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ButterflySwim01
July 17th, 2004, 02:23 AM
I'm love the IM and Butterfly but about 2 years ago I dislocated my right shoulder and ever since then it won't stabilze, it keeps slipping slightly out of place when I swim (which kinda really hurts ;) ) and I was wondering if any of you could recommend some drills and that I could do to rebuild the muscles around it to stop that.
Thanx
Oh yeah and I've already done PT but no one has really been able to help.

coach guy
July 17th, 2004, 11:56 AM
How bad was it? Was there complete or partial tearing of the ligaments? How did you do it?

I also dislocated my shoulder a few years ago. I have been dedicated to strength training and stretching to keep it in place since.

gull
July 17th, 2004, 02:22 PM
The USA Swimming web site lists sports medicine specialists around the country. It's not a drill, but I'd suggest you get in touch with an orthopedist who specializes in sports medicine. Otherwise you may just be spinning your wheels (or worse). Not every injury can be treated with PT alone.

ButterflySwim01
July 17th, 2004, 06:51 PM
well you see my shoulder has always been odd, I could dislocate it on command and it would never hurt. However during a swim meet on the first lap of my 200 IM it dislocated and came back in midstroke, which had never happened before. I didn't tear any ligaments, I just streached them out. So I was told by my doc to keep it in a sling until I saw an orthopedist a month later. He told me that I had tendonitis and gave me cortizone injection. This did make it so that my shoulder could move without pain and I could do some PT to get regular motion back, but I still have trouble swimming. So here I am 2 years later, I've gone through 2 injections of cortizone, 3 months of PT, and the only thing that makes it so that I can swim without major pain is my bi-monthly trip to my chiropractor (who also helps me with my lower back pain). I'm only 18, I should be able to swim normally again, but no one has been able to help me swim like I used to.

gull
July 17th, 2004, 07:04 PM
My orthopedist recommended a minimum of six months of PT before considering arthroscopy. I didn't see much improvement at first--it took about six months to really start to notice a difference. It's been a year and I'm continuing to improve--and still doing the exercises. Many cases of swimmer's shoulder are due to a muscle imbalance; the exercises are designed to strengthen the rotator cuff and stabilize the scapula. A physical therapist who has experience in sports medicine can design and demonstrate a program that you can do at home.

ButterflySwim01
July 17th, 2004, 07:12 PM
thanx, it helps to know that other people take a while to recover. I'll look into getting more PT.

gull
July 17th, 2004, 10:35 PM
The key to successful physical therapy is consistency--doing the exercises at home daily. The rotator cuff muscles are fairly small, so it takes awhile to build them up. For the same reason, it doesn't require a lot of weight/resistance.

EricR
August 31st, 2004, 10:04 AM
Perhaps my story will help.
My shoulder had partially dislocated perhaps 5-10 time over a 5 year period after a snow skiing accident. The partial dislocations usually occurred as a result of moderate trauma or abnormal arm/shoulder movement accompanied by a lot of pain. During the 5 yr period of shoulder instability, I swam competitively which included a fairly aggressive weight lifting program with minimal stability (no dislocations) problems during training and competition.
In Fall of 1995 I finally went to see an orthaepedist after dislocating my shoulder putting on chest waders (that was the final straw). In December of 1995, I had arthroscopic surgery on my shoulder. The surgeon found minimal tear/damage to the rotator cuff and diagnosed the problem as being caused by loose ligaments. He performed a procedure in which the ligaments were shrunk using electrically generated heat (I can't remember the name of the procedure). As I recall, I was his first patient using this new procedure of using heat to shrink the ligaments to stabilize the shoulder. After surgery, I wore a sling for 6-weeks. The doctor did not have me do PT because he was afraid the PT guys would try to restore full flexibility in my shoulder, which could undo the effects of the surgery. Post operative pain was minimal and I have had no long-term pain.
During the post operative visits, he assessed the success of the surgery by having me hold my arms to the side at 90-degrees with my fore-arms vertical. Then he would have me rotate both arms as far to the rear as possible. The "good" shoulder could rotate approximately 5-degrees to the rear, whereas the formerly unstable shoulder could only rotate to a vertical position.
In the 9-years since the surgery I have had no dislocations. I have had a couple mild traumas that may have tested the stability of my shoulder in those years. In all cases, the shoulder remained stable. I can still only rotate my fore-arm to a vertical position as described in the test above whereas my "good" shoulder will rotate approx. 5-degrees to the rear. In those 9-years, I have not done any formal swim training or other activity on a regular basis that would put strain on my shoulder. I have lifted weights very sporadically with the longest period of regular weight lifting being approximately 3-months. The only problem I have had is general weakness, as compared to my "good" shoulder. On one occasion several years ago I saw an orthopedic specialist due to a feeling of instability in my shoulder. The orthopedist conducted stability checks on my shoulder and found that the shoulder was stable. The doctor believed that I had irritated my shoulder by typing at a keyboard for long hours at a computer. He suggested this was due to the weakness in my shoulder. This is the only time I have seen a doctor about my shoulder since the surgery.
I have recently started training for a triathlon, which got me back in the pool for the first time in about 10 years. No problems with the shoulder except tightness in the streamlined position and weakness. I have started rotor cuff excercises to over-come the weakness and prevent stretching of the ligaments which might cause future instability. I am considering getting involved in Masters Swimming if I can fit it into my schedule. I have a little apprehension about how my shoulder will hold up with regular strenuous swimming. I am currently trying to get in contact with the orthopaedist who did my surgery to see if he has any recommendations or warnings for me.
Butterflyswim01 - I wonder if the orthopaedist you saw ruled out arthoscopic skrinking(tightening) of the ligaments for your situation. Perhaps he wanted to give PT a try first. I would see an orthopaedist again and ask him/her about procedures to tighten ligaments like the one I had. I have been very pleased with my results, but then again, I have not done any butterfly stroke with my post-operative shoulder to find out if it will hold up under that kind of stress. Good luck.

msgrupp
August 31st, 2004, 10:46 AM
Thermal Assisted capsular shift? The equipment was made by a company called ORATEC which has since been purchased by Smith & Nephew. How do I know? Same surgery in 1998 for a shoulder capsule that was loose.

I don't know if they're still doing it. You're one of the earliest patients I've heard of (since you said 1995). My doctor was one of the clinical test sites and I was told about the surgery by a friend who saw an article in US News & World Report in 1998.

It's worked for me--I only spent about 3-4 weeks in the sling---it was supposed to be 2 weeks but at the 2-week mark--doctor felt I needed additional time due to age (I was in my mid-40s). Therapy was started about 1 month after the surgery with passive movement done by the therapist.

I don't know what the long term succsess is for this procedure. My doctor did a number of followup studies (funded by various organizations and then published in peer reviewed journals) and he's still thrilled that 6.5 years later it is still holding up.

I wasn't a butterflier before the surgery and still don't do it. Sometimes the shoulder tires but doesn't dislocate anymore

EricR
August 31st, 2004, 02:31 PM
msgrupp,
You've got me really curious now. Thanks for responding to the post. I had my surgery my seniour year in college when I was 21. The doctor recommended surgery in my early consultations, however, he explained that he didn't know what the fix would be until he got in and discovered which way my shoulder was coming out (fore or aft) and the extent of the damage already done. The worst case involved cutting ligaments, drilling through my scapula, and reattaching with screws to the back of my scapula. This procedure would have a 20% chance of failure he told me. He did not mention the thermal shrinkage until minutes before I was put under. He explained that a colleague was doing this procedure in california with early success. He wanted to give it a try and said I may be a good candidate. He asked for my o.k. to do the procedure for the first time. He also explained that the alternative might be pretty drastic and that he could always go back in and do something else (In other words, he would not be burning any bridges). I said go ahead and I feel very lucky to this day. I'm thinking that after seeing that I had no significant damage to my rotator cuff, he would have either abanded the surgery and told me to come back when things got worse or he would have done the drastic cut and screw surgery with a sizable chance of failure. Apparently I found just the right doctor at just the right time.
The doctor asked me to come back and see him in a year so he could track the success of the new procedure. I graduated from college the following spring and moved out of the state. I also went from my parents health insurance to an interim emergency-use only insurance until I landed a permanent job a year and a half later. Regretably, I never contacted the doctor again until I sent an e-mail to his office yesterday. I'm anxious to see if he will respond.