Separated shoulder

[Yanaran]

Hey guys,

About two and a half months ago I suffered a separated right shoulder (http://en.wikipedia.org/wiki/Separated_shoulder) during a hockey game, and I haven't been able to do much powerballing since then because of it. It was a type 2 or 3 (using the rating on the wiki page) injury and it's still not quite back to normal but there's no pain anymore unless I do maximum strength lifts with the right arm.

I'm seeing a physical therapist and I'm doing basic mobility excercises (twisting and turning the arm) and we're going to start with strength this week, but I wanted to ask the powerball experts if there are any specific things I can do with the powerball to help build strength back up. I've tried a couple of things but mostly I end up getting really tired in my hand/wrist long before I feel anything in the shoulder. :D

Oh and I've also gotten a new appreciation for the need to rest between training. When I picked up the powerball for the first time since the injury last week, I broke my personal best in less than an hour. ;)

[Adrena1in]

Hi there, and sorry to hear about your shoulder, but I hope things are well and truly on the mend.

It's a tricky thing really, but the natural motion when people start Powerballing it to use their wrist and forearm a lot more than the upper arm and shoulder. I find that my technique, over the years, has moved to the position where I use my shoulder more than anything else...BUT, only really at high speeds. I have my arm quite straight and down towards the floor, palm sort of towards the floor and my fingers facing front. I keep my wrist and elbow quite locked, and oscillate my shoulders back and forth.

I wouldn't say this was something I tried on purpose...it just seemed to happen. But my shoulders have definitely changed a lot regarding their strength and muscle definition, so it's obviously these muscles I'm using the most.

I think if you just really try to lock your wrist and elbow, that's when the shoulder will come into play.

[Physioblue]

Hi,

Lets see if we can help you with this shoulder of yours.

You mentioned that you only get pain when trying to do full strength lifts with your right arm. But your Physical Therapist has only started you on mobility exercises, with a view to strengthening this week?
And the injury is nearly 3 months old?

So, do you have full movement back, or is there still some limitation? What percentage of movement would you say you have got?

A shoulder literally "floats" in its socket, with nothing holding it together except a combination of ligaments, joint capsule and muscles known as the "rotator cuff". When you dislocate (separate) your shoulder you more than likely damage these structures.
The most important thing when regaining full (painfree) use is making sure that all the muscles are balanced and that the muscles on one side of the joint aren't stronger than on the other. Otherwise the strong side pulls the joint towards it and slightly out of position.

The muscles need to be balanced both in terms of strength and stamina, and this is where the powerball will come in handy.
I don't believe you will get an enormous amount of strength from the powerball yet. As Tim (Adrena1in) said, most people don't use the shoulder until you can hit the really high scores. But it will help balance the endurance in the shoulder.
My recommendation (if you have 90% movement back approx.) would be to powerball normally, then spend one minute or so with your arm out to the side (no more than 90 degrees), another minute or so with your arm in front of you (90 degrees again) and then with it slightly behind you.
These three actions will provide an endurance work out for 3 of the 5 rotator cuff muscles. And don't be fooled, the other 2 muscles will be working just to stabilise the joint.

This should help a little, and listen to your physio, he/she will be able to provide you with the exercises that strengthen the joint and provide some stability. Using the powerball will help with that, but it still needs some hard work and effort.

Good luck.

[Autolupus]

Physioblue, what's the fifth rotator cuff muscle?
I know of the subscapularis, supraspinatus, infraspinatus and teres minor...didn't realise there were five!:confused:

[Yanaran]

Hi,

Lets see if we can help you with this shoulder of yours.

You mentioned that you only get pain when trying to do full strength lifts with your right arm. But your Physical Therapist has only started you on mobility exercises, with a view to strengthening this week?
And the injury is nearly 3 months old?

Hi, yes I've just started on mobility so far. The doctor I saw at the hospital after the injury only told me to keep the shoulder in use to help it heal faster and I only started seeing a phys.therapist after about 2 months when I felt it wasn't getting good enough on it's own. I don't know why I wasn't sent to one right away (and neither did the therapist after I told her about what happened and what the doc told me) but I've never had an injury like this before so I didn't think about it at first. I'm not doing mobility because it's limited, but because I had started moving the arm "wrong" to accomodate for the pain I got with normal use. I'm now unlearning those wrong movements so to speak.


So, do you have full movement back, or is there still some limitation? What percentage of movement would you say you have got?Just so there's no misunderstanding, it's not a dislocated shoulder (arm out of the socket kind of injury) but a separated shoulder. Basically the collarbone got torn lose from the top of my shoulder by about 10mm, so if I force my arm down the shoulder "drops" a bit from the collarbone, if that explanation makes sense. :D

I have full range of motion and have had some time now, the problem is that any lifting motion out/forward stretches the area that got injured and with enough weight on it gets painful.

I'll do some normal powerballing with the arm outstretched like you said. I certainly don't have the shoulder-movement Adrenalin described when I powerball (yet!) but if it can help even a little it's worth a shot.

Thanks for the help both of you! :)

[Autolupus]

An AC or acromial separation then.;)

[petemayhew]

Physioblue, what's the fifth rotator cuff muscle?
I know of the subscapularis, supraspinatus, infraspinatus and teres minor...didn't realise there were five!:confused:

Yer same here.

I'm not one to challenge Physioblue's Anatomy but I thought only 4 in the shoulder. :confused:

[Physioblue]

Physioblue, what's the fifth rotator cuff muscle?
I know of the subscapularis, supraspinatus, infraspinatus and teres minor...didn't realise there were five!:confused:
The long head of Biceps Brachii forms part of the anterior wall of the glenohumeral capsule. Because it reinforces the anterior wall during rotation it is sometimes considered to be part of the rotator cuff and should not be ignored during rehabilitation.
I could argue that the Triceps long head plays a similar role in posterior stabilisation, but since posterior dislocations are so rare, its not normally a consideration. You could also argue that because the Biceps Brachii doesn't rotate the shoulder it shouldn't be classed as a rotator cuff muscle. But since Supraspinatus does no rotation either, I think I have counter argument. ;)

So.. an AC Joint dislocation then. Serves me right for not looking at the Wikipedia site posted.:o

In that case, the rotator cuff is less important. In actual fact, there is no muscle that helps to reinforce that joint. The majority of the muscles in your arm will actually work to separate it further. But don't worry too much. The joint works perfectly well like this, even if its not "as God intended".
I maintain that powerballing with the arm in various positions would help regain some function, but with injuries like this the best advice is to do anything you like until it hurts.
You may struggle to do Shoulder shrugs, Bench press and Dips. But the sooner you try these things, the sooner your body will learn that its gotta put up and shut up.
Just remember to stop when it hurts.

[Jammy]

Gentlemen, thank you taking the time to really get into some details ion this thread. I find this fascinating indeed. We need more of this kind of thing.

[One-Eye]

You had me at "Hello".......

.....too many big words, One-Eye's brain hurt......:confused::confused:

;):D

[Autolupus]

One-Eye, until you'd typed it, "Hello" hadn't appeared, in this thread!;) :D

[Jammy]

You had me at "Hello".......

.....too many big words, One-Eye's brain hurt......:confused::confused:

Maybe you should have your son read this and then explain it to you..:rolleyes: ;) :p :D

[One-Eye]

Cheeky....

:p;):D