I Have Some Answers on my Shoulder

Thursday, July 10, 2014

Probably better than I expected, but not great nonetheless.

When I dislocated my right shoulder in January in a cycling crash on Black Ice, things started out fine for several weeks. I was going to Physio, and while swelling in the shoulder was going down things were improving rapidly, however six weeks out things started going downhill (fast) and ten weeks out I decided I needed to get more answers.

Emails back and forth with my wife's Uncle Jack (a Sports Medicine specialist) going over symptoms suggested two tears, one in the supraspinatus tendon and one in the Labrum, but until I was able to get in to see him for a physical exam at the end of May we couldn't progress any further. The physical exam gave essentially the same suspected diagnosis as the email conversation, with a request for two diagnostic imaging procedures (an MR Arthrogram and an Ultrasound) to see what's actually going on.

The MR Arthrogram (an MRI with a Gadolinium contrast agent injected directly into the joint) was last Monday. It was a supremely weird feeling having a needle directly in the joint, but the rest of it was fairly straight forward - lie still with my body in a great big washing machine. Today I met back with Jack to get the results.

First, my supraspinatus tendon is not torn. It has a fair amount of scarring yes, but it's not torn; if it had been it likely would have meant surgery. It is expected that this will heal on its own and/or with physio. The MRI also showed that the muscles of the rotator cuff were all in good shape and exactly where they should be, as is the biceps and the biceps tendon.

Second, I have a fair amount of scar tissue in the area of the acromioclavicular joint. I had to Google that - it's where the shoulder blade and collarbone meet. The scar tissue in this area prevented me from putting my arm behind my back, reaching backwards, and severely limited my range of motion. This scar tissue has gone down significantly since May, and things are much better, but my right shoulder is still significantly worse than my left. It is expected that this will heal on its own and/or with physio.

Third, I have a small Hill Sachs lesion on my humerus head. This is not unexpected - many (if not most) shoulder dislocations have this type of injury, essentially a groove in the bone that comes from dragging it across other bones as it gets pulled out. This injury is minor, and doesn't need any intervention.

Fourth, I have an anterior glenoid labrum separation. This is the big one, and most likely does mean surgery. It's at this point that Bruce (SPEEDYDOG) would put in a cool picture, but I'm feeling kind of lazy. Basically, the shoulder joint consists of two parts, a ball and a socket. The ball is the humerus head (where I've got the Hill Sachs lesion), while the socket comes in two pieces: the glenoid process which is bone and makes up only a small part of the socket, and the glenoid labrum which is a cartilage ring and makes up most of the socket. The biceps tendon attaches to the labrum (not to the bone) and when my shoulder was dislocated, the biceps tendon was jerked hard and violently pulled the labrum off the bone.

The next step? Meeting with a surgeon to get a plan in place.
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Member Comments About This Blog Post
    You go the extra mile! I like that!

    spark hug
    2147 days ago
  • no profile photo CD5826541
    anterior glenoid labrum separation- just got done with surgery for that on July 30th. I start PT on Sept 12th. They wanted 6 weeks for the reattachment to get secured and healed. the surgery went well and in about 6 days I had full use of my arm although it was still sore but I could do basic tasks.

    get it taken care of when you can but just be prepared to be off work for a while.
    2460 days ago
    It's good to have a plan. Hope it works out.
    2491 days ago
  • no profile photo CD5915724
    Ouch! I hope things work out for you with the decision on surgery. Take care!
    2492 days ago
    Sounds like a lot of work to get back to normal, hope it all goes quickly for you. It seems like we could crash our bikes as kids and need a band-aide, maybe some stitches; we crash in adult hood and the word 'surgery' starts getting thrown around.
    2492 days ago
    Great to hear from you, though I wish it'd been better news. Hope you'll recover nicely. Limited motion no matter where is not a fun thing, especially when it limits an active lifestyle. Be well.
    2493 days ago
    Best wishes for a quick recovery!
    2493 days ago
    Hi Bill,

    I am glad you let everyone know how you are doing. I will be interested to find out what your surgeon suggest for repair. Your injuries and scar tissue must be very painful. I haven’t had the heart to blog about my shoulder injury. But I do indeed have some great diagrams that I can include!

    I have a torn glenoid labrum, torn supraspinatus tendon and severe impingement “syndrome”. My shoulder makes a lot of noise. I have actually learned, as I am sure you have, not to move my right shoulder is ways that cause too much pain.

    I plan to have surgery after mountain biking season and football season comes to an end. I am not ready for 3 months of shoulder immobility and 3 months of physical therapy.

    I hope you can get back to 100%.

    Thanks, Bruce

    2493 days ago
    2493 days ago
    2493 days ago
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