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Old 11-10-07, 12:41 PM   #1
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Subluxed shoulder

I got this diagnosis yesterday -- it's a stage or so less serious than a dislocation, but the shoulder has been forced somewhat out of kilter and I'm on pain meds and antiinflamatories. It seems that the initial injury from a crash 4 weeks ago got worse somehow and the joint slipped, and my recovery process took a major nosedive. Doc says I'll need physio rather than surgery, which I suppose is good, and I'm getting an appointment next week for the fracture clinic, which will take another look and work out what to do.

I realize each injury is different, but has anyone been through this one and can anyone offer any advice? I'm normally pretty active, with biking, hiking, skiing, gym, and and will mention that to the orthopod next week. But the thought of being without all that is pretty depressing. Any clues on recovery time, and what I've got to "look forward" to?
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Old 11-10-07, 08:22 PM   #2
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Doc says I'll need physio rather than surgery, which I suppose is good...

Your insurance carrier would probably seek this remedy first anyway, but there's always a chance it won't get the job done right. If ligaments are torn, they aren't going to mend themselves. Their hope is that you can strengthen surrounding muscle enough to compensate. Go ahead and do the therapy. If it works, great. If not, you'll have a head start on returning to 100% after your RTC surgery.

In the mean time, the antiinflammatories should ease the pain. Do use ice immediately after the therapy sessions, it helps a lot. Good luck!
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Old 11-10-07, 09:13 PM   #3
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He's Canadian. Insurance isn't an issue.

However, I've had this problem with BOTH of my shoulders, and I'm telling you right now...DO THE EXERCISES. In therapy they're going to give you a bunch of rotator cuff drills to do. I suggest you do them and strengthen up. The surgery to rebuild and subsequent therapy is ten times worse than the pain you deal with now.

Oh, and stay away from baseball/football throwing. It hurts. Really bad.
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Old 11-10-07, 09:27 PM   #4
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Who's "he"?
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Old 11-10-07, 09:42 PM   #5
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Or she, whatever. I almost put down (s)he. Damn.
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Old 11-10-07, 09:43 PM   #6
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Ask the orthopod if you might benefit from the surgical alternative, specifically the Mumford procedure. Either arthroscopic or preferably an open procedure. I had a similar injury and after much therapy proved ineffective had the surgery.

Checked in in the morning and was home by the early afternoon (general anastesia). No post-op therapy was required and I was back on the bike in three weeks. No problems since then.
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Old 11-10-07, 09:44 PM   #7
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She's Canadian, and we don't worry about things like insurance ... at least not for X-rays, MRIs, and surgeries.

However, I had/have a separated shoulder which was a near dislocation. I was told it would take 6 months before I really started feeling better. I thought that couldn't possibly be right ... but it was. In fact 7.5 month's later that shoulder is still sore. However, my clothes are fitting me better because my shoulder is sitting in the socket better than it was.

Go for physio ... if you were here, I'd give you the name of a good phyiotherapist who is also a cyclist, and understands our desire to keep cycling. He let me keep cycling, but told me I could do no upper body exercise. I had to quit weightlifting, and I had to quit the job I had which involved a lot of heavy lifting. In fact, for a few weeks he wouldn't even let me stretch it ... it was in such rough shape, he just wanted it to heal. Then he started getting me into stretching a bit more.

I really should try to get in to see him again soon.
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Old 11-11-07, 07:09 AM   #8
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I have a physio I think I trust -- early days yet -- and an osteopath who has fingers like gold dust. She's the one who diagnosed the sublux in the first place, and I would trust her with my life. And I plan to tell the orthopod that want whatever treatment is best to get me back on my bike for the start of the riding season. Right now I couldn't even reach the handlebars.

Thanks on the exercise advice, and I aim to do whatever I have to, even if it means lying down on the floor of the office and stretching/exercising there. Sadly my office has glass all around, so that's going to look a little silly, but what the hell.

And thanks to Donna/Matchka for the he/she corrections. It's she.
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Old 11-11-07, 09:46 AM   #9
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Doc says I'll need physio rather than surgery...

Suppose you say, "Screw it Doc, let's just get it done right, and repair the tear via surgery." Is "the system" going to just allow that on your request? It's far cheaper to go the therapy route, than paying for a surgeon and anesthesiologist etc.. Besides, after surgery, you'll still need therapy.

The surgery to rebuild and subsequent therapy is ten times worse than the pain you deal with now.

I agree doing therapy now will always help in the long run, even if you do need the surgery, but post surgery therapy won't be that bad, if the surgeon does his job right. Check with people who have had successful RTC surgeries, and use the same surgeon. The sooner you get it done, the less time you'll be spending with a sore shoulder, gobbling naproxen.

BTW, there aren't many exercises to do from laying down. Only do the repetitions till it starts to hurt, using a light enough weight or tubing to allow at least 5 repetitions. Have an ice pack available for after your routine, and keep an accurate log to show your progress.

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Old 11-11-07, 11:33 AM   #10
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I'm getting my second opinion this week. Ultrasound showed nothing torn, although that was probably before the sublux, so it is possible that surgery isn't needed. I think it would be pulling rather than cutting anyway -- the type where they knock you out and yank the joint back into place.

I like the idea of a log though. So far I've just been mentally noting how far I can move the joint -- it's already up to 30-40 degrees, from barely 10 on Wednesday/Thursday.

So long as I go back to two-steps forward, one step back, from the two steps back, one step back I had before.
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Old 11-11-07, 12:20 PM   #11
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I have a physio I think I trust -- early days yet -- and an osteopath who has fingers like gold dust. She's the one who diagnosed the sublux in the first place, and I would trust her with my life. And I plan to tell the orthopod that want whatever treatment is best to get me back on my bike for the start of the riding season. Right now I couldn't even reach the handlebars.

Thanks on the exercise advice, and I aim to do whatever I have to, even if it means lying down on the floor of the office and stretching/exercising there. Sadly my office has glass all around, so that's going to look a little silly, but what the hell.

And thanks to Donna/Matchka for the he/she corrections. It's she.
With mine, I could reach forward, but couldn't even begin to reach back or off to the side and up.

And the exercises could be done sitting in a chair or standing ... just common upper body stretches. All the muscles around mine seized and we had to stretch them out to help me regain mobility.
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Old 11-12-07, 12:56 AM   #12
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I'm getting my second opinion this week. Ultrasound showed nothing torn, although that was probably before the sublux, so it is possible that surgery isn't needed. I think it would be pulling rather than cutting anyway -- the type where they knock you out and yank the joint back into place.

I like the idea of a log though. So far I've just been mentally noting how far I can move the joint -- it's already up to 30-40 degrees, from barely 10 on Wednesday/Thursday.

So long as I go back to two-steps forward, one step back, from the two steps back, one step back I had before.
Oooooooo... I had the knock-out and yank the joint back into place procedure a couple of years ago. I came off while riding to work on a slick section of wet chipseal -- the front tyre let go around 25km/h on a sweeping downhill curve. I knew something was wrong when I got up, apart from the pain, when my bicep was pressing inward against my rib cage. I got back on the bike and rode back to a doctor's surgery when I was given a painkilling injection while I waited for an ambulance!

I rode a 300km randonnee about 10 days later. You said you couldn't ride a bike now because you couldn't reach the handlebars... I ended up using my free hand to lift the hand on my injured side on to the handlebars, then "walking" the second hand around until I reached the hoods. From there I was right... until a possum jumped out from the side of the road late in the 300 (at night); I swerved and the sudden action resulted in pain that had me yelling loudly enough for my ride partner to hear me a half kilometre back.

I split the bone at the top of the arm, but that mended OK. I didn't have surgery -- I just rode my bikes. When I went to see the ortho surgeon with X-rays, he said that if the split bone had moved upward at all, I would have had to have surgery to correct it because I wouldn't have been able to lift my arm above horizontal. "But other than that, keep up the physio exercises. I don't need to see you again".

Of course, there were no physio exercises -- just doing stuff every day, including a few stretches in the shower.

I still have the occasional twinge when I am putting on a jersey, and I don't have complete range of movement --but I really don't need it, and I don't want the pain of surgery and recovery.
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Old 11-14-07, 02:21 PM   #13
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Update: Things are slowly getting better, in that I can lift my arm almost to shoulder height without suffering too much and the swelling seems to be down. Physio this week was brutal, and I needed pain meds once it was over, but I did feel better a couple of days later. I saw the specialist today, and he reckons I need some fairly aggressive physio to free the joint and strengthen the rotator cuff, but no surgery. I'll see him again in five weeks, by which time I hope to be able to be more or less mobile. I am also seeing an osteopath, who just nudges things around gently and causes no pain at all.

At least the weather's mostly cold enough that I don't feel too horrible about missing quality biking time.
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Old 11-17-07, 11:16 AM   #14
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I subluxed initially a few years ago...did a bit of therapy and thought that I had mostly full mobility and ability back....slowly through inactivity, the problem crept back...

dealing with this right now...grrrrrr

shoulder pain is no joke
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Old 11-17-07, 12:54 PM   #15
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My left shoulder has been frozen (adhesive capsilitis) for a few months now and PT hasn't been much help although they did help to increase my range of motion. I've been taking Naproxen as well. I will be seeing an ortho specialist in a couple weeks again to see what the next step is. My PT suggested my ortho may prescribe a cortisone shot or forced manipulation of my shoulder. Ouch....
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Old 11-18-07, 06:49 PM   #16
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Physio this week was brutal...

I've heard that from a couple other people in the past, but I can't relate. When I had PT to enhance muscles around the rotator cuff, I was told to back off when pain started. I showed up twice per week at a facility to check my progress, adjust my exercises, and run through my routine in front of the therapist. 80% of my PT was done by me at home for about 20 - 30 minutes per day.

After RTC surgery, it was the same routine except for lighter weights and tubes to start with. All range of motion and reps were ceased when there was pain. All sessions were followed by icing the shoulder. After surgery, my progress was steady and swift. I think about 4 months put me at around 90% with no pain.
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Old 11-20-07, 02:45 PM   #17
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I got this diagnosis yesterday -- it's a stage or so less serious than a dislocation, but the shoulder has been forced somewhat out of kilter and I'm on pain meds and antiinflamatories. It seems that the initial injury from a crash 4 weeks ago got worse somehow and the joint slipped, and my recovery process took a major nosedive. Doc says I'll need physio rather than surgery, which I suppose is good, and I'm getting an appointment next week for the fracture clinic, which will take another look and work out what to do.

I realize each injury is different, but has anyone been through this one and can anyone offer any advice? I'm normally pretty active, with biking, hiking, skiing, gym, and and will mention that to the orthopod next week. But the thought of being without all that is pretty depressing. Any clues on recovery time, and what I've got to "look forward" to?
I would avoid the surgery as long as possible, but if it gets worse and you start actually dislocating it, don't put the surgery off. I dislocated my left shoulder for the first time when I was 15. My labrum was torn (which I didn't find out until much later), so I pretty much dislocated it 2 to 3 times a year for the next 12 years until I had it fixed. Unfortunately, you never really get use to the pain a dislocation or partial seperation causes. Finally broke down and got the surgery when the shoulder would no longer reduce on its own. Kept putting surgery off because I didn't want to stop biking and backpacking to go through the 4 months of recovery. On the plus side, the surgery has progressed greatly over the years. When I had it fixed two years ago, it was a simple orthoscopic surgery done on an outpatient basis. RTC surgerys are done almost exactly the same way now. The three months of recovery was not fun, however. No probelms since besides a little ache during cold weather.
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Old 11-20-07, 03:11 PM   #18
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I realize each injury is different, but has anyone been through this one and can anyone offer any advice? I'm normally pretty active, with biking, hiking, skiing, gym, and and will mention that to the orthopod next week. But the thought of being without all that is pretty depressing. Any clues on recovery time, and what I've got to "look forward" to?
I can only share my experience, and the experience of a friend who also injured her shoulder in a fall.

Both of us made full recoveries. It took about six months. Now I don't even notice it. Back to normal.

It was gradual, and it slowly healed.
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Old 11-22-07, 07:19 PM   #19
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ok, a lot of terms are being tossed out here that are not accurate...this is what you get for online help.

sublux- pretty much your shoulder popped out and went back in, or slid a little bit in the socket. Your right that it is similar to a partial dislocation. The thing about dislocating your shoulder (different then a seperated shoulder) is that when you do it once, you have an 80% chance of doing it again. PT is normally the course of action for a sublux because normally nothing is torn. If it keeps happening they can do a capsule shrinkage or anchor it in. I have had a few operation, frozen shoulders, trigger points, dislocations, but no seperations! I was a swimmer hence the shoulder problems.

Getting the steroid shots help in the short term. They didnt do much for me except help me get through tough periods of training (pn mngt). The doc told me it works for some but I have never heard of other athletese first hand say that the shots worked. Stick with PT, it takes a while for it to show improvements and do NOT stop. If you are told to do stuff at home then for the love of your shoulder do them. They are stupid exercises that seems to do nothing, trust me...they really do help.
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Old 11-23-07, 06:01 PM   #20
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My left shoulder has been frozen (adhesive capsilitis) for a few months now and PT hasn't been much help although they did help to increase my range of motion. I've been taking Naproxen as well. I will be seeing an ortho specialist in a couple weeks again to see what the next step is. My PT suggested my ortho may prescribe a cortisone shot or forced manipulation of my shoulder. Ouch....
My physio does acupuncture too, and he says that's the best thing he knows for a frozen shoulder. You might want to give it a try -- might be less gruesome than forced manipulation.

On my side, it's finally starting to get better, although it's been a roller coaster ride. There are more step-forward days than step-back days, and sometimes I even sleep for a couple of hours at a time without waking up grumpily. I went to the gym for the first time since the accident this week, just using the recumbent bike for 25 minute stints. At least it means I'm keeping my legs moving.
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Old 11-23-07, 06:16 PM   #21
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My physio does acupuncture too, and he says that's the best thing he knows for a frozen shoulder. You might want to give it a try -- might be less gruesome than forced manipulation.
Thank you, I actually might give acupuncture a try. There's an acupuncture college nearby and a couple of my coworkers has had a few sessions to relieve their aches and pains and have been very happy with the results so far.
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Old 12-14-07, 09:23 AM   #22
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yoga with a sport injury competent instructor helped me more than anything else (1 major separation, 3 later subluctions - no surgeries). It strengthend and stabilized the joint. I still ski (and i go everywhere on the mountain), though when falling jettison the poles and tuck the arm in to prevent chicken-winging it again.

i got a lot of the mobility back (though it took some time), and yes, if i lay off the yoga for too long, it starts getting tender again. i'd rather the yoga than any surgery so long as i can get away with it.
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Old 12-14-07, 11:31 AM   #23
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On my side, it's finally starting to get better, although it's been a roller coaster ride. There are more step-forward days than step-back days, and sometimes I even sleep for a couple of hours at a time without waking up grumpily. I went to the gym for the first time since the accident this week, just using the recumbent bike for 25 minute stints. At least it means I'm keeping my legs moving.
Maybe you should be looking for a recumbent bicycle.......................Just to ride temporarily, you understand.
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