Separated Shoulder

[nuggs1]

At the beginning of November I suffered a cat 1-2 should separation. 2 weeks ago I started riding again and I'm starting to get more and more pain/discomfort when out of the saddle.

Is this normal ? The doctors said I should have been able to ride after 4 weeks but decided to take a bit longer. Is the pain just because my shoulder has been used much in the last couple of months and needs to loosen up or should I go back and get it looked at ?

 

[mtrejt]

The pain is normal, and you will have it for about a year. I had a grade III complete separation two years ago, started on the trainer that week, and was riding on the road in less than three weeks. However, I went to physical therapy three days after the injury, once the swelling went down. The PT had me start with range of motion, followed by gentle strengthening, and electrode application of a steroid gel. I still have to do PT exercises since the shoulder is no longer attached to anything, but a little over a year later there was no pain and full strength.

I also investigated surgical repair, but the orthopedic surgeon refused to do surgery, since I'm a cyclist, and in his opinion I would just crash again and ruin his repair job. Good luck and find a good PT.

 

[markrosen]

The pain is normal, and you will have it for about a year. I had a grade III complete separation two years ago, started on the trainer that week, and was riding on the road in less than three weeks. However, I went to physical therapy three days after the injury, once the swelling went down. The PT had me start with range of motion, followed by gentle strengthening, and electrode application of a steroid gel. I still have to do PT exercises since the shoulder is no longer attached to anything, but a little over a year later there was no pain and full strength.

I also investigated surgical repair, but the orthopedic surgeon refused to do surgery, since I'm a cyclist, and in his opinion I would just crash again and ruin his repair job. Good luck and find a good PT.

1+, Good advice. Had Grade 1-2 seperation as well, 4 years ago. Do the exercises recommended by the PT. You will notice improvement in your movement & range by the end of the month. Good Luck.

 

[delbified]

I also investigated surgical repair, but the orthopedic surgeon refused to do surgery, since I'm a cyclist, and in his opinion I would just crash again and ruin his repair job. Good luck and find a good PT.

he probably considered the damage to be not severe enough to justify surgery. i had 3 separations before i had surgery, which has been fantastic - it feels like a new shoulder and no problems for 16 years since.

you need to learn to fall without putting your hands out in the 'superman' position - that's what puts the load on the shoulder joint. of course, tucking your arm in increases the risk of snapping your collarbone.

 

[Fausto's Schnauzer]

I hate to be the bearer of bad news...

...but while it's true that it will probably be much less bothersome in a year to a year and a half, based on my own similar injury (1993) chances are you'll get nice little "reminders" once in a while. A night of bowling could bring about a few twinges, as can a simple reach to get a box of cereal off the top kitchen shelf. A winter morning shoveling snow might be downright painful. You'll probably want to order your firewood pre-split, and wait....here's the best part....by the time you reach your 40's you'll have a built in barometer. Yup, you'll know when a cold front of moisture is coming long before your local TV weatherman. Isn't that great?!

 

[Boeing]

It is all about PT and the lighter and higher the reps the better.

Looking in the mirror btw do you have that flat spot on your delt compared to the good shoulder?

 

[nuggs1]

Thanks for all the advice. I'll keep on with the PT as I have slacked off a bit. Haven checked for any flat spots on my delt but collarbone does stick up significantly more.

 

[STODRR]

I had a Cat 4 sep in Apr. I was riding the trainer by the end of the week and raced in two weeks. Like somebody said I have nothing but muscle holding my shoulder up and unless I keep with the PT it gets pretty sore on long rides.

 

[Richard S]

Some good advice above. I hope it is going well for you. The trick with this type of injury is to develop such a strong, stable shoulder from a musculature basis that you no longer need to rely on the 'last chance' stopping capabilities of the joint capsule. Couple this with good range of movement and there's no reason following a single or multiple separation you shouldn't be as strong and capable as you were before the incident.

As above, make sure you have a good PT or Rehab specialist, get them to understand your need for a 'High performance' shoulder rather than one that can withstand carrying some shopping. And get them to make a programme which you buy into...there's so much to be said for you being motivated by the exercises you are doing.

For example, rehab exercises need not be boring and you can work it into exercises that work other things that will increase performance at the same time. Things like, balancing on a wobble board while someone throws a ball out to different places for you to catch or pushes against your hands and moves you around in a wrestling style, can be quite fun as well as promoting neuromuscular facilitation of rotator cuff and shoulder stabilisers. Be creative, as your strength develops there's millions of options: Wheelbarrow races with the kids, medicine ball throw and catch, crunches with medicine ball overhead throws.....ad infinitum!

It will take a little commitment, but stick at it and you'll get there.

Good luck,

Richard

 

[skyline1241]

Some good advice above. I hope it is going well for you. The trick with this type of injury is to develop such a strong, stable shoulder from a musculature basis that you no longer need to rely on the 'last chance' stopping capabilities of the joint capsule. Couple this with good range of movement and there's no reason following a single or multiple separation you shouldn't be as strong and capable as you were before the incident.

As above, make sure you have a good PT or Rehab specialist, get them to understand your need for a 'High performance' shoulder rather than one that can withstand carrying some shopping. And get them to make a programme which you buy into...there's so much to be said for you being motivated by the exercises you are doing.

For example, rehab exercises need not be boring and you can work it into exercises that work other things that will increase performance at the same time. Things like, balancing on a wobble board while someone throws a ball out to different places for you to catch or pushes against your hands and moves you around in a wrestling style, can be quite fun as well as promoting neuromuscular facilitation of rotator cuff and shoulder stabilisers. Be creative, as your strength develops there's millions of options: Wheelbarrow races with the kids, medicine ball throw and catch, crunches with medicine ball overhead throws.....ad infinitum!

It will take a little commitment, but stick at it and you'll get there.

Good luck,

Richard

Thanks you for the post.