Shoulder Botox

Surgical procedures used in the management of HMS.

Shoulder Botox

Postby kmc82 » Wed Aug 08, 2012 11:17 am

Hi everyone,

I've had problems with my right shoulder since aged 14 (am now 29) with it subluxing and dislocation (though I didn't know it was dislocating as I managed to relocate it and health professionals told me I couldn't have dislocated it). I eventually found this out when I had to have it relocated in A&E after dislocating it at the gym. After this I have experienced pain and instability (though not dislocations, thankfully!!) and had a bankart repair and capsular shift (open). I currently have muslce patterning problems with lots of pain in the pec muscle and feelings of instability. I have just been told this is because my capsular shift has left not enough room for my tendons causing shoulder impingement. (Though I also had symptoms of muscle patterning pre op but no one diagnosed this, which I now know is a contra indication for surgery due to causing the repair to fail).

Anyway, I've had a cortisone injection in the subacromial space which maybe has given mild relief and was told the next step would be botox as the surgeon isn't keen on doing a subacromial decompression (good!!!). Has anyone here had botox for similar or different reasons? I'm not sure on its success and my biggest fear is that switching off my pecs entirely is going to make my shoulder feel incredibly instable yet I can't strengthen anything else until the pattering is switched off otherwise I just strengthen the patterning if that makes sense!!

Sorry for the essay!!! Kelly xx
kmc82
 

Re: Shoulder Botox

Postby Spireite » Wed Aug 08, 2012 5:20 pm

Hi kmc82,

I have had a fair bit of botox in various places around the spine so I can comment on that but not your shoulder isssue particularly. I used to suffer with terribly tight muscles and found botox useful diagnostically to see what happens if you paralyse a particular muscle. Usually there was good and bad while the botox worked which was about two months for me. The good was the relief of the muscle tightness and consequences of that. The bad was that the tight muscles were holding the bones/vertebrae together in the absence of good ligaments so without ligaments or tight muscles holding the bones together I still had various problems, other muscle eg leg muscle spasm, funny walking etc etc. Botox is good in a way but it doesn't get to the root of the problem which is lax ligaments (or tendons or capsule). Far far better for me was to get to the root of the problem which is tightening the lax ligaments with prolotherapy.

I have subluxed my shoulder many times and then I dislocated it. Prolo straight away around the ligaments and rotator cuff tendons stopped that happening again.
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Re: Shoulder Botox

Postby kmc82 » Sat Sep 29, 2012 9:34 pm

Hiya,

When you had botox did you have physio at the same time to strengthen up the other muscles? Being fast tracked for botox now (scared) as shoulder is awful but have to have it with specialist physio because, as you said, it's just temporary and not a cure. I'm really hoping it helps with this muscle patterning I'm having as it's horrible :(. Otherwise I have to go on the waiting list for Stanmore which I am guessing is long :( xx
kmc82
 

Re: Shoulder Botox

Postby Spireite » Sat Sep 29, 2012 10:04 pm

I didn't get to having botox until after many years of hell, suffering badly and made worse by a lot of physios etc who mainly wanted to do high velocity manipulation to dislocate my joints. I didn't generally get exercises from physios at all, just high velocity manipulation or airy fairy massage which did nothing. Hence I now physio myself successfully. The idea with botox is to use the window of opportunity it gives to strengthen the muscles which are being inhibited by the tight muscles which never switch off to give the antagonists a chance. Ideally you would be supported by a good physio who could help activate the right stabilising muscles while they are not being inhibited and make sure it is working. You would want to make the most of this opportunity and good physio if you were so lucky. If not, quickly study shoulder anatomy and stabilisers yourself. Then when the botox wears off, you should not be back at square one but at square two or three! Good luck.
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Re: Shoulder Botox

Postby kmc82 » Mon Oct 01, 2012 2:47 pm

Thanks. Yeah, am getting referred back to a shoulder specialist physio to conincide with the botox. Kind of freaking out about it as I am assuming my global muscles have taken over the stabilising ones so I am assuming my shoulder will feel pretty unstable?! Coupled with the fact my capsule is hanging off (!) but if I do need surgery obviously cannot address this until the patterning has been addressed (though not what happened the first time...!). Yeah, there are some PDF factsheets including exercises from the people at Stanmore...and I did get given exercises from there last time but have never really successfully managed to switch the patterning off completely (whenever my should hurts, it comes back or whenever my proprioception gets really bad). Also, not really sure how much I can improve my proprioception if my capsule is so loose as I would assume it's part of the problem?! K x
kmc82
 

Re: Shoulder Botox

Postby kmc82 » Mon Oct 01, 2012 2:51 pm

Just had a call, botox 15th Oct eek!!! Now best get on to my GP regarding physio referral...!
kmc82
 

Re: Shoulder Botox

Postby Spireite » Mon Oct 01, 2012 6:04 pm

I understand the problem of ligaments being too lax. In my opinion, strong stabilising muscles can compensate for slightly lax ligaments. However, if there is gross laxity, then the job is too much for little stabilising muscles which go on strike with fright or overload. Hence, I have prolotherapy to tighten the very lax ligaments to give stabilising muscles a fighting chance.
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Re: Shoulder Botox

Postby kmc82 » Mon Oct 01, 2012 6:24 pm

Is that something the NHS do? I've heard a bit about it but not a lot. Judging by the gap on my MRI where my capsule is meant to be I'd say my shoulder was very lax. I know surgery is bad with HMS but I can definitely see the sense in tightening it up. We shall see I suppose! x
kmc82
 


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