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Old 04-24-2009   #1
Boulder, Colorado
Paddling Since: 1993
Join Date: Mar 2004
Posts: 60
Shoulder Surgery vs Rehab

I separated my shoulder last Sunday skiing. I'm interested in hearing from any kayakers who have sustained this injury (a Class III AC separation -- both major ligaments that attach to the scapular are 100% torn), NOT had them surgically repaired, and gone back to kayaking without a problem. The docs are saying I could go either way. But because I kayak and swim, surgery might have a better long term result. If this hasn't happened to you, but you know the details of someone else's case, that would be helpful too. Thanks, Nick

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Old 04-24-2009   #2
Cisco, Utah
Paddling Since: Dawn
Join Date: Sep 2007
Posts: 351
My 2 cents.... The question of surgery is a question of how active would you like to be the rest of your life. You can do fine without these ligaments, but you will be prone to more and more problems with it being involved in an active lifestyle. Kayaking in particular, but skiing, etc., etc... The biggest problem is continued problems will only exacerbate the current problem. My experience is that shoulder injuries are inordinately painful too. And reguardless of the injury, shoulders taske a Long time to heal.

Ligaments hold bone to bone. Without these this thing will pop out easier and easier each time. It will get less and less painful and be easier and easier to pop back in too. Not a good trade off though.

These comments may be way out of line, not knowing the extent of injury, but as I said, my 2 cents. Not worth 3...

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Old 04-24-2009   #3
Idaho Springs, Colorado
Paddling Since: 2005
Join Date: Apr 2009
Posts: 189
I have had severe shoulder problems through my career. I've had two shoulder surgeries with excellent results. I paddle with no problems now. I'm no doctor, so i'm not sure how bad of an injury you have but rehab won't help a 100% tear at all. It will strengthen the other muscles though. that will help. Some tears may not affect your kayaking. my advice is to test it. keep boating and see if it dislocates. Make sure you won't be in a life threating situation if it does. give it some time to heal first. if it begins to dislocate on a regular basis, surgery is your only option from there. I hate to hear about these type of injuries. good luck and keep those elbows in!!! let me know if you got any questions about surgury or rehab. I got tons of info.
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Old 04-24-2009   #4
Boulder, Colorado
Paddling Since: 1993
Join Date: Mar 2004
Posts: 60
This resonates with my thinking at this point. Since I'm going to have to go through rehab and build this shoulder back up (which is probably going to be a painful process), I may as well address the fundamental integrity of the system first . I'm 44 and hope to be paddling when I'm 70! Thanks for sharing. Cheers, Nick
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Old 04-24-2009   #5
Boulder, Colorado
Paddling Since: 1993
Join Date: Mar 2004
Posts: 60
glcasson21, it's not actually a dislocation. It's the two main ligaments that attach to the scapula, which has resulted in my whole shoulder dropping an inch or two. I've been thinking about this all week and I think I've made up my mind to go get surgery. I have Kaiser insurance, so options for who to have do the surgery are limited unless I shell out big bucks, but given how important this is, I suppose I'd consider all options. Who did your reconstruction?
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Old 04-24-2009   #6
Seattle, Washington
Paddling Since: 1991
Join Date: Oct 2003
Posts: 71
I had a 2nd degree shoulder separation that resulted in Bursitis (sp?) of the shoulder joint. Combined with years of paddling canoes and C-1 boats, it needed a good cleaning anyhow. But I did have my AC repaired and reattached after the cleaning. The removed the Bursa and did it all arthroscopically, no cutting. That is probably what they did for you. I tried rehab before the surgery and laid off boating for three months while it healed. But it still was killing me so I went in for the surgery. Since it has been much better and I have maybe 90% back but not 100. I would say go for it if you are worried about it being unstable. I had mine repaired in Steamboat Springs.

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Old 04-24-2009   #7
Join Date: Oct 2003
Posts: 405
Wow, this happened on sunday and you are already testing it kayaking? After 5 days??? When I dislocated my shoulder kayaking (actually I was in a C-1), I was told I tore most ligaments and broke the socket of my shoulder (hill-sach deformity). I could not use my arm at all for over 3 months or my shoulder would pop out, and it took a year before I could kayak again, and almost 1.5 yrs before I could raise my arm above shoulder height. Never had surgery but I kayak regularly now without too many problems. Maybe this is just a different kind of injury though.
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Old 04-24-2009   #8
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Eagle, Colorado
Paddling Since: 1994
Join Date: Apr 2005
Posts: 696
Don't listen to anyone on here, unless they have a DO, MD, or DPT following their name (and I don't). With that said, it's my understanding that a full AC separation is a bitch to treat. I know several physicians, that are very active and are doing it with a full AC separation (it does haunt them sometimes).

Take your MRI or Xray to several ortho's and see what they suggest. Another option is doing a literature search on pubmed.

PubMed Home
-Hit this site up and enter "acromioclavicular and coracoclavicular separation", or any combination of the two. There are numerous articles discussing the outcomes of surgery in these patients (this is THE site for medical journals). If you see a journal that you can't access, send me a PM and I will download it and email the article to you (I have full access to these articles @ my school).

Good luck man. That's not one of the easiest to treat.


This injury isn't the same as a torn labrum or a rotator cuff (very common injuries for kayakers). Look for an orthopedic surgeon that has done a fellowship in sports medicine w/ a focus solely on the shoulders. There should be at least one of these in most major cities (Denver, Fort Collins, Colorado Springs, etc).

PS. This is the general consensus as of 2008 in the literature.

"Since there is not a preponderance of positive papers showing the benefits of a surgical technique over conservative therapy, the nonoperative treatment is still considered a valid procedure in the grade III acromioclavicular separation." - Grades 4-6 "require" surgery
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Old 04-24-2009   #9
Boulder, Colorado
Paddling Since: 1993
Join Date: Mar 2004
Posts: 60
Originally Posted by jennifer View Post
Wow, this happened on sunday and you are already testing it kayaking? After 5 days???
No way! I can't pick up a jar of jelly with my right hand. Yeah... it's a very different injury.

GAtoCSU... thanks for your input. I'll look at PubMed. Surgery is 90% successful according to a Steadman Hawkins sports med doc I saw yesterday. But rehab can work too.

I'm grateful for all this input from all of y'all!! Cheers, Nick
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Old 04-24-2009   #10
FRESNO, California
Paddling Since: 2004
Join Date: Dec 2007
Posts: 39
I dislocated my shoulder 4 weeks ago. After the MRI, I have decided to get surgery. With my lifestyle, I would never want to put myself or my friends in a situation where they would have to rescue me if it dislocated again. From my research, surgery is the only way to get it really strong again. Anything less could be rolling the dice.

Like others have said, talk to your doctor. But be careful, it sounds like your trying to rush back into kayaking. The water will be there next year. A messed up shoulder can last forever. Take the time and let it heal. I hurt my shoulder on the first real run of the season. My season is done, but I'll be back next year. No river is worth ruining yourself for. Plus, if you were my friend, I wouldn't boat with you in this condition. You are putting everyone in danger.

Good luck. I'm sorry if I came of preachy. I'm just trying to help.


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