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Dislocated shoulder recovery/rehab

post #1 of 16
Thread Starter 
This morning, on the first run of the day, I have my worst wipeout ever, and dislocated my shoulder. Kudos to the patrol at AZ Snowbowl for their professionalism, although my first time in sled, it was a relatively easy ride down.

40 years of skiing and never a serious injury until today. I felt worse for my friend who took his first personal day in 17 years to join me. He's a wilderness first responder who offer to do the reduction on the hill, but warned he'd never done one before, so I opted for the hospital. Not sure that was a very good call on my part, since there is no fracture or anything.

Because I had to go into to town to the emergency room, it was 2-1/2 long hours before reduction, but now it feels good, sore but good. I'll be seeing the otho doc later in the week, but I'm wondering how long to expect before getting back on skis, days or weeks? What have others done for rehab, anything ski specific? Thanks.
post #2 of 16
Uh oh... consider now your only opportunity to stop the evil cycle that will ensue if you think that a reduction in pain = a reduction in injury over any period of time.

Shoulder dislocations don't heal. Ever.

Well, let me slow down a bit.

Ligaments don't have the same blood supply as muscles and tendons. When you stretch them, they stay stretched. They're more like ropes than bungy cords.

So, now you have to build the surrounding muscle to do the work that your ligaments used to do. They can't support your shoulder any more.

The good news is, you get to get staunch shoulders like your youth. The bad news is- if you blow it again, you'll likely enter the cycle of continual dislocations until you accept surgery. Then you'll recover, and think it's fine... until you blow it again.

I have around 40 dislcoations between both my shoulders. I got my left shoulder scoped after about 12 dislocations, and that surgery failed. (it didn't fail, I took a highspeed tumble and blew it again.) The same happend to my right. Now, if I want another surgery, my ortho said he has to take ligaments from my hamstring and regenerate them in my shoulders. That is a fricking nightmare of a recovery that I am NOT willing to undergo. So, I work out a few days a week, keep my muscles strong and will wait the 10 years it takes for every cell in my body to replace itself. Theoretically, I'll have new ligaments by then. Until then- I won't take the risk.

I'm the extreme example, but I'll preach it to everyone-

If you blow your shoulder twice, you will enter this cycle.

Oh, and to answer your question, go skiing as soon as you can. Just don't ever fall again. Rehab = very little stretching (if any) and lots of light weight/high repitition lifting with bells, rubber-bands, and push ups. You don't want to be huge, but you do want to be ripped.

So, good luck ~~~ or welcome to hell. You choose.

(side effects of entering hell include:
circulation and nervous system problems in your arms, hands and fingers. Loss of preferred sleeping positions. Cuddling with the wife must follow a protocol of body positioning. Sex now only has the original two positions. Changing t-shirts is a task so tedius, all of your shirts will now have buttons down the front. Playing catch with your kid is impossible, unless you throw underhand. A period of 3 weeks of no physical therapy will result in another dislocation... even five years down the road when you think it's all hunky-dory.)
post #3 of 16
Not to contradict Samurai- but here is my experience in a nutshell:

Dislocated left shoulder Feb 2007 after booting out in a GS race. Not a spectacular fall, but put the arm out to try and tripod to ride it out and the arm augured into the new snow- fortunately the shoulder dislocated before my arm broke.

Shoulder was reduced in the ER about an hour after dislocation, was seen the following day by an Orthopaedic shoulder specialist who did an MRI to check the rotator cuff. Suggested PT and recovery before re-evaluation for surgery since this was the first time. Attended rigorous PT at about 2x the prescribed rate at my own expense for 3 months to facilitate a stronger and faster complete recovery for cycling season. I also did lots of stretching and rubber band work at home to facilitate this. My PT concentrated on heat and ultrasonic (?) to break up scar tissue and regain range of motion.

Following PT I worked with a trainer to build a workout that would tone and strengthen the shoulder (not bulk, tone) Built the supporting muscle and continued stretching. I have also worked considerably on core strength and I am still observing this workout to date and have added swimming.

One year later- (My Opinion) Complete recovery. I can do everything I desire to do pain free. Sleeping is at about 95%, however there are nights and positions that are still uncomfortable. Cycling in cold weather a causes a dull aching pain, but it's tolerable. Still working on my mental game when racing but it's coming along. My Orthopaedic suggested I continue with my current program to prevent re-injury. He feels due to the sports I participate in that another dislocation is likely (as opposed to being a couch potato) and at that point we would evaluate each injury on it's own merits and discuss surgery.

Do your homework, get multiple opinions from doc's and PT's, work hard, take time away from skiing or other sports to fully recover.
post #4 of 16
My experience is sort of a combination of the above, wherein I had a lot of soreness after my injury. Bottom line for me, the things helped most were glucosamine, getting back to the gym and doing light lifting and excercise on the affected shoulder. Over time the shoulder became stronger, offsetting the joint issues and inflammation, and as a result a lot of the soreness has gone away. Shoulder injuries are tough and require lot's of patience ... hang in there
post #5 of 16
I hope I wasn't misunderstood. My shoulders are stronger than ever. I have cut down on the heavy lifting, the glucosamine, the creatine and the amino, but still lift to keep strong a few days a week. I can still pick up my wife and throw her over my shoulder. I just can't change my t-shirt, or paddle a surfboard because I don't have the ROM.

That doesn't mean that the ligaments are healed, though.

I was 4 years down the road since my last dislocation and blew my right one stretching in my living room. I thought I was sweet before then.

FWIW, 90% of the guys I have met who have dealt with this injury have a repeat... and then a repeat. I hear very few say; I only did my shoulder once. I hope SJB and festus can keep it an isolated incident. You guys really do have to accept that a reduction in pain, or a recovery in range-of-motion does not mean the ligaments are healed or that the shoulder can support itself the way it could pre-injury. PT should be something that you consider a weekly event for the rest of your physical days.

I don't mean to be the antagonist here, but- If you dislocate it again, you'll enter the cycle.

The first time is the warning siren sounding off. The second time is the "So when do you want surgery?" siren sounding off.

What's the big difference between once and twice? Being as ligaments don't shrink back to their original condition- if it blows twice, it'll blow 3 times and four and five and six and seven and eight and you get the picture.

The good news is, generally, the first incident hurts the worst.
post #6 of 16
Thread Starter 
Thanks for responses. I hope this is the only time for me. 40 times? geez samurai, my sympathies, the pain was excruciating, especially after the first 30 minutes. I kept thinking of the Mel Gibson movie where he pops it back in himself and keeps on going.

My research of the last 24 hours has led me to believe that my ski season is over if I want to rehab properly, which sucks in itself, but also because the paddling season is starting, and around here cycling never stops. Big wake up call for sure, but my goal right now is to reduce the chances of re-occurence as much as possible. No doubt this will change my routine in the gym. I'm seriously thinking of hiring a trainer when I get the go ahead to start rehab.
post #7 of 16
Quote:
Originally Posted by samurai View Post
FWIW, 90% of the guys I have met who have dealt with this injury have a repeat... and then a repeat.

..........................

The good news is, generally, the first incident hurts the worst.
I got upwards of 200 going. I'm sure Samarai knows how awesome it is to fall asleep in a bad position and have it go out in the middle of the night. That's pretty great, nice sleep, then bam.

I have a hard time watching baseball pitchers.

I've definitely noticed if I'm strengthening it, it doesn't slip around as much. But, when it is stronger and it goes out, it hurts really bad again.

I try not to let it get in my way. I climb a lot in the summer. If I'm leading, I stick to relatively moderate climbs. If I'm following, I can work around it and climb relatively hard still.

I do miss playing basketball.

The first time is the worst.

Quote:
Originally Posted by Festus View Post
I kept thinking of the Mel Gibson movie where he pops it back in himself and keeps on going.
You can put it back in yourself fairly easy.

My dog went out on some ice when she was fairly young. She broke through. I was lying across the ice to help her out when the ice broke and it came out. I was in college at the time and was fairly close to the student clinic. They didn't notice at first I was dripping wet and had an arm on the front of my chest. Eventually they saw I was having a hard time filling out the paperwork and got me in.

The Doc had me lie down on my chest and gave me a small (1 1/2 lbs) weight and had me dangle my arm off the examining table. She told me to relax and left the room. Very quickly it slid back in. I started using that trick all the time.

I popped it during a mountaineering class. I grabbed everybody's axe and did the dangle and, slip, right back in. I did it backcountry on Tallac (Tahoe) once, dug a little hole in the snow, dangled the backpack, slid right in.

Eventually I noticed I didn't need to hold anything. I could dangle it, and apply the same force with my other arm.
post #8 of 16
splitter- I too have had a couple dozen instances where I could get it back in. I have also had guys hanging from my arm trying to get it back in.

The ultimate tragedy is when it doesn't go back in in the first 5 minutes or so. Each minute goes on and you know more and more that it won't go back in without aid. That sucks.

However, I don't recommend to people in their first few dislocations to be jarring it back in place. That's where you chip bone and sever nerves. If you have blown it a few times, you'll learn it's okay to reset it in the field. Until then, I'd refrain. I know one guy who blew his so bad the first time, he still hasn't moved his arm. He blew all the nerves out and now has a dead arm.
post #9 of 16
Quote:
Originally Posted by splitter View Post
I have a hard time watching baseball pitchers.
I don't remember the pitcher, but it was rumored that his shoulder dislocated every time he pitched.

I've had a few "oh my lord, what did I do?" instances where it came out.

Once, the last time I fell while skiing, I blew them both and slid like a dead fish on my back completely unable to control my slide. That sucked.

another time was in Chile. I grabbed a surfboard, paddled out for about 10 seconds, threw a shoulder and tried to swim with one arm while getting crushed by a set. That sucked too. Never go surfing with one arm flopping around telling you that you have about 2 minutes to get your ass on shore and the shoulder back in place before you find yourself in a 3rd world hospital screaming in Spanish MORPHINE WORKS.
post #10 of 16
Quote:
Originally Posted by samurai View Post

That doesn't mean that the ligaments are healed, though.

FWIW, 90% of the guys I have met who have dealt with this injury have a repeat... and then a repeat. PT should be something that you consider a weekly event for the rest of your physical days.

I don't mean to be the antagonist here, but- If you dislocate it again, you'll enter the cycle. The first time is the warning siren sounding off. The second time is the "So when do you want surgery?" siren sounding off.

Samurai- Nope, not at all misunderstood (by me) I agree with the above 100% and so does both my PT and Ortho. I am doing the PT exercise and ROM, stretching at home and in the gym daily in hope of fending off any re-occuring injury. I know, I know... even in doing so there are no promises that it won't happen again.

BTW- I had pain for months, nothing that I could not deal with but it was definately there. I did not mean to imply that my pain subsided any time following the reduction.
post #11 of 16
Be careful with the stretching. Avoid anything excessive beyond daily need for ROM. I blew mine stretching after four years of healthiness. Personally, I don't stretch anymore. Lightweight lifting is enough.
post #12 of 16
Fetus,

How bad is your arm now? Can you move it? Or is it too swollen?

I dislocated my arm 2 yrs ago here my advice:

You prob got an xray… but you should get an MRI make sure ligments are okay and to see if anything is torn..

Your over 40? That’s good the older you are the better the chances that you wont dislocate it again…

I used an external rotation splint… suppose to heal the dislocation better…
Some research shows that if brace the arm the traditional way… your chance of recurrence is greater because the ligments don’t heal correctly..
you can google the research yourself…

http://donjoy.braceup.com/ultra_sling_er_donjoy.htm

my experience was the 1st month I could barely move my arm… I pretty much had it slinged and used the donjoy brace when I slept….

Took me a month or 2… before I started any rehab… u need to give your shoulder time to heal properly….

I think I used ice the 1st week… then hot cold therapy after that…


Let me know if u need some rehab exercises…

After a month I felt like I could ski with one hand… but I didn’t risk it…its not worth the pain of another dislocation…not to mention a loose shoulder

After a year my arm was pretty much normal…it felt a little loose… after 2 years its fine…nice and tight.. I think the ER splint helped…

EDIT: MY LIGAMENT WAS TORN... SO THATS WHY I USED THE ER SPLINT....
IF YOU HAVE NO TEARS U PROB DONT NEED IT...
post #13 of 16
Thread Starter 
Quote:
Originally Posted by sk55 View Post
Fetus,

How bad is your arm now? Can you move it? Or is it too swollen?

I dislocated my arm 2 yrs ago here my advice:

You prob got an xray… but you should get an MRI make sure ligments are okay and to see if anything is torn..

Your over 40? That’s good the older you are the better the chances that you wont dislocate it again…

I used an external rotation splint… suppose to heal the dislocation better…
Some research shows that if brace the arm the traditional way… your chance of recurrence is greater because the ligments don’t heal correctly..
you can google the research yourself…

http://donjoy.braceup.com/ultra_sling_er_donjoy.htm

my experience was the 1st month I could barely move my arm… I pretty much had it slinged and used the donjoy brace when I slept….

Took me a month or 2… before I started any rehab… u need to give your shoulder time to heal properly….

I think I used ice the 1st week… then hot cold therapy after that…


Let me know if u need some rehab exercises…

After a month I felt like I could ski with one hand… but I didn’t risk it…its not worth the pain of another dislocation…not to mention a loose shoulder

After a year my arm was pretty much normal…it felt a little loose… after 2 years its fine…nice and tight.. I think the ER splint helped…

EDIT: MY LIGAMENT WAS TORN... SO THATS WHY I USED THE ER SPLINT....
IF YOU HAVE NO TEARS U PROB DONT NEED IT...
Reading these other stories, I think I'm lucky. I injured both shoulders, but only dislocated one. Its not really swollen compared to the other, but my ROM with the good arm is limited to chest high and below. The dislocated has been immobilized since Tuesday (day of the accident). I've been icing them both several times a day, and taking Motrin, they prescribed something stronger but I haven't felt the need for it. Monday I see the doc for both, I hope to get an MRI on each.

I hit the gym today to stay active, rode a stationary bike (recumbent) and did some leg lifts with the lightest weight on the rack, I've got to do something, just can't sit still. The dislocation was my first serious sports injury ever; at 48 years old I consider myself fortunate, but its a not so subtle reminder that I'm not 20-something anymore.
post #14 of 16
your ROM is pretty good... thats a good sign...

mine was like zero for the first 2 weeks...

if you do weight training after your arm is some what recovered (when you can raise hand over head)

you should regain full mobility and strength...

other tips:
glucosamine chondroitin might be helpful.
pendulum exercise while taking a hot shower....

again dont do any exercises till you ask your doctor and or talk to a PT.
post #15 of 16
Have done both shoulders and had to have one surgically repaired (Bankart procedure). The other one I just rehabed and rested and have had no problems . Once a shoulder comes out more than once ( according to my orthopedist ) you won't be able to regain full stability, so rehab it right now while you have a chance and you should be able to avoid surgery. I didn't do that with my first one and it became totally unstable and dislocated at the drop of a hat. After surgery in 1986, I've been skiing 20+ years with no problems. Good luck.
post #16 of 16
Another one of the shoulder oops people here. Forget about skiing this year, there's always next season. Get your shoulder back as good as possible. Hopefully it won't come out again, if it does, like skicub, I would look carefully at surgery, because it will continue, as you have read. I dislocated mine, (falling in lift line if you can believe that lol), rested, rehabbed, etc, and then within 3 years re did it playing volleyball and golf. Time for surgery. Had that done, not a problem since, had surgery in 1989.

Good luck.
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