Shoulder injury while climbing

Hi all,

Background: I was bouldering at the gym 1.5 weeks ago when my left shoulder dislocated. It wasn't very painful and I accidentally popped it back into place. I went to the ER afterward and was x-rayed and there was no Hill-Sachs lesion and the doctor said a sling wouldn't be necessary and I could get back to climbing; although, he did say to see an orthopedic specialist if it dislocated again. He also said he suspects it was a subluxation and not a full dislocation. 

I have full range of motion, and I do feel some pain in my shoulder almost exclusively when I reach my arm around my back and place it as high as I can on my back. I've been doing the stretches recommended by the ER doctor, and I've even done some easy climbing and I feel that I can do 95%+ of moves with confidence in my shoulder (the remaining 5% are usually just dynos).

As for shoulder instability, I currently feel like I definitely could not comfortably hang from one arm, but I can do pull-ups, pushups, and overhang boulders as long as I am careful not to apply too much weight to my left arm. Each day, my shoulder feels better, especially after stretching, doing push-ups/pull-ups and climbing.

Most folks I've read with shoulder dislocations have said they were in a sling for weeks and they that there was extreme pain, but my experience has not been the same. The doctor at the ER did say that I got lucky, but I think he was just referring to the fact that there was no Hill-Sachs lesion and that I was able to (again, accidentally) get my shoulder back into place.

I have an ortho appointment on Thursday and I fully intend to listen to the doctor/PT if PT is recommended; I'm just curious if anyone here has had similar experience to me, and maybe if they could say what they think I can expect to hear from the ortho.

Thanks =)

Yes - you almost certainly had a shoulder subluxation aka a partial dislocation.  This why you could get it back in yourself, and why it doesn't hurt all that bad now.  I would go see a PT, get some shoulder stability exercises (band work and what not), and stick to those.  Hell you can just google it and probably get a decent selection of exercises just from the webs.  Also just because you can climb, doesn't mean you should - give it a couple weeks off.  

The good news you shouldn't see a big loss of strength or long term pain, BUT the bad news you're likely to continue to see this to happen, especially on dynos or big deadpoints. After my first I've reliably done it every ~6 months thereafter, sometimes in expected situations but once just reaching overhead (barely weighted) and once serving a volleyball. 

Ortho won't be able to tell you much absent an MRI, and even then they'll say "we could probably operate and 'fix it' [meaning repair the small tears what occur each time this happens, and perhaps tighten ligaments], but that means 6-9 months no climbing".  Go follow Sean McColl on IG, he had this same issue and just got the surgery and is very slowly rehabbing.  

Math Bert wrote:

Yes - you almost certainly had a shoulder subluxation aka a partial dislocation.  This why you could get it back in yourself, and why it doesn't hurt all that bad now.  I would go see a PT, get some shoulder stability exercises (band work and what not), and stick to those.  Hell you can just google it and probably get a decent selection of exercises just from the webs.  Also just because you can climb, doesn't mean you should - give it a couple weeks off.  

The good news you shouldn't see a big loss of strength or long term pain, BUT the bad news you're likely to continue to see this to happen, especially on dynos or big deadpoints. After my first I've reliably done it every ~6 months thereafter, sometimes in expected situations but once just reaching overhead (barely weighted) and once serving a volleyball. 

Ortho won't be able to tell you much absent an MRI, and even then they'll say "we could probably operate and 'fix it' [meaning repair the small tears what occur each time this happens, and perhaps tighten ligaments], but that means 6-9 months no climbing".  Go follow Sean McColl on IG, he had this same issue and just got the surgery and is very slowly rehabbing.  

Thanks for the reply; I think I will go straight to a PT, since the ER doctor already told me it seems to be fine for now, and to go see an ortho if it dislocates again. How are you managing with the dislocations every 6 months? Are you still able to climb as hard as you were before?

I had a subluxation leading to a likely labrum tear. I didn't see a doctor forever and kept climbing on it and basically was really dumb with it. Even after doing all that further damage eventually I got smarter and rehabbed it and strengthened it and it's fine now, I would say 98%. I tweaked it sport climbing the other day but I was able to just rest it two days, load it on the hang board the day after, and then get back to regular climbing after that. I used to be scared of gastons or shoulders moves but I love them now. I found that bouldering is better for my shoulder even though a lot of people say the opposite. Sport climbing you're generally doing moves tired and that's when I would always re-tweak it. Bouldering and high intensity but low volume strength training has been the best, way better than the resistance band stuff, I don't know how much that actually helped (maybe a little initially). Probably not a good idea to go right into heavy strength training when you're still in the initial recovery phase but you will probably want to get there eventually. Anyway everyone is different so who knows. 

Jared B wrote:

Thanks for the reply; I think I will go straight to a PT, since the ER doctor already told me it seems to be fine for now, and to go see an ortho if it dislocates again. How are you managing with the dislocations every 6 months? Are you still able to climb as hard as you were before?

I'm a little hesitant on big right handed deadpoints and crazy stemmy stuff that exposes the shoulder joint, but otherwise no issues.  Focus on shoulder mobility exercises AND antagonist training (overhead presses, push ups, etc).  However best thing that's ever happened to it was COVID - gym closures forced me to take about 3 months off, and it's been significantly better since then. 

I have a history of 10+ subluxations, bilaterally. For me it came down to posture and muscle imbalance.

Docs are useless. Go straight to PT unless you need a doc first for insurance.

Buy a Body Blade, and make your PT give you exercises with it.

Take up alpine climbing and trail running, slack off on the roof problems and campus dynos.

Thanks for all the responses. Unfortunately couldn't go to PT without seeing the doc first, but he said my shoulder is doing really well given it's only been 3 weeks since the injury; he said to do PT and don't climb for 6-8 weeks and the shoulder will likely never be an issue again. That's a long time to take a break from climbing, but it's a small price to pay to have a fully healed shoulder. 

Jared B wrote:

Thanks for all the responses. Unfortunately couldn't go to PT without seeing the doc first, but he said my shoulder is doing really well given it's only been 3 weeks since the injury; he said to do PT and don't climb for 6-8 weeks and the shoulder will likely never be an issue again. That's a long time to take a break from climbing, but it's a small price to pay to have a fully healed shoulder. 

I hope that is the case for you, but I would advise really getting to the root cause of why it happened. Your PT should be able to help you understand the mechanics of how it happens, and the positions which are likely to precede a subluxation. If it happened in a fall or similar, then maybe it was just a fluke; if it was caused by something like a muscle imbalance, tightness, etc, then prevention may need to be a normal part of your training from here on out.

My first subluxation happened propping myself up in bed with my arm. Another memorable one was trying to take my shirt off at a noisy gym comp. I got stuck, shouting and swearing, until my friend helped me get free. If you sublux doing things like that, then there's a problem.

The best cure is prevention.  Shoulder injuries are the second most common, fingers are first.  I have been doing these exercises for the last two years, usually before I hangboard for a warm up.  And I feel that my shoulders are bombproof and I am 59 y.o.  Check them out.

Eric Horst: 10 minute shoulder exercises.

https://www.youtube.com/watch?v=G-_WiyE9HDg

J C wrote:

I hope that is the case for you, but I would advise really getting to the root cause of why it happened. Your PT should be able to help you understand the mechanics of how it happens, and the positions which are likely to precede a subluxation. If it happened in a fall or similar, then maybe it was just a fluke; if it was caused by something like a muscle imbalance, tightness, etc, then prevention may need to be a normal part of your training from here on out.

My first subluxation happened propping myself up in bed with my arm. Another memorable one was trying to take my shirt off at a noisy gym comp. I got stuck, shouting and swearing, until my friend helped me get free. If you sublux doing things like that, then there's a problem.

I was climbing past the point of exhaustion and really didn't want to let go of a downpulling crimp; but I was so tired that I started to fall off and basically pulled my arm with my entire bodyweight. That's how it happened for me. Currently, no daily activities affect my arm (taking shirt off, putting on a backpack, seatbelt, etc.)

James Robertson wrote:

The best cure is prevention.  Shoulder injuries are the second most common, fingers are first.  I have been doing these exercises for the last two years, usually before I hangboard for a warm up.  And I feel that my shoulders are bombproof and I am 59 y.o.  Check them out.

Eric Horst: 10 minute shoulder exercises.

https://www.youtube.com/watch?v=G-_WiyE9HDg

Will do! Thanks! Have you had a shoulder injury before, or do you just do these for prevention?

Jared B wrote:

Will do! Thanks! Have you had a shoulder injury before, or do you just do these for prevention?

Since I am 59 y.o., when I got back into climbing I started a full tendon exercise program because a injury may end climbing all together.  I also do a collagen program 45 minutes before any climbing training.  I use two small scoops of Amazon collagen(I do the Bolivian cheap stuff, not Chinese due to heavy metals.), two small scoops of whey protein, and two "pill size" scoops of vitamin C powder from Amazon.  The vitamin C is very important since the collagen won't work without it.  Again, Horst has a video on this, however, I don't use his because it it crazy expensive compared to the Amazon stuff. He does give out great information so I wouldn't fault anyone from supporting his product though.  Horst will say that the cheap collagen, what he calls "grandmother's collagen" is missing some amino acids but the one he is talking about is in the whey protein.  If you look at his products nutrition chart and compare it to grandmother's stuff and whey protein you can see that put together they match up.  The study he quotes compared collagen with and without vitamin C and found that it didn't work without the vitamin C.  They used unflavored Jello (gelatin) and orange juice for the studies.

Eric Horst: Tendon Nutrition.

https://www.youtube.com/watch?v=sIbotruEh2s  

James Robertson wrote:

Since I am 59 y.o., when I got back into climbing I started a full tendon exercise program because a injury may end climbing all together.  I also do a collagen program 45 minutes before any climbing training.  I use two small scoops of Amazon collagen(I do the Bolivian cheap stuff, not Chinese due to heavy metals.), two small scoops of whey protein, and two "pill size" scoops of vitamin C powder from Amazon.  The vitamin C is very important since the collagen won't work without it.  Again, Horst has a video on this, however, I don't use his because it it crazy expensive compared to the Amazon stuff. He does give out great information so I wouldn't fault anyone from supporting his product though.  Horst will say that the cheap collagen, what he calls "grandmother's collagen" is missing some amino acids but the one he is talking about is in the whey protein.  If you look at his products nutrition chart and compare it to grandmother's stuff and whey protein you can see that put together they match up.  The study he quotes compared collagen with and without vitamin C and found that it didn't work without the vitamin C.  They used unflavored Jello (gelatin) and orange juice for the studies.

Eric Horst: Tendon Nutrition.

https://www.youtube.com/watch?v=sIbotruEh2s  

Great info, thanks. I watched the shoulder exercise video and will definitely be doing those exercises after I meet with a PT. I guess the positive side to this whole experience is getting myself into preventative care practices that I don't think I otherwise would have been motivated to do. Much appreciated! I'll look more into Eric Horst, seems like he puts out a lot of quality content.

hang 7 minutes a day

active and passive

video info: https://youtu.be/PzQM49swPvs

Granite Grant wrote:

hang 7 minutes a day

active and passive

video info: https://youtu.be/PzQM49swPvs

These hangs are generally appropriate for individuals with shoulder impingement, but are contraindicated for those with suspected labrum tears, i.e. shoulder dislocations.

Granite Grant wrote:

hang 7 minutes a day

active and passive

video info: https://youtu.be/PzQM49swPvs

yeah, doctor specifically said that, given my current condition, I should be good to climb/hang in 6-8 weeks, so I will definitely not be doing this until at least then!

Side question: what do you guys do if you're not climbing for several weeks? I'm planning on getting on the bike more often now, and probably running a bit..

My bike made my shoulder significantly worse. It is a road bike with drop bars and that position was extremely taxing on my shoulder. Something like a mountain bike would probably be better. 

Jared B wrote:

Side question: what do you guys do if you're not climbing for several weeks? I'm planning on getting on the bike more often now, and probably running a bit..

Sit on the couch and use my other arm. 

Bryan wrote:

My bike made my shoulder significantly worse. It is a road bike with drop bars and that position was extremely taxing on my shoulder. Something like a mountain bike would probably be better. 

Interesting. I didn't bike during the worst years of my shoulder problems, but since then, I've found drop bars much more comfortable. My problems stem from too much internal rotation, tight pecs and bad posture, so riding thumbs up on drops lets me keep my shoulders less internally rotated than flat bars.

Not sure if this was true, but I kinda thought I noticed MTB helping my shoulder stability right when I started.

I opted for the stationary bike at my gym; no hands required :) I also did the shoulder exercises suggested by James - they felt great! In particular, after doing the dumbbell fly, my shoulder briefly felt like it was 100% normal. I hope that means that if I make it a routine exercise, it'll make my shoulder feel that good all the time. Right now, it feels normal except for when I reach my hand behind my back - that's when I feel a slight pain. After the exercises, there was no pain, even when my hand was behind my back. Eric says to do them 2 times per week in the video, but I want to just do them 1000 times a day, because it felt so good..