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Desk-pilot
23rd Jul 2001, 20:03
In my efforts to get fit I recently took up mountain biking and unfortunately took a tumble resulting in a partially dislocated shoulder three weeks ago.

I am having physio and it's getting better but I still have to be careful with it while the tendons heal.

I have a Class 1 booked next week and am concerned whether I should postpone it.

Does anyone know if this is likely to pose a problem? What kind of shoulder exercise/tests do they use on you?

Thanks,

Desk pilot

Docfly
25th Jul 2001, 00:27
Simple, if not fit to fly then you won't pass until you are. If you are a renewal then don't forget that you have to inform the authority after 21 days of an incapacitation.

Desk-pilot
25th Jul 2001, 21:50
Docfly,

I am an initial Class 1 but just wanted to know if they do anything particular with my arm/shoulder which may cause a problem.

I am able to drive, move it etc but I have to be careful not to over stretch it whilst the tendons heal eg no tennis etc.

regards,

Jonathan

Docfly
28th Jul 2001, 00:54
They will examine it in a general way although they are not orthopaedic specialists and may well requst reports from your own doctors before passing you for class1. Main problem after a dislocation is restricted movement and/or a tendancy to recurrent dislocation.

osito
27th Mar 2002, 22:11
I´m A CPL(A) who is in the a pretty similar situation. I am going though shoulder sourgery next month. I got a shoulder repetitive dislocation. No one ensure me that I´ll be able to pass my first class medical again.It seems like nobody knows what are the requierements to renew my medical, Really confusing for me.. . Does anybody knows what the regulation on that matter is or if there is a certain type of sourgery aproved for this? At this moment I´m really scared.. .. . Thank you <img border="0" title="" alt="[Confused]" src="confused.gif" />

Warrior Chief
27th Mar 2002, 23:56
Desk-Pilot:. .. .The general physical examination done during the Initial Class 1 should not pose a problem. The worst that is likely to happen is that they will want to wait for a report from your consultant to confirm the diagnosis, prognosis and outcome of treatment. This might delay your class 1 issue but I'd be very suprised if they refuse you on the basis of a single injury which should carry a good prognosis. However, if you still have a lot of stiffness that might raise an eyebrow or two. The best thing is to ring the CCA and ask their advice before you go.. .. .The problem is that some shoulder dislocations become recurrent and this is a particular problem in fit young men where the incidence of recurrence is highest. Sometimes the shoulder will eventually stabilise with physio but in many cases the problem gets steadily worse until it pops out with little or no provocation. This could become a serious problem reaching above your head in a confined cockpit!. .. .One minor concern of mine is whether is was the shoulder joint itself which dislocated or just the collar bone (acromio-clavicular joint - much more common in a cycling accident). It's important because the latter injury has a much better prognosis overall.. .. .Osito:. .. .Modern surgery for anterior shoulder instability (the commonest form) is now very successful if done properly but there is still a failure rate (probably about 5%). The operation can be done "open" with an incision across the front of the shoulder (most common op is called a Bankhart repair) which has the highest success rate but a longer recovery period (3-6 months). The same op can be also be done with telescopes/cameras/key-hole surgery (arthroscopically) and has a much shorter recovery period but a higher failure rate (10-15%). It requires a good deal of skill to get it right.. .. .The critical thing is to ensure that your surgeon is a trained shoulder specialist. If anybody mentions a "Putti-Platt" operation then run a mile - FAST. It WAS the operation of choice in the last century and is technically easy to do but is out of date and has been superceded by ops like the Bankhart repair. These ops are fiddly to get right and whilst the physio is essential and important a bodged operation is hard to overcome.. .. .There are other types of shoulder instability as well and it is essential to match the correct operation to the patient's needs. You should expect a full exam, pre-op physio, a scan (most commonly an MR scan these days but a good CT scan will do, and most importantly an examination under anaesthetic +/- arthroscopy to confirm the exact diagnosis and plan the definative operation. I always felt that the exam under anaesthetic should be done at a different time to the definative op so that any findings can be discussed with the patient before surgery but I accept that many surgeons will combine both together - it then becomes a matter of trust I guess.. .. .This is fairly major surgery with a significant recovery time (only a day or two in hospital but weeks of physio to follow) and I would advise you to ensure your licensing authority know in advance and have confirmed they will re-instate your medical if the op is successful. Unfortunately, nobody will know if it has worked until several weeks/months after the op.. .. .I don't think anybody will mind what type of operation is done provided that it is done by an appropriate specialist, is the right operation for the condition diagnosed and - above all - it's successful.. .. .Any surgery is frightening but stay cool! - Good Luck!. .. .(Incidentally, I was an orthopaedic surgeon who gave it all up to become a pilot - insane or what!!! But then again, all the medical/paramedical staff I met at the CAA during my Initial Class 1 had also chucked in main stream medicine for a career in avaition so perhaps there's hope for us all!!!)

osito
30th Apr 2002, 00:14
Thank you Chief Warrior!
Your information helped me quite a lot!!
If you are half good as a pilot as you are as a doctor I certainly think you are a great aviator!
I am getting ready for surgery.
I wish you the best!!!:rolleyes:

whitingiom
13th Sep 2004, 16:48
Hi Warrior Chief

I am about to go into Wrightington Hospital in wigan for an arthroscopy on my shoulder to try and determine why I get pain when I raise my arm above horizontal, and why it 'clicks' with every swing of the arm when I walk.

The specialist hopes it'll be in one day, out the next and straight onto physio.

Do I have to advise the CAA (I have a class 2, and am a student ppl) or just wait until I feel fit enough to go back flying. Do I have to get a 'fitness test' or similar

hope you can help?