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Dr 8a

Partially dislocated shoulder...

Hi dr... 36 hrs ago, while in the process of healing chronic inflammation in my right shoulder and getting back to hard-ish climbing, I unfortunately dislocated the left one :(. (felt a cracking in the shoulder while doing a very gymnast-like swing on jugs under a roof and clearly felt something was wrong with it...no sharp pain unless I moved my arm, this got worse after the first 30 mins) X-rays done just after show that luckily the shoulder went back into its normal position by itself and the acromion-clavicular joint is OK. I still have to do other kind of investigation to check out the damage in soft tissues. I'm wearing a simple arm sling and feels ok as long as I'm not trying to move my arm or lift it, and putting ice on the most painful parts (it expecially hurts at the back, along the outer edge of my scapula). very small active moves are possible without pain, except for extra-rotation, which is painful from the start, even if possible. Of course I'll go to doctors and try to find one who's familiar with climbing but... ...what can I expect from it? best case/worst case scenarios? how long to get back to easy climbing? Will specific climbing styles and moves (slab/vertical/overhang, face/crack/dihedral/layback/chimney) be less dangerous than others? Eg will *hard* climbing on true slabs (less-than-vertical) be possible sooner than on vertical or overhanging stuff? May I be able to climb my slabby 7a/b's while in the late rehabilitation process? Will I climb on vertical walls in céuse this summer? thank you... Gianluca
Hi Gianluca Yes - You will have to see a sportmedicine ortopaedic surgeon about this asap. Most proably the head of the upper arm bone (caput Humeri) has forced a keyhole in the capsular structure in the front of the shoulder joint. Likely is also that some (or all) of the 4 so called rotator cuff muscles have tears in them. So get a professional opinion "live" - if the above is true you might be better of having the "keyhole" sutured. If the injury is not that bad you need to seriously train your rotatorcuff muscles to stabilize and improve strenght for future climbing. If any climbing will work right now it might be easy slab/vertical not overhanging routes. Good luck with rehab. Björn
the verdict is rotator cuff ok but SLAP I and Bankart lesions (doctor explain it in english...I know what they are but...in italian!!!). *Suggested* arthroscopic surgery, exp since I also like to do some *alpine* climbs where a sudden injury would be a real pain in the ass (potentially dangerous situation). Could be ok for sport climbs where another subluxation would be just another f*cking injury, but then surgey would be mandatory. Will talk w/ the surgeon about how&when in detail soon...this decision needs a lot of planning. F*CK!!!
Hi Gianluca I will have to agree this is not good. The biceps muscle have one short and one long tendon in its upper part - the long one inserts at the back of the shoulder joint surface . The SLAP I and Bachard lesions means the there is a partial tear in this insertion an injuy that with yur level of activity is best to repair surgically Best of luck and be patient with the rehab. - it will pay off in the long run Carpe diem Björn
So, how to avoid getting into this situation? Particular activities to avoid? Particular early signals to heed? Particularly useful antagonist exercises?
Hi By training your rotator cuff muscles - inward and outward rotation of the shoulder - keeping muscular balance between chest and upper back/shoulder muscles and keeping your deltiod muscles strong ( the half melon shaped cap on your shoulder) - you will be less prone to this injury. In climbing the most dagerous move is to swing the body forwards of your hands ( arm rotated outwards) while keeping the shoulder relatively lax - thus putting to much strain on the long tendon of the biceps - also catching a dyno in the same maner - fully extended arms- not enough tension in the shoulder muscles. Early signal to heed is a feeling of the shoulder beeing unstable and pain in this position. As usual it is far better to actively prevent this injury than to wait for the rehab. Carpe diem Björn