Shoulder issues

[Guest machspeed22]

Four months ago I seperated my shoulder playing football. The clavacle is still seperated (level 2/3 seperation), and i have gone to three different orothopaedic doctors and they all agree that my shoulder should heal without sugery, but the bone will stay out of place. Can I still pass the FC I with my shoulder in such a condition?

[Toro]

They don't do any X-rays during the FCI, it will be more of a matter of your range of movement of the arm. I went into my first FCI with three broken bones in my hand from three days prior. I didn't cast the hand (wasn't sure it was broken at the time), but it was wrapped in an Ace bandage. When I showed up to the physical, one of the techs told me I wouldn't pass wearing the bandage, so I took it off. The doc did a couple tests on my hands - pushing, pulling, having me squeeze his arms, etc. It hurt like hell, but I pulled it off and passed the FCI.

[Guest Haji]

I was in somewhat of the same situation as you. I separated my shoulder in football at 16. had surgury the same year. Got through the FC1, but needed an ortho eval from a specialist. Found a cool civilian doc and he cleared me. FC1 passed with no hangups. The reason I checked "trick shoulder" of the SF88(medical form) was because I have a 6" scar that you can see. If you have no scar, do what you have to do! It may hurt like hell, but don't flinch when the doc pulls on you and take it easy till it heals!

[Guest F16PilotMD]

If I knew about your injury as the Flight Doc I would apply the following reg:

A7.26.1.6. Disease or injury, or congenital anomaly of any bone or joint, with residual deformity,

instability, pain, rigidity, or limitation of motion if function is impaired to such a degree it interferes

with training, physically active lifestyle, or flying duties.

A7.26.1.7. Unreduced dislocation; substantiated history of recurrent dislocations or subluxations

of a major joint if not satisfactorily corrected.

A7.26.1.8. Instability of a major joint if symptomatic and more than mild, or if subsequent to surgery

there is evidence of instability, weakness, or significant atrophy.

A7.26.2.5. Healed disease or injury of the wrist, elbow or shoulder with residual weakness or

symptoms of such a degree as to interfere with the satisfactory performance of flying duty. Grip

strength of less than 75 percent of predicted normal when compared with the normal hand

(non-dominant is 80 percent of dominant grip).

A7.26.2.6. Limitation of motion.

To assess your limitation of motion, I would make you do the exercises in AFI48-123, Figure A14.1. Upper Extremity Range Of Motion (can't copy the figure here).

As long as you're okay based upon the above, this injury should not affect your FC1.

[Vandal]

I was wondering if I could be DQd by DODMERB for a dislocated shoulder that occired while playing football about 6 years ago? A buddy of mine was going to enlist in the AF but was not allowed to for the same reason.

[Guest F16PilotMD]

A2.14.1.5. Chronic dislocation, when not reparable or when surgery is contraindicated.

A7.25.2.5. Healed disease or injury of the wrist, elbow or shoulder with residual weakness or symptoms

of such a degree as to interfere with the satisfactory performance of flying duty. Grip strength of less than

75 percent of predicted normal when compared with the normal hand (non-dominant is 80 percent of

dominant grip).

[Jkarl]

Vandal905:

I had the same problem with my shoulder, basically it came dislocated 4 or 5 times when I was in my teens. I had physical therapy and it hasn't happened since (4 years later), I let my Flight surgeon know this while taking my FC1 and it was not a problem.

[Guest rhildreth]

With regards to flying for the air force, how concerned are the folks at Brooks going to be regarding the Open Capsular Shift surgary which I had on my left shoulder 18 months ago?

Prior to surgary, my shoulder sublexed (although not completely dislocate) regularly. Since surgary, I have regained full range of motion and have not had a single sublexing incident.

What documentation will I need to take with me if/when I go to Brooks?

[Guest F16PilotMD]

Likely not a big deal. Details of your diagnosis, treatment (surgical procedure), recovery, and prognosis will be important. The biggest issue for you is/will be your current level of function (range of motion, strength, etc) and likelihood of further/future problems. All of that info will come from documentation from your treating physicians. Start there.

[Guest doctidy]

I don't know...

This is chronic shoulder dislocation/subluxation. You must have been having a significant amount of problem to have surgery. You were obviously handed a bum shoulder at birth or following injury, but despite surgery, all your problems will not go away.

I predict a significant up-hill battle. I hope I'm wrong for your sake.

[Guest rhildreth]

Rage,

It was a wrestling career of 16 years that caused the problems. Shoulder never fully dislocated, and the surgery was 110% successful in tightening everything up. I am lifting weights and doing my theraband exercises to strengthen my back and shoulder muscles to prevent further problems. Aside from getting my surgical report and a "statement of full recovery" from my surgeon, do you have any other suggestions?

I thought about not mentioning it, but that would be dumb as it is a 5 inch scar from collarbone to center of armpit and readily visible.

Thanks for your help and I hope you are wrong about the uphill battle. Knowing you are probably not wrong though, I am prepared to go another round with guard bureau or whoever wants to disqualify me.

[Guest doctidy]

It is not necessarily where you are today...what you can do today. Sometimes it is about where you will be tomorrow.

Take vision standards...I've told you that the higher the refractive error, the more mishapen the eyeball is and thus the higher the risk that one would have a retinal tear...partial or complete loss of vision in the affected eye.

Same for this...you're 110%...but over the years you shoulder will cause you future problems. All I'm saying is there will be an uphill battle, not that you will necessarily be DQ. Hope when all the data comes in you'll get the thumbs up!

[Guest rhildreth]

Thank you for all your insight. I will keep you posted on developments, as I have been officially picked up to fly KC-135s. I start the process next week, so my fingers are crossed.

[Guest RaptorKeeper]

If it helps... I had pretty extensive shoulder surgery for 3 full dislocations and 3 sublexes back in 2001. I had open surgery, Capsular Shift and Bankarts (sp?) procedure, and I just cleared my flying class I. Just be able to demonstrate full range of motion, and normal strength with no pain, clicks, or movement problems, and you should be good to go. -keeping in mind I'm no doctor.

[Guest rhildreth]

As it turns out, this surgical procedure was a NON-show stopper. In fact, once I was able to demonstrate full ROM and strength, it was not brought up again during my FCI exam. Instead they found other health issues in my past to grip about and waivers are in-process.

The next step is getting through Brooks, not sure when I will have to accomplish it.

[Guest downinthegroove]

I had shoulder impingement surgury and a rotator cuff cleaned up a couple of years ago. Was at Brooks about 3 weeks ago and they never mentioned it. They don't care about that if it already cleared on the FCI. They have what they are looking for and that is it.

[Guest gojags]

I had surgery on my shoulder about 2 years ago. It had just been dislocated a few times, and I got it repaired. I had to go through about 2 months of physical theoropy for it. It's in good shape now, and is as strong as it was before I ever injured it. My first choice for a military service was actually the Marines. However, they wouldn't grant me a waiver for my shoulder, so now I'm in Air Force ROTC. I've already gotten a waiver for the injury and there's no problem with me being in the AF. However, I'm afraid it may prohibit me from passing the pilot physical. Does anybody know what the AF's policy is on that kind of injury?

[Ill Destructor]

I don't remember anything about the FC1 where the flight surgeon checks the mechanics of your joints. Maybe at a MEPS facility, but if you're already in ROTC, I don't think you'll have a problem.

[Guest yogi]

(I apologize in advance for the novel)

First, a little background...

I was picked up for an F-16 ANG slot about 18 months ago, took the FC1, and was under the impression I passed. Life was super. However, about three months after meeting the doc, the wing commander called me up to tell me I had been medically DQ'd because the doc failed to notice during my examination I had dislocated my shoulder several times in the past. After consulting with a couple flight surgeons and reading the AF medical regs, I immediately scheduled surgery in hopes of obtaining a medical waiver.

I had my shoulder scoped and did all the necessary rehab, but the unit's doc refused to even consider issuing a waiver. Probably for good reason, because about 6 months after the surgery it dislocated again. Since then, it's popped out three other times (mountain biking, snowboarding, & basketball). Each time it has dislocated, I've managed to put it back in place without having to see a doctor, so I could avoid having it reported on my medical records.

My shoulder has full range of motion, good strength and feels perfectly fine. However, obviously it is not completely fixed and I've been advised to get a capsular shift (supposedly the end all shoulder surgery).

I've already been invited to two upcoming UPT fighter slot interviews this spring, but I'm unclear as to the best way to handle the shoulder situation. The way I see it, here are my options (if selected):

1. Since none of my post-surgical dislocations have been reported in any official medical document, I figure I should be able to either pass a FC1 or obtain a waiver based on the fact that (in their eyes) my surgery was a success. Only problem, there's a pretty high possibility it will pop out again if not fixed. Not a big deal, but I'd rather not have severe arthritis in my shoulder at the age of 30.

2. I could get the capsular shift surgery now, rehab, and basically skip an entire year of ANG apps in hopes of getting picked up with a waiver next year. Only problem, I would think it would look bad on my medical records to show two surgeries for the same problem (possibly making it more difficult to obtain a waiver). Am I just being paranoid, or is that legitimate concern?

3. Get picked up this spring/summer with my shoulder in its current state. Then, get the capsular shift during the time (approx 1 year) I would wait to be shipped off to AMS. This would be my most ideal option but seems like the most unlikely to be approved by the AF.

Any advice or similar experiences out there?

Cheers!

[Guest r_hildreth]

From someone who fought the same fight, have the surgery.

I am in UPT now, however it has been quite a process, medically. Aside from another serious medical waiver, I had to obtain one for the same issue you are having.

My recommendation... have the OPEN capsular shift surgery. I had the surgery in June of 2004, and after 6 months (and a ridiculous amount of PT) my range of motion and strength were 100%. Not to mention, my shoulder has stayed in the socket since! Even if you don't ever become a pilot, you will be able to do so much more after the surgery. As far as getting the waiver, it was very painless. I had my surgeon do a "statement of full recovery." That was seemingly all that it took.

Good luck and PM me with any questions.

[Guest jmac212]

My flight physical is in about three weeks, and I have been told to see an orthopedic surgeon to look over and give a thorough evaluation of my shoulder prior to meeting with the flight docs. This is because I have had repeated dislocations in the past but had arthroscopic surgery (Nov, 2005) to prevent any future dislocations.

I've been told that I'll more than likely need a waiver, so I should get the orthopod to be as detailed as possible when writing his evaluation. Is there anything specifically I should get the doc to check and write about? I'm not completely sure how detailed he can get without taking a MRI or busting out a bunch of PT equipment, but I want to make sure the evaluation is detailed enough to help the waiver process go smoothly.

Any advice?

PS My visit to the orthopod is Friday morning, so if you have anything to offer, please share it with me as soon as possible.

THANKS!

[Guest P27:17]

As long as you are asymptomatic, have full strength, range of motion and stability in your shoulder you should be fine. A statement from your doc saying as much and that you are released to full physical activities will help...probably won't even need a waiver.

[Guest MikeD]

Thank you for reading my post!!!

Situation: Staying "fit" in the AD world, I messed up my should bench pressing. Doc's took an X-ray, then proceeded to an MRI, etc....long story short, they came to the conclusion that I have either a "snap lesion", or have excess build up on either the Acromion, or the Clavicle causing pain when lifting above the head. My question is this: considering a successful or not surgery, would this inhibit my ability to fulfill an AF pilot job?? If you need more details please ask, this is an extremely tough decision, seeing I get out Nov 07, and about to apply for several reserve units.

Thanks

MIkeD

[Guest awfltdoc]

Thank you for reading my post!!!

Situation: Staying "fit" in the AD world, I messed up my should bench pressing. Doc's took an X-ray, then proceeded to an MRI, etc....long story short, they came to the conclusion that I have either a "snap lesion", or have excess build up on either the Acromion, or the Clavicle causing pain when lifting above the head. My question is this: considering a successful or not surgery, would this inhibit my ability to fulfill an AF pilot job?? If you need more details please ask, this is an extremely tough decision, seeing I get out Nov 07, and about to apply for several reserve units.

Thanks

MIkeD

I am not familiar with "snap lesion" I have heard of a sensory nerve action potential (snap) but I don't think it applies here. It sounds like you are describing a shoulder impingement syndrome. These are typically handled with some rest, physical therapy first. If persists, then maybe some shoulder injections with corticosteroids. And finally, if not improving then perhaps surgery. Every case is dermined on an individual case by case basis though. Perhaps the imaging studies show you have a significant narrowing of the space between the acromion and the upper arm bone. This would require a surgical procedure to shave off some of the bone.

I have had pilots and other patients who have had this procedure. It is generally well tolerated and recovery is usually quick. I have had no issues with pilots getting back to flying after the procedure.

At somepoint,I suspect if you try to push through this (STS) and make it worse trying to do pushups at unit pt or somthing, then you could get into a situation like the T1 guy I had that finally couldn't lift his arm up for the switchology in the jet.

Anyway, I don't know if you should have surgery or not cause I haven't examined you or the images of your shoulder. I doubt having the surgery for imingement syndrome given that is your issue is not likely to hamper an AF pilot job. Good luck!

[Guest MikeD]

Thanks awfltdoc,

I will continue to review my options. Within the last three months or so since the injury started, I have drastically halted my physical efforts, in an attempt for some sort of positive feedback, but nothing! Still hurts as the day it occurred. I would like your opinion on whether or not to tell these units I will be apply with. Is this something that can, or would eliminate me from selections?

Thanks again,

MIkeD