Last February I was involved in a collision with a car (me on my bike). My main injury was a fractured right femur. That's coming along nicely, thanks to the addition of some internal titanium scaffolding. I've been back on my bike for quite awhile, have pretty much full range of motion in my knee and hip, and have recovered much of my leg strength. At times I can even jog short distances with little or no discomfort.
Secondary to that I also dislocated my left AC joint. At the time, treating it seemed relatively unimportant as I needed both arms for crutches for several weeks, and my physical therapy focused on my leg. I haven't been in the pool in a long while. I tried a couple times after I was mobile, but decided I wasn't ready, and went so far as to give up my pool membership.
My AC joint still pops out in a number of situations, so I think I might need more than more r&r. I did get some attention from my physical therapist and do a couple exercises pretty regularly (standard horizontal rotation, and rolling my scapulae back and down), but wonder if there is more I could be doing. I'm coming up on my one-year follow-up, and plan to discuss options with my doctor. In anticipation of possible surgery, or just continued rehab, I'm wondering what other exercises I could do to improve strength around the joint.
I alot of physical limitations, and under constant care. which physical therapist you choose makes the difference. ( stenosis on 3 nerves ). Did you actually deal with a DPT or PTA? What exercises did the PT give you? Did they just give you the standard exercises, which most do, without really thinking hard? I am in PT 5 months a year.. Early december my shoulder dropped 2 inches basically overnight. So my right lat collapsed and the trap.. Also I don't know why you would get out of the water. Just floating or walking in the pool will be something.
I fully dislocated my left shoulder from a mtn bike crash in 1992 moab ut. A doctor just happened to pass by and reset it for me. Several years following, another crash and another anterior dislocation, this time I went to the emer rm for the reset. The following 6 years it would fully dislocate for various reasons - must have been 6 or 7 more times. I basically learned to reset it myself, not fun but quick. At the time I started lifting weights in 2002, and along with learning to protect the shoulder with daily activities, the dislocations stopped. When I started swimming from scratch in 2007 I feared reinjuring the shoulder as it had been a full 5 years without incedent, but luckily it never happened. As I started to compete I feared diving from the block would cause injury but, as I knock on wood, it has yet to happen. I never had surgery but I was only 35 when the last dislocation occurred. Now that my other (good) shoulder is likely about to be surgically repaired, I am still weary of having the left looked at as it really isn’t bugging me.
I can say that weights, RC exercises, stretching and swimming as well as a cautious lifestyle (most of the time) all contributed to keeping the left shoulder joint functioning relatively issue free. Don’t give up, do what you feel would be best, and be careful.
I would add something for the traps.. the traps will add stability.. Do should shrugs with straight arms and weights.. deep shoulder shrugs.. if you can.. deep shoulder shrug and then rotate to the back, down, and back up to neutral. start with low weights and keep progessing.
And welcome to the world of adaptive swimming.. I do the ice and cold water swimming.. for basic pain relief, specifically nerve pain, it works like a charm. Cold helps neurological tremendously. But wreaks havoc on soft tissue issues, and will be painful in the damaged soft issue.. Though it will enable you to swim using soft tissue that is painful, it will still hurt while you swim.. but it will be so tight from the cold that it can be worth it... So if you have alot of nerve pain.. go for it.
Thanks for the responses. Even before my crash I was riding much more than swimming, and once I was on my feet and had enough mobility in my knee was getting plenty of leg exercise either pedaling or walking/hobbling to and from the train. I would like to get back in the pool, but at this point, it wouldn't be worth it if I couldn't do some sort of stroke. I don't need water walking at this point. Also, as I live near Lake Michigan, I felt if my limbs were up to it, I could always hop in the lake. They weren't last summer, but maybe this year.
My primary shoulder joint (glenohumeral joint) itself is fine. My problem is with my AC (acromioclavicular) joint. It appears that the pectoralis major and anterior deltoid might have the biggest responsibility for keeping my clavicle from "popping up," which is the way it dislocates. In addition to the rotator cuff exercises and rotation of my scapula, I have been doing seated rows, which help activate my trapezius and drag my scapula down and back. (I have pretty rounded shoulders after a career as a software engineer, seated in front of a computer day-in, day-out.)
I am an Occupational Therapist, Certified Hand Therapist (Specialty in Upper Quarter Rehab), and Manually Certified in Orthopedics . I have been a therapist for 19 years. I treat a lot of shoulders. AC joint dislocations usually do fine after several months. Scapular stabilization exercises (lower trap, middle trap, rhomboids, Lats. serratus anterior exercises are all helpful) also you want to keep the rotator cuff strong. The problem with dislocations are that if its bad enough, you may not be able to achieve enough stability to keep it from dislocating without surgeon intervention. (Although, I must say, AC joint ligament repairs are not that common) Have a good discussion with your PT to see if indeed you are having an instability problem (they can usually screen that pretty easily and then help you communicate with your physician). Keep up with the home program until you see your physician. Hopefully you can get things sorted out soon!
Thanks, Christy. I'm completed in-office PT a few months ago. That was mostly focused on my leg (understandably). I'll ask my ortho about getting a few more sessions focused on my shoulder. My immediate goal is to try and stablize/strengthen my AC joint in advance of my next follow-up (early March) so my doc can see where I'm able to get without surgery or other outside intervention.
The journey continues...
