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SuperChloe
March 18th, 2013, 09:28 PM
For the past couple of months, my shoulder has been feeling "loose" or instable. I have some moderate pain and mostly the very odd feeling that it just is about to fall out of its socket. It usually feels okay while swimming but very bad afterwards. I've taken the past week off from swimming in the hopes that things would feel better, but no dice. I do have a call in to my doctor, but I've done some Googling around and it seems like it might be multi-directional instability of the shoulder. Does anyone have any experience with this? I am physically unable to participate in most other cardio (running, step aerobics, anything with any level of impact) so the idea of not being able to swim is very depressing.

mcnair
March 18th, 2013, 10:28 PM
Definitely see the doctor, but it sounds like if it isn't hurting during swimming, only after, that it might be an imbalance of some kind. My shoulders were great for freestyle, but since the majority of my cardio was running for so long I didn't have a lot of stability in the muscles around the ones I used primarily for freestyle... so any little exertion outside my normal range of motion was "dangerous." Swimming the other strokes has helped and doing some stability exercises has helped too. Good luck.

jim thornton
March 18th, 2013, 11:17 PM
A good PT who has worked with swimmers should be able to help you with some rehab exercises to tighten up the muscles surrounding the tendon capsule that keeps your shoulder from popping out. Do not do stretching exercises as this will only make things worse. Some strokes are also harder than others on the shoulder capsule. Backstroke is hard.on the joint for lots of people. Don't worry. You won't have to quit but you will benefit from PT with chords and remarkably lower weights to tighten up the rotator cuffs and scapular stabilizers. Females fo tend to have looser connective tissue than men.or perhaps to say it different. We're less flexible. You need more strength. We.need.more flexibility. Sorry if typos...typing on phone. Goog.luck!

no200fly
March 18th, 2013, 11:34 PM
I have this problem in my left shoulder. I have dislocated it before and i even dislocated it once while racing when I started back in swimming 10 years ago.

There is a set of exercises you can do with shock cords that strengthen your rotator cuff. I have had good success using these exercises when I have problems with my shoulder. I will see if I can find the sheet that shows them and post it. If you see a doctor or physical therapist, they will give you something similar.

A couple of years ago I broke both shoulders in a skiing accident and the exercises they gave me after I healed were basically the same. I think you will find that with strengthening, it should not interfere with you swimming.

swimshark
March 19th, 2013, 05:50 AM
Jim has some excellent points. It sounds like the shoulder needs to be strengthened to help it become stable. A bit of KT tape would probably help as well. A good PT can apply it well.

mermaid
March 19th, 2013, 07:03 AM
See your doctor, follow your doctors' orders. In the event they Rx PT and your insurance plan rejects it (it happens), here is a great video with exercises specific to swimming and shoulder stability. USMS' Dr. Jim Miller put this together with a couple of others.

I hope this helps.

http://www.youtube.com/watch?v=tP7fV_d7cDQ

__steve__
March 19th, 2013, 08:27 AM
My left shoulder first dislocated anteriorally, fully, 20 years ago mountain biking in Moab. A Md passing by on a bike eased my suffering and popped it back in socket. The following decade it dislocated about ten more times where I learned to pop it back in myself.since I have started lifting weights, and more recently swimming, it has not happened in ten years. It does however feel loose at times, but usually following long distances with bad form or overuse. I have to live with this limitation but stability strength training DONE CORRECTLY and proper form seem to keep my arm held tight against its socket.

Continue to avoid whatever is making it loose but just be assured there is hope doing what you enjoy without making it worse or even helping it . Many of the PT movements are excellent, but listen to how your shoulder responds specifically

SuperChloe
March 19th, 2013, 10:14 AM
Thank you all for the advice! I have an appointment with my PCP on Thursday now, but I'm sure she'll refer me either to PT or a specialist for anything helpful. I will definitely look into the strengthening exercises mentioned here. Is KT tape something that I could apply myself (after being shown how to do it)?

no200fly
March 19th, 2013, 10:37 AM
Here is a link with the excercise with bands:
http://ptclinic.com/medlibrary/pdf/208.pdf

swimslick
March 19th, 2013, 01:59 PM
Agree with others, sounds like some PT is in order. If you shoulder is just loose and you haven't actually dislocated it before, then you have a good chance with PT. An MRI might help to determine if it truly is multi-directional and the extent of the looseness, ie, if you have fraying or small to large tears in the labrum. Several years ago I fell and dislocated my shoulder, but unfortunately the damage was severe enough that multiple rounds of PT could not help. My shoulder kept popping out doing random daily things like putting on a shirt or reaching out to close my car door. Finally I got sick of constantly dealing with the painful aftermath so I went through with the surgery 5 months ago. But PT first, for sure!

Swimsci
March 19th, 2013, 02:12 PM
Evaluation by a physical therapist and diagnostic imaging (MRI) sound indicated in this scenario. For instability, improving the stability of the scapular stabilizing muscles (lower and middle trapezius) is likely more important than the rotator cuff muscle. Also, band exercises as indicated in one response treat the rotator cuff muscles are primary movers, which is not their main role! This is a common rehabilitative mistake, don't fall into the trap! Instead exercises of requiring the rotator cuff muscles to stabilize the humerus into the glenohumeral joint are needed to complement the exercises targeting the shoulder as the primary move (ie band exercises).

Here is a link to a piece I presented at the NorCal Coaches clinic:
http://www.swimshop.com/assets/images/PSCC/SwimmersShoulderNorCal.pdf

For more examples, check out www.swimmingscience.net or you can purchase the swimmer's shoulder system www.corswimmershoulder.com, however an in-person evaluation by a licensed also sounds indicated in your scenario.

sunruh
March 20th, 2013, 10:32 AM
because of my own ailment i have become very educated on this subject.
SLAP tear in august '09, but kept pushing it till march '10. finally surgery on it june '10. rehab and started swimming on it oct '10.
swam good in '11 but started having issues around dec '11. started taking ibuprofin like candy. think a lot and then double it. plus aleave on top. ice measured in 10lb per day. did everything i knew to get through italy. then i had to back off the pain meds for fear of my liver. 3 mri's, over a dozen xrays. with 2 orthopeds at 2 different clincs.
finally the 2nd week of jan '13 i started my own search for answers and found there is a difference between "shoulder instability" and "shoulder dysfunction". stability is usually because of a lack of strength in key shoulder muscles. dysfunction is usually because those muscles not working in a proper way. i have serious scapula dysfunction that caused atrophy of my trapezius and other scapula muscles. this atrophy then allows my humerous head to ride up into the glanus bone and force it into the clavicle at the ac joint and i get bone on bone grinding. this screws up my freestyle stroke and causes my fly to be 1 arm weaker than the other.
i have done lots and lots of rehab, but am nowhere close to 100% or even 75%. i cant swim much (ie 400m total for last week). with no training i cannot race. our zone meet is 2 weeks away at one of the best pools in the usa and i will be a timer. nats is not even a consideration and so there is no way i can defend my national title.
so, yes, i can understand your depression.
seek out a pt (or many many youtube videos like i did) that can understand you are a swimmer and how we use our bodies.
dont be affraid to try odd ideas or excercises.
i wish you a speedy and complete recovery.

steve

swimslick
March 20th, 2013, 12:37 PM
stability is usually because of a lack of strength in key shoulder muscles.

actually, shoulder instability is caused by having loose or stretched out tendons and/or joint capsule so that the shoulder does not function properly in the socket. it basically wobbles around and grinds up on stuff that it shouldn't. the looseness/instability is usually caused by traumatic injury (ex: dislocation due to forceful impact), or due to overuse which is more common among swimmers and other athletes. (instability due to overuse can eventually lead to partial or total dislocations down the road.) it can also be caused by age and normal wear and tear - i think i read that shoulder instability is quite high among the senior aged population for instance.

anyway, having strong shoulder muscles definitely helps negate and can sometimes eliminate the effects/symptoms of the instability, which is why it is often hard to diagnose and why PT can be very successful. but the root problem is always there, unless surgically fixed.

steve, do you know the cause of your scapula dysfunction? was it a result of your surgery/recovery? i've never heard about dysfunction before and would like to avoid it if possible lol.

sunruh
March 20th, 2013, 01:47 PM
everything points to my dysfunction being a direct result of my surgery and recovery. in that my muscles were not working correctly and i am suffeciently strong enough to overcome that with other muscle groups to still allow me to swim. well, to a certain point that the atrophy became so bad that i could not over compensate. none of my post-surgery rehab included anything that i can think that would have prevented this. most unfortunate for me.

from about 2:11 on in this video ->
http://www.youtube.com/watch?v=mve_pIrXGyo gives some good examples of what i have.
my brother is a PT (but does not live in the same city i do) and i sent him videos of my back in motion. he also works as a personal trainer in a gym. in the few days after he saw this video he tested his clients and most of the muscular men had issue where the women did not. no i am in the extreme area. where my neck is not the same on my bad side as it is on the good side. in a tshirt you can visably see the atrophy.

SuperChloe
March 20th, 2013, 10:14 PM
I really appreciate all this info! I have an appointment tomorrow morning and I'm armed with lots of info.

sunruh
March 21st, 2013, 08:20 AM
I really appreciate all this info! I have an appointment tomorrow morning and I'm armed with lots of info.

let us know how it goes. i am in the process of trying to see yet a 3rd ortho.

SuperChloe
March 21st, 2013, 09:07 AM
Okay, my PCP thinks it's bursitis of the AC joint. I will start PT in about 2 weeks (I'm going to be away for break). I have an NSAID regimen and I'm supposed to ice, ice, ice. She said I can still swim but to cut wayyyy back until I'm healed, mostly doing kicking. I can live with that if all it is is bursitis! I am slightly skeptical since I have been having the looseness feeling, but I'm going to give this a shot and see how it goes.

Michael Heather
March 21st, 2013, 10:17 AM
Interesting diagnosis. I am not a doctor, so I can only tell you what I have experienced and/or have been told.

Stretching: done correctly, it will not affect your condition. The stretch is for the muscles, not the joints.

Loose feeling with attendant pain could also be a stroke-related issue. Most doctors and PTs are not familiar with our unique use of muscle groups, but a good PT can actually correct your stroke mechanics through exercises and positioning. I had one session with a PT that removed all of my pain, simply by his observations of my stroke (lying on a table) and suggestions for change. I don't claim that this will be the case for you, but it is possible.

Swimming uses a lot of muscles in the shoulder and chest, but often we forget the many little muscle groups in the back that hold the shoulder together. You will likely do a lot of exercises to develop those.

Best of luck and don't rush your recovery. There is plenty of time to swim.

sunruh
March 22nd, 2013, 08:16 AM
Okay, my PCP thinks it's bursitis of the AC joint. I will start PT in about 2 weeks (I'm going to be away for break). I have an NSAID regimen and I'm supposed to ice, ice, ice. She said I can still swim but to cut wayyyy back until I'm healed, mostly doing kicking. I can live with that if all it is is bursitis! I am slightly skeptical since I have been having the looseness feeling, but I'm going to give this a shot and see how it goes.

while i am no doctor, i find it very odd that is the diagnoses.
http://www.webmd.com/pain-management/arthritis-bursitis
if you can go through pounds and pounds of ice (or bags of frozen peas/corn) like have and bottles of ibuprofin you will quickly learn that is either not the correct diagnoses or not the right treatment. for me even weeks off did nothing.
have someone video your back in motion (ie military press motion) and compare it to the video link i posted above.

tomtopo
March 22nd, 2013, 10:02 AM
A great article on the issue of Shoulder instability.
Shoulder Injury Prevention
Presented by USA Swimming and the Network Task Force on Injury Prevention. (April 2002)
Introduction by Scott Rodeo, MD // Chair of the USA Swimming Sports Medicine/Science Committee and Team Physician for the NFLís NY Giants


http://www.usaswimming.org/ViewMiscArticle.aspx?TabId=1645&mid=702&ItemId=700

sunruh
March 22nd, 2013, 11:13 AM
yes i do all of those. have for a while. as in years.

with Thera-Bands(tm) there is a color coded system of increasing resistance. i am way past the gold level.

no200fly
March 22nd, 2013, 02:34 PM
let us know how it goes. i am in the process of trying to see yet a 3rd ortho.

Steve -

Here is a video that discusses various causes of shoulder pain and treatment. Look at his discussion of SLAP tears and repairs at about 19 - 20 minutes in.


http://achesandjoints.org/2011/03/17/burkhead-shoulder-pain/

sunruh
March 29th, 2013, 09:26 AM
i saw a 3rd orthopod yesterday.

on top of whatever is wrong with my shoulder socket, all of my additional symptoms say i also have TOS.
http://morphopedics.wikidot.com/thoracic-outlet-syndrome

bonus for me!!!

and all of the range of motion strength tests showed that my doc is weak. ooops, um, i mean that i am not weak :D

i am to get an injection of moose snot in my shoulder joint with sonagram guidance next thrusday and then wait till may 13th.

i could have been chewing advil like candy and killing my liver and gone to Indy. oh well. it's only 1 arm, i've got another.

steve

ElaineK
March 31st, 2013, 09:59 PM
i saw a 3rd orthopod yesterday.

on top of whatever is wrong with my shoulder socket, all of my additional symptoms say i also have TOS.
http://morphopedics.wikidot.com/thoracic-outlet-syndrome

bonus for me!!!

and all of the range of motion strength tests showed that my doc is weak. ooops, um, i mean that i am not weak :D

i am to get an injection of moose snot in my shoulder joint with sonagram guidance next thrusday and then wait till may 13th.

i could have been chewing advil like candy and killing my liver and gone to Indy. oh well. it's only 1 arm, i've got another.

steve


Ohhh noooo! :bighug: You have my sympathy- and, empathy; been there, done that. It was not swimming related, but I had surgery for my TOS in 2003, long before I returned to swimming in 2010 after 31 years off. Swimdoc also had surgery for his TOS last year and is back in the pool. He is also in Texas (Houston), so you may want to send him a PM.

Good luck!

SuperChloe
April 1st, 2013, 10:12 AM
I went to practice for the first time in a couple weeks and even streamlining or kicking with a kickboard was very uncomfortable. I'm still having the uncomfortable feeling that my shoulder is too loose. I'm going to mention it to my physical therapist (who I will meet in three days, thank God) and possibly check back with my doctor. It feels wrong all the time. Ugh.

SuperChloe
April 4th, 2013, 07:42 PM
I had my first physical therapy appointment today. She said that my shoulder is very, very lax and there is a ton of inflammation in my shoulder and collar bone area. She gave me some really simple stretches to do and a 24-hour iontophoresis patch delivering anti-inflammatories. I'm not supposed to swim (kicking is okay) until I see her again next week. Has anyone else ever had this patch? It's really interesting to me and I'd love to hear other peoples' experiences. Also, has anyone else ever had any collar bone issues? Mine is swollen up so much that I look lopsided right now.

sunruh
April 4th, 2013, 08:32 PM
kicking with a board or kicking with your arms overhead (ie backstroke kick) or kicking with arms at the side?

i would HIGHLY suggest no board!!! if backstroke then far apart with hands (i've done this for 3+ years now).
or maybe just arms at side.

today i had a sonagram guided injection into my right shoulder socket. very nicely done and not really any pain and i *** H A T E *** needles.

if this works that means i probably need shoulder surgery again. if it doesnt it probably means i need neck or TOS surgery.

can this crazy merry go round stop please?

steve - with my 100 swiss francs

Atlantic
April 4th, 2013, 09:13 PM
I had my first physical therapy appointment today. She said that my shoulder is very, very lax and there is a ton of inflammation in my shoulder and collar bone area. I'm not supposed to swim (kicking is okay) until I see her again next week.
Getting rid of your kickboard will alleviate lots of stress placed on a weak shoulder. I stopped using one in college and never looked back. Kicking on my back has significantly improved my SDKs during my races (bonus)! If u must have a board, finis has a mini triangle shaped one that will not bug your shoulder as much. Ice as often as you can and stay on top of those anti-inflams. Good luck!

fdtotten
April 4th, 2013, 09:36 PM
Agree about getting rid of the kick board. Just wanted to say that for many years now I have not used a board with kicking, doing the dolphin, breaststroke, and flutter kicking on my back, and more recently I am also kicking on my front side with the snorkel. The fins are useful too for kicking while resting the arms, single arm swimming and/or combining kicking-sculling-drills. I wish everyone the best possible outcome with the shoulder issues towards pain free enjoyable swimming.

__steve__
April 5th, 2013, 11:11 AM
I wish everyone the best possible outcome with the shoulder issues towards pain free enjoyable swimming.
Me too!

Develop shoulder related knowledge, strive for form, and simply pay attention to how they feel.

I'm lucky to have 1.75 of my shoulders remaining, I will work to keep that many in the future