"Weightlifter's Shoulder" - Distal Clavicle Osteolysis - Resection Surgery

[Nikbruno]

Great to hear. Keep at it ! Just always be wary of how close to the surgery date you are. I'm 6 days out now and the pain has been lessening each day, but I'm slinged up for a month since I had way more work done. Everything I was told about that surgery from my doc was to take it slow for a month and then work on it like you had before but going slow and not ignoring any pain you may have. Keep icing after workouts !

Judging from my own experience and that of others on the board, it will take some time for the pain to subside completely so just stay upbeat and don't get discouraged. Though if pain persists and it doesnt quite feel right keep in mind that this op isn't always 100% effective as my case has shown !

[Warrior18]

Sport 1st: you seem to be on the right track. I know because I went through the same surgery. I logged my progress in the following thread. I personally liked to monitor the progress of others. It helped me gauge where I should be. Maybe my log will help you do the same. Here is the start of where I started logging.

http://forum.bodybuilding.com/showth...6076101&page=7

************************************************** *********

Nikbruno: From my understanding this is your second time under the knife. I myself am 6 months post op. I know you were the same and then things started to turn for the worse for you (I'm sorry to hear). Do you mind telling me what went wrong? I'm curious so I myself can avoid such an injury again. Did you hurt it by lifting to heavy to soon? Not enough rotator cuff work? Please be as detailed as possible so I can avoid this injury.

GL to the both of you on recovery. Reps for you both.

[Nikbruno]

hey warrior,

Its hard to answer that question. I went in for surg in sept 07 for the dco resection op and my surgeon deemed it succesful. As I outlined in my previous posts my progress in coming back was fine and it felt good but from the 6-9 month timeframe I noticed that pain was returning to pre-surgery levels. Laid off the bench a lot and other shoulder exercises but still was having significant pain. Pain soon started to develop in other parts of the shoulder as well. Mr arthrogram showed that the bone had begun to regrow and possible damage to the labrum somehow. I also had loud popping and clicking noises in the shoulder which baffled my surgeon as everything else had looked fine in my original surgery. Recommended an exploratory scope and an open shoulder resection of the clavicle to make sure he got the whole thing. Went in and found a slap tear of the labrum. He was able to really cauterize theend of the bone this time to make sure itwont grow back. You really can't control the bone deciding grow back and I have no idea how I tore my labrum. Just hope your doc did a good job is all I guess you can do. Let me know if I can answer anything else. From what I understand regrowth of the bone is very rare.

[Sport_1st]

hey Warrior, thanks for the link. Seems like I'm on track and hoping to keep it that way.

I gotta admit, I now see how guys can push things too early. After my stretching routine and half hour of icing my shoulder feels fantastic and I can understand how folks can be fooled into thinking the shoulder is ready to be tested.

Warrior, I noticed one post you had on the other link, acknowledging the importance of these blogs ? taking a peek into the future courtesy of those who've gone before us, getting the support of those in the same boat, and being gifted the sound advice and wisdom of others. Like you Warrior, I am truly grateful for the psychological support this thread has provided.

I'm also pretty humbled by the youthful commonsense that abounds here, with Grebanator at 21yo, Nikbruno at 23 and Warrior at 19 ... man I wish I had half the brains and good sense in my early 20's that you guys have. You're ALL awesome!

If I ever get to the States, I promise to treat you all to a Powerade or two, he he.

[Ivan25]

I have a bony prominence in my left AC joint...

I asked my PT about it, he said it is probably just the clavicle bone rehealed higher on the AC joint and caused the protrusion...

Personally, I don't ever want to have surgery, but I am open to the option if it came down to it..

I currently am doing PT exercises only... Rotator cuff, scapular stabilization, stretching etc... Even taking yoga..

I don't have pain at all in the shoulder... But when I press down on the AC joint hard enough, it feels slightly different than the right and is somewhat tender...

I have clicking in my left shoulder when raising arms overhead, but I am working on improving my posture for the next year or so...

I believe my left shoulder clicking can go away AND that it is purely from poor scapular rhythm... Muscles are imbalanced..

I also experience grinding in my shoulder girdle when I roll my shoulders, retract and protract them...

Any suggestions as to improving this?

Am I doing everything there is to be done non-operatively?

Can a person live with this minor bone deformities and never have pain associated with it?

[Sport_1st]

...I don't have pain at all in the shoulder... But when I press down on the AC joint hard enough, it feels slightly different than the right and is somewhat tender...

I have clicking in my left shoulder when raising arms overhead, but I am working on improving my posture for the next year or so...

I also experience grinding in my shoulder girdle when I roll my shoulders, retract and protract them...

Any suggestions as to improving this?

Am I doing everything there is to be done non-operatively?

Can a person live with this minor bone deformities and never have pain associated with it?

I'm certainly no doctor but I do know that , well... we all have little lumps and bumps which are just us and not necessarily symptomatic of anything. We're assymetrical beings.

After years of rowing and a bit of gym work both my shoulders grind and my left shoulder is (so far) pain free so I think it is just part of life

The feeling you note in your right AC joint MIGHT just be some minor inflammation of the joint - especially if you're right handed and favour that side - of course it could also hurt from the poking you're giving it - it's not the most stable of joints.

Personally I reckon if it's not hurting, then don't start planning for surgery just yet. If you're worried about osteolysis/bodybuilders-shoulder my humble suggestion is to balance all your bench-press out with serious weighted rows.

My background is that I broke my collarbone as a kid playing footy and all was well as it settled and the shoulder firmed from years of rowing. All that retraction motion balanced out any effect of bench press (I always preferred flies anyway).
Surgeon, sports physician and PT all suspect that when I stopped rowing, kept bench pressing and took up beach volleyball, the dramatic change in regular shoulder action combined with the sustained focus on the press, may have triggered the aggravation which led to the osteolysis. (even when my shoulder was at its worst, rows were never a problem).

So my humble advice is to maintain a balanced workout routine, stay flexible (the yoga is good) and stop digging your fingers into your AC joint. (I'll stop now before I start to sound like my mum).

[Sport_1st]

I can now wear t-shirts without worrying about having to possibly cut them off because I can't twist my shoulder in the right direction.

Surgeon is really happy with my range of motion and freedom from pain.
My only real pain comes when I lie on my good side and try to reach over and hit the snooze-button on my alarm clock. He explained the pain comes from the fact he had to cut the front delt off the bone and stitch it back on again so it's still healing. My PT/Physio confirmed that the arm motion in that position is a classic test for AC joint problem (along with extending the arm straight in front of the body and pushing outwards against light resistance.. that hurts too!). Physio said this is a key indicator in the AC joint healing too.

I asked the surgeon about the pain in the delts and biceps and lower scapular. He said it was because these muscles were 'protecting' the shoulder in actions they're not used to (or particularly well designed for) but it's only temporary.

So, 2 weeks out and I'm still just doing the stretching exercises, massaging the traps and delts and icing. I can now apply some heat packs too if I want, to help relax the traps etc.

PT/Physio says I can probably start doing some very light tricep extensions in a week or so. Woot Woot!

How's everyone else going?

Oh, surgeon took 6mm off apparently. I forgot to ask him to keep it for me, damn!

[stox34]

Hey all, leaving for surgery right now. cross my fingers. I will post later tonight and let you guys know how it went.

-stox

[Nikbruno]

I can now wear t-shirts without worrying about having to possibly cut them off because I can't twist my shoulder in the right direction.

Surgeon is really happy with my range of motion and freedom from pain.
My only real pain comes when I lie on my good side and try to reach over and hit the snooze-button on my alarm clock. He explained the pain comes from the fact he had to cut the front delt off the bone and stitch it back on again so it's still healing. My PT/Physio confirmed that the arm motion in that position is a classic test for AC joint problem (along with extending the arm straight in front of the body and pushing outwards against light resistance.. that hurts too!). Physio said this is a key indicator in the AC joint healing too.

I asked the surgeon about the pain in the delts and biceps and lower scapular. He said it was because these muscles were 'protecting' the shoulder in actions they're not used to (or particularly well designed for) but it's only temporary.

So, 2 weeks out and I'm still just doing the stretching exercises, massaging the traps and delts and icing. I can now apply some heat packs too if I want, to help relax the traps etc.

PT/Physio says I can probably start doing some very light tricep extensions in a week or so. Woot Woot!

How's everyone else going?

Oh, surgeon took 6mm off apparently. I forgot to ask him to keep it for me, damn!

Great to hear. I cant move my arm for a month so really cant comment on progress. My stitches are starting to hurt tho 11 days after, luckily I get them out tomorrow.

[Sport_1st]

Hey all, leaving for surgery right now. cross my fingers. I will post later tonight and let you guys know how it went.

-stox

Good luck Stox. The first day is ok, the second day gets pretty frustrating though... discovering all the random things you used that shoulder for. If you can, ease off the painkillers as soon as you can.

And as you already know from reading this thread.. take it VERY easy.

See ya on the other side of surgery.

Hang in there Nikbruno. Don't envy you one bit. Having the stitches out is a bit of a milestone though. Are you able to do any legs and core work at the gym?

[Nikbruno]

Hang in there Nikbruno. Don't envy you one bit. Having the stitches out is a bit of a milestone though. Are you able to do any legs and core work at the gym?

Yea I can do that but, again, I have to take it very easy so all the movements are limited. I find the best way to get my abs is to just lay on my bed with my legs hanging off and do raises. Anything involving my upper body moving around does not work. I'll be so glad when I can finally get back in the gym full go, my arm is getting so skinny... Not good !

Generally speaking, should I even be working out the other arm ? Is there any benefit to that ?

[stox34]

hey guys, so i had the DCO surgery yesterday. Dr. said it went well. he told me he took off about 1cm from the end of the clavicle. he also shaved bone off the top of the shoulder. im not sure if this will reduce the size of that lump i had at the top of my shoulder b/c i am all bandaged up. pain last nite wasnt too bad b/c of numbness but after sleeping on a recliner chair, i woke up in serious pain and all stiff. i want to try to take the sling off tom. and see how that goes. you are right Sports 1st, seems like everything one does involves the shoulder one way or the other. every movement i make is very deliberate and real slow. does all this sound about right guys?

[barneygym]

Be real careful with your shoulder. I'm coming off an RC tear and sprained AC, and it's easy to see how important the shoulders are, but also how the slightest overuse can flare up the injury and prolong it. So, put recovery first and avoid anything strenuous.

[Sport_1st]

pain last nite wasnt too bad b/c of numbness but after sleeping on a recliner chair, i woke up in serious pain and all stiff. i want to try to take the sling off tom. and see how that goes. you are right Sports 1st, seems like everything one does involves the shoulder one way or the other. every movement i make is very deliberate and real slow. does all this sound about right guys?

Sounds 100% right so far. I wish I'd stayed sleeping in the recliner on my first night - sleeping in a bed, flat on the back was tough (I normally sleep on my side).. my lungs and chest hurt a lot after sleeping on my back for 8 hours. Woke up about every 2 hours or so. (Oh and wait for the wonderful side-effect of the painkillers... you might want to invest in a mild laxative mate)

My doctor told me the sling was not really to stop mobility, just to support the arm when it feels heavy. After a few days I only wore it every now and then, and in public to try and keep people from bumping it. Also used it when going for long walks - the bouncing motion still makes the joint flare up a wee bit.

PT/Physio said no running or jogging for me for another month (6 weeks total) - I am SO sick of the stepper machine and the bikes at the gym. Not that I'm a huge fan of jogging, but I love sprinting and the weather is getting nicer here down under.

So Stox... Now the key is to really just take it easy. Keep us posted mate.

[stox34]

took the dressing (bandages) off yesterday to get my first look at the shoulder. surprisingly not much bruising. looks like doc made 4 insertions. how many did u guys have in you? also took the sling off and i was able to drop arm to my side pretty easily but ROM is not good. very stiff. my neck muscles also hurt on that side. but i know it is only 3 days out. patience is key here. cant wait to finally take a shower today. how did you guys keep the stitches dry while showering? thanks everybody.

[Sport_1st]

took the dressing (bandages) off yesterday to get my first look at the shoulder. surprisingly not much bruising. looks like doc made 4 insertions. how many did u guys have in you? also took the sling off and i was able to drop arm to my side pretty easily but ROM is not good. very stiff. my neck muscles also hurt on that side. but i know it is only 3 days out. patience is key here. cant wait to finally take a shower today. how did you guys keep the stitches dry while showering? thanks everybody.

Yeah, my ROM was REALLY limited till about a week. My doc told me all the shoulder muscles were sore because while they're not moving, they're constantly tense from protecting the shoulder. He also said to lift nothing heavier than a cup of coffee. By Day 7 I started doing some very slow, very controlled motion stretches which seemed to really help (see previous page, Post #300)

For the first few times I kept the stitches dry. I had a white hyper-fix strip over the scar though mine was an open surgery (one 5cm long scar). After about a week, it was getting wet in the shower and was fine.

Keep going Stox - sounds like things are exactly as I was 18 days ago.

[Sport_1st]

Hey, those who've gone before..... how long did it take you before you could sleep on your operated side? I'm getting so sick of sleeping on my left side only.

[Warrior18]

Hey, those who've gone before..... how long did it take you before you could sleep on your operated side? I'm getting so sick of sleeping on my left side only.

Honestly I only sleep on my back now. It took some getting used to, but I'm cool with it now. I find if i sleep on my shoulder it will ache in the morning, so I try not to do that.

Looks like you're on track with recovery sport_1st. Carry on my man.

Nikbruno hows the progress coming along?

[user345008781]

Looking at this thread scares me. I get clicks all around my body (without pain). But, still, makes you think. I use good form, warmups and do RC exercises.

[Sport_1st]

Time for an update I guess...

Well I've got pretty much full range of motion, virtually pain-free (apart from a tiny, tiny bit of a feeling like there's a lump of scar tissue in there... OK, so there IS a lump of scar tissue in there but I spent ages trying to think of something else it feels like, but only firm bubble-gum comes even slightly close... oh and my mum's sponge puddings.. blechhh)

My legs are getting a good workout which is a bonus. To all those who come after me, make sure you keep going to the gym, even if it's to do legs, lower back and abs... just do it for the psychological and social benefit and to get you out of the house. It's also made me explore some quite different exercises (as well as hitting my oft-neglected legs). It's also amazing how many people ask about my recovery too. So as soon as you can, get back to the gym and retain the healthy routine.

Other than that, I've been able to do some ultra-light tricep extensions (3xsets of 50 reps at 2.5-3.75kg - about 6lb I guess ... after 50 reps the lactic acid really hits) - the question is what to do with the good arm? Same weight and reps, slightly higher for a bit more strength training or the highest weight it can do over 10-12 reps?

Any ideas guys?

Still have a bed full of pillows so I don't roll on the operated shoulder and am still 'cuddling' one to support the operated arm when lying on my good side (though I am wondering if there is a potential chat-up line in there maybe "...um, I've just had shoulder surgery and I need to hold something in bed so it doesn't hurt... umm... I was just wondering if you'd be free to, well....y'know, maybe help me out so it doesn't hurt so much?"
Might give it a try this weekend... LOL)

Off to the Physio tomorrow and will update if there's anything to report. Otherwise... keep it up fellas!

Cheers from Down Under.

[Sport_1st]

I think I slept on my surge'd shoulder last night without too many problems.

Gym work is coming along gently. Low weight, high rep tricep extensions, cable bicep curls and even some high-rows (that machine that's sort of half-way between a lat pull-down and seated-row) and slow, very light upright rows.

Feeling the pump again is great... though VERY careful not to overdo it cos it's easy to do (that old saying... give him and inch and he'll take a mile)

Full, pain-free range of motion.

Enjoying focusing a bit more on the legs and abs and, of huge psychological importance... I had three guys at the gym tell me this week that I haven't lost much size at all. It's these little psychological things that keep you going, small gains, each to be celebrated.

[Spartaclaus]

This is my first post here but wish I'd found the forum years ago.

First the good news. I had arthroscopic resection of my right distal clavicle about 6 years ago. It took about 5 months to get back in the gym, but I never looked back. I represented England in martial arts tournaments, (and did well) and have trained hard ever since. I also joined the police force. The only thing I avoid is throwing over-arm so haven't played cricket since.

I have never looked back and think of the operation as a huge success. The shoulder will never be as strong as it was before the injury, but I think that's fairly standard for serious injurys especially after invasive surgery.

The bad news is that my left AC joint started hurting about 2 months ago and I have an appointment tomorrow with the same specialist who fixed my right shoulder.

I have had a scan through the thread but haven't seen anyone who's had both ac joints resected.... Is there anyone there who has?

[Spartaclaus]

Saw my specialist today and was hoping to get the cortisone shot straight away. Unfortunately the radiographer was off so I'll have to wait a couple of weeks.

The waiting list to see a specialist on the NHS is 3-6 months (for a consultation) and goodness knows how long for the op. I'm going to pay for as much private treatment as I can afford and then switch back to the NHS if I need surgery. Having experienced this in my other shoulder, I'm not optimistic about the joint healing without surgery.

Just the shot and consultation is going to cost about ?500 though.

I guess the plus side of having gone through this before is that I know it does get better after the op, it just takes an agonisingly long time. 3-5 months recovery doesn't seem like a long time for "normal" people, but to the likes of us it seems like a life time! An important role of physiotherapy should be to councel patients though our recovery but they tend to concentrate on just the physical rehabilitation.

I'll be 31 in December and although I've now damaged both AC joints, these are really the only serious injuries I've had. Not bad for someone who's played football, rugby, martial arts and gym membership for as long as I can remember!

Great posts about staying healthy and keeping up the CV fitness. I was toying with the idea of suspending my gym membership after the op, but I think I'll follow the advice given by you guys.

Keep the posts going guys. It inspires me when I'm low.

[Sport_1st]

It's been a while fellas, but that's probably because I am back in the gym. Both the surgeon and the physiotherapist (PT) are really pleased with the progress.

I can do pretty much everything I could before with a few minor limitations. I was never lifting REALLY heavy weights so my route back to pre-operation levels is not as long as some of you bigger guys - but still the foremost principle in everything I do at the gym at the moment is: Take it slowly, take it steadily and don't go too hard too soon.

Monday was my first session doing benchpress (incline, and flat) on the smith machine. Nothing too heavy (about 20kg on either end) but took it VERY VERY slowly and positioned the bar to fall towards the lower pec area (grip was really loose, about a hand-width wider than shoulder and elbows diverted outwards a bit). Keeping it very slow and controlled meant that it didn't take long to fatigue. All good.

Then also did some cable flies (low, horizontal and high), again slow and controlled and only about 25lb either side, but it felt good.

Of course yesterday I had DOMS across the chest and through the shoulders and man it is the best feeling! No AC joint pain either which is good too.

I know over the period I lost a bit of size off the shoulder (folk keep telling me which pisses me off somewhat) but with Osteolysis it was happening anyway. But I know it's coming back and taking the time off the shoulders and putting it into legs and abs has been a bonus.

So guys, until the left shoulder decides to give me grief, all is good so far and even in just eight weeks I reckon having an open DCR was the best decision I made - shame the scar is so pathetic.

...E

[c r a z y r a y]

ive read about every thread on this topic in the last 2 days...

the question i have is this:

how can i tell the difference between an AC sprain and DCR?

my shoulder looks to have no visable lump, but i get pain when doing any overhead presses/chest.

MRI showed hypertrophy of AC joint due to some kind of trauma. but ive been easy on it (time off) for 2 months and it hasnt seemed to get better).

due some some active release, ive pretty much gotten rid of all the tendonitis in my infraspinatus, but i have some left in my supraspinatus.

im confused as to how i'd be able to tell the difference between this being a painful impingement that can be cleared up through stretching, and DCR

is there a clear way?

this has been throwing me into a state of depression being unable to train. i really appreciate all of the efforts of the decicated people on this forum trying to report as accuractly as possible.

-ray

[Sport_1st]

The only way my sports physician, surgeon and physiotherapist could be sure it was osteolyis was for me to have a bone-scan.

A radiologist injects a small amount of radioactive 'juice' into you and it is then traced through the bones on a scanner about half an hour later.

The images showed trauma in the bones and they could determine it was osteolysis (though even then there was a suspicion it COULD have been arthritis - the cure is the same though... DCR)

My surgeon said the shoulder is a bugger to read without scanning because there is so much going on there.

Hope this helps.

[c r a z y r a y]

The only way my sports physician, surgeon and physiotherapist could be sure it was osteolyis was for me to have a bone-scan.

A radiologist injects a small amount of radioactive 'juice' into you and it is then traced through the bones on a scanner about half an hour later.

The images showed trauma in the bones and they could determine it was osteolysis (though even then there was a suspicion it COULD have been arthritis - the cure is the same though... DCR)

My surgeon said the shoulder is a bugger to read without scanning because there is so much going on there.

Hope this helps.

Its funny how it all comes together. I started developing pain mid summer (I want to say July).

Eventually, early august rolled around and a friend of mine who was national bodybuilder in the early 90s did some tendon tracing and sent me to his active release therapist.

He's done what he could, but things weren't getting better.

So about 3 weeks ago I went for a high contrast MRI. They sent the report to the ART guy, but not the actual MRI. There was some fluid in the shoulder, and a hypertrophy of the AC joint according to the report.

So they've continued doing ultrasound and stretching, and the in house PT has given me some exercises for the AC joint. Thing is, those exercises just have irritated things further.

Based on what i've read in this thread (and i've read this thread FULLY about 3 times), it has to be DCR.

I scheduled an appointment with probably the best Sports Orthopedics in my area. Schools were all ivy league, tons of accords, etc, etc. I did probably 2 days of research before scheduling my consultation..

On Nov 26, i'll know what the deal is. If its a DCR, i'm not even that upset because i've prepared for it. Credit to all of the fantastic members that have posted in this thread.

[c r a z y r a y]

Also, I have to wonder if there has been anyone that has gotten a DCR done and has used IGF-1 to speed recovery time. From what I can tell there have been a few threads dedicated to IGF for injury recovery, but nothing in direct relation to this.

Many of my friends have used IGF strictly post-surgery to get back to health faster.

[KrnMoFo]

wow this is a godsend thread for my type of injury. Im glad i read thru most of the post here and some of the advices are very helpful.

I have also been diagnosed with distal clavicle osteolysis with a 2mm separation between my clavicle and ac joint. This was due to a snowboarding accident but the inflammation and problem occured when i bench-pressed for chest workout. The doctor didnt really recommend surgery only if i wanted it for cosmetic purposes. im 22 years old and I've switched over from barbell to dumb bell. I have never undergone any surgery, only took ibuprofen and rested it for about a month before i resumed any lifting. I still have my full range of motion and no pain only a little tenderness and the slight bump that is on the tip of my left shoulder. i guess my question is will i have degenerative ac joint since i havent undergone surgery? and can i still resume my workout? i dont wnat to experience that kind of injury again. i love to lift.

[KrnMoFo]

Hey, those who've gone before..... how long did it take you before you could sleep on your operated side? I'm getting so sick of sleeping on my left side only.

i have the same type of discomfort when i sleep. The inflammation for me actually occurred when i woke up sleeping on the side of my inflammed shoulder (the day before i lifted). honestly to tell u the truth. i do not know when i could start sleepin on my left side again. Fear has led me to sleep on either my back or right side.

btw on the side note. ive been going to a chiropractor for my neck (its positioned crooked and need to go through a painful 5-6 months of rehabilitation treatment to get my neck back in its proper form). doctor said i cant lift while im goin through therapy for 6 months... such a disheartening remark when i heard this. Tommorow im suspending my gym pass.