AC Joint Injury/Shoulder Seperation Help!

[Dizzy]

Alright brothers I need a bit of guidance . Around late Nov early Dec last year I did my AC joint in a friendly[not so friendly] game of held[street style rugby league]. It wasn't very painful but I knew something was up and I didn't go to the doctor because I thought it could be just bruising. Then the next weekend after we had another friendly game and I was going in for a big hit up and my cousin actually grabbed me by the front of my jersey and fell to the ground pulling me over top of him. I landed directly on the top of my shoulder and instantly felt pain. I couldn't move my shoulder and it wasn't a massive surge of pain, I could handle it. I felt, I'll just sit out for a minute or two and get back into it. But I couldn't move it at all, so I went to the doctor and he confirmed I had an AC joint injury. This is where it get's all confusing, I had an x-ray, the doc put me in a sling and sent me away and that was it. No advice, no medication no nothing[he looked like he had been having a bad day altogether].

3 months on, I can move it fine, when I do circles with my arm I feel like my shoulder is clicking but it isn't painful at all and any time I come into contact with things it hurts alot. The point of my shoulder sticks out the front and that's the part that hurts the most. I can sleep on it, but staying on it too long hurts as well. Rugby season is about to start and I'm thinking of going back to the doc before hand to make sure I'll be alright.
Anyone got any experience with this type of injury? any opinions on going back to the doc or is it just the injury?

 

[nickdnz]

Yeah, I do and it's an ongoing problem. About three years ago I got flipped in Hapkido onto a plank of wood and I broke my colar bone and screwed my AC joint. Been going to physio therapy almost every week but when ever I get into scrummaging position at tighthead (where I used to be best) I get a huge serge of pain, and some tackles and rucks hit on that should and I can feel it pop out again and go dead.

The only advice I can give is see a physio and see if he can work on it. For me it's been largely helpful during the off season and it's getting better slowly. The faster you get it sorted the quicker the recovery time, so make sure you get onto it.

 

[SelimNiai]

Probably not hugley relevant but I have a stage 2 dislocation in my left shoulder, basically my shoulder joint pops in and out if I move my arm in a certain way. I left it for ages but it was getting to a stage it would pop out even on a bumpy road so I had to get physio for it. The muscles around the joint are stronger now after 8 months of physio and it doesnt give me issues all the time.

Hope the recovery goes well for you mate

 

[Zed]

I did a grade 4 ac joint dislocation - so the worst. It had to have a metal anchor and a screw in for 3 months and was in a sling for 3 months. I was out of rugby for 8 months. The bone still ticks out, but is about 90%, still hurts occasionally, but is fine to tackle with etc It does sound as though you haven't had correct medical advice. You need to get a see a specialist, not a GP. The Dr in emergency who X-Rayed me, said I had a dislocated shoulder he 'relocated' it then sent me on my merry way (in agony). It wasn't until a senior Doc saw the X-ray and then pulled be back in for surgery.
A lot of the time with an AC dislocation, no surgery is required, just a sling. But that is for grade 1 or 2. Yours could have been more serious and maybe needs surgery. I'd suggest seeing a Sports Doc or a Doc associated with a sports team who would be used to dealing with injuries like this. Your average GP is not going to have a clue.

 

[Robert Prosser]

You may need an operation on it depending on teh severity of ligament damage to the clavicle:

AC dislocations are also graded from I to VI. Grading is based upon the degree of separation of the acromion from the clavicle with weight applied to the arm. Grade I is slight displacement of the joint, and a badly stretched or partially torn AC ligament. It has the normal separation of <4mm. Grade II is a partial dislocation of the AC joint with a complete disruption tear of the AC joint and a partial disruption of coracoclavicular ligament. The AC gap is >5mm. Grades I and II never require surgery and heal by themselves, though physical therapy may be required. Grade III is complete disruption of AC and CC ligaments. On plain film the inferior aspect of the clavicle will be above the superior aspect of the acromion. This can also be assessed with an MRI scanhttp://en.wikipedia.org/wiki/MRI, which will also demonstrate disruption of the coracoclavicular ligaments (the degree depending on the severity of AC joint disruption) as well as tearing of the joint capsule. The joint will be very tender and swollen on examination. Grade III separations most often do not require surgery and shoulder function should return to normal after 16–20 weeks. However, there will be some physical deformity of the shoulder with a noticeable bump resulting from the dislocation of the clavicle. Grades IV-VI are complications on a 'standard' dislocation involving a displacement of the clavicle, and will almost always require surgery.

or maybe with seperation:
[h=3]Type I[/h] A Type I AC separation involves trauma to the ligaments that form the joint, but no severe tearing or fracture. It is commonly referred to as a sprain. Most doctors treat this type of injury with anti-inflammatory drugs, pain medication and the placement of the arm in a sling or an immobilizer.

[h=3]Type II[/h] A Type II AC separation involves complete tearing of the acromioclavicular ligament, as well as a sprain or partial tear of the coracoclavicular ligaments. This often causes a noticeable bump on the shoulder. This bump is permanent. By pressing on the sternal aspect of the clavicle you force the acromial end down, and by releasing, watch it pop back up eliciting a piano key sign due to the tearing of the AC. Severe pain and loss of movement are common. Treatment is typically an arm sling, bedrest, ice and heat therapy, and anti-inflammatory drugs. Most people recover full motion of the shoulder and arm within 6 to 8 weeks, often with the assistance of physical therapy.

[h=3]Type III[/h] An xray of a type 3 separation.



In a Type III AC separation both acromioclavicular and coracoclavicular ligaments are torn. A significant bump, resulting in some shoulder deformity, is formed by the lateral end of the clavicle. This bump, caused by the clavicle's dislocation, is permanent. The clavicle can be moved in and out of place on the shoulder. It may take as long as 12 weeks for the injury to heal and in some cases even longer for shoulder strength and range of motion (ROM) to approach feeling normal. Physical therapy, with emphasis on improving strength and ROM, can be beneficial. The AC and CC ligaments are the primary static stabilizers of the AC joint. When these ligaments are damaged, the roles of the deltoid and trapezius muscles become more prominent in providing dynamic stabilization. A regimen of physical therapy will focus on strengthening these muscles. The injured shoulder may not be able to take the abuse that it could previously, but for most purposes it will be quite usable and sufficient. However, there still is controversy within the medical profession as to whether or not surgery may be necessary for optimal shoulder use in sports.

[h=3]Type IV[/h] This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius. This injury is generally acknowledged to require surgery.

[h=3]Type V[/h] This is type III but with exaggeration of the vertical displacement of the clavicle from the scapula. This injury generally requires surgery.

[h=3]Type VI[/h] This is type III with inferior dislocation of the lateral end of the clavicle below the coracoid. It is extremely rare and generally only involved with motor vehicle collisions. This requires surgery.

 

[Dizzy]

Thanks guys, for some reason I feel a sense of security from reading your experiences. I'm going to see if there are any specialists in my area because I know it's not good at the moment and I don't want to risk further injury. Hearing that your shoulders pop out every now and then really sucks, I don't want that to happen and it sounds like you're all pretty content with it. It sucks even more because I pride myself on my big tackles and I have always only ever used the one shoulder and it just so happens to be the wrecked one. Thanks again guys, I'll post up here when I've seen a specialist.

 

[Zed]

Thanks guys, for some reason I feel a sense of security from reading your experiences. I'm going to see if there are any specialists in my area because I know it's not good at the moment and I don't want to risk further injury. Hearing that your shoulders pop out every now and then really sucks, I don't want that to happen and it sounds like you're all pretty content with it. It sucks even more because I pride myself on my big tackles and I have always only ever used the one shoulder and it just so happens to be the wrecked one. Thanks again guys, I'll post up here when I've seen a specialist.

I don't think AC joints dislocate after injury like shoulder dislocations do. I always tackled with my right shoulder, since the injury I only tackle with the left (most of the time). Took a while to adjust but now it feels odd when I tackle with the right shoulder.

 

[jb12780]

Had a grade 3 seperation about 2 months ago. Wasn't very fun. Still got the bump on my shoulder.

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[TrueSlawter]

Probably not hugley relevant but I have a stage 2 dislocation in my left shoulder, basically my shoulder joint pops in and out if I move my arm in a certain way. I left it for ages but it was getting to a stage it would pop out even on a bumpy road so I had to get physio for it. The muscles around the joint are stronger now after 8 months of physio and it doesnt give me issues all the time.

Hope the recovery goes well for you mate

Bit of a bump sorry, but saves a new thread being made.. I had the same as you in a way.. if I put any weight on my arm it would pop out by around 2-3 cm.. turned out I dislocated it when my shoulder hit someones knee after loosing grip and falling into a tackle, it then popped back into place chipping the bone and deflating the capsule or something :/ waited around 4 months to get it looked at (stupid I know) had surgery to repair it all been told never to play again by one guy got told next season by physio but one question are those shoulder supports you can buy worthwhile and work? I'll be wearing shoulder pads ontop of it if I get one but I dont really know if it'd be worthwhile or just a waste of money does any one know?