So here's a little background on the injury...
About 2 1/2 to close to three years ago, I started to notice a dull pain in my left shoulder. I would notice it mostly while doing chest exercises. I thought nothing of it, thought it was just a little extra soreness, or maybe I was just noticing the weakness more for some reason, being that it's my left shoulder. However, that dull pain continued to increase, and eventually got to the point where it would feel very fatigued with a warm, almost burning sensation after using it. So I decided to get a referral from my doctor to have it checked out.
To make it easier, here's a breakdown, as best I could remember, how things went medically:
Early 2009-April 2009: Got an MRI, went through a few sessions of Physical Therapy. During this time, the PT didn't notice much in my MRI, neither did the Ortho or some kind of Doc at the place that had it ordered. Said there was a little irritation, but nothing serious. So I did the PT, learned some exercises that to this day, I continue to do. Nothing worked with that.
June 2009-September 2009: Completely stopped lifting, except for the PT exercises.
October 2009-February 2010: Started lifting lightly because my shoulder felt alright, but I would soon find that nothing had changed.
March 2010-May 2010: I was sent to a Neurologist by my Doc to have Muscle tests done. Did all kinds of tests, found nothing wrong. This doc ended up giving me my first Cortizone shot, but it was about 4 inches below the point where the injection should have been given (I found this out later). He just asked where it hurt, and injected at that point.
June 2010-September/October 2010: Went to an Orthopedist, who after evaluation of my MRI, said I had Tendonitis. During this time, I got about 3-4 Cortizone injections, and they were high up on the shoulder, apparently where they were supposed to be done. I guess Neurologists don't usually give Cortizone shots, thats why it wasn't done correctly the first time and ultimately did nothing. Anyways, these shots worked and made my arm feel great. The pain never fully went away though, and the only other recommendation after two more shotless consultations, would be to get surgery. Keep in mind I didn't lift for about 7 months at this point. He recommended that I could give it time and if it felt better, I could start lifting lightly and go from there. He said he only recommended Cortizone shots if my shoulder felt less than 50%. So I continued to wait a few weeks, it felt good, with just minor pain, so I decided to lift lightly, using machines and isolated exercises only. Everything was going good, and I even started to regain some strength. However, recently, I feel like I've gone completely back to square one.
Keep in mind, I iced the shoulder, practically OD'd on Ibuprofen (anti-inflammatory's) and did the PT exercises, and obviously accompanied this with the Cortizone shots.
Now I've been weary of surgery because it's cutting you open and I know that nothing is guaranteed to work. I've gotten advice not to do it, and to stay on course with what I'm doing, but it's not working. I also didn't want to be out for 4 months. However, here I am back at square one and I feel like I've tried everything. So I decided to ask for recommendations/advice here, from fellow lifters/health enthusiasts lol
What else can I do? Should I get the surgery? Any other options? Stories/experiences? Sorry for the long read guys, but I appreciate any advice or responses I get.
Cliffs:
Have bad shoulder
Iced, Ibuprofen'd, Cortizone shots, exercises, no lift, light lifting, tests/MRI
nothing worked
Believed to be tendonitis but won't go away
Have done everything under the sun but surgery
Need advice
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03-14-2011, 11:44 PM #1
Need recommendations/advice on injured Shoulder
♠SO CAL CREW♠
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03-22-2011, 07:51 PM #2
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03-22-2011, 09:27 PM #3
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03-24-2011, 09:57 AM #4
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03-25-2011, 10:48 PM #5
Ya man, it's a real pain, especially because it makes it real hard to work out my chest. I can only lift so heavy, so I feel like my chest is lagging, and it sucks.
No, the doc didn't specify which tendon was inflammed. He just said that I had tendonitis. The PT definitely strengthened the scapulohumeral muscles, it was noticeable, and I'm sure it helped in some small way, but it definitely didn't fix anything.♠SO CAL CREW♠
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03-25-2011, 10:50 PM #6
Negative on the scope, he just marked the shoulder at the joint site, stabbed me and injected lol. It would be sore for about two days, nothing serious obviously, then feel pretty good for about a week. It did get better over time, but then sorta plateaued and never progressed.
I'm in SoCal, gettin ready for the beach season. Then again, it's almost always beach season here. Whats rain? lol♠SO CAL CREW♠
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03-25-2011, 11:02 PM #7
You should try doing Hip dumbell presses for your chest/triceps.
http://www.youtube.com/watch?v=eSnhS0S7swQ
Does that hurt to do?My website: http://www.posturedirect.com
The sole purpose of creating PostureDirect.com is to help those who want to improve their posture. Come visit :)
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03-25-2011, 11:25 PM #8
What you're going through sounds exactly what i went through from Feb 2010-November 2010 (got it from DB Benching).. Was told tendonitis, bursitis etc you name it.. Went through so much money (at 16, this sucked..) seeing multiple doctors all said same thing, did all there PT/ Treatment/scans for it.. Nothing worked
Talked to some guy at the gym, randomly.. (Best thing that happened thought), he recommended me to a Sports Physio who specialises in shoulders.. 5 minutes being there he diagnoses it as Shoulder impingment ..
4 Months of r physio, rehab every night and im finally back at the gym, Been back for 2 months now..
First month was only about 8 exercises, now im back doing everything basically but legs.. Since i blew my knee but thats a whole different story.
im maintaining my rehab work @ 1hr~ every night and its going well..
Flat Bench/DB Bench still gives me some problems, but only sometimes.. So im still being weary of this badboy.
Cliffs:
Had same problem as you, got told same stuff
Turned out to be shoulder impingment, go get your shoulder checked out by a Sports Physio who specialises in Shoulders.
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03-26-2011, 01:26 AM #9
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03-26-2011, 01:27 AM #10
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03-26-2011, 03:32 AM #11
Taking anyone's adivice on what specific work to do is well, it's not smart. it could cause more harm than benefit
Sorry.
here's why:
http://forum.bodybuilding.com/showth...hp?t=129391851
with all the best will in the world, folks who have had "something similar" are speaking from a really restricted knowledge base: experience of 1.
and speaking as someone who works with folks for this kind of injury it is impossible to tell you what's going on or make good suggestions without seeing you. There are just too many variables.
You've already been potentially screwed by someone giving you cortesone without a scope. Any of the literature practically screams this should only be done by someone who does this alot for athletes and with a scope and rarely.
So = best suggestion - work with someone who will work with you to analyse your movement, your muscle activation, your strength and who can help YOU work specifically on the rehab that you need and is possible.
If you pm me where you live if i know someone near you i'll be happy to make a recommendation.
But dude, the advice here is free and worth every penny.
i appreciate your frustration - great you reached out -but the best thing anyone here could give you is direction to a qualified pair of eyes to help you move better.
That said: any exercise that doesn't cause pain - dandy
if there's pain
reduce speed, load, range of motion one at a time till there's no pain.
jmo
mc
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03-26-2011, 03:15 PM #12
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03-26-2011, 07:31 PM #13
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This sounds like a case of "tendonosis." Tendonosis is the actual degeneration and physical changes to the rotator cuff. The area of damage and/or which has degenerated to a certain point is a "hot spot." This "hot-spot" is aggrevated by lifting.
Can you have the MRI images read again? There is a big difference between tendonitis and tendonosis. Tendinitis is short term and resolves itself, tendonosis doesn't. Have your doctor explain this to you. These changes, imaging will be evident on the MRI.
My position, and speaking only for myself, Cortisone should be used as a last resort. When the shoulder pain is too intense, inferring with daily living and effecting your quality of life, then by alls means do it. Treating the cause of your discomfort is imperative. Pursue what I told you.
Good Luck.
The SnakeE117
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03-27-2011, 12:32 AM #14
Thats something that I've been looking into. I think I might ask if I should get another MRI done. Like I said, it was done over a year before someone actually said it was tendonitis by looking at it. So I wonder if anything more may have occured since then. I have a new doctor these days, so he may be able to further assist me with it.♠SO CAL CREW♠
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03-28-2011, 06:17 AM #15
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Bicep tendinitis can be tough to beat. I finally did after 3 months of PT where the tendon was worked on to get the knots out of it. Tough going, but it worked. I could feel the knot "release" as the therapist massaged it out. "What the hell was that"?, I asked when it popped. The tendon has to be worked and stretched.
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03-28-2011, 09:07 AM #16
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Kornkulin:
I have the dubious honor of having the condition of rotator cuff "tendonosis." More specific is tendonosis of the supraspinatus rotator cuff. As I mentioned earlier, tendonosis is a degenerative condition that is treated completely different from its inflammatory misnomer, tendonitis (Dr. Ryan).
How do you get that? Working through, pushing through the active/acute phase of shoulder tendonitis. I did not allow my bouts of shoulder tendonitis to heal, thus turning into tendonosis. This "hot spot" or damaged area will take up permanent residence within the tendon. The hot spot is well noted during lifting.
Couple questions: What was your diagnosis from the doctor? If told, "shoulder tendonitis" can you be more specific? The MRI report, what was the radiological diagnosis? AC joint and labrum "ok"? How did your condition necessitate PT? In PT, what was the focus of your therapy?
Lastly, you will return to lifting. The treatment for tendonosis requires a varied step approach. The proper diagnosis is critical to determine your treatment success (Dr. Ryan). Work with your doctor, begin to rule-out causes. Thats what I did. I had the benefit of (2) shoulder doctors. My MRI looks like a "train-wreck."
Keep me posted. More to follow. Pleasure to met you.
The SnakeE117.
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03-28-2011, 09:12 AM #17
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03-28-2011, 10:28 AM #18
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03-28-2011, 10:30 AM #19
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03-28-2011, 10:34 AM #20
The higher order bit question is: what was causing this supposed knotting?
If that's not addressed, then what do you think the probability is of the condition recurring?
just a question.
the site of pain is not the source of pain.
i've worked with athletes with biceps tendon pain;
what they did was work their wrist extensors and brachial radialis. that sorted the issue with the biceps in that case.
In another case it was learning better form for their single arm overhead press - had nothing nothing nothing to do with striping the tendon itself.
So maybe that worked for you in your case, but it's impossible to generalise from an individual experience to others: there are too many variables.
mc
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03-28-2011, 11:43 AM #21
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Hello MC.
Very interested in his case; many similarities exist. However, first and foremost, I would like nothing to see but an accurate diagnosis and subsequent treatment identified for him.
I'm trying to look at the "big picture." Trying to manufacture questions and concerns that he may want to bring up with his physician regarding his current condition so that he is well informed in every aspect.
Myself, having shoulder issues for many years from lifting, I speak only from experience with my dealings. I'm a strong advocate of proper diagnosis and appropriate treatment.
Take care. Good speaking to you.
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03-30-2011, 12:13 AM #22
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03-30-2011, 12:15 AM #23
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03-30-2011, 12:45 AM #24
I never had a diagnosis from my doctor. He immediately sent me to PT, which I did a few sessions. Actually, the only thing my doctor did was tell me to start taking antiinflammatories (I know thats probably spelt wrong, too tired to correct). I did three MAYBE four sessions of PT, but I believe it was three. I would go in, stretch a little, do multiple exercises, then be hooked up to one of those electro-pulse machines. Think of a tens machine. It makes your muscles contract through electrical impulses. I'm sure you know what it is. Anyways, thats how I would end the session, with about 15 mins of that. I actually can't remember how long that would take place. My PT also gave me two exercises to do. The one where you put a rolled up towel between your elbow and waist, then pull weight (really light, like 15lbs. tops) laterally in a range of about 90 degrees. It would start at the stomach area then extend outward until your arm was facing forward. The other exercise was a pulldown with the same weight. I did both of these exercises on an adjustable weight station. One wear you can do cable flies or shoulder workouts, etc. The arms can adjust from straight up to straight down. It's hard to describe, but hopefully you get what I'm talking about. Oh, and there was a third workout, it was with a bodyblade. A bodyblade, just in case you don't know, is just a thin blade/sword shaped thing with a grip in the middle and two small weighted ends. I keep my elbow against my waist, and in a 90 degree angle, and wiggle the blade back and forth from side to side for about 30 seconds for four sets. All three of these exercises are for building and strengthening the underlying stabilizer muscles. I believe this was affective, but it did nothing to help with the pain. It wasn't until a year later that I was actually looked at by an Orthopedist and diagnosed with tendonitis. I can't elaborate any further because he didn't really say much other than I had some irritation in the area due to the fuzzy grayness that showed on the MRI and that he believed it was tendonitis. I have no idea what you mean by radiological diagnosis, and as far as I know, my AC Joint and Labrum are fine. Like I said, nothing has worked thus far. I really don't care what I have to do to fix this thing, I just want it fixed. If it means meditating and eating tree bark or something then thats what I'll do lol I appreciate the response by the way, nice to meet and talk to you as well.
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03-30-2011, 04:16 AM #25
Well, I can't offer much advice, but I have had FOUR shoulder surgeries, three on my left shoulder, which still isn't repaired properly and one on my right shoulder which healed great. I’m right handed and have never had one problem post op with the right side. (my first op on the left side was done by the military and they didn’t actually fix anything just removed some scar tissue, so I guess that one doesn’t count)
All I can say is I've NEVER gotten any relief from cortisone and NEVER had a tear identified though MRI or Arthrogram (which is PAINFUL) and I’ve always had MAJOR tears. All my surgeries have been orthroscopic and have been painless. At a minimum you could have them take a look with the scope and repair any minor problem while they’re in there (e.g. scar tissue, bone spur, ect). My only complaint with orthroscopic surgery is I’ve only had one successful surgery and it takes soooo long to recover. My doctor is awesome, but won’t let me do anything for several months after surgery, so I just watch while all my hard work from the gym dwindles away.
My advice is to find the best Physical Therapist and Surgeon you can before making your decision.
Hope this helps… Good Luck.Last edited by rickporter73; 03-30-2011 at 04:35 AM.
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03-30-2011, 04:33 AM #26
really sorry to hear about your experience with cortisone
it's all too typical
few gp's use a scope, and without a scope, you can miss the target - and most folks do.
even hitting the target the crap lasts in the tendon for months if not over a year, and the pain often returns.
the research on it is increasingly showing it should be treated as a far more rare and specialised application.
If used it needs to be part of a richer strategy for rehab. Usually it's given as a solution.
glad you have a great doc.
best
mc
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03-30-2011, 06:52 AM #27
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Kornkulin:
Thanks for the reply. The radiological diagnosis is the interpretation of your MRI report as read by the doctor (being the radiologists). His or her impression is then forwarded to the your physician to help aid in identifying a proper diagnosis.
Speaking of MRI's, had (2) done within the last 6 months. One was a plain, non-contrast MRI, the second was a MRI/Arthogram. My doctor wanted to rule out any labral issues as well as take a better look at my AC degeneration and distal clavicle. Findings were unremarkable. I also was told I had "tendonitis" which was incorrect.
To make a very frustrating, long story short. A second radiologist (the second opinion) read my imaging reports. I was able to met him, discuss my symptoms, showed him the areas of discomfort, stiffness and areas of painful ROM. In my case, the Supraspinatis
Tendon was effected with tendonosis. Most radiologists will not say that it is tendonosis or tendonitis, they usually call it tendinopathy. Tendonosis shows up black on a MRI (T1), whereas, areas of tendonitis shows up white on an MRI. There are weighted differences in color contrast in T1 and T2 imagining - your radiologists will be able to explain this to you, I can not. Leave this up to the expert, even if this involves viewing your MRI -- frame by frame, slice-by-slice.
In my case, as subtle as it is, imaging revealed thick dark lines in and about the distal end of the supraspinatis RC as well as "thinning" of the tendon. My RC had gone through physical and degenerative changes, well beyond that of "tendonitis."
When your doctor tells you to take anti-inflammatory drugs, you should consider seeing a new doctor. NSAIDs are recommended only for a short duration. Remember that not all orhto. doctors or (including radiologists) are created equal. Frankly, some doctors are better than others -- I encourage seeing another doctor.
My recommendation is see another Sports/Ortho. doctor, but better yet, one who specializes in shoulders. Have the MRI report read again, as mentioned. Be persistant.
If referred to PT, try to find a "joint person." I did, my PT was a shoulder specialist, whom now is my favorite person in the world -- I can not praise him anymore. However, make sure the PT person you see is a C.S.C.S.
Again, this is my story. I don't know whats happening in your shoulder, that is best left to the medical community to find out, however my case can be used and brought up to your physician as a "possible culprit." Keep me posted. As always stay the course and good luck!!
The SnakeE117.
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03-30-2011, 03:14 PM #28
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03-30-2011, 03:27 PM #29
Thats funny, we actually think the same way. The first person that read my MRI may have been the radiologist. Its been awhile, so I can't remember, but that may be it. He recognized the same gray areas that showed up and sited it as irritation and sent it back to my doctor. That gray area is what would eventually be said is tendonitis.
The part I found funny is where you said if my doctor says to take anti-inflammatory's, to see a new doctor, because thats pretty much what I did. As I previously stated, I recently started going to a new doctor, and this was because everytime I went to see my doctor, he would just refer me to someone else for more tests, and I felt very "brushed off" during every doctor visit. Doctor visits cost money, and mine would last all of a few minutes, so I finally got tired of it, and went elsewhere.
I took anti-inflammatory's alot, to the point where my stomach would hurt after so long. It would start hurting and I would realize that it was the pills doing it. My doctor did warn me of this, so when it happened, I would stop taking them. My doctor did refer me and try to help figure the problem out, but I just didn't see enough interest from him. He just seemed to want to pass me off to someone else and didn't really talk or explain much like he did when I first started going. All these tests and doctor visits cost me a lot of money, so I didn't have and still don't have, time to waste. Now I have a new doctor that I've been to a couple times for non related issues. I'm going to look at all my options, then I'll go to him and see what he can do to help me.
Thanks for the posts, I'll keep those specifics in mind when being referred. I'll bring those different specialists up and see what happens. I'll keep you guys posted for sure.♠SO CAL CREW♠
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