Shoulder dislocations - surgery and alternatives

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Messages 1 - 18 of total 18 in this topic
luquitos

Trad climber
santa cruz, ca
Topic Author's Original Post - Sep 30, 2012 - 07:24pm PT
Hi folks,

I'm starting this thread because I've recently dislocated my shoulder for the second time and am considering surgery. I'm 28 yrs old and the first time was about 6months ago. I had a microfracture on the head of the humerus, but not tearing of anything. This time it happened about a month ago and I haven't seen a doctor and don't really want to unless I decide on surgery or some other alternative treatment.

I'm looking for people that have had multiple dislocations and how they have dealt with it. Surgery successes/failures, physical therapy, alternative treatments.

I just heard about this treatment called prolotherapy that seems to have some use for helping prevent reccurrent dislocations. Has anyone have any experience with that?

Has anyone been able to manage dislocations without surgery?

I want to keep climbing! Thanks for any info.
luquitos

Trad climber
santa cruz, ca
Topic Author's Reply - Oct 3, 2012 - 12:59am PT
Anybody? I'm sure there's got to be some folks out there who have repeated shoulder dislocations.
Cosmiccragsman

Trad climber
AKA Dwain, from Apple Valley, Ca. and Vegas!
Oct 3, 2012 - 03:26am PT
My whole body reads like a pathology Chart.
:)

I hurt ALL the time, but I know if I stopped exercising, working, climbing,
My whole body would seize up.
The day I stop climbing is the day I take my permanent Dirt Nap.
crasic

climber
Oct 3, 2012 - 03:35am PT
Hard dislocation (read: forced) in HS during wrestling

SLAP Tear (Labrum tear with detached bone fragments), bankart lession (impact site on humerus)

6 weeks off, first day back, dislocated again. Scheduled surgery 2 months later.

Surgery was uneventful, three small incisions, they "fold" over the tendon to tighten the whole joint up. First three months the whole thing hurt like hell. PT was great, therapist said he's never taken a shoulder patient as far as I have. 100% strength recovery, 95% ROM recovery (compared to other shoulder).

Besides some mild aches (when I don't warm up) and otherwise general cautiousness, shoulder feels like new, its been 5 years since. No repeated dislocations (knock on wood) and the thing feels as stable as before injury.

Happy camper in the surgery campground here. No amount of therapy will tighten a loose joint, the only options are to get surgery, cut/limit activity, or let the whole thing loosen so much until the dislocations stop hurting, in order of decreasing preference.

If the tendons (Go for MRI) are fine then you need to strengthen the musculature around the joint. This means antagonistic exercises.
schwortz

Social climber
"close to everything = not at anything", ca
Oct 3, 2012 - 03:44am PT
first. it doesnt matter what other peoples experiences are unless they have the same mechanisms of injury and similar physiology/pathology. you need the opinion of a shoulder expert or two. (or three). a recurrent dislocation should be looked at by a specialist. not avoided.

that said i opted for surgery once, and against a second time on reinjury.

my first stop would be aggressive physical therapy with a shoulder specialist. preferably a DPT with upper extremity speciality. preferably someone with sports med experience - probably a CSCS. you should give it at least 6 to 8 weeks or whenever you start responding to the treatment via test/retest before you make a decision with respect to surgery.

that said most of the current research suggests that recurrent shoulder dislocations should be operated on.

i had recurrent subluxation (not dislocation) due to a labral tear but had nerve involvement and circulatory disruption so i opted for surgery. unfortunately i did not do PT first, and my PT was not especially aggressive post. my repair was also old school and if i'd searched out a specialist who worked with overhead athletes i might have had a different outcome other than reinjury.

i reinjured 5.5 years after first surgery while bouldering. my arm became almost unusable anywhere overhead. it took 8 weeks before i really started responding to PT but i had an excellent therapist - probably one of the best shoulder guys in the country - and wound up making an excellent non surgical recovery. i was stronger after several months of PT and other exercise than i was before reinjury. climbing harder than i ever had.

unfortunately several years later - now - i have some shoulder impingement and a frayed biceps tendon but thats probably more due to lack of maintenance and an additional neck/shoulder injury than the lack of surgery.

if i was repeatedly dislocating i'd seriously consider surgery, and certainly would see a shoulder specialist.

theres so much shoulder info out there online in medical journals, reputable websites, and forums. but ultimately everyone is different. and my experience means sh#t because my shoulder isnt yours. see some professionals.
ELM !

climber
Near Boston
Oct 3, 2012 - 07:52am PT
Ok...well here's my own experiance plus my professional experiance.
Two dislocations do not equal surgery. Even though alot of ortho Doc's will be more than happy to dice you up after one.
Surgery is an option if you have exhausted all other options. Work on getting stronger. If you can: get a good PT referral and they will give you a program. If you build even a small ammount of muscle you will improve the joints stability and lessen you chance of dislocation. Pumping iron isn't the only thing though. Work on your flexability as well.
I had surgery to my right shoulder after well over 10 dislocations. I was so loose that any errant move would sublux it. It dislocated with little force. After surgery I worked like crazy to get my range of motion back. I was lucky to get it all back. The surgery was 25 years ago. I have since dislocated this shoulder twice. I know If I work the shoulder I am more stable and I can push it; if I don't I'm at risk.
kc

Trad climber
the cats
Oct 3, 2012 - 10:08am PT
Swim. Freestyle. A lot. My shoulders used to sublux all the time until I started swimming. Now, no problems, climbing keeps things tight, and I don't have to swim anymore. That's my advice ONLY if you don't have an injury that needs surgical intervention. It's not a miracle cure, but it can help in some circumstances.
crøtch

climber
Oct 3, 2012 - 10:59am PT
I used to swim competitively and we did some very agressive shoulder stretches that I think loosened up the shoulder capsule but while I was swimming a lot I had a rotator cuff that could compensate well. After I stopped swimming competitively I dislocated my right shoulder (anterior) two times with SLAP tear and a Hills-Sachs lesion, and subluxed my left shoulder several times. My right shoulder was loose enough (even with aggressive physical therapy) that I felt like it would take very little force for it to dislocate again and again. I had open Bankart repairs on both shoulders about 18 years ago.

It took 3 months before I could start to swim again, and then another 3 months before I felt like I had sufficient range of motion and could lift overhead. I felt like I recovered 90% of my strength after 1 year, and 95 to 99% of my strength after two years. My range of motion in external rotation is reduced but I don't notice it day to day. I picked up climbing a few years after surgery so I don't know how my climbing would have changed, but I can do shouldery moves now with the same amount of concern as others with normal shoulders. My posture may have changed a bit. It feels like my shoulders are a bit farther forward in the socket than before.

Occasionally I experience pain in my left shoulder (the one that has less range of motion and was tightened up a bit more by the surgeon) which has been diagnosed as impingement and if I do regular rotator cuff exercises it gets better in a couple of weeks.

I think that faced with the same choice now, 18 years later, I would have surgery again. Good luck with your decisiion.
paganmonkeyboy

climber
mars...it's near nevada...
Oct 3, 2012 - 11:21am PT
never dislocated my shoulder that i'm aware of, but i've had 4 surgeries so far (2 and 2...), 3 in the past 6 years...

in each case i tried to mitigate with PT, exercise etc, only falling back on the surgery when it was obvious things were not getting better or actually getting worse. i'm told stem cell therapy can deal with micro-stuff, all mine have been macro so i have no experience with it firsthand...

shoulder surgery is rough - if you can avoid it and still be happy with your performance, i would go that route...
Marlow

Sport climber
OSLO
Oct 3, 2012 - 11:23am PT
Background information:
http://orthoinfo.aaos.org/topic.cfm?topic=a00529

Post-op program progression:
http://performanceorthopedics.com/files/ProcProtocols/ShoulderProtocol.pdf

Shoulder Pain - Scapula Exercises:
http://www.youtube.com/watch?v=u0pM5x3pX0A&feature=player_detailpage

More advanced training: http://www.olympiatoppen.no/fagomraader/trening/basistrening/styrke/grunnovelserarmerogskuldre/page120.html

http://www.youtube.com/watch?v=XZj5zGF9C8c&feature=player_detailpage

5 Dangers Of Shoulder Rehab Exercises:
http://www.youtube.com/watch?v=stfxHs-pI_M&feature=player_detailpage

The Science 1992:
http://jbjs.org/data/Journals/JBJS/704/890.pdf
TwistedCrank

climber
Dingleberry Gulch, Ideeho
Oct 3, 2012 - 11:27am PT
Post surgery, take PT very seriously. Follow through.

Post PT, take continued shoulder strength training very seriously. Weights, swimming, and XC skiing are awesome.

If you opt out of surgery, consider shoulder strengthening fitness. Weights, swimming, and XC skiing yadda yadda.

Evaluate what you want to do climbing-wise. e.g., crank 100 ft of desperate or cruise 1000 ft of awesome, wack-and-dangle or clip-and-gun, hike-and-peak, etx.


Personally, after numerous dislocations on both sides, I opted for no surgery, quality time in the weight room, and obscure all-day moderates halfway on the road to Nowheresville.
Sierra Ledge Rat

Mountain climber
Old and Broken Down in Appalachia
Oct 3, 2012 - 05:32pm PT
Multiple dislocations to both shoulders.

Eventually the pain became so bad that I had the RIGHT shoulder done first. Tremendously painful surgery. Gotta sleep sitting up for a month. The surgery didn't help. I can't climb anymore. I'm considered a partially-disabled veteran because of the injury.

I kept dislocating my LEFT shoulder over and over. (I blew out the left side extreme skiing.) I really didn't want another shoulder surgery. I was in the gym every day doing my physical therapy. It didn't help.

When I dislocated my shoulder reaching forward to flush the toilet, I knew I had to get surgery on the left side. Tremendously painful surgery that didn't help much.

I dislocated my left shoulder again in an accident running class 5 rapids in a kayak. Couldn't get my shoulder back into the socket because the surgery had tightened up the joint capsule. What a mess.

Chronic pain now, both sides. Limited range of motion, can't climb much, I still dislocate my left shoulder a lot, especially if I sneeze or laugh suddenly. That's why I hate jokes, I hate to laugh.
luquitos

Trad climber
santa cruz, ca
Topic Author's Reply - Oct 10, 2012 - 09:23pm PT
Well, thanks for all the replies. Seems like people have really had a whole range of experiences with it.

Right now, I'm planning on starting to see a physical therapist and consider/look into more this prolotherapy treatment.

No one out there had any experience with prolotherapy?
aneel

Gym climber
Jan 29, 2013 - 12:03pm PT
Hi guys, i was searching for suggestions to strengthen a dislocated shoulder. Recently i had a partial shoulder dislocation which happened when i fell from a motorcycle competition. Range of shoulder motion has been restricted. I gave my shoulder two months rest. Now i am attending yoga classes under a guidance of yoga therapist . I feel my shoulder gaining strength after doing SURYA NAMASKAR'S . ..the basic principle in yoga is u should never extend ur limits and u should be comfortable in ur posture.. Try this under the guidance of a teacher or try ur self if ur aware and comfortable.. I hope this helps u..
G_Gnome

Trad climber
Pebble Wrestling.... Badly lately.
Jan 29, 2013 - 01:25pm PT
There are many climbers on this forum that have had shoulders fixed. There are multiple threads on the subject. Most have had complete recoveries and some are better than ever. Get it fixed now!
slabbo

Trad climber
fort garland, colo
Jan 29, 2013 - 04:53pm PT
Multiple dislocation in my earlier years (18-21) I did hard therabands for nearly six months and have never had an issue some 30 years later....I also think that doing a variety of climbing types really helped
donini

Trad climber
Ouray, Colorado
Jan 29, 2013 - 04:55pm PT
Surgery should always be the last choice but don't be stubborn if it's the only choice.
shady

Trad climber
Jan 31, 2013 - 01:39pm PT
Ouch! This is the injury that ended my climbing career. For someone your age this is a minor set back. If you want to have a long and happy climbing career, do not rush your recovery. Be very methodical about your return to climbing. If you can't control your desire to climb hard you could end up grounded, for life.
My shoulder dislocated a second time, and when it popped back in it briefly pinched that big nerve in the armpit. Career done. It's been eleven years since that injury and I still have some numbness in the index, middle finger and thumb of my left hand. I reluctantly sold my gear and hung up my shoes seven years ago, leaving a huge void in my life. One I still struggle to fill to this day. Hence my lurking on climbing forums.
Don't be a shady.
Have patience with your recovery. Take the time to recover fully and have a long and fruitful climbing career.

shady
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