To Surgery or Not to Surgery? That is the Question!

I seperated my shoulder a few months back playing rugby and have now completed all my physio and healing. The physio is now saying that I have to decide whether or not to get surgery as I have a rather nasty step deformity on the left shoulder. I have recently started back to lifting and can do most things.

I still struggle with some overhead movements like the snatch and overhead squats however am fine with cleans and deadlift etc. Obviously I 'd rather not get the surgery if possible as I’d have to take time off work and training. I just wonder if anyone could help me out with some advice as to whether there are any other alternatives???

Any help would be much appreciated!!!

From the looks of the picture, it seems to be a fairly significant grade of AC ligament tear. What did the doctor initially say when you were evaluated? How much play and movement do you still have? Surgery vs non-surgery is also dependent on what level of activity you plan on returning to post-injury.

The doctors to begin with were really unhelpful at first the doctor told me I had a dislocated shoulder but later told me it was seperation of my clavicle. I 'm starting a masters in strength and conditioning at university in september and would like to play rugby on a regular basis so a shoulder that will be able to withstand that amount of activity would be nice!!

I have a great range of motion probably better than I did before the injury however it still feels (the only way I can describe it is) awkward at times!!

With that big of a separation between the clavicle and acromion, I’ve generally seen a emphasis on surgery by the physicians I have worked with. But again, that is just from a visual from the picture you showed on here. You and your docs will have to go by the X-ray results.

As Levelheaded has mentioned, the severity will be graded on your xray. Grades 1-2 are non surgical, 3 is debated, 4-6 is surgical. You should definitely see a sport medicine orthopedic surgeon, so he can inform you surgery vs no surgery, lay out your options, explain the risks/benefits if surgery is warranted.


Regardless of what you decide, definitely get the advice from several doctors directly involved in the surgery. Talk to PTs to see if they have rehabbed this with further work. Get further imaging done (why not MRI?).

And as a last note, make sure “the juice is worth the squeeze”. The surgery can either go good or bad. You could end up much worse. Make sure you know all risks and what activity level you would be able to return to.

I had a similar injury back in '06, motorcycle racing crash.
Opted not to bother with surgery. Although it took a little time, everything came back. It’s a fun conversation piece to show off my no longer properly attached collarbone, and I can overhead press as well as I could before the accident. Better, actually because the injury motivated me to train harder/more, oddly enough.

My shoulder looks exactly like both of those photos… still. I injured it about 10 years ago and where I don’t have any significant pain in it anymore, it still bothers me slightly from time to time. It could have been aggravated more by going through basic training a couple months after I separated it though. Time is the best healer.

It’s more uncomfortable than anything. I also opted not to have surgery per my doctor’s recommendation and I’m pretty happy with my decision. Going under the knife isn’t something to take lightly and in some cases can just make the problem worse.