AC Shoulder Sprain - Grade 3 Separation

ev79sf

New User
Has anyone else had to deal with an ac shoulder sprain grade 3 separation? Not fun! Normally caused during high impact sports. I ran for a drop shot and lost my balance running forward, rolling onto my shoulder. The ER and X-rays show no other muscle or bone damage. It is essentially stretch out and torn ligaments causing your bones to separate about a finger width.
There is a lot of debate whether or not surgery should be done for this type of injury to push my collarbone and shoulder back together or let it heal and make new soft tissue. Lots of people (including my doctor) and articles say you recover 100% most of the time... but they are not tennis players. I'm so concerned about overheads and serves becoming a chronic pain problem. Any tennis players here go through this injury? Looks like I'm off the courts for around 2 months. It's been 4 days. I guess that's 1/15th there hahaha.

THANKS :)
 

Devil_dog

Hall of Fame
Also had ac joint shoulder separation and the pain and lack of movement was to the point I could barely swing a racquet. Serves and OH were out of the question. Went to Airrosti for a consult and they had me serving again within a week. I had 4 visits and in-home physical therapy and I'm pretty much back to normal before the injury. Good luck and hope you have a quick recovery too.
 

LeeD

Bionic Poster
Crashed motocross in 7 years, easily 150 AMA sanctioned races, 20 CME, and 20 CMA outdoor races.
Separated my left shoulder 3 times, my right once. Dislocated each one once. Totalled 4 collar bone breaks, each one broken twice.
Everything heals, but can you delineate when it's healed divided by the year's you've aged? I never went to a doc except for the first separate and the 2nd collarbone break. Never had further treatment besides the first useless visit. "How much pain can you stand?" Don't ride motocycles. Riding is fine, I was CRASHING.
Just before I started my 2nd try at motocross, I was times at 129 mph at the old Golden Gateway Tennis Center in San Francisco.
Didn't get back into tennis for 11 years, and when I came back, everything was rusty (I'd suffered two more compound tib/fib fractures with handfuls of pins, plates, and screws), and maybe I could serve just over 110 max.
Now, another 35 years after the motocross injuries and some aging, I can serve right at 100 mph, fastest of 90% of 4.0 level players, but cannot approach the old days. I can't run, haven't for 9 year's now, so not much pushoff on serves, nor hop up to the ball.
Everything heals ,but very few ever come back to before the injury status.
 

shindemac

Hall of Fame
I had a shoulder pop out so i don't know what you classify that as. And i had an initial bad fall, that weakened my shoulder, but no dislocation at the time. It will take a few months of rehab and recovery to get your strength and flexibility back.
 

movdqa

Talk Tennis Guru
A friend tore a ligament in his rear shoulder. Had a doctor look at it 9 months later because he was missing some strength. Doc said that they could have reattached it if he brought it in much sooner but they can't reattach it and it has shrunk now. So he's playing left-handed these days.
 
I had a grade 3 AC joint separation from a fall back in August 2009. I was not playing tennis at the time, so opted to just do rehab and not have surgery. It took 1.5 months to get full range of motion. My shoulder still has a bump where the collar bone doesn't lay down like it should.

Fast forward to October 2010 and I started playing tennis again for the first time in about a decade. Granted there was a ton of rust to knock off. But, as far as the shoulder goes, it took 8 or 9 months before I had no pain and full confidence in serves and overheads. I have been playing ever since with no issues, even using full beds of poly. I hit a OHBH and get into the net a lot, so the shoulder certainly has a lot to do when I play.

For me, the best thing during the recovery period and when I started back playing tennis was to (1) make sure you got a good warmup; (2) don't overdo it; and (3) make sure you cool down/stretch every time. As for #2 above, I didn't really hit flat serves for well over 6 months. I didn't really consider my serving as being to the level of a true 2nd serve for those first 6 months too. Use this time as a chance to commit to working on placement and/or easy spin on your serve and overheads. That will benefit you in the long run once your shoulder heals.
 

ev79sf

New User
Really helpful and encouraging stuff, thanks. I rarely hit flat serves, though I try them up the middle here and there, especially to a weakness. Generally I'm spinning them out wide either with slice or kick or both. My serve isn't super fast, but it has a lot of action on it. Placement is the most important thing, most of the time anyway. I've won whole matches based on it. I hit with multifilament and go through them about every 3 weeks. I like the comfort and feel.

I'm likely going to opt for just rehab and phys therapy and keep training ongoing. From what I've seen, some people have had bad surgery experiences, too... and it looks like a much worse recovery. I'm pretty good about stretching, so I'll keep diligent. Has anyone tried those neoprene shoulder braces, like the EVS ones? I used one for another injury a few years ago and I found that it brought warmth and peace of mine until I weaned myself off. I'm not too worried about ground strokes... it's serves and overheads that scare me. Both of them are so important to my game and strengths, as I like to play at the net and come in after serves, and people like to lob. My ground strokes are generally more about placement and spin than powering someone off court. I don't hit many flat shots at all.
 

adamino

New User
Also had ac joint shoulder separation and the pain and lack of movement was to the point I could barely swing a racquet. Serves and OH were out of the question. Went to Airrosti for a consult and they had me serving again within a week. I had 4 visits and in-home physical therapy and I'm pretty much back to normal before the injury. Good luck and hope you have a quick recovery too.
Can you tell us what the Airrosti visits were like,what they did,treatment etc?
 

elga

Rookie
Had a complete separation of left shoulder (I'm right-handed) from landing directly on it on concrete. Sling immobilization for a bit, a couple months off with rehab/PT and made a 100% recovery. Played D1 basketball and if didn't affect any strength or ROM after recovery - this was about 9 years ago. Even today when I shrug the shoulders there's an obvious bump (google image and you'll see what I mean).

It's really nothing to worry about in my non-medical opinion, having had 100% recovery with no surgery, and even if I were a lefty I'm sure it wouldn't have affected playing tennis full force even with serves and overheads. Obviously lean on your doctor for advice...and if he doesn't recommend surgery in your case then he's likely doing you a favor and knows what he's doing. Dislocations and torn labrum are much more of an issue.
 

Dartagnan64

Legend
I've had 7 shoulder dislocations and one surgery. And a broken collarbone. All by age 21. No other problems in the last 30 years. The broken collarbone healed. The dislocations eventually stopped (and not due to surgery but more due to altering my activities). The surgery left me with very limited ESR and shoulder power. I was told I'd never play baseball, football, tennis again. I learned to throw sidearm and alter my serve technique so i could still play those sports with friends. But I still have a crappy serve and overhead and likely always will.

An AC sprain is nothing like a dislocation fortunately. The shoulder joint is stable. It's painful but that will eventually heal. The pain can lead to restricted ROM, so rehab and stretching/strengthening exercises are an eventual must. But 100% functional recovery is the norm even for 3rd degree seperations.
 

ev79sf

New User
By the way I'm about 7 weeks into the recovery... getting lots of range back but still not enough to consider playing with my right hand. However, I've been playing lefty, and not too badly! Thanks for all your encouraging responses. I'm enjoying the PT and there is less and less pain each day.
 
Thanks for the update. I remember recovering from the same injury. I went to play a softball game at around the same time period after injury. At that point I could throw a softball about 20 feet. Anything longer than that I had to toss underhanded. I thought I would be able to bat and just drop my dominate hand off the bat for the follow through. BUT, muscle memory took over on that first real swing. It hurt a bit and was an ugly swing. I barely made contact with the ball and ended up hitting a full swinging bunt single that went about 18 inches.

It is definitely a process. Keep working.
 

elga

Rookie
Glad to hear you're improving quickly - are you doing rehab / PT now on it instead of just rest? Just curious what the doctor recommended for you. Projection about 5 more weeks or so to full recovery?
 

ev79sf

New User
Therecanbeonlyone - great story. Looks like you got full range of motion faster than I. I'm 7 weeks in and far away from that. But every day is a little better.

Thanks, Elga. I am doing PT, yes. I can do biceps, triceps, rotator cuff strength training as well. And several slow controlled movements to try to get my range back. I'm still nowhere near getting my arm over my head, but I have a little more than 90 degrees. That's forward and to the side. Within the range, there is little pain or discomfort. Out of the range, it pops at times and definitely lets me know if I go too far... strong pulling. I'm able to play lefty tennis for now (at a low 3.0 level I'd say.) I COULD hit the ball with my right, but only short court, as I have no ability to follow through. So I'm just leaving that alone until I'm recovered. I'm guessing 5 weeks sounds about right for when I'll be able to play... hopefully sooner at least I can gently rally with my right. I really messed myself up with this injury. I still cannot sleep on that side. I was out of work for a month. I'm just glad I didn't break anything or do worse damage.
 
Therecanbeonlyone - great story. Looks like you got full range of motion faster than I. I'm 7 weeks in and far away from that. But every day is a little better.
You are right. I gained full ROM at about the 6-7 week mark. I remember going back to the doctor at the 4 week mark and still couldn't do anything toward the right side of my body (left shoulder injury). However, at that time I had pretty much full ROM on the left side...just couldn't reach across my body at that time.
 

ev79sf

New User
You are right. I gained full ROM at about the 6-7 week mark. I remember going back to the doctor at the 4 week mark and still couldn't do anything toward the right side of my body (left shoulder injury). However, at that time I had pretty much full ROM on the left side...just couldn't reach across my body at that time.
Ya the reaching across has improved a lot, as well as sideways and out. Straight out front is the hardest. Pain in the front area of the joint.
 

jaxadam

Rookie
My grade 3 happened over 10 years ago and took about 9 months to fully recover. It actually still bothers me to this day. I had a grade 1 about a year and a half ago and I would say I was good to go about two weeks later, and it doesn't bother me at all.
 

Turbo-87

Hall of Fame
Had a complete separation of left shoulder (I'm right-handed) from landing directly on it on concrete. Sling immobilization for a bit, a couple months off with rehab/PT and made a 100% recovery. Played D1 basketball and if didn't affect any strength or ROM after recovery - this was about 9 years ago. Even today when I shrug the shoulders there's an obvious bump (google image and you'll see what I mean).

It's really nothing to worry about in my non-medical opinion, having had 100% recovery with no surgery, and even if I were a lefty I'm sure it wouldn't have affected playing tennis full force even with serves and overheads. Obviously lean on your doctor for advice...and if he doesn't recommend surgery in your case then he's likely doing you a favor and knows what he's doing. Dislocations and torn labrum are much more of an issue.
Same here. Everyone is different. My first ortho wanted to do surgery right away after putting my shoulder back in place. I opted to get a second opinion and was told to avoid surgery at all costs and see if rest and rehab would do it. I chose the latter. At first I couldn't even get my hand above my chin. It took a 14 months to get back to 100%. It was my left shoulder so I was able to play tennis 4 months into the recovery period. I was scared of surgery because you just never know. If it hadn't healed itself properly, I would have opted for it later on if it was still an option. Thankfully didn't have to.

I wish the OP the best of luck.
 

ev79sf

New User
Here's an update for others to hopefully find useful. It's been over three months. I am indeed playing again, but still lack full range of motion. My Orthopedist told me I should indeed continue to play and do Physical Therapy, etc. AND that the injury is not the issue anymore... I now have a Frozen Shoulder. He said it could take up to a year to have full motion again. The morale? Appreciate and use what you have (I've still already won a singles tournament since coming back.) AND - perhaps do not keep yourself in a sling as long as recommended... I used mine for 3 weeks religiously as instructed. Perhaps that is not why I have a frozen shoulder, but... I wonder. I have an interesting bump that isn't too bad but it becomes a party trick when i cross my arm across my chest and it pokes straight up! :)

Oh I can also mostly sleep on it again finally. But it gets a little sore.

Playing does not seem to bother it most of the time, but I cannot get high overheads... however, I switch to my left hand, since I worked on a lefty game for a month or so. :)
 
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