Shoulder Pain 12 Months on from Dislocation

Bones, joints and muscles
1

Hi All

​New to forum but need some help or advice....  I had shoulder surgery 13 years ago due to shoulder instability, and this seemed to work wonders.  The surgery was done to shrink the capsule and reattach the ligaments etc...

​It lasted well up until last August when I dislocated my shoulder again swimming - breast stroke.  The shoulder was relocated but the pain has just not gone this time round.

​I had a CT scan which was clear, I then had a MRI with injection and this came back clear, the 2 doctors who looked at it both said the labrum was attached and the rotator cuff muscles were all in tact as were the ligaments.  This was good news so I was discharged from fracture clinic in Nov 2016 and told to just undergo physio.

​I am still doing physio nearly 9 months on from starting and the pain is just no better.  I do the exercises and the shoulder clicks constantly, and I have a stabbing pain on my shoulder blade, it feels the pain is coming at the bottom of the shoulder blade.

​I reach out to a side and I am very apprehensive as the shoulder feels loose but I mention this to my physio and she always says everything is fine, the MRI is clear. I tried to get referred back to fracture clinic and was told No, everything was clear.

​I am at a loss as to what to do, is it normal to have this pain 12 months on as I dont remember this from my constanty dislocations 13 years ago.

​I am now 37 and know age has an impact on these things,  my mum suffers with arthritus so not sure if it could be this setting in but this doesnt explain the loose feeling

​Can anyone share their thoughts/experiences as I am off on holiday in 2 weeks and am dreading it as the last time I went abroad was last August when I dislocated the shoulder swimming and it was a big ordeal with the hospital and travel insurers, so I am really nervous and dont want to go.

​I want to strap it with tape but I keep reading you cant wear the strapping tape in the sun as it can burn the skin, so I just dont know what to do.

​Hope someone can help me

2

Hi there, 

I completely understand the frustration since the pain still hasn't been resolved. When you dislocate the shoulder joint, there is not necessarily a tear on a muscle hence everyone says there is nothing wrong which is again frustrating!

What is wise understanding is the fact that there is a muscle behind the shoulder blade called "Serratus Anterior" and another one calles "Subscapularis". These two are attached to your ribcage directy under the shoulder blade so basically between your blade and your ribs. Any shoulder injury nomatter dislocation (!) will force these muscles to permanent spasm meaning super tightness. This is something that can never been shown on any scan and there is limited undertsanding out there in regards to how muscles react after an accident, incident or injury. 

These two muscles will definitely need attention in this case. Deep treatment to break down the stiffness following your last injury and i am sure you will receive unbelievable relief! 

Then exercises. But at this stage exercises will not help since you have what we call muscle imbalance where certain muscles get very tight and stiff and as a result your shoulder will change shape. You will also be using your shoulder the incorrect way which will add more stress in these muscles and then the whole thing becomes a viscious circle causing pain and frustration! 

Let me know if this helps  

3

Hi

Thank you very much for your reply and the information

​How can i stretch those muscles or get the balance right, what would be your recommendation?  My GP is referring me back to the hospital for further investigation as can see the pain I am still in and said it is not right but I dont know what else I could or should do to help strengthen the muscles and get the balance right.

Thanks again

4

Slow and steady.  Use ice to help relieve pain and discomfort. Take it easy and let it heal.  Follow the instructions provided by your doctor and physical therapist.  GOOD LUCK!!