View Full Version : Type III ac separation and aikido
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11-26-2006, 04:47 PM
Nope, I didn't get it doing aikido (went over the bars on my bike when I blew a biggish jump (yes, I know that at 37 I shouldn't be doing jumps (Silly Paul, jumps are for kids!))).
Anyhow, it's done and I'm wondering how it has effected other's training. I know that I won't be training for a couple of months, and may even take the month off of teaching, but I'm wondering more about the long term. If anybody has had experience with this injury, and how it affects your ability to take ukemi, or anything else, I'd greatly appreciate it.
11-26-2006, 11:26 PM
I got the same injury in Judo. I was a student at Stanford at the time and I saw the surgeon who treats the Stanford football team, who recommended against surgery. I had some pretty intensive physical therapy starting from a week or so after the injury. I was told that it's bad to immobilize the joint, so they took my arm out of the sling very quickly, it seemed to me. I was supposed to avoid doing things which hurt, but other than that could do anything I wanted to.
Recovery (for me) was very slow. After 3 or 4 months I could do everything around the house and could take ukemi as normal, but my shoulder still hurt when I lifted weights. It took about a year for that to stop, at which point I considered myself healed.
At this point the only lasting impact is that I have a bump on my shoulder. I'm stronger now than I was before the injury, and I have the full range of motion in that shoulder. I don't know what the effects will be as I get older, although I suspect that there is a higher likelihood of getting arthritis or something similar in that shoulder.
My only advice would be to take it slow and to get to the physical therapist. I think the therapy helped a lot, both in speeding the healing process and in recovering my range of motion.
11-27-2006, 01:21 AM
Ouch -did it a year ago snowboarding. In some countries they recommend surgery, in others not. I went with not. In UK they usually just give it to models "how about people who are just vain" was my respoonse at being told this) for aesthetic reasons.
Think I started a thread about this last year.
Has taken a year to get completely better, but was on the mat a few weeks after which was probably too soon. Ukemi sill a little awkward on that side still, but manageable. Bump grosses people our which is fun.
When you get better keep jumping - no age limit there man!
11-27-2006, 12:05 PM
Interesting it was not done on the mat - it is one of the most common newbie injuries, caused by letting weight fall onto the shoulder in forward rolls.
I was taught, and once applied, an old technique for immobilizing via athletic taping, involving a coin at the point of separation (I'm told in old days the sensei would use cigarette butts; this may be apocryphal) and a rolled towel used as a temporary spacer during application to keep it from being too tight.
This is now out of fashion in western medicine, where for most acl separations they counsel rest and slow return to use w/ physiotherapy involved.
my own first degree separation, about 10 yrs old, every now and then bothers me if I try to lie on that side in cold weather; never flares up in training.
11-27-2006, 08:07 PM
it is one of the most common newbie injuries, caused by letting weight fall onto the shoulder in forward rolls....therefore a problem for newbie females in particular. I've seen women who spend YEARS with sore painful shoulders. Ouch!I was taught, and once applied, an old technique for immobilizing via athletic taping, involving a coin at the point of separation . . . This is now out of fashion in western medicine, where for most acl separations they counsel rest and slow return to use w/ physiotherapy involved . . . my own first degree separation, about 10 yrs old, every now and then bothers me if I try to lie on that side in cold weatherI find this quite amazing. An AC separation is a SEPARATION and often a DISLOCATION.
Whence comes the astonishing notion that a DISlocation need not be RElocated?? From the medico-bean counters perhaps? The Bad Patient who wants the AC separation reset is trying to steal our Christmas Bonus? How about NOT setting it, referring to phy$iotherapy and if that doesn't satisfy the patient, then on to $urgery. We wouldn't put up with such nonsense if it involved an arm or a leg or a jaw . . . why put up with a big shoulder lump (by definition a DISLOCATION) that hurts for the next 10 (or 20?) years?
To me this sounds a lot like the oversheduled orthopedist who counsels "Wait and See" for a torn Achilles tendon which in my opinion is bleeping nuts. Things do not necessarily magically reattach when left to shorten and contract ending up further and further away from what they need to reattach to. They CAN, however, reattach very nicely if shoved back into position
Sit! Stay! Heal! -- hence the coin as splint at point of separation.
11-27-2006, 09:11 PM
...therefore a problem for newbie females in particular. I've seen women who spend YEARS with sore painful shoulders. Ouch!I find this quite amazing. An AC separation is a SEPARATION and often a DISLOCATION.
Whence comes the astonishing notion that a DISlocation need not be RElocated?? From the medico-bean counters perhaps? The Bad Patient who wants the AC separation reset is trying to steal our Christmas Bonus? How about NOT setting it, referring to phy$iotherapy and if that doesn't satisfy
the patient, then on to $urgery.
I can't speak for the others, but in my case the tendons were completely severed between my collarbone and scapula (I think). I would have had to wait a month or so for the swelling to go down before surgery, and the recovery from surgery would have taken much longer than recovery from the injury. The only real benefit from surgery, in my case, would have been to reduce the bump on my shoulder, so I decided against it. I didn't feel pressured by my surgeon, who gave me his opinion but left the choice on surgery up to me. From my research and from talking with other doctors, this seems to be a common course of action for type III AC separations at this time.
My impression is that it's not like a dislocation or broken bone where it needs to be put in place to heal. Once the tendons are torn they will not grow back. Immobilizing the joint during healing sometimes reduces the size of the resulting bump, but from what I read that often doesn't occur, and when it does the effect is not very large. Also, the injury is supposed to heal faster if it's not imobilized. Functionally, I don't think there's any benefit to setting the joint, at least in my case. Perhaps if the tendons are still partially connected there is some benefit.
Anyway, that was my experience.
11-28-2006, 12:29 AM
Same thing happened to me mountain biking a few years back.
Funny story, when the doctor first did the X-rays he didn't have me hold a weight in my hand and ended up misdiagnosing it as a dislocation. It didn't dawn on him that it wasn't a dislocation until after he did a shihonage on me over and over but wasn't able to get the shoulder to pop back in..... good times :hypno:
Hey, in the future, if someone dislocates their shoulder and I'm around I'll just get some practice in :D
To clarify what it is, it's not a dislocation. It's when the clavicle separates from the scapula. Basically you rip or stretch the tendons connecting the two. Mine was type II, some partial tearing. Surgery is a waste unless you are really vain or need 100% of your range of motion back. Also, even with the surgery your looking at a nearly guaranteed re-separation in the future if you are moderately active. No thanks.
Like must others it took a solid year before it was back to 95%. I did start doing light weight lifting after about 4 months which helped I think.
I would say don't do any rolls or falls until a year at least. I actually caused additional tendon damage by trying to get on the mat to soon which put me back about 4 months in the healing process. You may have to modify your forward rolls as well so be ready for that. Also, stay far away from any shoulder isolating locks for a year as well. Learn from my mistakes :D
11-28-2006, 01:04 PM
Thank you all very much for your insight, I really appreciate it. It's good to hear that most of you that have had this injury have been able to return to training at some point. It looks like teaching without training much will be a plan for at least a couple of months, and that falls on that side will be out for possibly a good bit longer. That hurts a bit to think about, but is bearable.
Again, many thanks,
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