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So, to (be) cut or not

post #1 of 8
Thread Starter 

As many of you know, I'm a veritable catastrophie of injuries.  I managed to dislocate my right shoulder for the second time in February (no, it was not at an ESA event).  My orthopod has stated that the probability of a redislocation, given that it has gone out twice, are now 70%.  However, my shoulder feels really stable given that I've been doing a bit of strength training.  It was really solid, more solid than it has been since well before I dislocated it the first time, prior to the freak accident where I hit a buried log and body slammed it so quickly I had no idea what was happening.


My reluctance to get it cut stems from several issues.  First, in order to be ready for ski season, I'd have to get it cut in July.  That'd put me out of commission on my bike for a couple of months, and I'd only just be able to start wearing a pack at the time of my fall hiking vacation with my spouse in Yellowstone and Grand Teton.  It'd mean that my biking season is more or less over after the Bicycle Tour of Colorado, and I wouldn't be able to see if I could ride the Buff Classic Century in under 5 hours.


On the plus side, my chances of dislocation after surgery would drop to 20-30%.  This last dislocation I recovered from pretty quickly, and while my orthopod was not very supportive, I was back skiing in two weeks with a brace.


So, what do you folk think?  Should I just suck it up and get cut, or take my chances?



post #2 of 8

I had shoulder surgery about 30 years ago for recurring dislocations.  No problems since it healed.  In those days it was an open procedure.  I had my arm in a sling for about 8 weeks.  Then a very long rehab.  Now they can do it arthroscopicly.  You heal much quicker.


I recommend you do some google searches and check out what the down sides are.  Read the horror stories so you can make a more informed decision.


Ask your orthopedic surgeon the following three questions:

  • How many of these surgeries have you performed?
  • How many infections have your patients had as a complication?
  • What would you do if it were you in my position?


He should be willing answer those questions.  If not then ask him why he won't answer.


I've done this with my surgeons.  It makes them think and it gets you some good information on what to do.

post #3 of 8

Mike, I have a good friend who races dirtbikes and plays volleyball that had this surgery done.  Prior to surgery, he'd have a few dislocations a month and rarely got through a volleyball game without some kind of issue.


Since the surgery he's been dislocation free and still does all the activities that he has always done.


If you have a good ortho and this is his recommendation, I'd go for it(if I were you)


post #4 of 8


I would get a second opinion - with only three questions.

1. If the shoulder dislocates again; What's my chances of just getting it popped back in place without additional injury?

2. If I do the surgery now; Whats the rehab period, before returning to normal activities?

3. If I don't do the surgery now; Whats the chances of strength training reducing the chance of additional dislocation's in the future?


After these 3 questions are answered by a surgeon - your desision........


In my yrs of patrolling activity's I have seen many shoulder dislocations - from the person popping it back in place themselves, to having to call a ALS unit for pain medication to be administered before transport. There is always a level of pain involved.

I always recommend - see a doctor and get a xray.

post #5 of 8

My girlfriend's doctor didn't want to operate on her until the third time she popped it out.  Because it popped so easily the third time she had surgery.  The surgery was relatively painless but the recovery was long and arduous.  The physical therapy regiment went for months and has to be done religiously to limit the loss of motion.  My girlfriend did hers for 6 moths and lost about 5% of her range motion which was not missed since she was very limber to begin with.  A co-worker had shoulder surgery after dislocating it repeatedly playing basketball.  He lost between 5 and 10% of his motion....he was fairly dedicated to doing his exercises by not as dedicated as my girlfriend.  Both he and my girlfriend are very happy they had the surgery.


If you are going to have the surgery see how much range of motion you will lose in exchange for having a more secure shoulder and definitely check on how long the physical therapy/exercises will go.  Be very aware that if you don't religiously do the exercises you will suffer a larger loss in your range of motion.




post #6 of 8

I love reading these dislocation stories. Always there's an assumption that it's a torn rotator cuff and more exercise will just make the problem go away. If your surgeon really wamts to operate, it may be because you have a torn labrum or a torn capsule and more damage occurs in those cases with subsequent dislocations. I'd bet your surgeon would prefer to fix your shoulder during business hours than to have a person like me call him at 2 am, saying I can't relocate your shoulder. Or worse yet, I call another doc to fix your shoulder and he screws up and your surgeon has you coming by his office, demanding to be fixed, and your surgeon knows that emergency on-call surgeon botched your surgery. You've already sued me and the on-call surgeon, that's a given. Do you want to go thru life with a screwed up shoulder-or even risk it?


Just my $0.02 as your friendly ER doc

post #7 of 8

I don't know the threads, I've told my story over and over on this board, so you can search. 


Left shoulder = 9 dislocations before a scope surgery, ~11 after. No surgery again. 

Right shoulder= 12 dislocations before a scope surgery ~ 8 after. No surgery again. 


I don't know the exact numbers, I stopped counting around 20 each. 


My advice after 20 dislocations in each shoulder and scope surgery in each, is this-


Stop dislocating your shoulder now. Stop falling. Start living a life that doesn't threaten a dislocated shoulder. That doesn't mean stop skiing, it means stop falling. If it's dislocating in your sleep, get surgery. Until then, be honest with yourself- humans were never meant to be skiing at 60mph and then cartwheeling. Of course I have shoulder problems, I skied like a maniac. 


I'm 34 and have arthritis. I can't swim. I can't surf. I can't throw a baseball. I wake up with numb hands. Why? because I thought I'd just get surgery and keep living a reckless life. 


Now, I ski 3-4 days a week. Hold a season pass at a very private resort in Japan. If the snow has been cold, I get pow all day. The solution? DON'T FARKING FALL! 


Surgery is a last-resort option, what you do when you wake up at night with your shoulder out. Until then, learn to live like a human. 

post #8 of 8

This thread was interesting reading, especially from those that have had multiple dislocations.  I've had 9, all in the same shoulder.


While I haven't stopped falling, I have given up icy bumps and modified my skiing somewhat.  Gave up surfing completely.   I think that has greatly reduced my risk.  Falling in soft snow has never been a problem for me, and I've had some spectacular ones.  It's always the hard landing forward  smackdown that gets me.


There is too much variation in shoulder injuries to speculate on whether or not you should have surgery.  The questions raised to ask your doctor are excellent, and I would ad one more -


What is the likleyhood of permanent loss of range of motion, and how much would it be?


In my case, after an MRI and 2 orthos, I was told that the surgery recommended for me would reduce my range of motion severly in raising the arm over shoulder height.  Since my shoulder is not falling out on its own, and I have not suffered any significant joint degredation (other than being looser than desired) I've gone without surgery. 


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