PassmorePT community
Thanks for your reply on the surfing forum and for your advice on maybe helping me with getting back to surfing again ? what do you recomend that i should do to stop or prevent this problem reoccuring? im open to any sugestions.
this is the 3rd time i have dislocated the same shoulder, the last time it dislocated was about 10 years ago then i had surgery to stop it coming out again.
Skeesh72,
I am assuming your are referring to dislocating the Gleno-Humeral joint?
When did it happen?
What were you doing when it dislocated?
Did it set itslef back in, or did someone do it for you?
Does it dislocate anteriorly, forward? Or another direction?This will matter in regards to reccomendations I make for you...
Keep in mind, as a surfer/swimmer you will always be vulnerable to an unstable shoulder because of the repetitive motions. Our goal for you is to minimize this from occuring again.
Do you do any type of resistive strength training?
Have access to a gym?
Be willing to pick up a few things from a near by sporting goods store?
Let me know your situation and please answer as many of the questions as you can and we will move forward on this. I have several ideas for you, but just need to know a little more about you.
Thanks for the question and if you know anyone else dealing with an issue, pass the word...
~J
Just thought of another question:
What type of boards do you ride, long, short, all? I'll explain why later...
~J
i was surfing at the time of dislocation, fell backwards of the wave arm up , i would say that the shoulder looked like it dropped/dislocated downwards.
While i was waiting in the hospital to see a doctor i myself peeled my arm out of the wetsuit and the arm went back into place itself whilst doing this.
No i do no resistive training apart from press ups 40 per day.
yes i have access to sport store.
I ride a short board , also a twin fin fish.
regards Steven
Steven,
When doing your daily press-ups, make sure you DON"T go deeper than your upper arm parallel with the floor. I mean, don't let your elbow come past your ribs. This places to much stress on the joint!
This is why I was asking about your board type. Usually when we "pop up," it is a sudden, all forces go movement from a DEEP stretched shoulder position. This is just stretching your shoulder out more. This would be easier to modify on a longboard, but play around with techniques on your boards.
Do you have full range of motion in that shoulder compared to the other side?
Exercises:
Start with some multidirectional isometrics...
If you have more pain, stop or do less!
With these, start easy, see how your body reacts and increase workload accordingly. Start with 1 set, at 50% effort and so on...
Keep me in the loop with what your feeling after the workouts...
External rotation: Stand next to a door frame, elbow bent at 90 degrees and a rolled up towel up under your arm pit and palm of your hand facing midline of your body. Press your fist into the frame as your try to externally rotate your arm. Hold for 6 seconds, 3 sets of 15 reps.
Internal rotation: Stand next to a door frame, elbow bent at 90 degrees and a rolled up towel up under your arm pit and palm of your hand fcaing midline of your body. Press your fist into the frame as your try to internally rotate your arm. Hold for 6 seconds, 3 sets of 15 reps.
Adduction: With a pillow between your chest and your arm, squeeze the pillow with your arms. Hold 6 seconds, 3 sets of 15.
Flexion: Stand facing a wall with your elbow bent at a right angle and held close to your body. Keep your elbow near your ribs, not in front and not behind or out to the side. Press your fist forward against the wall. Hold 6 seconds, 3 sets of 15.
Extension: Standing facing away from the wall with your elbow bent at a right angle and touching the wall. Keep your elbow near your ribs, not in front and not behind or out to the side. Press the back of your elbow into the wall. Hold 6 seconds, 3 sets of 15.
Abduction: Standing with your injured side towards the wall and your elbow bent at a 90-degree angle. Press the side of your arm into the wall as if attempting to lift it. Hold 6 seconds, 3 sets of 15.
Depression: Sit in a firm chair. With arms at your side, press down on the chair seat and lift your butt up. This is much harder and maybee too advanced... Hold 6 seconds, 3 sets of 15.
Work up to the sets and reps as your body acclimates to the activities without pain!
Once you master (pain free sets and reps completion, during and after) these, I will advance you.
KEEP IN TOUCH
~J
Steven,
Do these every other day for now.
Let me know how you feel after the workouts, good or bad...
Thanks
~J
ok thanks il let you no.
not to painfull and i done the sitting depression one so alls well only trouble is i twisted my ankle yesterday at work so thats blown up an swollen, is it best to rest the ankle , should i support it with bandage? elevate?.. not had much luck lately
thanks steve
Steve,
Man, you are having a taste of bad luck.
Ankle: Elevate when ever possible, use compression wraps for about a week-two when you HAVE to be on your feet, ICE the ankle with elevation 2-3 times a day for 15 minutes, NO MORE than 15 minutes a session! As soon as 3 full days past after the twist, start actively moving your ankle in multiple pain free directions so you don't loose range of motion. Do this in a non weight bearing elevated position. Move it up/down, in/out, clockwise and counterclockwise circles. You can do this as much as pain free possible. ICE AFTER!
What do you do for work?
Shoulder: Where are you with all of the reps, sets, and pain/discomfort following/during?
Stay in touch and spread the word to anyone you know else that needs help...
...anytime
~J
thanks J i work on a fishing boat with my father, he left a hose where it shouldnt of been at door exit point , look before you leap i was told?.
Just doing 1 set of reps everyday and the shoulder is not painful or is there any discomfort, i will try doing 2 reps tonight? it did take me a day ot two to work out what i was doing properly , i do feel its working on the shoulder but no discomfort as of yet.
cheers Steve
shoulder pops sometime when i move it especially while paddling like when you crunch your knuckles?
That popping is a result of the instability and not really the best thing for you. Did you read my post about better paddling for a surfers shoulder?
I want to add to that, when pushing down through the water, Don't round your shoulder/shoulder blade fwd, Keep your shoulders retraction in a good postural position. Let me know how that works for ya?
I would hope the popping will slowly decrease as we progress you fwd with your exercise routine...
One piece of advice while on the boat: Avoid, the best you can two things... 1) reaching back with your arm to do something. Especially something that requires force. This will place your arm more like to dislocate again. So, rather just turn towards the object. Cool? 2) when working in front of you, just like the paddling advice, don't round shoulders forward, keep them retracted into good posture.
Looking fwd to helping you when your exercises have progressed.
Any questions in the meantime, fire away!
Take care of that ankle...
~J
thanks J
The first thing I would look at would be your mechanics and paddling posture. After making a pass under water with that arm (this goes for either arm) as you begin to take it out of the water and reach fwd for another stroke, try a few things for me:
1) keep you elbow bent and arm as close to you and the water as possible
2)externally rotate your arm as you bring it fwd. This would mean instead of your palm facing the water, you should attempt to have it facing the stringer of your board (ie midline).
just copied that so i can look at it all together, ty
hello J just to keep you in the no of how im getting on ? im now on 2 repsx 15 a day and thats ok but i still have popping of the shoulder on movement at random times, have to say it was doing this before the 3rd dislocation but maybe not as much as now.. cheers steve
Steve,
Good to hear you are staying with your program! Keep up the good work and always keep me in the loop. I will advance you when your body is ready.
Does any popping occur during any of the exercises? If so, which ones?
Wehn you still get an occaisional pop, do you notice what type of position your in, what your doing, and what you posture looks like? Make mental notes...
How it is with surfing?
How have the waves been?
Ever surfed Morocco? I am itching for a trip!
~J
Paddling posture:
Please also consider your posture...During the entire motion of paddling, minimize your shoulders from rounding fwd and towards the board. Keep a decent amt of shoulder blade retraction active when paddling.
When pushing through the water, use the large muscles of your back, with shoulder blade retraction and less of your arm in a poor posture position.
Hope this makes sense...
cheers,
~J
Not been surfing yet since arm problem not that theres been much surf around and the weathers been -3, morocco is a awesome surf destination only been there for a week but it has serious potential if you can stay for a month it wld be best, missed out on morocco this year as i had chicken pox the day before my flight
Not been surfing yet since arm problem not that theres been much surf around and the weathers been -3, morocco is a awesome surf destination only been there for a week but it has serious potential if you can stay for a month it wld be best, missed out on morocco this year as i had chicken pox the day before my flight
cheers again J
hi J just to let you no where im at on the strengthning of my shoulder?, ive been away fishing for over two weeks now and ive been doing the programe you set for me and i feel my shoulder is alot sronger now, i admit ive only been doing 2 reps each day. but i thought that is better than nothing , what do you recomend now? ive not been out to surf yet since injury.
chhers S
Skeesh, Just saw your post and I wanted to let you know I will have an answer for you 2morrow. I have to get some things done at home. Keep up the good work!
One thing always leads to achieving goals.... CONSISTENCY!
~J
How is your ankle?
Do you have access to dumbells, weights, resistive bands?
What do you fish for?
Let me know what you have access to, and we will move fwd...
~J
hey J yes i have dumbells and i have acccess to a sport shop where i cld purchase resistive bands no probs.. we fish for scallops shell fish around the uk coast. ty
Here is your next stage:
Keep doing the...
Depression: Sit in a firm chair. With arms at your side, press down on the chair seat and lift your butt up. Hold 6 seconds, 3 sets of 15.
Now replace the isometric exercises with the following...
Tubing exercises
Internal rotation: Using tubing connected to a door knob or other object at waist level, keep your elbow in at your side,with a rolled up small towel between your arm and ribs, and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 15.
External rotation: Using tubing connected to a door knob or other object at waist level, keep your elbow in at your side , with a rolled up small towel between your arm and ribs, and rotate your arm outward away from your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 15.
Adduction: Stand sideways with your injured side toward the door and out approximately 12 inches. Slowly bring your arm next to your body, keeping your elbow straight, holding onto the tubing for resistance. Do 3 sets of 15.
Flexion: While standing on the tubing, keep your elbow straight and pull your arm forward. Do 3 sets of 15.
Extension: Using the tubing attached to the door, face the door, and pull your arm back. Be sure to keep your elbow straight. Do 3 sets of 15.
Scaption: Stand with your arms to your side and with your elbows straight. Slowly raise your arms to eye level.(at about a 30 degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 3 sets of 10. Start with no weight, and then add 1# increments and let me know as you add poundage, how you feel?
Resistance bands and tubes come in different levels, and you might use diff levels for diff exercises...just use common sense. Always remember, quality over quanitity!
Do these every 2-3 days...
Do this for a good 4 weeks and then hopefully get ready to surf! You could try it now, but I would wait...
Keep me posted on your progress...
~J
thats great J thanks again i'll keep u posted once i get tubing
regards Steve
Hi J just to let you know that my shoulder feels very strong and i have no pains with even stretching my arm above my head so alls well there, one thing that bothers me has nothing to do with my shoulder but my ankle if you rememeber i twisted it i heard a pop on the outside ankle, i supose if times a healer then thats ok but i was wondering if you think i should get it checked out? its still sore after 2months, if i remember rightly a twisted ankle takes a while so maybe i've answered my own question but just looking for reasurence
Skeesch,
Great to hear positive things about your shoulder! Happy for you...
Ankle: Pop can be usually 1 of 2 things: 1) joint pressure releasing, like when you pop your knuckles on your hand, or 2) a ligament can make the noise when it tears.
I would have expected it to be doing much much better after 2 months. How much better is it? When you say sore, how sore? Possibly more time needed, but hard to say. Is the pain local to a small spot or is it still large area? Swelling still? Discolored still?
Get back to me...
side: my lil sister was just vacationing in london...
~J
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