Shoulder Subluxation, Tips for Managing Going Forward

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Sorry to hear about your shoulder. I'd been subluxing mine since I was kid, just thought it was normal until talking with my surgeon to repair a labrum tear after a couple of dislocations. Looking back I realize that I had been subluxing as a technique to help out on reachy cruxes...not good! In order to prevent further injury you need to keep hyper aware of what climbing positions are bad and avoid those positions. It's tough to do and makes a lot of climbs harder than they need to be, but it'll keep you in the game. For exercises the key for me is high reps and low to moderate weight.

Does your PT discuss proper shoulder stabilization when doing those exercises in your link? I am not a PT or doc, but I think pulling the scaps down and in is an important component to building stronger and more resilient shoulders.
In my experience I had scrappy shoulder balance, which unfortunately was made worse by climbing and strength exercises. I experienced on-going pain, injury etc, until I finally figured out how to stabilize my shoulders properly and activate my lower traps. Now I am a fanatic about doing this for all motions but esp pull-ups, lat-PD and every other shoulder exercise I do.

+1 for the Old man River Advice!

I have re-habed(not real word) a labral tear sans surgery for 7 years using many of the techniques described above. The tubing pulls are referred to as internal and external rotation and can also be done with a pillow or towel inbetween your arm and ribs to insure proper technique.

One to add is sitting with your back flat against a wall and Sloooooowly raising and lowering your arms at 45 deg angles as high and as low as possible without your arms losing contact with the wall serface> 12 reps x 3day.

Old Man River the most important thing is to be honest with your therapist. Make sure he/she knows what activities you are doing as it appears you aren't going to "rest" the injury. Then once your joint is stable again it is imperative that you continue your rehab routine to maintain that stability indefinetely or at least until having a stable shoulder joint isn't important to you anymore. Good luck!

I had the same problem 25 years ago. Back then there was no concept of PT or rehab. My surgeon just did a surgery to keep my shoulder from being able to sublux. He moved some muscles and a small bone around. That kept the sublux from happening but it didn't keep my shoulder from trying to sublux. I didn't climb back then.

Jump forward to two years ago. I had to get a partial replacement on that shoulder because the head of my humerous wore out from moving around so much. There is no cartalidge in that joint so I had bone rubbing on bone. Now, I have bone rubbing on titanium. My shoulder does feel better than it has for 15 years or so though.

As a result of the whole mess, I have a limited range of motion and can't lift my arm straight up over my head. That makes for some really awkward movement on vertical climbs. Overhanging and low angle stuff isn't too bad but straight vertical can be extra challenging sometimes.

Lesson learned - whatever you do make sure you take care of that joint and don't let that extra movement continue to happen or you could wear it out and cause yourself all kinds of problems.

Definitely make sure you don't rush back into high-impact activities. I had the same thing happen a few years back, and was advised to follow essentially the same plan you described. I did for a while but was still climbing, snowboarding, etc. after it dislocated about 10 more times i ended up needing stabilization surgery and it still doesn't feel quite back to baseline yet. Take your time and do those PT exercises!

OldManRiver wrote:
"PART I
"1. Isometrics:
"A. Adduction: With a pillow between ...
... etc ...
"Appreciate genuine feedback on this"
-----------------------------------------

To me that list of exercises looks like a systematic (though not complete) enumeration of possible shoulder motions ... for general strengthening of the shoulder, but without prioritization for relevance to the climbers' subluxation problem.

I'm not any sort of physical therapist or medical doctor, just someone who's spent lots of time working on human + robot mechanical motions, and my instinct is that ...

the list looks too "tidy", too neatly systematic, not what I would expect from deep insight into the messy complexity of the subluxation problem.

I'd love to see some serious attempt at scientific justification for how each of those exercises is specifically relevant to support for the climbers' subluxation problem.

A slightly different perspective: It does not seem credible to me that each of those exercises is equally relevant to subluxation. Especially since several of them are pairings of one motion with its opposite. Perhaps I can believe that both members of one of those pairs are equally relevant, but very hard to believe that both members of every oppositional pair are equally relevant to subluxation.

That's a lot of exercises to do, so I sure would want someone to give me a prioritization (with a plausible scientific justification) -- at least for days when I was short on time.

Sorry but somehow I've lost the links I had to web pages which seemed to have a shorter list of more targeted exercises - (tho I'm not qualified to say if they were correctly targeted). But anyway that's the sort of thing I would look for.

Or if you've got lots of free time and you want extra security, do lots of different exercises (? including others not on the list given above in this thread - perhaps from several different websites ?) with the hope that some of the them are actually relevant to the climbers' subluxation problem.

Ken

Bumping this thread to see if anyone else has notes here.  Sublux'd 5 times in the last year.  2 occurred while shock-loading my shoulder climbing, but one occurred serving a volleyball overhead.  PT has given my strength/stability exercises, and MRI confirmed no massive damage (partial labrum seperation from surrounding muscles or something - no labrum tear though).  Options are surgery with a 6 weeks in a sling, followed by 6 weeks of no weight bearing, and then a year of rehab, or just "be careful".  That was an easy choice.  

Matthew Bertolatus wrote: Bumping this thread to see if anyone else has notes here.  Sublux'd 5 times in the last year.  2 occurred while shock-loading my shoulder climbing, but one occurred serving a volleyball overhead.  PT has given my strength/stability exercises, and MRI confirmed no massive damage (partial labrum seperation from surrounding muscles or something - no labrum tear though).  Options are surgery with a 6 weeks in a sling, followed by 6 weeks of no weight bearing, and then a year of rehab, or just "be careful".  That was an easy choice.  

I had an ongoing shoulder sublux issue for years that eventually contributed to the closest call I have had climbing.  I walked away with a severe rope burn, but avoided the life changing head first ledge fall by a couple of feet (owe my life to a good belay and a solid camalot, the only piece in on a very easy pitch).  I opted for surgery immediately afterward.  Bankhart and slap repair.  The recovery sucked, but no regrets now.  Interestingly, I think that my surgery was around the time of this original post. 

smellygregman wrote:

I had an ongoing shoulder sublux issue for years that eventually contributed to the closest call I have had climbing.  I walked away with a severe rope burn, but avoided the life changing head first ledge fall by a couple of feet (owe my life to a good belay and a solid camalot, the only piece in on a very easy pitch).  I opted for surgery immediately afterward.  Bankhart and slap repair.  The recovery sucked, but no regrets now.  Interestingly, I think that my surgery was around the time of this original post. 

I had a complete dislocation about 2 years ago and was able to manage it with pt and kept on climbing up until I had a subluxation a few weeks back. My shoulder feels like it will pull out if I put any weight on the joint. I am scheduled to have the surgery to repair the labrum and fix a Bankhart lesion. The surgeon says I will lose some range of motion when reaching back behind me. The surgeon says he has done this type of surgery on climbers before but I'm still nervous that I will not be able to climb as well because of a loss of mobility. Did you lose any mobility in your shoulder? If so was enough to impair your climbing?

Wyatt Peake wrote:

I had a complete dislocation about 2 years ago and was able to manage it with pt and kept on climbing up until I had a subluxation a few weeks back. My shoulder feels like it will pull out if I put any weight on the joint. I am scheduled to have the surgery to repair the labrum and fix a Bankhart lesion. The surgeon says I will lose some range of motion when reaching back behind me. The surgeon says he has done this type of surgery on climbers before but I'm still nervous that I will not be able to climb as well because of a loss of mobility. Did you lose any mobility in your shoulder? If so was enough to impair your climbing?

When I had my shoulder surgery after 5 complete dislocations, the surgeon told me he was going to purposely tighten the joint capsule to reduce my ROM and prevent further dislocations. I worked really hard in post-op PT to get most of that ROM back. While it is definitely restricted, I am climbing harder than ever!

I had surgery after dislocation in 2007. Initially had nerve damage to deltoid. The surgery was put off for 6 months. The shoulder was unstable and deltoid was soft. Surgery. Detoid fired again i couldnt be happier. I like chin up isometrics to work on the anterior portion of the shoulder. Maintain good anatomical position. Its easy for me to keep doing them because it feels like a workout not like theraband activities 

Zac Clark wrote:

When I had my shoulder surgery after 5 complete dislocations, the surgeon told me he was going to purposely tighten the joint capsule to reduce my ROM and prevent further dislocations. I worked really hard in post-op PT to get most of that ROM back. While it is definitely restricted, I am climbing harder than ever!

Thanks that makes me feel a lot better! I have the surgery scheduled for December 2nd. Maybe I will start a new post detailing my struggle for the next poor soul lol.