[Closed] Level 3 AC joint separation- recovery advice

I did a level 3 or 4 (just shy of surgery needed, whichever that is).

I was on a roadbike in a only few weeks and MTB a few more weeks after that.

Hurt like anything at the time but quickly got better. Still looks ridiculous nearly 10 years later!

6 weeks on from a grade 3 separation myself, no surgery required but still have open 6 months appointment just in case. Apart from sleeping on that shoulder side, it’s pain free now and I was riding again after about 3 weeks. As Mikertroid says, still looks ridiculous though with the step up bone bit!

Had a brilliant physio to help me. Get yourself some physio latex bands to help target the shoulder, loads of decent YouTube videos on stretches.

Do what the physio says, that's THE most important thing. Not much else you can do for it tbh.

Once back riding, learn to fall off without putting your arms out, seriously! I'm a master at it now! Tuck n roll! 😆

If you haven’t already seen a physio and if you can spare the £ sooner would be better that later. +rubber bands and a door frame if I remember my injuries correctly. I’ve done both, left not too bad but just lived with it. Took ages to get better. Right (worse) saw physio next day, recovery 2/3 weeks back on bike.

Once back riding, learn to fall off without putting your arms out,

Most people I know who’ve done their AC joint did it by landing on the point of their shoulder, me included. If I’d put my arm out I might have been better off.

Did mine grade 3 and managed to survive PDS 3 weeks later albeit very very heavily strapped. Joint still crunches a bit and it’s taken about 8 years to be able to throw over arm again properly. Took about 3 years before I could ride with no twinges at all.

Edit: I was nearly 50 when I did it though so take longer to heal. YMMV.

Most people I know who’ve done their AC joint did it by landing on the point of their shoulder, me included. If I’d put my arm out I might have been better off.

I can only speak from my own experience, mine started with my arm sliding out on jet fuel crawling out from under an aircraft engine, after that it came out regularly when my arm was extended and moved the wrong way.

Eventually had it repaired with an operation, physio comment was in relation to my rehab post op.

I had a relatively minor AC joint injury after a car hit me, but it lead to a heck of a crunchy shoulder and painful pulling any weight (e.g. climbing on the road bike). Didn't improve over about 2 years so had AC Joint Decompression surgery. That took about 18 months to be good after that, and it's better than my non-operated on shoulder. It's survived an OTB about 3 years ago !

Have a grade 3 separation on my left shoulder from when i was in my mid 30's (bmx accident)

Have a grade 2 separation on my right shoulder from when i was in my late 30's (bmx accident again)

Recovery times can vary, with both of mine i was back on the road bike within a week of each separation (my road bike was my only transportation for getting to work)

On the road bike it felt great as holding on to the hoods & tops supported the shoulder, when i got off the bike and the shoulder was unsupported was when it hurt the most

I didn't bother with any physio for both separations, pretty much just carried on as normal

Each separation prob took 2 years until the muscles had built up enough to help support them and became pain free

The two bumps are the only thing that reminds me of the accident when i look in the mirror

I did mine years ago skiing into a cluster of frozen drifts at the top of the M1 on Cairngorn. The mechanism was, as I flew through the air, my shoulder impacted straight into a frozen drift. The sound made me think I'd broken every bone on the shoulder. I managed to ski down to the base and get inside, then the pain hit in a meaningful way.

I was out of action for a while (weeks, not days or months), but no surgery was required - I was told I was just below the threshold, maybe try say this to everyone? - and I still have the bulge. The shoulder is the first place to start hurting when I start to get into oxygen debt, so while annoying, it is a useful cue to wind effort back a notch.

maybe try say this to everyone?

They don't - when I did mine I was told by the consultant "Any worse would be a mess, the surgery is elective but I'd be having it in your situation if I were you"

Thanks everyone- the consultant said that in his experience some grade 3s heal without surgery while some need surgery. I’m hoping it’ll not need surgery, I intend to go to super-physio Tim Deykin in Stockport.

I landed straight onto my left shoulder and head without putting my arms out. I knew I should’ve stuck to MTB! Earlier this year I went OTB on my MTB in a deep rut filled with liquid mud but I did a full somersault and landed on my feet totally unscathed!

I’m 52 so hopefully my age isn’t against me. I normally do upper body exercise with weights, press ups etc so I hope all that protected me from a worse injury.

Grade 2/3 (my own fault, cycling while p!ssed). I was in China at the time and, after a few weeks of discomfort, went to the local hospital. Consultant looked at it, shot a massive hypo of steroids right into the problem area (agonising), but I was fine within a fortnight, although it took a year to get full range of movement back.

A fraction of a second before I did mine. A robust 2, bordering on 3 according to the physio I saw. As with others I landed on the point of my shoulder.
The physio told me to stay off the tougher trails for 12 weeks or so to give it time to heal properly as another crash would not be good.
In the end I just used the turbotrainer for a few months (it was winter in Scotland so I wasn’t that fussed) and then just eased back into it.
I did it at the very end of 2018. I’ve still got the lump and it still crunches, clunks and pops at both ends of the collar bone. About a month ago I crashed really hard on the same shoulder and it seems to have held up okay.

Did mine about 3 months ago with right shoulder hitting a deep rut. Surgeon decided against surgery & sent on my way with sling. Luckily physios were back open again so had regular visits. This has really helped (along with rubber bands) to get 90% movement without any pain.
Started very easy cycling at 4 weeks and off-road at 6 weeks. Been building up on more difficult terrain but very rough fist sized rocks still give me a fair bit of grief. Still have some difficulty making quick & tight left turns (e.g. between trees in normal woods)
Spoke to surgeon at 7 weeks who, having listened to my recovery so far, said he'd leave the surgery and see how it goes over the next few months. Any change for the worse then will look at surgery but up to me.
btw I'm 73 so not expecting a quick return to normality. However, doing about 250/300 miles a month so not too bad I suppose.

Sorry to hear that, Vicky. I did mine a few years ago, ended up having the surgery, it's now the most problem free injury of the many I creak about with!

Much more here, and lots of input from others:

https://singletrackworld.com/forum/topic/separated-shoulder-grade-34-surgery/

Good luck with it!

I had a grade 3 year last year.
I made sure to eat lots of protein and veg - figured it’s good for muscle growth so must be good for ligament growth 😃

I spent a couple of weeks with an NHS physio who wanted to gradually reintroduce movement and strength to the area — 3 weeks in and I was still only doing some stretches and 10 press ups against a wall each day. I went to see a private physio who took a totally different approach - they had me doing about an hour of exercises a day and said i wouldn’t be able to over train/ do additional damage to the muscle without being in pain which seemed to work out pretty well
I got myself one of these for going back on the bike as well, maybe it was just a bit of placebo but I definitely felt more secure wearing it: https://www.24mx.co.uk/motocross-gear/motocross-protection_c15/other-protection_c167/evs-sb04-shoulder-brace_pid-PM-0014865?gclid=EAIaIQobChMI0bjGpJGF7QIVieF3Ch1FSAcCEAQYCCABEgLbEfD_BwE&gclsrc=aw.ds

Get well soon!

I interpreted what the surgeon told me as "work it really hard to avoid surgery". I did all the exercise with "gusto" and carried on lifting heavy furniture.
More by luck than anything it worked (at the follow up he said "no, that wasn't what I meant") and I'm fully functional. The resulting small protrusion on my shoulder where the joint is slightly displaced is useful as it stops shoulder bags slipping off. 😄

15 years on from doing mine when hit by a car. Similar to BigJohn, worked it hard. We were doing the house up at the time with a wall knocked out and winter trying to get in, so not a lot of option but to carry on heavy lifting, working above my head etc. Hurt but worked. And kayaking - the paddling movement stretched what needed to be stretched. Not 100% now, but not far off.

Thanks everyone for taking the time to reply. It seems as though different people have had different experiences with recovery. I was feeling a bit grumpy about it over the weekend but then I realised that 2 weeks ago I couldn’t even pop a tablet out of a foil packet or move my arm more than a couple of inches in any direction, and now I can hold a mug of tea and can raise my arm to just above horizontal.

I've done both shoulders as well as my right collarbone over the years. First one was my right and I did a proper job of it, overshot a high speed double and pretty much planted my shoulder into the ground, no slide/roll at all, just dead stop! I broke 2 ribs with my own elbow with the impact too. This was also in the middle of nowhere, deep woodland. Thank god my good friend who is a paramedic was with me at the time. He fashioned me a sling from a spare inner tube to support my arm, but I remember barely being able to breathe and getting my bike /self to the road to be taken to A and E was one of the most painful things I've ever had to do. Sleeping for the next 6 weeks or so was an ordeal with the ribs and shoulder combo. Anyway, I'm a long way down the road now, this was some 8 years ago, and I have full mobility and no real issues other than the odd little click on rotation and some funky shoulder bumps to freak out the kids with! I had a really good NHS physio, followed his instructions to the letter and took about 2 months or so before I was able to ride off road. Tbh, my ribs were slower to heal and caused me more grief I reckon. Oh, and I managed to rebreak one on the second ride down my local woods losing the front on a greasy root and taking a tree trunk to the ribs. Boss was pleased... 😬🤣

Could have sworn my last one was level 5? I have done mine 3 times now - rightx2, leftx1.

They were offering surgery. Was almost tempted. Until doctor said that he had a builder who did not have the operation and was still able to move bags of sand/cement.

The only limiting factor I have found is when I was helping at a velodrome, holding a bike with a rider and they wanted me to lift them so they could move the back wheel. That motion was not pleasant/possible. Other than that it causes me no issues (other than backpack straps slipping off more easily!).

I had the decompression surgery on 2nd Jan this year. I'm still seeing the physio and still doing the exercises, and still in a bit of pain, but it's better than where I was this time last year. Get to a private physio if you can asap, and take it from there.