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Matthew Apostol 09-16-2009 02:42 PM

Distal Clavicle Resection: how long to recovery?
Greetings all,

Four weeks ago, I had surgery on my left shoulder. Here's what the doc did:

1. Distal Clavicle Resection w/ AC joint capsule repair
2. Subacromial decompression
3. Drilled holes in the back of humeral ball (the side that points inwards towards the chest) to promote re-growth of lost cartilage

My question: how long will recovery (rull range of motion without pain) take?

Right now I can go cross body without pain, but abduction straight forward and backwards still hurts. Also, going overhead still hurts. The pain is more or less located at the AC joint.

Some history on the injury:

Male/26/no prior shoulder problems

Cause: bent arm bar (jiu jitsu tourney) 10 months prior to surgery

PT since surgery: standard Army protocal (rubber bands, UBE, isometrics etc)

Paul Coplin 09-16-2009 05:17 PM

Re: Distal Clavicle Resection: how long to recovery?
My doc had me wait until 3 weeks until I started to move it. I did some wall crawls, and some side/front arm lifts (elbow bent). Then my PT guy started me doing passive movements using an overhead pulley. I had over 180 degrees of ROM within a week. The trick is passive movement. When you actively lift it, my PT said the deltoid activates and basically moves the joint into the AC joint area, producing pain. It'll decrease over the next few weeks.

I'm 8 weeks post-surgery right now, and besides using it too much last night at drill, I can use it day-to-day for most everything, but still watching the weight movements. I'm focusing on scapular and back activation, and rotator cuff stretches and strength. My PT said as long as the inflammation/pain doesn;t last more than 24 hours, you aren't going to extend the healing time.

Are you seeing a PT?

Steven Low 09-16-2009 05:58 PM

Re: Distal Clavicle Resection: how long to recovery?
Paul has it about down.

But talk to your PT!

I don't understand why most people want to ask on a forum about injuries when they can talk to professionals....

Matthew Apostol 09-17-2009 09:14 AM

Re: Distal Clavicle Resection: how long to recovery?

Originally Posted by Steven Low (Post 665002)
I don't understand why most people want to ask on a forum about injuries when they can talk to professionals....

Steve, trust me I've tried. My physical therapist is not really knowledgable about the surgeries that are done by the docs. He follows a protocol for sub-acromial decompression, but my surgery was more extensive than that. I've asked about the other procedures that were done and if they would affect recovery time, and he doesn't know. Additionally, I have to constantly prod him for details on the exercises I'm doing, what their purpose is and what exactly I should be doing on my own and how often. I've never received the kind of information that most people who post on this forum receive from their PTs. He is an Army PT, and he must work with a large number of personalization is not really a big priority at his clinic.

Honestly, I've received much better info from this forum from you and others that answer posts. :D

Paul, thanks for sharing your own recovery experience. I also get pain from active ROM movements just like you had. Great to know that that's normal. Hopefully, by 8 weeks I can be where you are now.

Steven Low 09-17-2009 09:52 AM

Re: Distal Clavicle Resection: how long to recovery?
Ah that sucks dude. I would say go find another PT, but I don't know if you can do that.

There's good and bad PTs just like there's good and bad docs/lawyers/etc.

The ones that strictly follow protocol instead of learning what is going on and how to respond to different patients based on complications/needs/progressions/etc. are obviously the better ones.

If they can't explain why they're doing some sort of treatment they're probably just following protocol. Granted, protocol will work most of the time. But may not be the most effective either.

Everett Steinbarger 09-17-2009 09:57 AM

Re: Distal Clavicle Resection: how long to recovery?
I would suggest tlaking to the surgeon that did your distal clavicle resection, (DCR).

If your PT is active duty Army it shouldn't be a surprise that he isn't all that up on distal clavicle resections. Most of his patients are going to be younger on average, and DCR patients are typically in their 50's.

All that being said, most patients are back to a full range of motion, (ROM), by post-op week 4. I usually tell my patients they can get back to intense exercise 1-2 weeks AFTER the pain has gone. For most people that is about week 6-8.

Listen to your body and your surgeons advice.

Matthew Apostol 09-18-2009 02:19 AM

Re: Distal Clavicle Resection: how long to recovery?
Thanks, Everett.

Matthew Apostol 10-02-2009 05:57 AM

Re: Distal Clavicle Resection: how long to recovery?
Just thought I'd update this thread in case there's someone out there who's had or is considering this surgery and has the same concerns I do.

I talked to the doc who did my surgery and explained what I was still having pain at 7 and 1/2 weeks post op. He said that 8 weeks is normally the recovery time for a DCR but it is completely normal and somewhat common for patients to still feel pain out to about 12 weeks post op. At that point, if a patient has not returned to complete range-of-motion without pain, then there may cause for concern.

Most likely, inflamation of the AC joint (or false joint, rather, since it's been replaced with scar tissue) is still an issue with me. He advised that I continue to take NSAIDs (I use Mobic, which lasts much longer than Ibuprofen and is easy on the stomach) and ice my shoulder down several times after PT. On days where my shoulder is particularly tight and aggravated, I soak in a hot tub for about 20-30 mintues, gently stretch my RC muslces out, and then immediately ice it down before I go to bed.

I've done a lot of online research on this surgery, and it seems there is a small percentage of patients who don't get any relief from a DCR. Sometimes there's is not enough clavicle removed and impingement remains an issue. It's just the way the cookie crumbles I guess. I'm trying to stay optimistic and hopefully things turn out for the best.

Will update again at 12 weeks post-op...

Steven Low 10-02-2009 11:57 AM

Re: Distal Clavicle Resection: how long to recovery?
Fish oil for anti-inflam.

Work on your scapular mobility. Most impingement and other such shoulder problems arise from posture problems and lack of scapular mobility

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