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Acromion Hook

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MNichols View Drop Down
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    Posted: 1/11/14 at 3:43pm

I don't post often but I've been throwing and training for about five years. I recently turned 60 and compete in most of the SHA games in California, along with a season finale at the Ventura game. At the end of this past season I was experiencing some ongoing shoulder discomfort in my right front deltoid area. After light lifting and rest failed to eliminate the pain I had a consult with the best ortho doc in the area a few days ago. He went over my xrays, put me through some diagnostic movements and, then, I learned more than I ever wanted to know about a shoulder condition called a hooked acromion.

This is the small bone at end of the shoulder under which the rotator cuff muscles contract to move the arm up and around. The acromion bone is supposed to be flat. However, some people come equipped with an acromion that hooks downward, thereby inhibiting and ultimately damaging the rotator cuff. As we age, damage is increasingly probable if one regularly engages in sports involving throwing or overhead lifting. That's me on both counts, hence my shoulder pain. The doc told me that the severity of the acromion hook is classified from 1-3 with 3 being the worst; according to him, I've got a 4.

I could rest the shoulder until the current pain diminishes and then not do anything that would aggravate it, ever. Or, I can get my shoulder scoped to shave off the hooked part of the acromion, resume training in about six weeks with full recovery expected within six months. Given that I'm nowhere close to even considering the possibility of retirement, you can guess which option I've chosen. Surgery is scheduled for February 7th.

If anyone has any experience with this type of shoulder rehab and recovery, I would really appreciate hearing from you. What worked, what didn't, how long it took to get back in action, or anything else you found important.
Martin Nichols
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CKasson View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CKasson Quote  Post ReplyReply Direct Link To This Post Posted: 1/11/14 at 5:07pm
I'm an ortho physical therapist, PM me and we can talk more.
Chuck Kasson
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Sammy68123 Quote  Post ReplyReply Direct Link To This Post Posted: 1/12/14 at 10:27am
Hi Martin,

I don't remember the type of acromion I had when I had a small supraspinatus tear in 2008. However, I'd had ongoing crabby issues in the right shoulder for years and conservative measures weren't working. The surgery I had was "sub-acromial decompression with distal clavicle resection". To my knowledge, the surgeon did not shave the acromion, but instead removed the bursa and shaved back the clavicle from the AC (acromioclavicular) joint. That leaves more room for stuff to move without being cramped by other structures. He also had to repair the 1 cm full-thickness supraspinatus tear I had, which made for a longer recovery than if the tear had not been full thickness.

6 months seems to be the magic number that always gets thrown around for the full recovery. In fact, when I first saw PT at 2 weeks post surgery, his eval showed me at the 3-4 week point. They have a pretty standard protocol they follow to guide your return. My surgery was in Nov 2008: I did state PL championships at the end of Apr 2009 (about 3 weeks before the magic 6-month date). My plan was not to go all out--just to get a total. I'm not a great bencher by any means, but I was at about 95% of the previous year's meet BP and was able to up my DL to equal the previous year's total. Threw a bigger schedule of games beginning in June 2009 (I needed to get enough to qualify for MWC 2010) with no problems.

I'm a fitness professional, so I was well aware of where the boundaries needed to be. Feel free to PM me also.

Teresa Merrick, Ph.D.
Bellevue, NE
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DaleGehman View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DaleGehman Quote  Post ReplyReply Direct Link To This Post Posted: 1/14/14 at 9:11am
Martin,

I'll give you my experiences. I had the decompression surgery Dec 2011 on my left shoulder, at age 49. I'd had cortisone in it several years before, but eventually the pain was an issue again, and the doc recommended surgery. He found a spur (hook), and some damage to the muscle, but not a tear yet. The surgery was early Dec., and I was doing light machine work in the gym in late Dec., free weights in Feb, and throwing ok by May. It took several weeks of PT and the range of motion came back slowly, but it worked and the shoulder is great now.

In Sept of 2012 I tore the supraspinatus in my right throwing WOB, but didn't realize the extent of it. It was improving through the winter, but in March was getting ouchy, so I got cortisone. 10 days later I ripped the tendon off the humorous benching (because it didn't hurt!). So this time the fix was repair the muscle, reattach the tendon, and grind off the spur, which was the root of much of the problem.

I had surgery late May, was lifting machines in August, and free weights in October. I'm still getting better, but it's slow to regain strength.

My suggestion is to get it over with and have the spur removed before it becomes a full-fledged tear, which is a much bigger deal. The pain isn't fun, and the PT a pain, but it's much better than both with the tear. Good luck

Partner in JDJ Caber Co. "Proudly serving the Scottish Heavy Athlete with fine cabers for sale. No orders too large or too small."
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MNichols View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MNichols Quote  Post ReplyReply Direct Link To This Post Posted: 1/16/14 at 5:13pm
Many thanks for the responses to my shoulder question. The more info I get, the clearer it is that surgery really is the best option at this point. And, it is encouraging to know that a full recovery is entirely possible within a reasonable period of time. Assuming all goes well, I'll be aiming for Monterey in July.

Thanks again.

Martin Nichols
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