John’s Blog

[This is mostly for my own future-self edification than for general interest, but might be useful to others with shoulder issues.]

A couple of weeks ago, I dislocated my left shoulder, and am planning to have it surgically repaired a couple of weeks from now. I wasn’t doing anything unusual at the time — was only putting my iPad on my bedside table — but put my arm in a bad position and the shoulder came out. (As a side note, for those of you keeping score at home: Kindle: 0 shoulder injuries. iPad: 1 shoulder injury.) Anyway, it came out, and Kathy was good enough to hold my forearm for me so that I could get my shoulder back in the socket.

This is a bit of a longstanding problem for me. I first dislocated my shoulder when I was 14 years old (give or take) — our soccer team had practice one evening, but another team was using the field, so we were warming up on the asphalt basketball court. I was dribbling around a guy but tripped over his foot, and caught my fall with my left arm, and my shoulder popped out. It took about 90 minutes to get me to the hospital and see a doctor — when I saw one, he lifted my arm above my head, and the shoulder got reseated, much to my relief. In retrospect, I don’t really know how much it hurt, but I know that I was pretty scared because I had never been through anything like that before.

I went through the normal rehab and physical therapy, but had continued problems — my shoulder dislocated maybe a dozen more times up until my freshman year at Stanford. It got to be so that the slightest thing could cause it — even turning over in my sleep did it a couple of times. So I decided to see a surgeon about doing something more to repair it.

In either 1990 or 1991, I had surgery near Dallas — something called a Bankart procedure to repair the tear in my labrum and to retension the capsule. It was an open procedure — not like the arthroscopic procedures that are most common today — and I remember it being tough to recover from, even as a 19 year old. Was in the hospital for 3 or 4 days, then a ton of rehab after that.

But the really, really great news was that my arm didn’t dislocate anymore. I lost some range of motion in the shoulder, basically because they tightened the capsule more than “normal.” But it was definitely worth it to have a more stable shoulder. In 1997 or 1998, though, it happened again during a softball game at Stanford, as I was in the batter’s circle. Surprised me, and hurt a lot.

And then, life was better for a while. I started lifting weights around that time, and generally getting into better shape, and my shoulder got stronger than it had ever been.

Until a couple of weeks ago.

I’ve been in to see Dr. Eakin at the Palo Alto Medical Foundation a couple of times now, and I like him — he was pretty clear from the outset that I would very likely need surgery, and after looking at the x-rays and MRI images, it’s confirmed.

He actually drew me the set of pictures above — the top left shows a top view of the shoulder — you can see the ball connected to the very shallow socket, with the pointy bits of cartilage called the labrum keeping it in, along with the capsule that’s surrounding the ball. When the dislocation happened, as shown in the upper right diagram, it broke part of my labrum and detached the  capsule (or stretched it really thin). The procedure he’s suggesting is called a Bankhart procedure (I think) to repair the labrum and retension the capsule, resulting in the happy picture in the middle of the image. Unlike the procedure I had 20 years ago, this will be an arthroscopic one.

One side note is that part of the ball chipped during some earlier dislocations — resulting in the notch he’s drawn. That doesn’t seem to be causing me any particular issues at the moment.

As a rule, I’m very hesitant to choose surgery — it’s just very difficult to undo if something goes wrong. But since I’ve had such trouble over the years with this shoulder, and since it’s been surgically repaired before, I’m pretty clear that it’s the right thing to do. I think that if I don’t do it, my shoulder will always feel very unstable, and will have a pretty high likelihood of coming out again. I figure I can heal better now than I’ll be able to in the future.

Rehab is longer than I was hoping for — 1 week out of work, then 4-6 weeks in a sling, then 4-6 weeks in physical therapy, then another 4 weeks of strengthening work. So it eats up a lot of the summer, and is a little hard to swallow because I’m feeling pretty good right now, am able to go to the gym, etc. But I should come out of the summer with a more stable shoulder for the long term, so I think it’s the right thing to do.

For the sake of completeness, I’ll note that my right shoulder has dislocated a couple of times, too, but is decidedly more stable, and doesn’t really give me any problems at this point. My brother has dislocated one of his, too.

Anyway, as I’ve said other places, it’s a bummer, but I’m not really too unhappy about this development. I’ve got time to take care of it without hugely disrupting life, and it’s basically a fixable problem, with a minimum of drama. I’ll be able to do some working out while I rehab (like the exercise bike), so that will help, too. And I’d always take shoulder problems over knee issues — don’t have to walk on my shoulders.

Surgery in a couple of weeks — hopefully I’ll be in the 80% happy category on Dr. Eakin’s drawing. 🙂