Hi, looking to get some advice. Typing with one hand so bear with me.
Tore my AC - type 3 shoulder separation. I'm in Canada right now, doc reckoned it was about as bad as they come without immediately requiring surgery (type 4+).
For physical severity, currently my shoulder is about 35mm lower than it should be.
I fly back to Aus in 2 weeks. I'll have it re-assessed and xrayed when I get back.
I will probably start seeing a physio as well.
For those that have had type 3 separations, how did recovery go? Any issues down the track (months/years)?
Slumped shoulder, immobility, weak?
Anything you wished you'd done?
e.g. you can have elective surgery to have holes drilled into the bones and have them held in place by cables while the soft tissue connections regrow.
Hmmm, Deja vu. Wind back 12 months and I also had grade 3+ AC separation. Unlike most on this forum though, I'm 57.
I ended up at a public hospital, so saw a public funded ortho.
He saw my occupation and assumed I had been on the net (and rightly so - I'm a research scientist by profession), so discussed options with me, him erring on the side of lets give it 6 weeks and see.
Two weeks later I'm going nuts. Cant drive (well you can according to VicRoads, but you open yourself to insurance legal challenge re capability in event of accident - work wouldn't allow me to drive as consequence), cant ride motorbike, nor pushies, longer walks are uncomfortable, along with sleeping and decided to see my long term physio for advice.
He looked at my 25-35mm shoulder drop, explained the physiology of the complex joint (3 ligaments involved, all of which I had separated) and suggested I needed a second opinion. My (young but switched on) GP concurred.
I have private health insurance so saw another ortho (well known in AFL circles as shoulder/knee specialist in Melbourne). Similar discussion (but more facts, like 15% (across all ages) who don't have initial surgery have to have significant remedial surgery, along with an anticipated recovery time blowout from 10 months to 24 months: fitness helps but age against me - there is only a 6 week window for a critical ligament to repair (just doesn't without surgery), etc so, while not keen on odds really not keen on extent (my risk management approach) and decided on hook plate surgery (also has a synthetic mesh installed between scapula and acromium) . Once I made decision he then offered his basic rule: "if I can see the drop through a T shirt, recommend surgery".
So, once recovered from surgery (and recognising there are attendant risks, some of which befell me) I'm back in the car straight away, on the motorbike in three weeks, and MTB in 5.
12 weeks later plate comes out and I regress slightly until next level physio kicks in. Still a bit frustrated by recovery to some extent but have learn't shoulder stability is both muscle and ligament, so working on improving muscle memory and strength.
10 months later, I'm back to motorcyling, MTB, bushwalking and kayaking @ 90% of previous capacity, but with perhaps only 70% mental confidence.
Lessons:
1. Always, always get second (even third) opinion on stuff that has long term consequences (there is just more at stake) for you (be aware it can also have consequences for future employment).
2. A basic sling is useless. If going down that path get an orthopedic one designed for the specific injury (unfortunately ~$300 in AUS)
3. Age is a significant factor (despite being 57 and fitter and more active than most 40 yo). Was watching TeK's comment, with some frustration, on his experience at the time (he opted for no surgery) and discussing with my physio. Age means young have more time and capacity to develop muscle response to mitigate the inherent weakness in the ligaments (ie compensate for the irretrievable loss of the clavicle- coracoid ligament stability as consequence of no surgery). Fine but need to recognise ongoing stability relies on maintaining fitness of muscles involved.
4. As usual, no one size fits all. Choice of surgery or not requires information from a number of sources (and probably least of all the great unwashed unqualified and based on relatively short term experiences). See a range of qualified people to inform decision.