Separated shoulder

I’m 6 weeks out from a separated shoulder. I crashed my bike on New Year’s Day and separated it. It did get better over the course of a month or so and is maybe 80% back to normal range of motion. But certain movements and directions cause pain and there is weakness in certain directions, especially overhead. I have not climbed in 6 weeks, and I’m not sure I could do so now without causing more pain. The ortho I saw said to give it another month, that separations can take 1-3 months to heal, and to worry about an MRI after another month. He did say I’m ok to do some light climbing, but I do think that will set it off. It seems like this is going painfully slow and I’d like to get back to doing some climbing. Anyone else have experience with a separation?

I had a 2nd degree AC separation about 10 years ago. I was out of climbing for over 4 months, and it took quite a bit of daily PT to get back into it. Any attempts at climbing before then definitely "set it off", like you said. It was probably 6-8 months before I was climbing close to my level before the injury. You can get back to it faster depending on the severity of your injury/ recovery plan.

Sorry you're going through this! This injury sucks. I'd look for the best physical therapist you can find. Mine really made a difference on my mental and physical recovery.

Separated my shoulder a week ago. The sling is good, but very surprised at how much better it’s feeling day to day. I’m hoping I can be out of the sling soon and start PT within the next 3 weeks.

I’ve heard anecdotally it takes 6+ months to get back to “normal”, and that my dreams of being an Olympic lifter are over. 

What degree separation is your shoulder?  Mine, also cycling related, was a complete grade 3. The ortho, who at that time was the head ortho surgeon for UNM athletics, told me that once the inflammation subsided and I completed initial PT, I could engage in any activity as long as I could tolerate the pain. His reasoning was that the damage was done, and I could not make it any worse. I was swimming within 30 days of injury, and was climbing about 30 days after that, or about two months post injury.

If your separation is 2 or less, I assume that you could damage the remaining ligaments. If 4 or higher, there is more damage than just severed ligaments. 

Kip Kasper wrote:

Separated my shoulder a week ago. The sling is good, but very surprised at how much better it’s feeling day to day. I’m hoping I can be out of the sling soon and start PT within the next 3 weeks.

I’ve heard anecdotally it takes 6+ months to get back to “normal”, and that my dreams of being an Olympic lifter are over. 

Yeah, within a week I didn’t need a sling. Within two weeks I was able to more easily do things like get shirts on/off, and after four weeks most normal stuff during day to day life didn’t hurt. Oddly enough putting on and tying shoes still hurts. I still think climbing would hurt a lot. I did a road bike ride at 6 weeks. It was ok, but I felt it the next day.

I think the ortho said grade II/III. He said 3 or higher actually hurts less since the is less or no bone on bone grinding. He didnt give me any PT and other than saying the rest of the X-ray looked ok, did t really assess additional soft tissue damage. Said an MRI after another month if no improvement.

I broke my collarbone and separated my shoulder (2nd degree AC joint separation) exactly a month ago today. I was in EPC when it happened and didn't make it to a doctor till I got back about 5 days later. While I was still in Mexico I was in and out of a sling as I wasn't really sure how bad I was injured. It was very painful for about 2-3 weeks and very hard to sleep, but I tried to move it as much as possible and do very light YTWL band exercises. Last week it suddenly felt pretty much fine except now I have some pain in my armpit and the outer part of my elbow. I have always had issues with my elbows, but this is a sharper pain then normal and a bit surprising since I haven't been climbing. Everything from my neck down feels tight especially where my bicep hits my elbow joint, so I have been trying to stretch those areas. Yesterday I started doing easy traversing on my home wall and my elbow is bugging me much more then my shoulder. I was even able to do a light hangboard session. Based on what the doctor said I was expecting to be totally out for at least 3 months, but it really feels like the light band work helping me heal much quicker.  I went to one PT appointment and they recommended some basic stretches. The PT also said that this is a low blood flow joint, so one way to speed up the healing is to improve your overall cardio. I don't know if this is true or not just what he told me. I did start running again as soon as the pain was bearable so maybe that helped too.   I am supposed to go back to see the ortho in 2 weeks. I am curious what he says about the other pain I developed and if it is related, but I feel really good about the AC joint and collarbone. I hope your injury heal fast! 

7/8 years ago I had a complete AC tear and then broke my collarbone on the opposite side a year later. I think the biggest issue now with both injuries is overcoming all the compensations that took control during this period. It will heal, no doubt, but you want to maintain as much mobility as possible while that happens. Earlier rather than later, make sure you can still activate the correct muscles during various movements, especially climbing. It might be worth consulting a PT anyways and just picking their brain. 

Either way, listen to your body while moving the joint as much as possible during recovery... you'll know if you are doing something bad, then back off (obviously start small). I think most modern PT's are on board with moving the joint/tissue in all phases, as much as possible, whilst avoiding pain. Wish I had done that. 

Just my 2 cents. Good luck! 

My wife chipped part of her shoulder in a mountain bike crash.  That was back in August.  She did her Physical Therapy 70% of the time (slacker!), but she does not have the strength, flexibility, or mobility.  This past weekend, she had followed a steep 5.7 and 5.4 and was really struggling because of a weak shoulder and affiliated pain.  Of course, lower angled routes she was fine on.
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So...  I realize the injury isn't the same.  Yours is much worse.  I suspect its going to take time and you have to stick with physical therapy.

csproul wrote:

I’m 6 weeks out from a separated shoulder. I crashed my bike on New Year’s Day and separated it. It did get better over the course of a month or so and is maybe 80% back to normal range of motion. But certain movements and directions cause pain and there is weakness in certain directions, especially overhead. I have not climbed in 6 weeks, and I’m not sure I could do so now without causing more pain. The ortho I saw said to give it another month, that separations can take 1-3 months to heal, and to worry about an MRI after another month. He did say I’m ok to do some light climbing, but I do think that will set it off. It seems like this is going painfully slow and I’d like to get back to doing some climbing. Anyone else have experience with a separation?

What grade was the separation.... huge recovery time difference depending on how bad it is.
I got a grade 5 years back. Took almost year before I could climb at all.
I got a sweet love handle on my shoulder now. Push ups and pressing are still not back to full capacity and I doubt ever will be.

Mr Rogers wrote:

What grade was the separation.... huge recovery time difference depending on how bad it is.
I got a grade 5 years back. Took almost year before I could climb at all.
I got a sweet love handle on my shoulder now. Push ups and pressing are still not back to full capacity and I doubt ever will be.

It is also important to note that all separations from 3 and up are complete separations and all will give you a hump. 4 & 5 also have displacement as well as bone and/or muscle damage, which is really bad. Grade 3 is probably the best grade of separation you can get, as you have annihilated the ligaments but everything stayed in place and you can’t cause any further damage.  

Light climbing is usually fine, if you truly have to pull hard it hurts. Pushing exercises actually help a lot. Try bench press, incline press, shoulder presses with light weight if you can do them pain free. It has taken me almost 6 months to have my shoulder near to full strength again and I can finally do pull ups again, those are the real test for if it is healed or not. 

It is possible to have it flair up or become inflamed so listen to your body and stop if something hurts alot. 

I crashed my bike on Halloween and was diagnosed with a grade 2 AC separation. I only used the sling for a few days, and my doctor told me to "let pain be my guide". So I started gym climbing again 2 weeks later on easy stuff (5.5). Basically I climbed one handed and used my injured arm only to lightly stabilize myself, keeping it close to my body in a comfortable position. I stopped whenever I felt bad injury pain and did not really push it. I began to use climbing holds to facilitate stretching the bad shoulder, gripping a hold with arm extended and muscles relaxed and exploring the limits of my range of motion. At about that point I began getting back into my morning sun salutation yoga routine. I believe it was another couple weeks before I could do a plank or downward dog, and a couple more weeks before I could do a single pushup. Now, almost 4 months out I am back to climbing the same grades I was before the accident, although my pecs and deltoids are still a little weak. My shoulder gets fatigued more easily and it still kinda crunches sometimes. It is still uncomfortable to sleep on my right side and the distal end of my clavicle still pokes up in the mornings, forming a wicked bump. I credit my recovery to "letting pain be my guide" as I tried to get back into my normal life/workout routine ASAP.

As a follow-up, this video really helped me

AC joint separation grade 3 successful rehab protocol

Harry K wrote:

Light climbing is usually fine, if you truly have to pull hard it hurts. Pushing exercises actually help a lot. Try bench press, incline press, shoulder presses with light weight if you can do them pain free. It has taken me almost 6 months to have my shoulder near to full strength again and I can finally do pull ups again, those are the real test for if it is healed or not. 

It is possible to have it flair up or become inflamed so listen to your body and stop if something hurts alot. 

Thats way different from my recovery. I was doing pull ups well before could do even a knee push. Pulling only hurt in certain positions, where pressing just hurt no matter what for ages.  

Cest la vie!

The listen to your body aspect is very real IME with this kind of injury. Knowing the difference between being uncomfortable and being in pain was a balancing act.... lots of re learning for the body.

• Mr Rogers wrote:

Thats way different from my recovery. I was doing pull ups well before could do even a knee push. Pulling only hurt in certain positions, where pressing just hurt no matter what for ages.  

Cest la vie!

The listen to your body aspect is very real IME with this kind of injury. Knowing the difference between being uncomfortable and being in pain was a balancing act.... lots of re learning for the body.

Totally, everyone is different!  I definitely did have pain while doing bench press or push ups for a long time, maybe three months.  I would say around 3-4 months a person can start pushing hard again but it really does seem to take a while to gain back full strength. I have read it can take up to one year if you bash it good.  

I had a grade III separation several years ago. I was told I could do whatever I wanted as long as I could tolerate the pain - I couldn't make it worse and it was going to "heal" at the same rate regardless. (It was explained to me that "healing" meant my body would build up scar tissue around it etc.) So... for me, I did whatever I could tolerate - which was surprisingly quite a lot. So... if it's grade III this non-doctor says, climb away if you "feel" like it. Can't say anything about grades I or II.

Think mine was four weeks ago, hockey incident. The day after the incident felt like it was a life changing injury, but I then saw 100% day over day improvement. Monday I couldn’t lift the arm away from my chest without extreme pain. Tuesday I was helping move furniture (limiting to dead hang), but was still struggling with range of motion. Getting better, better, Friday was my big victory I was able to apply a bar of soap into my opposite armpit, previously bringing the arm across was the most lasting pain. That Sunday I played hockey again and kept it at 50%. My PT told me to do as much as possible and ensure to keep my pain below a 7/10. I’m grateful because this advice was contrary to the cautionary advice of all else. I still haven’t climbed but I think I’m ready for some light duty, and I have done very controlled pull ups. They only diagnosed my Grade 2 via X-ray so who knows, maybe a lighter injury. That first day/night was intense though. I’m sort of able to get not great sleep on that side right now, but still having other issues of pain when sitting funny against the couch or cold-related issues.

Dunno if any of that helps, but I think a positive PT and having to furnish a home office (covid related) day two of my injury, that both those lead me towards a quicker recovery.

Did any of you folks have extreme crepitus in your shoulder? I’m 8 weeks out from a low grade ac sprain (x ray didn’t even show it, basically diagnosed by my PT) and while I have some light pain with certain movements, my rom and overall pain has improved a lot. That said, I’m getting WAY more crunching, grinding and popping in my shoulder than I had in my early stages. I can recreate the crunch any time I engage my scapula hanging on a bar but it also happens randomly. Rarely, but occasionally, I can actually feel my collarbone moving too. I usually don’t feel pain with the crunching but it feels super gross. Anybody else have anything similar? Did the noises eventually stop? I’m headed back to the ortho on Monday but I read this thread and I like hearing others experiences. Cheers

jed wards wrote:

Did any of you folks have extreme crepitus in your shoulder? I’m 8 weeks out from a low grade ac sprain (x ray didn’t even show it, basically diagnosed by my PT) and while I have some light pain with certain movements, my rom and overall pain has improved a lot. That said, I’m getting WAY more crunching, grinding and popping in my shoulder than I had in my early stages. I can recreate the crunch any time I engage my scapula hanging on a bar but it also happens randomly. Rarely, but occasionally, I can actually feel my collarbone moving too. I usually don’t feel pain with the crunching but it feels super gross. Anybody else have anything similar? Did the noises eventually stop? I’m headed back to the ortho on Monday but I read this thread and I like hearing others experiences. Cheers

I too have a fair bit of crunching, grinding, etc on my AC  joint side whereas my surgically repaired collarbone break has no crepitus. Both sides are equally tight and require constant maintenance but also due to lifestyle/desk job. 

jed wards wrote:

Did any of you folks have extreme crepitus in your shoulder? I’m 8 weeks out from a low grade ac sprain (x ray didn’t even show it, basically diagnosed by my PT) and while I have some light pain with certain movements, my rom and overall pain has improved a lot. That said, I’m getting WAY more crunching, grinding and popping in my shoulder than I had in my early stages. I can recreate the crunch any time I engage my scapula hanging on a bar but it also happens randomly. Rarely, but occasionally, I can actually feel my collarbone moving too. I usually don’t feel pain with the crunching but it feels super gross. Anybody else have anything similar? Did the noises eventually stop? I’m headed back to the ortho on Monday but I read this thread and I like hearing others experiences. Cheers

I did have crunching. It was not crepitus but scaring. It was accompanied with a dull ache, and resolved with time. I had a lot of soft tissue damage with mine. My color bone never moved despite a complete separation. 

thanks for the responses. Met with the ortho today and he said as long as theres no pain the crunches don't matter, which has given me some hope to try some 5.7 top ropes at the gym. although he did order an MRI for a few weeks to rule out a labral tear..