Another Dislocated Shoulder

Inland paddling
Post Reply
JohnK
Posts: 319
Joined: Wed Dec 21, 2005 11:01 pm
Location: In a van somewhere on the North coast

Another Dislocated Shoulder

Post by JohnK » Tue Mar 10, 2009 7:37 pm

On Sunday I finally got to do the Upper Dart. What a fantastic stretch of river. All went well until the rapid below Surprise Surprise when suddenly I failed to support on my left. Finding myself tangled up with the rocks I decided to bail out. My first attempt I realised my left hand wasn't getting to the release strap. My second attempt with my right hand I couldn't find it at first - probably the first time I've ever tried to release the deck with that hand - I'm left handed and right control. But the worst time was walking back to Newbridge. The path was less distinct than I thought. I didn't realise at the time but note to self: don't ever let anyone walk out with a dislocated shoulder on their own.

User avatar
Paul Stewart
Posts: 440
Joined: Thu Aug 25, 2005 8:27 pm
Location: Norfolk

Re: Another Dislocated Shoulder

Post by Paul Stewart » Tue Mar 10, 2009 9:54 pm

Sounds painful, were you paddling on your own?
Paul

User avatar
Ricks-Freestyle-Mind
Posts: 3976
Joined: Mon Dec 20, 2004 8:54 pm
Location: Bury/Preston

Re: Another Dislocated Shoulder

Post by Ricks-Freestyle-Mind » Tue Mar 10, 2009 9:56 pm

Hope you get better soon dude. I know the feeling and it hurts!

DaveWortley
Posts: 1299
Joined: Sat Jul 15, 2006 6:01 pm

Re: Another Dislocated Shoulder

Post by DaveWortley » Wed Mar 11, 2009 2:25 am

I can sympathize, 1.5hours with a shoulder out of place driving on a bumpy road, the last thing u'd want is to be on your own in that much pain!

Go see a physio as soon as possible (days not weeks) and if he is as good as mine was you'll be boating again in 4 weeks!

User avatar
SwamP
Posts: 3101
Joined: Fri Feb 01, 2008 6:14 pm
Location: Edinburgh

Re: Another Dislocated Shoulder

Post by SwamP » Wed Mar 11, 2009 8:29 am

Scumbag_Scout wrote:Go see a physio as soon as possible (days not weeks) and if he is as good as mine was you'll be boating again in 4 weeks!
Seconded, NHS lies to cover their backs and avoid you suing them

Miss Sports Physio knows best!

Sorry mate, hope you get better soon, and ignore people who say once its popped it'll always pop very easily. If it was clean out clean in you should be fine if you follow the physio's advice!
Lets not try to understand each other. Thanks.

JohnK
Posts: 319
Joined: Wed Dec 21, 2005 11:01 pm
Location: In a van somewhere on the North coast

Re: Another Dislocated Shoulder

Post by JohnK » Wed Mar 11, 2009 9:38 am

Thanks guys, I didn't know there were so many.
Paul Stewart wrote:Sounds painful, were you paddling on your own?
We were a group of 5 experienced paddlers. I took the decision to walk out while one of the others towed my boat to the end (or let it bounce down anything tricky which I don't think there was much left). Before I got to the flatter more distinct path there were some steep sections I just remember thinking that I'd be stuffed if I fell. If it happened to someone else in the future I'd send a buddy, with two boats being towed or even left overnight.
Scumbag_Scout wrote:...1.5hours with a shoulder out of place driving on a bumpy road
Yes, my driver was from Frome so we decided to go all the way back to the local hospital. Frome was shut. Over to Trowbridge. No X-ray on a Sunday night. So on to Bath.

User avatar
Jim Pullen
Posts: 2237
Joined: Mon Oct 25, 2004 11:21 am
Location: Darlington
Been thanked: 1 time

Re: Another Dislocated Shoulder

Post by Jim Pullen » Wed Mar 11, 2009 9:54 am

Bad luck! Much respect for walking out - I was seeing spots and borderline passing out when I did mine. I couldn't have walked anywhere let alone along that path! Probably would have been a good idea to have someone with you - I found the pain hackable at first but gradually increased over half an hour as everything started to contract.

Good luck with the physio. It took me three months to get back on the water (I've been out three weekends in a row now and even managed a waterfall on Sunday!) However mine was caused by impact with the road resulting in a broken humerus and subsequent longer time immobilised. If you can get away with ten days of immobilisation and then go really hard at the physio, 8 weeks should be doable.
Done any NE/NW rivers not on the site? PM me!

User avatar
morsey
Posts: 6275
Joined: Wed Jan 22, 2003 12:36 pm
Location: West Country :-)
Been thanked: 2 times

Re: Another Dislocated Shoulder

Post by morsey » Wed Mar 11, 2009 10:19 am

Ryan P wrote:and ignore people who say once its popped it'll always pop very easily.
Unless they are consultant surgeons standing in front of you, with your file, interpreting your Xrays and MRi scan and having just made a physical assessment!

Here is my thinking:
1) Get it relocated--straight away if lucky or with Medical attention if the period is extended.
2) Give it initial rest (anti inflammatory and pain relief).
3) Mobilisation--Physio.
4) Assess longterm stability--Consultant Surgeon.
5) If long term stability good then intensive physio.
6) If long term stability poor then intensive physio until surgery followed by intensive physio.

Steps 3 and 4 should hopefully happen simultaneously, request a consult when you go to your GP/physio/Hospital/BUPA spa centre.

A surgical consultation does not mean you have to have surgery, it investigates the best longterm possibilities for you. Dont get me wrong, a good physio is worth their weight in gold, and critical to recovery, but they are just part of the overall team that together can deliver the full package.


John you walked down the river and then drove on a tour of Somerset to Bath! Man alive that must have been a painful journey. Hope you have a speedy recovery.

User avatar
Jim Pullen
Posts: 2237
Joined: Mon Oct 25, 2004 11:21 am
Location: Darlington
Been thanked: 1 time

Re: Another Dislocated Shoulder

Post by Jim Pullen » Wed Mar 11, 2009 11:03 am

I'd be impressed if you get option 4 on the NHS. The consultants I saw just seemed to want me off the books ASAP - the attitude seems to be wait until two or three dislocations until even considering surgery as an option.
Done any NE/NW rivers not on the site? PM me!

User avatar
StoneWeasel
Posts: 4421
Joined: Wed Aug 03, 2005 12:46 pm
Location: Cornwall

Re: Another Dislocated Shoulder

Post by StoneWeasel » Wed Mar 11, 2009 11:43 am

As with Jim I found the NHS very uninterested in my shoulder apart from getting me through the initial pain relief and getting the tangled mess of nerves and muscle back out of my shoulder joint (shoulder went out, shoulder went back in taking a load of nerve and muscle with it). My physio on the other hand was a legend and helped me no end.

Denzil

P.S. if anyone wants a really good Physio in Cornwall at any point that really understands the fact that you want to be back out doing what you love as soon as possible I highly recommend L.S Gifford MApplSc, FCSP, SRP
Falmouth Physiotherapy Clinic, Kestrel, Swanpool, Falmouth, Cornwall TR11 5BD
Tel: 01326 312156

User avatar
morsey
Posts: 6275
Joined: Wed Jan 22, 2003 12:36 pm
Location: West Country :-)
Been thanked: 2 times

Re: Another Dislocated Shoulder

Post by morsey » Thu Mar 12, 2009 3:23 pm

Jim Pullen wrote:I'd be impressed if you get option 4 on the NHS.
I went and asked my GP for a referral to a specialist, which I had already researched. Two friends went private to see the same consultant at roughly the same time and I had surgery three months after them. I was offered sooner surgical slots but with a different surgeon. They had Physio arranged in the BUPA clinic I had mine in the NHS Hospital, which involved: Initial assessment-Several weeks hydro therapy, a brief hop to France and a cheeky bob down the Durance river, land based assessment-several weeks stretching and mobility, two more assessments, saw the consultant, six weeks of progressive circuit sessions in the hospital gym. The physios spent time working through all the range and strength requirements of my sports and general usage (As they did for all the others in the circuit group) and helped to develop specific exercises for gym and home. Another gym assessment. I stopped the gym sessions as I was able to start paddling again to put the strength back on. I was left with an open appointment to phone and book back onto the gym circuits if there were any weakness issues. Then I had a final appointment with the surgeon and I have a floating direct line appointment to see my consultant with any problems for the next year.

I am quite satisfied with the service I was provided with. I think I agree with Jim that the thrust seems to be, especially if you attend A&E, that they want you patched up and out the door. Several friends have expressed similar experiences. I was lucky enough to be able to put my shoulder back in straight away and attend to my own initial recovery (rest and mobility) so my initial contact was with my GP a week later requesting a referral.

If you attend A&E at Hospital, any direct referral will most likely be to the general surgical consult in that hospital. Now they may be the best knee surgeon in the country but might only do one or two shoulders a year and for paddlers that is going to be less than ideal. Physios in hospitals generally will work to get you fit to go back home and to work so you have to identify your aims as being higher than just home recovery, if you are lucky there will be a sport injury clinic in your hospital. Get yourself motivated for your Physio sessions, even the simplest of movements can feel really hard and difficult to control following trauma. Mobility, control, then flexibility and strength building. GP's see patients, they treat where possible and refer where not. They love referring patients, it helps them to keep networking with all old their chums from medical school. So do not be shy to ask your GP to check out your best options and wing off a letter or emailer. NHS systems seem to have a habit of back logging or stalling so if you get no reply within a couple of weeks, chase it up.

User avatar
Jim Pullen
Posts: 2237
Joined: Mon Oct 25, 2004 11:21 am
Location: Darlington
Been thanked: 1 time

Re: Another Dislocated Shoulder

Post by Jim Pullen » Thu Mar 12, 2009 4:49 pm

It sounds like you got amazing treatment Morsey. Having said that I'm not saying the consultant I saw wasn't any good, he seemed to know what he was talking about.

Me: I'm a kayaker and really worried I'll pop this out again.
Him: Yes, I've seen hundreds of you over the years I'm aware it's very common.
Me: Should I have an MRI scan to see how bad the Bankard lesion was?
Him: No there's no point I can virtually guarantee the lambrum will have torn off and reattached in the wrong place.
Me: Should surgery be considered as an option?
Him: No, work on the physio, surgery will put you out for 6 months and I'd only consider doing it after two or three dislocations.

The NHS physios seem to have been ok, but I haven't had any gym work or hydrotherapy. They tend to just stretch the joint out in various directions and then give me sheets of different exercises to do with free weights or therabands. The latest set seem to be concentrating on the control aspect - she even said that I don't want to be looking where my arm is whilst going down a rapid!

I had four sessions of private physio with a shoulder specialist paid for by the insurance company (my injury was caused by a driver knocking me off my bike). The stuff he did seemed virtually identical, but he also gave me a sheet of hydrotherapy exercises. The insurance company is now of the opinion I can self-manage.

The main problem I seem to have is hitting the physio too hard and then not being able to move the shoulder for a few days! The worst thing I did was go swimming, thinking it felt fine and knocking off 50 lengths at getting on for my pre-injury pace. I couldn't move my arm for almost a week!

Having said that, the first time I got back in a boat, afterwards my shoulder felt the best it had since the injury - go figure!

I'd just like to get to the point where I can move it in any direction completely pain free, but I guess that'll be a few more months...
Done any NE/NW rivers not on the site? PM me!

KrisBD
Posts: 140
Joined: Sat May 13, 2006 9:49 am
Location: Cornwall

Re: Another Dislocated Shoulder

Post by KrisBD » Thu Mar 12, 2009 9:38 pm

Hope if gets better soon John. Wasn't it a little optimistic hoping that Frome or Trowbridge would sort you out?

JohnK
Posts: 319
Joined: Wed Dec 21, 2005 11:01 pm
Location: In a van somewhere on the North coast

Re: Another Dislocated Shoulder

Post by JohnK » Thu Mar 12, 2009 10:08 pm

Thanks Kris. Yes, it seemed the best idea at the time. Next time straight to Exeter.

Gromit :D
Posts: 47
Joined: Tue Dec 02, 2008 4:38 pm
Location: Rochdale

Re: Another Dislocated Shoulder

Post by Gromit :D » Fri Mar 13, 2009 8:59 pm

Massive respect for walking out on your own - walking in straght lines was beyond me when I first did mine, my legs were jelly!

Get yourself to a good physio, there are some nhs ones that are great, and stick with it. Ive done (still doing) my fair share and am the first to admit it can get a bit dull and sometimes you just dont feel like messing around with a theraband or whatver but its worth it... eventualy.
The main problem I seem to have is hitting the physio too hard and then not being able to move the shoulder for a few days! The worst thing I did was go swimming, thinking it felt fine and knocking off 50 lengths at getting on for my pre-injury pace. I couldn't move my arm for almost a week!
Know that feeling... starting off with a wee bit to much enthusiasm and then suffering for a few days!
And of course the old "an easy swim will be good for it". EASY being the important and unfortunatly in my case repeatedly ignored!

Hope your better soon
Only when the last tree has died and the last river been poisoned and the last fish been caught will we realise that we cant eat money.

Native American saying

mattcarus
Posts: 24
Joined: Thu Dec 06, 2007 9:54 pm

Re: Another Dislocated Shoulder

Post by mattcarus » Sun Mar 15, 2009 11:45 pm

Good luck, I did my shoulder in about 4 years ago - I'm still waiting for the MRI scan.

User avatar
AS Watersports
Posts: 641
Joined: Tue Dec 23, 2003 11:15 pm
Location: Exeter
Contact:

Re: Another Dislocated Shoulder

Post by AS Watersports » Wed Mar 18, 2009 2:27 pm

Hey John,

As every one says, bad luck.
I'd go with what Simon has said. I'm now 7 weeks after surgery for 4 dislocations over the course of the last two years, first one june 2007.
After the first one I had some private phys and was back riding Dh mtb after 6 weeks. Your shoulder may be natually lax and unstable so get it checked by a consutlant. I had massive forces involved in all my dislocations but it did gradually get weaker as the scar tissue was all floppy and not holding my arm in properly. I was paddling ww this last season and should be back paddling ww this winter, riding xc in 8 weeks time and DH in 6mths (racing). Keep at the physio and remember: theres two types of bracing; a low brace and a low brace!
Plus is if you get open surgery like me you get a cool scar to get the chicks with!
Happy days!
Ewart

User avatar
Bommy
Posts: 67
Joined: Fri Jul 18, 2008 5:31 pm
Location: Vancouver, BC

Re: Another Dislocated Shoulder

Post by Bommy » Thu Sep 30, 2010 4:59 pm

Sorry to bring this back from the dead, but i'm currently recovering from a shoulder dislocation so i'm researching everything!
morsey wrote:
Here is my thinking:
1) Get it relocated--straight away if lucky or with Medical attention if the period is extended.
Why straight away?
I've been told by one or two paddlers that you should relocate it straightaway if possible, as extended periods cause more damage. Mine was out for a two hour walk out before i got in the ambulance. I asked my consultant about this and he said no. His words were once it's out, if you sling it properly it's fine just get to hospital, if you try put it back in and do it badly then your just causing more damage.

Also the NHS have been awful with me. I've seen the consultant once and he didn't seem to care. Slinged up for 8 weeks and out the door before i even knew his name! I've been to my GP 3 times to ask to be referred to a shoulder specialist and for an MRI scan but he say's he cant do anything until the consultant decides at the end of 8 weeks! So i've gone private for an MRI and a sports physio!
Rob Beaumont
Ex - Lancaster University Nutter

User avatar
Jim Pullen
Posts: 2237
Joined: Mon Oct 25, 2004 11:21 am
Location: Darlington
Been thanked: 1 time

Re: Another Dislocated Shoulder

Post by Jim Pullen » Thu Sep 30, 2010 5:09 pm

If it was a simple dislocation you really don't want to be in a sling for 8 weeks, it'll take you months to get it working again! I think the old-school advice was to immobilise for this long, the newer ideas seem to be more along the 10 days immobilisation followed by the physio. Doubt there's much point with an MRI on your first dislocation unless you want to go for surgery straight away! Did your consultant give any indication of anything unusual about your dislocation? I also chipped the humerus with mine, meaning I had to wait longer for the bone to fuse, but even then I was doing physio after 4 weeks.

With regards to getting it put back in again (reduced) as fast as possible, this is to avoid extra weeks of physio - the longer its out the more stretched everything gets, meaning the longer to get everything back to normal. Your consultant is correct in what he's telling you though, if you get nerves/tendons/vessels stuck in the socket as a result of an incorrectly reduced dislocation that will create far more problems. Unless you've got someone there with medical training it is best to get straight to A&E.

Good luck!

Edit: Also keep popping the NSAIDs to reduce the inflamation, dichlofenac if you can get it or ibruprofen if not.
Done any NE/NW rivers not on the site? PM me!

Madsalty
Posts: 303
Joined: Thu Jan 14, 2010 7:15 pm
Location: Lincoln or Durham

Re: Another Dislocated Shoulder

Post by Madsalty » Thu Sep 30, 2010 5:10 pm

Jim Pullen wrote:I'd be impressed if you get option 4 on the NHS. The consultants I saw just seemed to want me off the books ASAP - the attitude seems to be wait until two or three dislocations until even considering surgery as an option.
There is alot of truth in this. It took 4 Knee Dislocations (non-boating related) for them to even contemplate surgery, which they did, and I've been pain free in the operated knee for a while now.

Also i don't want this to seem like once it's dislocated it'll go again, it turns out i have a shallow Trochlear Grooves so it was a blessing i've suffered so little.

If i was to give you one bit of advice, Listen to your Physio! Physio is the key in my experience, however and don't wait for them to call you. Offer to take the paperwork yourself and be proactive in seeking physio as soon as possible.

Good Luck.

User avatar
Rinseout
Posts: 432
Joined: Mon Nov 09, 2009 3:54 pm
Location: Exeter

Re: Another Dislocated Shoulder

Post by Rinseout » Thu Sep 30, 2010 10:52 pm

Quite off topic but just quickly is there anyway to help prevent dislocations?
And i dislocated my collar bone DH riding and havnt felt and weakness so far but what should i be doing to strengthen it?

Cheers

George

eeonz
Posts: 849
Joined: Sun Feb 15, 2009 3:12 pm
Contact:

Re: Another Dislocated Shoulder

Post by eeonz » Thu Sep 30, 2010 11:51 pm

I was told that I'm at risk of dislocation due to having shoulder impingement (well more correctly, having the factors which caused it).

IMHO the best way of trying to prevent a disclocation (because nothing is foolproof!) would be to:

1) Balance out the muscles around the shoulder joint. A lot of people have rounded shoulders, due to tight pectoral muscles etc and bad posture (slouching over a computer a lot doesn't help). Having an awareness of what correct posture is and strengthening/stretching the correct muscles should hopefully go some way to correcting this. From my experience that means lots of doorway stretches and time spent with resistance tubes/therabands working on the rotator cuff. I believe that scapular stability has a role to play as well, but I'll leave that to someone more qualified to comment.

2) Try to use correct (safe) technique. Theres a section on this in Franco Ferrero's WWSR book that shows "good" and "bad" high brace and bow rudder positions. Personally, I've learnt to love the low brace instead, ever since reading this:

http://www.netscribes.co.uk/stuff/kayak ... Rev1b1.gif

On the subject of technique, try to practise dong things the correct way. I used to get praise off my instructor for doing "hero" braces with shoddy form - now I try and concentrate on keeping in the box.

I'm just another forum member - definitely speak to a physio or a good coach for more advice if it's something that worries you.
http://www.iboutdoor.com- Your outdoor resource!

User avatar
SwamP
Posts: 3101
Joined: Fri Feb 01, 2008 6:14 pm
Location: Edinburgh

Re: Another Dislocated Shoulder

Post by SwamP » Fri Oct 01, 2010 1:12 am

Just to concrete what Jim, Madsalty and eeonz said. This all seems very spot on from my experience also.

My most recent physio told me once you've popped it it will then be 50% of what it was and continually 50% less each time....this is of course nonsense!

You can wholeheartedly get your shoulder, after even 4 dislocations, in to a stage where you can do this sport at a high (in terms of being controlled at a high grade) level.

I was also asked why I didn't go for surgery after my 4th dislocation....the wave that abused me and one other very experienced paddler was massive, very heavy and dumpy causing even him to consider going back to the beach. I could be wrong, but when you're dislocating your shoulder on 12ft dumping waves or powerful G5's and similar then fair play, do the physio. When you're dislocating your shoulder whilst sleeping, taking a drink or changing gear in your car then I would say it's time to consider seriously having surgery done.

The only way to avoid it is give up the sport....but it's not that sore and rivers a fun. (regardless of if it means watching really crap paddlers making a name for themselves in their rafts and being better than your'broken'self...aaarrrgggghhhh rant over ;o) )

Bommy, sling for 8 weeks is, IMO, worth going back and kicking their ass. Hope you get better. NHS gave me the same terrible advice (I don't care why, before some nurse comes in with reasons) but thankfully I ignored them.

Good luck!

(swimming, boxing, gym ball, resistance bands, delts, lats, rhomboids, stretching, yoga, stability, core, impact therapy, balance and weights....should all become words in your new bible)
Lets not try to understand each other. Thanks.

User avatar
Bewildered sassanack
Posts: 178
Joined: Mon Dec 12, 2005 9:56 pm
Location: Edinburgh
Contact:

Re: Another Dislocated Shoulder

Post by Bewildered sassanack » Mon Oct 04, 2010 9:24 am

Ryan P wrote:I was also asked why I didn't go for surgery after my 4th dislocation....the wave that abused me and one other very experienced paddler was massive, very heavy and dumpy causing even him to consider going back to the beach. I could be wrong, but when you're dislocating your shoulder on 12ft dumping waves or powerful G5's and similar then fair play, do the physio.
http://tinyurl.com/28ejpev

;-)
Can I get stabilisers for this?

www.stirlingcanoeclub.info

User avatar
SwamP
Posts: 3101
Joined: Fri Feb 01, 2008 6:14 pm
Location: Edinburgh

Re: Another Dislocated Shoulder

Post by SwamP » Mon Oct 04, 2010 8:37 pm

Haha typical Doctor, just want to cut folk open ;o)

You're right though after the third dislocation it would just fall out whenever I even sneezed....that last two years have been boring on G1 rivers....

Image

Your favourite Adrian ;o)
Lets not try to understand each other. Thanks.

User avatar
Joe Pineapples
Posts: 429
Joined: Sun Sep 26, 2004 8:56 am

Re: Another Dislocated Shoulder

Post by Joe Pineapples » Mon Oct 04, 2010 9:12 pm

Do your recovery , then live by the code of the "BOX" , you should anyways !!!!

and then forget about it , the more you think about it , the more its going to happen again ..
Live your dreams , do not dream your life ......

User avatar
SwamP
Posts: 3101
Joined: Fri Feb 01, 2008 6:14 pm
Location: Edinburgh

Re: Another Dislocated Shoulder

Post by SwamP » Mon Oct 04, 2010 10:35 pm

Do your recovery , then live by the code of the "BOX" , you should anyways !!!![/quote]
Right on
Joe Pineapples wrote:and then forget about it , the more you think about it , the more its going to happen again ..
You know I love you man...but I disagree with this. I'd say when on the river/and definitely the surf, always think about it, as thinking about it will keep you elbows tight, in the "unplanned" situations that you get hurt in the first place....

Another prime example of how weak it can get...
Image


hahaha happy days Ian! ;o)
Lets not try to understand each other. Thanks.

User avatar
Joe Pineapples
Posts: 429
Joined: Sun Sep 26, 2004 8:56 am

Re: Another Dislocated Shoulder

Post by Joe Pineapples » Mon Oct 04, 2010 10:44 pm

refer to my first statement .. by living in the box you are already subconsciously proactive .. keep thinking about it and you will only slow your reaction and definitely make yourself tense should a situation ever arrive ..

Everything I ever say is IMHO
Live your dreams , do not dream your life ......

Post Reply

Return to “Whitewater and Touring”