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Shoulder Subluxation

post #1 of 9
Thread Starter 

I couple years ago, I fell.

 

I suffered a posterior subluxation of my left shoulder. The joint reduced easily in the field. I was hoping that with rest and recovery I would be back to full strength in a few months. Unfortunately that hasn't been the case. 

 

The shoulder joint has good mobility and strength, however I experience chronic subluxation with most dynamic actions, partiularly with the elbow externally rotated and abducted. Along with deceleration actions. 

 

I want to avoid surgery if possible, the days of throwing a baseball, spiking a volleyball, Stretching for a bounce pass etc are behind me. 

 

However I do want to ski at a high level.  The issue on the ski hill comes from the moments where control is lost. I will swing my arm wildly trying to regain control. Usually the result is a shoulder subluxation. Some times I do crash, other times I recover and ski away and have to stop or slow down and reduce the joint. The pain is obviously severe, and takes about 72hrs for the swelling to decease and mobility to return.

 

I'm looking for a brace to support the shoulder. In normal skiing the elbow stays close to the body and there really isn't that much movement other than some flexon and extension. I would like something that prevents the shoulder from abduction and external rotation, while allowing the shoulder flex/extend freely.  

 

Any ideas? 

post #2 of 9

last year I sub'd out the back and then the front. I can tell you it will take a long time to heal. I also thought it would heal within a few months, its not the case

 

Couple of questions:  how old are you?  This is important, older folks  do not normally experience any additional risk of subluxation or dislocation provided there has not been any damage to the joint.  Is there any damage? Did you have an MRI?   If you are a younger guy, 30's or younger, you need to discuss the risk and how to protect the shoulder. 

 

I ended up having 2 cortisone shots and worked a long time to rebuild up the Rotator cuff area. I had a lot o PT and also found that ART therapy to be extremely helpful. Active Release was very effective at getting the muscles to release. Its painful but it did help. I only skied 4 days so far but I didn't have any real pain. just some soreness. That's a year after the fall. I did ride mtn bikes quite a bit this summer (and am still riding) and that took a long time to be able to ride without a fair amount of pain. It still gets sore..  Bottom line is it will take a long time to heal.

 

Good luck!  

post #3 of 9
Thread Starter 

I'm 27 now, the initial injury happened when I was 25. I have not had an MRI, although my brother is a radiologist and he and I both feel there is damage to the capsule and at this point, surgery is the next step. 

 

I am very familiar with ART as well as most other rehab modalities. Unfortunately my shoulder has not responded well to non envasive treatment. 

 

I'm about as anti-surgery as it gets but I think I will go under the knife in the spring. 

 

Really what I am looking for is a good brace, that will prevent my shoulder from continuing to sublux. However, I don't think there is anything on the market that is good enough. I have tried the Don Joy brace, and picked up a Sully brace yesterday. Both of these braces are OK. But there has to be something better. 

post #4 of 9

I had a very bad should injury a few years ago. My shoulder dislocated and the head of the femur crushed my brachial plexus (the main nerve junction of all the nerves that serve the arm (and some of the higher shoulder muscles)). Since I started out with 0 function nerves, I had 0 functioning muscles and was subluxing (anterior mostly) almost constantly when I wasn't in a sling until my nerves started regrowing and re-enervating. I had the opposite problem in that my capsule was way too tight and full of scar tissue. I know that in my case the therapists and I were able to remodel my capsule by a ridiculous amount of PT (most of which I had to do anyway to give my nerves a prospect of ultimately working the muscles by preventing contractures and maintaining and extending ROM - every muscle and joint from the shoulder thru all fingertips - literally all I did from awakening till bed). The idea was that by continuing the therapy long and diligently enough, the new cells of the capsule tissue would more properly align and ultimately replace the damaged tissue as it died off. However, if your problem is, as it sounds to be, that you have torn tissues, I don't know that this would work for you and I would guess you are not going to have much of an alternative to surgery. If you go that route, do lots and lots of research on the MD you pick, there are a lot of people doing that work and not too many stars. Almost as important is picking the PT for post op. There are tons of shoulder therapists but just a handful of real experts.

post #5 of 9
Quote:
Originally Posted by vsirin View Post

I had a very bad should injury a few years ago. My shoulder dislocated and the head of the femur crushed my brachial plexus (the main nerve junction of all the nerves that serve the arm (and some of the higher shoulder muscles)). Since I started out with 0 function nerves, I had 0 functioning muscles and was subluxing (anterior mostly) almost constantly when I wasn't in a sling until my nerves started regrowing and re-enervating. I had the opposite problem in that my capsule was way too tight and full of scar tissue. I know that in my case the therapists and I were able to remodel my capsule by a ridiculous amount of PT (most of which I had to do anyway to give my nerves a prospect of ultimately working the muscles by preventing contractures and maintaining and extending ROM - every muscle and joint from the shoulder thru all fingertips - literally all I did from awakening till bed). The idea was that by continuing the therapy long and diligently enough, the new cells of the capsule tissue would more properly align and ultimately replace the damaged tissue as it died off. However, if your problem is, as it sounds to be, that you have torn tissues, I don't know that this would work for you and I would guess you are not going to have much of an alternative to surgery. If you go that route, do lots and lots of research on the MD you pick, there are a lot of people doing that work and not too many stars. Almost as important is picking the PT for post op. There are tons of shoulder therapists but just a handful of real experts.

 

 

some good advice here!  Yeah, unfortunately, if there's damage, you are going to run the risk there are some slings out there but I don't know if any are going to help in the event of a crash or outstretched arm fall.  I wish you a good season.

post #6 of 9

Sorry to hear of your misery. Had a similar experience three years ago. Booted out, right arm went up reflexively, body weight down and pop - dislocation right shoulder. Got up, and within a few minutes  it reduced. Skied down. To hospital. Ultimately had an MRI which confirmed torn supraspinatus and glenoid. Saw two really good shoulder docs neither of whom suggested surgery. Used this pulley rig to maintain ROM. About 8 weeks into stalled recovery I just went back to the gym and started doing my regular workout routine and immediately felt better. Was all good within about five months after that. Now I have to think which shoulder I injured. No surgery.

I have had no issues with subluxation since. But that is likely a benefit of age. I was 53 when I did it. My reading suggests that the younger you are when you first have this injury, the more likely you are to have spontaneous subluxations. It is a function of the laxity of the soft tissue that supports the shoulder joint. A young shoulder like yours has very pliable and elastic soft tissue. As you age, it becomes much less flexible. Not so good for most things. But stiff tissue apparently makes a spontaneous dislocation far less likely.My reading suggested there is a 90% chance of a recurrent sublux if the first one happens before age 20. I know guys who had their first playing ball in high school and could pop their shoulder out just by rolling over on it in bed.

Wish I could offer more support for you. Perhaps there is a way to reduce the elasticity of the tissue in the shoulder to keep the humeral head from popping out. But as an attorney who has represented many folks with shoulder injuries, I am not aware of such treatment. Botox?

I do wish you well in your recovery. As in most things, attitude is the key ingredient to a full recovery. And sounds like you have that part covered. 

Happy trails,

David

post #7 of 9

considering ALL the injuries I've had over the years, until this past summer, I've never had a shoulder dislocation... until this summer's hockey league...

anyway, it was really bad - now 6 months on I'm finally able to get some range of motion and it looks like I'll have to miss summer hockey this year...

 

one less geezer for the guyz to make fun of...

mad.gif

 

But I did find these, and with some adjustment work, seems to support the shoulder pretty well...

 

I use the McDavid Light Brace for when the 'risk' level is low - as in MTBing...

 

then use this for higher level risk or serious crash potential...

 

http://www.amazon.com/EVS-Sports-Shoulder-Brace-Large/dp/B005MJYUAA/ref=sr_1_3?s=hpc&ie=UTF8&qid=1360087230&sr=1-3&keywords=shoulder+brace

post #8 of 9
Thread Starter 

That brace looks similar to the Sully brace that I use, except I paid 6x more. nonono2.gif

 

The brace does help. Although it hasn't "fixed" the problem.  And it doesn't breath at all. 

post #9 of 9
Quote:
Originally Posted by surfacehoar View Post

That brace looks similar to the Sully brace that I use, except I paid 6x more. nonono2.gif

 

The brace does help. Although it hasn't "fixed" the problem.  And it doesn't breath at all. 

yeah, saw the sully - just felt it was a bit overdone for my use -  even the EVS seemed a bit much, but glad I got it now... a lot more comfortable than the McDavid and better support...

 

sounds like surgury for you...

 

I have a friend who did his shoulder in about 2 mos.before I did... he had surgury - I'm gonna wait until he has some more recovery time before I decide...

 

best of luck - post here when things change...

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