Acromion Clavicle Joint Swelling

[rothman]

I am a 20 year old, 6'5'' healthy male who is (was) an active swimmer and weight lifter. Over the past month and an half, I have not been able to bench press nor do much shoulder work due to pain generated on my left shoulder. After a MRI and a X-ray, my doctor came to the conclusion that nothing was torn and my Acromion Clavicle, or AC joint, was swollen, and needed about two months of rest. My doctor did not give me a shot of cortisone. About three and a half weeks have gone by and I have seen no improvement. I went to the gym today to "test" my shoulder, and found it extremely difficult to bench a mere 135lbs (I am used to doing reps at 185-200). Also, my pool performance has been drastically hindered. I am not able to swim at a competitive level, and I had to quit my college water polo team due to pain during practice.

Comparing my two shoulders, the left shoulder's AC joint feels larger than the right, healthy shoulder's. If feels like there is a larger bone mass surrounding my left shoulder's joint than my right. When I apply pressure to the left shoulder's AC joint, it generates pain. Also, I can create a repetitive clicking and grinding noise when I rotate my entire arm like a screw driver screwing. I have consulted another local physician, and have scheduled myself physical therapy.

Considering my age, I highly doubt that arthritis would hinder my joints this early. I have heard about a common, non-invasive procedure called an decompression surgery. Considering my symptoms, is it possible that I would need surgery in the future? Is there a possibility that the swelling and size of my AC joint will return to normal and I can resume my regular exercise routine? Please give me your experiences or any information you have on this problem.

[rothman]

This weekend I got a cortisone shot in my joint, only to find the popping sound in my arm amplified. My doctor still tells me to not put any pressure on my joint for the next month and a half.

When I place my arm out directly in front of me, streight, and do elastic pulls across my chest, I can actually feel my clavical and acromium separate as one seems to go on top of the other and vice versa. There is no pain since I have this cortisone shot. Also, I knotice a grating noise, which is not apparent in my other arm. Any new suggestions?

[jbova]

I see it has been over 1-1/2 years since your post. I was wondering how you made out.

I am a professional MMA fighter with identical symptoms, although I have a history of separated A/C joints on both sides. My treatment has been as follows:

-- First physician --

• 1 cortisone shot in back of shoulder -
  • did nothing.
• Rest + 8 weeks of physical therapy -
  • did nothing.

After losing weeks of valuable time and more therapy suggested, I went elsewhere!

-- New physician --

• X-ray, MRI, and Cortisone shot given on first day.
• 1st cortisone shot placed directly between the acromion and clavicle (A/C joint)
  • helped for a few days
• Sub Acromial Decompression Surgery -
  • I am still recovering from the surgery
• 2nd cortisone shot placed directly in the A/C joint
  • This seems to be helping a bit

About 1-1/2 months after the surgery. I got another shot in the joint during my follow-up. My shoulder feels more stable than before, but it is still painful. I lost a great deal of strength and still have trouble doing a pushup without a lot of pain. I just got the shot 2 days ago, and I worked out for the past two days grappling and boxing.

------

I'll keep anyone who is reading posted on my recovery and overall feelings of the surgery. The decompression surgery is arthroscopic. The procedure involves shaving the bones back to recreate the necessary space between them. With proper recovery, scar tissue grows in the space to form the pad which was once supplied by your natural cartilage. Make sure you get a "Polar Care" or similar device with the shoulder attachment so you can ice the shoulder constantly following the surgery. It makes a big difference and your insurance may cover it. Mine did.

Thanks and good luck!
Jim

[shoulderpain]

http://www.anatomy-physiology.co.uk/...my_bones01.jpg
I started this with a link to a picture of the shoulder bones to help readers understand the basic anatomy that I am trying to explain. I am home today, as I have on many other days, recovering from my 4th shoulder surgery. My story is very similar to both of your surgeries. My initial problem started on January 30, 2007. I am a nurse. I was washing a bed, overstretched and had a loud popping in my right shoulder. This incident caused a lot of pain with lifting and when my arm was above 45 degrees, occasional popping, and has a grinding noise and feel with many movements. I went through 6 months of PT and two cortisone injections before my first surgery for an A/C joint resection (acromian/clavicle), DCE (distal clavicle excision), SAD (subacromial decompression), and bursectomy. Six more months of therapy and another cortisone injection later I was still having symptoms. This surgery helped slightly but I did not form the scar tissue from the clavicle to the acromion process to form a false joint to stabilize my shoulder. My clavicle was kind of floating and my arm was drooping off my body because it was not supported. I had a second surgery to tie down my clavicle and shorten my stretched out ligaments. The second surgery was a success from the start. Three months later and eight weeks of PT I was back to work on full duty. My second to last PT session I had a PT intern who told me to never tell a PT where it hurt because that is where I needed more work. Needless to say he tore my surgery apart. So two months later I had my third surgery. This surgery was a C to C resection (coracoid to clavicle) or (coracoclavicular) with a cadaver graft in an attempt to secure my clavicle for a permanent repair. This surgery involved hardware and a graft. A hole was drilled through my clavicle and through my coracoid process. A button type of hardware on top of my clavicle and a pin that slipped through the hole in the coracoid with the donor ligament attached to these hardware pieces pulling my clavicle down to a stable position. I knew that my surgery had failed at the time of my follow up visit 12 days later. My shoulder had fallen back into the droopy position. An x-ray revealed problems. My coracoid process broke off. So back to surgery I went. Now I needed a pin to put my bone back together and a huge graft surgery to tie everything together to try to make it stable. It has been a week since this last surgery. I hope it hasn't completely destroyed my shoulder. I hope anyone reading this finds it helpful in their decision-making regarding any shoulder surgery. I wish I would have made changes in my activity level to deal with the pain instead of thinking surgery would fix everything. I work in a surgery center and know my physician is an excellent shoulder surgeon. I have seen many shoulder revisions. He did tell me that less than 100% of the surgeries produce great results, I just thought I would be able to beat all the odds.
A quote I found from a Dr Wagner "Surgery is surgery, and is NEVER pain free especially on weight bearing areas. Never. Having a resection, to put it simply, sucks. Your clavicle will NEVER be the same, there never should have been that implication or assumption."

[mark04]

Wow bad luck, I suffered a level V AC dislocation in an accident tore both AC ligaments and CC ligaments. Surgeon took of the 1cm distal end of my clavicle and used a cadaver tendon and 2 holes inthe clavicle to reduce the clavicle. One difference, no holes in the coracoid process, simply looped around.

After 6 weeks it feels ok, stiff but no pain, clavicle is still a little elevated but only slightly. Now I have PT but little pain and almost full range of motion. How is yours doing? sorry to
hear about your situation, is your shoulder healed.

[shoulderpain]

Thank you Mark04 for your well wishes. I hope you have a speedy and full recovery. I am 6 weeks post op from my 4th surgery. I have gained 50-75% of my motion depending the direction of movement. At my recent doctor appointment my x-ray looked like the claicle had been brought down into the proper position, although it still looks slightly lower than the other shoulder. I haven't been to PT yet because I had to allow the broken bone to heal. I am allowed to start working towards lifting 20lbs, but I must be able to lift 50lbs in order to return to work at 100%. My pain has gradually decreased and I have actually had brief moments of being pain free over the last couple of days. My surgeon said that this is the surgery that will resolve all my issues, but he has said that with the previous surgeries. I have been pretty sad over the past few months but I have goals to get back to doing the things I love. At this point I still wish I never had the 1st surgery, hopefully that will change over the next couple of months.

[Unregistered]

Hello,

I have exactly the same condition as you - I couldn't believe what I was reading when I read your post as I have searched hi and low for people in similar situations! I am a 25 year old male, and have been weight training since I was 15. I first started experiencing the pain just over a year ago, and gradually through the months it has worsen substantially. I have had an MIR scan, which reviled that that the tendons and ligaments are fine. However, later having an X-ray it reviled that my acromion and clavicle had swollen together.

The Doctor advised me that I not have arthritis and that my options are;

Have part of the bone removed to prevent any further pain, but remain permanently week in that shoulder

Stop training to reduce the pain

Carry on training and preserver with the pain as no further damage can be caused

Really stuck here and have no idea what to do next! Do you have any advice you can offer me?

[Unregistered]

Below is a link to a good forum discussing AC problems especially Distal Clavicle Osteolysis, with members explaining their issues anr recovery from operations

http://forum.bodybuilding.com/showthread.php?t=2693501

[sblevins3707]

I see it has been over 1-1/2 years since your post. I was wondering how you made out.

I am a professional MMA fighter with identical symptoms, although I have a history of separated A/C joints on both sides. My treatment has been as follows:

-- First physician --

• 1 cortisone shot in back of shoulder -
  • did nothing.
• Rest + 8 weeks of physical therapy -
  • did nothing.

After losing weeks of valuable time and more therapy suggested, I went elsewhere!

-- New physician --

• X-ray, MRI, and Cortisone shot given on first day.
• 1st cortisone shot placed directly between the acromion and clavicle (A/C joint)
  • helped for a few days
• Sub Acromial Decompression Surgery -
  • I am still recovering from the surgery
• 2nd cortisone shot placed directly in the A/C joint
  • This seems to be helping a bit

About 1-1/2 months after the surgery. I got another shot in the joint during my follow-up. My shoulder feels more stable than before, but it is still painful. I lost a great deal of strength and still have trouble doing a pushup without a lot of pain. I just got the shot 2 days ago, and I worked out for the past two days grappling and boxing.

------

I'll keep anyone who is reading posted on my recovery and overall feelings of the surgery. The decompression surgery is arthroscopic. The procedure involves shaving the bones back to recreate the necessary space between them. With proper recovery, scar tissue grows in the space to form the pad which was once supplied by your natural cartilage. Make sure you get a "Polar Care" or similar device with the shoulder attachment so you can ice the shoulder constantly following the surgery. It makes a big difference and your insurance may cover it. Mine did.

Thanks and good luck!
Jim

I've had the same problem for about a year now. I have had a cortizone shot, 8 weeks rest, 4 weeks physical therapy, 2 x-rays, 2 mri's and 1 mri/ athrogram (contrast).

The specialist I went to says i have a torn labrum but that's inconsistant with my symptoms. My pain is right on the very top of my ac joint. My problem started out slow and then progressed over time. It wasn't an "all at once" thing. I lift weights and it really hurts on my bench pressing. Sometimes, the pain isn't as bad as other times, but it's always there.

The Dr. told me surgery was up to me....which doesn't really make sense to me. In my mind I either need surgery or I don't.

I have an appointment for a 2nd opinion this coming Thursday. Hopefully that specialist will give me some answers. Right now I'm $600 out of my own pocket with no answers in sight.

I'll repost and let you guys know what the Dr. told me. In the mean time, if anyone has had a diagnosis and treatment that worked, let me know.

[Unregistered]

As a physical therapist I am glad you are scheduled to see one. Sounds like you have an inflammed AC joint. I hope you are applying ice (no heat!) about 10 minutes at a time a few times a day. Do not do any exercises that involve overhead shoulder movement or any chest or overhead presses. All of these will aggravate your AC joint. You can do rows, bicep and tricep exercises as long as your arm is positioned by your side.



Hope this helps.