A.C. joint seperation

ivanooze · #1 08-12-2017, 01:14 AM

-on a fateful afternoon of august the 1st 2017 i participated in a weekly mountain bike race at irvine lake called over the hump. it was my first mtb. race so i was pretty excited/nervous.

-i knew that the race will have a cyclocross feel to it in that you have to explode from the gun to get a good position going into the climb or into any single track parts of the course. this is the type of racing i love, being at threshold from the beginning and holding it for the entirety of the race. Full on grinding through the course with no real strategy, no covering moves for teammates, no slowing down, etc.

-race starts and i get left behind from the beginning. I've never had a good start to a cyclocross race which carried on into this race as well, but i wasnt worried because before the technical stuff came, i had a huge amount of dirt and rocky pavement to move around in and pass all my competitors which i did.

-coming up on the one major climb of the race i knew i had to do some amount of pacing here otherwise i would blow up and get caught (the 1 piece of strategy that i followed). Regardless of how i went up the hill, there were still 2 other guys that passed me, and my hat goes off to them. at the top of the hill there lay waiting the descent, a tricky (in my mind) single track descent through some slightly muddy, yet solid, bee infested trail that takes you down for about 2 miles or so.

-i had the chance to pre-ride the course so i knew what to expect, but... seeing as how there were 2 guys ahead of me, i knew i had to make up some amount of time. and this is where my ego got the best of me...

-as soon as i approach the descent, i ramp up the speed and make it all of 30 feet down the single track before going shoulder first into the dirt beneath my wheels. yep... i endoed pretty hard and flipped over the bars. as soon as i made contact with the dirt i heard a snapping noise. i get up right away and feel my collar bone. this is the part of the story where my kinesiology degree came into play and i didn't feel like a complete idiot.

-i felt a lump on the lateral side of my clavicle and did a self-diagnosis of my injury. My self-diagnosis was correct in it being an AC joint separation.

- luckily, there was a medical cart at the top of the hill just 30 ft. above me, i figured the logical thing to do was to go up instead of take my bike with a tacoed front wheel and try and ride down. i get to the top, they drive me down and i get a makeshift sling from the paramedic.

-here's where i thought the story was a bit tragic: the medic that put the sling on me asked what happened, so i told him the story then i told him that my AC joint had separated, he was what that was. In my mind i rolled my eyes and was thinking to myself "bro.... you're a medic and you dont know what that is? wasn't anatomy a prerequisite to get into any health field, especially when you get a job that deals with people in a life or death situation?"

-anyways.. I digress from the main point in all of this. i saw the ortho. and he mentions that i dont need surgery. I asked him if i'll be able to have FROM because i need to be able to rock climb as it is my passion off the bike, he says yes but in such a nonchalant tone. Does anyone have any experience with this particular injury? had surgery or not had surgery?

merlincustom1 · #2 08-12-2017, 04:01 AM

Depends on the grade of separation. 1,2, and 3 don't require surgery, and surgery is the way for grades 4, 5 and 6. I had a 5 from a bike crash and had surgery. By 6 months I had full recovery, could do pushups, handstand, etc. no limitations. That was 10 years ago and my repair is still perfect. You'll be ok.

regularguy412 · #3 08-12-2017, 08:41 AM

I separated my left AC many years ago in a road race. Happened similarly to your explanation.

I was in a chase group of 5 off the front ,,, chasing 2 guys at the front of the race. It was flat and we were pretty fast ~26mph. along the right edge of the road ran a BIG ditch ~ 8 ft deep and 10 ft wide. I pulled off the front and was sliding into position at the rear. I dunno if I sped up or the guy whose wheel I was getting slowed, but I managed to clip his back wheel with my front. Didn't go down right away, but when I looked up, I was gonna do a lil cyclocross down the ditch bank @ 25 mph. I hit the brakes, but of course, grass doesn't stop 23mm SuperComp HD's too well. I was still upright, but hit something HARD! hidden in the grass. I was still on the brakes, so I couldn't easily let go of the bars. I flipped completely straight over the bars and woke up on my back in the bottom of the ditch. I had to take my cleats off just to climb outta there. I knew my left shoulder was really sore and couldn't move it much.

I never got it checked out. 2 days later with my hand hanging straight down by my hip, I could not raise my hand straight out to the side more than a foot from my leg. Over time and wearing the arm in a sling for about 3 weeks, the full range of motion came back. I can now raise my hand from by my leg to straight up overhead. I've done a lot of rehab with light-er weights, but there's still a small amount of looseness in the joint and that shoulder tends to get 'tired' easier than the right shoulder.

All in all, I'm glad I didn't have surgery. About 5 years later, I went over the bars again in a training ride and broke the collar bone on that same side. Poor ol' left shoulder has been on the receiving end of a couple of my roughest crashes.

** added note-- my old Giro ProLight helmet came apart in 3 pieces when I took the lycra cover off AFTER that wreck down the ditch bank. I didn't even KNOW that I hit my head.

Mike in AR

beeatnik · #4 08-12-2017, 09:33 AM

Heal up.

ivanooze · #5 08-12-2017, 11:21 AM

Quote:

Originally Posted by merlincustom1

By 6 months I had full recovery, could do pushups, handstand, etc. no limitations. That was 10 years ago and my repair is still perfect. You'll be ok.

this is the reassurance i needed. I neglected to mention to the doc. that i do a 100 burpees a day and was worried that this injury would prevent me from doing that again. So dynamic movements such as burpees should be fine?

PeregrineA1 · #6 08-12-2017, 11:30 AM

I wondered why you were so non-chalant when I asked if you were OK as I rode past you....

merlincustom1 · #7 08-12-2017, 12:39 PM

Quote:

Originally Posted by ivanooze

this is the reassurance i needed. I neglected to mention to the doc. that i do a 100 burpees a day and was worried that this injury would prevent me from doing that again. So dynamic movements such as burpees should be fine?

Yeah. I've been lifting overhead in the gym since my recovery.

ivanooze · #8 08-12-2017, 01:30 PM

Quote:

Originally Posted by PeregrineA1

I wondered why you were so non-chalant when I asked if you were OK as I rode past you....

you were at the race? awesome! i figured i have to stay calm and not freak out. That's always been in my nature whenever i crash in a race or on a training ride. Makes things much easier for the medics when they deal with someone calm rather than being overly dramatic.

PeregrineA1 · #9 08-12-2017, 02:41 PM

I bring up the last 25% of the Sport 50+ class every week. #443.

Sent from my iPhone using Tapatalk

sfghbiker · #10 08-13-2017, 09:30 AM

Similar to story to those above. Had non-surgical low grade AC separation after a crash. Limited ROM intentionally for about a week and then returned to use and let my shoulder tell me what was ok. Had full return of strength and range within several months. That being said still weaker than the other side so that will take some time

doomridesout · #11 08-13-2017, 04:46 PM

I did a Grade 3 separation in a similar MTB endo incident a few years ago. Went to the ortho and was given some take-home exercises and therabands. Kept after it and I managed to get back to normal-ish, but I still get some asymmetric soreness sometimes and I'm not sure I could go back to the pull-up routine I had before. I'd say I had a good experience just keeping up with a self-managed PT routine, but I would strongly emphasize to your doc that rock climbing is important to you and see what they say. I still don't have the strength in my left shoulder that I used to and certain types of motions and lifts can make me sore in weird places in my neck. Good luck, and heal up quick!

Seramount · #12 08-13-2017, 05:04 PM

sustained a Grade 3+ separation one year ago...

did chiro, massage, PT...shoulder is weaker than before the accident, but I can swim and ride with no issues now.

the joint is noticeably weaker than before, but I wanted to avoid surgery if at all possible.

shovelhd · #13 08-13-2017, 07:42 PM

Quote:

Originally Posted by Seramount

sustained a Grade 3+ separation one year ago...

did chiro, massage, PT...shoulder is weaker than before the accident, but I can swim and ride with no issues now.

the joint is noticeably weaker than before, but I wanted to avoid surgery if at all possible.

Same here. Surgery was an option, but it's a 50-50 proposition at best, and if you land on it again, it's all over. I chose PT and rehab. It took 3 years to regain my strength without pain, and it still flares up every once in a while, but it's in a state now that I can live with it.

YesNdeed · #14 08-14-2017, 10:23 AM

Quote:

Originally Posted by merlincustom1

Depends on the grade of separation. 1,2, and 3 don't require surgery, and surgery is the way for grades 4, 5 and 6.

This is also my understanding. I have a type III resulting from a shoulder to pavement contact crash, five years ago. No surgery was my ortho's recommendation. I would say I have 90% or more use of my shoulder. I haven't rock climbed since before the accident, but I am confident it would be OK, not that I am anything like a skilled a climber. I make adjustments as necessary while doing yoga, and that's about the extent of my limitations.

benb · #15 08-14-2017, 10:41 AM

Maybe someone else with more MTB racing experience than me can comment, my racing was a long time ago, perhaps before I even really knew what Threshold means, but MTB is not cyclocross... you don't want to go quite as intense as you need to maintain concentration + some energy reserves to deal with the technical stuff. For me if I ride too close to threshold too long it's almost a guarantee I'm going to be too cooked to jump a log or get up that short 30% section or whatever that you need to deal with in MTB.

Best wishes on the recovery. I kind of wonder if I did something like this way back when... I had a bad shoulder thing from a crash and stupidly didn't go to the doctor... it went away and I managed to rehab it myself by the next season. I was young and dumb.