AC Separation Post Surgery

Hello, I just wanted to share my experience recovering from a grade 4-5 AC separation because when I was in the early stages of recovery I had a lot of questions and spent a lot of time searching for answers. But now that I have been through it, I can tell others about my own experience. Since it has been 5 months now, I probably can't remember many explicit details of how I felt from day but I do remember some key things.

The short story:

For many weeks I wondered if my shoulder would ever feel the same, and I sometimes wondered if I accidentally messed up my recovery, but now after 5 months I feel 98% to full recovery.

The long story:

Let's start from the beginning. on November 16 2018 I separated my AC. It was my 1st day of snowboarding season and I was already sending front flips on the barrel bonk. But I didn't go full send when I landed right smack on the tip of my shoulder! It obviously hurt like hell so I drove home then stupidly went to my serving job that night wearing a sling because I'm dumb and my job didn't understand what I was going through and they were very busy. The next day, getting off the couch was excruciating so I went and got xrays and a referal to an orthopedic surgeon. The surgeon told me that my separation was a Grade 4 and I would NEED surgery. He even said that if I was his daughter he would make me get surgery. So I had the surgery done on November 27 (11 days after the accident). My surgeon said that he noticed during the surgery (which he didnt notice in the xrays) that my clavicle wasn't just separated from my accromium, but it was pushed backwards and protruded into my muscle a bit. So he thinks the pain level for me is probably higher than normal due to the torn muscle. He also now referred to it as a grade 4 to 5 separation... the hardware he used was a metal plate with a scoop to it and 3 screws. He predicted that he would take my plate out in about 4 months. I now had to leave my arm in a sling and not move it at all for 6 weeks, with the exception of starting arm pendulums after 2 weeks post op. Although I did take the sling off from around my neck every night. I just laid on my back and used a little pillow to prop my elbow. I recommend using a reclining chair for the first 2 or 3 nights if you have one. On surgery day, my arm and hand felt dead for the rest the day. I took a percocet that night so I wouldn't wake up with terrible pain. The next day I also took percocet because the pain was all there. The 3rd day I switched to ibuprofen since the pain really wasn't that bad by the 3rd day unless I moved my arm. The bandage was very bloody looking, which made me wonder if the stitches came undone or something, but the doc said that was completely normal.

After 2 weeks, I had met with my surgeon and had some xrays . The xrays showed my bones in perfect alignment, and I just needed to wait for the 3 ligaments to grow back together. I was told to massage my scar (after 24 hrs of bandage removal) as much as possible, and to wear the sling as much as possible. But I say "as much as possible" because in my case, maybe not your case, I didn't need to wear it around the house if I wasn't doing an activity with lots of movement like cooking or cleaning. So sometimes I wouldn't wear it if I was just going from my bed to the bathroom or bed to couch. Although I usually kept it on anyway because it felt right. During week 3, I massaged my scar and felt a weird clicking sensation in my plate. So I started thinking that I was massaging too hard causing my plate to reject which worried me for a bit. It was fine.

Over the next 3 weeks my shoulder slowly felt a little bit better. I still wasn't allowed to use any active movement of my arm. But I did once or twice test it a little and then regretted it when my shoulder felt sore the rest of the day. So LEAVE IT ALONE.

On week 5 I was feeling a lot better. I even drank some alchohol on a Friday night and didn't wear my sling (I know how stupid you think I am) but I felt great the next day (minus the hangover). I started wearing my sling a little less often but after a few days I noticed some fatigue from the weight of my arm and began wearing it full time again.

I met with the surgeon again at 6 weeks post op. He said that my recovery progress was amazing and he believed that my level of motion at this point of time was way better than expected. My arm was able to passively stretch upward nearly vertical, but not quite. And my shoulder muscles were able to lift my arm about 150 degrees from my hip. The best part of this visit was my surgeon told me that I could start waitressing again! I was so excited to work again. I usually worked from 5pm to 10pm. By 8pm my shoulder muscles felt tired and fatigued. But the muscles grew stronger over the next few weeks. I think I spent the next 4 weeks doing streches, and I had 1 PT session on week 7 post op. Stretching is important at this stage! My shoulder still hurt when trying to reach maximum overhead extension but I was told the plate itself was limiting my motion, and tissue was kind of rubbing the plate too, causing pain. The physical therapist told me that I was amazingly mobile with my injured arm. He said a girl similar in age (25) was recovering from an AC separation at the same time span, and yet she was still in a lot of pain and wasn't able to remove the sling yet. So this shows that everybody heals differently, and everyone's case could be a little different.

By 12 weeks post op, I met with my surgeon again. Xrays still looked great, and he was ready to make an appointment to remove the hardware in another month. I was so eager to get the plate removed!! And the best part of this visit was when he gave me the okay go snowboarding (as long as I promised to stay off the park and just cruise around the blue and green trails). I ended up not going snowboarding right away because I didn't want to risk going through the pain that I went through before. I even went on a 2 week roadtrip during my spring break to WY, UT, CA.. and brought my snowboard along of course. But every time we found ourselves in a mountain town (Jackson, Brighton, ect..) the conditions were either very icy or 50pmh winds (which wasn't worth 160$ lift tickets AKA 4 tanks of gas). I began to think it wasn't meant to be, like I shouldn't be risking my vulnerable AC.

On March 28th 2019 (4 months post op) I had my second operation to get my plate removed. Apparently most people don't get their hardware taken out but I'm sure glad I did. Getting mentally prepared for the surgery was much better because I already knew what it was like so I even made some humor with the nurses and doctors. The recovery was amazingly quick. I was told to keep my arm mobile and keep going on with my everyday activities and motions. I couldn't work for 2 weeks though.

I had a 2 week post op appointment to remove the bandage and get xrays. HOWEVER, the xrays showed that my clavicle went into slight misalignment and I have a small bump that I can feel but not really see. The scar isn't that bad. Looks a little worse than the 1st scar did but it's not terrible. I rub coconut oil it. Once the pain from the skin wound healed up, I immediately noticed that my arm was able to fully extend over my head without any pain that used to exist from the plate.

On May 4th I went snowboarding and I even fell a few times practicing spins on the jump and felt zero shoulder pain.

Today is June 4th and I feel great. I'd say maybe 98% to full recovery. The lack of 2% is notice when I lift my shirt over my head using a crossbody pullover motion. That feels a little tight but I'm working on it. I haven't done any weight lifting prior to or after my injury. I feel like if you're a weight lifter then you should listen to your doctor and avoid exercising to soon or to heavy because it's not worth a prolonged recovery or lifetime of complications. Listen to your body closely. Pain means something needs to healed and left alone.

Over the course of the recovery I thought many times that I was recovering too slow, or I accidentally made something worse. I also read forums that told me it would be an entire year or more to reach a full recovery. But I mostly stayed pretty positive because it is what it is. But I learned that everyone's recovery is different, and don't be alarmed if it's a slow recovery because ligaments are extremely slow at healing. I was sad to miss out on my snowboarding season but I am excited for backpacking season! It's 5 months later I have already gone snowboarding once and backpacking once.

I am so thankful and grateful that I had such a kind, wonderful, talented, positive, and confident surgeon. He was always optimistic.

I hope that this story helps you on your journey to a full recovery! The weeks and months seem long but you WILL reach full recovery!!

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