Shoulder Reduction

This is a bit long, but it works - from the kayakers...

A "dislocation" is a joint injury where the end of a bone in the joint ends up out of place. The cause is usually a combination of the right forces and the right position, at (of course) the wrong time. For the shoulder, a "ball in socket" joint, the further the joint is open (i.e. the arm is out away or "abducted" from the body) and externally rotated (palm of hand is forward as in throwing a baseball), the weaker and more vulnerable it is. Any abrupt, intense force against the arm in this position extending it too far back can cause the "ball" to pop out, usually in front of or "anterior" to the socket. So now imagine yourself on the river and someone may have just dislocated a shoulder. How do you know it's dislocated and not broken? The answer is often easy. The victim will probably tell you. It's like having an underwear wedgie; they just know things aren't where they're supposed to be. And frequently, they "felt it pop out." This is especially true if they've ever dislocated before. Anyone who's ever had one is at higher risk to do it again, and if they say, "it's out again," believe them. Suppose all they do is scream and tell you nothing. Remember that the mechanism is important. Any force pushing the arm back while its abducted and externally rotated (again, as in a throwing position), a dislocation is much more likely. Falling directly against the arm or shoulder while the arm is held against the body usually results in bruising or a broken bone, not a dislocation. There is no crunching or grating of bone against bone (crepitus) as in fractures, and dislocations cause extreme, unrelenting pain. The pain, in contrast to fractures, often doesn't improve much even without moving and splinting the arm. Looking at the shoulder will also give you more clues as to the type of injury. Before swelling sets in and on thinner individuals, the dislocated shoulder looks different. It will have a "squared-off" appearance. To appreciate this, you need to look at both shoulders for comparison. Remove the shirt. There will seem to be a small hollow underneath the bony shelf of the shoulder. Look at how the arm is being held. For dislocations, the arm is usually held away from the body, where with fractures it's often braced directly against the body. To try to make a person hold it otherwise or move it, frequently results in slurry of naughty words. So, the shoulder looks out and it feels out. What could be worse? Imagine it's you, and you're alone. Now what? Speed is crucial. The sooner it's put back in place, the better. Joints hate being out of place, and the longer they remain out, the harder they are to put back. Plus, they'll often get even with you for long delays by giving you arthritis down the river. Enter the Kayaker Special. This is the quickest, easiest and most effective way to reduce a dislocated shoulder in the field. Plus, it can be performed by the injured person alone - even in turbulent water. It's simply done by sitting (or floating) and tucking the knees up to the chest. Lock both hands together in front of the knees as if to hug the legs to the chest. Now relax. That's right, relax, and lean back. Let the weight of the upper body do the work. With the arms locked around the legs traction is put on the arm and transmitted to the shoulder, this then pulls the shoulder back into place. Pushing out with the knees against the locked hands can increase the traction if needed. It's that simple. There are plenty of other methods to reduce shoulder dislocations, from dangling weights off the injured arm, to someone pulling on the arm with a foot in the victim's armpit for leverage. Unfortunately, these can take a lot more time, need assistance, and are often really hard torture to get a sober person to volunteer for. Fortunately, the Kayaker's Special is a lot less traumatic. It also probably has the best margin of error that allows you to not do further damage to the shoulder if you guessed wrong and were actually dealing with a fracture. How effective is it? Reportedly 97%! (Hey, if this doesn't work, the others probably won't either. That's why I left them out.) How do you know the shoulder is back in place? Usually there is a "pop" as it slides over the socket rim and back into place. The deformity corrects and there is immediate relief of the majority of the pain. Gentle rotation of the arm will confirm normal gliding of the joint. If so, check that the wrist pulse is good, and that movement of the hand and fingers is OK. Also make sure sensation to light touch over the shoulder and arm is intact. If there is a problem with any of these, an evacuation is needed, pronto. If there is no problem, put the arm in a sling. A person can stay with the trip, but the arm is down for the count, at least 1-2 weeks. This means everything, especially lifting the arm! Wrapping the arm against the body ("swathing") adds another layer of bondage for those who insist on trying to move it. The rest is up to time and the healing powers of Mother Nature. As soon as you get off the river, a follow-up with an orthopedic doctor should be done, x-rays should be taken and further treatment determined.

seems like a reasonable approach. It wouldn't work with a hysterical patient and it would work best if done very quickly after the dislocation. I've dislocated my shoulder about 20+ times and was able to get it in every time except for once. Then I couldn't talk the ER doc through it and had to call in one of my friends who got it back in quickly. We manipulate it into a reduced position and never "pop" it back in.

That was really good, Thanks. I admit that I got light headed and queasy following that. Hope i never get to see that.

--- In Yahoo Canyons Group, "rick demarest" <water44@...> wrote:
This is a bit long, but it works - from the kayakers...
> A "dislocation" is a joint injury where the end of a bone in the joint ends up out of place. The cause is usually a combination of the right forces and the right position, at (of course) the wrong time. For the shoulder, a "ball in socket" joint, the further the joint is open (i.e. the arm is out away or "abducted" from the body) and externally rotated (palm of hand is forward as in throwing a baseball), the weaker and more vulnerable it is. Any abrupt, intense force against the arm in this position extending it too far back can cause the "ball" to pop out, usually in front of or "anterior" to the socket. > So now imagine yourself on the river and someone may have just dislocated a shoulder. How do you know it's dislocated and not broken? The answer is often easy. The victim will probably tell you. It's like having an underwear wedgie; they just know things aren't where they're supposed to be. And frequently, they "felt it pop out." This is especially true if they've ever dislocated before. Anyone who's ever had one is at higher risk to do it again, and if they say, "it's out again," believe them. > Suppose all they do is scream and tell you nothing. Remember that the mechanism is important. Any force pushing the arm back while its abducted and externally rotated (again, as in a throwing position), a dislocation is much more likely. Falling directly against the arm or shoulder while the arm is held against the body usually results in bruising or a broken bone, not a dislocation. There is no crunching or grating of bone against bone (crepitus) as in fractures, and dislocations cause extreme, unrelenting pain. The pain, in contrast to fractures, often doesn't improve much even without moving and splinting the arm. > Looking at the shoulder will also give you more clues as to the type of injury. Before swelling sets in and on thinner individuals, the dislocated shoulder looks different. It will have a "squared-off" appearance. To appreciate this, you need to look at both shoulders for comparison. Remove the shirt. There will seem to be a small hollow underneath the bony shelf of the shoulder. Look at how the arm is being held. For dislocations, the arm is usually held away from the body, where with fractures it's often braced directly against the body. To try to make a person hold it otherwise or move it, frequently results in slurry of naughty words. So, the shoulder looks out and it feels out. What could be worse? Imagine it's you, and you're alone. Now what? Speed is crucial. The sooner it's put back in place, the better. Joints hate being out of place, and the longer they remain out, the harder they are to put back. Plus, they'll often get even with you for long delays by giving you arthritis down the river. > Enter the Kayaker Special. This is the quickest, easiest and most effective way to reduce a dislocated shoulder in the field. Plus, it can be performed by the injured person alone - even in turbulent water. It's simply done by sitting (or floating) and tucking the knees up to the chest. Lock both hands together in front of the knees as if to hug the legs to the chest. Now relax. That's right, relax, and lean back. Let the weight of the upper body do the work. With the arms locked around the legs traction is put on the arm and transmitted to the shoulder, this then pulls the shoulder back into place. Pushing out with the knees against the locked hands can increase the traction if needed. It's that simple. > There are plenty of other methods to reduce shoulder dislocations, from dangling weights off the injured arm, to someone pulling on the arm with a foot in the victim's armpit for leverage. Unfortunately, these can take a lot more time, need assistance, and are often really hard torture to get a sober person to volunteer for. Fortunately, the Kayaker's Special is a lot less traumatic. It also probably has the best margin of error that allows you to not do further damage to the shoulder if you guessed wrong and were actually dealing with a fracture. How effective is it? Reportedly 97%! (Hey, if this doesn't work, the others probably won't either. That's why I left them out.) > How do you know the shoulder is back in place? Usually there is a "pop" as it slides over the socket rim and back into place. The deformity corrects and there is immediate relief of the majority of the pain. Gentle rotation of the arm will confirm normal gliding of the joint. If so, check that the wrist pulse is good, and that movement of the hand and fingers is OK. Also make sure sensation to light touch over the shoulder and arm is intact. If there is a problem with any of these, an evacuation is needed, pronto. If there is no problem, put the arm in a sling. A person can stay with the trip, but the arm is down for the count, at least 1-2 weeks. This means everything, especially lifting the arm! > Wrapping the arm against the body ("swathing") adds another layer of bondage for those who insist on trying to move it. The rest is up to time and the healing powers of Mother Nature. As soon as you get off the river, a follow-up with an orthopedic doctor should be done, x-rays should be taken and further treatment determined. >

Uh, yeah...

Important to point out that there are many times when trying to reduce a shoulder dislocation is COUNTER-INDICATED. If there is a chance of broken bones, or any indications thereof, the arm should be splinted in a position of comfort and the victim evacuated gently. Trying to reduce with broken bones present could result in rupturing things in the area = very bad. Perhaps the Doc could comment on this.

Kayakers have it easy, because they are more likely to have a clean dislocation due to odd forces on the paddling shoulder. For canyoneers, a fall hitting the shoulder can result in a dislocation, but can also result in various broken bones. Careful out there.

Had the person dislocated before? Who was the reducer, and were they trained in reducing shoulders?

Here is a 1 mb pdf file on the Kayaker Special:

http://www.canyoneeringusa.com/rave/shoulder.pdf

Tom

--- In Yahoo Canyons Group, "adkramoo" <adkramoo@...> wrote:
That was really good, Thanks. I admit that I got light headed and queasy following that. Hope i never get to see that.
> --- In Yahoo Canyons Group, "rick demarest" <water44@> wrote:

This is a bit long, but it works - from the kayakers...


A "dislocation" is a joint injury where the end of a bone in the joint ends up out of place. The cause is usually a combination of the right forces and the right position, at (of course) the wrong

Not too sure I had a "dislocation" last april as I ended my wild ride down the waterfall in Deep Creek (knocked unconscious half way down), but after a fair amount of discomfort all last summer and various attempts to do the right thing for recovery......"rotator cuff surgery" became the faire last october. The shoulder is the most complex, yet fragile joint in the body. Many semi fragile tendons, ligaments and muscles work together to hold the joint together. My surgery entailed repairs of supraspanitus, infraspinatus, and labrum. Decompression also entailed some bone grinding to make room for scar tissue. Hopefully in your dislocation the tendons and ligaments were not significantly damaged? Good luck!

--- In Yahoo Canyons Group, "rick demarest" <water44@...> wrote:
This is a bit long, but it works - from the kayakers...
> A "dislocation" is a joint injury where the end of a bone in the joint ends up out of place. The cause is usually a combination of the right forces and the right position, at (of course) the wrong time. For the shoulder, a "ball in socket" joint, the further the joint is open (i.e. the arm is out away or "abducted" from the body) and externally rotated (palm of hand is forward as in throwing a baseball), the weaker and more vulnerable it is. Any abrupt, intense force against the arm in this position extending it too far back can cause the "ball" to pop out, usually in front of or "anterior" to the socket. > So now imagine yourself on the river and someone may have just dislocated a shoulder. How do you know it's dislocated and not broken? The answer is often easy. The victim will probably tell you. It's like having an underwear wedgie; they just know things aren't where they're supposed to be. And frequently, they "felt it pop out." This is especially true if they've ever dislocated before. Anyone who's ever had one is at higher risk to do it again, and if they say, "it's out again," believe them. > Suppose all they do is scream and tell you nothing. Remember that the mechanism is important. Any force pushing the arm back while its abducted and externally rotated (again, as in a throwing position), a dislocation is much more likely. Falling directly against the arm or shoulder while the arm is held against the body usually results in bruising or a broken bone, not a dislocation. There is no crunching or grating of bone against bone (crepitus) as in fractures, and dislocations cause extreme, unrelenting pain. The pain, in contrast to fractures, often doesn't improve much even without moving and splinting the arm. > Looking at the shoulder will also give you more clues as to the type of injury. Before swelling sets in and on thinner individuals, the dislocated shoulder looks different. It will have a "squared-off" appearance. To appreciate this, you need to look at both shoulders for comparison. Remove the shirt. There will seem to be a small hollow underneath the bony shelf of the shoulder. Look at how the arm is being held. For dislocations, the arm is usually held away from the body, where with fractures it's often braced directly against the body. To try to make a person hold it otherwise or move it, frequently results in slurry of naughty words. So, the shoulder looks out and it feels out. What could be worse? Imagine it's you, and you're alone. Now what? Speed is crucial. The sooner it's put back in place, the better. Joints hate being out of place, and the longer they remain out, the harder they are to put back. Plus, they'll often get even with you for long delays by giving you arthritis down the river. > Enter the Kayaker Special. This is the quickest, easiest and most effective way to reduce a dislocated shoulder in the field. Plus, it can be performed by the injured person alone - even in turbulent water. It's simply done by sitting (or floating) and tucking the knees up to the chest. Lock both hands together in front of the knees as if to hug the legs to the chest. Now relax. That's right, relax, and lean back. Let the weight of the upper body do the work. With the arms locked around the legs traction is put on the arm and transmitted to the shoulder, this then pulls the shoulder back into place. Pushing out with the knees against the locked hands can increase the traction if needed. It's that simple. > There are plenty of other methods to reduce shoulder dislocations, from dangling weights off the injured arm, to someone pulling on the arm with a foot in the victim's armpit for leverage. Unfortunately, these can take a lot more time, need assistance, and are often really hard torture to get a sober person to volunteer for. Fortunately, the Kayaker's Special is a lot less traumatic. It also probably has the best margin of error that allows you to not do further damage to the shoulder if you guessed wrong and were actually dealing with a fracture. How effective is it? Reportedly 97%! (Hey, if this doesn't work, the others probably won't either. That's why I left them out.) > How do you know the shoulder is back in place? Usually there is a "pop" as it slides over the socket rim and back into place. The deformity corrects and there is immediate relief of the majority of the pain. Gentle rotation of the arm will confirm normal gliding of the joint. If so, check that the wrist pulse is good, and that movement of the hand and fingers is OK. Also make sure sensation to light touch over the shoulder and arm is intact. If there is a problem with any of these, an evacuation is needed, pronto. If there is no problem, put the arm in a sling. A person can stay with the trip, but the arm is down for the count, at least 1-2 weeks. This means everything, especially lifting the arm! > Wrapping the arm against the body ("swathing") adds another layer of bondage for those who insist on trying to move it. The rest is up to time and the healing powers of Mother Nature. As soon as you get off the river, a follow-up with an orthopedic doctor should be done, x-rays should be taken and further treatment determined. >

Also...x-rays didn't show anything definitive; it was only after an MRI was done that the tears became quite apparent. Costly, but worth knowing!

--- In Yahoo Canyons Group, "bomabro84738" <bomabro84738@...> wrote:
Not too sure I had a "dislocation" last april as I ended my wild ride down the waterfall in Deep Creek (knocked unconscious half way down), but after a fair amount of discomfort all last summer and various attempts to do the right thing for recovery......"rotator cuff surgery" became the faire last october. The shoulder is the most complex, yet fragile joint in the body. Many semi fragile tendons, ligaments and muscles work together to hold the joint together. My surgery entailed repairs of supraspanitus, infraspinatus, and labrum. Decompression also entailed some bone grinding to make room for scar tissue. Hopefully in your dislocation the tendons and ligaments were not significantly damaged? Good luck!
--- In Yahoo Canyons Group, "rick demarest" <water44@> wrote:

This is a bit long, but it works - from the kayakers...


A "dislocation" is a joint injury where the end of a bone in the joint ends up out of place. The cause is usually a combination of the right forces and the right position, at (of course) the wrong time. For the shoulder, a "ball in socket" joint, the further the joint is open (i.e. the arm is out away or "abducted" from the body) and externally rotated (palm of hand is forward as in throwing a baseball), the weaker and more vulnerable it is. Any abrupt, intense force against the arm in this position extending it too far back can cause the "ball" to pop out, usually in front of or "anterior" to the socket.
So now imagine yourself on the river and someone may have just dislocated a shoulder. How do you know it's dislocated and not broken? The answer is often easy. The victim will probably tell you. It's like having an underwear wedgie; they just know things aren't where they're supposed to be. And frequently, they "felt it pop out." This is especially true if they've ever dislocated before. Anyone who's ever had one is at higher risk to do it again, and if they say, "it's out again," believe them.
Suppose all they do is scream and tell you nothing. Remember that the mechanism is important. Any force pushing the arm back while its abducted and externally rotated (again, as in a throwing position), a dislocation is much more likely. Falling directly against the arm or shoulder while the arm is held against the body usually results in bruising or a broken bone, not a dislocation. There is no crunching or grating of bone against bone (crepitus) as in fractures, and dislocations cause extreme, unrelenting pain. The pain, in contrast to fractures, often doesn't improve much even without moving and splinting the arm.
Looking at the shoulder will also give you more clues as to the type of injury. Before swelling sets in and on thinner individuals, the dislocated shoulder looks different. It will have a "squared-off" appearance. To appreciate this, you need to look at both shoulders for comparison. Remove the shirt. There will seem to be a small hollow underneath the bony shelf of the shoulder. Look at how the arm is being held. For dislocations, the arm is usually held away from the body, where with fractures it's often braced directly against the body. To try to make a person hold it otherwise or move it, frequently results in slurry of naughty words. So, the shoulder looks out and it feels out. What could be worse? Imagine it's you, and you're alone. Now what? Speed is crucial. The sooner it's put back in place, the better. Joints hate being out of place, and the longer they remain out, the harder they are to put back. Plus, they'll often get even with you for long delays by giving you arthritis down the river.
Enter the Kayaker Special. This is the quickest, easiest and most effective way to reduce a dislocated shoulder in the field. Plus, it can be performed by the injured person alone - even in turbulent water. It's simply done by sitting (or floating) and tucking the knees up to the chest. Lock both hands together in front of the knees as if to hug the legs to the chest. Now relax. That's right, relax, and lean back. Let the weight of the upper body do the work. With the arms locked around the legs traction is put on the arm and transmitted to the shoulder, this then pulls the shoulder back into place. Pushing out with the knees against the locked hands can increase the traction if needed. It's that simple.
There are plenty of other methods to reduce shoulder dislocations, from dangling weights off the injured arm, to someone pulling on the arm with a foot in the victim's armpit for leverage. Unfortunately, these can take a lot more time, need assistance, and are often really hard torture to get a sober person to volunteer for. Fortunately, the Kayaker's Special is a lot less traumatic. It also probably has the best margin of error that allows you to not do further damage to the shoulder if you guessed wrong and were actually dealing with a fracture. How effective is it? Reportedly 97%! (Hey, if this doesn't work, the others probably won't either. That's why I left them out.)
How do you know the shoulder is back in place? Usually there is a "pop" as it slides over the socket rim and back into place. The deformity corrects and there is immediate relief of the majority of the pain. Gentle rotation of the arm will confirm normal gliding of the joint. If so, check that the wrist pulse is good, and that movement of the hand and fingers is OK. Also make sure sensation to light touch over the shoulder and arm is intact. If there is a problem with any of these, an evacuation is needed, pronto. If there is no problem, put the arm in a sling. A person can stay with the trip, but the arm is down for the count, at least 1-2 weeks. This means everything, especially lifting the arm!
Wrapping the arm against the body ("swathing") adds another layer of bondage for those who insist on trying to move it. The rest is up to time and the healing powers of Mother Nature. As soon as you get off the river, a follow-up with an orthopedic doctor should be done, x-rays should be taken and further treatment determined.
>

--- In Yahoo Canyons Group, "bomabro84738" <bomabro84738@...> wrote: > My surgery entailed repairs of supraspanitus, infraspinatus, and labrum....

Finally.... Something I have experience with. Bo, how is your recovery? I had my labral tear repaired in January and am now fully insane with the lack of activity.

As Bo said, the shoulder is fragile and complex. Pretty much anything you want to do inside or out requires the shoulder (or at least no pain in it). Even running will aggravate it.

The insult added to the injury is hearing/reading/seeing pics from your friends who are out adventuring while you sit on the couch playing with rubber bands.

-tom(w)

--- In Yahoo Canyons Group, "bomabro84738" <bomabro84738@...> wrote:
Also...x-rays didn't show anything definitive; it was only after an MRI was done that the tears became quite apparent. Costly, but worth knowing!

In my case, the MRI wasn't terribly clear. It was done without contrast, because my (first) surgeon was a nitwit. When I had my surgery it turned out the labrum was 75% detached, and severed just to the side of the biceps tendon.

My advice to anyone with shoulder issues is to find a surgeon who focuses in sports medicine. They understand the injuries (both physical and mental). My first doctor wasted months and months of my time with lines like: "you have excellent strength and range of motion"... well fine, but I have a lot of pain and I used to be able to do pullups off of doorjams....

Also, rotator cuff injuries tend to respond to physical therapy, evidently labral tears don't - my current surgeon relayed this to me after I told him I had done 6 months of rotator cuff P.T. which did not result in improvement.

-tom(w)

I'm a bit late chiming in on this, but this is what I found when I came upon the situation. The person had attempted a simple 8 ft down climb in East Lep about 5-10 minutes after the 1st rappel. He told me that he did it while stemming and had turned/looked the wrong way and it popped out. It had happened to him once before about 15 years previous, while climbing Devils tower, but hadn't bothered him since. The dislocation was easily palpable through the sweatshirt. He was in considerable pain and was it was difficult for him to move w/o increasing his discomfort. I started to do the math and realized that if we were able to escape from the canyon, we were still about an hour and a half from the car (rim walking at regular speed) and a few more hours of driving before we would find an emergency room. That was a long time to be dealing with this type of pain w/o anything stronger than Advil. So I decided to try and reduce it there. I then laid him down on his belly and was rotating his arm over a drop. The patient did very well following my instructions and controlling his response to the pain. Once the arm was over the ledge was when the miracle happened. I was preparing to attach some weight to his arm (in the form of a rock) when the joint went back into place. Just the simple weight of his arm was able to reduce the dislocation. The relief was immediate and sounded more like an orgasm. I then tried to immobilize the arm but the individual opted out of it. We then found a weakness in the canyon that allowed us to remove him and Brett was able to guide him back to camp. He then chose to drive himself home to SLC

I have since communicated with the individual and he told me that he visited the ER in SLC. The Xrays showed no broken bones. He will visit an orthopedic guy Thursday for an exam of soft tissues and rehab advice. However, he is still seems to be beating himself up over the incident.

I have once again put my Wilderness First Aid book back into my dry bag. It's not that big or heavy and is presently giveing me some peace of mind.

Greg



--- In Yahoo Canyons Group, "Tom Jones" <ratagonia@...> wrote:

> Had the person dislocated before? Who was the reducer, and were they trained in reducing shoulders? >

Just in case some readers might get the impression that reduction is always possible, here's my tale.....   My first dislocation was in the central Cascades, high and remote. This dislocation was the result of attempting a move (one arm pullup), not the result of impact. Attempts to reduce were unsuccessful. The first 30 hours anchored to a 6 inch ledge without so much as an aspirin were excruciating. Overcome with fatigue, I fell asleep on the second night, waking up to a reduced arm. For me, total relaxation was the key to reducing the arm.   I dislocated three other times, each with access to professional medical care (ski area first aid and hospital emergency rooms). Each time reduction was attempted (at length) with hanging weights, big strong fellas and sedatives. The only method that proved successful was general anesthesia to unconsciousness; then the arm slips back in place.      

--- On Wed, 4/1/09, Greg Cornelius damngreg1@yahoo.com> wrote:

From: Greg Cornelius damngreg1@yahoo.com> Subject: [from Canyons Group] Re: Shoulder Reduction To: Yahoo Canyons Group Date: Wednesday, April 1, 2009, 1:17 PM





I'm a bit late chiming in on this, but this is what I found when I came upon the situation. The person had attempted a simple 8 ft down climb in East Lep about 5-10 minutes after the 1st rappel. He told me that he did it while stemming and had turned/looked the wrong way and it popped out. It had happened to him once before about 15 years previous, while climbing Devils tower, but hadn't bothered him since. The dislocation was easily palpable through the sweatshirt. He was in considerable pain and was it was difficult for him to move w/o increasing his discomfort. I started to do the math and realized that if we were able to escape from the canyon, we were still about an hour and a half from the car (rim walking at regular speed) and a few more hours of driving before we would find an emergency room. That was a long time to be dealing with this type of pain w/o anything stronger than Advil. So I decided to try and reduce it there. I then laid him down on his belly and was rotating his arm over a drop. The patient did very well following my instructions and controlling his response to the pain. Once the arm was over the ledge was when the miracle happened. I was preparing to attach some weight to his arm (in the form of a rock) when the joint went back into place. Just the simple weight of his arm was able to reduce the dislocation. The relief was immediate and sounded more like an orgasm. I then tried to immobilize the arm but the individual opted out of it. We then found a weakness in the canyon that allowed us to remove him and Brett was able to guide him back to camp. He then chose to drive himself home to SLC

I have since communicated with the individual and he told me that he visited the ER in SLC. The Xrays showed no broken bones. He will visit an orthopedic guy Thursday for an exam of soft tissues and rehab advice. However, he is still seems to be beating himself up over the incident.

I have once again put my Wilderness First Aid book back into my dry bag. It's not that big or heavy and is presently giveing me some peace of mind.

Greg

--- In canyons@yahoogroups .com, "Tom Jones" <ratagonia@. ..> wrote:

> Had the person dislocated before? Who was the reducer, and were they trained in reducing shoulders? >

The first 30 hours anchored to a 6 inch ledge without so much as an aspirin were excruciating. Overcome with fatigue, I fell asleep on the second night, waking up to a reduced arm. For me, total relaxation was the key to reducing the arm.

Your not kidding, are you? That's crazy. If it didn't reduce would you still be on that 6 inch ledge? Did someone go out for help? How was it making it down after the spontaneous reduction?

Oh and Greg, thanks for posting the first person story of what happened. Crazy stuff. R





--- In Yahoo Canyons Group, bary bruner <barylbruner@...> wrote:
Just in case some readers might get the impression that reduction is always possible, here's my tale..... >   > My first dislocation was in the central Cascades, high and remote. This dislocation was the result of attempting a move (one arm pullup), not the result of impact. Attempts to reduce were unsuccessful. The first 30 hours anchored to a 6 inch ledge without so much as an aspirin were excruciating. Overcome with fatigue, I fell asleep on the second night, waking up to a reduced arm. For me, total relaxation was the key to reducing the arm. >   > I dislocated three other times, each with access to professional medical care (ski area first aid and hospital emergency rooms). Each time reduction was attempted (at length) with hanging weights, big strong fellas and sedatives. The only method that proved successful was general anesthesia to unconsciousness; then the arm slips back in place. >   >   >  
> --- On Wed, 4/1/09, Greg Cornelius <damngreg1@...> wrote:
> From: Greg Cornelius <damngreg1@...
Subject: [from Canyons Group] Re: Shoulder Reduction > To: Yahoo Canyons Group
Date: Wednesday, April 1, 2009, 1:17 PM


> I'm a bit late chiming in on this, but this is what I found when I came upon the situation. The person had attempted a simple 8 ft down climb in East Lep about 5-10 minutes after the 1st rappel. He told me that he did it while stemming and had turned/looked the wrong way and it popped out. It had happened to him once before about 15 years previous, while climbing Devils tower, but hadn't bothered him since. The dislocation was easily palpable through the sweatshirt. He was in considerable pain and was it was difficult for him to move w/o increasing his discomfort. I started to do the math and realized that if we were able to escape from the canyon, we were still about an hour and a half from the car (rim walking at regular speed) and a few more hours of driving before we would find an emergency room. That was a long time to be dealing with this type of pain w/o anything stronger than Advil. So I decided to try and reduce it there. I then laid him down on > his belly and was rotating his arm over a drop. The patient did very well following my instructions and controlling his response to the pain. Once the arm was over the ledge was when the miracle happened. I was preparing to attach some weight to his arm (in the form of a rock) when the joint went back into place. Just the simple weight of his arm was able to reduce the dislocation. The relief was immediate and sounded more like an orgasm. I then tried to immobilize the arm but the individual opted out of it. We then found a weakness in the canyon that allowed us to remove him and Brett was able to guide him back to camp. He then chose to drive himself home to SLC
I have since communicated with the individual and he told me that he visited the ER in SLC. The Xrays showed no broken bones. He will visit an orthopedic guy Thursday for an exam of soft tissues and rehab advice. However, he is still seems to be beating himself up over the incident.
I have once again put my Wilderness First Aid book back into my dry bag. It's not that big or heavy and is presently giveing me some peace of mind.
Greg
--- In canyons@yahoogroups .com, "Tom Jones" <ratagonia@ ..> wrote:
> Had the person dislocated before? Who was the reducer, and were they trained in reducing shoulders?










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