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SHOULDER


 

I had anterior shoulder dislocation. MRI shows bankart lesion. I don’t have any issues for past years and I was lifting weight in gym as well. But it got dislocated again after 2 years. Can it be fixed without surgery? How long will it take to recover if I do surgery .Can I do all my activities without caring about dislocation? Can I do all movements after surgery?

A number of factors would determine your best course of action at this time. Did you have surgery, and if so, was it open or arthroscopic? After a failed arthroscopic surgery there is evidence that an open surgery can lead to low recurrence rates and good functional outcomes. You can try a more conservative approach with only physiotherapy; however the evidence suggests that this approach leads to a higher recurrence rate.

A physiotherapist can help you with a conservative approach to rehabilitating your shoulder, and would help you help you achieve the best outcomes prior to and after surgery. Physiotherapy would involve an initial assessment to determine your current pain free range and strength. Treatment would include manual therapy, electrotherapy, and a progressive exercise regime.

In the initial stages of your injury (0-4 weeks) you should keep your arm in a sling with very limited range of motion at the shoulder. After 2 weeks a physiotherapist would start passively moving your arm slowly increasing the range of motion. I would discourage you from resuming all activities before you have given your arm a chance to heal and sought help/advice regarding rehabilitation from your doctor or a physiotherapist. Doing too much too soon can greatly increase the risk of recurrence and may negatively impact long term functionality.

Give us a call at North Shore Sports Medicine to start working with a physiotherapist today: (604) 973-0242

I play rugby for a team and I got injured a while back, ever since then my shoulder has never been the same. The bone will move and click and leaves a dip in my shoulder where I can put my finger in to feel it. You can see the bone come out of my shoulder. I’m in excruciating pain and I’m not sure what to do? Do you know what could’ve happened to it?

I am sorry to hear about your shoulder injury. If your pain is that significant you likely should see a doctor and get an X-ray to make sure you don’t have a fracture. That being said, there are many injuries that can occur in the shoulder that can lead to discomfort and visible deformities. Specifically, and perhaps most commonly, you could be experiencing an AC joint separation (this is the joint between your collar bone and shoulder blade).

This injury can lead to a step deformity with a visible lump on top of your shoulder, and pain on the bony point on top of the shoulder. I would advise you to get assessed by a physiotherapist who can determine the cause of your discomfort and make a recommendation for treatment and recovery. In the mean time, I recommend you avoid movements that increase your pain including lifting weight over head.

Usually soft tissue injuries heal within 6-8 weeks as long as you give them the time and space to heal without aggravating the injury (doing anything that increases your pain).

A year ago, I was playing cricket, i got sudden shock on shoulder and my shoulder got injury. Injury was little series, I was feeling pain in moving hand then I stopped playing four 5-6 months I again went to play after 5-6 throws my hand becomes dead for few seconds now i don’t have any pain in my shoulder but when i warm up i fell sound of friction of bones only at injured shoulder and power in my throw is lost what should i do to recovery my shoulder strength

Shoulder injuries can be complicated, and if you are still having pain more than 6-8 weeks after the injury it would be a good idea to get help from a physiotherapist. A PT can help determine the cause of your outstanding weakness and prescribe the best set of exercises to help you regain your strength. A number of structures could be at the root of your problem and without a full assessment it is difficult to provide advice that will be safe and effective.

When you have symptoms in a part of the body that was not involved in the initial injury (your hand) this can indicate that you have some nerve involvement. If you come in to see a physiotherapist they could give you an assessment to determine the cause of your outstanding symptoms and determine the fastest course of action to recovery.

Call us at 604 973 0242 and one of our healthcare coordinators can help you set up an appointment

I injured my left shoulder and it doesn’t seem to be making any progress in the healing department. I’m hearing from people with similar issues it may have to do with the rotator- does this require surgery if it is the rotator? Anyway, I got to get this thing looked at!

Shoulder injuries can be persistent and the correct exercises (strengthening and stretching), manual therapy and other physiotherapy modalities can be important to ensure optimal and accelerated healing. A rotator cuff injury implies there is an injury to one or more of the four muscles that surround the shoulder. In extreme cases this type of injury may require surgery, but definitely not always.

Shoulder pain can be due to a number of different structures not just the rotator cuff and the appropriate treatment is determined by the cause of your discomfort. It is important to treat shoulder injuries to maintain your ability to fully move your shoulder and use it in all of your activities. While you are experiencing shoulder pain you should try to avoid activities that increase the pain including lifting anything overhead. Here at North Shore Sports Medicine, we can perform a full assessment to determine the cause of your discomfort and use a range of treatments including manual therapy, exercise prescription and other modalities to help ensure the best possible healing.

Call us at 604 973 0242 and one of our healthcare coordinators can help you set up an appointment.

I injured my shoulder two weeks ago and finally went to the doctor this past week. He told me I have rotator cuff tendinitis. I am supposed to go for sports physio; however I currently do not have the finances to allow for that. I am wondering if there are specific exercises or stretches I can be doing to strengthen and stop the pain.

I am sorry about your injury. An injury labelled “rotator cuff tendonitis” can involve one or more of the four rotator cuff muscles. Without a full assessment it is difficult to provide a program that will directly benefit you. With that in mind, many rotator cuff injuries are from overuse, and misuse of the shoulder. You can start by checking your posture, and ensuring you don’t hunch your shoulders up or forward throughout the day especially as you move your arms. While you are still experiencing pain you should try to avoid lifting heavy objects overhead to allow for healing.

Continue to move your shoulder within your pain-free range of motion including swinging your arms freely when you walk. There are some strengthening exercises and stretches that can be prescribed to help with optimum healing – however we would first need an assessment to ensure these exercises do not make your injury worse. Depending on your yearly income the medical services plan of BC (MSP) does cover part of some physiotherapy visits, and most extended benefit programs include physiotherapy. If you can get a more precise diagnosis we can give you some more specific exercises.

Thanks for your question.

Will physiotherapy fix a partial thickness tear towards the bursal surface of the supraspinatus tendon?

If you can avoid surgery you should, it is recommended that you give a physiotherapist 8-10 weeks to develop a strengthen program, restore joint motion and educate you on activity modification which has been shown to decrease pain and restore strength.

Rotator cuff tears (one of the four is the supraspinatus) are common in a huge portion of the population and most are resolved with a combination of manual therapy (restoring joint motion), exercise and therapeutic modalities.

The most important thing you can do is restore joint strength and motion as soon as possible so the pain doesn’t start to travel into your neck and back because you are compensating.

You are also welcome to come to the clinic anytime for a thorough assessment and individualized treatment plan.

Will physiotherapy fix a partial thickness tear of the supraspinatus tendon or is surgery?

If you can avoid surgery you should, it is recommended that you give a physiotherapist 8-10 weeks to develop a strengthen program, restore joint motion and educate you on activity modification which has been shown to decrease pain and restore strength.

Rotator cuff tears (one of the four is the supraspinatus) are common in a huge portion of the population and most are resolved with a combination of manual therapy (restoring joint motion), exercise and therapeutic modalities. The most important thing you can do is restore joint strength and motion as soon as possible so the pain doesn’t start to travel into your neck and back because you are compensating.

You are also welcome to come to the clinic anytime for a thorough assessment and individualized treatment plan.

In February 2013 I had surgery on my right shoulder for a torn labrum. After many months of recovery I decided to go back to the gym and make an attempt to regain the muscle and strength that I lost. My visits to the gym were going great until I got back to the bench press. I started with just the bar, which doing so I noticed there was a very strong and loud pop in my right shoulder, during the decent and just before I reached 45 degrees. I figured using a barbell put my shoulder in an awkward position, therefore I tried other variations of the bench press. These variations included floor press, dumbbell, reverse grip, as well as incline. All variations of the exercise presented the same pop at the same place, just prior to 45 degrees , therefore I decided it was too soon to resume training at the gym. Now, a year+ later, I am again trying to re-establish my place in the gym, but the same pop is present. I have often thought the surgery was not successful or I did not heal correctly. Could this be the case? Does this merit going back to my Ortho? Or, do I simply lack the muscle/strength in my shoulders, which is prevent the success of the bench press?

It is difficult to know exactly what is going on with your shoulder without doing a full assessment. However, from what you have describe, it sounds like you are experiencing some anterior instability through your shoulder. This is most likely due to weakness in your rotator cuff muscles.

The shoulder joint is a very unstable joint because of the way it is made (think of a golf ball on a tee). There are not many supports providing stability through the front of your shoulder joint. As such, the shoulder joint relies on the rotator cuff muscles to maintain good alignment within your shoulder. Following surgery and immobilization, your rotator cuff muscles can become weak and tight. If you did not complete a full post-surgical rehabilitation program to address this, then these muscles will continue to be weak and/or tight. When you are completing an exercise such as bench press you need to have adequate strength through your rotator cuff muscles to keep the shoulder joint aligned properly.

If the bones are not held together securely you may experience a slight pop as the bones move too much. This may lead to future damage of your labrum. Unfortunately, exercises such as bench press do not directly target these muscles and therefore will not be beneficial at this stage. You must first begin with isolated rotator cuff exercises. A physiotherapist can guide you through a progressive resistance program, ensuring you establish correct movements and control as you get stronger. Once you have regained basic strength through your rotator cuff muscles you can begin weight bearing exercises such as push-ups focusing on a limited range of motion and good scapular control. Finally, you will be able to recommence your weighted bench press.

As you can see the shoulder is a very complicated structure with lots of factors that contribute to its stability and mobility. I strongly recommend being assessed by a physiotherapist so they can set you up with a targeted strengthening program. That will give you the best chance of getting you back to your full gym program as soon as possible.

Thank you for any feed back you can provide.”

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