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AC Joint Reconstructive surgery
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By Chris Graham
From Bartlett, NH
Feb 8, 2012
portrait <br />

Hey Man!

Surgery is scheduled for the 22nd of Feb...two weeks and counting. I blew out all three ligaments and tore the labrum in the process. I have been climbing with the injury but still experience a lot of pain. I have difficulty sleeping at night and my traps get very tight and almost feel bruised after climbing. The clicking, and popping is getting old and I can't lift heavy objects the way I used to (tough when you heat your house with wood!!!) so I decided to go ahead with the surgery.

My Dr is going to do a complete reconstruction with donor tissue, and graft them in so I am not doing the tightrope or screw it down method. This was the only surgery that seemed to address the AC joint itself. I will definitely send you a shout when I get it done and keep you posted on my progress. I am currently working on a video to document the process.
Chris


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By Chris Graham
From Bartlett, NH
Feb 14, 2012
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Surgery is in one week (Feb 22nd), getting nervous and trying to let the idea of inactivity to settle in...I generally don't do well with being idle!

My goal is to be back climbing slab and easier routes by June! We will see.


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By clemay
From Boulder, CO
Feb 14, 2012

Chris, just think of it as an extended mud season ;-)


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By Chris Graham
From Bartlett, NH
Feb 14, 2012
portrait <br />

clemay wrote:
Chris, just think of it as an extended mud season ;-)



I will try...not going to be easy I am afraid! lol


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By Chris Graham
From Bartlett, NH
Feb 22, 2012
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success! surgery went an hour longer than expected as they discovered that i also had torn my rotator cuff so they fixed that while they were in there. let the recovery begin! thanx to all of you for the love and support. it meant a great deal to me and still does as i face the months ahead.


20 minutes ago. 5 hours post op!
20 minutes ago. 5 hours post op!

bruises (from the head of the bicep right up through the armpit
bruises (from the head of the bicep right up through the armpit


incision locations
incision locations


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By Chris Graham
From Bartlett, NH
Mar 1, 2012
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Starting to feel the tightness in my shoulder. Stitches are being removed one week from today then rehab begins. My goal is to be climbing at Cathedral Ledge before June. I am feeling like I have pulled something in my bicep, but can't be sure. Really tired of being in this flipping sling and sleeping on the couch.


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By Chris Graham
From Bartlett, NH
Mar 8, 2012
portrait <br />

Only had two stitches...the rest were glued and still have steri-strips over the wound. Eventually, the strip will disintegrate and fall off. Good news is that I can now have a full shower, and the x-rays taken today looked good. The bad news is that I am stuck in this flipping sling for 6 more weeks with very limited mobility.


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By Chris Graham
From Bartlett, NH
Mar 30, 2012
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got the green light yesterday from my Dr to start PT next week. I am now without the sling and so happy for that. Already starting to extend the arm a bit, picking small objects up with the right arm...even brushed my teeth (pain level 5) this morning! Can't wait for PT to begin.

AC Scar and Rotator Cuff scar visible. Labrum scar is located on the other side.
AC Scar and Rotator Cuff scar visible. Labrum scar is located on the other side.


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By Chris Graham
From Bartlett, NH
May 22, 2012
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hey guys!

Just a quick update on my recovery. 13 weeks post op this week, I bettered my goal of June climbing and have been climbing now for over a month! I have sent a number of hard routes here in NH, been back on the bike, have about 90% of my full range of motion back...still some soreness and there are a few movements that pinch, but for the most part, I am very happy with the progress that I have made and happy with the whole procedure. The graft is definitely the way to go. The shoulder joint is very stable and everything feels locked back in place. Now I am working on strengthening the surrounding muscles but feel that in another month I will be right back where I should be...plus a little weight (working on that one too!!!)

grammy


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By Chris Graham
From Bartlett, NH
Aug 10, 2012
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Hey there!

I am now 6 months post op and thought I would write a brief update:

The shoulder is feeling good and I would say that I am at somewhere between 70%-75% back to where I was prior to the accident.

Limitations are as follows and really only apply to climbing and little else:

1. gastons to the right both at shoulder height and above
2. lack of total strength pulling up from a straight arm hang
3. The throwing motion is coming...slowly but coming. I think it will be better by next spring.
4. deadpoints on the right arm are still uncomfortable but doable...they were out of the question two months ago
5. shoulder press still lacks strength but is getting stronger
6. Crimps above shoulder level still are uncomfortable but doable

Benefits to the surgery:

1. Ticked off a few 5.11's by the end of June so I have adapted to some of the lack of strength and range of motion
2. shoulder is much tighter
3. can lift backpack with the right arm and wear it comfortably
4. underclings are strong again!
5. pushing and pulling motions above, level to and blow shoulder 100%
6. Range of motion almost 100% and getting better
7. Virtually no pain or discomfort in the joint whatsoever
8. Can sleep on the right side with no discomfort and find myself forgetting that I ever had the procedure which is HUGE!!!

Tomorrow I race again in the 24 hour race that blew out my shoulder last year, so I am both excited that I am able to race again, but nervous that I may re injure the shoulder or something else. Today was nothing but rain, and they are predicting steady rain tonight and tomorrow for the race...right through sunday. I am not thrilled with the forecast but will take it easy and get through it.

If I had it to do all over again, I would definitely go through with this procedure. I am now able to do pretty much everything that I was able to do prior to the surgery with just a few exceptions and those my Doctor promises will get better the more I use it and with more time to heal.


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By Chris Graham
From Bartlett, NH
Sep 4, 2012
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If ever there was a test for my new shoulder, my latest project was it with two cruxes that opppose both arms and hands...sent it on the 1st of September...shoulder feels great!


Thin Line, 5.11 Attitash Crag, Bartlett, NH
Thin Line, 5.11 Attitash Crag, Bartlett, NH


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By dannl
Sep 4, 2012

Awesome, thanks for the progression of updates!


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By Chris Graham
From Bartlett, NH
Sep 5, 2012
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dannl wrote:
Awesome, thanks for the progression of updates!


Thanks dannl!


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By jamesschumacher
Feb 10, 2013

An ac separation can be serious for grade 3 and up. Most need surgery on grade 3s and all of the grade 4 and up require surgery if you wish to use that shoulder ever again. As for the individual who said he had a grade 5 and only missed 2 weeks before climbing again, he was either miss diagnosed about his injury or lying. With a grade 5 which is very sever, you would never be able to do any climbing or any other activity that requires the use of your shoulders. Many waffling ideas about whether or not to do surgery on grade 3 or higher. Get the surgery. If you dont, youll regret it later. Your shoulder will deteriorate faster, arthritis will set in stronger, and you will never regain decent strength without re attachment. I had a grade 4, and am a steel worker, and i can tell you that without surgery it would have been impossibe to do my job. You risk further injury and why take the risk. The recovery time depends on you. After surgery for the first four to six weeks, do nothing. Then gradually rehab the shoulder with a therapist. Work your way up, be consistant and dont over do it. You should do well to recover near or at 100% within a year, and your shoulder will be strong, be healed correctly, and have the support it is supposed to have so you can perform the activities that require such strength and strain. If your below a 3, surgery may not be needed. otherwise, dont fool around and risk a more serious injury or have it fail you in a most critical time. Scar tissue is no replacement for ligaments.


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By tonyre31
Feb 10, 2013

hi all,
had surgery 3 weeks ago for a stage 4+ separation after downhill mountain bike crash
how long before the pain stops?
its worse in the morning
many thanks
tony


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By Chris Graham
From Bartlett, NH
Feb 11, 2013
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tonyre31 wrote:
hi all, had surgery 3 weeks ago for a stage 4+ separation after downhill mountain bike crash how long before the pain stops? its worse in the morning many thanks tony


Tough to say Tony, but it takes a couple of months anyway. Make sure you take your meds and ice it constantly. I was given a cryocuff...it was fantastic. I slept sitting up in a recliner with pillows stuffed under my arms for several weeks. But my surgery was on Feb 22, 2012 and by the end of May I was back out rock climbing. I am moving up on a year here this month...so far so good. I am feeling strong and am less aware of the shoulder. It will take a good year or more to get it back to 100%. IT has only been this past month or so that I have kind of forgotten that I had the surgery...less aware of the surgical site...so I am happy with that. Keep up with the PT...do it religiously and you will be happy you had the procedure.


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By JoshuaP84
From Pensacola FL
Jun 5, 2014
Railay Beach West Thailand

I was mountain biking porcupine rim in Moab UT 4 weeks ago today and was within the last 2 miles of the trail and hit a steep section and flipped my bike. I now have a type 3 tear in my Left AC. (Shown in the PICS). I have been to 3 different Docs, 1 in Moab and the other 2 here in my home city. The first doc said that I probably would not need the surgery and the second doc said I prob would not need the surgery either but he sent me to another doc who specializes more in this type of injury. The third doc recommends that I have the surgery. I work as a firefighter and I am also a rock climber so given what I do for a living and my active lifestyle I am choosing to go threw with the surgery. I know there is a lot of controversy on Type 3 AC tears so I really do not know what the best option would be in the long run but I think I have decided to go threw with the surgery on JUNE 16th. I have noticed that most people that have this type of injury do not go threw with the surgery but I think I might follow Chris on this and OPT for the surgery even tho the recovery time will be long and rough. If anybody has any other suggestions or experiences I would like to hear them...

Thanks Chris for your post...this is what helped me lean more toward having the surgery

AC tear 1
AC tear 1


AC tear 2
AC tear 2


AC tear 3
AC tear 3


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By Chris Graham
From Bartlett, NH
Jun 6, 2014
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Hi Joshua!

I tore all the ligaments, fractured the clavical, tore the rotator cuff and labrum. For me, surgery really wasn't an option as I guide and climb personally. I shopped around like you have done and that is the smart thing to do. I too was told by several Doctors that I could forgo the surgery...they were the ones that started the conversation with "At your Age...". I basically checked the doctors off the list that started the conversation with that line...pissed me off.

I had the graft done in Littleton on Feb 22 and was back climbing easy rock by early May. It was exceptional, I did a very aggressive PT protocol (I would recommend this approach for you too). I was going to PT 2-3 times per week. I had climbed rock right up until the day before surgery much to my Dr's dismay. Doing that was dangerous and risky, but when they got into the shoulder there was little to no scar tissue, I had good range of motion and the muscles had not atrophied. I believe staying active aided me in my recovery post Op.

If I can stress anything Josh, do the PT...do it religiously, take the meds...work on range of motion...push it and push hard. Typically just the labrum or the rotator cuff surgery can take 6-9 months. I had the whole show done...including new ligaments and screws...clavicular reduction, etc...and was back climbing three months later. It can be done and if you are willing to fight through some pain, get high quality sports focused PT folks that know how to push you...you will be back in no time.

I still feel the shoulder. I am aware of the injury every day, it will never be 100% but I was back to climbing hard in 6 months and continue to push it at 49 years old. Good luck with your procedure and keep us posted on your progress.

Grammy


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By Evan Riley
From San Francisco, CA
Jun 30, 2014
A lovely chimney

Chris, thanks for this awesome thread! It's a godsend. I'm 4 weeks out from the surgery to repair a grade 3 ac seperation. A taxi clipped me (illegal lane change and no signal) on my bike commute and I went flying. I thought I did a good job of rolling over my shoulder, but I guess it wasn't good enough. I have the bonus of having a broken right hand and left wrist too.

Question: did you run at all with your sling on during the first 6 weeks? God knows we all love approaches (hiking) but running is way more interesting. My doc gave me the ok so long as I keep my sling on but something tells me his number of patients that ask that question is low.

My thoughts are to just suck it up for 2 more weeks but hot damn I miss running, or cycling, or climbing, or tying my shoes, or not having to use my feet to open a beer.


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By Chris Graham
From Bartlett, NH
Jul 1, 2014
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Hi Evan!
Get out there and run. I sure did...I'm not a runner..don't realky like it but it helped keep my sanity and a few pounds off. Lace them up an go!


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By JoshuaP84
From Pensacola FL
Jul 1, 2014
Railay Beach West Thailand

Well I am 2 weeks out of surgery and not feeling good! I woke up out of surgery not only with a sore shoulder but with a paralyzed left arm. Apparently the doctor either placed the clamps over my nerves during the surgery and put them to sleep or it might have something to do with the anesthesiologists...I am not sure and neither is my doctor...so basically I have a left arm that I cannot use as of right now. The doc failed to mention that this surgery could result in nerve damage. So now not only is my shoulder recovering but I have to wait and see if I get any feeling back in my left arm over the next few weeks. My shoulder is actually doing better than my arm. I have pain that shoots down from my shoulder to my finger tips because of the nerves and it sux. Makes me kinda regret getting the surgery. Apparently this is a rare thing so it only makes sense that it would happen to me.


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By Chris Graham
From Bartlett, NH
Jul 1, 2014
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Holt shit Josh, that is awful news. Any time you go under the knife you take a risk, but this sounds like somebody screwed up. Never heard of this happening. Do you have any recourse? I hope you recover from this bro


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By Evan Riley
From San Francisco, CA
Jul 8, 2014
A lovely chimney

Josh,

Give it some time. I had no movement for 2-3 weeks but by week 4 I could do 5lb curls and by week 5 I had 25% range of motion.


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By AGFW
From Durango, CO
Jul 8, 2014

Well I am 2 weeks out of surgery and not feeling good! I woke up out of surgery not only with a sore shoulder but with a paralyzed left arm. Apparently the doctor either placed the clamps over my nerves during the surgery and put them to sleep or it might have something to do with the anesthesiologists...

Josh,
If something goes wrong with surgery, the first knee-jerk response of any surgeon is to blame the anesthesiologist. Surgeons can do no wrong in their mind. The only way your anesthesiologist could possibly hold some blame for your persistent nerve injury is if you had a nerve block for postop pain. And even then, the nerve block might not be to blame. Just remember who it was cutting, retracting, and generally mucking around near your nerves in there - the surgeon. Sorry to hear about your injury. You should inquire about taking pregabalin (Lyrica) and be diligent about your PT.


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By JoshuaP84
From Pensacola FL
Jul 17, 2014
Railay Beach West Thailand

I got a MRI and I did a EMG nerve test the other day and they say that it is my radial nerve that is damaged and that it was probably caused by improper positioning during the surgery or they said the blood pressure cuff might have been to tight around my arm. So I am basically stuck waiting to see if the nerve will recover on its own. They say it could take 2-6 months. U know doctors spend all of their time in books and learning new ways of doing things in our advanced society that it just amazes me how little common sense they have so now I have to suffer for who knows how long because the doctor and his medical staff were to smart to realize a simple mistake. Very Frustrating!


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