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Old     (ralph)      Join Date: Apr 2002       02-25-2010, 9:29 PM Reply   
So I was on my fixie drafting a buddy, he had to panic stop and I hit his back wheel @40kph. Boom, the bike stopped dead and I went up and over the handle bars. Sustained a severe grade 3 or low level grade 5 dislocation of my Ac joint, aka separated shoulder. The collar bone is about 1" out of alignment. I am collecting my x-rays tomorrow and will post the image.
This is a log of my recovery, I figure there are lots of active people here who have been through this and can guide me along the way and there will be others who will do this in the future and can read this archive.
Attached Images

Last edited by ralph; 02-28-2010 at 6:49 PM. Reason: Add back photo
Old     (ralph)      Join Date: Apr 2002       03-02-2010, 10:43 PM Reply   
Week1 Update: Everyday still improving. Two issues today. Hit my shoulder getting out of the car and the clavical popped up about 1/2" from where is was. I can press it back down with my free hand but...... Issue 2. Developed a blister on the skin about 3" long and 1/4" wide from the strapping. I think its an illergic reaction to the glue on the tape. In two minds about restrapping it down because I am worried about my skin, I have taken the strapping off to give the skin a break. I have been going in to work every morning and home early afto but I think I need to take some time off, I am getting very tired and feeling pretty juiced.
Old     (ralph)      Join Date: Apr 2002       03-03-2010, 7:51 PM Reply   
Not sure where the other posts went but here is the earlier log added back.

Arrive at A&E and pain is starting to kick in pretty good. They strap a heart mointor on to make sure I don't have a punctured lung? I tell them i was ok but they insist. When the waves of pain hit my heart rate drops to low 30's and I feel pretty light headed. Lying flat on my back i can push the bone back in position and the pain subsides, sitting up the shoulder drops away and the pain rolls in. The nurse trys to sling my arm for support but the tradition style sling forces the AC joint open and it hurts. A LOT. I convince the nurse to let me lie down and get him to tape the bone down in position. Feels much better. Make an appointment for specialist tomorrow.

I get home and start researching. Found this site with proper strap technique:
Re-strap and joint feels like its in proper alignment.
Start iceing every hr and alternate paracetamol and Nurofen plus (ibuprofen + codeine) every two hrs.

Day 2:
Slept really well, felt much more comfortable as soon as I woke up. I am suprised at how much better the shoulder feels after a sleep. Continue with ice and drug routine all day. Find out Dave is shutting down wakeworld for days. Nooooooooo.
Meeting with "specialist" @ 3pm. Turns out while an orthopedic surgeon he knows little about shoulders in general and zero about this specific injury. Great. Does know that surgical option is mostly for cosmetic reasons only and they do not operate in accute phase. He says strapping bone in correct position and allowing to heal will not prevent the bone from rising up as soon as the strapping is removed. I do not believe him. He refers me to shoulder specialist, appointment in 8 weeks time! Great.
Get home and back on google. A friend refers me to the Cochrane library, a great medical resource for measuring treatments and outcomes.
Sets my mind that non surgical is prefered option. Book in to phsio who can refer me to different surgeon in a week or so.

Day 3:
Slept really well again but road rash on back means I stick to the sheets pretty bad. My shoulder is most comforable on my back but turning over results in the scabs being left behind.
Shoulder feels better again, feeling very positive about my progress. Have small range of movement without pain, do some excersises. Continue ice and start to reduce drugs to 4 hr intervals. I have a special birthday dinner planned in an exclusive resturant which has been booked for 6 weeks, I decide to go. Bad call. Get very tired and achy after a few hrs. Get home fairly late and feel destroyed.

Slept ok but very very sore in morning. First day feeling like I have gone backwards. Noticable swelling, reduced movement and increased pain. Back to ice and drug routine. Swelling reduced by midday, retaped joint and feeling much better.

Day 5:
Slept well but sore again in the morning. After Icing it, the shoulder felt better and starting to regain meaningful movement and function. Done some more reading and seems that without surgery the tendons will not reattach and the collar bone will return to "up" position when the strapping is removed. A little dishearting but if it turns out to be true I can get surgery at any stage to tie it down. I don't really consider myself a vain person but I do admit that having badly asmetic shoulders bothers me.
Found out you can get an illergic reaction to the tape if you leave it on perminantly so removed it this afto and cleaned the skin up. Bone seems well placed and hasn't moved with tape off. I will sit on the couch with everything supported until bed time when we will retape. My physio friend has arranged for an ultra-sound tomorrow so we can see if any tendons are still intact. Really missing wakeworld!
Attached Images
Old     (magic)      Join Date: Mar 2002       03-03-2010, 9:35 PM Reply   
Man, that just sucks. When I did my collar bone, it was right in the middle. I did find that spending some time in the pool while it was healing really helped things out (eased the pain and discomfort). Your injury is quite a bit more serious than what I did though.

take care and heal!
Old     (duramat)      Join Date: Feb 2008       03-04-2010, 6:26 AM Reply   
That sucks bro! I wouldnt wish that on anyonrone

Sun was in my eyes for a split second and my front tire went off the trail and I too sailed over the bars. I had the wind knocked out of me and busted my collarbone. Hurt like a mofo. I seriously debated leaving my brand new bike On the mountian before walking back 6 miles with my arm in an innertube sling. Had to wear that stupid bra/brace that pulled the shoulders back.

I havnt mountainbiked much since

speedy recovery, I hope you the best!
Old     (ralph)      Join Date: Apr 2002       03-04-2010, 8:10 PM Reply   
Just finished an appointment at the "Adidas sport centre" super refreshing to meet someone who is a specialist and has there game on. I'm making super rapid progress and doesn't look like I will need surgery. It has been confirmed as a grade 3 separation meaning both the ligaments on the end and underneath the scapular are 100% ruptured. The ligaments off the end are toast but the ones underneath may recover and re-nit. I officially have a abnormally high pain tolerance, he manipulated the joint a number of ways asking "does that hurt?, huh,it should!" Ha ha. Seems strapping the joint correctly is they key to a good recovery, the boss has it down and things are looking good. The blister which has developed on the arm is not an allergic reaction to the tape but because the skin was folded and pulled tight reducing the blood flow. Good to know. The doc also let us know peanut oil is a good way to get the strapping off without damaging the skin. Super happy and positive about the recovery, looking forward to getting back on the bike ASAP. The doc says 12 week is recommended before I start playing rugby again, 6-8 for wakeboarding. I presume I can wakesurf again in a few weeks seeing as it is so low impact.
Old     (blabel)      Join Date: Jul 2001       03-04-2010, 8:29 PM Reply   
Damn that looks gnarly and I wish you luck. I just had a grade one seperation and I was 4 months out of the water surfing and a couple more before I wakeboarded. 1.5 years before I was 90 percent or so. I can do everything now but every once in awhile it let's me know that it's still there.

Shoulder injuries aint no joke.
Old     (ralph)      Join Date: Apr 2002       03-09-2010, 12:03 PM Reply   
Still getting better every day. Regained most of my movement below shoulder level already. Completely stopped pain meds, still icing 3 times per day to control swelling and pain. Started PT to keep things moving along. Driving again which is nice. Yesterday I removed the tape in the night because it was itchy as, by the morning the collar bone was up 1/2" which was disappointing. I restrapped it in the morning but I am coming to the realisation that the dream of looking symmetrical without surgery is just that, a dream. Regardless strapping allows me to function semi normally and I'm sure it is helping the recovery. Skin management is becoming critical as it is starting to show signs of breaking down under the strapping. Biggest struggle is the extreme tiredness, by 2PM I am totally juiced and need to rest. Not sure if its due to the light concussion or the body healing.

Heading to the lake this weekend, looking forward to soaking in the spa.
Old     (jtnz)      Join Date: Sep 2007       03-09-2010, 9:29 PM Reply   
Damn dude that looks nasty but good to hear you're recovering. If you are in need of a specialist still look up Tim Astley (Ortho) in Remuera he is the shoulder man in NZ, did my surgery 6 years ago.
Old     (ralph)      Join Date: Apr 2002       03-16-2010, 2:00 AM Reply   
Still getting better fast, no set backs so far. Almost back to full range of motion. Still got a way to go for strength and confidence. I am persisting with the taping and it seems to be starting to work, collar bone is staying put when I take the tape off to rest the skin.
Old     (gunz)      Join Date: Sep 2001       03-16-2010, 9:30 AM Reply   

Rehab is never fun,but you'll get through it,remember to push,BUT NOT TO HARD!
I set myself back by 3-4 weeks by getting in a hurry............and get rid of the bike
Old     (ralph)      Join Date: Apr 2002       03-18-2010, 2:15 PM Reply   
Hell no, can't wait to get back on the bike!
Old     (ralph)      Join Date: Apr 2002       03-23-2010, 11:10 PM Reply   
Still going well, No set backs but I am getting the dreaded shoulder ache every couple of days. I can relieve it with ice so managing it pretty well. The shoulder is feeling stronger and have 95% range of motion pain free. Had the strapping off for 5hrs yesterday and the collar bone stayed put, not sure if thats a sign of the tendons starting to renit or something else.

I realise this is a super dangerous time for over confidence, thinking the shoulder is better than it actually is and damaging the tendons as they heal so trying to be sensible and not do too much. The taping is key to a good recovery IMO, I have spoken to a lot of people who did not rupture the tendons completely like I did, did not strap and had a much harder recovery than I am having.
Old     (ralph)      Join Date: Apr 2002       03-31-2010, 1:54 AM Reply   
Really good week. The shoulder feels almost normal now, still got the strapping in place and plan to keep it on until the 8 week mark if possible. The skin is holding up well, I have been moving the strapping around on the chest and back as much as possible to give the skin a rest, where I can't move the strapping (over the bone end) I have been rubbing arnica into the skin before the strapping goes on so it doesn't stick down hard on to the skin. Have wakesurfed, 2 sessions on the wind trainer and one spin class this week. The collar bone is really feeling locked in place now and visually there is very little difference from the good side. There is a little bit of swelling but the bone placement seems pretty bang on. Super happy.
Old     (bruizza)      Join Date: May 2009       04-01-2010, 11:19 AM Reply   
Sounds like your recovery is going really well. Good luck with the rest of it!!!
Old     (ralph)      Join Date: Apr 2002       04-20-2010, 2:17 AM Reply   
An an awesome few weeks. The shoulder feels normal day to day now. Full range of motion is back and strength is returning. First day back at the gym today, went great, trained chest and back. I was only pressing the 50 pounder dumbells but did lots of reps. Slapped some ice on it when I got home just in case there would be any swelling. I can probably remove the strapping now but might keep it on for another week or so. Heading back to the lake weekend after next, might even have a cheeky ride!
Old     (ralph)      Join Date: Apr 2002       05-31-2010, 1:35 PM Reply   
Final Update:
I'm fixed! Recovery is pretty much done, almost full strength and full range of motion. Still get a poppy grindy sensation when pressing heavy dumbells but no pain what so ever. Almost 100% symmetrical in appearance, I am presently surprised at how little difference there is between damaged and normal clavicle. If you have this injury yourself I can stress how important it is to strap aggressively and keep up the ice regime for at least 2 weeks, but most of all stay positive good outcomes can be had by taking it seriously and doing what is required to heal properly.
Old     (michal)      Join Date: Jul 2010       07-20-2010, 5:22 AM Reply   
I wish I've found this topic few weeks ago. 23rd June I've flew over the bar with same outcome - AC dislocation grade 3 or even 5. They didn't put any straps on me, and it was late until I realized that could be done. In my case they also decided to treat me conservatively and as I've read, that's pretty common nowadays. Anyway, 3 weeks later I have full motion range in the shoulder and a bit of pain only during push-ups, so I skip them for now.
The only thing I'm wondering about is whether it would help me if I start putting the straps on me now... Collarbone sticking out bothers me a bit, as it bothered you. Did any doctor tell you whether strapping makes sense only if started immediately after the accident? I know few weeks passed already so the chance of ligaments repairing themselves is rather slim (or at least I think so, may be wrong). What tape did you use for strapping the shoulder?
Great to read about your successful recovery - except for the bump on my shoulder I'm pretty happy with my results too.
Attached Images
Old     (ralph)      Join Date: Apr 2002       07-20-2010, 1:14 PM Reply   
I would strap aggressively now. There is nothing to loose IMO it takes about 12 weeks for the scar tissue to form so I think there is still time to pull it back. You need to have a undertape layer to prevent allergic reaction and then the strapping over top to stabilize the joint. Go to your drug store and get some advise about what is available locally. Plan to change the tape every two days, even if you don't get a reaction because strapping for 10 weeks WILL cause your skin to break down and you need to get a head of the curve and protect your skin.

When you apply the tape put your hand on your hip like your are singing the "I'm a little tea pot" song and use the strapping to pull the collarbone back into place, you can put your other arm out like the spout if you like but its not required.

Look forward to lots of rotor cuff PT at around 8-10 weeks.
Old     (michal)      Join Date: Jul 2010       07-20-2010, 1:54 PM Reply   
Thanks for your reply. I got myself the tape already, got to buy also the breathable one to put it underneath. One question for you - how stable was your clavicle? On this video you can see the doctor can pretty easily push it down. In my case thou, it requires quite a force to push it down, so I may have some trouble strapping myself with the clavicle in place. For now I've failed strapping clavicle being in place. But maybe it's gonna be getting better with small steps. Even a centimeter down would make me happy.Did you leave the straps on during sleep?

As for PT, I've found a page with a set of different exercises:

Cheers, Michal
Old     (ralph)      Join Date: Apr 2002       07-20-2010, 4:58 PM Reply   
When I did it, it moved like it was pushed through heavy mud, his looks crazy loose. The doctor would be on the floor collecting his teeth if he pushed it around like that when it was fresh.Mine doesn't move all all now. If you can move the bone it is worth strapping IMO. You cannot strap this yourself, you need a wife or mother to dote over you.

Yes in my experience you must leave it taped during sleep. I tried sleeping without it being taped and in the morning it was up. What you are trying to achieve is to hold the bone in the right place so that as the scar tissue forms the bone is in the correct place. The tendons do not rejoin but the scar tissue makes a bridge to remake the connection.
Old     (brockman)      Join Date: Jan 2011       01-31-2011, 12:09 PM Reply   
Any update on how the shoulder is holding out now?
Did a complete rupture of mine 10 days ago, dislike the new collarbone protrusion!
Old     (ralph)      Join Date: Apr 2002       02-02-2011, 9:21 PM Reply   
100% recovered. Feeling strong and almost undetectable to the eye. If you haven't been icing keep at it every hr for another week and strap that puppy hard, IMO critical for a good result.
Old     (magic)      Join Date: Mar 2002       02-03-2011, 9:18 AM Reply   
Glad to hear you are doing better!

I just picked this up via eBay and looking to hit the local Velodrome this coming season. Really hope to stay injury free, I did my right collar bone many years ago, no desire to every do that again.

Old     (ralph)      Join Date: Apr 2002       02-07-2011, 1:44 PM Reply   
I rode a little bit of track for the first time at Christmas, was super fun.
Old     (G00MBA)      Join Date: Mar 2011       03-23-2011, 1:00 PM Reply   
Thanks for sharing this. I'm a week into my AC separation after a mountain bike crash . I've read many, many, articles etc, and this by far is the most constructive and useful. It gives me some hope because this injury is so ****ing depressing. My only question is, did your bone pop up even when strapped? mine is fine while sitting or lying but the weight of my arm pulls my shoulder and clavicle out of alignment and the bump comes back, even when strapped, although it isn't as bad as if it's not strapped. Thanks again for such a frickin' useful resource.
Old     (trace)      Join Date: Feb 2002       03-23-2011, 6:44 PM Reply   
^^Absolutely. I partially tore my AC joint last August. I had read this thread months prior, and dug it back up after my injury because Google couldn't find anything more informative.
Old     (musikero)      Join Date: Dec 2011       12-18-2011, 10:43 PM Reply   
I wish i saw this forum earlier on. Did a type 3 end of Nov and it was 4 weeks after that I saw your posts. I tried taping it last week. It did look better but when i took out the tape after 3 days my skin was so raw and there were sores. My bump didn't look any much better too .

My clavicle is getting harder to push down so i think the scar tissue if forming already, not sure if taping it some more will help. How do you prevent the rawness from coming out? Do you have a post strapping picture? Mine looks pretty awful.

Old     (ralph)      Join Date: Apr 2002       12-19-2011, 12:01 AM Reply   
To look after the skin I have a few tips:
1. Use an undertape layer
2. Replace the tape every 2-3 days. Maybe more often if you have delicate girly skin.
3. When you replace the tape give the skin a rest for at least a couple of hours, make sure you stay immobile with the joint stabilized. I found sitting on the couch watching telly with a pillow under the elbow perfect. Clean the old glue off the skin with peanut oil.
4. Move the tape around on your chest and back by changing the angle over the joint to give the skin a rest, where you can't avoid the common part (over the joint) coat the skin in arnica so the tape doesn't stick to it hard

If the bone is popping up with the strapping on then I don't think you are strapping it properly. Watch this video:, The strapping over the joint is critical, I dropped the down the arm strapping after a couple of weeks. Unlike in this video make sure you put your hand on your hip and elbow out from the body like you are doing the I'm a little teapot song. Head up, chest up back slightly arched so you have super good posture then get the tape applied.

I don't have any current photos of the skin but there is no scaring or blemishes, like the skin on my bum its perfect.
Old     (ibrahim)      Join Date: Apr 2013       04-11-2013, 7:59 PM Reply   

inspiring bro! will you post a current photo of your right shoulder? want to see it! i've been strapping mine down for 10 days now just 'cause it felt "right" and letting it hang felt "wrong"

How about lifting above your head and do you rock climb?
Old     (ralph)      Join Date: Apr 2002       04-11-2013, 8:32 PM Reply   
Due to popular request here are a couple of up to date pics, they are selfies but I do have pants on. I pretty much only cycle now for fun, no gym work so I carry about 7-8kg less weight than I did at the accident. Shoulder feels great and gives me no problems what so ever. i might hit the gym this winter to put a bit of mass back on. Cyclist arms are stupid.
Attached Images
Old     (ibrahim)      Join Date: Apr 2013       04-12-2013, 8:03 AM Reply   
close up is your left shoulder but you injured the right shoulder, right? man looks awesome! good job completing a rehab that is unheard of in the medical system as far as i've heard so far. i.e. you have to have surgery to reduce the bump

Last edited by ibrahim; 04-12-2013 at 8:04 AM. Reason: spelling
Old     (ibrahim)      Join Date: Apr 2013       04-12-2013, 8:49 AM Reply   
oh or is this a mirror image?
Old     (magic)      Join Date: Mar 2002       04-12-2013, 9:21 AM Reply   
Originally Posted by ralph View Post
...Cyclist arms are stupid.
Totally. I'm proud to be able to both reach peanut butter jars from the top shelf and actually open them without my wife's assistance.

I found moderate weight kettle bells swings and body work did wonders to rebulk my arms post a couple years of cycle and Ironman training.
Old     (ralph)      Join Date: Apr 2002       04-12-2013, 11:26 AM Reply   
Yes mirror image, it is the bung one. There is a slight thickening sound the end of the bone, I presume scar tissue but I doubt you would notice unless looking for it.

Thanks sean, it will be winter here in another month, I will get started soon
Old     (actiondcpd)      Join Date: Apr 2003       04-12-2013, 11:42 AM Reply   
Does the bone stick out a bit when you move your arm into a non-resting position? I separated my shoulder after being hit by a car on my bike years ago. I don't have any pain and have full mobility however if I intentionally try to poke that bone out I can make it look like your first picture. If I hold my arm to my chest and shrug it looks odd for sure.
Old     (snyder)      Join Date: Feb 2006       04-19-2013, 8:58 AM Reply   
Weird. I never paid attention to this thread but as bad luck would have it, i hurt my shoulder in the gym about 3 wks ago. and i'm fairly certain it's a strained/pulled AC joint (class 1 maybe). I haven't been to the dr. yet because i know that's what he's gonna tell me and it's just gonna cost me money to affirm what i already know. pain on top of my rt shoulder. tender at the end of the bone that connects from my collar bone, and hurts like hell when reaching across my body. Most of the time, I can't even touch my left shoulder w/my right hand. the bone isn't protruding up any that i can tell though.

my dilemma is I had been slacking off away from the gym while my wife was pregnant and now I've been back hitting it hard for the last 11 weeks and making great progress. I know the solution is to back off the weights for a while, BUT... I've pushed thru the pain thru extensive warm up and once my shoulder is warmed up properly it doesn't hurt and i can actually go pretty heavy. a few hrs later though, that's a different story. I took a few days off completely right after it first happened, and have been doing mostly metabolic type workouts (p90x like stuff) with just a few heavy days. and this week i've done nothing but cardio... and it's not really improving. not any worse, but not really better. it's been a little over three weeks. I really want to get back to the weights...

Can i make it worse, or will i just prolong the healing?
Old     (wakeboardern1)      Join Date: Aug 2007       04-19-2013, 8:32 PM Reply   
I always ignored this thread... Then the sunday before last I thought it would be a great idea to tackle the fun box at Hexagon Wake Park with my left shoulder. Pretty sure I sprained the AC joint. So I'm at a party with some friends last weekend, and one of their drunk asses tackles me to the ground, and based on your pictures, it's a pretty clear grade 2 tear. Definitely not as bad as yours, but still.

I'm glad this thread exists, because now I know that I can tape it up to get it to stay in place, so thanks! This was all great timing though, because we're currently moving out of our house that has entirely too much stuff...
Old     (ralph)      Join Date: Apr 2002       04-20-2013, 2:24 AM Reply   
Pound, go see a physio asap, you need to start pt to strengthen the supporting muscles around the joint. My advise is to take it seriously, chronic shoulder issues are no joke.
Old     (snyder)      Join Date: Feb 2006       04-22-2013, 7:54 AM Reply   
Thanks Darren! I think I'll make an appt w/an ortho today. (I guess that's who i'd see?)
A few times over the weekend I felt it popping when I'd move it a certain way but I couldn't isolate exactly what I did to make it pop.

This is apparently a very common injury... Found out yesterday that my neighbor went thru similar issue and let it ride long enough to need surgery and he said it SUCKED!
Old     (trace)      Join Date: Feb 2002       04-24-2013, 4:14 PM Reply   
Weird, I haven't been on this forum in probably a year, and near the top is an ancient thread that I was in... My lump isn't even noticeable now, other than a very slight asymmetry when looking really hard. I've had chronic shoulder issues for about 15 yrs - many full dislocations and one arthro surgery on my left, this AC thing, etc. When you are ready for it, strength conditioning and stretching are the BEST therapy and preventive measures BY FAR. I have been really focusing on fitness in the last few years, and I never have shoulder problems anymore.

Last edited by trace; 04-24-2013 at 4:16 PM.
Old     (snyder)      Join Date: Feb 2006       05-03-2013, 8:15 AM Reply   
I made it to the Dr. (Ortho) last week. He took x-rays and confirmed what i already knew. (and charged me $114) He didn't specify a grade, but it's an AC Joint injury. I assume grade I of course. Basically said it could take up to 6 months to heal. but that working out won't necessarily make it worse, just stay off the bench press and in his words, "use girly weights". So i'm going to paint the 100lb dumbells pink (lol)
Old     (td_in_nc)      Join Date: Dec 2014       01-13-2019, 2:05 PM Reply   
I know this is an old thread but wanted to hear the long term outcome as I now join the club of grade 3 shoulder separation as a result of a hard fall at the cable park.

I am post injury 3 weeks, been doing lots of PT and things are progressing well (lucky no other damage to shoulder as far as I know). Initially I was thinking of surgery but after talking to a number of folks I decided the PT route,and if it goes bad have surgery.

My question is for those that did not have surgery for the grade 3 separation, has the lump on the shoulder less noticeable after a year or more?

Old     (ralph)      Join Date: Apr 2002       01-13-2019, 7:27 PM Reply   
Mine is perfect mate, I have to think hard about which one it was now. You have to strap that mofo when the scar tissue is forming tho, keep it in place.
Old     (jarrod)      Join Date: May 2003       01-14-2019, 10:39 AM Reply   
My buddy has that same weird colarbone thing going on. We call it the shoulder d1ck!


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