Serious shoulder questions for BC skiers, and my own labrum WTF thread
First, a really serious questions for those of you with a history of shoulder dislocations who tour in the backcountry - especially those who opted to not surgically repair:
Imagine this scenario - you and your partner fucked up. Didn't read the terrain and windslab properly and now your best buddy is under 3 feet of debris (you know because you practice beacon and probe searching every season, right?). So, now your task is to relocate about 45 cubic feet of heavy sintered snow (5 feet wide by 2 feet high by 4.5 feet into the slope), which happens to weigh around 850 pounds at 30% water density, as fast as humanly possible because the debris just keeps setting up firmer and firmer and your bud is choking on snow and CO2.
Except that last year, your MRI showed a signal suspicious for a torn labrum and the doctor wanted you to get the arthroscopic surgery. Did you do the surgery or do the rehab? How do you feel about moving all that snow in the next 5-7 minutes with your bum shoulder? (and just to be clear, this is about repeat dislocation during rescue becoming a liability as opposed to dealing with pain)
I do not think I can conscientiously choose the rehab and then feel okay touring in groups of less than 4 people. How often do you tour in groups of 4 people, especially when trying to move fast for deeper, bigger objectives, such as overnighters? I'd say that well over 50% of my touring has been me and my partner. And it's not like I've never practiced shoveling. I am religious about "chop, chop, chop" shoveling to move pre-cut blocks rather than trying to shear off wedges of snow from a lifting position (which is more likely to cause injury and fatigue). But working fast even with good technique, for 7 minutes of continuous shoveling the shoulder will undoubtedly get torqued. I've thought about this several ways, but I think this question is probably the single most deciding factor for treatment if I say that I absolutely will not give up backcountry skiing/boarding.
Second, now that you have thought about the question, here is my situation.
* 32 years old (in 6 weeks)
* First time dislocation of the left (non-dominant) shoulder - inferior dislocation
* MRI shows anterior labral tear, minor hill sachs injury of posterior superolateral humeral head, mild suprastinatus tendinopathy but no full thickness rotator cuff tear, some subacromial impingement
* Other than the minimal hill sachs, no bone damage - xrays look good
* 2 weeks post injury and every day feels different - but the shoulder just feels messed up. Like the all the muscles nearby - pec, bicep, delt, lat - are confused and compensating differently every day. Reaching far in front of me or behind me can be slightly to incredibly painful
* Arm came out while I was gym climbing in a hyper abducted position (sideways stemmed across a corner with left arm overhead on a sloper), and a sudden shift in body weight + my grabbing firmly with the left arm created a lever that forced my arm out of its joint - inferior dislocation (loud as hell SNAP! sound)
* Tingling sensation while dislocated from nerves impinged but I reduced it immediately and the tingling went away after a minute
* Only history on that shoulder is that I fell very hard on it 11 years ago and it didn't dislocate but it was messed up for 6 weeks or so
* No complications from a recent lung surgery (two fat 1" ports or something, titanium staples, lung tissue cutting) or anesthesia. My skin does scar very badly from surgery, and I think my rib muscles scarred up a bit from the fat 1/2" chest tube I had between my ribs for 3 days after lung surgery ... but the chiro worked out a lot of the rib displacement issues and got me re-aligned.
So I've been going back and forth about this, and leaning toward surgery. My doc wants me to do arthroscopic surgery to re-attach the labrum with anchors. He said that anyone else he would ask to try rehab but he does not think I will be happy without surgery. And he thinks I can ski without the surgery, but a) a bad pole plant could be game over, and b) he's not so sure about climbing and mountain biking given my current pain symptoms.
Everyone who didn't do the surgery and hasn't yet had major recurrent problems is saying not to do it; everyone who did it without problems is saying to do it; the folks who waited, had problems, and then did it successfully are saying it was the best thing they could have done and should have just done it right the first time around; and every once in a while for some people it just does not work out as planned and life sucks.
Here's how you can help - convince me why I shouldn't cut, or tell me what information I should get before cementing my decision.
Many thanks ... I'm so fucking tired about reading about this nonstop for the last 3 days and being confused out of my mind.