury. Do what you feel best works for you.

Bill

An operation is probably not needed. It will heal itself in time. I for instance had rotator cuff damage to both shoulders. Exercise and lifting weights, light ones at first fixed both shoulders.

I have a Type 3 separation of my left shoulder (thanks to a little old lady whose driving skills were subpar).

They did not operate, so, I, too, have a pointy thing. I was about 44 when it happened, and it was months before I was pretty much pain free. Twenty years later, I'd rate the shoulder at 90%. Most activities are fine, but th shoulder is unhappy with some actions.

Thanks for these fine answers. I'm tossing them all into my think-about-it pile.

It seems I could be much worse off. Perhaps I am expecting too much too soon. I am riding, and I am playing tennis. So there's that. But it sure feels weird, like someone is touching my shoulder when I move. I could live with that if it didn't hurt at night, which is weird because that's when it hurts the most.

Thank goodness for ibuprofen. Or as I think of it, vitamin "I"

I was going to ask, what does your doctor advise? But then I saw that it happened two months ago and you haven't seen a doctor yet.

But you're getting free advice from lay people based on anecdotes and their own experiences, which may involve a different severity from yours. You know what I say about free advice from non-professionals? It's worth exactly what it costs. ;)

Go see an orthopedist.

A friend of my has one of those bumps...he says it keeps his shoulder bag from sliding off!
I crashed a couple of Julys ago and acquired one of those bumps. After studying the X-rays and not finding any broken bones, I figured out a PT program for the shoulder. I found out that if I grabbed a door knob and over rotated my arm at the shoulder, the bump would diminish. After a year it is gone. Still "CLICKS" once in awhile.

+1!!

I separated a shoulder in similar circumstances. No surgery, just 3 months of physio to help the ligaments pull the joint back into shape. The step in the shoulder ("pointy shoulder") never goes away entirely, it's a complicated joint - you're just going to have to live with being imperfect.

I was back on the bike in a month and comfortable in three. Two months isn't a long time. Obviously you need medical advice, but I've worked with a lot of orthopods and I wouldn't let one inside my shoulder unless I was certain it was necessary.

Read about NSAIDs and tendon/ligament healing.

This is a summary article, and perhaps biased.
When NSAIDs make pain worse - A significant public health concern | Caring Medical

The data does seem to be somewhat inconsistent, especially with arthritis. But, there is a fair amount of evidence that chronic use of NSAIDs impairs tendon healing.

You are at risk of both tendon healing issues as well as arthritis, so take your pick.

Personally, I do believe in the use of NSAIDs in a couple of cases. Acute non-injury pain (back spasms), perhaps where one can knock out the pain permanently. Also, there are occasions when one seems to get cyclical pain, perhaps from muscle spasms that doesn't go away, and may need a little extra kick to stop the pain cycle.

I'd be reluctant to take NSAIDs on a chronic basis.

I had a grade III acromio-clavicular separation several years ago. The orthopedic surgeon told me he could do surgery, but that surgical outcomes were not statistically better than just physical therapy and time. I opted for the physical therapy. Three years on, I have full function of the shoulder, but I can tell it's not the same as the other one.

http://www.os2.dhs.org/~john/view1.jpg

Did same as you Nov 9, 2014. During big bike trip at mile 62 and hit a truck, but that's another story.

Went to a shoulder specialist who diagnosed problem and wrote script for PT. Therapy definitely helped build up all my related muscles and back on bike in four weeks.

Shoulder still sticks up like yours and guess our badge of honor. Get little ache once in a while but have all my range of motion and strength back. That took about four weeks too.

Suggest you see a doc just so you know what you have and what your options are from here.

I've never separated my shoulder, but friends have. And that's the reason I couldn't believe no one asked until now what grade separation your injury is. As I understand it, surgery is pretty much required for higher grade separations, and not recommended for others. What grade is your separation injury?

Shoulder separations are the reason I said "Thank God" when the ER doc told me I had a broken collarbone. Collarbones heal up pretty well ... often without surgery.

Having fully and quickly recovered from a mild separation, admittedly when I was about half my current age, I concur with this advice. Instead of a GP, I would go straight to a reputable sports medicine practice which has both DPTs and surgeons. Get expert opinions from both cutters and non-cutters -- the honest ones will give you an objective risk/reward scenario and let you know where you fall on the spectrum of "surgery neither required nor recommended" to "you would definitely benefit from surgery." A second opinion should be from someone in a different specialty, because two DPTs (or two surgeons) may say the same thing as each other. "When your tool is a hammer, every problem looks like a nail."

(This is why I detest HMOs and small networks and have always paid for health insurance which allows me to select specialists for myself and my family members.)

I would value the opinion of a surgeon who has a reputation for conservative treatment and who has proven himself not to be knife-happy. Otherwise, balance your surgeon's advice with that of a non-cutter.

Curtis, I separated my left shoulder way back. Our little group here had a slow-pitch softball team where we competed against other teams in the employer league. For some reason, they had left-handed me at third base one inning. A batter hit a pop fly in foul territory behind me. I quickly spun around, started running, and made one of those leaps that you see on highlight reels. Since my body was twisting as I was horizontal in the air, I came down on my left shoulder. Oooh! Got grass stains on my shirt. Of course, with the adrenalin of playing, I carried on. But, oh boy! That next morning!

Had to call in sick the next day and went to the urgent care room. Yup, separated. All they did was place me in a sling to immobilize my shoulder and upper/lower arm. No surgery. And like you, I now have one pointy shoulder. The left one sits a littler higher than the right one. Can't remember how long it took to heel. I have a pretty high pain tolerance, so that would skew anything I could offer as far as a timeline. I think I wore the sling for about six weeks or so. Maybe less, certainly not more.

It hasn't affected my tennis game at all. (Hey? Maybe I can use this as an excuse for my pitiful play.) Since I serve with the right arm, the left is for everything else. Plenty of power on the forehand, not problem with radical topspin, strong single-handed backhand, slicing works well, and volleys sharp and crisp. The separated shoulder really hasn't affect my game at all.

My unqualified recommendation to you is to nix the surgery, (of course, you doc knows best). I wouldn't want anyone to cut into me if it is not absolutely necessary. What do we care at our age if one shoulder is a little higher than the other? It's just a 'battle scar' of a life well lived. After you heal, there will be no loss of range-of-motion. (I also kayak and scull. No ill effects do to the separation.)

p.s. Worst thing about that whole softball event . . . the ball tipped the top edge of my glove and fell harmlessly to the grass. Fellow got another chance to put one past me.

That's funny. My orthopedic doc told me, "On the bright side, with that separated shoulder, now you'll never break your collarbone!"

Thanks for your uplifting story. It's funny that when I play tennis my shoulder doesn't hurt at all. I'm making an appointment with Kaiser, but I have littl ehope that they'll help. They're great if your bleeding, but less great if you have something "wrong" that isn't squirting red.

I'm with Kaiser too. They do all right. I use to say that Kaiser is great for healthy people. The premium is the best of any plan our employer offers. They've changed their tune the past five or so years, at least in the SoCal area, couldn't say about up your way. They're a lot more proactive these days. Almost to the point that they are starting to annoy me. I've had the same doc for 33 years and he takes pretty good care of me. But, the urgent care people are different. Just be firm and insistent. They'll take care of you.

Back in '01 I had a third degree A-C separation in my left shoulder, thanks to an "improper right turn" by a pickup truck. Doc said it was a coin-toss as far as surgery, and surgery didn't have a good track record for actually improving things. So I elected not to go under the knife. Recovery was uncomfortably slow (typical for soft-tissue injuries), and that shoulder will never be 100%, but it works well enough. I'm confident I made the right choice.

SP
OC, OR

I never learned how to fall by rolling. In '85 I was bumped off the road just before one of those traffic calming bollards they have in the UK - put my arm out - pop>Type two on my left. In '91, first day of a 2 week tour from St. Johnsbury, wifelet stopped short right in front of me> over the handlebars> on right type 3 separation. ER doc says "too bad, you'll be deformed". No ops on either, just PT slowly building ROM and strength - did it for me. Neither look bad now, and there's not much appreciable shoulder drop on the worst one. I don't think that it took me more than a year of strengthening to get to greater than 90% again. OK, I was younger... more anabolism going on back then.