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Old 12-27-2007, 12:10 PM   #21
Steven Low
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Here's something from a post on active shoulder:

Quote:
Here's a simpler explanation:

With any PUSHING exercise you try to push the arms away from you as hard as you can. For example, in overhead squats you drive the shoulders up the whole time, with handstands you push down into the floor (when upside down) to so that your shoulders don't shrug down (also gives more control over the handstand because it activates all the muscles in the shoulder to stabilize the joint), with pushups you push down into the floor especially when working towards planche and dips you depress your shoulder girdle like Tom said.

With any PULLING exercise you generally tend to try to keep the ball of the shoulder in the socket with active shoulders. So with pullups of any variation you might notice that you tend to pull the shoulder ball into the socket before starting any of the exercises especially weighted pullups. The same with any type of rows or inverted pullups. The tendency of the shoulder to pull out of the socket in the pulling movements can cause subluxations/dislocations/strains in people newer to lifting which is why active shoulders is strongly recommended for kipping pullups. Plus, like Roger said earlier it tends to put the shoulder in a more advantageous position for the muscles that are pulling namely the lats and chest.

A few notable exceptions to the pulling 'rule' are disadvantaged lever positions like front lever and cross where pulling/pushing is sort of more blended even though it uses the pulling muscles.
Also, would like to add that with the pushing the scapulae are generally in the protracted position (only retracted in bench) and are elevated or depressed depending on if the exercise is located above (overhead pressing) or below (dips).

Any type of pulling is generally has the scapulae retracted and depressed besides a couple things like face pulls... but ALWAYS retracted except for the couple of things mentioned above in the quote.

The whole thread is here (wfs):
http://www.board.crossfit.com/showthread.php?t=24512

TGUs are a "pushing" exercise so you want the joint activated/pushed out so all of the muscles are active to stabilize it.

As Corey was saying in the post above mine.. you can generally fix all shoulder problems by looking at mobility of the "shoulder joint" as a whole... which includes thoracic and cervical mobility, the scapulae and then the shoulder capsule itself with the RC muscles and delts. Often times if something in the shoulder is hurting and it's not part of the capsule it's referred from the scapulae or other areas especially with ROM issues can be the thoracic spine.

The trick is to find the poor movement patterns BEFORE they lead to an injury. This can be done pretty easily by ROM assessment, looking at posture and checking for muscle imbalances.
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Old 12-27-2007, 12:44 PM   #22
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Quote:
Originally Posted by Steven Low View Post
Here's something from a post on active shoulder:



Also, would like to add that with the pushing the scapulae are generally in the protracted position (only retracted in bench) and are elevated or depressed depending on if the exercise is located above (overhead pressing) or below (dips).

Any type of pulling is generally has the scapulae retracted and depressed besides a couple things like face pulls... but ALWAYS retracted except for the couple of things mentioned above in the quote.

The whole thread is here (wfs):
http://www.board.crossfit.com/showthread.php?t=24512

TGUs are a "pushing" exercise so you want the joint activated/pushed out so all of the muscles are active to stabilize it.

As Corey was saying in the post above mine.. you can generally fix all shoulder problems by looking at mobility of the "shoulder joint" as a whole... which includes thoracic and cervical mobility, the scapulae and then the shoulder capsule itself with the RC muscles and delts. Often times if something in the shoulder is hurting and it's not part of the capsule it's referred from the scapulae or other areas especially with ROM issues can be the thoracic spine.

The trick is to find the poor movement patterns BEFORE they lead to an injury. This can be done pretty easily by ROM assessment, looking at posture and checking for muscle imbalances.
Thanks for the info Steven...didn't realize you're from my neck of the woods (Silver Spring). I wish I knew this stuff before my injuries. Regardless these techniques will be helpful. The dislocation stretch still boggles me. It's very difficult without trying to bend one arm or the other. Amazing as I'm really a pretty flexible guy too. I guess my muscles are tightening up like Corey says because of my subluxations.

Day after prolo update: WEll I'm really not as stiff or in pain as I was expecting to be. I'm not sure if that's good. Prolo depends on this inflamation period. There is swelling, but I'm not sure if that counts. Does anybody know if you need to be in pain afterwards or does that depend on the person? I think the numbing agent's still in there as my shoulder still feels a little numb to the touch. Amazingly, I do feel a bit more stable just in general I think due to the inflammation. I think this is standard.
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Old 12-27-2007, 12:47 PM   #23
Garrett Smith
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Bryant,
Sounds like things are going swimmingly.

No problem with the creatine during the shots that I know of...
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Old 01-01-2008, 06:22 PM   #24
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Okay, it's only been about a week now and my shoulder is feeling pretty darn good. Maybe even 50% better. Swelling has went down so I think that means that the true healing process is starting. Basically, I feel like I don't have to think twice to use my shoulder, my arm seems to tire less, and the odd sensations I would normally get during the deadhang portion of a pullup is simply not there. Definately isn't completely perfect, but then again, it's only been a week. At this pace, however, things are looking VERY good. (Corey, I even feel more stable on the TGUs)

Bad news is I think I did something with my other shoulder. Will start a new thread for that......
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Old 01-03-2008, 01:06 PM   #25
Mark Brinton
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Boy, if I had read this thread 25 years ago, my life would have been much different. I feel like I could play the role of Jacob Marley - replace jangling chains with shoulder's falling out of sockets for 15 years - to Corey's warning of how acute shoulder problems turn chronic without attentive rehab.

The one thing I would add is: learn how to fall as the violent, unplanned act of flinging/flailing your arms out "reflexively" to regain balance or avoid a pratfall can undo substantial rehab progress.
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Old 01-16-2008, 10:32 AM   #26
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Here's an update on my second prolotherapy session which I received yesterday:

Same procedure as noted in my first prolo session, but this time my doctor injected in more areas around the AC Joint (I think). Same post injection feelings: swelling and a bit of stiffness...maybe even more so than the first time around.

Since my first prolo session, I have noticed no "skipping/slipping" sensation when doing wide grip pull ups and military presses. My doctor confirmed that she can no longer feel a "hole" in my shoulder capsule. However, my shoulder does not feel completely stable--I still have some sense of instability and weakness when doing things like holding my arm straight out or above my head--but as a whole, the results are very promising. My doctor thinks one or two more sessions should be all I need.

Incidentally, I mentioned my exertion headaches to my doctor, and she injected some of the tendons (I think) near my traps (?), and a few injections in the back portion of my skull (). As wierd as that sounds, I did some pullups today, and I was able to do multiple sets of 8-10 pullups with just slight headache pressure rather than the "bomb-going-off" feeling.

I guess some people might consider this stuff voodoo, but I have to say, the results have been significantly too noticeable for me to ignore. I think the experience of my doctor in the orthopaedic world combined with the 19 years of prolotherapy experience shows substantially. I will keep you guys updated as my shoulder heals, but I think there's promise for those of us who have experienced these shoulder instability problems! Cheers,

Bryant
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Old 01-17-2008, 07:04 AM   #27
Garrett Smith
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Bryant,
That's awesome.

Next thing to work on is thoracic spine mobility, especially anterior-to-posterior (front to back). Robb Wolf wrote a great article on drills for this in the PMenu (on kyphosis). If your t-spine isn't moving, especially to the front, then the shoulders have to move even more, which screws them up over time.

Glad to hear you got such great results. When prolo is indicated, it is a great modality.
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Old 01-17-2008, 11:24 AM   #28
Corey Duvall
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Is there a link to that article, Dr. G?
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Old 01-17-2008, 06:36 PM   #29
Garrett Smith
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

WFS Kyphosis by Robb Wolf, FREE. I just saw that Greg Everett put that out as a free sample, that is quite simply an awesome thing for him to do.

If you buy the whole WFS Performance Menu Issue 35 December 2007, you'll get my second article in the PMenu on nightshades......:if you're interested!
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Old 01-27-2008, 07:44 PM   #30
Bryant Yee
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Re: Prolotherapy for Recurrent Shoulder Dislocation?

Well guys, it's been about a month and a half since my 2 prolotherapy treatments, but I have some bad news to report :

I was doing pullups and on about my 4th set right when I grabbed onto the bar, my shoulder completely gave out. I had to go the ER and the whole 9 yards.

Now I believe that this has nothing to do with the effectiveness of prolotherapy. In two treatments, I did feel noticeably better and the instability was decreased significantly. I think the problem was that perhaps I pushed it too soon. I think the lesson here is that for all those considering prolotherapy, it is not an overnight treatment. Perhaps my doctor could be a bit at fault: she did tell me pullups were okay, but then again, maybe she did not know the whole extent of the problem. Afterall, she is not me.

So this past dislocation was the last straw for me. I've decided to get surgery on it. I guess I'll have to settle with being inactive for a few months, but I'm too young to keep having all these injuries. Again, I don't feel it's the prolo's ineffectiveness, but at 200 dollars a treatment, it's alot of money and the surgery is covered by insurance. Perhaps fixing multiple dislocations is asking too much out of prolotherapy.

Sorry, if this news is a downer for those considering prolo for shoulder dislocation. Like I said, the results were positive, but I do believe you really have to take it easy unlike what all the advertisements say--maybe just not completely inactive like surgery. Thanks everyone for the help, and if anybody has questions regarding my experience with prolo, I think it's documented pretty well in this thread...or you can just ask me!

I wish all of you the best of health in your WODs!
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