Dislocated Shoulder

Typing with one hand so keeping it short…

Paddling WW solo canoe yesterday I zigged instead of zagged and took a swim. I finally surfaced with a dislocated shoulder and hiked out with a makeshift sling. X-rays showed no breaks. (Doctor who reset it was a local boater so that was cool.) No pain since resetting. Wearing a sling for the next week. To those of you who have had this same injury, will I be back on the water this summer or am I out for the season?

If the physician who reduced your shoulder dislocation was not an orthopedic surgeon, I would seek the opinion of an orthopod who specializes in shoulder pathology.

There is a significant risk of permanent shoulder instability and recurrent dislocation following first time anterior shoulder dislocation and that risk is higher in individuals age 40 and less. In some cases, arthroscopic stabilization is advisable.

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I have an appointment next week with non-surgery orthopedics (per the doctors’ recommendation.)

I’m well over 40 and am glad to know that finally being old is an advantage! :slight_smile:

You will find out after you get out of the sling if you can paddle or not. It is very unlikely that there is no damage to the cartilage in your shoulder. I second the orthopedic consult.
Also do yourself a favor and avoid jumping into physio without a proper diagnosis. You are more likely to be tortured by a therapist who thinks they " know" what is wrong.

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With luck the orthopedic doctor will get you started on physical therapy. That is your best bet for getting back on the water.

Gotta build the muscles back so it will stay in place, that I do know.

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Intelligently guided PT is clearly important, perhaps crucial. I have a compromised shoulder (bone-on-bone arthritis) and my exercises are helpful for increasing the flexibility and strength of supporting structures. My additional therapy is medical massage. These therapies help me continue to kayak.

An alternative is shoulder replacement which won’t necessarily work; I’d rather keep kayaking.

I don’t know about dislocation injuries, but I have a story about my torn rotator cuff. At age 65 I slid off a metal camp roof I was painting, happening by chance to land in a pile of concrete rubble from a masonry chimney I had just dismantled. On the way down I was thinking “how many bones?” But I was able to stand up and walk with no injuries evident. The next day I could not raise my right arm above the level of my nose. I was in training for a trip to the Yukon for a canoe race the next season and had to figure out if I could paddle a canoe. So I went to see an orthopedic sports medicine surgeon. X-rays and an MRI later showed a severely torn rotator cuff. The doc wanted to fix it surgically. I had known other paddlers with the same problem, and then had to hold their arm in a sling against their stomach for 3 months. So I asked the doc what the procedure was. He confirmed 3 months after surgery. Is there anything else I can do and still train and paddle in the Yukon just seven months from now? Well, we can try a cortizone shot directed to the exact tear he said. Ok let’s do it. A long needle went in and any pain was gone for 3 months. He directed me to a PT clinic near me and I went there several times a week for a few weeks, doing all the exercises there and what I could at home.

Then I realized that could do all the the critrical exercises at home and did not need to pay the co-pay several times a week. With the doc’s caution I did continue to train for paddling without the PT clinic.

A couple of months before my Yukon departure, a twinge of pain returned. So another visit to the doc and another directed cortizone injection made me good as new. Off to the Yukon races I went and paddled 500 race miles (in addition to many prior training miles) without any problem or pain.

I credit the proper exercises, cautious canoeing with my team training, and use of a canoe paddle machine simulator during the winter months to strenthening my shoulder and allowing me to continue paddling recreationally and racing to this day.

Any idea what happened - just curious.

What others said: orthopedist, PT. Don’t be surprised if they order an MRI or CT to further assess the joint. Expect to go sloooooow.

I dislocated my dominant shoulder 5/9 in a bike crash. Follow up showed I also broke the socket. I’m 17 days post op and facing 4 weeks in a sling followed by 3-4 months of PT. I was told not to expect to paddle> this year! The shoulder is amazingly complicated and takes a while to heal. Don’t take short cuts unless you want future dislocations, arthritis, tendon issues etc.

OP here.

I am just smart enough to respect and listen to people who are smarter and more knowledgeable than me. I’m a good and obedient patient. While my favorite place to be is in my boat, I have other interesting things to entertain me until next season (if it comes to that.)

I really don’t know what happened. A paddling friend and former guide said a common reason for a dislocation while open boating is “over bracing” I think I know what that means. Also, usually, when I go over, I pop right out of the thigh straps and my head doesn’t even get wet. Not always but usually. This time I didn’t pop out and spent an uncomfortably long time underwater. Not panic-inducing but getting close. Maybe I did something in my struggles. (BTW, those straps aren’t tight, which is why I usually pop out.) I didn’t notice the pain or injury until I was standing in thigh-deep water holding onto the boat with no idea as to what just happened. I had good, experienced friends with me who have extensive up-to-date wilderness first aid training. They really only had to help me hike out, but their coolness in handling the situation was a definite and welcome asset. :slight_smile:

That is a bummer, and kind of scary to think about. Bracing is definitely a time when you can end up with your arm extended and a lack of torso rotation (outside the paddlers box). I edit out the worst examples in my own pictures, but a quick look and I could still find some.

Surfing the Playhole - Erik

Riding the waves

Surfing below the Route 112 Bridge - Erik

I try not to ride braces down rapids, but like many people I often get into this bad position while surfing, or when doing stern pry/rudder strokes at the back of the boat. Rotate the torso and keep that arm bent - easier said than done.

I did have a dislocation when paddling once, but it was a finger not my shoulder. I had a long swim in some standing waves. When I got myself to shore, I looked down and noticed that my pinky finger was pointed out at a 45-degree angle. It was January and I had a glove on, so I pulled on the glove and it popped back into place. Fortunately, it was over before I even thought about it. Sore and bruised for the next couple of weeks, but fine otherwise. .

Good luck to you – hopefully you will be back in the boat and good as new shortly.

The shoulder joint has great range of motion but that comes with the price of considerable instability. The shoulder is most stable when the humeral head is down low and toward the back of the glenoid fossa (socket) and weakest when the humeral head is up high and toward the front of the glenoid. And the arm acts like a pretty long lever that can very easily transmit enough force to push the humeral head out of the glenoid fossa.

The force required to do that is surprisingly little. If your torso was somehow immobilized, by lashing your body securely to a tree say, and you held your arm and hand straight out to your side I would have to apply only 10-15 lbs to dislocate the shoulder joint anteriorly in most individuals. That much force can easily be applied if your paddle hits a rock or even by a very strong wave, especially if your torso is moving in an anterior direction when your arm and hand is moving in the opposite direction.

I would not pay too much attention to the experience of others who have had shoulder injuries, even those who have had first time anterior dislocations. The amount of permanent damage and potential instability resulting from shoulder dislocation can vary widely from person to person.

I have one friend who was a pretty avid whitewater kayaker who dislocated his shoulder. He underwent a prolonged period of physical therapy and had a recurrent dislocation while paddling a couple of years later. He then underwent arthroscopic shoulder reconstruction and later had a third dislocation simply pushing forward with his arms and hands to get out of a ski lift. He no longer paddles.

If you spoke to a few hundred individuals who had suffered first time anterior shoulder dislocations you would hear about a very wide range of outcomes all the way from those who had great success with physical therapy to stories like that of my friend above. You are more likely to hear about the former than the latter on a paddling message board.

A life well lived involves some risk.
Thoughts for rapid healing rocketing straight to you from a stranger.

Thank you. I’m going to show this to my wife. As it is, she said that I’m grounded for a very long time. :slight_smile:

I’ve been reading up on recovery. As I didn’t experience bruising or swelling and have not had pain since the reset, I’m thinking that maybe I’ll at least be able to paddle flat water before the end of summer.

I dislocated mine years ago. With my orthopedist’s blessing I started flat water after 10 days.

That is certainly encouraging! :grinning:

The forum could create a new “category” focused on coping with shoulder injuries. This is perhaps the most common injury (in its various forms) that afflicts kayakers. There is a lot of wisdom, experience, and useful information lurking in this group.

Now in my 80s, I have bone-on-bone arthritis in my left shoulder. Luckily it does not hurt while I paddle, but does wreak vengeance that evening. With PT exercises and medical massage I have increased mobility and strength while avoiding surgery. Surgery would likely halt my kayaking and I haven’t that many years left on the water to take that step.

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It’s great that you’re still going in your 80s.

Not necessarily. I have a friend who has been an expert whitewater kayaker since the 1980s who had to undergo shoulder replacement with a prosthetic joint a couple of years back and he was back paddling within a year.