 Poster: A snowHead
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Hello Peeps, looking for some more advice please...
So I have a grade five ACJ injury which I have not had surgery on. All things considered we (me and various consultants) decided we would see if was possible to successfully rehab a grade five... (She said squeaking like a Guinea Pig!) It is mostly ok (+/- occasional pain, altered sensation and for want of a less descriptive word - clunking!) it's liveable with most days.
So, I am going skiing in January - first time since injury last January - does anyone have any experience of a good brace/support for this type of injury? The only advice my consultant gave was "don't tape it, buy a sleave". Endlessly helpful!
Please advise on personal experience of good vs bad types, makes etc Is it worth spending more? Where to buy etc...
Many thanks 
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@frankEvb, my Mum has a one, but it immobilises her shoulder so not good to ski in.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Thank you! Wouldn't you? I ski'd off the mountain with it so at least the 'get back on your horse' thing was conquered immediately! I think my exact words were " I'm not getting in a ****ing bannana - my legs still work perfectly!" (Would have inserted photo of my X-ray but I can't work out how to do it on my phone  )
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| Hells Bells wrote: |
| @frankEvb, my Mum has a one, but it immobilises her shoulder so not good to ski in. |
Foes she wear it for a ACJ injury? Think I'm going to have to accept a little modification (?) of technique... I've never been all that gracefull anyway!
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You'll need to Register first of course.
You'll need to Register first of course.
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Does not foes
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@frankEvb, she has had multiple shoulder injuries following a fall, including one to her rotator cuff, which was the one that needed surgery. A snowHead I know who skied with a shoulder problem had to learn to do without poles. What does your physio/consultant recommend you use?
My hubby skied off the mountain with a broken neck. It doesn't mean it was a wise thing to do.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Have you any physiotherapy organised?
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| Hells Bells wrote: |
| Have you any physiotherapy organised? |
I had NHS physio for the first 6 months (now 10 months post injury) or so till we moved up here. I have persisted with doing it myself since in a rather ad-hok fashion. I requested a new physio referral when I saw my new consultant but she said it wouldn't really make any difference now!?!? I think she just wasn't interested. (NO offence to any ortho-pods, but I tend towards thinking; if you're not about to let them do their surgery thing, they loose patience fast...) Any advice on this gratefully received!
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@frankEvb, I incurred a type 3 AC joint separation in a skiing fall a few years ago. I was also advised to not go for surgery. I still have a lump and get the occasional dull pain. I had physo which included some strapping. I also skied off the mountain!
I was skiing again in around six weeks all be it a little timidly.
So six years on my shoulder is still weaker than the other one and feels unstable, I stopped rock climbing apart from easy stuff after the injury as I no longer trusted it in funny positions. It feels weaker and I don't do the big pole plant anymore, more of a New Zealand tap. I have been told to expect arthritis as I get older.
I do sometimes wonder if I should have gone for surgery, at the time l was advised that the operation would take a long time to recover from and that the shoulder would still be weaker than before.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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| Quote: |
(NO offence to any ortho-pods,
...
if you're not about to let them do their surgery thing, they loose patience fast...)
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That's my experience too.
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@frankEvb,
PS the physo was mainly focuses on posture, i.e. Not hunching or being round shouldered.
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You know it makes sense.
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| jbob wrote: |
@frankEvb,
PS the physo was mainly focuses on posture, i.e. Not hunching or being round shouldered. |
Yeah that was how mine was too! Do you (did you) wear a support of any kind?
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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@frankEvb, Different problem I know, but following surgery for a recurrent dislocating shoulder (a Putti-Platt in 1972) I was left with fairly restricted movement in my arm/shoulder that I thoroughly expected to have to live with for the rest of my life. I had some fairly pathetic post-op physio. Some 25years later, I had my first encounter with a personal trainer at the gym & he had my arm moving pretty freely after about 3months! So my advice would be not to give up on the exercise thing & maybe get some pt instruction. Although the pictures that @Jonpim, posted would frighten me into getting a further specialist opinion (@Jonpim, knows what he is talking about, being in the trade!). Good luck - I hope it all works out well for you.
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Poster: A snowHead
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| frankEvb wrote: |
| jbob wrote: |
@frankEvb,
PS the physo was mainly focuses on posture, i.e. Not hunching or being round shouldered. |
Yeah that was how mine was too! Do you (did you) wear a support of any kind? |
I don't wear any support. I did buy a neoprene thing at the time but it didn't really do much good, and certainly wouldn't have been any use had I fallen on it again which was what I was concerned about. Best that could be said of it would be it kept my shoulder warm. I did need to take anti inflammatory pills for a while for the pain.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@genepi thank you for your post - very inspiring. Glad you have seen such great improvement! Might go and suss out the local gym up here and see what's what. Thank you for your advice. My xrays are a very close match for @Jonpim's pictures. Horrific really. They did indeed inspire a second opinion. All told I'm on Consultant number 5 now... Would indeed swap number 5 for number 4 any day but they are unfortunately in Southampton - which is a little far to go from Edinburgh! Ho hum.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@jbob that is my major concern too, can cope with the idea of it hurting a bit. But have literally had nightmares about my collar bone coming through my skin from falling on it skiing.  Am just not prepared to let it stop me. Thank you for Support advice - had thought that keeping it warm was maybe a way of warding of the ache? So may get a neoprene thing for that reason - if I can find one suitable for a woman... Thanks again for your advice.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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@frankEvb, Oh yes, I know the Soton guy well - he has a good reputation. Having moved there from Edinburgh many moons ago though, I know it is a indeed a long haul!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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frankEvb, Consultant number 5? Not good. The key thing here is to make sure you are seeing a Shoulder Specialist - NOT a general orthopaedic surgeon who occasionally dabbles in a bit of shoulder work. A shoulder surgeon works with only shoulders and elbows, and nothing else - if they do hips or knees as well, look elsewhere.
I suspect your Southampton Surgeon was Simon Lambert, now at the Royal National Orthpaedic Hospital. A proper surgeon (doctor) would not behave as described by frankEvb: surgery should be only a last resort.
I am sure there is at least one decent shoulder specialist in Edinburgh. Christopher Robinson and Jeffrey Reid look promising, but i would still like to see their CVs.
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You'll need to Register first of course.
You'll need to Register first of course.
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| Jonpim wrote: |
frankEvb, Consultant number 5? Not good. The key thing here is to make sure you are seeing a Shoulder Specialist - NOT a general orthopaedic surgeon who occasionally dabbles in a bit of shoulder work. A shoulder surgeon works with only shoulders and elbows, and nothing else - if they do hips or knees as well, look elsewhere.
I suspect your Southampton Surgeon was Simon Lambert, now at the Royal National Orthpaedic Hospital. A proper surgeon (doctor) would not behave as described by frankEvb: surgery should be only a last resort.
I am sure there is at least one decent shoulder specialist in Edinburgh. Christopher Robinson and Jeffrey Reid look promising, but i would still like to see their CVs. |
The whole thing has been a bit of a nightmare really. I was told by an Austrian Trauma Consultant initially " if you have surgery on this do it within 2 weeks, or never do it." Given obvious language difficulties on both sides I chose to wait till I came home to decide (probably a huge mistake).
I saw a fracture clinic Orthopod Consultant at day 8. He told me I had a grade 3 injury and to go away and wait to see a shoulder specialist (around 4 weeks he thought, which in true NHS fashion turned into 6)! I challenged him on his diagnosis and management plan and explained what the Austrian chap had said; but I was told the Austrian system was over keen to operate as they could make money doing the procedures and that a swift referral to a specialist wasn't needed in my case.
I saw my first shoulder specialist (not any of the names above) who told me that in fact I had a grade 5 (Confirmed by MRI). That It would indeed have been better had I had immediate surgery using and augmenting my own (by this point withered, scarred and useless) ligaments. That given the situation, 'in about 6 months or so' I could have a Modified Weaver Dunn procedure if I wanted. He wasn't over keen on my plan to attempt to conservatively manage my injury (he had only seen 2 others do this before) but was willing to let me try. Instigated by what the Austrian chap had said and my back ground in Trauma I did a lot of research into this injury. All the research I have done indicates that the reason there have been 72 (!) different surgical options for attempting to fix this injury is that non have yet proven successful enough not to inspire further surgical development. Most of the currently used options (except early surgical intervension) have moderate to high levels of risk of short and long term complications. Given the limited pain and restriction I currently have - I feel it is better to try to conservatively manage it. I accept this may be folly.
This recent dissertation references much of the literature and may prove useful for those with clavicle injuries...
https://helda.helsinki.fi/bitstream/handle/10138/44829/virtanen_dissertation.pdf?sequence=1
All in all I was less than reassured and so sought the opinions of 2 further shoulder specialists. As it stands all concerned have been in agreement that trying to live with it is probably the best option for me for now. We have recently moved to Scotland where my latest (lady) Consultant (seen for the first - and last - time last week) has given me her secretaries phone number and said; if I ever change my mind and want her to do (the only operation she has had any experience doing) a Modified Weaver Dunn (I don't), she would then see me again. She declined my request for further physio and made me feel like I was wasting her time as I am clearly not inclined to have a MWD any time soon.
All in all am a little P'd off with the whole thing! And seemingly back to managing it myself - my initial physio was nearly a month after injury, so I had to work out what to do for myself! Thank goodness for the Internet and the fact I had a little knowledge and some useful mates - prior to this incident I was an A + E nurse for 10 years!
I will definitely look into trying to see either of the Edinburgh Surgeons you mentioned as I think I will certainly need ongoing input and expert advice with this unusual injury in the future... I just hope I can find it! 
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Friend of mine is a very high-level snowboard instructor and had a grade 5 AC injury a couple of seasons back. He "lived with it" for the rest of the season, but eventually had surgery on it.
He shopped around extensively for the surgeon with the best reputation for shoulder stuff and eventually got the op from the amazingly-named Doctor Funk in Manchester. Had the tendon replaced with an artificial one.
He's had a very good result from it, depsite managing to set it back significantly falling off a skateboard...
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This from shoulderdoc.co.uk:
TREATMENT:
Grade 4,5 and 6 injuries often require early surgical reduction and fixation .
Most Grade 1,2 and 3 ACJ dislocations do not require surgery (see links below) and almost all can be managed with:
1. Physiotherapy - to 'retrain' the shoulder muscles
2. Painkillers and anti-inflammatories
Most people fully recover without any problems, however overhead athletes and manual workers may have persistent symptoms and require surgery.
Surgery is indicated if the shoulder is still painful and there is some functional loss at about 3-6 months after the injury.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| stevomcd wrote: |
Friend of mine is a very high-level snowboard instructor and had a grade 5 AC injury a couple of seasons back. He "lived with it" for the rest of the season, but eventually had surgery on it.
He shopped around extensively for the surgeon with the best reputation for shoulder stuff and eventually got the op from the amazingly-named Doctor Funk in Manchester. Had the tendon replaced with an artificial one.
He's had a very good result from it, depsite managing to set it back significantly falling off a skateboard... |
Doctor Funk! Amazing! Love it. Have considered having an artificial tendon, just can't find anyone who'll do it! Dr Funk you say... In Manchester... Ta
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@Gordyjh, Spent the first week after my injury reading (almost) all of shoulderdoc - agree it is a very useful resource, especially in the beginning...
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| frankEvb wrote: |
Hello Peeps, looking for some more advice please...
So I have a grade five ACJ injury which I have not had surgery on. All things considered we (me and various consultants) decided we would see if was possible to successfully rehab a grade five... (She said squeaking like a Guinea Pig!) It is mostly ok (+/- occasional pain, altered sensation and for want of a less descriptive word - clunking!) it's liveable with most days.
So, I am going skiing in January - first time since injury last January - does anyone have any experience of a good brace/support for this type of injury? The only advice my consultant gave was "don't tape it, buy a sleave". Endlessly helpful!
Please advise on personal experience of good vs bad types, makes etc Is it worth spending more? Where to buy etc...
Many thanks |
I don't think any brace or sleeve will help if you fall on the shoulder.
Most just get on with it.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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@Jonathan Bell,
Thank you for the advice. I shall resist the urge to try to protect it! (And just get on with it )
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@frankEvb, I can probably find out contact details, etc. if you want, PM me. The name has only stuck in my head because of its awesomeness...
I have a minor AC injury myself (grade 1, I believe) and I can confirm that it never really goes away. 3 years since I did mine and it's still a niggling issue. Working hard on the rehab helps a lot, falling on it sets it back instantly.
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You know it makes sense.
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@stevomcd, That would be really helpful, thank you - it's always good to have a back up plan! Although, I might need to win lottery first if it was a private op... So don't worry if it was! 
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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My mate got it done privately but he had no choice as he's a French resident and therefore has no right to free NHS treatment for something like this. Interestingly, the French won't do the "artificial tendon" op - too expensive apparently!
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Poster: A snowHead
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@stevomcd, c
I figured it would be... C'est la vie!
Least I know where to find him should my numbers come up! Cheers
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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you probably need a brace aswell and physio for sure.. esle risk of reinjurying the shoulder is pretty high..
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