Weightlifters Shoulder - This is what the doc thinks...

[Matth3wJL]

Hey guys I've been having some minor pain in my left shoulder for some time now but nothing to bad to where I couldn't lift... Recently it?s gotten to the point where it's stopping me from benching... So I went in and get it checked out... Here?s what the doc had to say:

His clinical impression:
Left shoulder, glenohumeral instability, question of biceps tendon partial detachment, early A/C join arthritis (osteolysis/weight lifters shoulder).

History:
Left shoulder discomfort in 21 year old right handed, bodybuilder. Active weight trainer having gradual pain over the last few months in the left shoulder. Certain activities like bench pressing, incline bench and overhead activities cause discomfort.

The physical examination:
Demonstrates the patient is 5 foot 10 inches, 210 pounds and very muscular. He has point tenderness over the A/C join. There is a little periscapular muscle spasm but no complaint of pain in that area. There is a full range of motion without discomfort. No clicking or grinding is noted. Supraspinatus, infraspinatus and subscapularis strength are 5 out of 5. The biceps tendon is painful in the front of the shoulder made worse with horizontal flexion. This is not found on the opposite side. There is a significant laxity in the left shoulder and no the right shoulder. The right shoulder has slight physiologic play, inferiorly, and the left side has 4 times the laxity with an inferior sulcus sign and increased anterior/posterior laxity, 4 times more than normal of the opposite side. He finds this somewhat symptomatic and complains of his shoulder pain with weight training, especially bench pressing.

X-ray Exam Results:
Show osteolysis at the end of the clavicle, with cystic changes and sclerosis, showing this has grown in from an absorbed situation, narrower than usual. It has a small spurring under the A/C joint on both sides. There is sclerosis around the glenoid rim, sclerosis at the greater tuberosity and there is no avulsion, impact changes or loose body.

Now hes recommending I go right to surgery operative arthroscopy to remove bone spurs, to open up the A/C joint (Gurd or Mumford procedure), to tighten the join capsule using a heat probe, to reattach the biceps tendon using absorbable anchors or to fix a small hole in the rotator cuff.

After seeing this doctor and hearing many negative things about him saying he likes to send his patients right into surgery I have been kinda of hesitant about his opinion.

I went into a therapy clinic the next day and had them run a strength test on me they told me my left rotator cuffs were at about 50%... She also said there wasn't a noticeable separation in the AC joint. She also said she sees allot of his patients for therapy and said that he has really screwed some up.

Basically I really need your guys input from this doctors write-up, previous experiences and what not. I'm only 21 and would like to avoid surgery at all costs! Your feedback and suggestions are welcome... Rep points will be provided.

I have a second opinion with another doctor this Friday... I will update as soon as I return!

I appreciate the help,
Matt

[jbrowncbr]

Are you currently doing any direct rotator cuff work? I would try this first, especially if they said your one shoulder was only at 50%. I would recommend trying PT first. My doctor sent me straight to PT, no xray or mri. After several weeks of PT I asked if I should get a mri or xray and they said not necessarily because even if there was a tear in my rotator cuff they would send me to PT first anyway. Apparently the recovery for rotator cuff surgery is harder than a torn acl. Now I have read that there are other things they can surgically do to your shoulder that are not as serious. Any case I would get a second opinion and run away from that Dr. if he has screwed up other ppl, try rehabbing your shoulder first it can't hurt.

[Fresch]

You have not had an MRI as yet?

[sybaris]

There very well may be something off with your bicep tendon but then if this Dr. is incompetent then he may be confusing the symptoms.

I have an issue with my shoulder. It is likely a rotator problem as I have weakness in certain positions and HAD a lot of pain especially during BP. After I read one of the stickies about behind the back stretching the pain went away and I can bench as normal.

[HudsonHicks]

I used to get pain in my left shoulder (right handed) during bb bench press and front raises, sometimes dips. It started getting to the stage where I would have to cut bench sets short due to pain. I took a week off, then carried on training but avoided bench and front raises, or anything else that aggravated it. Did cable rotator cuff work after shoulder workouts, using extremely light weight. Took about two months of no benching and RC work and now my left shoulder is 100%. I dont know how serious the injury was, but it was painful and stopped me from training to my potential.

Definitely look into other methods of healing instead of surgery, 21 is a young age to need that.

[Matth3wJL]

Originally Posted by jbrowncbr

Are you currently doing any direct rotator cuff work? I would try this first, especially if they said your one shoulder was only at 50%. I would recommend trying PT first. My doctor sent me straight to PT, no xray or mri. After several weeks of PT I asked if I should get a mri or xray and they said not necessarily because even if there was a tear in my rotator cuff they would send me to PT first anyway. Apparently the recovery for rotator cuff surgery is harder than a torn acl. Now I have read that there are other things they can surgically do to your shoulder that are not as serious. Any case I would get a second opinion and run away from that Dr. if he has screwed up other ppl, try rehabbing your shoulder first it can't hurt.

Thanks for your input! I really appreciate it!

The PT told me to do direct rotator cuff exercises. But she said its a good idea to get an MRI done to make sure there not torn.

My second opinion is tomorrow I will update the thread as soon as I know!

[Matth3wJL]

Originally Posted by Fresch

You have not had an MRI as yet?

Not yet.. I'm going to tell my doctor tomorrow that I would like to request one to see what if anything is damaged in my shoulder.

[Matth3wJL]

Originally Posted by sybaris

There very well may be something off with your bicep tendon but then if this Dr. is incompetent then he may be confusing the symptoms.

I have an issue with my shoulder. It is likely a rotator problem as I have weakness in certain positions and HAD a lot of pain especially during BP. After I read one of the stickies about behind the back stretching the pain went away and I can bench as normal.

I really have no pain while doing bicep exercises I think he was almost trying to scare me into surgery.

Do you think you can link me to that thread?

I appreciate your input!

[Matth3wJL]

Originally Posted by HudsonHicks

I used to get pain in my left shoulder (right handed) during bb bench press and front raises, sometimes dips. It started getting to the stage where I would have to cut bench sets short due to pain. I took a week off, then carried on training but avoided bench and front raises, or anything else that aggravated it. Did cable rotator cuff work after shoulder workouts, using extremely light weight. Took about two months of no benching and RC work and now my left shoulder is 100%. I dont know how serious the injury was, but it was painful and stopped me from training to my potential.

Definitely look into other methods of healing instead of surgery, 21 is a young age to need that.

This sounds exactly like what I have been going through... I had to cut out bench last week because of the pain.

I have been doing standing cables for chest not to heavy and it doesn't aggravate my shoulder at all... Did you try cable work for your chest?

Also what kind of exercises did you do for rotator cuff?
Im doing external and internal rotations.. I keep my arm by my side and rotate my hand outwards. I also put my elbow at head level and rotate my hand from the front upward.

Thanks for posting!

[paulytosway]

My experience,

I had a grade II shoulder separation and as a result narrowing of the AC joint. MRI showed: arthrosis, tendonosis, and mild bursitis along with a small bone spur.

This was a result of overhead press followed by bench 2 days later. I was out of commission for quite some time but now, almost a year later I'm stronger than I was when I first injured myself. Doc told me more than likely i'll need surgery to remove my ac joint 10-15 years from now but she tried to persuade me AGAINST surgery now.

Obviously we all have different situations but since my injury i've learned to listen to my body and I've effectively been able to work around any discomfort.

[RyanGrob]

Hey, I'm from Roch hills too

Get a second opinion with at least an MRI.

[sybaris]

Originally Posted by Matth3wJL

I really have no pain while doing bicep exercises I think he was almost trying to scare me into surgery.

Do you think you can link me to that thread?

I appreciate your input!

http://forum.bodybuilding.com/showthread.php?t=529968

[Matth3wJL]

Originally Posted by paulytosway

My experience,

I had a grade II shoulder separation and as a result narrowing of the AC joint. MRI showed: arthrosis, tendonosis, and mild bursitis along with a small bone spur.

This was a result of overhead press followed by bench 2 days later. I was out of commission for quite some time but now, almost a year later I'm stronger than I was when I first injured myself. Doc told me more than likely i'll need surgery to remove my ac joint 10-15 years from now but she tried to persuade me AGAINST surgery now.

Obviously we all have different situations but since my injury i've learned to listen to my body and I've effectively been able to work around any discomfort.

Thanks for the feedback.. I can't believe this happened to me.. It happened so quickly too. I hope its not as bad as the first doctor made it out to be. An MRI will tell the real truth..

Was your injury a result of weak rotator cuffs or tares?

Thanks!

[Matth3wJL]

Originally Posted by RyanGrob

Hey, I'm from Roch hills too

Get a second opinion with at least an MRI.

I'm so eager to get one.. I can't stand not knowing whats going on with my shoulder.. Its really driving me crazy!~!

[paulytosway]

Originally Posted by Matth3wJL

Thanks for the feedback.. I can't believe this happened to me.. It happened so quickly too. I hope its not as bad as the first doctor made it out to be. An MRI will tell the real truth..

Was your injury a result of weak rotator cuffs or tares?

Thanks!

Separated shoulder is measured in grades 1-3 are most common. AC joint injuries can be anywhere from a sprain to a full tear. I had some tearing. The injury had nothing to do with rotator cuff rather doc thought i simply sacraficed form in doing a forced rep.

Her explanation was simply that your shoulder joint is very unstable. Only held together by muscles. When working out you fatigue those muscles thereby weaking the joint. If form is scaraficed in that vulnerable state you open yourself up to injury.

Her advice was simply, listen to your body--if it hurts don't do it. It's been a slow recovery process but i'm stronger and smarter than I was when I got hurt roughly year back.

[Matth3wJL]

Thanks for the advice!

[m1nd64m3]

I would find a new doctor ASAP!

[orthodoc]

Get a second opinion. You don't necessarily need an MRI right away -- typically I get it when I'm discussing surgery. There are few things in a 21 year-old's shoulder that need surgery right away without therapy. Some of the things this guy told you are crazy.

See a fellowship trained sports med or shoulder doc.

[grebnehtor]

http://forum.bodybuilding.com/showth...#39;s+shoulder --- Good luck!

[Drekkor]

I used to have shoulder issues similar to what you speak of and the solution was to take 3 months off the gym. After coming back, I quit doing barbell work and have been fine ever since. Shoulder press went from 60 lbs to 100 lb dumbells.

[low blow]

(No expert)

but what did the doctor do to identify the CAUSE of this? Do you know? what anaylsis did the doctor do?