AC joint arthritis - anyone undergone surgery?

Micah - I have had the same experience - long layoff from swimming, with a diagnosis of AC joint arthritis after about a year back in the pool. Over the past 3 years I have had at least 6 injections. Having said that, I have been pain free for close to 8 months now. What has helped: - religiously doing my RC exercises (particularly theraband "press-out" with shoulder blades squeezed) - avoiding any heavy overhead lifting (military press, etc) - by my own amateur diagnosis, improving the "balance" between the strength in my chest (pecs) and the weakness in my back. The imbalance led to my shoulders rotating forward. - avoiding lots of hunched over keyboard typing. Re the balance, I have been doing the P90X routine, which includes lots of back strengthening exercises (pull and chin ups, mainly). This has made a huge difference. Unless your surgeon shows you a significant bone spur that is rubbing and causing pain, I would view surgery as a last resort. Two years ago I was in so much pain that I begged my surgeon to do the procedure. He refused(!).

Hi, I have had multi shoulder scopes,which I always have less pain and better range of motion several days after the scope. I would recommend you talk with a orthopedic surgeon who is a sports med and specializes in shoulder injuries. Also I think it is important to work with a Physical therapist that will give you exercises that will help keep your shoulder stronger and that you will need to do to keep your shoulder healthy. I would also have a swim coach analyze your swim stroke. Sometimes with an injury we adapt our strokes so we can swim,but might cause more damage in the end. If you are anywhere near Cleveland Ohio,the Cleveland CLinic has a wonderful sports med.dept where PT/acupuncture/dietician/surgeons are all together in 1 area. I would also recommend Dr Anthony Miniaci. I wish you the best of luck and take care.let me know how you are doing. Sandy

I just had my MRI this week. AC joint inflamation and supraspinatus tendonopathy... that tendon is inflamed and may have some microtears. I've been kicking for a month, and now I'm giving that up for a month, since kicking puts pressure on my shoulder, and I still can't swim without severe pain. The plan now is to rest for a month, and ease back into it... for now, then add back the dryland. I hope to avoid surgery, but time will tell. I've been back swimming USMS for several years, but it just caught up to me this year. One contributor to my shoulder problems may have been I slacked off the dryland this summer (sleeping in), which I always do some RC related exercises. I may be paying the price now. Or maybe I'm getting old. It's doubly frustrating, since I had a good SCY season with several masters PRs, so I was looking forward to building on that, and we finally have some good younger swimmers on the team now to push me, at least on freestyle (what are those other strokes about anyways?). Now all I can do is watch them swim. Maybe I need the rest, and will come back stronger. In the mean time, I'll try to pick up the running, biking, and spinning and work may weak legs and strengthen my core and try to lose too much conditioning. I will be going to swim practice in the morning, but will go for a run, then hit the gym for some legs and core work.

I've been swimming for four months. Diagnosis is osteoarthritis with two possible tears (supraspinius and infraspinius). I'm waiting for the results of my arthroscopic MRI now. I'm swimming but backing off when the shoulder barks at me. I'm considering surgery and all that entails, but am leaning toward PT and shoulder strengthening first. It's bumming me out. I've dropped 25lbs (with at least 30 more to go) and recently posted SCY times between 110 and 120% of national qualifiers. Swimming is literally saving my life, but my shoulder isn't cooperating. If anyone has gone down this road, deferred surgery, and was able to swim with minimal pain I would be interested to hear your story. Jeff

Sorry I don't know anything about this condition, but would like to know: do you think this is a result of your intensive swimming? Is this and other similar conditions (e.g. shoulder arthritis) a result of swimming frequently, even in correct position? Do most long-term frequent swimmers develop this kind of conditions eventually? I would think backstroke is the most likely culprit? But the main thing I'd like to know is: are they avoidable if your movement and position in swimming are appropriate?

I think, depending on your physiology, they are somewhat inevitable for many people. I swam intensively for ten years when I was young, capping with workouts like 100x100 on the 1:45. When I returned to swimming twenty years later, nagging shoulder problems became chronic. I am in the process of changing my stroke. I was taught to keep my shoulders level and use my arms to get leverage. I'm now trying to keep my hands inside the shoulders and use my core to get leverage (with more roll). I slip into old habits, however, when I get tired. I do believe that technique has a lot to do with the strain we put on our shoulders. If I defer surgery, I'm going to be looking for a stroke coach in conjunction with my PT.

I have not been able to swim much since April 2010 because of shoulder pain. 3 doctors and 2 therapists later, I came to the same conclusion as JimRude. The 3 Drs told me something different. 2nd therapist was a college swimmer/coach said I was internally rotated. He mentioned that swimmers are stronger in the chest and weaker in the back (at least that was my case). Stronger doing internal rotations than external rotations. I started doing stretches to “open the capsule” as well as others exercises. I started swimming slowly with mostly kicking. The Therapist did say that kicking with the board causes some stress and I should try kicking free without a board and hands on my side to reduce stress and strengthen the core. I went to 2 practices of an hour each a week apart of ~2500yds and the pain came back. I sharing what I learned but I am in the same freaking boat as before. I am working on it but I am not successful at it at all.

I've been swimming for four months. Diagnosis is osteoarthritis with two possible tears (supraspinius and infraspinius). I'm waiting for the results of my arthroscopic MRI now. I'm swimming but backing off when the shoulder barks at me. I'm considering surgery and all that entails, but am leaning toward PT and shoulder strengthening first. It's bumming me out. I've dropped 25lbs (with at least 30 more to go) and recently posted SCY times between 110 and 120% of national qualifiers. Swimming is literally saving my life, but my shoulder isn't cooperating. If anyone has gone down this road, deferred surgery, and was able to swim with minimal pain I would be interested to hear your story. Jeff I'll chime in about my experience, because it's been positive so far. I too was a collegiate swimmer, took 20 or more years off (I'm now about to turn 53), dropped 50 pounds and started back swimming about 18 months ago, only to have issues with both shoulders. My left had a SLAP II tear, and partial tears of the subscapularis (a large one), supraspinatus, and infraspinatus. My right had a SLAP II tear, partial tears of supraspinatus and infraspinatus, and bad AC joint arthropathy (which was killing me). Last June I tried PRP (platelet rich plasma) injections of the left shoulder in all the affected regions (in one session under ultrasound guidance), did PT and kicked for a month. My left shoulder felt so good at that point, that I realized how bad my right shoulder hurt, so I had PRP injections of the areas (in one session) for that shoulder in July. I was able to resume training (maybe 4000 yards a day) in September. My right shoulder has had no problems at all. My left shoulder still gets sore if I do too much fly, but it's definitely manageable. Two weeks ago, I swam in 10 events in a 2 day SCM meet and both shoulders held up fine. I assume my good outcome was the combination of the PRP injections, rest, and rehab, but I'm certain in my own mind I wouldn't be swimming regularly now if it weren't for the PRP. Time will tell how long it holds up, but I've avoided surgery, get to train and compete regularly, and had some of the worst looking shoulder MRIs around. There's no great clinical trial evidence that PRP works, I haven't had repeat MRI's to show definitive healing, and it's generally not covered by insurance (I sank about $2000 into it), but I'm very glad I did it.