# On the topic of shoulder dislocations...



## Berkley (May 21, 2007)

Not medical advice, just experiences from someone who's been there too frequently...

I had my 4th shoulder dislocation this past Saturday while downhilling. First time on my left shoulder, but I've done it 3 times before on my right. I thought I would share the information I've learned on the topic with other forum members (plus, I'm a couch potato right now and can't ride).

This is the first shoulder dislocation I've had from riding, but I dislocated my right shoulder three times in my competitive swimming years. Each dislocation was the result of a traumatic impact to a straightened arm with the elbow locked out. It seems this is how most dislocations occur. I have loose shoulders, as does my sister. Each time I did it I went to a hospital and had it put back in. Some people are able to do it themselves, but I'm too much of a *****. 

Something that gets glanced over in medical articles is the amount of time the shoulder spends out of the socket. In my experience, this is directly related to recovery time. During my 1st dislocation, my shoulder spent 5 hours dislocated and I spent a week and a half in a sling. Blame a busy hospital. On my most recent, it was out for only 2 hours, and I'm already out of the sling stretching it and doing light exercises (after only 4 days).

Every time you have the shoulder reduced (readut back in the socket) by a doctor, they will want an X-ray to check for damage to the bone. Fortunately, I've never damaged the bone - apparently it complicates the reduction, and subsequent healing time. Post-reduction, you'll be put in a sling and sent home, probably with some pain meds.

Plenty of medical articles suggest spending weeks in the sling with the arm immobilized. For a regular dislocation, with no bone damage, my orthopedist has never had me in a sling for more than two weeks. In addition to regular patients, my ortho guy does a lot of work with athletes, who due to their good physical condition generally heal quicker. I would recommend seeing an orthopedist who deals with sports injuries. He seems to have a more forward thinking attitude and rather than immobilize the arm, I begin passive therapy after about a week. This entails a physical therapist moving and stretching the arm for me, without much effort on my part. Reading reveals that long-term immobilization can result in a stiff or frozen shoulder which delays and prolongs rehab.

Rehab progresses to mild resistance work. A lot of therapy bands and medicine balls. Eventually, light weight training, and then on to regular workouts in the gym. Almost everyone who dislocates their shoulder once does it again, but building muscle around the joint can help prevent that. After my 2nd dislocation I tore the labrum, cartilage surrounding the ball and socket. Through upper body workouts I was able to prolong surgery, until the weather got nice, I stopped going and dislocated a 3rd time. Most people have surgery after the 2nd dislocation, or even the first if there's cartilage damage, like a torn labrum, or frequently rotator cuff.

I had surgery after my 3rd dislocation on the right, was doing light riding again after two months, and technical riding after three. For my other dislocations I was out for about a month. Everybody's healing time varies, but with good rehab, I was back at it pretty quick. 

Being hurt sucks. Maybe this info helps.

- Chris


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## nuggets (Jul 7, 2008)

I'm afraid I have a torn rotator cuff because I can't lift my arm over my head. I'm concerned that the doc will not want to operate on my shoulder. This could end my biking. The pain is 10+ on the pain scale.


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## Berkley (May 21, 2007)

I'm having surgery on 12/22 to repair my *2nd* torn labrum. It worked well on the right shoulder, so I'm hoping for a similar result on the left.


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## ddraewwg (Jul 22, 2004)

nuggets said:


> I'm afraid I have a torn rotator cuff because I can't lift my arm over my head. I'm concerned that the doc will not want to operate on my shoulder. This could end my biking. The pain is 10+ on the pain scale.


Have you done PT? I dislocated my left shoulder snowboarding (my rt. elbow snowboarding, right pinky and ring finger biking...just last week).

With my shoulder dislocation, I wore a sling for maybe 2 weeks? Forget really. Started PT immediately thereafter. All range of motion stuff. My orthopaedist told me that he was pretty confident that I tore something..I think there's 3 major tendons/ligaments that kinda "hold" the shoulder together...in it's "place". The shoulder isn't a "socket" per se, a better way to look at it is imagining a golf ball sitting on a "tee". That is why the shoulder "socket" can have the range of motion it does, which is also why it's easy to dislocate. Odds are you woudl have torn/stretched/partially torn one of those ligaments. With the scar tissue that forms, being able to rotate the arms up and over your head, becomes difficult because it can rub up against the rotator cuff causing sharp pains (as what happened to me). My Dr. didn't advise surgery though because my range of motion was not that bad. Surgery may have caused more problems and he advised that I do some PT first to see if they could help me strengthen that area and regain my full range of motion. I haven't had problems ever since ( no more dislocations ) but my left shoulder is no where near as strong as my right. I continue to lift weights to strengthen it. I don't have any pain, range of motion is probably 95% so I can live with that.

So my PT regiment was a lot of shoulder blade exercises. Also used a foam roller to stretch my shoulder blade area. Feels sooooooooo friggin good using one of those. What allows the rotator cuff to smoothly clear the shoulder is controlled in a lot of ways by the scapula. The scapula has to move down and back in order for the shoulder to "roll back". If not, the shoulder stays "high", rubbing up against the cuff, causing pain.

That's what I could remember....it's been 3 years. I may not have all the terms correct or even the reasons but if you have not gone through PT, you should. It should also be noted that prior to the dislocation, about 2-3 years prior, I had a shoulder impingement due to a...yes...you guessed it, snowboarding accident. That could have contributed to the problems I had when I dislocated the shoulder.

FYI: I know a few friends that have had multiple dislocations and have went through surgery only to have more problems.


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## nuggets (Jul 7, 2008)

Thanks for the info friend. I'm in the middle of my therapy as we speak. I have a torn tendon and the doc says surgery could further complicate the injury and he wouldn't guarantee a successful surgery. Lots of exercises in my future.


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## Speedster (Nov 30, 2006)

Four weeks ago I had surgery from a major dislocation (labrum 75% torn thus removed, rotator cuff and trauma to the bone) from OTB at Downieville needing 5 anchors. After several methods and 4 hours later the local doc was able to relocate (it was lodged under my arm pit).

I've been on a restricted sling (strap around shoulder and waist), started PT one week (2X week)) post surgery with positive signs of recovery. Lots of ice first week and no pain killers. Range in motion is ahead of schedule. PT does wonders!

Today ortho released me from restricted sling but wants me to keep during activity which could cause backward movement. Also, I’m disappointed that doc says no riding for 3-4 more months mainly because of the forward pressure on the bars and of course re injury if I fall. I was hoping to be either on a road bike or fireroad riding by Jan 1. He seems to be very conservative. This really sucks. I need to find an alternate method of cardio. Any suggestions?


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## CuzinMike (Jul 6, 2010)

I experienced 8 anterior dislocations (caused by impacts) of my left shoulder between 1998 and 2006, mostly due to motorcycle accidents (pretty common in dirt bike racing), and unfortunately, every time I did it the joint would seem looser after recovery. 

After my last dislocation in the Spring of 2006, I decided to take action before surgery became a necessity. 

After the requisite PT had rehabbed the shoulder back into weight-bearing shape, I decided to start adding a lot of high weight/low rep shoulder-dominant exercises to my weight training program. Lat raises, military presses, scarecrows, etc. And never more than 3 sets of 6-8 reps during a workout, if I could manage more than 8 reps in a set, it was time to add more weight (the idea is to build muscle strength, not endurance). 

After about a year of this, I got my left shoulder to where it was as strong as my right, and in the 2 years since, have continued to increase my strength in both. My ortho has been really happy with my progress, and despite quite a few spills, I have yet to dislocate that shoulder since.

Keep in mind, my dislocations didn't cause major labrum damage, and my main issue is a Hill-Sachs lesion, but my doctor feels that by strengthening the muscles around the joint far beyond where they were pre-injury, I've become much less susceptible to impact-related dislocations. 

It might sound like an obvious thing, but it's surprising to me how few folks I know who've suffered from dislocations continue to work on strengthening that area post-PT.

Of course, I'm just a dude on the internet, so consult your doctor first.


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## nuggets (Jul 7, 2008)

AS far as pedaling for the next few months, get a recumbent stationery bike. Boring but does wonders.


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## nuggets (Jul 7, 2008)

The docs final conclusion is that surgery won't help my torn tendon. Refuses to operate so I'm going to the Hershey Med Ctr. Feb. 1 to get a second opinion because as of now I've made no progress at therapy. This injury can leave disabled and never ride my bike again.I'll update you as I find out more.


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## STT GUY (May 19, 2009)

CuzinMike said:


> I experienced 8 anterior dislocations (caused by impacts) of my left shoulder between 1998 and 2006, mostly due to motorcycle accidents (pretty common in dirt bike racing), and unfortunately, every time I did it the joint would seem looser after recovery.
> 
> After my last dislocation in the Spring of 2006, I decided to take action before surgery became a necessity.
> 
> ...


+1

I HATE those damn rubberband things but they have worked wonders for me.


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## Berkley (May 21, 2007)

T minus 7 hours until left shoulder surgery. Kinda crummy because weather in NY's Hudson Valley has been spectacular for riding. Little to no snow as of 12/21. Ahh well, I'd rather give up this than riding in the spring.

In any case, I'm hoping to recover in about a month. Haven't dislocated it since September and I'm going to use the winter months to hit the gym and get it nice and strong in time for my 3rd trip to Moab in April. Preparing 2011 resolutions and things of that nature.

I'll keep you posted on my updates (mostly for the sake of my sanity as I begin some serious couch potato-ing)


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## nuggets (Jul 7, 2008)

*massive rotator cuff tear*



nuggets said:


> I'm afraid I have a torn rotator cuff because I can't lift my arm over my head. I'm concerned that the doc will not want to operate on my shoulder. This could end my biking. The pain is 10+ on the pain scale.


Well the facts are in and it's not good. I have what is called a massive rotator cuff tear. That means that every cuff tendon is torn and in addition to that the bicep tendon is torn.
They are going to try to repair the cuff orthroscopically . Then at a later date try to fix the bicep tear. I say try because there are no guarantees with either surgery. The doc said I was a good case for reverse shoulder replacement???


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## fattireb (Jun 17, 2004)

nuggets said:


> Well the facts are in and it's not good. I have what is called a massive rotator cuff tear. That means that every cuff tendon is torn and in addition to that the bicep tendon is torn.
> They are going to try to repair the cuff orthroscopically . Then at a later date try to fix the bicep tear. I say try because there are no guarantees with either surgery. The doc said I was a good case for reverse shoulder replacement???


Keep your chin up dude - I ripped all 4 tendons of the rotator cuff clean off the bone in November 2009. Surgery was 5 hours and I now have 9 anchors holding everything together. Had to keep the arm in a sling for 3 months for healing then started PT. Got back in the saddle in 6 months and was riding aggressively around the 8 month mark. Feeling good now (actually just got back from 4 days of backcountry snowmobiling in Alaska). I find that riding made it feel better because it fires up the muscles you don't strenghten during PT. There IS a light at the end of the tunnel - its not an easy journey just go at it with a strong positive mindset and you'll get through it. 
You near Danbury CT? I got a great Doc for you if your :thumbsup:


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## king_andre (Feb 16, 2009)

I feeling like I'm joining and elite club! A few weeks ago I managed to dislocate my right shoulder and fracture the gleniod and tear the labrum. While not a major injury, I am still a fortnight away from surgery. All up I will off my rides for 10 weeks and going bat **** crazy already.


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## nuggets (Jul 7, 2008)

Well I finally got my surgery scheduled for April 1. They plan on doing the rotator cuff orthroscopically. Then they will schedule a second surgery to fix the bicep tendon. Then there will be lots of PT. Wish me luck guys.


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## tyler243 (Oct 28, 2009)

Best wishes mate!! Just follow PT and docs orders and you'll be good to go in no time.

Kind of off topic but do any of you have had major shoulder injuries i.e. requiring surgery do you find you need to wear armor now to protect your shoulder from further injury?


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## nuggets (Jul 7, 2008)

Well , my surgery is complete and doc says it was successful. He was able to fix 3 of 4 tears. Now looking at 4 months PT. Can ride in 6 months.


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## Berkley (May 21, 2007)

Not bad all things considered...

Good luck with the rehab and keep us posted!


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## dj_bliss (Oct 30, 2020)

*Any update? And thank you!*

Any update on any of your surgeries, conditions, etc? I dislocated my shoulder 9 weeks ago and right now crawling through the internet to find as much info as I can. This forum has been an invaluable source of wisdom and human connection for me through this difficult period.


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## henryspencer (Jul 29, 2020)

Not a dislocation, but I had a grade 3 separation after going OTB seven months ago. No surgical repair, but lots of PT. I've been riding since about three months after the injury, but it still holds me back quite a bit. The biggest change has been psychological and emotional: I've been really rattled when riding dirt, and my fear of going down again has me riding--and especially descending--really timidly. The pain has been the worst I've ever experienced, but it is gradually improving.


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## theturquoisewarrior (Nov 15, 2005)

dj_bliss said:


> Any update on any of your surgeries, conditions, etc? I dislocated my shoulder 9 weeks ago and right now crawling through the internet to find as much info as I can. This forum has been an invaluable source of wisdom and human connection for me through this difficult period.


I had surgery on my right shoulder 2 1/2 weeks ago. I had completely torn rotator cuff tendon and 3/4 torn biceps tendon. Surgeon cut completely through biceps tendon before re-attaching both tendons.
I'm in a sling that holds my arm slightly out from my waist and prevents outward and upwards movements. The sling only comes off for bathing and doing my PT which i do 3 times daily plus I see a physiotherapist once a week. I hate having to sleep with it. 
I'm taking a multitude of pain killers and anti-inflametary pills.
I had a nerve block drip attached to a pump in a bag for the first 5 days as well. 
Quite frankly, it's been the worst time of my life. Sleeping is difficult (it's well past midnight as I type this) and I tend to sleep on the couch after falling asleep watching TV. Then nap on and off throughout the day. 
Unfortunately it's just coming into Summer here too. I considered delaying the surgery till Winter but was scared I'd crash and dislocate it again in the meantime and do further damage.
The dislocation happened back in April (first day we were allowed back at the MTB park after lockdown) and it would have been out only slightly over an hour I think before the ambulance crew put my shoulder back in place.
Looking at my bikes in the garage keeps me motivated though and I know plenty of people in the world have it far worse than I do, so I know I just have to suck it up and do my best.


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## Ft.Rock (May 7, 2020)

theturquoisewarrior said:


> I had surgery on my right shoulder 2 1/2 weeks ago. I had completely torn rotator cuff tendon and 3/4 torn biceps tendon. Surgeon cut completely through biceps tendon before re-attaching both tendons.
> I'm in a sling that holds my arm slightly out from my waist and prevents outward and upwards movements. The sling only comes off for bathing and doing my PT which i do 3 times daily plus I see a physiotherapist once a week. I hate having to sleep with it.
> I'm taking a multitude of pain killers and anti-inflametary pills.
> I had a nerve block drip attached to a pump in a bag for the first 5 days as well.
> ...


My wife had this surgery a year ago - do you have the ice machine that circulates freezing water over your shoulder? If you can get a hold of one it made a lot of difference for her. Got it from another friend who also had that same surgery. It's like a cooler you load with ice then pumps the freezing water into a pad over your shoulder all night.


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## Stu Pidassle (Feb 6, 2010)

Having had to deal with dislocations a few times, I have found one of those shoulder braces from EVS make a big difference when getting back on the bike. Well worth the 40ish dollars


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