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My first ride in a blood bucket

 Poster: A snowHead
Poster: A snowHead
I dislocated my left shoulder whilst cross country skiing in the Vercors some years ago. An Army doc who was with us said that it had gone back in and I should just rest for a bit. Some hours later my friends said I wasn't looking too good and took me down on a chairlift, then drove to the med centre. French doc there took my top layers off and, on seeing my arm hanging some way below my shoulder, asked how long it had been like that. About 4 hours I said. Sharp intake of breath. He spent next couple of hours trying (gently) to get it back in. Finally, after giviing me a syringe of valium about the size of a courgette, he managed to do it.

My arm then remained immobilised in a fancy French sling (80 squid or so I think) for at least 3 weeks. Went for physio over here after that and about 6 weeks later had full movement back. I'm not a medic so can't answer your question Mike, but the French way seemed to work for me.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Mike Lawrie, I'm not a medic, but I do have some experience of this - I too dislocated my right shoulder this February in Banff after a fast forward fall - ouch Skullie . Like you, it was a first time dislocation. It was also a first time ride down the slope in a blood wagon for me, but in my case I was well strapped in and travelled down feet first, with the sled being controlled by 2 patrollers. With the pain of the dislocation I was dreading being bumped, but in fact the ride was fairly smooth. I posted about it in this thread

As you will see from that thread, the very useful pre-printed instruction sheet issued by the Banff hospital recommended immobilisation in a sling for the first 3 weeks, but doing gentle pendular exercises in this period, followed by a progressive exercise regime. When I got back to the UK I was referred to a very good NHS physiotherapist. The first time I saw him (in March) he somewhat surprised me by saying I could expect to be seeing him until September - it takes a long time to fully recover from a shoulder dislocation. I've been going through a varied physiotherapy programme, involving:
exercises with a pulley system (the pulley fits over the top of a door and you sit with your back to the door)
exercises rolling a football up against a wall with the affected arm
exercises using a hand weight to increase the rotational extent of movement
exercises using a hand weight to increase the extent of movement of the muscles under the armpit (which had shortened due to lack of use)

My physiotherapist is very pleased with my progress Very Happy - he says my shoulder joint is strong and there is little chance of it dislocating again, I just have to continue work at lengthening those muscles which had shortened. He says this is a much more preferable situation to be in than the situation where the joint is loose and can re-dislocate again easily.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
I recently purchased a Powerball to help to rebuild the strength in my right arm and shoulder. A little workout everyday, and I'm seeing some improvement in muscle endurance.
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As a patient, rather than a medical person, I do sympathize - it's very hard to get such conflicting opinions. It's bad enough being in pain and discomfort, but if you're sure you're doing the right thing to fix yourself, much easier to put up with. The whole episode sounds grim, and very bad luck.
Quote:

he is a lowly physio

I have loads of time for physios, who cost heaps less than doctors, and can be great value for money. Almost all of us could benefit from physios, almost all the time - not just when in hospital, or injured. Best wishes for a good recovery, if not a speedy one.
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Anyway, snowHeads is much more fun if you do.
snowbunny, is that one of those gyroscope thingies?
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Mike Lawrie, Yes, so small, but really tiring to use Toofy Grin I purchased one with a counter, so that I can judge my progess, and measure the difference between each arm's strength.
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Quote:

My physiotherapist is very pleased with my progress - he says my shoulder joint is strong and there is little chance of it dislocating again, I just have to continue work at lengthening those muscles which had shortened.

Had the muscles shortened before or after the dislocation? I am wondering, after these reminiscences, whether there are certain things people can do to avoid this kind of injury in the first place? What kind of thing pre-disposes someone to a dislocation, or is it a pure chance accident which is likely to happen to anyone falling in this particular kind of way?
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
pam w, Speaking from a non-medical viewpoint, I think that there is really very little one can do to avoid this type of injury. It is just the nature of how hard you fall, the angle, etc...
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You'll get to see more forums and be part of the best ski club on the net.
pam w, in my case it was a forward fall after skiing straight into a bank of snow in almost zero viz conditions. The reflex reaction was to slow the fall by putting the arms out in front. Somehow the elbow took the brunt of it which transferred the force directly to the shoulder. Game over. I don't think I could have done anything to stop it happening, seeing as the fall came totally out of the blue, or out of the grey as it were Crying or Very sad Messed up the whole of the season, and that in one of the best years we've ever had Crying or Very sad Crying or Very sad
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 Ski the Net with snowHeads
Ski the Net with snowHeads
snowbunny, tell me how you use your powerball, hubby got one as a gift, and we haven't been able to quite work it out, as the instructions aren't in English!!
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
pam w wrote:
Quote:

My physiotherapist is very pleased with my progress - he says my shoulder joint is strong and there is little chance of it dislocating again, I just have to continue work at lengthening those muscles which had shortened.

Had the muscles shortened before or after the dislocation?


After the dislocation.
It seems that there is a general medical concensus that after a dislocation, for a period of period of time (say up to 3 weeks) you should keep your arm in a sling, to avoid further damaging the damaged tissues (at this time re-dislocation could occur fairly easily), although daily gentle pendular exercises (holding the arm downwards and swinging the arm in a small arc and also small circles about that position) during this period are still recommended.


Last edited by snowHeads are a friendly bunch. on Sat 3-06-06 17:19; edited 1 time in total
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Helen Beaumont, Okay. There should be a skinny string with it. Drop this into the hole in the ball, and wind it tightly round the groove until you have about 3" left. Hold the ball in the palm of your hand string up and give the string a good hard pull with your free hand (like starting a mower). Turn the ball over and use the momentum your pull start gave you to slowly build up speed with big circles (think cake baking). As it gets faster, make the circles smaller, and hold tight. I hope this makes sense!
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
snowbunny, aah, that's what you do, maybe it won't just lire round gathering dust now!!
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 You know it makes sense.
You know it makes sense.
snowbunny, Also - remove knick knacks from mantlepiece before twirling hehehe
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
All info, FAQS, videos etc here:

http://www.powerballs.com/

Cheers,

Greg
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 Poster: A snowHead
Poster: A snowHead
With various shoulder injuries different regimes are recommended. Generally for a simple disocation, imobilisation in a sling is recommended, complete for one week, then gentle pendulum exercises until week three, at which point active physiotherapy may be started. (IIRC)

To prevent shoulder dislocations, exercises to strengthen the rotator cuff would be recommended.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Hi again Mike Lawrie, it is good to hear how you have progressed.
I think that you are getting the idea that there is some controversy on how to treat shoulder dislocation!

The "established" method is immobilisation in a sling for a varying amount of time, usually at least 2 weeks. The theory behind this is that any ligamentous structures that have been stretched or torn will get a chance to settle and thus lessen the chances of having a shoulder which is sufficiently weakened that it dislocates more easily the next time. (If you look at an Xray of a shoulder, there is not much of a boney "cup" for the ball to sit in; most of it is made up of a tough "soft-tissue" called the labrum). If in the course of your injury you tear the labrum, you are much more likely to re-dislocate in the future.

However there is no evidence (that I am aware of) that labral tears can actually heal on their own, and the treatment of choice if you have a tear would be arthroscopic surgical repair.

Similarly another soft tissue that is often torn in the course of dislocation is the rotator cuff - which is an aglomeration of all the tendons from both the back and front of your chest wall that control the upper end of the humerus.

There does seem to be a feeling now that if your first dislocation occurs when you are young and with relatively trivial trauma, then you are going to be at long-term risk of recurrent dislocations and it is worthwhile immobilising the shoulder for a couple fo weeks to allow things to "tighten up" again. However, if you have got to your 40s and your first dislocation (and relocation) require a good amount of force then you are not likely to be a recurrent dislocator unless you are unlucky enough to have torn your labrum - and that immobilisation will not make any difference to the tear and will either result in your shoulder being unstable... or not - and if it does result in instability then it needs repairing surgically.

So, the more progressive (younger?) shoulder specialists now tend to mobilise "older" first dislocators early (in order to avoid some of the muscular wasting that you have seen).

I mentioned earlier about the lack of boney stability of the shoulder joint, and Kramer rightly talks about strengthening the rotator cuff as much as possible so the these muscle tendons can help to hold the humerus in its socket (this is analagous to people strengthening their quads after an ACL rupture in the knee).

All the best.


Last edited by Obviously A snowHead isn't a real person on Mon 19-06-06 9:51; edited 1 time in total
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Last week (on 6.6.06!) I tripped on a wooden walkway at work and fell forward (having dislocated my right shoulder only 3 months ago!) As I fell I tried to keep my arm close to my body so that it wasn't outstretched - fortunately that protected my shoulder. I got some nasty bruising to my right forearm Skullie and a few scratches, but no broken bones and no damage to my shoulder.
Accident wise, this doesn't seem to be my year Toofy Grin
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Phew

Well done. Has the claim gone in yet wink
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Alastair Pink,

Post card next trip please wink
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Alastair Pink, 6.6.06 - devil's day - what did you expect? wink
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