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Old 12-23-2007, 08:33 PM   #11
Tim Donahey
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Hearing you describe your shoulder is like hearing myself. I get the same clicking with the Cubans (no pain), and actually had my shoulder subluxate once when doing them (also no pain), at which point I stopped doing them. I was using a light barbell (10-15 lbs) and maybe should have switched to dumbbells instead of stopping altogther.

I just found this on YouTube, titled Shoulder Rehab Protocol. This stuff looks pretty good actually, not sure about the "capsule stretches" though... You might want to put a litte music on while you watch it, lol: (wfs)
http://www.youtube.com/watch?v=A0ONHZmsFec

Corey: The Cuban Rotations are illustrated @ 1:30 and 9:10 into that video. I've seen them done both ways, I did them like in the 2nd part of the video and prolly should have done them as in the 1st.

There's a lot of "Related Videos" to the right.

Last edited by Tim Donahey : 12-23-2007 at 08:46 PM.
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Old 12-23-2007, 10:01 PM   #12
Megan Greene
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

I've had unstable, subluxing shoulders with pain on and off for a couple years now. I got two prolo treatments in the right shoulder this fall. I am waiting to continue treatments because I need to treat some other stuff in my body with anti-inflammatories for a bit.

After the first treatment I felt great for a month, just a little of the usual old pain near the end of the four weeks (but a single treatment is not supposed to be enough to produce any results).

I got a stronger irritant for the next treatment and the pain from the initial injections never seemed to go away, and now two months later I am still having fairly sharp pain in the back of my shoulder. I haven't been to a doctor for it yet. It intuitively feels like it was caused BY the prolo, but that is not supposed to happen, so maybe I injured it at some point after that treatment, although I never noticed any specific injury and I've never had this exact kind of shoulder pain before.

After the first injection I felt like the shoulder was more stable but right now it seems just as loose as the left, untreated one. So I'm kind of disappointed but I know I need to have at least one more prolo treatment before I write it off.
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Old 12-23-2007, 10:48 PM   #13
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Quote:
Originally Posted by Megan Greene View Post
I've had unstable, subluxing shoulders with pain on and off for a couple years now. I got two prolo treatments in the right shoulder this fall. I am waiting to continue treatments because I need to treat some other stuff in my body with anti-inflammatories for a bit.

After the first treatment I felt great for a month, just a little of the usual old pain near the end of the four weeks (but a single treatment is not supposed to be enough to produce any results).

I got a stronger irritant for the next treatment and the pain from the initial injections never seemed to go away, and now two months later I am still having fairly sharp pain in the back of my shoulder. I haven't been to a doctor for it yet. It intuitively feels like it was caused BY the prolo, but that is not supposed to happen, so maybe I injured it at some point after that treatment, although I never noticed any specific injury and I've never had this exact kind of shoulder pain before.

After the first injection I felt like the shoulder was more stable but right now it seems just as loose as the left, untreated one. So I'm kind of disappointed but I know I need to have at least one more prolo treatment before I write it off.
Sorry to hear that Megan. Perhaps the doc injected you in the wrong spot the second time? Was your subluxations posterior or anterior? I don't know why you'd have pain in the back of your shoulder, but then again, I really don't know too much about the procedure. I've never had any odd sensation in the posterior area of my shoulder. In a wierd way, I think I might be lucky to have a handful of subluxations, as I know exactly where the discomfort is. I told my doc this, and she confirmed it through tests. From what I gather, being precise with the injections is the key to success. My doc can "feel" the tear in the shoulder capsule. While this sounds terrible, in my mind it's positive, because at least there will be no guessing at what to inject.

I will ask her if she will specifically hit the inferior glenohumeral ligament. From what I read, this is common practice for shoulder instability prolo, but I want to be sure. I remember my MRI being inconclusive for a Bankart lesion, but I do experience some symptoms of a Bankart lesion. The standard ortho test of putting your extended injured arm straight across your chest with thumbs pointing downward occasionally gives me some pain. Apparently, if you show pain then you might have a labrum tear. My only problem is that sometimes I don't have pain, and I also have the same pain in my left (healthy) shoulder, so I'm not sure if I'm over reacting this. Make a long story short, a bankart lesion is essentially a tear of the IGL, and I have a feeling that my IGL is the problem so I hope she'll inject that one. Probably shouldn't be making my own diagnosis, but I figure the more I try to understand my problem the better.

I wish you luck with your shoulder. Again, I'll keep y'all updated with my prolo injections.
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Old 12-23-2007, 11:17 PM   #14
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Garrett: Doing a google search under "RIT" instead of prolotherapy definately gave me some more scientific results rather than essentially prolo ads. Thanks. I'm beginning to more fully understand how prolo differs so much from case to case. But this is why--despite reading some negative reactions--I feel confident that prolo might actually work for me. The fact that my doc is experienced with solid credentials, is able to exactly pinpoint the problem area, and has treated athletes with my problem with success gives me hope. No Anti Inflammatories for me for sure. Will taking creatine during the injections be counter productive?


Corey: Thanks a million for the information. I was told to always try to keep your shoulder "locked in" towards your side. So whether I was hanging during a pullup or at full extension during an overhead press, I kept my shoulders "down." A pretty knowledgeable sports chiro told me this. Perhaps I misunderstood him, but your idea of backing your arm motion with your shoulder blade makes much more sense. I tried this at the gym tonight, and automatically my shoulder felt MUCH more stable. So that when I did an overhead press I tried to "jam my shoulder towards my cheek" as you say...instead of locking it down to my sides (which by the way doesn't feel very natural either). Now at the dead hang portion of the pullup should I be doing the same--ie. let my shoulders rise? Somehow I feel like my shoulder would yank out in this position, so I was afraid to try it. I would say this is my main fear. My shoulder has subluxed at the dead hang portion of a pullup so I'm always nervous when I hang at the bar. At OCS, we will be doing alot of "monkey" swinging on the monkey bars. Do you have any specific techniques for this with regards to shoulder stability? Is is the same as letting your shoulder blades follow with your arm movement?

As far as the clicking goes... the spot of the click is hard to pinpoint. I do occasionally get the click at what I think is the AC joint, but I don't think this is causing me any problems. I do occasionally hear a click in my shoulders whenever I lock out my arms during a press or even the dead hang portion of the pull up. This sometimes makes me think I have a labral tear--but again that's just speculation. However, the part that bothers me the most is an occasional very awkward "slipping" feeling, that happens as I am about to lock out my arms during a military press and the dead hang portion of a p/u. It feels like my shoulder sort of "skips" during the motion rather than glide smoothly through the motion like in my healthy left shoulder. But tonight, after trying your tip on lifting my shoulder blade up with the arm movement, I didn't get the awkward slipping feeling. So perhaps before, I was inadvertently causing this sensation on my own. My guess is that because I was trying to hold my shoulder blades down while my arm was moving up, then I was in a sense semi subluxating my GH joint? Am I understanding this correctly?

Sorry for the book, I hope I wrote a clear description of my problem.
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Old 12-24-2007, 08:39 AM   #15
Corey Duvall
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

The outer aspect of your A/C joint is the acromion. It is a section of bone that overhangs your shoulder slightly and covers the upper aspect of your arm bone and shoulder. When you shrug your shoulders in an overhead press, the rotation of the shoulder blade allows this acromion to move out of the way and the arm bone to slide through easily. You have a nub of bone on the upper aspect of your arm called the greater tuberosity, where some of the rotator cuff attaches, and this tuberosity will bang into the acromion if you raise your arm up without shrugging your shoulders. This, combined with the decreased ability of the rotator cuff to hang onto your arm bone, could cause the slipping feeling as well as the clicking. There are a few other possibilities for the clicking, and while a click now and then shouldn't be too detrimental, you don't want to be doing an exercise in a way that causes repeated clicking as it could create some micro-trauma over time... this could cause problems. It may not specifically be the exercise you are doing, just your technique for the particular exercise.

When dealing with pullups it is a rather tricky situation to describe, especially when calling them dead-hang. First, you need to make sure you have good shoulder flexibility... i.e. the ability to do the shoulder dislocates. If your shoulders aren't properly flexible, the tight muscles can pull your shoulder in directions it is not meant to travel. Second, your shoulder blades should be up near your ears when your arm is over your head, but your shoulder should never be relaxed (as "dead-hang" might have one think). Does this make sense? As you pull yourself up, your shoulder blade should slide down your back, so that when your chest reaches the bar, it looks very similar to having the bar in the rack position before an overhead press. The pullup retractions shown in one of the videos above is good for strengthening this musculature, but not for training movement patterns. That video has great ideas, but looks at shoulder rehab in a very body-builderesque, isolation exercise paradigm. I like crossfit because it does not look at the body this way, instead as a connected whole that must be trained as such. If you like doing the isolations as supplements I don't think they are inherently bad, but you MUST train proper movement patterns. Most shoulder problems are due to faulty movement patterns as opposed to faulty structure.

After any traumatic injury, like a shoulder subluxation, the body will tighten down the musculature in an attempt to protect the area from further trauma. This changes the movement patterns and if not properly addressed (even if pain goes away), chronic problems will result.

As the full compliment of your rehab, I would work on TGU's, overhead presses, pullups, dips, highpulls, and pushups. This will work on pulling and pushing in many planes. Always keep your shoulders strong and active, with your shoulder blades pushing through the force in your hands. When at the top of the dip, push yourself up as high as you can, spread your chest and drive your shoulder blades down through your hands. As you descend into the bottom of the dip, keep your shoulders back and don't let them travel too far forward. If you get pains in the front of your shoulder, it is because your shoulders are moving too far forward. For the highpulls, keep your elbows as high above the bar as possible, hands close but not touching, and shrug your shoulders as your arms raise up. You can do it just from standing or with a sumo-deadlift as well. Pushups, same thing. As you reach the top of the pushup, push through your hands with your shoulders.

I think I've covered most of it. Let me know how things go.
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Old 12-24-2007, 12:38 PM   #16
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Corey: Awesome, you're great. Your thoughts on the shoulder mechanics make complete sense. My problem was I tried to keep an active shoulder but with my shoulders locked down and in rather than shoving my shoulders to my ears. I should note that it's not really a click--it's almost like a "grind/click"...kinda nasty, but again not painful. But from what you say, perhaps I didn't let my shoulder blades go up, and this didn't give me enough room for the overhead arm motion which led to the click/grind.

*From now on, whether it's the military press or the dead hang on the p/u, I will let my shoulder blades rise while still keeping it "active" and tense.

I love that workout you planned for me....simple yet effective...will do it. BTW, the grinding/clicking sounds doesn't surprise me...I know my ligaments are loose, so I would suspect that no matter how good my technique is I'm sure to have some noise in there. Perhaps the prolo will fix that.

Thanks again for the tips. It's like you gave me a Christmas gift , haha !
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Old 12-26-2007, 02:50 PM   #17
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

First Prolo session down! My shoulder's got a dull ache to it, but nothing unexpected and certainly nothing terrible. The actual shots don't hurt. You get some sort of anathestic popped into you, so I didn't even know the needle was in me till the assistant was like "feel anything?" Doc says to take it easy for the next day or two, but you can have at it after that. Obviously way too soon to tell, but in all honesty I like this pain...makes me feel like somethings working. So that's that...just a waiting game now. Will schedule another appt. in like 3-4 weeks. But for anybody worried about the shots...it's not bad at all. BTW all injections were directed towards the anterior shoulder capsule. You could feel that bad boy all the way deep within the joint. Probably about 10-20 injections all together. Again it's really hard to tell that the needle's even in you on some injections! If anybody has any questions regarding the procedure, feel free to ask.
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Old 12-26-2007, 03:34 PM   #18
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Sorry guys, don't mean to add another post, but I couldn't figure out how to edit my previous post.

Just wanted to add that I noticed something interesting while looking at my shoulders in the mirror just now. Normally my right injured shoulder sits noticeably more forward and awkwardly out of place. I'm not sure if it's the prolo or what, but it's not like that when I looked in the mirror. I know nothing is supposed to happen this quickly, but my right shoulder certainly looks like it's sitting more correctly now. Regardless, I guess I'll take this as a good sign...
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Old 12-26-2007, 03:43 PM   #19
Lenora Galitz-Pfeffer
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

This is an important thread. Many of us have shoulder challanges and issues. I hope to read more on this. Steven Lowe, what say you on this thread? Any part of this on past injuries threads?
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Old 12-27-2007, 07:50 AM   #20
Corey Duvall
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Bryant... that altered shoulder position was just what I was talking about happens after a traumatic injury. After learning of this and treating a few patients that I noticed it on I had the opportunity to feel it first hand. I injured my shoulder pretty good while body surfing... was flipped by a tough wave, thrown head over tea kettle and slammed onto my shoulder. Took a nice scrape and I think it subluxed briefly. Within the next hour I could feel my pec and trap on that side tighten down, drawing the shoulder forward and closer to my body. I was stretching on greater than an hourly basis trying to reverse this and my shoulder kept tightening down this way. It was probably 36 hours after the injury that I was continually stretching. I have hurt my shoulder on a few other occasions in a similar manner, and it would often take 6-8 weeks before I felt comfortable getting back in action. My shoulder would feel "strange" and I was afraid to do anything with it. The strange feeling I realized were the muscles tightening down and changing how it moves. To get back on track, I stretched repeatedly trying to keep the shoulder blade back and down when I was sitting. I got two treatments with ART, and 4 days after injury I was doing heavy overhead squats.

There are MANY injuries, especially with the shoulder, that do not initially have severe structural damage (torn rotator cuffs, bankart lesions, etc) but become chronic due to this change in movement patterns. Your rehab of movement patterns and shoulder blade placement is the most important part of your treatment. If you take one thing away from this thread, let it be that.
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