Messed up shoulder

Ok, so I'll start off by saying i'm new on here...just joined last night. I'm 25, live in paradise (Santa Barbara, CA) and am in love with bouldering.

Unfortunately, in my past I have had multiple shoulder injuries from racing downhill bikes and racing motocross. After I "retired" from my racing in 2011, my shoulders (mostly my right) have not bothered me much. Well, 6 months ago I took up bouldering since we have some incredible places with hundreds of problems only 10 minutes from my house. In the beginning I took a good fall to my shoulder from about 15' and dislocated it for probably the 30th time. Now the shoulder pops out reguraly and after multiple MRI's have been told I have a "Bony Bankart Legion."

Does anybody on here have any experience with getting surgery to fix it? Also, any idea on the recovery time for someone who is in pretty decent shape? I'm getting desperate because its not only annoying and painful but really affecting my climbing.

Oh, and I've only finished one V6 but am pretty consistant with finishing V0-V5. I think either way my shoulder will hold me back in progressing but want the opinion(s) of people with more than 6 months experience!

I had the same problem. I dislocated my shoulder over 30 times and wore out the socket. I had the surgery back in 2011. It was a brand new surgery at the time where the use a piece of cadaver ankle bone to rebuild the shoulder socket. The ankle bone works because it has the same symmetry as the shoulder socket and it is a weight bearing bone so it is much more dense. Easier to anchor in with screws and it will last longer.

The procedure worked well for me. It took about a year to fully recover and I have not had any complications. Actually my repaired shoulder now feels better than my other shoulder. I lived with a shoulder that would dislocate for 12 years. I wish I had gotten the surgery sooner.

If you want me to look up the name of the surgery let me know and I can send you specific details.

Good luck!

Recovery from shoulder surgery is kind of a bitch. Expect to be nearly immobile for about 4-6 weeks, and out of action for several months. You'll probably be able to pull very, very gently after 3-4 months, a little harder after 6, but it'll likely be a full year before you're all the way back.

That's the bad news. The worse news is that you absolutely must rest! If you re-injure it, you're not back at Square One, you're back at Square Minus A Lot. Don't underestimate the difficulty or the importance of that component.

The good news is that you're likely to regain full use, which it sounds like you haven't had for awhile. More good news: physical therapy will make an enormous difference, especially if you're faithful about doing what they tell you to.

Just be sure you get a surgeon who understands exactly what you want, not somebody who thinks that fully functional means being able to sit at a computer and/or do twelve-ounce curls!

Good luck.

Also do your rehab after the surgery like your life depends on it. Rehab can be painful! I thought it was worse then the surgery.

IMO you owe it to yourself to get your rotator cuff and scapular stabilizers as strong as possible via a good PT routine before you consider surgery. This is often enough for many climbers. The stabilizing surgeries are good and getting better everyday but are in no way a slam dunk success for everyone.

I would like to hear from a climber that has dislocated their shoulder 30+ times and fixed it through just PT. I tried PT for years and my shoulder kept coming out. I think most shoulders are beyond PT repair after a few dislocations. Anybody out there have long-term success with just PT after mulitpule dislocations?

Thanks guys! I'm also waiting to hear from my insurance as to how much this is going to cost me. I live in a crazy expensive town (my rent is over $1,000 for a crappy outdated apartment in a sketchy area), so money is a big issue for me also!

So it looks like I'll be out climbing for at least 6 months then if I get the surgery? Lame!

I am a physical therapist and a climber who has had previous shoulder injuries. My injuries were nowhere near this severity. I had a labrum tear on the left that I had surgery for, which actually led me to become a PT. Recovery was 100%. Since then, I have torn the right one too, done a little rehab, and am also 100%, without surgery or ever feeling unstable.

Research is showing physical therapy and non-surgical interventions to be as good or better than surgery for many things with clear, significant tissue damage involved. This includes meniscus tears, disc bulges, labrum tears, arthritis (even the dreaded 'bone on bone'), and more.

I think Jon has it right that you should see a PT first. I don't think your prognosis for acceptable recovery with PT is good, though, and I expect you will likely need surgery due to your long history of apparent significant instability and multiple dislocations, as well as you being an overhead athlete. PT will likely improve your post op experience, though, by improving your strength pre-op. Your PT will probably have a few recommendations for surgeons you may work well with. A well skilled surgeon is nIce, but it seems that the patient-provider relationship you have with your surgeon may be strongly linked to your recovery too. Also, an interest area of mine, pain neurophysiology education before surgery may be linked to reduced pain and increased range of motion after joint surgery.

Consider waiting until the new year, since it is so close. Then all of your surgery and rehab will be paid under the same deductible.

I originally dislocated my shoulder snowboarding. After further dislocating the thing from swimming, pull ups, and yoga, I had desided that surgery was the only way to go forward. I had the procedure done October of 2012.

I had a full socket reconstruction. My left arm ended up atrophying pretty good, like 3 inches of muscle loss. I still have not recovered full range of motion, but it's pretty close.

I'm happy I went through with the surgery. I'm stronger now than before. Just gotta keep up on the rehab work and shoulder stability. Hopefully with those I can prevent any further damage.

I have been researching thermal capsular shrinkage surgery. That seems pretty promising.

Be careful of thermal capsular shrinkage surgery. A very knowledgeable shoulder specialist friend of mine warned me away from this. In brief, this is cooking some tissue, and it will never be the same.

Not exactly your problem, but via high school wrestling, I separated my shoulder and tore my labrum. And I couldn't raise my right arm above my head (So no full extension). I had to undergo a few months of PT, but it also lead to working out/stretching with light weights and then into a more strength building work out routine. The Bankart Lesion is a type of labrum injury -- something like what I had, except yours is at the bottom of the labrum whilst mine was at the top. It actually can heal on its own, but if it doesn't, it will just keep recurring until surgery is preformed. My advice? I'd go check with a Physical Therapist if you haven't already. If they can't really do anything to help, undergo the surgery which will put you back in PT with (hopefully) a shoulder that is pretty useful for whatever.

Leo Paik wrote:Be careful of thermal capsular shrinkage surgery. A very knowledgeable shoulder specialist friend of mine warned me away from this. In brief, this is cooking some tissue, and it will never be the same.

Well I will toss in My success story. I was in the middle of an 11D dihedral at the end of the day of hard climbing. My form was off and I was tired, not a good combo. My shoulder ended up rolling forward and POP my shoulder ended up dislocating and some other damage as well the ligaments were quite stretched. Resulting is a super weak and unstable shoulder. I ended up talking with a shoulder specialist and he told me that for my active life style a rotator cuff and scapular stabilizer would be beneficial; I got two recommendations that agreed. So after talking and finding a highly recommended surgeon. Got it fixed up and two days later was at PT. 6 months later I was able to do some light ice climbing, by the end of the first year I was back up to 5.10s and it been two years. I have been a bit cautious with pushing this too fast but I am back to working 5.11s and feeling stronger than ever.

I spent the last year doing clinical outcomes research for an orthopedic shoulder specialist at Mass General in Boston. In regards to evidence based practice-- I would say that thermal capsular shrinkage has been debunked at this point. Additionally, for your condition--a bony bankart, treatment course may vary. Bankart repairs are often successful but have about a 15% recurrence rate based on the literature. Most surgeons in the States are too busy saying 'next' to track their outcomes, so I'm sure your local sports surgeon would say his or her failure rate is closer to 3-4%, which is not in line with the evidence. Anyway, the point is, for anterior shoulder instability with a boney defect there is a technique called a Laterjet procedure, in which the coracoid is transferred to the anterior glenoid (the socket) and acts as a boney block. Additionally the ligament still attached to the coracoid acts as a tether to keep the head from dislocating anteriorly. There are other techniques as described above for doing a soft tissue repair as well as doing an allograft to address bones loss.

The degree to which there is a boney defect can significantly affect outcome. Coming out of the socket so many times can severely damage the bone to the extent that just doing a soft tissue repair would probably be o.k. for a while, but could easily add up to you becoming a repeat customer. Not uncommon that I saw many revision instability surgeries (multiple Bankart repairs) and many of them were due to failure to address bone loss.

Advice about doing PT to strengthen Rotator cuff and stabilizers is not bad advice but not really founded on any sort of evidence (it's ok to act on intuition though). The surgeries will have you immobilized for many weeks... so any short term gains from preparatory PT would probably be lost. I think the most important point here is that it's really worth seeing a shoulder specialist. At very least, it's worth seeing someone who can fully address the bone loss in addition to the soft tissue damage-- this would only be a shoulder-specific trained doc imo.
I can put you into contact with a friend of mine who is shoulder fellowship trained surgeon working in Ventura, CA-- not too far from you. Actually quite lucky that he just moved from Boston out there- He's a really good guy. Send a pm if your interested.

on behalf of the OP and the rest of us, THANKS for the very informative post :)

Just saw your post.

About 25 years ago I had the bankart surgery to stabilize my shoulder from dislocations. The results have been good and the shoulder is stable, and I use is (although cautiously) without restrictions. There is some reduction in range of motion, but my understanding from the doctor is that this was intentional since he knew how I would be using it. As for the recovery, I was back to feeling mostly normal at 6 months and completely recovered with full strength at 1 year. Before the surgery I had about 4 dislocations from different outdoor and recreational activities, with the final one being an overhead Gaston move on a climb.

Just another data point - hope this helps. Feel free to PM me for any questions.

Thanks for all the information guys! I have a lot to think about/research, that's for sure.

From what I am thinking at this point, I might just delay a surgery for the next year or two. I'm used to the pain if it does come out again, and have had huge success using KT tape to help stabilize it after it pops out (also use it if I will be doing a dyno). My only logic for that is right now I have a job that involves a lot of shoulder activity. About two years from now (money/hour requirement willing), I will be applying to become an airline pilot...and that seems to me like a better time to get the surgery.

I'll be sending out a couple PM's to some of you that have offered additional information. Cant thank you guys enough...the doctors I have seen have been very vague about the surgery, recovery, costs, etc....which has had me worried.

5150.... bummer, hope you recouver ASAP....

If your a serious climber, athlete and only 25- and wish to climb/boulder for the next 50 years don't screw around.

Load these names into google.

Kerlan-Jobe...
Neal S. ElAttrache MD

the best in the bizz

I have had many friends get done by the good doc...

I have a ton of experience and insight with this, as I had surgery at a well regarded sports medicine clinic to repair a bankart lesion causing frequent reoccurring left shoulder dislocations that I dealt with for more than a year, dislocating and manually relocating my shoulder almost weekly at times. Sometimes it happened a few times in a week, but it always felt traumatic regardless of how accustomed I was to hopping around like a fool for a few seconds during the initial shock of having my arm severed, then reaching over to grab my wrist and yank my lifeless arm above my head while it felt like it was dipped in napalm.

I lived & worked on Mt. Hood for years and rode (snowboarding) every day until just after 21. At that point, I had broken both collarbones, separated both shoulders multiple times, had AC separations (where the clavicle joins the scapula) on both sides and I could literally cause my shoulder to come out just by kicking a soccer ball.

The most traumatic injurious experience I ever had shredding occurred when attempting a switch backside 180 off a relatively small, maybe 15 ft. cornice on a nearly perfect powder day, and I didn't even wreck. I popped a nose butter 180 to go switch and wind up as I approached the lip, but when I as I popped my Ollie and swung my arm up to spin, it came out of the socket completely... just as I was popping off the lip.

That is usually the moment when all the work to set up your spin has basically been done and you just let your moment do the work while you add your steez, but instead of going for style points, I was flying through the air squirming around like I had just had my arm chewed off by a great white shark while paddling out to surf. Funny thing is, I actually landed on my board, sideways and to an almost dead stop, because when your arm (or any big limb for that matter) removes itself from the socket specifically designed to secure and operate your arm after millions of years of natural selection, you lose sight of everything around you. All I could do was drop everything I was doing and try to get hold of my arm so it wouldn't be swinging around outside of my socket while tearing through ligaments, bone, cartilage and muscle. And not because I'm worried about injury but because all of that really fucking hurts.

All that said, I needed to get that resolved so I could go back to hucking myself off cliffs with a peace of mind that had been robbed from me through a series of sudden, violent assaults on my musculoskeletal system. After going through multiple ignorant doctors who refused to believe that I was actually experiencing full dislocations rather than a subluxation, which is sort of a step below full dislocations and is relatively minor, I finally went to a high quality sports medicine clinic where they understood the concept of TAKING A FKING MRI IF YOU CANT SEE IT IN AN X-RAY . Despite me pleading with numerous Ivy League educated idiots before finding a specialist, telling them I knew this was a real problem not only because I could feel the bone grinding throug cartilage as I jostled it through the displaced muscles and tendons that were struggling to hold it together;I knew because I had been experiencing reoccurring subluxations in both shoulders for nearly ten years, beginning with my right shoulder after annihilating it when I ate shit sliding a handrail on my bmx at the age of 13, then my left when I broke myself off at the mountain a few years later. I haven't been able to put all my weight into throwing a baseball, or been able to finish a full frizby golf game since before I could legally drive.

So, good doctor does MRI, comes back and says... "Did you know you have Scoliosis?", just after revealing to me that yes, in fact, my shoulder is irreversibly fucked due to a severe bankart lesion that isn't just a tear but has also managed to wear a nice groove out of the corner of the socket where my arm slides neatly into as it makes its way out of the hole it has lived in its entire life, like a toddler diving head first down a playground slide. Apparently, my arm, my collarbone, my scapula, my ribs, my upper back, my lower back, my spine, neck and cranium... all this shit, it's connected. Also, it's not good when one of this machine's 5 primary functionality components gets yanked out of a joint repeatedly, especially when it's isolated to one side of the body.

So now my spine is curved. Ok. Frequent traumatic injury that requires manually jostling the broken limb through permanently damaged cartilage while shredding important soft tissue to stop the 'I feel like I'm on fire' pain. Ok, moving on.

I end up getting major surgery, which was described to me as not that invasive because they are doing it arthroscopically; however, I learned that the big difference between a simple bone fracture or injury that doesn't require surgery and actually having someone cut you open and go into your body with tools to fix a major defect is the extended recovery time. I was practically bed ridden for 3 months, strapped into a shoulder brace connected my hoses to a pump that ran ice cold water over my arm, shoulder, chest and back for timed intervals while eating gallons of gogurt to help ease the nausea that accompanies 2 Vicodin 3 times a day.

Once that was done, I did physical therapy and rehabilitation for about a month, went and got a maintenance job downtown and never really spent much time trying to strengthen my shoulder. I left my ski bum life but I still worked as a snowboard instructor on my days off to get a free season pass for a few years after. I had a lot of residual pain as I recovered over the next few years and my left arm was just slightly weaker than before. I play drums and I was never the same after that, as my left hand and arm was just a little off, almost like it was kind of numb. I also started having tolerable but concerning back issues shortly after surgery. For instance, since then when I bend over to pick something up my back will kind of lock up sometimes, like I have a pinched nerve, and I have to kind of stop and carefully stand up straight.

All in all, I would say the surgery went pretty well and would have probably been permanently healed had I really put my mind to getting it strong again, but I continued being young and reckless and irresponsible and after about 5 years, I dislocated it again goofing around trying to jib something. Unfortunately, by this time I had established a career that was taking off and I've never been in a position where I can take the time to have another procedure that requires a 3 month recovery.

It comes out every now and then when I'm playing pickup basketball and I forget that my left arm can't be used for things like blocking shots or corralling rebounds above my head but not directly in front of me. I just started using kinetic tape recently and that has actually been great, if for no other reason than it reminds me that my shoulder needs to strapped down to be stable so I don't go swinging it around. Weigh lifting also makes a huge difference and I find that my shoulder comes out much less frequently if I've been lifting at least 3-4 days a week.

If you are considering surgery and are in a position where surgery is an option for you financially, personally and professionally, I would offer one thing: do. not. wait.