Grade 3 Shoulder Separation

Ouch! It's pretty bad everyone. I have (almost) the worst kind of shoulder separation: a grade 3. All three of the A/C ligaments are severed and my clavicle is severely detached. The good news is that my skin is still in tact and there are no signs of skin abrasion from underneath. This means that surgery may not be necessary.

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It's possible that this injury will mostly heal on it's own. To help and give me the best chance of healing, I'm wearing a clavicle sling. A clavicle sling is like the straps of a backpack except without the pack. It's purpose is to maintain posture and to prevent slumping and favoring of the injured shoulder. I go back to the doctor in two weeks for further evaluation. If I am pain free, then I can begin rehab. If there's little or no improvement, then surgery will be required. Surgery is bad as it would necessitate cutting of a whole bunch of muscles that really do not need to be cut; it would also considerably weaken my entire left shoulder.

But if all goes well over the next couple weeks and with rehab, then I will have nearly 100% range of motion, but with a little chronic pain (ache), and a bump as the clavicle will not return to the place God intended it to be on its own. But I can live with that.

For those of you that are interested, the following text and diagrams from Sportsandortho.com illustrate exactly what happened when I fell on Wednesday afternoon and explains treatment.

A separated shoulder is a common injury among contact athletes, especially hockey and football players, but it can happen to anyone who falls and lands on the tip of their shoulder or elbow. The result can be an injury to the muscles, tendons and ligaments that hold the bones in your shoulder together. It is a very different injury than a shoulder dislocation, which is a separation of the large joint (glenohumeral) in the shoulder. Often these two types of injuries are confused.

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Evaluation
You may have a partial or complete tear of one or both of the main ligaments that connect your collarbone (clavicle) to your shoulder blade (scapula). These are the acromioclavicular (AC) joint and coracoclavicular (CC) ligaments. X-rays may be taken to help diagnose the extent of your problem and exclude a fracture at the end of your clavicle.

Your shoulder separation is classified by the extent or magnitude of your injuries.

* Grade 1: A mild shoulder separation involves a sprain of your AC ligament that does not move your clavicle and looks normal on X-rays.
* Grade 2: A more serious injury tears the AC ligament and sprains or slightly tears the CC ligament, putting your clavicle out of alignment to some extent.
* Grade 3: The most severe shoulder separation completely tears both your AC and CC ligaments and puts your shoulder joint noticeably out of position.
* Grades 4, 5 and 6 AC separations are very rare.

Treatment
Since the severity of your injuries may vary greatly, all injuries are treated on a case-by-case basis. If your injury is a grade 1, 2, or 3 AC separation, you'll possibly wear a sling for a few days until the pain subsides. It is recommended that you ice your shoulder for 20 minutes, 3-4 times a day during the first 48 hours. You may also use anti-inflammatory medications and pain relievers. In most cases, your doctor will send you to physical therapy to restore and rebuild motion, strength, and flexibility.

You may resume your normal daily activities when the pain in your shoulder eases. If you are a contact athlete, you will be allowed to return to your sport once you have full range of motion and good strength in your shoulder. You may also be required to wear special protective devices or padding.

Surgical intervention when treating a separated shoulder is very rare and only performed in the most severe cases.


Thanks for reading.

14 comments:

New York City's Watchdog said...

Oh wow... you really did it to yourself!!! I thought it was a mild one! Feel better... and take those drugs...

June 03, 2006 2:23 PM
Anonymous said...

Ouch. Sounds like a terrible injury.

I broke my arm a few years ago and I was all pity party for me, but a quick set and in six weeks the bone healed with no after effects.

And I got all that lovely vicodin...

Take care and heal quickly.

June 03, 2006 2:59 PM
Anonymous said...

I feel your pain. I had AC joint decompression surgery about 6 weeks ago on my right shoulder. I was originally diagnosed with a grade-2 to grade-3 separation. Apparently it stemmed from a childhood injury 30 years ago that caught up with me(broke my collarbone when I was 4). The MRI showed bad swelling and deterioration of the bones. The 2 bones of the AC joint were touching sometimes, which is where most of the pain came from. Physical therapy and 2 cortisone shots didn't help much. During surgery they found 2 big bone spurs. They removed the spurs and the end of my collar bone (to widen the gap in the joint). The doctor said it will hurt for about 3 months, then I should be back to normal. Good luck to you.

June 03, 2006 6:04 PM
npanth said...

Good research, I would definately corner the doc and get more info

June 03, 2006 9:16 PM
Anonymous said...

Sorry to hear that it's that bad. I hope rehab goes well and that you don't need surgury. I'll raise another pint (or several) to your quick recovery.

June 03, 2006 11:10 PM
Shelly said...

I'm happy to hear that you may not need surgery, but I'm totally wincing at the pictures of the grade 3. Keep us posted!

June 04, 2006 9:06 PM
Laci said...

I'm keeping my fingers crossed that you won't need surgery Matt.

In the meantime, enjoy the painkillers! ;)

June 06, 2006 12:29 PM
Unknown said...

Ouch! Over visiting from Karolczak.com...love your site!

June 06, 2006 12:41 PM
"Jet" said...

WOW Matt! I have been wondering where you have been! It's been awhile. I hope you are recovering quickly!

Take care of yourself and I'll send cookies or something if you want! :)

XXOO,
JTL

June 25, 2006 4:33 PM
Unknown said...

these stories all sound famaliar since I had an 3rd degree AC separation myself. they told me that I needed surgery.....now I wish that I had not been on pain pills and was able to research more before having it. 2 yrs later I still have pain and numbness in the area. Bump is still there too.

July 19, 2009 1:14 PM
Matthew S. Urdan said...

Lori, thanks for your comments. Sorry you had to have surgery. And although this is after the fact, always do your research before doctors recommend surgery. I hope you can find a solution to the pain, but the bump will never go away.

July 20, 2009 8:06 AM
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