dislocated my shoulder surfing : (

[aerodyne]

This might be long.. I dislocated my shoulder surfing two days ago and I need some advice to anyone suffering from the same kind of injury.

A little backstory: about 8 years ago when I was 15, I dislocated my left shoulder playing chicken in the pool (that game where you get on top of someone and try to knock the other person down) I ended up falling in the pool and my arm was tweaked under someone's leg and it dislocated it. I came up and for about 5 minutes, I massaged and moved my shoulder around a little bit and it popped right back in. Although I should've, I didn't go to the doctor because after that it didn't hurt at all and I figured it was fine. Everything was good after that

I've been surfing on and off without problems and now two days ago, I was trying to paddle into this 3 foot wave and somehow on my critical stroke, (the last few strokes to put me in the wave) I put alot of strength into, my shoulder made a popping noise and at that moment I knew something was wrong. Came out of the water to find my same shoulder dislocated. I used the same procedure and after about 5 minutes of massaging and moving my arm it came back in. The pain when it was dislocated wasn't that bad. I wasn't on the ground in pain or anything, just a dull pain. When I put it back in the pain was immediately gone.
I got an x-ray today and the doctor said that there's not much of a problem and everything is where it should be.
But he said that there is a chance to pop it right back out due to possible ligament stretching and tearing and said that I could resume my regular activities in a month. He didn't recommend physical therapy, or even talked about surgery though... Because i'm not in any kind of pain today, I don't suspect that I tore anything or did much damage to my ligaments. My questions are, what can I do to prevent this in the future? certain types of exercises? Do I need to change my paddling technique?.. I paddle deep right before I catch the wave. What are your own experiences and/or experiences of others who have dealt with this same issue?

tl;dr I dislocated my shoulder 8 years ago, dislocated it again surfing; didn't hurt so i don't think there was any ligament tear. doc says i can surf in a month, but I'm afraid it'll pop out again.

[jaffa1949]

Hi Aerodyne, not good luck there for you. This is what I would recommend to my patients in a similar situation of repeated shoulder dislocation.
You've done the right thing had the medical check had the x-rays reviewed etc so you know what you are dealing with and you would certainly notice the difference if there was a major tear.
Repeated dislocation stretches the ligaments of the joint a little more each time making the joint more and more unstable and more likely to dislocate again. Reduction of the dislocation can sometimes be spontaneous, problems can occur if the reduction of the dislocation traps or damages a nerve, this dramatically effects the motor and sensory function in the arm (sometimes permanently).
Repeated dislocation can also lead to arthritis as the ends of the bones involved in the joint get subjected to misplacement and unusual wear as the joint surfaces don't align like they should. Inappropriate ligament strain on their attachments also occurs.
+ One fact nobody really considers, another dislocation may well occur at some time when you may really need to rely on the joint.

Please follow up with the Doc, (there are some joint adjustments some Chiropractors or Physiotherapists can do, and maybe a specific course of exercises as recommended by the physio).
However I believe that it has happened often enough that a thorough discussion about surgery and choice around that should considered.
It better done young than waiting for work later when the ancillary damage is there too.

Expert problem requiring a little more than just forum advice.

[Jimi]

Simple explanation: If you dislocated your shoulder, it's likely to have weakened the front of the socket (hence why it's happened a second time). It may happen again doing the same activity, particularly in the situation where you're reaching and using your shoulder muscles heavily.

More than likely, you're carrying a bit of tension in the posterior rotator cuff muscles that are pushing your arm forwards in the socket, and that makes the shoulder want to dislocate forwards out of the socket too. This is typical of surfers, and I too have the same trouble.

Best thing you can do is follow your doctor's instructions and rest up for a while, but ALSO see a physiotherapist. Don't worry about a chiro, as you need to just get some exercises to stretch and strengthen your rotator cuff muscles to stabilise the shoulder joint. Manipulation of the joint by a chiropractor might feel good, but won't be addressing the root of the problem which is your rotator cuff being stronger at the back than at the front of the shoulder joint.

[aerodyne]

Thanks alot Jaffa. I have been researching alot about this and your advice is definitely on the ball. I'm learning that this is quite an unfortunate injury for me. It's been about three weeks and I was out in the water yesterday for a very light surf session, and I took it easy on my paddling for my left side. I have been doing external and internal rotations with a band and have been taking glucosamine as well.
I also have changed my paddling technique. Now my arm enters the water at not a full stretch, elbows bent, and exit the water up to my rib cage while having the recovery stroke with my hands inwards. It's definitely always on my mind when i paddle for a wave and it has made me lose my confidence but at least i can catch waves again.
If things get worse then i will consider surgery as an option.

Do you guys have any other paddling techniques which are particularly easier on the shoulder? because my altered technique has given me a loss in speed to enter the waves and it is definitely harder now.
I think Jimi also brings up good points that because I believe the problem lies when i reach too far in my stroke. What are things that you do (since you have the same problem) to mitigate that issue? any specific exercises or changes in paddling technique as well? I'm all ears.

[garbarrage]

I don't think paddling technique is your answer here. I could be wrong here, but working on the premise of "every action has an equal and opposite reaction" then the force you apply to the water with your hand propels you at the point of contact with your body (ie. your shoulder) through the water. You could hop in the water on a flat day with your board, and look at technique that applies that pressure to your shoulder in a way that doesn't pull against the joint and see if you can come up with a technique that works consistently. Certainly not going to be able to describe a way that works for you on a forum though. If it is possible it will be through trial and error and only you will know what works.

I can't help but think that even if you find away, with the unpredictable nature of this sport, you are inevitably going to put yourself in a position that puts you shoulder at risk of dislocating again. As others have said the more this happens, the worse it gets. As big a pain as it might be, I would definitely reconsider a surgical option, or contact a sports physio and see if you can come up with a way of supporting or strapping up the joint thats not too restrictive. I certainly don't think that there is an easy fix to this one.

I'm surprised there haven't bee more responses to this question as I know quite a few surfers with the same problem. All of them are a little too cavalier about the healing process, and I cant help but think they are going to be prematurely reduced to (oh no.....) longboarding. To be honest, if I was in their situation, I'm pretty sure I would be the same, but the smart money would be on, get it sorted properly before it becomes too big a problem... Or take up sponging, until you dislocate your knee.

[Jimi]

Hey sorry for the slow reply. I would just suggest you try to arch your back to avoid reaching in front of you as much as possible while paddling. Try to only reach in front of your chest, and not above your shoulder (as much as possible) while doing most of your paddling, and this will hopefully lessen the chance of a repeat dislocation, but really, it's a tricky one, since you can't change paddling too much before it's inefficient.

Most importantly do some stretching before you paddle out. This is really important!!!!!! Did I mention that it's very very important?
You NEED to stretch the posterior capsule of your rotator cuff otherwise you will do yourself damage when you paddle, and exacerbate the problem.

http://www.sportsinjuryclinic.net/cybertherapist/stretching/posterior_shoulder_stretch2.php

This stretch is a good one for before a surf. You only need to take a few seconds before you enter the water. When you do it, make sure you feel it stretching the back of your shoulder. If you get pain at the front, stop immediately, as you may be putting pressure on the side it was dislocated before it's ready.

Also - forgot to mention - KEEP doing the band exercises for internal and external rotation - this is what will rebuild the shoulder socket best without resorting to surgery.

[sandiegoman]

Simple explanation: If you dislocated your shoulder, it's likely to have weakened the front of the socket (hence why it's happened a second time). It may happen again doing the same activity, particularly in the situation where you're reaching and using your shoulder muscles heavily.

More than likely, you're carrying a bit of tension in the posterior rotator cuff muscles that are pushing your arm forwards in the socket, and that makes the shoulder want to dislocate forwards out of the socket too. This is typical of surfers, and I too have the same trouble.

Best thing you can do is follow your doctor's instructions and rest up for a while, but ALSO see a physiotherapist. Don't worry about a chiro, as you need to just get some exercises to stretch and strengthen your rotator cuff muscles to stabilise the shoulder joint. Manipulation of the joint by a chiropractor might feel good, but won't be addressing the root of the problem which is your rotator cuff being stronger at the back than at the front of the shoulder joint.

Rotator cuff repairs are at the top of the list of sports injuries when it comes to surfing. That's what we do!!Today, my left shoulder is popping like crazy, I guess I am just learning to deal with a sore shoulder now after a ride. But like another above reader said this type of injury, is slow process and when you re injure you start all the way at the bottom. I will put up with it as long as I can. I know I don't have money for a specialist but what about a regular ortho doctor, would trust them to work on your shoulder?