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  1. #26
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    Alex - Look for striderGT's posts. He wrote a book on curing your own shoulder injuries. My gf just ordered it for me.
    striderGT swears that hanging will reshape the muscles to support your shoulder.

  2. #27
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    ^ I think I bought that book last week, and it says very clearly (not verbatim but the gist of it is):
    "This is for people with rotator cuff problems. Do not do these if you have an unstable or dislocating shoulder."

    thanks for looking out though, Pat.


    Oh yeah, and on the "wait til it happens again" front - the main thing is that if it happens again in 8 years, no big deal, if it happens again in less than a year, maybe look at screwing down/cleaning up that labrum.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  3. #28
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    Great news! Good luck with it Schralph.

  4. #29
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    I woke up in a lot of pain last night. When the haze of confusion wore off I realized my shoulder was out. Just from sleeping on it wrong.

    How screwed am I?
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  5. #30
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    Others here have dislocated it in their sleep and recommended learning to sleep on the other side. I have been lucky enough to sleep on my other side.

    CW, you said it had dislocated recently? Was that your first time?

    If there is bone deformity or damage then you're pretty screwed and probably looking at surgery. If you can live with reducing it yourself and it's not getting worse, then maybe you can live with it. You should definitely see an ortho though.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  6. #31
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    First dislocation was in October 2010. Saw an ortho then, he said to work on strengthening the shoulder and wait to see if it continued to be a problem.

    Seemed to be healed up and working fine all winter then in June I slipped on some roots on a hiking trail, fell backwards and popped it out again. Didn't feel like it came all the way out that time and went right back in. Minimal pain once it was back in, it felt like it was all healed up after only a few days and I didn't bother to see a doc about it that time.

    Then last saturday I skied off a small windlip, landed slightly off balance with my weight on that pole and popped it again. I kept skiing and popped it twice more that day from doing nothing more than a hard pole plant one time and reaching up to pull myself up a rock on a short scramble the second time. It feels REALLy loose now, seems like it slides out and back in pretty easily...

    I move around a fair amount in my sleep. I wasn't even sleeping on that side (hurts too much), when I woke up I was on my stomach.

    I have an appointment with an ortho on Tuesday
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  7. #32
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    I tore my labrum in rear of my shoulder. I also was prescribed PT to help strengthen the muscles that help keep the joint in place. However, due to my lifestyle the PT wasn't enough to keep up. My shoulder continued to pop out, whether it was hitting a hard mogul or trying to push myself out of bed. Over 2 years after the first incident, I decided to have surgery. I am not going to lie, the recovery SUCKED. It didn't help that they prescribed pain meds that didn't agree with my body. But overall, it was not fun being in a sling for weeks, slowly recovering and strengthening. I didn't feel it was fully recovered until 2 yrs after surgery (lifting weights, full range of motion, etc). I couldn't be happier now that I had the surgery. I continue to do PT, but mainly it is included in my normal workout routine at the gym.

    My recommendation is PT is bs and go with the surgery if you can afford it and find a good doctor. It may suck for a couple years, but in the long run, it will be worth it. I am more confident in my skiing, rock climbing, mt biking, etc knowing my shoulder isn't going to collapse on me, and I am sure you would feel the same way.

    Good luck.

  8. #33
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    Thanks for the input!

    I'm familiar with sucky recoveries. The aftermath of my ACL surgery back in '95 was way worse than the actual injury itself. Fortunately the recovery was swift and I was doing high routes off-trail by August and skiing again the next season.

    I'm not working right now, this seems to be the optimum time to get this dealt with as long as Congress extends the emergency unemployment benefits beyond the two months they agreed to. If they don't, I'm going to HAVE to find a job of some sort by the end of April when my current benefits run out.

    Of course, it's going to start snowing as soon as I go under the knife...
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  9. #34
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    Yeah Willie I think you are hosed, I'm sorry

    I think my 2nd doc's advice of waiting for the next dislocation is sage, because not everyone has continued problems. He honestly seems to believe that I only have a 20% chance of recurrent dislocation. I have to find out where that number came from.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  10. #35
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    Quote Originally Posted by SchralphMacchio View Post
    Yeah Willie I think you are hosed, I'm sorry

    I think my 2nd doc's advice of waiting for the next dislocation is sage, because not everyone has continued problems. He honestly seems to believe that I only have a 20% chance of recurrent dislocation. I have to find out where that number came from.
    That's what the doc told me the first time I went to see him. He also said the older you get the less likely it is to happen again. He said I'd probably be fine since I was 42 when the first one happened. I think if I hadn't fallen and popped it that second time that I'd probably be fine. Oh well, all I can do is hope the surgery fixes it.
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  11. #36
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    Medical Opinion #3: A slightly more conservative (from a risk of re-dislocation perspective) version of #2. Two months aggressive rehab and leave open the option of surgery before a repeat dislocation if the joint feels unstable/compromised after a full rehab schedule. Rotator cuff strength looks good so I have a fighting shot at not dislocating again, though there is is minor bone, ligament and capsule damage that can't be addressed without surgery and it may or may not cause lingering issues. She also wants me to wait a little longer before, and ramp up a little slower with, resuming activities than #2 does.

    Sooooo given the seemingly low odds of permanent nerve damage and life-threatening arterial bleeding from a future dislocation in the backcountry ... I'm going with Opinion #3! I've gotten a lot of strength, muscle function and alignment back in the last week, which makes it easier to make a rational decision. It's a lot harder to decide when your body looks crooked in the mirror and you can hardly put on a t-shirt or reach for a box of Cheerios without shrieking in pain.

    Rehab and photography here I come! This will also be a good excuse to look forward some of those super long but super flat tours late this season - like Mokelumne Peak.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  12. #37
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    Quote Originally Posted by MJbumper1121 View Post
    I tore my labrum in rear of my shoulder. I also was prescribed PT to help strengthen the muscles that help keep the joint in place. However, due to my lifestyle the PT wasn't enough to keep up. My shoulder continued to pop out, whether it was hitting a hard mogul or trying to push myself out of bed. Over 2 years after the first incident, I decided to have surgery. I am not going to lie, the recovery SUCKED. It didn't help that they prescribed pain meds that didn't agree with my body. But overall, it was not fun being in a sling for weeks, slowly recovering and strengthening. I didn't feel it was fully recovered until 2 yrs after surgery (lifting weights, full range of motion, etc). I couldn't be happier now that I had the surgery. I continue to do PT, but mainly it is included in my normal workout routine at the gym.

    My recommendation is PT is bs and go with the surgery if you can afford it and find a good doctor. It may suck for a couple years, but in the long run, it will be worth it. I am more confident in my skiing, rock climbing, mt biking, etc knowing my shoulder isn't going to collapse on me, and I am sure you would feel the same way.

    Good luck.
    /\This. Get the surgery. If you have good insurance you're blowing it. Surgery will not make it worse.

    Ralph: Modern joint surgery is awesome. You found a doc that told you what you wanted to hear. I found a doc that listened to what I wanted. I had elbow and shoulder surgery. I love my doc.

  13. #38
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    4matic, thanks for the input.

    It's tricky because everyone has different experiences, and you can't play the anecdotes because those are so specific to each individual. If you play the stats, it gives you a little way to "beat the mean," but then you are ignoring specific situational data. So it's by no means an easy decision to "get right."

    One thing is that I'm just about to turn 32 in a few weeks. I can't find good references on the stats, but the gist is something like almost all people who suffer their first dislocation below the age of 20 will repeat, most people below 25 will repeat, and like 20% of people above 40 will repeat. So what happens in the early 30's?

    I had 3 different docs, from 3 different clinics, all experienced with basketball/football injuries. They had 3 different opinions, with no knowledge of the other doctors or opinions before they went into options and recommendations. The one who understands snowboarding and skiing the most, and has operated on pro basketball players and pro snowboarders, and who took the most time to describe the procedures and shoulder anatomy, was the one to most strongly oppose surgery and suggest getting back into BC snowboarding this season.

    I was very close to signing up for the operation after the first doc's input, and if it was a case where they all said I would have continuing problems down the road for sure, then I'd get the surgery now no question. I'm basically giving myself the option to still have surgery in April while I still have awesome insurance and coming back into peak ski season for next year. I even planned my 2011 FSA benefit amount around this possibility. And believe me, the next time my shoulder dislocates, I will get surgery. This isn't a question of waiting for the 5th or 6th time. For me it's a matter of waiting the 2nd time as positive feedback that the rehab didn't take and 100% reinforcing the need for surgery.

    Oh yeah, and here is the crux piece that I didn't understand at first. this is what the radiology report says:
    "There is an increased signal within the anterior labrum suspicious for a tear ... abnormal signal within the anterior labrum suspicious for a labral tear (cartilaginous Bankart injury)." It's like the radiologist wasn't sure if it was frayed or separated. The first doc went straight to "oh yeah that's torn etc etc." The other two were a bit more cautious about extent, thinking that I had good odds to recover without surgery.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  14. #39
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    anyways, to put this in perspective ...

    I'm just really happy I don't have cancer and am having to debate the merits of various treatment options for that. Either way, I can walk, take photos, drink great beer and wine, spend time with friends and family ... I'll ski and bike again soon enough

    Fingers crossed to buy myself plenty of time before I go down that road ...
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  15. #40
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    Quote Originally Posted by SchralphMacchio View Post

    Oh yeah, and here is the crux piece that I didn't understand at first. this is what the radiology report says:
    "There is an increased signal within the anterior labrum suspicious for a tear ... abnormal signal within the anterior labrum suspicious for a labral tear (cartilaginous Bankart injury)." It's like the radiologist wasn't sure if it was frayed or separated. The first doc went straight to "oh yeah that's torn etc etc." The other two were a bit more cautious about extent, thinking that I had good odds to recover without surgery.

    My best friend is a radiologist. They never know for sure until they go in surgically and look. Indications, signals, etc. That's why they call them medical opinions. When I had shoulder surgery there was nothing indicated on the MRI; it just hurt all the time. Exhausting. I told the doc I don't care. Cut it! Glad I did.. He found major bone spurs and a partially torn labrum from swimming wear and tear.

    The other thing.. When you are a "pro" you may need to play and can't afford the down time. So when you ask if you have to have surgery the answer is no. I told my doc my doc to cut it because I'm sick of it hurting all the time.

    Remember, they are never "sure" until they go in. If the first doc said it's torn. I'm betting it's torn.

  16. #41
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    I bet it's torn too, the thing I don't understand is, how much, and how much would RC strengthening help or buy me time until the rest of the labrum and the rest of the joint gets tighter as I get a little older? And maybe it doesn't buy me any time, so I'll cut. I can't really see a downside to this plan other than a) prolonging impaired mobility by some number of months, and b) waiting so long that I move to a different job and lose my currently awesome insurance before I realize I have to cut.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  17. #42
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    I'm suspicious of those stats. My doc is telling me the same thing, but do older guys suffer fewer repeat dislocations because they tend to slow down and back off activities that might cause them, or is it because the joint is "tighter?"

    Getting an MRI tomorrow. Got X-rays today and no apparent bone damage. Doc said rehab would be his first choice unless the MRI shows major damage to labrum and/or rotator cuff. Thing is, I've dislocated this damned thing 5 times in the last 6 months. How much is rehab really going to help?

    Going to get an appointment with another sports medicine ortho surgeon at UW Sports Medicine clinic after I get the MRI done.

    Should I start my own thread? Not sure piggy-backing on Schralph's thread is the right thing to be doing...
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  18. #43
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    Quote Originally Posted by SchralphMacchio View Post
    Oh yeah, and here is the crux piece that I didn't understand at first. this is what the radiology report says:
    "There is an increased signal within the anterior labrum suspicious for a tear ... abnormal signal within the anterior labrum suspicious for a labral tear (cartilaginous Bankart injury)." It's like the radiologist wasn't sure if it was frayed or separated. The first doc went straight to "oh yeah that's torn etc etc." The other two were a bit more cautious about extent, thinking that I had good odds to recover without surgery.
    When I had surgery on my shoulder they went in thinking it was fully torn, but when they cut me open, they found out it was just so loose that it looked torn. They had to change surgery plan right then and there.
    So I think the truth is that they just don't know for sure till they cut you open. Imaging technology is getting better and better, but it's still a science and an art combined it seems. Looking at MRIs, I have no idea how the hell they can tell what's what and what's torn or not.

  19. #44
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    Chainsaw, I don't mind the piggybacking. Whatever works for you, and there is plenty of relevant discussion in here.

    But 5 dislocations in 6 months sounds dubious for PT given what I've tried to learn this month. It's not like you're an inactive guy. Have you been doing mountaineering and climbing in the last year? It seems those activites would give you reasonable RC strength to begin with - so again, what more will rehab do? I'd ask those questions very strongly.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  20. #45
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    Oh yeah, powdork is no super young stud (I won't go so far as to say he is old) but he sends it bigger than I do and beaters just about as much as I do. He's had shoulder issues that he mentioned did tighten up with age, and he never did surgery. Maybe PM him.
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  21. #46
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    Quote Originally Posted by SchralphMacchio View Post
    Oh yeah, powdork is no super young stud... He's had shoulder issues that he mentioned did tighten up with age, and he never did surgery. Maybe PM him.
    Building up strength is just a matter of putting in the time. For now you want to achieve flexibility in tendons/muscles...imho. Yes strengh, I think, is good, but need to do (at least!) as much time with flexibility exercises... Once muscles become stiff...seems as though most whom I know say = really tough & painful to strengthen..

  22. #47
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    Results are in from the MRI - it's my labrum. No rotator cuff tear, no bone damage. Made an appointment to discuss treatment with the doc on Friday.

    Got a recco from one of my ski buddies who's a general practitioner for another shoulder specialist who he says is the best around so will get an appointment with him for 2nd opinion.
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

  23. #48
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    i had my surgery at age 31. since it was just progressively getting worse. i didn't have repeat dislocations, had several sublexes, but stability kept getting worse and worse. I think i initially dislocated when i was in college. eventually the pain and feeling like my arm was getting pulled constantly led me to surgery

  24. #49
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    Hey Willie, what's the word?

    My PT is going well - looks like I have a fighting shot of rehabbing a stable shoulder. No "clicking" around my labrum that my PT was searching for ...
    _______________________________________________
    "Strapping myself to a sitski built with 30lb of metal and fibreglass then trying to water ski in it sounds like a stupid idea to me.

    I'll be there."
    ... Andy Campbell

  25. #50
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    Schralph - good to hear the PT is going well for you! Hopefully we're in basically the same boat and we'll be back in shape soon.

    Doc #1 really wants me to do rehab/PT rather than a full-on surgical repair. He does want to do a minor arthroscopy as the MRI showed a small piece of detached cartilage is floating in the joint plus he wants to clean up any rough/frayed cartilage and get a better look at the separated section of the labrum. For now I'm going with the PT/rehab route though doubt I can afford it as an ongoing option. I don't think I want him cutting on me unless it's absolutely necessary, and at that point might as well go all in and get the thing fixed.

    Have an appointment with doc #2 at end of February. This doc is supposedly "THE Shoulder Guy" according to one of my ski buddies who's a general practitioner. Doc #1 is more of a knee and hip specialist and works in the same office as doc #2 and also highly recommended him for a 2nd opinion -said if he was going to have his shoulder worked on that doc #2 would be the guy he'd want doing it.

    Went to first PT session today. The therapist immediately saw that my shoulder is all out of whack/alignment from me compensating for pain/weakness. She taped it back into a normal position and told me to leave the tape on for as long as I can stand it as it cues my body to hold the shoulder in a more natural position. Also gave me several exercises to do twice a day and I have a follow-up appointment on Thursday.

    I've been thinking about this situation. I can use my arm as it is now. I have full ROM though there is definitely some pain/weakness. I need to get back to work, I've been unemployed since last May and my money is going to run out in a few months, not to mention that living on a shoestring like I have been is really getting to me and I really want to change my living situation. If I get surgery I'm not going to be able to work for several months, whereas if I can rehab/PT this thing I can go back to work as soon as something comes up.

    I don't like the idea that it might dislocate again, but putting off the surgery and the long recovery seems like the prudent thing to do at this point. At least when it does dislocate I can get it back in pretty easily...

    I went skiing on Sunday because I just had to know whether I could still do it. It was a freaking blizzard all day, just got deeper as the day went on. I didn't really push myself, didn't take any steep drops or small hucks like I might have on a day like that, but I didn't exactly hold back either. I still skied the steep lines I enjoy and skied them reasonably aggressively, enjoyed the hell out of myself and didn't hurt myself any further. I'm going to look into a brace that will hold the shoulder down to wear while skiing and go from here.
    ...Some will fall in love with life and drink it from a fountain that is pouring like an avalanche coming down the mountain...

    "I enjoy skinny skiing, bullfights on acid..." - Lacy Underalls

    The problems we face will not be solved by the minds that created them.

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