Subluxating Shoulder & Hanging Leg Raises

Since around 2012, my shoulder will partially dislocate a few times a year. It’s often when I’m just getting back into working out and not quite paying attention.

A few examples of when it has happened:

  • Reaching behind my head to get something behind me in the car
  • Briefly attempting pull-ups without controlling my descent following ill-informed advice to “just drop to the bottom so you don’t waste energy”
  • Doing an “around the world” with a light sandbag where you rotate it around your head
  • Reaching up for a high hand-hold while rock climbing
  • Performing a barbell snatch
  • Doing floor slides (lay on back, arms bent at sides with palms and elbows on the deck. Slide arms up and as close to overhead as possible while maintaining contact)
  • Reaching up behind me in bed to grab something near the headboard

However, 99% of the time, I don’t have issues. I can still do everything I need to do for my job (primarily pull-ups), and I don’t typically notice it as an impediment when I’m working out. So it’s not like “Oh woe is me, my shoulder is the bane of my existence” all the time.

However, the issue is that the workout program I’m running now involves hanging leg raises. Any kind of hanging (knees to chest, let alone the more difficult variations) makes my right shoulder feel like it’s going to pop right out. I don’t have any issue at all with pull-ups; it’s the hanging that does it, and it’s just the one shoulder. I try to engage and not just dead hang, but regardless I can only manage a few reps before I have to stop.

This is frustrating, because I feel like the leg raise is something I ‘should’ be able to do. Yet whenever it shows up in workouts, I find myself either barely getting the reps in (without much percieved benefit, since I stop for my shoulder well before I feel anything in my core) or skipping it entirely.

Has anyone with a similar shoulder issue dealt with this before? Is it something that can be fixed, or should I just avoid it in terms of juice vs the squeeze? Simply dead hanging from the bar has the same result - it doesn’t feel like I’m getting stronger, just feels like I’m on the edge of it popping out again.

If leg raises are really that great an exercise then I’m willing to try, but given that I’m not competing in anything and can already perform what I need to for my job, this isn’t a hill I necessarily want to die on either.

1 Like

Easiest solution:
Lying leg raise off bench
Or:


Or

4 Likes

The labrum is a ring of fibrous cartilage that lines the glenoid. The glenoid converges with the top of the humerous, establishing a glenohumeral cavity

This is your shoulder ball/socket joint. Tearing within that lined cartilage leads to laxity as the labrum acts as a buffer that deepens the shoulder socket, thus keeping it in place.

Labral tears can be degenerative, traumatic or from overuse in positions that facilitate impingement (think overhead athletes).

Many degenerative labral tears aren’t accompanied by excess laxity or a notable decline in shoulder function.

For some such as myself in the past, labral tears can get so large that pockets of joint fluid leak out from under the labrum. This results in neuropathy, wasting, severe weakness. Labral tears can otherwise cause neuromuscular inhibition, pain, laxity etc.

Symptomatic presentations differ from person to person. Those with multidirectional instability/pathological, systemic hypermobility may sublax shoulders without initially tearing the labrum.

Chances are if you are having repeat sublaxations you’ve done damage.

Many will recommend PT… but imo all the strength in the world won’t necessarily keep your shoulder in place. If you continue to be active and push your ROM and you have a tear (these tears can’t heal… very little blood supply to cartilage) the tear will get bigger with time and you risk progressing from sublaxations to traumatic dislocations. This is what happened to me

The good news is… this can be fixed. You need to see an orthopaedic suregon. Note a clean MRI doesn’t =/= no labral tear. MR arthrogram is the gold standard for non invasive ways to diagnose a labral tear

I’m not saying you need surgery… but if you actually are having repeat sublaxations/dislocations, the shoulder is pathologically unstable.

I spent thousands on physio before going under the knife for this… it’s different from person to person but I wish i’d opted for the surgery sooner.

Physio with unrepaired tears was equitable to trying to put out a forest fire by peeing on it…
That was MY experience.

Shoulder instability caused by a tear will not get better in terms of being able to do the tasks you’ve outlined above.

If you stop any and all overhead exercise you might be ok… but with exercises like benching etc… I also initially found it was predominantly overhead activities that caused problems. Eventually EVERYTHING hurt all the time and rolling over in bed was enough to cause my shoulder to sublax

It was initially instability starting from my firsr sublaxation when I was 14

By age 19 it hurt all the time and I’d had my first dislocation

By 21 i’d rapidly made things worse by choosing to ignore what was obviously a problem that needed surgical correction

Don’t be me… it’s the difference between a surgery with a 6 month recovery time and a 12+ month recovery time.

3 Likes

Brilliant, and so obvious now that you say it that I’m embarrassed I didn’t think of this. I was so frustrated with my body that I didn’t think to look for tools out there that would let me get the benefits of the leg raises without putting my shoulder in that position. Thank you!

2 Likes

Thank you for the in-depth response, I found it very informative and helpful.

I’ve been to PT a few times, but they just give me a print-out of stretches and send me away. I stopped going since it wasn’t affecting me 99% of the time.

Surgery isn’t necessarily an option right now unless it really starts interfering with my day-to-day requirements, but I will certainly not shy away from it if/when it starts affecting me more.

The military probably let me have surgery unless I tell them it’s affecting my ability to perform, and right now it’s really not -it’s just some specific exercises that I avoid (and don’t ‘need’ to do even though I may want to) like BB snatches, dead hangs/hanging leg raises. Plus TBH I don’t really trust military medicine not to mess up the surgery anyways. However, if it starts worsening or heading the direction you described I will absolutely revisit that option.

What you said about strengthening only helping to a point absolutely makes sense; I’ll keep trying to get stronger, but won’t spend excessive time on PT that doesn’t seem to (and based on your experience, isn’t likely to) help all that much.

Stop overhead activities that aggravate the condition.

Barbell snatches… do you have to do them?

Rock climbing is also super dicey… Try keep the affected arm as close to your body as possible

Physio can help a bit if you don’t have weakness, a lot of neuromuscular inhibition, a lot of apprehension, nerve entrapment caused by paralabral cyst etc. Symptomatology stemming from degenerative labral tears for instance can frequently be rehabbed.

Same goes for very small tears in specific locations… or if you only have fraying but no tear.

But it can’t stop your shoulder from sublaxing at extreme ends of ROM, esp when you are putting strain on an already damaged shoulder

To reduce the risk of a traumatic dislocation… i’d say get your rotator cuff muscles stronger, work on scapular stabilisation (if possible. If you are at the stage where you can’t really pull your shoulders down and back then don’t bother… when I got to that stage literally nothing other than surgery was going to help).

Can you work rear delts? Depending on where the damage is this will either be fine, or super painful OR it’ll induce serious apprehension as the shoulder will feel like it wants to pop out

At the areas of ROM where shoulder feels unstable… don’t push that, stop putting your shoulder in those positions.

It feels unstable because it IS unstable. With each sublaxation/dislocation you have, the threshold for another event lowers.

Was just about to post the ab straps but @ChickenLittle already beat me to it! I dont have any yet but they are on my to order list.

Other options are to do them on dip bars if you have the upper body strength to maintain that position. If you are purely doing them for ab development then you could just do cable crunches, easier to progress the resistance, less hip flexor involvement and more comfortable.

2 Likes

Yep, haven’t done a barbell snatch since 2020. Single-arm snatches feel fine though.

I can do rear delt flyes without much concern; I’m more aware of how I’m moving my arms when I lift them, but thus far it hasn’t seemed to be an issue.

I appreciate this confirmation - it’s what I’ve been thinking, but a previous trainer kept trying to train me out of the shoulder instability vice just changing out some of the movements. Right now it has very little impact on my life (like I said, maybe 2-3 times a year it will happen), and I’d like to keep it that way. Sounds like there’s no significant benefit to trying to make myself do hanging leg raises or train to them, and glad to know it’s not just in my head - I’ll sub out for the alternatives other folks mentioned.

Posted this in you log, moving it here for the lurkers.

MDI without traumatic dislocations or sublaxations can frequently be treated conservatively provided underlying systemic connective tissue laxity isn’t present.

Once the shoulder starts coming out of place you need to modify activity or get surgery.

I believe @startingagain has EDS (connective tissue disorder) but i’m not sure of the subtype he is afflicted by. He has severe multidirectional instability in both shoulders yet has somehow managed to avoid recurrent dislocations and sublaxations. Might want to ask him what he did to avoid damaging his shoulders. Much harder for a person with EDS to avoid dislocations.

I’m not sure why he hasn’t opted for something like a capsular shift or capsular plication procedure. Statistically speaking outcomes for people with EDS or HSD (i’m lumped in the latter category… thank god…) associated with shoulder surgery are inferior… but they still wind up better than baseline.

A suregon wanted to do an open capsular shift on me when I was 19. I opted out because I didn’t want to stop exercising… stupid, stupid decision…

I found getting strong helped to a degree provided you don’t put the shoulder in positions that aggravate it. But nothing can save you if someone yanks on your arm… or you fall with an arm outstretched.

All the physio in the world didn’t stop a small tear from progressing into a very large one. Then again I was hard on my body

1 Like

I’m not sure why he hasn’t opted for something like a capsular shift or capsular plication procedure.

My ortho surgeon at the time recommended against surgery. Hopefully I’m remembering correctly, but he said: (1) Since my instability was multidirectional and I didn’t have any shoulder labrum tear, a “shoulder tightening” surgery had less than a 50% chance of working. (2) Even if it worked, there was a high chance of my shoulder getting “loose” again in a couple of years.

@RCKeeper

I’ve been to crappy PT offices too where they just hand you a lazy print out of stretches and send you off. Have you been to any PTs who give you strengthening exercises such as band pull aparts?

I hesitate to give any advice since I can only say what worked for me, and your case could have competely different causes. My Elhers-Danlos makes every joint like how your shoulder is, but my ortho docs also confirmed that my shoulder labrums were fine. My hip labrums were ripped to shreds, though. Haha. I bring this up because endless pull aparts, similar band exercises, and serratus work got my shoulder from instantly getting inflammed and loose when lifting a remote control to being able to lift. However, I needed surgery for my hips since the labrums were damaged. Years of PT pre-surgery did nothing for the hips.

I’d definitely go to a better PT and see an ortho doc to check for a labrum tear. As for a short-term solution: I second @ChickenLittle 's recommendations. Just don’t do hanging leg raises, or find a way to do them pain-free like in the ways shown in this thread.

1 Like

I had some subluxations from a couple of seizures. I had to have surgery but in the end it is just not the same