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Rehabbing Seperated Shoulder?

Seperated my shoulder about a month or two ago…

any good methods to rehab it and strengthen the AC joint?

[quote]Xen Nova wrote:
Seperated my shoulder about a month or two ago…

any good methods to rehab it and strengthen the AC joint?[/quote]

Broke a small chip off my collarbone recently and strained my AC, I rehabbed by doing this :

Light overhead pressing with dumbbells
Alternating dumbbell pressing
Lots and lots of Cuban Presses
Lots of high rep face pulls(any kind)
Very high rep trap work(35+)
Lots of seated rowing, or better yet, on a Concept 2 Rower, but gently.

I started out by training shoulders twice a week, and was sure to do one press, followed by Cuban Presses and an upper back movement(such as face pulls).

I didn’t train chest during this period, and took it easy on bicep work(as that puts a lot of tension on your shoulder), and back work. The latter progressed quickly and didn’t hurt as much.

I iced a lot afterwards, and in about a month I could do all exercises without pain again, bumped upper body up to 3-4 times a week, and in 2 months I’d regained all strength from before.

I know your pain!

I separated mine over a year ago now so I know how frustrating an injury it can be. Anyway here are some tips you may find useful:

  1. Avoid exercises that hurt an in any way (a no-brainer but you would be surprised how many people dont heed this advice).

  2. make use of partial exercises - floor presses, lockouts etc are good.

  3. Avoid ballistic and dynamic exercises - no exercises with load projection / band work etc.

  4. Make use of Isometrics to help maintain current strength levels - overcoming and yielding isomtrics for max effort or duration are good choices.

  5. Address mobility - your focus should be on regaining painless mobility.

  6. Address the external rotators

  7. Address the scapula - lots of retraction / protraction, rowing movements, mid and lower trap exericses are neccessary.

Hope that helps mate,

Some great advice from the 2 previous posters there.

I know your pain bro, 15 shoulder dislocations and a spot on the operating table is my story!!

I would stress mobility and patience over anything else.

Please don’t rush things. You might get back to 70% quickly doing it, but 6-12 months down the line you probably will still be around the same level.

Take however long it takes to get it pain free and 100% mobile, then take the strength as it comes. If you take it slow you’ll come back better than before.

First off so that we are all on the same page–Did you sprain your AC jt or did you sublux or dislocate at your glenohumeral joint? How bad of a AC sprain Grade I, II or II? The severity of the sprain will dictate what you should be doing. I will assume you had a Grade 1 (a stretching of the ligaments that hold the clavicle and acromion together).

At 1-2 months, you should have all of your ROM back. I would concentrate a lot on rhomboid, post. delt and, RTC strength as well as throwing in some lateral and front shoulder raises with light DB presses. Look into YTWL’s they are in a Cosgrove and Waterbury article on shoulders. You may want to avoid Dips, heavy flat and incline bench press, and heavy DB incline and flat bench press.

These put a great deal of stress on the AC joint and may recreate some pain. My philosophy has always been try it first with very light weight (provided you have full ROM) and over the course of several days (even weeks in some cases) progress into heavier stuff. Floor presses and 2-3 board presses maybe something to try if going all the way down on the bench bothers you. As for overhead pressing, start out light with dumbbells and progress as tolerated.

As another poster put it, if you have pain then stop. Pain in the case of an orthopedic injury is an indication that you are putting a stress on the injured area that it is not ready for. This can create further injury and slow the healing process. Hope that helps.

Thanks a lot guys I appreciate it!

[quote]obatiger11 wrote:
First off so that we are all on the same page–Did you sprain your AC jt or did you sublux or dislocate at your glenohumeral joint? How bad of a AC sprain Grade I, II or II? The severity of the sprain will dictate what you should be doing. I will assume you had a Grade 1 (a stretching of the ligaments that hold the clavicle and acromion together).

At 1-2 months, you should have all of your ROM back. I would concentrate a lot on rhomboid, post. delt and, RTC strength as well as throwing in some lateral and front shoulder raises with light DB presses. Look into YTWL’s they are in a Cosgrove and Waterbury article on shoulders. You may want to avoid Dips, heavy flat and incline bench press, and heavy DB incline and flat bench press.

These put a great deal of stress on the AC joint and may recreate some pain. My philosophy has always been try it first with very light weight (provided you have full ROM) and over the course of several days (even weeks in some cases) progress into heavier stuff. Floor presses and 2-3 board presses maybe something to try if going all the way down on the bench bothers you. As for overhead pressing, start out light with dumbbells and progress as tolerated.

As another poster put it, if you have pain then stop. Pain in the case of an orthopedic injury is an indication that you are putting a stress on the injured area that it is not ready for. This can create further injury and slow the healing process. Hope that helps. [/quote]

Yes you assumed correctly.

And I do have my full ROM back (or at least 98% of it. But certain areas are still very painful or I hear a great deal of “clicking” and “popping”.

I can’t hold things in a “snatch” position, and pullups are uncomfortable. i can do pullups though and bench pressing isn’t a problem with dumbbells. It hurts with barbells. Overhead presses are pretty much a no no unless I do a bent press then I don’t have much problem.

I had first seperated it while training(grappling), and I had rested for about a week and I thought it wasn’t that serious. I had finished training for an hour or so and just iced it when it got home (the pain was ridiculous). I reinjured it nearly the same way at a tourney like the next weekend. In my fucking WARMUP, but I finished two rounds and had to cut my rashguard off because I couldn’t raise my arm above my solar plexus.

I had to get a nuclear medicine/fullbody/ mri type scan shit (not sure what its called) for my shins (see if stress fractures were healed b4 I started running again). and my shoulder area LIT UP, so they explained to me how injured it was.

all this while I’ve just been working around it, I decided to seek some help and get back to 100%.

I haven’t thrown a full power right hand since i injured it, just use it to set up things… but my double jab left/check hook is so money right now haha.

again thank you guys

Oh and I’m seeing an ART guy asap

for the tightness in my hips as well.

I am not cro-cop lol

[quote]
And I do have my full ROM back (or at least 98% of it. But certain areas are still very painful or I hear a great deal of “clicking” and “popping”. [/quote]

This is not unusual at all. The popping and clicking you describe is the number 1 thing I look for (besides point tenderness) when I evaluate one of my athletes for an AC sprain. Even a Grade I AC jt sprain can linger for several weeks sometimes months if not given adequate time to heal. I know you hear a lot about college and professional FB player playing w/ seperated shoulders but they are able to play b/c prior to the game most get Lidocaine and Marcaine injections to numb the area for roughly 3 hours.

They are also wearing extra padding underneath their shoulder pads to give further protection to the joint. You as a grappler don’t really have those options. If you really want to get rid of the pain quickly, you can go see an Orthopedic and ask for a corticosteriod injection. However, I would only do this if your grappling is your livelihood and you paying the bills and eating depended on it.

If you are just a weekend warrior or grapple for fun, I would just start w/ (3) 200mg tablets of Motrin 3x’s per day w/ meals. This will help w/ pain and any inflammation you may still have in the joint. Also, ice for 20 min. after any activity that aggravates the shoulder.

Pretty much anything you try to do overhead is going to bother you for sometime becuase of the amount of stress you place on the joint on on the ligaments in an overhead position. I would hold off on those until the joint has had sufficient time to heal. How long is that? Well, everyone heals at different rate but most of the athletes I have dealt with it takes anywhere from 6-8 weeks provided they don’t reinjury it during the course of a game or practice. I also give them restrictions on what they can and cannot do in the wt. room so as not to hurt themselves. As for the ART, I am not well versed in what all they can do or do. So if they are willing to help and you think it helps, then go for it. Actually, I would like to know what they do for it so please let me know for my own curiosity. Maybe I can learn some new tricks from another profession.

Had somewhere between a grade 1 and grade 2 sprain about 2 years ago.

The AC joint has purely ligamentous restraints with no muscles crossing it directly. When those ligaments are stretched, there’s nothing you can do to “tighten” it back up.

Stay away from what hurts in the short term and get your shoulders functioning correctly (not just glenohumeral… scapulae, thoracic spine, hips, etc…). With the added instability at the AC joint, having everything else functioning correctly is critical.

On the gym side of things you can permanently can dips.

Bearing a lot of weight on the clavicles (ie front squats) often causes AC joint upset in those with a previous injury.

Hey , good luck with ur shoulder. I dont really know much about it but my doc gave me cortozone for my seperation . It hurt like a bitch when he was trying to get the needle in the right spot. I dont know much about cortozone and the side effects when u get older ive heard its pro and cons. ? does ne one have ne pros and cons about cortozone.

Stick in their. I seperated my shoulder in october during a football game. I fell under the peer pressure from the coaches and tried playin the next week. Two practices with jus shoulder pads on and couldnt sleep at night. Finnaly i said f$ck it. 2 months later and it still hurt bad. so i went and seen a shoulder doc and thats where i got a cortozone shot . The hardest thing for me was not lifting when im addicted to it, and noing maybe i wouldnt of messed it up as much if i wouldnt have listened to my gay coaches.

Im paying for it now, nike combine is only about 2 months away, and im jus starting to bench light weight. My goal was to bench 185 25 times but now im aiming for 15 cause of the delay.

Well good luck with everything dont rush it … and look into cortozone and ask around