Shoulder Issues

[BlackWhiskey]

Long story short: I received shrapnel wounds from an RPG to my right shoulder in 2006. For the remainder of my enlistment I had stability problems in that shoulder and I could only carry my pack on my left shoulder. After doing that for two years my left shoulder began to sag about three inches lower than my right, and now both have stability problems.

I went to physical therapy several times while I was still in the Corps, and I currently use resistance bands to work out both shoulders, but I really haven't seen much improvement in range of motion or confidence in it's stability.

I have had two MRI's and have been told by the VA that I am not a candidate for surgery because the issue in my right shoulder is due to burns and scar tissue from the shrapnel, and that they can't really do anything about it. And they won't really give me a straight answer on my left shoulder regarding what is actually wrong with it, or what can be done to help it.

My question is (as I'm sure I'm not the only one here with shoulder problems) what are you guys doing that is helping your shoulders without surgery? I know that shoulders, once injured, are very difficult if not impossible to get back to 100%, but I would like to be able to throw a football again and do pull ups. Any help would be appreciated.

Cory

 

[Zebra644]

Re: Shoulder Issues

I would seek out a good sports medicine clinic if you can and get another opinon. I am still waiting to get released from my Doc. from having shoulder surgey and that was at the beginning of the year. I have been able to regain pretty much my full range of motion.

 

[canman]

Re: Shoulder Issues

+1 for a sports medicine Doc. A physical therapist got my knee back with no surgery. Shoulders are a tougher fix though,especially trauma like that. Good luck

 

[WhiskeyWebber]

Re: Shoulder Issues

Do you have enough range of motion to do an overhead press with a barbell?

 

[SeanRT]

Re: Shoulder Issues

I've had problems with my shoulders as well (not from an RPG or anything as intense as that). I would HIGHLY suggest that you do the best thing for your situation; go see a doc, man.

 

[stefan73]

Re: Shoulder Issues

Go see a Doc. I was able to work my right shoulder back to feeling better to the point where it doesn't wake me up when I role over now (after a year). It was shooting my bow (archery) that helped my right shoulder feel better. However my left shoulder has been feeling the pain now because I babied my right so much that I started messing up the left thanks to over compensating.

I would avoid over head press. There are a number of things to help build shoulder stability. Work light and be careful. Shoulder injuries are a pain and hard to get over as you already know.

 

[BlackWhiskey]

Re: Shoulder Issues

Thanks for the suggestions. I think I'll see a doctor outside of the VA. Anyone from Utah have any suggestions?

 

[ganyana]

Re: Shoulder Issues

Took a 7.62x39 bullet to the right collar bone and dislocated the left shoulder in a car and aircraft crashes. A 'regular' surgeon patched up the right shoulder- good enough job I supose but 17 years on it still gives me trouble. My left Shoulder I waited until I could see a specialist - Mr Bowers (now mainly based in London UK) but originally from Zimbabwe. Got three small titanium pins in the left shoulder but all stability issues gone and full range of motion returned in under 6 months. Wish I had made the effort to get it seen to 10 years earlier!

Knowing something of the medical costs in the USA, it may be cheaper to see a specialist in South Africa! And there are several top pro's there who learned their trade during sundry wars. Cost about US 5k including hospital stay etc. plus your ticket over.

I have also learned the difference between regular and specialist when it comes to surgeons...Regular will do for most things but shoulder and neck injuries require a man of above average skill and knowledge.

 

[hankpac]

Re: Shoulder Issues

Definitely go outside the V.A. there is a pervasive attitude that seems to be getting worse in some areas, that it is better to delay, and defer, and temporize than to actually DO anything. This is really too bad, since the residents are never going to get skilled in their procedures if they keep putting off the opportunity to do a surgery, and of course the patients eventually die off, waiting.
This attrition factor is how the VA stretches an inadequate budget, and is what Obama care will eventually look like.
I worked for a hospital in Texas that took on the VA contract for an outreach clinic. Part of the training was on how we couldn't do the same things for a patient who came in under the VA plan, vs the same patient under Medicare or private insurance or cash only. Couldn't do the same labs, couldn't do the same x-rays, and couldn't do the same treatments or procedures. Couldn't give the same meds either.
The Attendings don't want to work any harder, and the residents are held under a production threshold.
I saw a specialist yesterday at the Portland VA: a Pakistani with a chip on her shoulder. All the basics of professional courtesy were missing: No introduction, No after treatment care instructions, no patient education, no answers to questions. Couldn't leave the room fast enough.
In case someone wants to be an asshole: I was bathed, and dressed neatly, presented my self as a gentleman, and offered my hand with my name, when she walked in.
Not to mention the guy at the travel pay window acted like my travel pay was coming out of his wallet.

 

[WhiskeyWebber]

Re: Shoulder Issues

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Stefan73</div><div class="ubbcode-body">I would avoid over head press. There are a number of things to help build shoulder stability. </div></div>

This is a common misunderstanding in shoulder problems. The press is the best exercise at building overall shoulder gurdle stablility but most docs and physio types won't recommend it because they have been taught isolation exercise techniques. The shoulder is a complex joint but it can be strengthened like any other joint/muscle. That being said there are cases where the only answer is surgery due to scar tissue impingement issues that limit range of motion to the point where exercises like the press cannot be properly executed.

 

[Slippery_Pete]

Re: Shoulder Issues

Google Active Release Technique and find a guy that does that in your area. It keeps me going.

Also, you will probably need to do stability and strengthening work. I know Joe Defranco fixes shoulders with things like the seated dumbell clean, (I think it's called.)

Google his name with shoulder rehab and/or Eric Cressey. Those guys are solid.

Best of luck man. Protect those shoulders.

 

[rdgshooteer]

Re: Shoulder Issues

Shoulder injuries are tough. I went through 6 months of PT that ended the middle of last month and I feel my shoulder is probably worse strength wise now then when I started. I would definitely get a second opinion from outside the VA. I'm getting lucky with my shoulder issues being up at Ft Drum and them not having an actual hospital here I'm getting to go see civilians for everything so far. The difference alone though in the two PA's I have seen on post is night and day. My primary is like here's some pills take these. The other PA I have seen twice. The first time he sent me to PT the next he sent me to the Ortho. So I know how you feel about the whole thing. I'm actually scheduled for surgery at the end of the month to repair an impingement and see what else is going on since I have pain and instability in my left shoulder. I wish you luck though with yours and hope you can get it corrected without surgery as this was the last option I wanted.

 

[3fingervic]

Re: Shoulder Issues

I've been lurking on this forum for a little while now. I've been soaking up the info on shooting. This was my first time in the fitness section.

First of all, let me say thanks to you and to all that have sacrificed for our freedom.

I have been dealing with shoulder issues since I was 15. I do like the second opinion with a sports medicine physician. Have you tried a few rounds of deep tissue massage? It may help to break up that scar tissue.

As far as the left shoulder is concerned, I think you have stretched tendons. You may also have spinal curvature, that is making it look lower than the right.

My right shoulder has extremely stretched tendons. I was told, at 16, that I had two choices. Have a surgery or make the muscles real tight so it stays in the socket.

Lastly, weight training. I would try to do light isolation exercises such as lateral raises and front raises. Also, the trap muscles, back and chest have a lot to do with shoulder carriage, so make sure those muscles aren't being neglected.

I hope that you find some of this useful. On behalf of all the civilians I would like to say thanks again for your service, and I'm sorry you have to endure this.

 

[auge_zwo]

Re: Shoulder Issues

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: 3fingervic</div><div class="ubbcode-body"> the second opinion with a sports medicine physician. </div></div>

That and and the best physiotherapist you can find.

First thing get a proper diagnosis for your left shoulder as well, and go see a good physiotherapist. From my experience with recovery from injuries and working your way back to 100% a good physiotherapist is always key. Try find one who has experience working with professional athletes, that way you don't waste time.

So many nasty physio exercices for shoulders..

You got all the options. Resistance bands are quite nasty..

If you don't see progress despite working hard, my guess is there's something wrong either with the selection of exercises or the way you conduct them. Let the physiotherapist review your work out, make a plan and have the physiotherapist check on your progress.

All the best to you man, hope you will be able to throw some again soon!

 

[auge_zwo]

Re: Shoulder Issues

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: BlackWhiskey</div><div class="ubbcode-body"> I know that shoulders, once injured, are very difficult if not impossible to get back to 100% </div></div>

Difficult maybe, but depending on the individual case far from impossible. Find the right people that can provide quality instruction, and if you put a good effort in you will have your shot at the 100%. Good luck!

 

[RichardTractorGuy]

Re: Shoulder Issues

Can you post x-rays of your shoulder?

 

[RichardTractorGuy]

Re: Shoulder Issues

The sag could come from an ac joint separation, weak deltoid/axillary nerve injury, or injury to the rotator interval/ coracohumeral ligaments

 

[fx77]

Re: Shoulder Issues

Ok
Once the diagnosis is made concerning whether or not surgical reconstruction for your shoulder is indicated and what kind shuld be done....

first with respect to your shoulder skin quality:
If the tissue is scarred and thin..one could consult a plastic surgeon to consider inserting a tissue expander over the back top of the involved shouldr or chest wall to stretch the skin overlying the shoulder for a couple of months and then excise the bad scars and advance the stretched "new" high quality skin flap over the bad areas, and when that heals conventional/arthroscopic surgery could be performed at a later date through "virgin" tissue.

the next issue is to determine whether or not your shouder problem is intra or extra articular, and then the appropriate specialist could address the management options.

If the Left shoulder is unstable, there are many options for surgical reconstruction which lead to excellent results.

U R in Utah...go here for an opinion where they have 4 operating shoulder specialists

http://medicine.utah.edu/orthopaedics/physicians/ortho_physicians.pdf

 

[rdgshooteer]

Re: Shoulder Issues

I just had surgery yesterday on my left shoulder due to the instability. Nothing really showed on the MRI. When they went in they found I actually had three impingments, one above, and below the ligaments and then one around the labrum. The doctor said if I would've waited they probably would've become tears. The thing was none of my MRIs showed anything really to begin with. I would find an ortho surgeon you can trust and get a second opinion. Im hoping once I heal the instability I had will be gone.

 

[RichardTractorGuy]

Re: Shoulder Issues

Hmmm above and below which ligaments? Sup GH, Middle Gh, ant and post band of inf GH, CC lig, CH Lig? post superior labral impingement is found sometimes in people that abduct and externally rotate the shoulder (pitchers)to extremes and this can lead to a RC tear/post labral tear.

 

[rdgshooteer]

Re: Shoulder Issues

I'm not sure of which ligament. They told me a bunch of stuff as I was waking up and don't really remember. They told my wife about the labrum and the above and below but she says she didn't remember which one it was.