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Thread: AC Joint Injury (Grade I)

  1. #1
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    Default AC Joint Injury (Grade I)

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    I self-diagnosed an AC joint injury (left shoulder) and determined it's a grade 1 injury. I can palpate the exact location of the pain, it doesn't radiate, but it also doesn't hurt with the normal tests for AC joint injuries (pull-apart, arm across chest, etc.). It does hurt when I roll my shoulders forward and shrug them a certain way, and I cannot lie down on that side because of the pain, even though it's mild and dull. The pain is not severe enough to warrant NSAIDs.

    I feel like I could bench press and press, but I don't want to take any chances. Given the lesser severity of the injury, what activities should I avoid and how long? In cases like this, would pain have to be my guide in returning to normal bench pressing? It seems to be a thing with me now to get injured when I'm about 8-10 weeks out from a competition.

    Thanks in advance.

  2. #2
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    Quote Originally Posted by marcf View Post
    I self-diagnosed an AC joint injury (left shoulder) and determined it's a grade 1 injury. I can palpate the exact location of the pain, it doesn't radiate, but it also doesn't hurt with the normal tests for AC joint injuries (pull-apart, arm across chest, etc.). It does hurt when I roll my shoulders forward and shrug them a certain way, and I cannot lie down on that side because of the pain, even though it's mild and dull. The pain is not severe enough to warrant NSAIDs.

    I feel like I could bench press and press, but I don't want to take any chances. Given the lesser severity of the injury, what activities should I avoid and how long? In cases like this, would pain have to be my guide in returning to normal bench pressing? It seems to be a thing with me now to get injured when I'm about 8-10 weeks out from a competition.

    Thanks in advance.
    "self-diagnosing" is unreliable- if even possible on AC separations. When you start talking about "grades" you are talking about some degree of tearing/ separation. I had a grade 3 /grade 4 in 2013 (the grades are a spectrum and not always perfectly delineated) during a mountain bike accident. Had to have multiple sets of xrays done- some required hanging weights from the arm in order to measure AC separation. Family doc thought it needed surgery- surgeon said surgery was possible but probably not advised. Grade 5-6 require surgery, 3 and 4 grade tears are controversial. Surgical repair is usually done via ligament graft (often from the hamstring). I was advised that among active people the surgery often times doesn't hold anyways. Surgeon said given my active lifestyle and career (cop) I would probably waste 6-12 months of inactivity after surgery only to have it re-tear again at some point. He advised physical therapy and letting other shoulder muscles compensate.

    Talk to your doc and get a firm diagnosis. The shoulder joint is complex- could also be rotator cuff or other problems. Without knowing exactly what injury you have you risk a dislocation under tension. As far as recovery, pending a doc visit- Back off barbell weight on over head exercises and maybe add light dumbbell exercises in the interim. Give it 2 weeks and test it out with some overhead presses and increase weight accordingly- if pain or instability occurs give it another 2 weeks rest from heavy overhead barbell. Band exercises are nice too when a true tear has occurred.

    My shoulders are forever uneven when I have my shirt off and mild arthritis has already set in around the joint (I am 31 yo)- but with time and dedication I got my bench back over 300 again and am confident my shoulder joint will hold. Side note: I went about 20 months without barbell after my AC tear- it was a very very long recovery road. Granted, I am sure a grade I tear will allow for a much quicker recovery.

  3. #3
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    Thanks, sheepdog. I self diagnosed because it's not severe (I can palpate the area of pain, it's very local to the distal end of my left clavicle, the pain doesn't radiate, etc.) and the pain isn't so bad that I can't put clothes on over my head, I can press an unweighted barbell over my head with no pain, and in general I forget that the area is even hurt unless my backpack smashes the exact area where the pain is. And even then it doesn't hurt much-feels more like a bruise. Based on this, and what I've read everywhere online and in the forums, it seems like a grade 1 injury where there is no separation.

    I'm going to give it another week (it's been 6 days already) and check back in.

  4. #4
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    what caused the injury?

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    Quote Originally Posted by MBasic View Post
    what caused the injury?
    Funny enough, I think the reason it's so mild is it was caused by two things that happened over time: bench pressing, and consistently leaning on my elbow the way I do in bed when I read the news at night, which I shouldn't be doing, anyway.

    When I lay on my side and lean on my elbow like that for an hour or so, and I get up, I feel the tension and aching in the area that hurts now (distal end of clavicle), but it would always go away after a minute or two of stiffness, so I thought nothing of it. But after bench pressing last Friday (245lbs 5x5) combined with this bad habit, when I got out of bed it finally hurt enough to be really noticeable and the pain didn't go away as it always does.

    The pain is even milder and less noticeable now than the day of the injury, which was 5-6 days ago. I almost feel like I could bench again in one or two days and see how it feels during warmups, but I figured I'd give it another 5-7 days to be on the safe side. Rushing back into things usually makes injuries worse, but I also have a meet coming up and I don't want to take too much time off.

  6. #6
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    Hard to say, but this sounds like an issue I have struggled with for the last year or so. After lots of misdiagnoses (similar to you, nothing showed up on the standard tests other than it hurting when I shrugged or sort of rolled the shoulder forward), MRI revealed an AC sprain (no separation) and tiny osteophyte. Onset was gradual, over about a month. Since I'd been suffering through it for 3-4 months by that point and it has completely derailed my training, I got a cortisone injection which alleviated all pain within a week. That was last April. Since then the pain has come back intermittently. NSAIDs (topical and oral) help the most, as does avoiding movements that aggravate it (leaning on that shoulder/elbow, high impact things like burpees, and barbell rows). I've also seen great improvement since adding some slingshot benching into my training.

    If it continues, my advice would be to do everything you can to get an MRI sooner rather than later.

  7. #7
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    I've had this problem recurring on and off for 2 years. I did get it diagnosed as AC Joint Arthritis via x-rays. The only medical option for it is a mumford procedure. Which seemed way too invasive for my symptoms. I've done NSAIDS for a few days to help it in the past. I've also had to take multi month benching breaks before.

    However, what really helped is changing how I sleep. Sleeping on my side is much easier on my shoulder than sleeping on my stomach. I can immediately feel a difference when I change sleep positions. I also use a slightly narrower bench grip and touch lower on my chest than ideal. But...my bench is moving up and after months of start/stop...I've been at it 5 months with no significant pain. Note: I also take Tylenol before benching and the night after benching. But don't need it any other time.

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