Shifted Scapula from Shoulder Dislocation

[arborvitae]

Hey, I'm 23 year old and I dislocated my left shoulder a couple of years ago...I slipped down from stairs that was layered in black ice I didn't notice. My shoulder popped out as I tired to grab on to the railings on my way down the stairs and I relocated it myself when I got up. I went to the hospital the next day and I was told to go to physiotherapy. I didn't cause I couldn't afford it and I started feelings better relatively quickly.

This past May I decided I should get back into swimming and weight training, I started off really slow cause I knew I wasn't 100 percent. I dislocated my shoulder a second time when I went swimming and was free styling.... again I relocated it myself, this time the doctor told me I just need physiotherapy and I'm good.


This is my problem now though, my girlfriend was giving me a back massage a couple of months ago and she immediately noticed my left scapula (I dislocated my left shoulder) seems to be a little out of place. It is lowered and pushed flatter, more into my back. When I told my doctor this on my last visit he seemed to disregard it. I'm no doctor but it just seems to me though my scapula shouldn't be like this thought is my shoulder is back in place normally.

Would anybody be able to give me some insight on this, anything would be appreciated.

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[gcoe]

Hi arborvitae

The scapular is held in position with the trunk mainly by a multitude of muscles. All those muscles need to be working optimally in order for the scapular to provide an adequate base for the main shoulder movement at the glenohumeral joint. When the posture of the scapular is altered like how you describe this is usually a sign that the muscles are not working optimally. The posture of the shoulder is important and given that you now have a second recurrence of dislocation I think this would be worth looking at.

From what your limited description I am not confident to give you a diagnosis of the state of your muscles. It is very important that the scapular adequately moves when you are elevating your arm in order to support the movement and thereby put less strain on the glenohumeral joint as it moves into the position where it is most likely to dislocate.

I would go and see a physio who can give you a really thorough assessment. Shirley Sahrmann at the University of Washington, St Louis, regularly offers training to Canadian physios and her system that examines Movement Impairment Syndromes would be helpful. So you could ask if the physio is trained in this. Alternately go and see a specialist sports physio in your area who should be able to help you with such an issue. It just involves getting an appropriate assessment of your muscles and a programme to strengthen the weak muscles and lengthen out the shortened ones, and retrain your shoulder girdle muscles to work optimally. Usually very straight forward and doesn’t require thousands of visits. It takes some time and perseverance to retrain the muscles but the physio can usually just give you the appropriate exercises and monitor your progress from time to time. It could be a good investment in reducing the likelihood of future dislocations – as you now have a weakness there and a re more likely to have future dislocations.

[iliastolos]

Hi all!
I agree with what gcoe has already mentioned. The shoulder complex is muscle-dependent and in case of bad positioning of the scapula, muscles attached to it are the ones to be treated mainly. Another aspect of your problem, arborvitae, is also recurrence of dislocation. It seems that repeated dislocation is not only a muscular but a capsuloligamentous problem as well. An unstable shoulder is pretty much what you suffer from -according to your problem's description- and in such cases a physiotherapy scheme including motor control retraining might not solve your problem 100%. A surgery might be indicated, according to your expectations and to certain criteria.
What you should do, in order to avoid future dislocations, is to visit an MD specialist of the shoulder or a physio specialist to give you a good assessment and guide you for treatment. It is very difficult to give you specific exercises without a clinical assessment here.
Hope I helped somehow.
ilias