Question
QUESTION: Hi Scott,

I'm in my 50's.  Doing isometrics some 6 months ago, I dislocated the
cartilage connecting to my right first rib resulting in a large bump and some
pain.  

In a martial arts class some weeks later, we did a series of explosive
movements called fajing.  This resulted in terrible pain followed by shoulder
girdle instability on both sides and the feeling of ligament laxity throughout
the area including the left side of the neck.
It's been nightmarish since.
I've been seeing a chiro for a few months and the adjustments help my spine
decompress, but the instability, though slightly better, continues.  He feels
that potential improvement in the neck area where there had been damage 3
decades earlier in a very bad collision will help stabilize things throughout,
though it could take a long time.

Surgery is not practical since the area affected covers such a wide area.  Are
there any other modalities that could help with this awful situation?  Any
other input you might have would also be appreciated.

Thanks in advance for your feedback!
J. Mike









ANSWER: J,

Go to www.grastontechnique.com and find a provider.   There's your perception of instability, and then there is the real objective evidence that there really is instability, i.e. an loose and unstable joint.  The doctor should be proficient at determining this, e.g. by looking for "sulcus sign" or others on physical examination.   Also, have the doctor be specific about the exact anatomy of what you think you dislocated or disrupted.  

'Hope this helps.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Thanks for the quick reply!  A follow up:

The instability has been confirmed by a doctor who told me that the shoulder
girdle was unstable, but there was little that could be done medically.  It was
palpable to him (and me) that different "bands" are moving around and
making "snapping" sounds.

I looked up the graston technique as you suggested.  My question is whether
it would be potentially applicable to a laxity problem as well as to a problem
of restriction/scar tissue that the website seems to primarily emphasize?

Thanks very much!
j mike

Answer
J,

I'm still not clear on the instability.  "Girdle" implies the entire shoulder region.  This is not what the term "instability" is used for.  Loose/limber girdles are great if you're a swimmer, and the girdle can also be strong and in control, and this has nothing to do with instability.   If the glenohumeral joint is loose, in other words, if the ball sloshes forward in the socket, then you have "anterior glenohumeral instability."   THis happens if the ligaments that hold together the ball-socket (glenohumeral) joint are loose, stretched out, or damaged, and are therefore no longer secure that joint system.  Instability can also be seen at the acromio-clavicular joint, or AC Joint, following dislocations.  So the doctor must identify which joint (i.e. name the anatomy) is unstable.   Girdle means the whole region: scapula, shoulder joints, ribs, muscles, etc...

G'