Chronic Injury from joint instability, Please help!!!!!

[Erin Roepke]

Im embarassed to be having to post about this, because the way i injured myself this morning is so stupid...but to start from the beginning, the summer before last i had to go to physical therapy for my right shoulder because i kept dislocating it and it was becoming a very serious problem. I teach MMA and i kept throwing my shoulder out while throwing punches that went out too wide or trying to pull peoples' legs in when wrestling. A doctor i saw told me that i had shoulder instability and the pt gave me exercises to help correct it. After maybe a year, i had no more problems, and abandoned the exercises. Then i started some of the progression in BtGB, and even though ive made very little progress, im stronger now than ive ever been before. The BtGB exercises are not what caused my injury today (i dont think). No, i injured myself trying to kill a moth that was on the ceiling. :oops: I got a swatter and swung at it in a way that was kind of like a baseball pitcher and i felt my shoulder kind of roll out of place. It went right back in, and i wasnt in agonizing pain. It felt like that feeling of when you almost get injured, that shocking feeling of omg, that almost hurt REALLY bad--but not really any pain. I was only alarmed because thats exactly the feeling i used to get when my shoulder dislocated, before it became chronic and started causing lots of pain.

I put ice on it right away, and a couple of minutes later i took a pain reliever just to make sure nothing in there would swell up. I still dont really feel pain, but my shoulder is tired, and i dont want to go back to where i was before. What exercises should i be doing to help correct my instability? Im going to start up on those pt exercises again, but i dont know what kind of shoulder stretches i should be doing.

I want to do exercises that will strengthen my shoulder joints to keep them from being dislocated. The past couple of months, ive been working on low lsits, the adv. frog stand, tuck back lever (but i never did german hang because i couldnt figure it out) and im going to also work on the front lever but i cant hold a tucked one yet. instead im doing chin-up grip deadhangs, definitely the weakest part of my training, as my bad shoulder is very weak when in the "open" position. Ive also been doing pushup and row variations and some pullup work with jumpstretch bands and hespus on a box. I admittedly dont do much prehab (i know i should and now i def will) but i usually do do wall shoulder extensions and dislocates with a band. The wall extensions are very uncomfortable and sometimes painful on my bad side, i think because of inflexibility. I just wanted to know, Is any of what im doing a bad idea? Are intentional shoulder dislocates bad for an instable shoulder? Should i do the german hang first instead of back lever (and how do you go about doing progressions on it? will it be in liquid steel™?) And also what are the best exercises as far as strength to help correct this problem?

Any help is deeply appreciated, as i dont want to spend another summer injured and unable to compete. Like really, I will love anyone who can give me helpful advice on this. I really dont want surgery or a permanent problem. Also, sorry the post is so long.

[Quick Start Test Smith]

Erin, I'm sorry that I'm not knowledgeable enough at this point to help you (thankfully Slizz, BlairBob, Mr Brady, and some others will be able to), but have you ever read the book, "Pain Free," by Pete Egosque?

[Erin Roepke]

I have not heard of that. Ill have to look it up

[Quick Start Test Smith]

Perhaps you can get it from the library... I got mine from the local library and since nobody else is interested in reading it, I can just keep checking it in and out until I'm done with it!

[Cole Dano]

I'm sorry to hear about the trouble with your shoulder.

I'm very reluctant to give any specific advice, i feel in cases as severe as yours its imperative to actually see the person, how they move, where the weaknesses, and restrictions are etc. This just can't be done on a forum.

Consult with your PT, i'm sure he will have good advice. There are many, many different exercises and often we feel if we just find that right one it will solve the problem. In reality the solution is doing the exercises you been given, be present while doing them, and let time do the work. The being present is more important than we realize when doing rehab, there is a vast underground, subconscious network of neurological wiring that these exercises untangle. We are in essence not only strengthening the muscles of the rotator cuff, but also the software that operates them and often its this software that is what allows the problem to happen, or at least teaches us how to protect against it happening.

Of course there are bad PTs if you think what he gave you to do isn't working, seek out another PT. And if there is someone you can work with on a more regular basis as well.

I have some shoulder students, they come do a private with me, i teach some basic exercises, then they come to group free practice class where i can monitor them as they do the exercises. Its amazing at how many will do basic exercises with poor movement patterns and get poor results. Its a shame that most PTs show an exercise for a couple of seconds and then expect the patient will perform it perfectly. It just doesn't work like that. I know this is a pretty unusual set up, but it has given pretty good results and its economical.

The most important thing in doing rehab is attempting to do the exercises with as much quality as possible. This is very subjective, i know, and what it means will change, but it will get you into doing them. Listen, feel whats happening, get into it, let your body teach you how it works. At the same time teach yourself, Google rotator cuff, shoulder dislocation etc. One other excellent resource is anything from Eric Cressey as he's worked with numerous high level shoulder injuries, baseball pitchers in particular. Your case is similar.

As for stretching, if your shoulder is that vulnerable you need to be careful. And again i'd want to asses the situation. More than likely you have one movement direction that is very open and another that is very closed. This combination of tightness and looseness will help squeeze the shoulder off its perch.

Do understand that with the shoulder there are two 'joints' the actual joint where the arm connects to the shoulder blade at the side of the body, and the shoulder blade/collar bone. The moment of each is synergistic, but often when stretching we will inadvertently stretch one when we should the other.

Sorry this is so general. Its not because i don't want to help, i just know that the same specific advice can help one person in your situation and hurt another, i don't want to make a guess as to your problem. But if we continue the conversation over time, and you consult your PT or relay more specific information he gives, perhaps we can help...

[Quick Start Test Smith]

Erin, I just found Dr. Egosque's website. There's some basic information on common problems here: http://www.egoscue.com/wherePain.php - You don't have to sign up, just click skip.

[Erin Roepke]

Thanks for the help! i really appreciate it. I checked out the pain free book from my library, but it had been badly abused and some pages were missing, so i ordered one and am waiting on its arrival. Thanks for recommending it! Unfortunately i cant consult my PT because i had the therapy more than a year ago and my insurance will no longer cover it. But the stuff Mr Brady said about one part being too loose and the other too tight sounds right. Ive started doing my rotator cuff strengthening exercises again and i believe it will help, although it wont get rid of my inflexiblity within the joint. I'm hoping that the pain free book and also Liquid Steel™, when it comes out, will have some exercises that will help both with shoulder joint strength and flexibility.Again, thanks for the comments. They were a lot of help.