Replying to For those with shoulder issues!

 Alright NS, this is for everyone with shoulder issues! I have seen so many threads now from people with shoulder dislocations, AC joint issues, etc, and so figured I'd create a thread for those people to refer to!! I have had multiple disloactions of both shoulders, and have had reco's on both, so I will give ya my experiences, and all the knowledge I now know!! I'll apologise now as I have the tendancy to ramble, so I'm letting you know now that this is gonna be a long post, haha, read at your own will, but I encourage those with shoulder issues to read! I woulda put it in NSG but figured more ppl will see it here.

Firstly, I'll give ya the scope of people who I have worked with for my shoulders, so you know the 'legitness'. My sports doctor is the doctor the Crows, an AFL footy team here in Aus, this is something to the equivalent of being a sports doctor for an NFL or NHL team. My surgeon is also the surgeon for the crows, plus many other high profile atheletes and sports teams in Australia. My physio has practiced for years in Verbier, and now practices here in Australia, and is the physio for the Australian volleyball teams, and has also worked with heaps of other Australian sports teams. So you know the info I am giving you is reliable, and I have also researched this a shitload for myself!!

I first dislocated my right shoulder in 2007, in a big air comp. I was simply reverting around from switch to natural and the bottom of the landing, but caught an edge in all the sugary shit where everyone else had reverted around too (we don't have the best snow is Aus). I fell with my arm outstretched and with my body turning, effectively my arm pulled the shoulder out of its socket. It must have had some pressure loading, because it blew the spring out the back of my FKS bindings!! I know, hella effort! Anyway, this is one way of dislocating your shoulder, the other is by landing directly on it, and the pressure pushing your shoulder out. I have dislocated my left shoulder in this same way. Anyway, I got up from my fall and moved my arm, and my shoulder immediately popped back into place. Thinking I was sweet I grabbed a mates skis and started running back up the the drop in, full of adrenalin, but about half way up I realised my shoulder was fucked. This shoulder was reco'd in April 2008. I dislocated my left shoulder in early 2008, and did it many times since, and had surgery early jan this year. So here is the treatment process following this!

Firstly, my shoulder dislocations were always subluxations (ie. the shoulder comes out and goes back in itself). Slightly better than if you gotta put it back in, but treatment process is the same. You go into a sling for a week or 2, icing on and off for the first 4 or 5 days. I then had an MRI and saw my sports doctor. He told me that cause it was only the first disloaction, and I wasn't heaps young (21 at the time I think) that I should do 3 months of rehab. Sorry kids, if you're young, you have faaarrr more chance of redislocating, if you are older, your shoulder is stronger and more developed so you have less chance of redislocation and more chance of effective rehab. Rehab will involve inital work with a theraband, and then hours in the gym! With the theraband, the Idea is to do build up endurance - many many reps at a relatively low level of resistance!! Once you are doing say 3 x 50 reps, it will then be time to hit the gym. Don't try and quickly work your way up to the highest  resistance theraband, because this will not target the right muscles!!! The idea is that the shoulder is a ball and socket joint - the shoulder cup (socket) is lined with cartelidge that sucks the ball into the socket so to speak. When you dislocate your shoulder, you tear the shoulder cup and damage cartelidge - so socket no longer sucks the ball in place properly. My right shoulder was done so bad it even tore down to some of my bicep. The idea behind rehab is to get the muscles surrounding the ball and socket joint strong enough that they can hold the ball in the socket without the full effectiveness of the cartelidge. Realistically, if you have given your shoulder a fair dislocation, it takes 3months of rehab to really try and get this right. In my case, I did 3months of rehab, in the hope of avoiding surgery, but then came up slightly backseat, put my arm back, and it got caught on the knuckle while the rest of me made the landing - it popped out again. Basically, once you have done your shoulder more than once, it will need surgery to get it right!! For those of you who have done it once, but want to get through the rest of your season - take 2 weeks off, wear a sling and ice for the first 4 or 5 days. You can then return to skiing, but strap it up (I'll go through this later), and see a physio to get some theraband and do some excerices to improve the stability through the muscles.

SURGERY!! Depending on the level of tear you have in your shoulder, you will either have an arthroscope (key hole surgery), or open surgery - recoveryt process for both is the same. In both my cases I had an arthroscope. Surgery is balls, and you will be in some serious pain for the first 4 or 5 days. You will be in a sling for 4-6 weeks, and the first week you will need to ice on and off at pretty much all times! The process from there is basically getting mobility back, helping your shoulder learn to react to situations, and also to rebuild the strength. Hopefully after 4 weeks you will be out of a sling and ready to start some physio. With my left shoulder, I am currently 2 weeks into physio. Do your excercies religiously, I cannot stress this enough! You will start with static excercies, pushing and pulling against a door frame, pushing against a wall, pendulum exercises, etc. This will only last a week or so, then it is time to start with the theraband. Once again, you will look to build up to as many reps as possible, with a relatively low level of resistance. This process will last probably 4-6 weeks, possibly more. Once your physio feels you are ready, the time will come to go to the gym. I recommend going to a gym where you get supervision and assistance, or to get straight up PT (personal training) sessions, as you will need someone who knows about shoulders to build you up a program over a couple months to get your shoulder right. You should try to stay away from working for around 3months, unless you do something completely non-physical - computers or something. Anyway, you will spend somewhere around 2-3months in the gym getting strength back, and also doing excercises that re-train your shoulder in reaction speed etc.

So basically, the recovery from surgery is 6months. This is totally dependant on the individual, if you train all the time, your shoulder will naturally be stronger, and you may take slightly less time. Doing rehab before surgery is super handy, it builds up your shoulder so that the recovery process is slightly easier! Plus you will know the excercises then! You can probably ski lightly at 4-5 months, but really it's not a good idea. I'm pretty sure you all know how hard it is to go out for a ski without being tempted to try shit!! So realistcally, if you have surgery, at 6 months you will be able to really give er again. And then from there, continue going to the gym, or at the very least doing your theraband excercies, to maintain the strength and composure in your shoulder. If you continue to do this, your shoulder will simply get better and better over time. I had my right shoulder reco'd in april 2008 and it has stayed in ever since, and I have taken some solid bails. I'm hoping the same will go for my left!!

Sorry, final part. Alot of people wonder about shoulder braces, strapping, etc. In my experience, strapping and bracing works to an extent, and will get you through the rest of your season or whatever, but it will not stop your shoulder from dislocating on every occassion. Think about it, if you dislocated your shoulder when it was 100% perfect, if you fall on it the same way when its weakened, it will go again! After I did my right shoulder the second time, I was then strapped each time I rode by a mate that used to strap for NRL rugby teams, and it was sick. Most sports doctors/physios etc will all agree that strapping is infact more effective than any form of brace - however you need to do it properly!! For the last couple seasons I have worn 2 shoulder braces, and they have been good, but my shoulder has still popped out. My left shoulder got to the point where if i knuckled a big enough jump, even if i didn't bail, the sheer impact would cause it to come out - at this point you know you need surgery! But yeh, if you really want a brace, go for a donjoy shoulder stabiliser or something similar, if you only have one bad shoulder, as it limits your range of movement so your shoulder doesn't extend past the 90deg range, which is where it is most likely to dislocate. If you have a friend you can teach to strap your shoulder properly, this is the best option!! Have a look on some of the strapping tape sites for videos on how to tape properly, or even better find a physio or someone that has experience in taping and learn from them

One last thing, for those of you with AC joint issues. The process is completely different. A torn AC joint is an un-fixable injury, it's with you for life. However, it is nowhere near as bad as a dislocation. If you do your AC joint, the idea is to ice one and off for the first few days, sling for the first week, and stay away from any activity for about 2 weeks. Once your 2 weeks is up, if you feel ok, then you are good to shred again!!

Sorry for the huge post, but wanted to cover as much as possible. I will add to this thread as I remember stuff! If you have specific questions, want some advice relating to your personal situation, or need some reassurance, feel free to send me a PM and I am more than happy to help out. Having said this, I am not a doctor, I am only speaking from experience and a lot of research - there will be no substitute for going to a sports doctor and getting advice for your own situation. I have the arthroscope pics of my shoulders, I'll try scan em and post em up at some stage!