whatz is going on with my shoulder….? Diagnosis, please…

three weeks ago to the day i came off my bike and hit the ground hard. as i tried to pick myself up off the ground i knew instantly that something wasn’t right. train ride home was unpleasant. i couldn’t lift/move my arm. i went to the hospital that evening and after an x-ray the doc said “nufzing is broken. only ze tendons und musckle are rhipped” (actually, he said it in perect German, but that is beside the point).

three to four weeks of rest was his advised treatment.

things have improved. the swelling has gone right down and the green/yellow bruising has gone. movement is much greater and i can get dressed without my GF’s help. still only wearing shirts as i can’t get my arm up comfortably above my head and getting out of bed is a struggle. i think this might have something to do with it:

here is my left shoulder as a comparison:

have got another appointment for tomorrow with a different doc. bit pissed off now. the novelty of being injured has worn off. and because i’m privately insured i’m having to pay the first 600€ of any treatment and i kinda feel a little duped by the first doc….

That does look bad, are you sure you didn’t break your collar bone?

Hello AC Joint separation 😀

Really looks like you’ve **** your ACJ – There’s 4 ligaments that attach your collarbone to your shoulder blade.

Probably a level 3/4 but hard to tell without an x-ray and seeing if the bone has moved forwards/backwards.

Have they not x-rayed you?!

Something liek this 😀
https://www.dropbox.com/s/s2scl8kau9l4ayd/2013-03-29%2014.35.03.jpg

Google images dislocated clavicle

As above, it may be ‘no bones broken’ but that doesn’t mean it shouldn’t have had a bit more investigation and treatment at the time.

Hopefully it’s something that can be sorted with relative ease/little expense.

http://kneeandshoulderclinic.com.au/shoulders/surgical-conditions/ac-joint-seperation/

Looks a hell of a lot like this pic to me……….ouch!

scaled – Member
Hello AC Joint separation

This is the one! Did mine years ago, still has a bit of a bump. You (well not “you”, try a medical professional, preferably a physio) can tape the shoulder up to pull it back together a bit, mine was just left as we had somewhat bigger issues at the time 🙂

From recent experience similar to yourself, If you’ve torn your shoulder muscle then it’ll be 6-8 weeks before you’re able to move it properly with no pain. I was (gingerly) back on the bike last week after tearing my shoulder muscle at the end of November.

Are you taking anti-inflammatories? I was on strong prescription ones to reduce the significant swelling. You should be doing the same

This is the one! Did mine years ago, still has a bit of a bump. You (well not “you”, try a medical professional, preferably a physio) can tape the shoulder up to pull it back together a bit, mine was just left as we had somewhat bigger issues at the time

Mine required some surgery

Couple of little plates and some ‘string*’ https://www.dropbox.com/s/155o94jozgyedxf/plated.jpg

*from dead people

Good luck tomorrow. Sometimes you have to be a bit scepticle with the doctor’s advice and push for more treatment, which is counter-intuitive because you basically grow learning to trust a doctor implicitly. This was my experience with my broken collar bone and the NHS anyway, it’s not that the treatment wasn’t available but I found you have to be very proactive in making sure you get it!!

I share your pain.

Following a 20 mph crash on the roadie I ended up with that. Same side as a broken collar bone from another crash years ago that had left me lop-sided.

I had surgery with metal work put in followed by intensive physio. Ended up with having more physio a couple of years later as it was becoming painful again.

My advice would be to not ignore it and to not put up with a painful or lop-sided body.

Do hope you get it sorted. 🙂

no, not popping ay pills. i’m of the opinion that anti-biotics are shit for you (not allowed to drink, are you) and pain is a good thing.

it was x-rayed at time. doc said nothing is broken. plus, would i not be in even more pain if it were?

having private health insurance, rather than state, treatment is usually “better” (some docs won’t see you if you are state insured! German health system isn’t that great!), but that may have something to do with the fact that they can charge you for all sorts of unnecessary crap that you probably don’t need.

if it is the ACJ, how long is it going to take before i can get back to work? already cost me over 4k so far. got another big job (3,5k for ten days) due in three weeks that i might have to say goodbye to.

#feelingsorryformyself

They XRayed to rule out breakages so unlikely to have broken a clavicle so looks like an A/C separation. I have done both shoulders.

This will not repair itself, the pain will go, well mostly. The tendons hold your arm in the shoulder socket and you have overextended and torn tendons.

A good sports physio is the person to see ASAP.

The Madjak guide to AC separated shoulders*

1) Get Xrayed – (Straight to A and E!) to find out whats happened, IMO if nothings broken they’ll kick your a**e back out and tell you to go and see your doctor. If your lucky (I wasn’t) someone may spot it’s a AC problem. I had to work it out for myself.

2) Once you know its a A/C separation support the joint so it’s where it should be (You can get braces). Support Joint for 2 or so weeks and wait for swelling to subside. Supporting the joint allows the tendons to knit shorter affording more support at the cost of future mobility.

3) Ice pack it 2-3 times a day from the start. This encorages blood flow and healing for the first 4-5 days. You’ll move to alternating hot/cold and then hot as the injury progresses.

4) From around 2 weeks its time to start the fun physio. Go and see a professional sports physio. They’ll poke and prod you in to extreme pain. This is good if you want the use of your shoulder back. This allow the muscles that locked to protect the injury to be freed off and a good assessment to be made.

5) Do the exercises you have been given and build the muscle up, this will pull the joint back together and help prevent future disclocations. It will hurt but no excuses.

*These are things I have learnt and been told by professionals – I’m not qualified to make any of these comments or suggestions, you probably shouldn’t take my advice on anything….

thanks madjak….. sounds like you know from experience. 🙂

here’s the x-ray… prob not much help….

How long? too many variables to say but both mine were 60% or so within 6 weeks and gradually improving over the following months to a year. In my mid and late 30’s

Was back on a bike in 3 months but was being on the safe side as there is no support (from muscles/tendons), another injury to the shoulder before its fully remidiated will obviously leave it worse and risk future dislocations.

Would appreciate some professional input but there should not be a gap between the arm and the socket.

that looks bad, mate did same after poor landing and OTB.
Mrs G got put back together by this guy. she was meticulous with physio after op for dislocations now stronger than ever. She got referred by GP as we know the surgeon quite well good rep etc.
top shoulder specialist (north west area).
Good luck healing vibes etc

I had/have one of those.

Look at Dezbs link ^^

Common reconstructive surgical techniques today use either a screw or suture loop, and on some occasions an artificial ligament is used.

Go see a good physio and they will tell you what you can do.

Edit> Oh,and this ..

and i kinda feel a little duped by the first doc

I think so < edit

Proper job! Def need some further advice on this one.

Diet and rest also essential for a good recovery but tricky with a knacked shoulder. Normally takes me about 2 weeks to sleep round an injury.

+1 “Good luck healing vibes”

3 weeks old injury so no need to go to A&E which luckily you have seen sense and visiting a Dr, 600 Euros is staggering amount to pay up.

Your right shoulder should level it shouldn’t look like that.

X-rays don’t always spot fracture depending on the angle amongst many other things.

That X-ray isn’t great to look at on here but I’m not commenting anyway.

Good luck and hopefully your sorted soon and see a better Dr this time.

One final thing.

Thank **** for the NHS.

I had one of these after motorbike crash in Ibiza in 1997. Never got it looked at as didn’t have medical insurance just kept shoulder in sling for a few months and eventually it mended itself. Still have a slight lump where the break was but doesn’t cause me any problems nowadays.

Thank **** for the NHS.

yup… i pay a tiny 127€ a month with 600€ excess… that was the least i could pay a month. and that is “basic” care. if i go to hospital i might have to share a room with 3 other people! if my yearly medical bills don’t exceed 600€ then there in no point in informing my insurer as the tariff would go up despite not having used their services.

it is only going to go up the older i get.

i know people that are paying over 600€ a month! women in general pay more because of their lady bits and constant visits to the docs…

i’m of the opinion that anti-biotics are shit for you (not allowed to drink, are you)

myth; drinking makes no difference to effects of anti-biotics

cheers!

Bloody hell that’s an incredible cost.

myth; drinking makes no difference to effects of anti-biotics

Well that entirely depends on which one your talking about. Which one is it your thinking of prescribing just to be clear?

hmmm… always been told by the docs that i shouldn’t drink as is screws up your liver.

besides that, constant use of anti-biotics decreases the body’s natural immune system meaning that over time you are more susceptible to illness.

I bet that smarts!

It needs a mri scan. Some fractures are only visible on one. I work on Orthopaedics but I’m not a doctor.

As for no alcohol, well I got home after 3 days in hospital after my accident. My adult kids needed to be told so needed a beer for courage before I phoned them.

Yes, heavy duty pain killers said no alcohol but I ignored that!

I’ve got pain and a lump there after a heavy body-ground connection on Dec 11th. Think I’ll need to go Loddrick’s route and wait.
I can ride me bike now, but can’t pull-up and sleeping on it’s painful.

I’m gonna go with a low grade acj separation. Which means you should make fully recovery ( maybe slight ache now and again ) in 2 – 3 months.

I’ve had my acj totally reconstructed ( which has now failed ) following an almost completed separation and am in agony everyday.

Rest up stay off bike and good luck

I’m in no way medically qualified but that’s an AC joint separation I reckon. I did mine back in 2011 in Nepal and after a few weeks in a sling/support I as able to start moving it and increasing mobility. Make sure you do the exercises as you’ve been told – I failed to do so as I thought it was ok and it would continue to get better. That’s probably the reason I struggle with stability in my shoulder now and it’s noticeably weaker. I didn’t realise it until later, but I probably ripped my rotor cuff as well. Get it sorted properly otherwise it will linger.

This has useful info/pics

I self diagnose this:

……and prescribe Talisker on a nightly basis

Hard to tell from your x-ray, I presume a camera phone photo of the original? You look like a grade 2-3 AC joint separation from the photo of you, again the bony alignment of the x-ray helps in grading but the x-ray is to poor quality. Conversely you may have a displaced fracture of the distal clavicle! A review with a good clinician who can repeat the x-rays is your best course of action. If its an AC joint grade 2-3 injury basically thats a dislocation of the joint. Therefore the joint is f**ked, tape is a pile of S**t it will make no difference to the degree of deformity in the long run, you have several months of pain ahead and plenty of physio exercises to do! Surgery for it has very poor outcomes the shoulder surgeon my wife works with rarely does them because the outcomes are s**t (he’s very good, works at Oswestry national orthopeadic hospital, been doing it for years lots of publications, operated on some very interesting people! I would trust his professional knowledge and judgement). If its fractured (broken) it will heal and remodel hopefully the pain will settle and function return.If its badly displaced may need surgery to fix.

BUT to re-iterate you need to see a good clinician who can review YOU and YOUR X-RAYS properly to get an accurate diagnosis and the correct treatment.

PS I really am a fully qualified chartered physio, I work as an A and E specialist clinician and can interpret x-rays. I see a lot of these injuries both frontline in A and E and to rehab.

I’ve got on-going AC joint problems following a crash on my snowboard nearly 2 years ago.

Fortunately (especially for me!) one thing that doesn’t seem to cause any problems (and actually seems to help) is riding my bike!

Drinking and antibiotics can be fine, if it’s something penicillin based say. Depends entirely on the antibiotic.

If you’re on metronidazole (or another one I can’t remember, begins with ‘t’), you’ll likely be very ill very fast if you so much look at a packet of wine gums. There’s a few others that it’s not a good idea to drink with.

@ mtbphysio ….. thanks for your very informative (and long!) reply.

don’t sound too good, steve…

looking forward to tomorrow.. have just been looking up the German equivalent of separated shoulder (Schultereckgelenksverrenkung) AC joint, type II & III damage…. should be fun.

Looks like the worst case of bad AIDS I’ve ever seen. Could even be bad cat AIDS.

I had a bad fall a couple of months back, went to A+E for an xray and was told I’d broke my collar bone.

Went for my follow up appointment 3 days later and was then told that it actually wasn’t broken and probably just torn some ligaments or tendons.

I then went back 2 weeks later in a lot of pain and was again told it was probably just tendon damage and it would take up to a month to get a scan by which point I’d probably be better anyway.

I get private health care through my job so I then decided to go and see a specialist and get a second opinion.

The subsequent MRI scan then revealed I had…..

A broken collar bone!

Which now hasn’t healed properly as I kept using it thinking it wasn’t broken. I might have to get it screwed together.

Moral of the story, if the NHS are telling you it’s not a broken collar bone, demand a second opinion.