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Old 11-02-2007, 07:27 AM   #1
Mike Kelley
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AC Joint

I tried to search to see if there were any relevant thread, but of course AC is under 3 letters...so yeah

I recently tore my ACL and had the bright idea to just do Upper Body work...I know this was dumb, but at the time I thought I could get away with it.

Anyway, I seem to have aggravated my shoulder. The pain seems to come from the AC joint on my left arm...the joint itself sticks out more than the right (which I read is one of the signs for AC problems).

It doesn't really hurt during the day...it's just uncomfortable. If I try to do any lifting (bench press, anything over head, pullups, dips) it seems to get aggravated again.

I've been giving myself the week off to see if that helps, but it doesn't seem to be getting too much better.

any advice/suggestions/whatever?
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Old 11-02-2007, 09:31 PM   #2
Nicholas Hahn
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Re: AC Joint

I'm not a doctor, but I can give you my two cents.

I separated mine in April and since then, I've learned *a lot* about that particular area and the surrounding muscles that will inhibit further functional movement of that area.

I'm just now beginning to be able to do push-ups, presses, and dips with minimal pain.

The bump does indicate that you might have an AC problem. What were you doing prior to seeing the bump?

As for your pain, I'd have to advise you to not do an dips, push-ups or presses for a while until the pain becomes lessened. You might not want to stretch those ligaments out more.

If you didn't injure it in a fall or collision, it is possible that you only have a Grade I separation.

What worked for me initially was to first get TENS treatment from the physical therapist for a couple of months for the pain and inflamation. After the constant headaches and pain were gone, I started doing more exercises that worked my shoulder ROM and strength, like TGU, overhead squats, KB Snatches, rowing, and light push-presses. These didn't force me to press on my shoulder, but I have a feeling that they did allow me to strengthen the muscles around my shoulder area.

One danger of any joint separation is that the muscles surrounding the joint will tense up. In my case they did and it caused scapular diskynesis, which led to further pain and shoulder immobility.

Cortizone shots were good temporarily to loosen up the muscles, but I also got three deep tissue massages (the painful kind--don't go to a fru-fru spa) and about five appointments with the chiropractor. I'm doing pretty well now. I think a couple more massages will be good, though. The massages were the best to clear up any tight muscles.

I would advise you to figure out if you have a separation or not and just lay off of it for a few weeks. It doesn't sound too serious, if it only bothers you when you use the joint. I had a Grade II and I could hardly shift my car with my arm or use a mouse for the first 2-3 weeks.

Get well soon.
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Old 11-03-2007, 12:55 PM   #3
Mike Kelley
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Re: AC Joint

I actually took this entire week off from any kind of lifting and the pain is basically gone. I'm going to try some light stuff next week and see how it goes.

I'm meeting with a PT next Friday for some ACL stuff anyway, so I figured I'd just ask about my AC joint while I was there.

As far as sticking out...it's been like that ever since I played hockey when I was 13. I got hit and I remember I could barely move my arm for a week, it hurt to stick handle or try and shoot...but the coach made me keep playing anyway. Flash Forward 9 years later and it just started to become a problem due to overtraining...not sure how big of a deal it is, but we'll see how it goes.
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Old 11-03-2007, 01:26 PM   #4
Steven Low
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Re: AC Joint

Do very light work and of course stretching. Sounds like you got it figured out though. Seems like some sort of sprain instead of a separation (because a separation would probably be worse for a bit longer). In any case, hope you get better.

P.S. There's nothing wrong with doing upper body if the legs are injured. That's what I'm doing with my knee at the moment. You just have to be prudent with your workout plan.
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Old 11-03-2007, 03:04 PM   #5
Derek Weaver
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Re: AC Joint

Mike,
I have had a variety of shoulder issues over the years, including blowing my shoulder out of the socket which resulted in damage to my biceps tendon, detachment of the shoulder capsule from the joint, a torn rotator muscle and resulting pain/immobility/inflammation for about 9 months til I was able to get scoped and repaired.

I would say if your joint is visibly misaligned/"sticking out farther" than the other, you should see a doctor ASAP. The thing with shoulders is that they can get bad very quickly.

If you are sent to a PT they'll probably have you doing a bunch of rotation exercises along with ice/stim/ maybe even ultrasound.

Good luck, and know that a shoulder injury doesn't have to have negative long term impact. I was lucky enough to only have arthroscopic surgery for my major shoulder injury (very good surgeon) and rarely notice any difference in power or pain. Flexibility can be an issue if I don't warm up properly, but that's easily remedied.
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Old 11-04-2007, 10:07 PM   #6
Matt Rodgers
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Re: AC Joint

i have had a TON of shoulder injuries (mostly from hockey) and even though it sounds like you are doing alright i thought id drop my two cents..

the "bump" on your shoulder will only look bigger because the AC joint supports the arm. when the joint is damaged your arm actually sags a tiny amount making the bump look larger.

in january i tore my ac and even though i will be going into surgery in january, i originally rehabed it and still went through a fire academy and am playing college hockey now, i would say since it wasnt really a trauma injury they will just rehab it at most
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Old 11-05-2007, 12:19 AM   #7
Jeff Yan
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Re: AC Joint

For what it's worth, here's my experience with my AC.

I think I strained my AC (MRI turned up negative), probably from benching with bad form, although there is an outside chance that it was from hockey. It felt like I had a dull tugging sensation on my arm, it made sleeping on my side uncomfortable, and it persisted for months. Even though the pain wasn't unbearable, I was now afraid to load more than 75% of my max on the bench press so, despite my skepticism, I eventually decided to go check out this PT practice that specializes in athletes and follows what they call an "aggressive rehabilitation" approach.

I was basically told two things:
1. My posture sucked.
2. My rotator muscles were not sufficiently strong.

My workouts were imbalanced and so were my muscles.

Some of the stuff I had to do in therapy included:
lots of dumbbell rows bent over a bench
slow pull ups
rotator external rotation and internal rotation exercises
a variety of lightweight dumbbell lateral raises
push ups using a variety of instability devices

I was doing PT for months until I got impatient and demanded to know how long I would have to continue coming in to pay for treatment. My therapist then said that I could half the frequency of my visits and that I only needed like 3 more sessions. Sure enough she was right.

I'm going to type the word "acromialclavicular" and "ac joint" now so that somebody will be able to find this thread in the future using the search.
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Old 11-05-2007, 10:38 AM   #8
Mike Kelley
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Re: AC Joint

Tried some exercises today to see where I was at and how my shoulder held up...here's what I found:

NO PAIN:
pullups
DB Row
OH Press (surprising)
front raises

mild pain:
DB Bench (didn't even try BB because last time this hurt the most)
side raises
dips (not so much pain as just being a little shaky)

so I would have though all pressing would be out of the question, but really just benching seems to be the only activity that directly causes pain...DB bench was very milk but I felt like if I had tried BB bench it would have been a little more unpleasant

not really sure what to make of this (OH Presses don't hurt!?)...guess I'll ask the PT on Friday when I go in about my knee
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Old 11-09-2007, 07:03 AM   #9
Ryan Blair
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Re: AC Joint

Mike, there is lots of good advice and not a lot that I can add, but I have had shoulder issues for 10 years, and the movements and pain that you indicated line up exactly with mine. I did go to Dr Andrews here in Birmingham he is the one who operated on Bo Jackson, Micheal Jordan.... He may be the #1 ortho in America. He told me that I had very loose joint structures, he said it was the way I was put together and it would cause me to have chronic joint instability, he also told me not to stretch - tighter muscles would help the stability.
Anyway... since I started CF and read about the Turkish Get Up I have done them religiously and am working my way to 100lbs. My shoulder pain is gone, no more pain on dips/overhead.. whatever, wish I would have know about these 10 years ago. I start with them every workout, I can't believe the difference!
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Old 05-04-2008, 10:19 AM   #10
Jeff Alexander
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Re: AC Joint

Mike,

I just joined the discussion board, and although it's been 6 months since you first posted, I feel that I might have something that can help anyone else with similar trouble...

First off, take a picture of your full profile (head to toe). Drop a vertical line through your profile at the ear and see if the line splits the ear, shoulder, hip, knee, and ankle. I bet that your ear is forward of your shoulder, and your shoulder is slightly forward of your hip. If you have a "head-forward" posture, then the neck and upper back muscles are in a permanent-stretch position. This reduces circulation and weakens them. This will also allow the anterior delts and pecs to pull the shoulder blades and upper arms forward towards the sternum, even further exacerbating the problem. If your shoulder blade is tilted sharply towards your sternum, the outer tip (acromion process) pulls on the AC ligament, and can push the outer edge of your collar bone (clavicle) forward, producing the "bump" you spoke about.

If your posture needs fixing, then begin by being very aware of your head position throughout the day. Use your headrest every chance you get. Consciously pull your ears back over your shoulders when you walk. Make a commitment to allow those neck and upper back muscles an opportunity to shorten to their normal length. Do back exercises that retract your shoulder blades. (rowing movements, external rotations, etc.) You may need massage therapy or to do self-therapy to release contractile knots in the pecs and shoulders to allow your shoulder blades to drop back away from the sternum. Stretching might help, but if you have really tight knots in the muscles, the tendons and ligaments might stretch in addition to the muscles (like Ryan mentioned), and you end up with a joint that's too loose.

The fact that overhead presses felt fine, but bench press hurt the worst tells me that your shoulder blades are rounded down and in towards your sternum. The overhead press forces the shoulder blades down and back towards your spine, the direction of good posture and more power. The bench press tends to force the shoulder blades towards the sternum, away from the spine, and into a position of weakness. Dumbbell chest presses allow you to widen your grip as the weight descends, which allows your shoulder blades to rotate backwards to some extent. (which explains why DB bench presses felt better than BB bench press)

If you haven't already found relief, then drop me a line. I help people with shoulder problems every day. (I teach certs for Trigger Point Technologies)

I wish you luck in your continued CF efforts!
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