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Surgery for shoulder instability / dislocation - anyone had it?

 Poster: A snowHead
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I have instability in my right shoulder (repeated partial dislocation through awkward movements, not trauma).

Currently seeing the specialist and had MRI scan today. Treatment not yet been prescribed, but I know the options are physio (building strength) or surgery. I know that physio has a very low success rate in repeated dislocations. I'm youngish (just over 30!) and play lots of sports like netball, so I know that makes me high risk. SUrgery is quite likely to be recommended I think, eventually.

However, I have no pain, and I like to do a lot of sport and exercise, so the thought of subjecting myself to an operation doesn't appeal much!

Has anyone had an op for shoulder instability? What was your experience of it and how long until you were skiing and playing other sports again?
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 Obviously A snowHead isn't a real person
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I had this from playing rugby. Left a pretty big scar on my shoulder, but better than always being dislocated.
If you get back in the gym and train it will be about 6 months till back to normal, the muscle wastage was quite scary, but is now fine.
Never had a problem since.
Coincidentally both my neighbour had exactly the same operation and all are fine, one still played rugby all be it at local level.
Good luck, and get the bio oil on it.
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Was that some time ago? I believe it's usually keyhole surgery now. No way I'm having the op if not, I'm a girl who likes to wear strapless tops, not a rugby player!
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It was some time ago. I had the whole joint rebuilt so maybe not applicable. They had to make a big cut to dislocate the arm for the operation, and make the ball and socket hold together, key hole would not have worked for me.
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Filthyphil30k, ah probably a bit different to mine. I've never had a traumatic dislocation caused by a fall or accident, i think my joint is just "loose". So when it's dislocated there is almost no pain once it's reduced - i guess as it hasn't damaged surrounding ligaments.

Will see what the MRI shows, my feeling is it won't be much!
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beanie1, Yes, sounds different, I had "broken" the socket quite alot, was dislocated about 40 times in total.
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beanie1, If he hasn't seen this thread yet, send Freddie Paellahead a PM. IIRC his wife (Sally L) had this op - or at the very least some similar issues fairly recently. Even if it's not exactly the same thing, being a GP he probably knows quite a bit on the subject.
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beanie1, I had an old school "putty platt" many years ago. Multiple dislocations caused by rugby. Essentially the three main ligaments in the area are severed, platted to shorten them and then rejoined.

frankly it wasn't a great success and I found that getting a lot of weight work done at the gym had a much greater benefit. I couldn't really see you as the next Jody Marsh though wink
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Thanks everyone!

Saw the doctor again today, i had choice of conservative management (only 50% success rate) or straight to op. In order to be recovered by ski season I went for the op straightaway.

I don't know the technical terms, but in basic terms the cup that surrounds the joint has puled away from where it should be in a couple of places, and there are a couple of small tears in the ligaments. He said it has fully dislocated at some point - but i have no idea when that was! No damage to the cartilage or the socket itself.

Good news is it can be done by keyhole surgery, so scars will be no longer than 1 cm. And after 6 weeks I can run again, and after 3 months play netball, ski etc again.
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Hi Beanie,

I had the same surgery you're going to have. The ligaments had torn away from the bones and had to be stitched up and attached back onto the bone via anchors. They actually missed this in the first place thinking it was a bone spur within the joint that was causing me pain in overhead movements. I think the initial damage had been done years before doing self defence work, but at the time I was training quite a bit with rugby and weights and so the muscle held everything together.

The surgery was to take the bone spur off with only two weeks off work, but when I woke up and realised I'd been in surgery for a lot longer I knew something was up. I was quite surprised when the doctor mentioned how hard it must have been to keep having my shoulder dislocating. They'd found the torn ligaments when looking around cleaning up and done the surgery there and then. I was told to take 4 weeks off (10 days off as I'm self employed), no weights for 3 months, but physio. It hurt like hell for a day or two and then calmed down, but sleeping was awkward.

There seems to be a lot of different opinion on what should happen next with recovery rates and what you should be doing/able to do. The doc at the hospital said the physio would explain that and left me to it. My physio wanted the sling off as soon as it was comfortable, but not more than a few days and would book me a physio appointment within the week. I misunderstood this as meaning I needed to start physio within a week and chased the appointment a few days later and had my first seesion 8 days after surgery. They have you 'walking' your arm up walls to increase range or movement and stuff like that as it really stiffens up to begin with. The physio thought I was doing alright until she realised surgery had been the previous week, turns out there not allowed to start physio for 6 weeks min. oops. As I was there she gave me my rubber bands and showed me the exercises I'd be doing and told me to take it easy, so I got a bit of a head start. I did these all through the six weeks as often as I could

Looking around at how others organised the rehab it seems some are told to keep the arm sling'ed for the full 6 weeks. I dread to think the shape you'd be in after that period of time in a sling. I was on the exrecise bike within a week of surgery and the cross trainer within a couple of weeks and started running again at 3 weeks. Nobody mentioned not running for 6 weeks to me, but it was quite sore with the jogging up and down. The recovery seemed to go in stages, it improved a lot in the first two weeks then stagnated for a few weeks. Then improve again and hold and so on. At 3 months to the day I started weights again. Felt odd having to do shoulder exercises with 1-2kg weights. I had surgery at the start of August 2010 and in the October we went to Orlando, just before the 3 month mark. I was able to gently swim in the pool by that time. We skied in Feb and April of 2011 and no problems at all. There are 3 key hole scars each about 1cm and barely noticable.
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mac, thanks for the long post, I have my surgery tomorrow, so feeling pretty nervous (terrified).

Since I posted the above I've seen the doctor again and got a bit more detail. I got it the wrong way round - there's no ligament tear (I think that is generally an acute injury requiring immediate surgery), although there is evidence of ligament sprain. What is torn is the gelnoid labrum, between the head of the humerous and the shoulder socket, I think it's like cartilage.

Similar to what you describe, they will re-connect the labrum where it has torn away from the bone with sutures. This is known as an anatomical procedure, as opposed to the old style non-anatomical procedures they used to use such as Mosha Marc, describes, which masked the problem rather than trying to fix the problem.

You're right, rehab protocol does seem to differ hugely. My doctor has pretty much said the opposite to yours - i must wear the sling for 6 weeks, but start physio after 2 weeks. There are certain movements, such as the pendulum, that I have to start the day after syrgery. As soon as the sling is off I can do CV exercise, and after 3 months return to certain sports. People on other forums I've been on have completely rubbished that and said I shouldn't think about sport for 6 months, and i may want to re-think my ski holiday for next Feb! Oh well, I have chose to believe my own doctor! The physio he's associated with specialises in sports and treat a lot of athletes, so i guess they're used to getting people back into it asap. Whilst the sling is on as soon as it's bearable I plan to walk up the Peak so i don't lose all my CV fitness.

4 weeks off work sounds a lot, is it manual? Assuming no complications I should be able to go back within a few days, the doctor says i should be able to type and use a mouse "almost immediately".
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beanie1 wrote:
....I must wear the sling for 6 weeks, but start physio after 2 weeks. There are certain movements, such as the pendulum, that I have to start the day after syrgery. As soon as the sling is off I can do CV exercise, and after 3 months return to certain sports. People on other forums I've been on have completely rubbished that and said I shouldn't think about sport for 6 months, and i may want to re-think my ski holiday for next Feb! Oh well, I have chose to believe my own doctor! The physio he's associated with specialises in sports and treat a lot of athletes, so i guess they're used to getting people back into it asap. Whilst the sling is on as soon as it's bearable I plan to walk up the Peak so i don't lose all my CV fitness....

beanie1, Only just seen this thread. My son had the same keyhole op about ten weeks ago after dislocating his shoulder a couple of times boxing for the Army. His rehab regime was exactly as you've described & his recovery has been excellent so far but this might have helped more than usual by the excellent daily physio treatment he got at his base. He also did a lot of swimming with a float to keep his CV fitness as he found walking too jarring.

He's now got full movement of his shoulder above & around his head which was amazing after seeing shoulder totally immobilised just a few weeks ago. He's been told 3-6 months for sport depending what it is. He's big into circuit training but won't be able to do pull-up's for 6 months - but he's 6'3"/16st so that's a lot to lift. No more boxing though due to the shock/impact damage.

Good luck for tomorrow.
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Anyone got any tips to wash my hair?!
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You know it makes sense.
beanie1, my son's no.1 cut army haircut made that pretty easy Very Happy. Hope the op went well. Presume you're on some pretty strong pain killers at the moment? My son was on some morphine base stuff for a few days but tried to get off them asap & on to std para/ibu - which was fine until he either knocked his arm or accidently tried to extend it outwards.

Best wishes for a speedy recovery.
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No strong painkillers - just panadol! The pain is really not too bad. The only time it tinges is when I'm doing the pendulum exercises, otherwise it's a dull ache at worst. Straight after the op I had no pain at all, and the nurse said I"d been given a nerve block - i was therefore dreading that wearing off and the pain coming. But it never did, and speaking to the doctor the next day, he said he'd just injected some local anaesthetic which lasts about 6 hours, so this is about as bad as it would get. Until I start physio, which I suspect is when it will start to be more challenging!

I managed to wash my hair yesterday without getting the dressings wet - it was challenging! Lucky my shower has a v low setting! As soon as I can do all that sort of thing, put on smartish clothes and make up etc, i can go back to work. Going to work from home for a few days, and practice those tasks!
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I had my first follow up with the surgeon yesterday. He took the stitches out, moved my arm around, and said he wants me to start physio now due to my lack of pain! Great news! The PT I want to see wasn't available until Monday so I have my first appointment then. Quite excited about it, it feels like the first step!

6 days in the sling down, 5 weeks and 1 day to go...
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beanie1, how's the shoulder.

My son played his first round of golf at the weekend & hit a 320yd drive straight down the middle on the first hole rolling eyes Shot a 78 gross less than six months after shoulder surgery without a twinge rolling eyes
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 Well, the person's real but it's just a made up name, see?
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spyderjon, much better thanks, although still a long way to go. Currently about 9.5 weeks after surgery.

I lost the sling after 6 weeks, but was told another 6 weeks until I could start strengthening due to the extent of my tear. So at the moment just active assisted range of motion exercises. My ROM is coming back very well - I'm at about 90 / 95% of normal now, and the physio is pretty pleased with progress. I can reach my arm behind my back and over my head. I can hold light items in front of my body. he most painful is external rotation. But apart from when I'm doing my exercises, I don't really have much pain at all. Lying on the repaired side at night is a bit painful - I'd say it feels "squashed". I sleep with a pillow beside me, so I'm lying on a squishy pillow rather than the mattress.

In terms of exercise I'm now running and hiking, which is fine, although running downhill jarred my shoulder a bit.

I've been pretty lucky through the whole process with experiencing very little pain.
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3.5 months post surgery and I'm now working on light strengthening exercises. I've been cleared to return to sports and played netball for the first time tonight. Range of motion pretty much back to normal. I don't lift very heavy weights with my right arm, or any heavy weight above shoulder height.

Only thing that still feels a bit painful is sleeping on the operated shoulder.

Other than that all has gone well! The shoulder feels stable again, although I still have a slight paranoia about stretching - this was how I dislocated it the last time!
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Well done beanie1, I had a two rotator cuff tendons sewn back and it was just about the most painful operation I have ever had. It took 9 months for the shoulder to recover fully, but I am glad I have had it done. And I bet you are as well now. Stick with the gentle stretching.
What are the scars like? you cannot see mine.
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Just reminded me my right shoulder op and subsequent rehab for broken ball (chip of the block) and socket (2 places) was the most awful experience. Odd thing was that breaking it wasn't so bad. Even went skiing the next day. 7 hours under the knife and 3 titanium screws later, I wasn't allowed to move it for 3 months. Was on morphine for about 2 weeks - which was nice until the constipation kicked in! About 3 weeks after, it became infected, requiring a heavy bout of antibiotics. 18 months later it still hurts occasionally but I can sleep on it. Movement is OK but I will never bowl for England. Actually, throwing a ball overarm is so pathetic I don't bother. But I can ski!
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