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Forum Name: Joint surgery

Question: shoulder trauma- multiple diagnosis


 dretti33 - Thu Apr 23, 2009 4:41 pm

I was bodysurfing in the ocean 3 weeks ago and caught a wave wrong. it ripped my arm up and to the side and instantly felt like it "popped out." Had x-rays done. they said I separated it but also feared rotator cuff damage. Had an mri that revealed more than one problem. I've read a lot about treatment for each but not anything that tells much about if you have more than one injury. My mri result reads....
Supraspinatus Tendinosis
Small Glenohumeral Joint Effusion
Trace findings of Subacromial and Subscapularis Bursitis
Degenerative Superior Labral Cartilage Tear
I have an appointment with an orthopedic surgeon next week but wondered what to expect.. will this be an automatic surgery case or possibility of conservative treatment?
 dretti33 - Sun May 10, 2009 9:09 pm

I have since been to my orthopedic dr... he didn't hardly examine it at all. He touched the front of it and had me lay on my back and he moved it around a little and that was it. I was really disappointed in the lack of thoroughness. He recommended that I go to physical therapy for a month and then recheck it. My physical therapist has been great. He believes that I dislocated my shoulder and when it came out of socket it popped up and hit my collar bone and separated my shoulder. I for sure dislocated and separated it. I have torn cartilage. And I have severe scapular winging. One of the worst my pt has seen. It's been 6 weeks since the injury and I've been going to therapy for 2 weeks but the winging isn't getting any better at all. He believes it might be due to nerve damage. I also still can't hardly lift my shoulder without getting sharp severe pain in the front of my shoulder. It also slips out when I'm doing my passive excercises. I'm getting really discouraged with it and just want it to be fixed already. I wish somebody could give me some insight on what to expect with this type of injury.
 Tom Plamondon PA-C - Tue May 19, 2009 9:07 pm

User avatar Hello,
It sounds from the MRI and the mechanism that you tore the superior labrum (aka SLAP lesion). Sometimes the biceps tendon is torn with this injury which may account for the anterior shoulder pain.

The best clinical test for a SLAP lesion is the resisted supination and external rotation test.

Arthroscopic surgery can repair this lesion.

The serratus anterior which holds the scapula is place is innervated by the long thoracic nerve which may have been damaged by the trauma. It may take up to 6 months for the nerve and muscle to be restored to normal function.

Hope this information helps you make the best decision regarding your shoulder.

Take care.

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