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Rotator cuff injury
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boggsman1



Joined: 24 Jun 2002
Posts: 6623
Location: at a computer

PostPosted: Mon May 07, 2018 4:14 pm    Post subject: Reply with quote

I've had 3 full tear repairs...a nightmare injury,which I don't recommend to anyone. Push ups and overhead weight training is not a good idea, lots of strain on the joint...But windsurfing if fine, provided you don't get rolled in the waves, trying to hang on to your rig....
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surfersteve



Joined: 24 Apr 2007
Posts: 178

PostPosted: Tue May 08, 2018 9:28 am    Post subject: professional advice Reply with quote

As a PT who has seen hundreds of injuried shoulders and also sails here, I am happy to offer some alternate perspectives.

First, the AC joint is not the rotator cuff, and reacts quite differently. It is merely the place where the end of the collar bone lies on a small antenna off the shoulder blade. The ligaments which hold it together resemble straps of duck tape holding the bones together.

If you have enough financial stability to pay for IW, you are probably old enough to have an AC joint which may never be 100%. The AC is a unique joint to the body which does not resemble nearly any other. Once injured as a not-so-young adult, your problem is not really one associated with time for tissue healing past 12 weeks +/-. It is the manner in which the tissue heals. You should expect the ligaments to heal with a different composition much less elastic vs. the God-given one. As such, sailing is putting it in harm's way regardless of how long you have recovered.

The Gorge is a very gusty place and very tough on the shoulder girdle as a result. Why? Because the gusts over 30 are just not the type of activity our tiny rotator cuff and tenuous AC joints are designed to handle.

My advice? Make sure you are as flexible as possible in the trunk, spine, ribs, and at the other end of the collar bone (the sternoclavicular joint). Doing this will directly reduce the stress through the AC joint and keep it happy.

If you do not have a PT and are interested in some free treatment, I am happy to help out a local sailor. Send me a msg anytime. Steve 541-806-7838

Good luck.
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isobars



Joined: 12 Dec 1999
Posts: 18693

PostPosted: Tue May 08, 2018 9:55 am    Post subject: Reply with quote

There are also several things we can do to reduce the stress on our arms and shoulders -- especially RC, AC joint, forearm tendons -- while sailing. One is using bigger sails ... just one of over a dozen reasons I rig big.

It took 32 SUBMITS to post this. The first 31 were INVALID. C'mon, iW ... this is an OLD, OLD problem that needs fixing.
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biffmalibu



Joined: 30 May 2008
Posts: 433

PostPosted: Thu May 10, 2018 1:24 pm    Post subject: Flexibility Reply with quote

Steve would appear to be the expert here. So I would listen to Steve a lot. It seems his bottom line is FLEXIBILITY.

Speaking from personal experience, all I had was a class 1-2 tear in my dominant shoulder (from bench press). Doc was not greedy, had plenty of work always, and said let it be; no surgery. There was scar tissue, adhesions, etc. It took a full year for pain to go away (definitely interfered with sleep) and for full flexibility to be restored. At every reasonable opportunity in daily life, I would rotate my arm slowly and carefully. I recommend similar; pay little heed to the situation and don't be embarrassed. Check out line at store, business meetings, romantic dates, etc. Bystanders might think you have an obsessive-compulsive disorder, but it's for your own good. Keep rotating gently as you are able. I am certain Steve will have a few simple safe exercises to demo and recommend.

Also, welcome to the Gorge where the wind is rarely non-gusty. I thought I'd never say this...consider a wind sport with less structural impact...such as kiting.
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dllee



Joined: 03 Jul 2009
Posts: 3960
Location: East Bay

PostPosted: Thu May 10, 2018 1:39 pm    Post subject: Reply with quote

Recovering from injury, you need to be smarter, not rig differently than your norm.
You can't control the windgusts from coming, but you can recognise and react accordingly.
And if you decide to go out at Dougs in switchy 7 to 35 mph conditions..take responsibility for your decisions.
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jgda



Joined: 19 Jul 1999
Posts: 76

PostPosted: Thu May 31, 2018 4:17 pm    Post subject: Sc joint Reply with quote

Ok, I had not really noticed this, but the SC joint also is popping out a bit when I move my arm around. I dont think it is dislocated, but it is, not surprisingly loose. My PT had told me about this, and I am not sure if I added insult to injury doing my exercises. However, I have no pain, and I have full range of motion and have now reached my pre-injury strength as far as shoulder exercises...I am NOT doing any overhead lifting, and only 65-75 lbs, very high rep bench press. I was kind of bummed when I saw the SC joint also was messed up. I went online and saw an ortho doc who stated many high level pro atheletes have this condition and still function quite well...even football players. The one thing my PT is encouraging is prolo therapy where the inject dextrose to scar/tighten down the ligament. This question is directed to Steve, but I see some evidence in that it works, but then I hear from those who have paid out of pocket for this (not cheap) that the results have been mixed. I see no evidence to support use of plasma injections. Heading into month 4 and still staying off the water, but wanting to go out on a 5.0 day....arggggh!!!
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surfersteve



Joined: 24 Apr 2007
Posts: 178

PostPosted: Thu May 31, 2018 10:23 pm    Post subject: Reply with quote

My understanding of prolotherapy or PRP is that it is NOT dextrose, which is sugar. These treatments involve taking out some of your blood, putting it into a centrifuge to separate out the red blood cells, and injecting these cells as a group directly into a site needing a boost.

The reason this treatment has become popular is because many soft tissue injuries involve tissues/structures which do not have the best blood supply and nutritional input - a rotator cuff tendon, a tennis elbow, etc. The injection directs a lot of highly nutritious cells to the site and is supposed to speed up and promote healing when healing is delayed by age, anatomy/circulatory limitations. You don't hear about this treatment for a hamstring or quad tear because muscle tissue has much better circulation to promote faster healing.

I do not have enough personal knowledge to know if prolotherapy is decent, good, or excellent for these problems. There are other things being done which could be far superior including stem cell injections. The biggest problem is that anyone who performs these procedures wants everyone to get better with their particular method. It makes them $ and promotes their clinic and proves efficacy.

As for the joint problems, people can certainly sail, lift weights, or do lots of things with dysfunctional joints. What typically happens is when one joint (say an AC) does not have normal movement, the other associated joints compensate until THEY start to have problems. So the SC joint, glenohumeral joint, etc. And so on and so on. It all depends on how much dysfunction, what activities are you performing, at what intensity, etc. A lot of variables.
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wsurfer



Joined: 17 Aug 2000
Posts: 690

PostPosted: Tue Jun 12, 2018 8:04 pm    Post subject: Re: professional advice Reply with quote

surfersteve wrote:
As a PT who has seen hundreds of injuried shoulders and also sails here, I am happy to offer some alternate perspectives.

First, the AC joint is not the rotator cuff, and reacts quite differently. It is merely the place where the end of the collar bone lies on a small antenna off the shoulder blade. The ligaments which hold it together resemble straps of duck tape holding the bones together.

If you have enough financial stability to pay for IW, you are probably old enough to have an AC joint which may never be 100%. The AC is a unique joint to the body which does not resemble nearly any other. Once injured as a not-so-young adult, your problem is not really one associated with time for tissue healing past 12 weeks +/-. It is the manner in which the tissue heals. You should expect the ligaments to heal with a different composition much less elastic vs. the God-given one. As such, sailing is putting it in harm's way regardless of how long you have recovered.

The Gorge is a very gusty place and very tough on the shoulder girdle as a result. Why? Because the gusts over 30 are just not the type of activity our tiny rotator cuff and tenuous AC joints are designed to handle.

My advice? Make sure you are as flexible as possible in the trunk, spine, ribs, and at the other end of the collar bone (the sternoclavicular joint). Doing this will directly reduce the stress through the AC joint and keep it happy.

If you do not have a PT and are interested in some free treatment, I am happy to help out a local sailor. Send me a msg anytime. Steve 541-806-7838

Good luck.


Shite!!! I am on week ten of recovery from AC joint and rotator injury from windsurfing (took a spill off a wave and right shoulder was slammed into the board).
Just starting to feel better but would not even think of sailing, golfing, lifting weights, etc. Even had to cut back on bike riding as it seemed to slow my recovery. Just trying to continue PT. My non-surgical Orthopedic Sports medicine doctor said I should be good in two weeks ( but then again he said that two weeks ago).
I'm not that young anymore (60) so it does take longer, I should be at the 12 week mark in two more.
I am an East Coaster but was searching rotator cuff!!!
Thanks for the insight!
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jgda



Joined: 19 Jul 1999
Posts: 76

PostPosted: Fri Jun 15, 2018 10:33 am    Post subject: Hang in there Reply with quote

If it helps, I am a very young, but yet 62 year old, and I have been doing my exercises 2x a day now for 15 weeks. I make significant and noticeable gains about every 2 weeks. I have now backed off to light exercises in the morning and heavy every other day as I am now back to my pre-injury weights except I do not lift overhead, and bench press is with TRX and very light with high repetition. Collagen III won’t convert to the stronger type I unless you keep working those ligaments. I have no pain but I a waiting 5 months before I hit the water and then I am adding some extra padding on my shoulder. Thing is, it is not just hitting the board, but as someone else said, hanging on to the boom or reaching out to brace yourself when falling into the sail (happens) that can reinjure those ligaments. At least for this summer, it will be easy cruising 4.7+ sail size. After a year, I will go back to waves and aggressive swell riding. Good luck. Thing is, this happens to the 20 year olds and out still takes a long time to heal for then too.
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rswabsin



Joined: 14 May 2000
Posts: 366
Location: New Jersey

PostPosted: Tue Jun 19, 2018 7:58 am    Post subject: Reply with quote

Also, think about your ability to water start with your weaker shoulder. Straight overhead strength re-gain has been one of the slowest and tougher parts of the shoulder recovery process for me. But it does recover. I missed a jibe last evening and was quite pleased that I could raise the sail again just fine with the weaker shoulder - it was key in regaining confidence.

Rob
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