Anterior shoulder dislocation recovery process

It's nice to hear that things are moving forward for everyone - good luck. Since all of you are at some point close to or just after surgery, I thought it worth mentioning that I'm now 9 months out, and my shoulder feels stronger than it ever did before. There is some reduced range of motion with most external rotation (no surprises there - I was more or less assured this would happen), but this is minor enough not to affect anything I do. At this point I've worked it pretty thoroughly climbing and snowboarding, doing all the motions I would never have dared to do before (gastons, cranking on jugs with the shoulder fully extended, etc...), and it feels bomber!

@Berweger and nate: so, i'm on the sling now. The doctor told me I can take it off to shower, lie down, etc. He said "no external rotation or elevation" for 6 weeks. I'm a bit paranoid with small movement I make that hurt a bit, when I shower, finding comfortable positions in bed, sitting etc. Am I freaking out for no reason or should I really stay put like a mummy? I have a fair amount of discomfort from the sling that weighs down't on my back, so I don't know what pain is normal, discomfort or evil surgergy-unmaking pain. Also, I tie the sling to sleep in fear I might do some stupid movement during sleep. How did this sling-phase go for you guys? Did you remove it, let gentle motions happen or were you completely frozen?

@paul Im still in the sling. The Dr prescribed 6 weeks of sling time with the same rules as yours - I take it off for showering and some daily elbow and forearm ROM work but otherwise i live in it 24/7. Ive been sleeping in a recliner as I was told specifically not to sleep lying down. At my 4 week followup with the surgeon he said I could begin taking the sling off for typing and other nonstrenuous arm work.

I was initially really worried about little movements as your are, but both my PT and surgeon have a lot more cavalier attitude towards movement and potential for undoing the surgical work. I think it would be pretty hard to rip out the sutures and the sling is more of a reminder to oneself and others that the shoulder is weak and healing. According to my PT most surgeons will move the arm through full rom post op to make sure everything is put back together properly, so the surgical work must be fairly stable even before healing. I'm not 100% sure on all this but this is the impression I've gotten in the last month.

Paul and Nate, I had effectively the same experience. I don't know if you guys have that abduction pillow with the sling too too - but I wore that for the first 5 weeks. While I was deathly afraid of everything while I had it out of that sling (showering and changing clothes), as well as sleeping for the first week or so, I got the same impression from the PT that small movement - especially within the limitations of the sling - were not going to hurt anything. When I started PT at 4 weeks I was already told that apart from a hard fall I was not going to damage the repair.
But reading between the lines the impression I had (and there is a healthy dose of speculation filling in the gaps) was that a lot of this is precaution because the repair failing (i.e., another dislocation) and damaging the repair are not necessarily the same thing. As such I think the accepted recovery process errs very strongly on the side of caution to minimize the few percent of cases where it fails for no apparently clear reason.

@berweger

I have the abduction pillow. Its actually pretty uncomfortable to have my arm against my ribs as opposed to in the sling with the pillow, probably from the increased pressure around the bottom of the labrum where the repair occured. Im glad it seems that there's a consensus among surgeons and PTs that its hard to damage the repair, calms my nerves a bit, ha. How long did you do PT?

Thank you guys. I do not have the pillow though. I'm on week 2, and it still hurts, especially when I go do my errands. I walked a lot around yesterday and had a lot of shoulder pain. But I imagine that's just pain around the "surgical wound" after having blood flowing a bit faster than it should. I feel a bit more relieved now that you guys claim that the surgical repair isn't o flimsy. But I need to return to work next week, that will no be comfortable.

I didn't realize that the pillow was less of a curse than I thought... I remember the sheer absurdity of trying to buckle my seatbelt in a car (sitting on passenger side, left arm in sling).
In any case: I started actual PT sessions at 4(ish) weeks which went for a total of 3 months (the first few were more nothing more than the therapist moving my arm through the very limited range of motion it had). My last session I did my first pull ups and then continued various ROM exercises and strength training until 6 months. Once I started climbing again I figured that this was enough of a workout, so I tapered off...

Ha seatbelts can be interesting. You were doing pullups 4 months post op? for some reason that amazes me. FWIW my PT generally follows this protocol:

brighamandwomens.org/Patien…

Hey everyone, figured I would update this as I am almost 4 months post op.

Recovery has definitely been nonlinear. I started doing PT at about a month post op, and have been going 2-3 days a week since. Its mostly static stretching with about 20 mins of passive ROM work by the PT at the end of the session. We are transitioning into very light work with weights.

Because of the severity of my shoulder damage my doc prescribed a PT regimen on the slow end of the general protocols. That, coupled with the fact that my arm was pretty dead bc of the nerve injury has lead to a bit of adhesive capsulitis aka frozen shoulder. Im still only at about 160 in flexion and 140 in adduction and my scapula still feels pretty welded to the anterior capsule. Its loosening up over time though, and lacrosse ball rolling on a wall seems to be helping with the tightness from the shoulder across the scapula and my lats, traps, infraspinatus and Teres major muscles. Theres a fair bit of catching from fibrous tissue rubbing over things when i adduct in the scap plane but other than that the shoulder movement in the labrum feels pretty healthy.

Wrt returning to sports I started jogging slowly a couple days ago and have been bumming around belaying friends and hiking a bit. Nothing major but i hope to start running more and road riding by the end of june.

How are you guys recovering?

Hi Nate,

I'm really sorry to hear you're dealing with frozen shoulder and that your lesion was so extensive. Coincidentally, I met a buddy today who wrecked his shoulder last year (a real mess, biceps tendon, fractures, etc), has a big open-surgery scar, and he's doing well. Not 100%, but he climbs hard (7's here in Switzerland) and is cycling a lot.

I'm 3 months from the operation, 2X a week PT. It was mostly passive ROM, but now I've been cleared to do pretty much anything, so lots of exercises. It hurts a lot to abduct and externally rotate, but the surgeon says "that's a good sign, we fixed exactly the structure holding that movement together".

The surgeon is quite cavalier, he gave me the green light to go hiking, cycling and claims I can do rope manipulations for simple alpinism in July-August, but no climbing until September. So, I've been hiking a lot....and god I'm out of shape. He said I'm not allowed to play any contact sports....but I already don't do these things, so I don't care.

Also I can work again, lift my arm and pick stuff up, etc.

But it feels like I have a whole year ahead of me to actually feel solid again.

And yes, some days hurt more than others....

It's been almost 2 months since my surgery (simple arthroscopic bankart repair) and my shoulder is still pretty stiff, but I'm optimistic. It's actually about exactly what Nate has--160 deg flexion, but my external isn't all that bad. My mechanics are AWFUL--the scapula wings out and my humeral head lifts a ton when I raise my arm, but that happened post-injury and eventually improved. I didn't go into the surgery with perfect ROM, so I started somewhat disadvantaged.

If I use flexion as a metric of progress, it was really rapid in the first 2 weeks of pt, lulled until I took off my sling at 6 weeks, and now for the last 2 weeks it's been slow but in the right direction. I don't think I'm going to have full ROM for a while since this is paralleling my experience post-injury. I'm really hoping October, my 6 month mark, will be a happy month!

NateGfunk wrote:Cool He changed his opinion of surgical necessity post op when we spoke, and described more damage to the labrum than he had expected to find. My anterior glenohumeral ligament - part of the capsule - was detached, and there was a longitudinal tear in another part of the capsule.My labrum also had a 6-11 o'clock tear, larger than the MRI indicated.

I had a bi-directional unstable shoulder. I had to have surgery because eventually I was rolling in my sleep and taking it out, ouch! Surgery was in 99. My doctor did open surgery, used a scope in the beginning because he said you don't know what is in there until you see it. Damage was worse than shown on any scan.

For recovery really focus on stretching as recommended. I was lucky that it was my left arm. It is 1 inch shorter and I have a permanent loss of range but I really don't notice a difference day to day.

I know its cliche but I'll say it anyway, listen to your body.

Thanks rick for your input. Out of curiousity why is your left arm one inch shorter now?

There was a lot of damage, they had to tighten it up. Initially post op I had an impingement where my humorous did not clear the socket when I raised my arm. I had to stretch over months to get my arm to clear the socket. No one is truly symmetric anyway so no big deal. Makes getting a suit tailored interesting.

I'm a member of the shitty shoulder club as well: first dislocation was a year ago, second one was just over a month ago--almost exactly a year apart. Both times while climbing--first time in the gym, second time outdoors. I found this thread as I was stuck in a sling, and I'm so grateful to everyone for sharing their experiences along the way.

My question for everyone is about rehabbing the mental game. A few days ago, I climbed outdoors (following multipitch trad) for the first time since injuring, after putting in a few really solid sessions in the climbing gym. I climbed easy stuff without any pain, but by far the biggest crux of the day was dealing with my own terrors and insecurities.

It definitely helped to be hyper-conscious of protecting my shoulder with each movement I made, but there was also this background noise of doubt and frustration that was keeping me from enjoying myself on the rock. Does anyone here have recommendations, either books and articles or general wisdom, for dealing with mental rehab after injury?

Brianna Harden wrote:Does anyone here have recommendations, either books and articles or general wisdom, for dealing with mental rehab after injury?

Time... Your fears are reasonable, the last thing you want to do is re-tear your shoulder. It took me many years to re-learn how I can use my shoulder.

Your shoulder may have been stabilized, but it wasn't "fixed."

It's incredible to hear how different everyone's experiences are... I hope things are progressing nicely for everyone recovering.

Brianna, I agree with Rick's advice wholeheartedly. I found that the best thing to do is use it and slowly explore what it will let you do - and this of course depends on what your experience with your injuries has been. I suspect that unless you can convince yourself over time that it is solid and will stay stable in strange positions and odd movements, or hold if you're grabbing a jug and your foot greases off a small crystal, your head game is going to have to suffer. Shoulder dislocations are so insidious for rock climbing largely because there tends to be a slippery slope. So while it's incredibly frustrating, try to think of this as a good self-preservation instinct, and not as something negative limiting how hard you can climb. What got me by for a long time was limiting myself mostly to well-protected trad routes at lower grades where I knew I could get up the wall without putting my shoulder in a compromising position, or I could at least (shudders) pull on a piece of gear to avoid having to do a sketchy move. Frustrating, and it often wouldn't pass scrutiny for doing a route free, but I still had a smile on my face at the top...

I hope the advice helps - and hopefully you manage to get your head game back and avoid any further incidents!

Hi Brianna,

I had a labrum tear a long time ago, and I did my best climbing ever 2 years after it, and I had no operation. It took a while, and I had introduced swimming into my routine, which helped understand my own shoulder.

Eventually I simply forgot it was an issue.

As for coming back after the operation, I guess I'll only be able to give you an answer in two years. But seeing friends who have had even worse injuries and are climbing and enjoying their hobbies, I think it's simply a matter of time and re-adjusted expectations. I don't care so much anymore to "climb hard", I prefer long easier trad climbing, so I am confident I'll be fine. Even if I were to venture in the more difficult sport climbs (which I do not have the build for), I think the shoulder would be fine eventually. Time and self-respectfing progressive work. You'll be ok if you were treated correctly.

Rick, Berweger, Paul: thank you so much for your wisdom.

Berweger wrote:but I still had a smile on my face at the top...

Berweger, your point about humbleness is well taken. Why should it shame any of us to pull on gear, or, god forbid, bail off of something, if the alternative is months of rehab?

I'm clear on the fact that I reinjured because I got comfortable with my strength at the one year mark. I made it to that benchmark, and suddenly that cautious voice in my head completely switched off, allowing me to think that I was safe to go back to any range of movement I might like. And I blew my shoulder attempting a move (at external rotation/abduction) that I had absolutely no business doing.

So perhaps, confirmed by what you guys are saying, it's best to never let that cautious voice fade out completely. If that's the case, I'll figure out how to stay in this phase of healthy anxiety for as long as I can!

I am 6 months out from shoulder labrum surgery (i had a posterior tear from 6 to 11) and had 5 anchors put it. I'm wondering if it is normal to still have a lot of pain in the shoulder at this point? The PT protocol said return to sport 5-6 months and It also when i read around it seems like some people are back to climbing by 4 months and pain free? I know everyone is different, but i'm starting to be concerned that i still can't climb and the shoulder still hurts so much 6 months out? (I've been very careful with the recovery process and do my PT religiously).