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I've been having troubles with my right shoulder. I have something called shoulder instability, in addition a minor SLAP labrum tear. The top theory so far is that the laxity of my shoulder joint allows it to rest forward and downward rather than in it's normal place and that this position is pulling on my neck and low back to create symptoms away from the original source.
Now, I've been evaluated by just about every doctor for every respected field over the years. Neurologist from a movement disorder clinic has told me he's seen it before-- "...increased muscular activation of the right shoulder musculature, which though not suggestive of a primary dystonia syndrome could represent chronic muscle contraction and tension in response to injury".
Following that appointment I met with a Physiatrist:
This gentleman has a long history of right shoulder issues that are gradually worsening
over last 2 years. He now has pain in the right neck, upper back, chest and anterior
shoulder with some occasional radiation down the right arm. He also feels laxity or
looseness in the right shoulder and feels this is causing compensation in other areas. His
examination showed restricted right cervical rotation and with the apprehension test he
had guarding which made it difficult to assess and the guarding did not improve with a
relocation maneuver. I suspect there are several areas of myofascial pain in
compensation for underlying shoulder instability. He is already being followed by a sports
medicine doctor in his local area of ------. He's tried extensive conservative treatment
without much in the way of benefit. He has seen four orthopedic surgeons earlier in the
course however not recently and I recommended he follow-up with orthopedic surgery as
he does have a labral tear in imaging and may have some element of shoulder instability
which is not responding to prior conservative treatments.
Every shoulder specialist I see has one of these common answers:
- SLAP tear is minor, not worth a surgery to fix.
- Physiotherapy is the best solution for shoulder instability.
- The issue is neuromuscular in that the muscles are not maintaining the shoulder in a proper anatomically correct position (Solution- Physiotherapy).
- I have genetically lax joints, so any sort of stabalization surgery would be rendered ineffective.
- The symptoms in the neck and low back are unrelated to the shoulder and I should address those issues seperately with the necessary therapies.
I've now spent years of attending physiotherapy, in addition to other therapies as well and there has been no improvement. I've recently begun Prolotherapy, an injection therapy to try and create tissues to stabalize the joint. Again, no change. Right now the best response is to continue with Prolotherapy or move it up to PRP injections.
Has this happened to anyone else, chronic shoulder instability not being resolved? Does the labrum play that much of a role in stability? Does a damaged labrum really matter?
The symptoms in my neck and low back have become quite debilitating over the years and gradually worsen as time goes on. Any thoughts on where to go or what to do next?
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