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Old 11-15-2008, 10:06 AM   #1
Marc Juliano
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2nd/borderline 3rd degree AC joint Separation...

So I was kicking as with crossfit for about 5 months straight up until about a month ago when I separated my AC joint in my left shoulder snowboarding. I Currently have full mobility back (regaining full mobility only took a bout 2-3 weeks post injury) but strength of the join seems like it's going to take MUCH longer to get back to 100%. Still feel a "light" sharp pain while doing push-ups (can rep out about 20 w/out too much pain) and can put up about 115lbs on the bench-press w/out pain. The thing that is really bad is pull ups, still cant do a complete pull up.... even hanging from the bar kinda stresses the joint and I get some sharp pains. Seems like it will be months before I can kip again.

Anyone have experience with this injury and have an idea of the recovery time back to 100%? I've heard 6 months.. which sucks. Also, any suggested rehab moves? I have been doing alot of general shoulder stuff with light weight (front/side raises, upright rows, military presses) I want to swim but it's still a little tender when I get into a hard free-style stroke. One thing I can do again with virtually no pain is jumping rope. Ah well. Just really looking for some more insights about this injury and how long I can expect until I get back to full cross-fit capacity.

Thanks,

Marc J.

here is my initial x-ray.

http://i54.photobucket.com/albums/g1...g/f0a09973.jpg
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Old 11-21-2008, 02:21 PM   #2
Kevin McGuinness
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Re: 2nd/borderline 3rd degree AC joint Separation...

1. See a Physical Therapist

-or-

2. Try this. I'm a Kinesiological Science major, studying Physical Therapy and working as a PT assistant.

W/F/S
http://www.youtube.com/watch?v=BWxcl...eature=related

W/F/S
http://www.drloweshoulder.com/pdf/th...%20PROGRAM.pdf

Start with the first one program, light weight, 2 sets of 10-12. Added weight as pain allows. Use this program 2-3 times a week for roughly two weeks. Move on to the second program "Throwers Ten" once your shoulder starts to feel stronger, light weight at first, 3 sets of 10, add weight cautiously.

Keep strict form on all of these exercises and stop immediately if you feel ANY PAIN. Rehab isn't the time to man up and grunt through pain, it's the time to listen to it.

I'm two months out from a 2nd degree AC sprain, so I feel your pain.

Be patient and diligent with the rehab, hopefully we'll both be back doing max cleans and puke-inducing OHS workouts soon.

-Kevin M.
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Old 12-04-2008, 07:37 PM   #3
Adam Kemmerly
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Talking Re: 2nd/borderline 3rd degree AC joint Separation...

Marc,

I have a complete 3rd degree seperation of my right AC Joint from a dirt bike wreck 3 yrs. ago. I completely tore my AC ligaments and most of my trapezius ligmants that attach to the clavicle. All you can do besides surgery is have time to heal as much as possible.

My bench press went from 285lbs to 10 in a heartbeat. Start rehabbing slowly, do very light db/bb bench presses, play with hand position on db bench neetral grip, pronated grip or rotate wrists to somewhere in between.
Also, do as much rotator cuff type exercises with light tubing, or light plates/dbs as possible. I used a series of what is known as the throwers ten to rehab mine.

Surgery options are not all that great. You can have the clavicle screwed back to the AC process or have the clavicle cut off and basicially have the free end wrapped in packing tape and sutured back up. The first option has a long recovery and rehab time and reduced range of motion, the second a shorter period of time.

I just rehabbed mine for aout a year. Result, I bench 265, I can do a bunch of muscle ups, Overhead press 175. The downside, my shoulders look uneven, I have a noticable lump where the end of the clavicle pokes up.

Hope this helps
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Old 12-13-2008, 03:25 AM   #4
Daniel Pfiefer
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Re: 2nd/borderline 3rd degree AC joint Separation...

Marc,

On Thanksgiving, I had a similar problem... Turkey Bowl got a little rough and I suffered from a 1st/Borderline 2nd degree AC separation on my left side.

I am three weeks and two days since the separation, and I went to a physical therapist through Kaiser at about 1.5 weeks. Here is what she told me to do:

10x3, 2x/day of each (until pain) - body weight/calisthenic - increase strength and flexibility:

* standing front arm raises, thumb up
* standing side arm raises, thumb up
* cross arm across chest, trying to reach around and touch trapezius (use other hand to assist)
* cross arm to mid back, raise up (use other hand to assist)
* stand next to wall, place pinky side of hand against the wall, and using the wall, track hand up (keep back straight)
* wall push ups (only to 90*). As strength increases, lower in the inclination (progress to chair, then floor).

10x3, 1x/day of each (until pain) - using bands - to keep the rotator cuff strong:

* rotator cuff outward flies (hold band in front, fly out)
* rotator cuff inward flies (double the band in two, attach to fixed point)
* stand facing wall, pull band (from point affixed on wall) in both hands toward sides.
* stand facing away from wall, pull band (from point affixed on wall) in toward sides.

I have my next PT appointment on 12/17, so I'll let you know what else I find out as far as adding/modifying exercises.

Shoot me a PM if you have any questions on any of the exercises, or any questions at all. And if you could let me know of any exercises that you've found helpful I'd appreciate the tips as well...

Last edited by Daniel Pfiefer : 12-13-2008 at 03:38 AM.
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Old 02-17-2010, 05:35 AM   #5
Justin Alcober
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Re: 2nd/borderline 3rd degree AC joint Separation...

Hi Marc,

I know its been a while since your post but I was just wondering how is your shoulder holding up now a year or so after the injury? I just wanted to get a perspective on how things progess in a years time because I also have a 2nd degree/borderline 3rd degree AC joint seperation as 2.5 weeks ago from snowboarding. So far I've got about 80% ROM and absolutely no strength in my injured shoulder.

How long did it take before you were completely comfortable and pain free to do pull-ups/push-ups/and any type of pressing exercise? Do you have the "bump" on your injured shoulder as well? If so, has that gone down for you at all in the last year? Or have you been able to make the bump less noticeable by building more muscle around it?

I'd really appreciate the input and I hope all is well with your shoulder now.

Best Regards,

Justin Alcober
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Old 02-17-2010, 06:53 PM   #6
Steven Low
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Re: 2nd/borderline 3rd degree AC joint Separation...

For reference Sam bradford (QB) was back to playing within about 6-8 weeks of a 3rd degree AC joint separation.

You can do that as well if you have perfect recovery (fish oil, anti-inflams, lots of sleep, good nutrition,etc.) and good genetics for it.
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Old 02-18-2010, 02:00 AM   #7
Justin Alcober
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Re: 2nd/borderline 3rd degree AC joint Separation...

I appreciate the info Steven!
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Old 02-18-2010, 10:32 AM   #8
Mike Mallory
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Re: 2nd/borderline 3rd degree AC joint Separation...

I've done the same thing......You may end up with the 'lump'......and my shoulder is uneven, but just be dilligent with your PT and you'll come out fine on the other end

IN the end, you'll probably have some laxity in the joint there, all it means is in the future you'll have to be a little more conscious of keeping your humerous tight to the glenuhumeral joint

lose ligamentous stability-->make up with neural and muscular stability.
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Old 02-18-2010, 07:51 PM   #9
Steven Low
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Re: 2nd/borderline 3rd degree AC joint Separation...

Yep pretty much.

Here's a general outline I wrote up for someone in the past:


Basically, you can follow tendonitis protocol minus the exercise and stretching for now:
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

The AC joint connects scapular to the rest of the body through the clavicle. The joint is supposed to be immobile. Once it gets moving via sprain or tearing of the ligaments, it's very easy to get arthritis in the joint since the cartilage wears down pretty quickly.

1. Basically, what you do with AC joint is rest, massage the muscles around the area to increase blood flow for healing + keep the muscles from tightening up, fish oil for anti-inflammatory, ice if it helps.

2. Once it start feeling better improve range of motion with non-painful movement, and start strengthening rotator cuff muscles to make the shoulder more stable.

3. Then work slowly back into compound movements.

Usually each of these steps (1 through 3) will take 2-4 weeks each. Can take more or less depending on how your body recovers -- to improve recovery capacity take the fish oil, sleep more, eat quality foods, etc.
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Old 02-19-2010, 03:53 AM   #10
Justin Alcober
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Re: 2nd/borderline 3rd degree AC joint Separation...

Excellent info Steve! I'm defenitely going to look into prolotherapy and getting some fish oil and glucosamine pills.

Btw...I looked into Sam Bradford and found out that he ended up having surgery on his throwing arm. My injury is on my non-throwing arm however I still use it a lot in my physical activites. Do you think I'll be fine w/o the surgery in the long run? Will I still be able to do pressing exersices (shoulder & bench presses) the way I use to pre-injury?

Again....Thank you so much for all of the info!
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