Understanding Distal Clavicle Resection
If you’ve been experiencing persistent pain at the very top of your shoulder, especially with overhead activities, lifting, or when reaching across your body, and other treatments haven’t helped, your doctor might suggest a Distal Clavicle Resection. This surgery aims to relieve pain by removing a small portion of your collarbone where it meets the shoulder blade.
What’s Going On with Your Distal Clavicle?
At the very top of your shoulder, your collarbone (clavicle) meets a part of your shoulder blade called the acromion. This forms the acromioclavicular (AC) joint. Like any other joint in your body, the AC joint has cartilage that allows the bones to glide smoothly, and it’s surrounded by a capsule and ligaments that provide stability.
Problems can develop in the AC joint due to:
- Osteoarthritis (Wear-and-Tear Arthritis): Over time, or after previous injuries, the cartilage in the AC joint can wear down, leading to bone-on-bone rubbing. This causes pain, swelling, and stiffness.
- Previous AC Joint Injuries: Even if a previous AC joint separation healed without surgery, the joint can still develop arthritis or persistent pain due to altered mechanics.
- Repetitive Stress: Activities that involve frequent overhead lifting, pushing, or reaching can put stress on the AC joint, leading to degeneration and pain.
When the AC joint becomes arthritic or painful, the ends of the bones can rub together, causing significant discomfort and limiting shoulder movement.
How Does Distal Clavicle Resection Help?
Distal clavicle resection (also known as Mumford procedure) is a surgical procedure designed to create more space in the AC joint and eliminate the painful bone-on-bone rubbing. The goal is to relieve your pain and allow for more comfortable shoulder movement.
During the surgery, the surgeon will:
- Access the Joint: This procedure can be done using a small incision (open technique) or through very small cuts using a tiny camera (arthroscopic technique). The arthroscopic approach is often preferred as it is less invasive.
- Remove a Small Bone Section: A small amount (typically 5-10 millimeters or about 1/4 to 1/2 inch) of the very end of your collarbone (the distal clavicle) is carefully removed.
- Create a Gap: By removing this small piece of bone, a space is created between the collarbone and the acromion. This prevents the two bone surfaces from rubbing against each other, which is the source of the pain. The space then fills in with scar tissue, forming a “false joint” that is flexible and typically pain-free.
Life After Distal Clavicle Resection:
After your distal clavicle resection, physical therapy is important for a successful recovery and to regain the full use of your shoulder. Your physical therapist will guide you through a structured rehabilitation program, which typically includes:
- Pain and Swelling Management: Techniques to reduce discomfort and swelling around your shoulder.
- Gradual Movement Restoration: You’ll begin gentle exercises to slowly restore the range of motion in your shoulder, typically starting soon after surgery.
- Progressive Strengthening: Your therapist will introduce strengthening exercises for your shoulder muscles (rotator cuff, deltoid, and shoulder blade muscles) to improve overall shoulder stability and function.
- Functional Return: As you progress, your therapist will help you gradually return to your daily activities, work tasks, and sports, focusing on proper mechanics to prevent strain on your shoulder.
Recovery from distal clavicle resection is generally well-tolerated, with significant pain relief often experienced within weeks to a few months. Following your physical therapist’s instructions closely is crucial for achieving the best possible outcome and safely returning to your desired activities.