For those with shoulder issues!

Alright NS, this is for everyone with shoulder issues! I have seen so many threads now from people with shoulder dislocations, AC joint issues, etc, and so figured I'd create a thread for those people to refer to!! I have had multiple disloactions of both shoulders, and have had reco's on both, so I will give ya my experiences, and all the knowledge I now know!! I'll apologise now as I have the tendancy to ramble, so I'm letting you know now that this is gonna be a long post, haha, read at your own will, but I encourage those with shoulder issues to read! I woulda put it in NSG but figured more ppl will see it here.

Firstly, I'll give ya the scope of people who I have worked with for my shoulders, so you know the 'legitness'. My sports doctor is the doctor the Crows, an AFL footy team here in Aus, this is something to the equivalent of being a sports doctor for an NFL or NHL team. My surgeon is also the surgeon for the crows, plus many other high profile atheletes and sports teams in Australia. My physio has practiced for years in Verbier, and now practices here in Australia, and is the physio for the Australian volleyball teams, and has also worked with heaps of other Australian sports teams. So you know the info I am giving you is reliable, and I have also researched this a shitload for myself!!

I first dislocated my right shoulder in 2007, in a big air comp. I was simply reverting around from switch to natural and the bottom of the landing, but caught an edge in all the sugary shit where everyone else had reverted around too (we don't have the best snow is Aus). I fell with my arm outstretched and with my body turning, effectively my arm pulled the shoulder out of its socket. It must have had some pressure loading, because it blew the spring out the back of my FKS bindings!! I know, hella effort! Anyway, this is one way of dislocating your shoulder, the other is by landing directly on it, and the pressure pushing your shoulder out. I have dislocated my left shoulder in this same way. Anyway, I got up from my fall and moved my arm, and my shoulder immediately popped back into place. Thinking I was sweet I grabbed a mates skis and started running back up the the drop in, full of adrenalin, but about half way up I realised my shoulder was fucked. This shoulder was reco'd in April 2008. I dislocated my left shoulder in early 2008, and did it many times since, and had surgery early jan this year. So here is the treatment process following this!

Firstly, my shoulder dislocations were always subluxations (ie. the shoulder comes out and goes back in itself). Slightly better than if you gotta put it back in, but treatment process is the same. You go into a sling for a week or 2, icing on and off for the first 4 or 5 days. I then had an MRI and saw my sports doctor. He told me that cause it was only the first disloaction, and I wasn't heaps young (21 at the time I think) that I should do 3 months of rehab. Sorry kids, if you're young, you have faaarrr more chance of redislocating, if you are older, your shoulder is stronger and more developed so you have less chance of redislocation and more chance of effective rehab. Rehab will involve inital work with a theraband, and then hours in the gym! With the theraband, the Idea is to do build up endurance - many many reps at a relatively low level of resistance!! Once you are doing say 3 x 50 reps, it will then be time to hit the gym. Don't try and quickly work your way up to the highest resistance theraband, because this will not target the right muscles!!! The idea is that the shoulder is a ball and socket joint - the shoulder cup (socket) is lined with cartelidge that sucks the ball into the socket so to speak. When you dislocate your shoulder, you tear the shoulder cup and damage cartelidge - so socket no longer sucks the ball in place properly. My right shoulder was done so bad it even tore down to some of my bicep. The idea behind rehab is to get the muscles surrounding the ball and socket joint strong enough that they can hold the ball in the socket without the full effectiveness of the cartelidge. Realistically, if you have given your shoulder a fair dislocation, it takes 3months of rehab to really try and get this right. In my case, I did 3months of rehab, in the hope of avoiding surgery, but then came up slightly backseat, put my arm back, and it got caught on the knuckle while the rest of me made the landing - it popped out again. Basically, once you have done your shoulder more than once, it will need surgery to get it right!! For those of you who have done it once, but want to get through the rest of your season - take 2 weeks off, wear a sling and ice for the first 4 or 5 days. You can then return to skiing, but strap it up (I'll go through this later), and see a physio to get some theraband and do some excerices to improve the stability through the muscles.

SURGERY!! Depending on the level of tear you have in your shoulder, you will either have an arthroscope (key hole surgery), or open surgery - recoveryt process for both is the same. In both my cases I had an arthroscope. Surgery is balls, and you will be in some serious pain for the first 4 or 5 days. You will be in a sling for 4-6 weeks, and the first week you will need to ice on and off at pretty much all times! The process from there is basically getting mobility back, helping your shoulder learn to react to situations, and also to rebuild the strength. Hopefully after 4 weeks you will be out of a sling and ready to start some physio. With my left shoulder, I am currently 2 weeks into physio. Do your excercies religiously, I cannot stress this enough! You will start with static excercies, pushing and pulling against a door frame, pushing against a wall, pendulum exercises, etc. This will only last a week or so, then it is time to start with the theraband. Once again, you will look to build up to as many reps as possible, with a relatively low level of resistance. This process will last probably 4-6 weeks, possibly more. Once your physio feels you are ready, the time will come to go to the gym. I recommend going to a gym where you get supervision and assistance, or to get straight up PT (personal training) sessions, as you will need someone who knows about shoulders to build you up a program over a couple months to get your shoulder right. You should try to stay away from working for around 3months, unless you do something completely non-physical - computers or something. Anyway, you will spend somewhere around 2-3months in the gym getting strength back, and also doing excercises that re-train your shoulder in reaction speed etc.

So basically, the recovery from surgery is 6months. This is totally dependant on the individual, if you train all the time, your shoulder will naturally be stronger, and you may take slightly less time. Doing rehab before surgery is super handy, it builds up your shoulder so that the recovery process is slightly easier! Plus you will know the excercises then! You can probably ski lightly at 4-5 months, but really it's not a good idea. I'm pretty sure you all know how hard it is to go out for a ski without being tempted to try shit!! So realistcally, if you have surgery, at 6 months you will be able to really give er again. And then from there, continue going to the gym, or at the very least doing your theraband excercies, to maintain the strength and composure in your shoulder. If you continue to do this, your shoulder will simply get better and better over time. I had my right shoulder reco'd in april 2008 and it has stayed in ever since, and I have taken some solid bails. I'm hoping the same will go for my left!!

Sorry, final part. Alot of people wonder about shoulder braces, strapping, etc. In my experience, strapping and bracing works to an extent, and will get you through the rest of your season or whatever, but it will not stop your shoulder from dislocating on every occassion. Think about it, if you dislocated your shoulder when it was 100% perfect, if you fall on it the same way when its weakened, it will go again! After I did my right shoulder the second time, I was then strapped each time I rode by a mate that used to strap for NRL rugby teams, and it was sick. Most sports doctors/physios etc will all agree that strapping is infact more effective than any form of brace - however you need to do it properly!! For the last couple seasons I have worn 2 shoulder braces, and they have been good, but my shoulder has still popped out. My left shoulder got to the point where if i knuckled a big enough jump, even if i didn't bail, the sheer impact would cause it to come out - at this point you know you need surgery! But yeh, if you really want a brace, go for a donjoy shoulder stabiliser or something similar, if you only have one bad shoulder, as it limits your range of movement so your shoulder doesn't extend past the 90deg range, which is where it is most likely to dislocate. If you have a friend you can teach to strap your shoulder properly, this is the best option!! Have a look on some of the strapping tape sites for videos on how to tape properly, or even better find a physio or someone that has experience in taping and learn from them

One last thing, for those of you with AC joint issues. The process is completely different. A torn AC joint is an un-fixable injury, it's with you for life. However, it is nowhere near as bad as a dislocation. If you do your AC joint, the idea is to ice one and off for the first few days, sling for the first week, and stay away from any activity for about 2 weeks. Once your 2 weeks is up, if you feel ok, then you are good to shred again!!

Sorry for the huge post, but wanted to cover as much as possible. I will add to this thread as I remember stuff! If you have specific questions, want some advice relating to your personal situation, or need some reassurance, feel free to send me a PM and I am more than happy to help out. Having said this, I am not a doctor, I am only speaking from experience and a lot of research - there will be no substitute for going to a sports doctor and getting advice for your own situation. I have the arthroscope pics of my shoulders, I'll try scan em and post em up at some stage!

 
I dislocated my shoulder 2 weeks ago. Torn AC and labral tear. The first time it popped out i had the ER put it back in. But after that it popped out 2 more times within 2 days of the major injury. After poppin lots of meds. i kept it in well. and got the arthpgram/mri/ct scan (which hurt like a mother fucker getting the iodine into my joint capsule. Anyways it was starting to heal up real nice(pains were goin away and i was off my meds. but, today as of 2-22-10 it popped out again. and after trying for an hour i couldnt get it back in. but after popping some vics and helplessly giving up on my couch(not wanting to go to the ER since we already have tons to pay for) it just slowly starting coming back into place.

But im scared since i saw my collerbone stickin out where my ac is like a mother fucker. and now i feel like im starting the healing process over again which completely throws 2 weeks of progress away. and the worst part is my orthopedic told me that i probably wasnt guna need surgery cuz its only a type 3 tear. but i feel like i put myself into a deeper hole. but its feeling ok now that several hours hve passed.

sorry to rant. just wanted to throw in my 2 cents. its soo stressful not being able to ski. watching my friends shred he beautiful spring weather and uber sunny conditions. a shoulder dislocation is not to be taken lightly. just cuz it may feel better doesnt actually means its better( so deceiving). But thanks for your information and ill probably look to you from time to time on advice. +++++KK and vibes.
 
i broke my shoulder socket today. straight fractured. it was wierd, it didnt even hurt terribly, but i cant move my arm
 
^^ thats pretty nasty dude!! Now you have done it for a second time, it's worth really getting the healing process right! I know its expensive, but getting the right treatment and the right advice is priceless - afterall it will get you back to shredding asap with the most strength, and you can't put a price on being able to shred!! My suggestion is for you to go see a physio, give it 2 weeks off, and get some theraband to do some excercises with, build up some strength to account for your laberal tear! It will at least help you with the rest of the season, take it easy for as long as u can handle! If you end up needing sugery, at least you might be able to put it off till summer! Vibes for a quick recovery dude!
 
yeah sucks alot. i'm givin it 2 weeks before i start physical therapy. but hopefully i wont need surgery. and i gotta take it easy cuz even a little pressure pops tht shit right out.

if i let it heal for about a month without it popping out and then start shoulder workouts, will i be able to shred/play full contact sports 100% within lets say about 3 months???
 
^ well the idea is to do 3months of quality rehab and then you are in the position to test it out again. If you committ 3months to quality rehab, then I would say you could get back out and try skiing and playing contact sports at 100%. However, if it pops out again at that point, you're really in the position where you will need surgery, but dude 6months is worth it for the peace of mind to be able to ski properly!! Your physio will be able to give you a more accurate answer based on you personal situation - sounds like you gave it a good tear. Just don't let it get to you - it fucken sucks, but you can get it right, and you can ski 100% again - just don't forget that!
 
Quality post. It's obvious you have the knowledge. Good too see my shoulders have sublaxed since I was 10 and now my shoulders sit half out of the socket all the time, so I'm going to need a reco soon. Now I know what i'm up for, i'm stepping up my exercises.
 
Excellent thread!

My first subluxation occurred 3 years ago. Arm got trapped behind my body when I fell landing switch. Popped out and in quickly. I never saw a doctor on it and never did anything about it.

Next winter I subluxed two more times. The following summer, I did a handstand in the pool and fully dislocated and had to go to the ambulatory care center to have it reduced.I did PT for the first two weeks, and then just stopped. Dislocated a second time last season, and again, did nothing.

This past January, I dislocated for a third time (as opposed to subluxations). I have taken the hint and hit PT HARD. 30 minutes a day, every single day, all rotator cuff exercises, low weight and taking each exercise to complete fatigue. I have noticed definite improvement and feel that it is actually stronger than it was prior to the most recent dislocation.

My plan is to be diligent about the PT and slightly shift my lifestyle. Going forward I will not be skiing park aside from easy jumps that I know I can stick without flailing. I will be limiting my risks more. If I ever get to the point where my shoulder is limiting me in many situations, then I will get the joint repaired surgically.

For now though, I will continue to hit PT hard daily, focus on learning to fall more properly, and reducing my risks in certain situtaions.
 
your time frame for an ac joint is really for a minor one, grade 1 probably. it's going to be a bit longer for any more serious ones. my grade 3 took about 4 or 5 weeks until i felt good enough to really be doing anything.
 
and shred confidently knowing your shoulder is as strong as it can be... i ignored my shoulder pain and now when it moves fast, or rotates beyond normal use, i get a slight pinching pain, it blows.
 
Nice write up. It is a good bit of info for those of us with shoulder injuries and especially those new to them. I don't wish this on anyone as shoulder injuries are a tough thing to deal with. Maybe a shoulder injury prevention thread to follow? Something along the lines of stretches, shoulder workouts, how to crash... (Though I do understand many of these injuries were fluke and so quick and unexpected that there was not a single prevention for them).

My dislocation was so rare that it took 4 different doctors/orthopaedics to figure out what was wrong. It turns out that the way my arm came out, it damaged the web of nerves in my shoulder and basically rendered my arm useless until the nerves repaired themselves. Atrophy in your dominant arm sucks. My shoulder muscles withered away and my arm would drop out of socket by merely a sudden stop of movement (going down stairs...). It has been over 13 months and I'm still trying to get full motion back and arm control is still a bit of an issue, however it is still progressing. Keep in mind, this is opting for no surgery, just extensive rehab. The major damage was the nerves which do heal (approx 3mm per month). My rotator cuff was damaged, but not completely torn and the ligaments were slightly damaged but still have a chance at near full recovery on there own if I give it the time to heal.

 
thanks for the thread. i also injured my shoulder this season about a month ago. It is still bothering me quite a bit. I'm just starting PT now. I have no idea what I did to it, but it still hurts just as much as it did when I injured it. the wierd thing is i can still use it to play basketball and stuff, it just hurts a little bit.
 
doing the rehab is KEY! but shoulders are so hard, being a ball and socket and all.

if you don't do the rehab, with nearly any shoulder, the shoulder can sometimes go into what is known as locking and freezing. With extended use then it is not uncommon to get "electric shock" or "lightening bolt" nerve pain down the arm. When you're this far in you're basically screwed and the most common diagnosis is bursitis, to which there generally isn't much help... and if applying for new health insurance, you will most likely be denied any coverage on that shoulder since it is known as a "chronic condition."

DO YOUR REHAB.

it's been 12 years for me now since the first shoulder injury and I don't have a day without my shoulder being an overall fuck in life.
 
Sick that people are adding more to this thread - the more people with experience and advice the better!! I would put up a shoulder injury prevention thread, with some stretches and excercises, but as long as people don't get shitty with me if they still dislocate, haha, because you can do all the work in the world but if you fall on it bad enough in a bad enough way, then it'll go! Yoga is apparently amazing as well, something I am definitely going to get into when I am allowed. But let me know what you think people, if you want me to post up some excercises, I'm happy to do it!! Vibes to all those who posted with shoulder issues, keep working on that shit and get it right!!
 
so i dislocated my shoulder last week, really just a simple fall on a kink box.. fell on my outstretched arm and bummed out my shoulder. Went to ER and got it reduced, went through the whole shibang.. got knocked out, they popped it back in, xrays but when I asked the doctor how long I should keep the sling on, he said just a couple of days (3 days later I took it off), and I asked how soon I could consider skiing.. he said you can probably be out there next week (its roughly been a week).

my shoulder feels pretty good, some stability is gone in more awkward positions (like tucking in a dress shirt into the side) but all the motion is there. i haven't done extensive PT yet other than simple stretches but Im getting Therabands today to start a program. this is my first dislocation so I'd rather get the healing right since ski season is pretty much done here with all the rain expected, but i'd like to start aggressive inline asap.

but back to what the doc said, he said I could be out right now basically.. thing is I doubt he knew that I was referring to park skiing and probably thought I was just skiing piste. Like the shoulder feels good enough to ski on, BUT i know shoulders can feel good before they start healing. I'm almost certain if I fell on this shoulder like that again it'll come out, but I figure that would happen regardless of any previous dislocation. I'm more concerned about it popping out doing more common, simpler things (i.e. everytime i land, setting my twists, etc.). You guys think its a good idea to give skiing a whirl? Or man up and hit up PT for 3 months.
 
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