Richard Haynes PTA/CPT - 8/12/2009

Question
Hi Richard

I was in a boating accident about 6 weeks ago.  I dislocated my right shoulder and took a blow to my right knee also.

I went to hospital and had X-rays and was told I has a posterior dislocation.  About 2 hours later and after some morphine I was given laughing gas and the shoulder was reduced. My arm was put in a sling and I was told to go home and rest and see my family Doctor in a few days.

My Doctor got me to have an ultrasound to check for soft tissue damage.  The results were that there were some micro tears in the subscapularis and the bursa was thickened.  After these results my Doctor told me to wear the sling and to see a Physiotherapist.
The Physiotherapist was given my X-rays and ultrasound results.
I have been going to the Physio for the past 4 weeks and now have a bit of movement, about 90deg in front and 60 to the side.
We have got to a point that progress is very very slow.  The Physio has told me that I should have more movement than I do and that there could be something else causing my shoulder not to go past the 90deg.

I was just wanting you advice on this and what you think I should be doing now?

On to my knee, the first week 2 weeks after the accident I had to lock my leg to walk/hobble, if I tried to walk normally the knee would give way.

I explained this to my Doctor and he did some tests on it and said it was a post ligament sprain and didn't seem overly concerned about it.  He said if it was a serious tear there would be a lot more swelling and pain.  Now six weeks later it still feels a bit unstable but I can walk fairly normal.

Just wondering what you think about the knee and how long you think it would take to fully heal, given what my Doctor has said etc etc.

Thanks very much, I really appreciate your time.

Kind regards

John k

Answer
John,

Regarding your shoulder, Unless there is some more rotator cuff damage that was not picked up in the original MRI then the only thing left to do is to continue with gentle exercising. Using heat if you are not already before exercise and, stay persistence with the program the therapist has given you.

Shoulder injuries along with dislocations are stubborn and take time to get back into workable condition. All the surrounding structures in the shoulder were either stretched or damaged. They will need more time to strengthen and assist with movement of the shoulder.

The question regarding your knee,If you need to use a cane to help take some stress off the knee for now. The cane would go on the opposite side of the injury.
Make sure you are doing some exercise for the leg to strengthen the knee. Leg extensions for starters would be great. if the pain continues to slowly subside then your doctor is right on.

A sprain to a ligament takes considerable amount of time as well. depending on your physical condition, bodyweight etc... 6-10 weeks is not uncommon. The fact that a ligaments bllod supply is virtually non-existent healing is slow.
Continue to give these areas more time.
Right now I do not feel there is any reason to be alarmed.

Sincerely
Richard Haynes PTA/CPT
Punta Gorda, Florida.
http://www.richardhaynes.com