Dislocated Shoulder
Discussion
I bloody dislocated my left shoulder on Thursday. Doing weights, i lifted a (light) barbell over my head doing warm down and over balanced a bit (I wasn't concentrating properly) and my arms went backwards past vertical and my left shoulder popped out.
Absolute agony with my arm stuck above my head, was told I'd had an inferior dislocation where the arm falls out below the socket. It's the second time the left has gone, the last time was 25 years ago when it came out of the front so a different type and I'd had no problems since.
I'm hugely active, doing something pretty much everyday and had got into decent shape, so this has come at worst time. I'm really anxious to find out how long I'm going to be 'out' for, how long in the sling, etc so I can mentally prepare. I have a follow-up at the hospital next week, should I get an ultrasound or will they just do some wiggling about? I have private health if needed and I just want to make use of everything to recover as quickly as possible.
Finally, while in a sling, is there anything I should avoid and anything I shouldn't be able to do? I say that as I can shrug my shoulder and move my arm out slightly without pain. Just seems a bit weird as it's not hurting like I assumed it would.
Absolute agony with my arm stuck above my head, was told I'd had an inferior dislocation where the arm falls out below the socket. It's the second time the left has gone, the last time was 25 years ago when it came out of the front so a different type and I'd had no problems since.
I'm hugely active, doing something pretty much everyday and had got into decent shape, so this has come at worst time. I'm really anxious to find out how long I'm going to be 'out' for, how long in the sling, etc so I can mentally prepare. I have a follow-up at the hospital next week, should I get an ultrasound or will they just do some wiggling about? I have private health if needed and I just want to make use of everything to recover as quickly as possible.
Finally, while in a sling, is there anything I should avoid and anything I shouldn't be able to do? I say that as I can shrug my shoulder and move my arm out slightly without pain. Just seems a bit weird as it's not hurting like I assumed it would.
I dislocated mine playing cricket a few years ago. Once it was back in place there wasn't much pain, a little with certain movements but if I got it at the wrong angle then it felt like it was about to fall out again.
Assorted NHS physios helped but didn't completely cure it. Finally discovered a physio who found that I'd got one of the muscles in my shoulder that was underdeveloped. He gave me some specific calisthenics to improve the problem and it's been fine since. From the dislocation to being ok day to day was about four weeks, then it was another 4 months before chancing on a decent physio over a beer, after which it was only a couple of weeks before everything felt strong again.
Assorted NHS physios helped but didn't completely cure it. Finally discovered a physio who found that I'd got one of the muscles in my shoulder that was underdeveloped. He gave me some specific calisthenics to improve the problem and it's been fine since. From the dislocation to being ok day to day was about four weeks, then it was another 4 months before chancing on a decent physio over a beer, after which it was only a couple of weeks before everything felt strong again.
Luxatio Erecta
very rare, only 0.5% of all shoulder dislocations
https://www.ncbi.nlm.nih.gov/pubmed/22263209
vignette: "Our results indicate that the majority of patients return to preinjury level of shoulder function, despite associated injuries. Closed reduction constituted definitive management in 100% of the cases in our series, and there was no recurrent instability at follow-up."
very rare, only 0.5% of all shoulder dislocations
https://www.ncbi.nlm.nih.gov/pubmed/22263209
vignette: "Our results indicate that the majority of patients return to preinjury level of shoulder function, despite associated injuries. Closed reduction constituted definitive management in 100% of the cases in our series, and there was no recurrent instability at follow-up."
Thanks, i spent hours on Friday researching this type of dislocation and whether it is better/worse than an anterior dislocation. It appears, to my untrained brain, that it's possible i have caused less damage having an inferior dislocation but there's no way to know this for sure.
I decided as I have private medical, and i've already spent the excess this year, to get a referral to coincide with my NHS follow-up as I may be able to get an ultrasound to see what ligament damage there is. 4 days in now and the area at back of the shoulder and deltoid region is now sore to touch which i guess is progress as i've iced it religiously in that time and there was no soreness before.
As an aside, i'd spent years building muscle in my upper body so i'm hoping this would have made a difference to the level of trauma.
I decided as I have private medical, and i've already spent the excess this year, to get a referral to coincide with my NHS follow-up as I may be able to get an ultrasound to see what ligament damage there is. 4 days in now and the area at back of the shoulder and deltoid region is now sore to touch which i guess is progress as i've iced it religiously in that time and there was no soreness before.
As an aside, i'd spent years building muscle in my upper body so i'm hoping this would have made a difference to the level of trauma.
I dislocated mine a few years ago skiing. Labrel tear, took a piece off the humerus which needed removing and then got "very rapid onset" to quote the specialist frozen shoulder. I did it properly apparently.
I did loads of rehab with a Physio and a personal trainer but also had a lot of very painful "massage". In my case and as is apparently quite common the major muscle groups tense up to stabilise the joint as the rotator cuff has been weakened. The worst bit was persuading those major muscles to relax again....lots and lots and lots of stretching and that "massage".
Touch wood absolutely fine now.
I did loads of rehab with a Physio and a personal trainer but also had a lot of very painful "massage". In my case and as is apparently quite common the major muscle groups tense up to stabilise the joint as the rotator cuff has been weakened. The worst bit was persuading those major muscles to relax again....lots and lots and lots of stretching and that "massage".
Touch wood absolutely fine now.
Edited by Cheib on Tuesday 1st November 17:27
6 days on and i'm already (probably mistakenly) taking the arm out of the sling every now and then. I have full external and internal rotation without issue, abduction is a bit more challenging but feels more like stiffness. All of these are without resistance at the moment so i'm not pushing it. I have a trip to the hospital tomorrow for the follow up, hopefully the doc will agree I can start physio although perhaps he/she will move my arm into different positions that challenge the joint a bit more.
I guess I just expected to be in a lot more discomfort, including swelling and tenderness around the shoulder, but have had hardly any. I've been almost waiting for the past few days for something to flare up but nothing has occured. At most, it feels like the deltoid is the area that's maybe slighty sore (very mild throbbing after abduction) but nothing really hurts to suggest the body doesn't want me doing it.
I'm probably like dozens of patients who are trying to rush recovery, but if i can at least go for a run this weekend i'll be happy.
I guess I just expected to be in a lot more discomfort, including swelling and tenderness around the shoulder, but have had hardly any. I've been almost waiting for the past few days for something to flare up but nothing has occured. At most, it feels like the deltoid is the area that's maybe slighty sore (very mild throbbing after abduction) but nothing really hurts to suggest the body doesn't want me doing it.
I'm probably like dozens of patients who are trying to rush recovery, but if i can at least go for a run this weekend i'll be happy.
Edited by Jefferson Steelflex on Thursday 10th November 10:17
I think the advice with all these things is mobilise and use as quickly as you can. Worst bit about my dislocation was when they were trying to put it back in...laid me on a camp bed in the middle of the doctors surgery and then they put my arm on a stool next to me (for support I thought)...had some morphene and then a few minutes later the doctor walked over. Sat on the stool and told me "you're a big bloke so you need to relax or this isn't going to work"....he then put his foot in my armpit and tried wrestling my shoulder back together. Reasonably painful!
20 mins later he gave up and off to hospital in an ambulance so they could put me under to get it back in.
20 mins later he gave up and off to hospital in an ambulance so they could put me under to get it back in.
I've had a posterior dislocation, ripped my arm out of the socket after going over the handlebars of my bike.
Horrendous pain. Had to have Morphine to get me into the ambulance, and two more shots whilst going to hospital. Had to be put to sleep for them to get it back in.
Off work for 6 weeks. Had a course of physio, but that did nothing.
Eventually had an operation, off work another 6 weeks. I had torn 70% of the cartilage out of the socket, much worse that they had thought. Surgeon rebuilt it as best as he could. Now have 3 screws in the joint.
Never been the same since.
Hope you recover.
Horrendous pain. Had to have Morphine to get me into the ambulance, and two more shots whilst going to hospital. Had to be put to sleep for them to get it back in.
Off work for 6 weeks. Had a course of physio, but that did nothing.
Eventually had an operation, off work another 6 weeks. I had torn 70% of the cartilage out of the socket, much worse that they had thought. Surgeon rebuilt it as best as he could. Now have 3 screws in the joint.
Never been the same since.
Hope you recover.
pah, do it another 20 odd times then come back to me! 
i've lost count of the number of times i've dislocated my shoulder, but its easily in the 20s. it was going once or twice a month at one point. i'd pop it back in and carry on what i was doing. i lost faith in physios after i was told by more than one physio that there is no loss of strength or stability compared to the other side...
for me, going to the gym is the only thing that has helped me, and i've only dislocated it once in 12 months now. i do remember the first time was absolute agony, but dont worry, its almost pain free by the 6th or 7th...
i've lost count of the number of times i've dislocated my shoulder, but its easily in the 20s. it was going once or twice a month at one point. i'd pop it back in and carry on what i was doing. i lost faith in physios after i was told by more than one physio that there is no loss of strength or stability compared to the other side...
for me, going to the gym is the only thing that has helped me, and i've only dislocated it once in 12 months now. i do remember the first time was absolute agony, but dont worry, its almost pain free by the 6th or 7th...
I'm pretty pissed off to be honest, had a follow up today at the hospital (1 week after the injury). Appt was 75 minutes late, and the guy couldn't wait to get me out of the room - I was in there 5 minutes tops.
The
didn't ask how I was, whether it hurt or not, any issues, etc. - just told me to keep the sling on for another 3 weeks and not move my arm at all. When I challenged him by explaining that I'd had some pain-free movement and had already moved to Phase 2 of the NHS-issued leaflet on treatment (the one which says a sling is on for a maximum of 2 weeks and mobilisation can be attempted before this) he simply said "well you can ignore my medical advice and you'll re-dislocate it).
He told me I had damaged all of the rotator cuff muscles and torn my labrum. I asked how he knew this - "it is what has happened, you shouldn't question these things". He asked me to come back in 3 weeks, I told him I would not as I'll go private and get seen by a proper doctor who at least has a look at the injury first.
An utter waste of time, on every level. Although I'm disappointed not to be out of the sling, i can live with a slower recovery if it's based on some form of examination. This was just some bloke going through the motions.
The
didn't ask how I was, whether it hurt or not, any issues, etc. - just told me to keep the sling on for another 3 weeks and not move my arm at all. When I challenged him by explaining that I'd had some pain-free movement and had already moved to Phase 2 of the NHS-issued leaflet on treatment (the one which says a sling is on for a maximum of 2 weeks and mobilisation can be attempted before this) he simply said "well you can ignore my medical advice and you'll re-dislocate it). He told me I had damaged all of the rotator cuff muscles and torn my labrum. I asked how he knew this - "it is what has happened, you shouldn't question these things". He asked me to come back in 3 weeks, I told him I would not as I'll go private and get seen by a proper doctor who at least has a look at the injury first.
An utter waste of time, on every level. Although I'm disappointed not to be out of the sling, i can live with a slower recovery if it's based on some form of examination. This was just some bloke going through the motions.
Jefferson Steelflex said:
I bloody dislocated my left shoulder on Thursday. Doing weights, i lifted a (light) barbell over my head doing warm down and over balanced a bit (I wasn't concentrating properly) and my arms went backwards past vertical and my left shoulder popped out.
I did EXACTLY the same thing back in May .. they seemed to diagnose as a sub-lux.Sleeping on my side was painful for the first couple of weeks, pain gradually died down. Did physio for about 8 weeks which helped restore motion and confidence in how far I could push my shoulder. Inability to swim front crawl went on for months but i'm back at the gym now and working on that muscle group more .. back to around 90% now maybe 95%.
C+ ... would not recommend, but way less painful than throwing your back out
I didn't use any kind of sling as per doctor & physio instructions.
So, 2 weeks on and out of the sling and getting decent unassisted mobility in the joint:
- 120deg forward flexion (where 180 deg is arm straight up)
- 90deg abduction (arm in neutral position, I know not to rotate it at the same time)
- full internal and external rotation with elbow at the side
I went private in the end and saw a consultant earlier this week. He said the exact opposite of the NHS consultant and told me to take off the sling and only wear it when out in public to avoid getting bumped. General advice was to mobilise and slowly strengthen the shoulder through physiotherapy and home exercises for 6-8 weeks and then go back when the consultant will do some strength and range of motion tests to verify it has healed properly. It was also good for someone to talk me through the joint, how i dislocated it and the relationship between the muscles in the back and shoulder.
In medical terms, it was explained that the glenoid labrum is likely permanently damaged, but with proper rotator cuff strengthening and scapula setting I can be as good as new, but it can take many months to fully get back to normal.
This is a good opportunity to get my posture sorted - I'm a little hunched forward and chest dominant in the gym so getting more upright and getting stronger shoulders and back will help with the aches and pains i get.
- 120deg forward flexion (where 180 deg is arm straight up)
- 90deg abduction (arm in neutral position, I know not to rotate it at the same time)
- full internal and external rotation with elbow at the side
I went private in the end and saw a consultant earlier this week. He said the exact opposite of the NHS consultant and told me to take off the sling and only wear it when out in public to avoid getting bumped. General advice was to mobilise and slowly strengthen the shoulder through physiotherapy and home exercises for 6-8 weeks and then go back when the consultant will do some strength and range of motion tests to verify it has healed properly. It was also good for someone to talk me through the joint, how i dislocated it and the relationship between the muscles in the back and shoulder.
In medical terms, it was explained that the glenoid labrum is likely permanently damaged, but with proper rotator cuff strengthening and scapula setting I can be as good as new, but it can take many months to fully get back to normal.
This is a good opportunity to get my posture sorted - I'm a little hunched forward and chest dominant in the gym so getting more upright and getting stronger shoulders and back will help with the aches and pains i get.
Edited by Jefferson Steelflex on Thursday 10th November 10:20
Jefferson Steelflex said:
In medical terms, it was explained that the glenoid labrum is likely permanently damaged, but with proper rotator cuff strengthening and scapula setting I can be as good as new, but it can take many months to fully get back to normal.
How did they diagnose a Labrel tear without doing a scan or did they ? I had a Labrel tear which was diagnosed following a CT scan. The specialist I saw was 50/50 on the need to repair it but because they had to remove the piece of bone I'd managed to take off my humerus they did the labrel repair.Edited by Jefferson Steelflex on Thursday 10th November 10:20
No scan, the guy just said it invariably tears and won't repair itself. So even if it was torn, he would only propose to operate if it was causing me aggro in 2 months time, or if I was a professional sportsman and getting to 100% was absolute necessity.
He was clear that regardless of the damage to the labrum, proper strengthening and mobility was likely good enough to get back to normal anyway.
He was clear that regardless of the damage to the labrum, proper strengthening and mobility was likely good enough to get back to normal anyway.
I just wanted to close this out for anyone unfortunate enough to suffer a similar injury.
Following my last post, I went through about 4 sessions of physiotherapy, which basically just worked on mobilising and stretching the joint, accompanied by rotator cuff exercises using a theraband. The movement returned naturally, maybe a few degrees every day until after about 6 weeks I was able to life my arm straight up, scratch my back etc. although there was a little discomfort.
Gym work started at Week 7, light shoulder lateral raises, bicep curls and machine chest press and similar. Nothing heavy and no free weights of any significance. The idea was to get the delts, bicep and pectorals strengthened again as these are supporting muscles for the shoulder. Rotator cuff work moved to internal/external rotation using a dumbell, so more weight based but still high rep (I was using 3kg dumbell).
This week is Week 11 post-injury, and I am now clear for overhead work, so I am doing shoulder press using a smith machine but I am back to full strength on chest, back and arms (now using free weights), so feeling much more positive.
I've been given the all-clear to go swimming but that's making me very nervous so I'll leave it a few weeks yet.
NB - During physio, some of the tests done identified that I had very tight pectorals that limited my shoulder movement, and the physio suggested this was likely a significant contributor in how I injured myself - in effect the shoulder had nowhere to go as it was being pulled tight by the chest. It's a bad explanation by me but the physio explained it much better and it's taught me to stretch a lot more to avoid these sort of risks.
I hope this helps anyone in the future who suffers such an injury. The key thing is to focus on early mobilisation if it feels ok, then religiously follow the rehab to strengthen the joint.
Following my last post, I went through about 4 sessions of physiotherapy, which basically just worked on mobilising and stretching the joint, accompanied by rotator cuff exercises using a theraband. The movement returned naturally, maybe a few degrees every day until after about 6 weeks I was able to life my arm straight up, scratch my back etc. although there was a little discomfort.
Gym work started at Week 7, light shoulder lateral raises, bicep curls and machine chest press and similar. Nothing heavy and no free weights of any significance. The idea was to get the delts, bicep and pectorals strengthened again as these are supporting muscles for the shoulder. Rotator cuff work moved to internal/external rotation using a dumbell, so more weight based but still high rep (I was using 3kg dumbell).
This week is Week 11 post-injury, and I am now clear for overhead work, so I am doing shoulder press using a smith machine but I am back to full strength on chest, back and arms (now using free weights), so feeling much more positive.
I've been given the all-clear to go swimming but that's making me very nervous so I'll leave it a few weeks yet.
NB - During physio, some of the tests done identified that I had very tight pectorals that limited my shoulder movement, and the physio suggested this was likely a significant contributor in how I injured myself - in effect the shoulder had nowhere to go as it was being pulled tight by the chest. It's a bad explanation by me but the physio explained it much better and it's taught me to stretch a lot more to avoid these sort of risks.
I hope this helps anyone in the future who suffers such an injury. The key thing is to focus on early mobilisation if it feels ok, then religiously follow the rehab to strengthen the joint.
Jefferson Steelflex said:
I just wanted to close this out for anyone unfortunate enough to suffer a similar injury.
Following my last post, I went through about 4 sessions of physiotherapy, which basically just worked on mobilising and stretching the joint, accompanied by rotator cuff exercises using a theraband. The movement returned naturally, maybe a few degrees every day until after about 6 weeks I was able to life my arm straight up, scratch my back etc. although there was a little discomfort.
Gym work started at Week 7, light shoulder lateral raises, bicep curls and machine chest press and similar. Nothing heavy and no free weights of any significance. The idea was to get the delts, bicep and pectorals strengthened again as these are supporting muscles for the shoulder. Rotator cuff work moved to internal/external rotation using a dumbell, so more weight based but still high rep (I was using 3kg dumbell).
This week is Week 11 post-injury, and I am now clear for overhead work, so I am doing shoulder press using a smith machine but I am back to full strength on chest, back and arms (now using free weights), so feeling much more positive.
I've been given the all-clear to go swimming but that's making me very nervous so I'll leave it a few weeks yet.
NB - During physio, some of the tests done identified that I had very tight pectorals that limited my shoulder movement, and the physio suggested this was likely a significant contributor in how I injured myself - in effect the shoulder had nowhere to go as it was being pulled tight by the chest. It's a bad explanation by me but the physio explained it much better and it's taught me to stretch a lot more to avoid these sort of risks.
I hope this helps anyone in the future who suffers such an injury. The key thing is to focus on early mobilisation if it feels ok, then religiously follow the rehab to strengthen the joint.
Pec minor was/is probably tight/short. This muscle basically tightens and shuts down in a foward head posture. This pulls the scapula out of position with inevitable effect on the rotator cuff. The rc is the most complex joint in the body and must be kept in the correct position re posture, to function correctly. Following my last post, I went through about 4 sessions of physiotherapy, which basically just worked on mobilising and stretching the joint, accompanied by rotator cuff exercises using a theraband. The movement returned naturally, maybe a few degrees every day until after about 6 weeks I was able to life my arm straight up, scratch my back etc. although there was a little discomfort.
Gym work started at Week 7, light shoulder lateral raises, bicep curls and machine chest press and similar. Nothing heavy and no free weights of any significance. The idea was to get the delts, bicep and pectorals strengthened again as these are supporting muscles for the shoulder. Rotator cuff work moved to internal/external rotation using a dumbell, so more weight based but still high rep (I was using 3kg dumbell).
This week is Week 11 post-injury, and I am now clear for overhead work, so I am doing shoulder press using a smith machine but I am back to full strength on chest, back and arms (now using free weights), so feeling much more positive.
I've been given the all-clear to go swimming but that's making me very nervous so I'll leave it a few weeks yet.
NB - During physio, some of the tests done identified that I had very tight pectorals that limited my shoulder movement, and the physio suggested this was likely a significant contributor in how I injured myself - in effect the shoulder had nowhere to go as it was being pulled tight by the chest. It's a bad explanation by me but the physio explained it much better and it's taught me to stretch a lot more to avoid these sort of risks.
I hope this helps anyone in the future who suffers such an injury. The key thing is to focus on early mobilisation if it feels ok, then religiously follow the rehab to strengthen the joint.
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