Shoulder Injury - At My Wit's End

[CoQ10]

Hey Everybody,

I had some shoulder pain gradually creep up on me last winter, and finally had to stop most upper-body work in early-January. Here's a brief history:

November - December: Mild shoulder pain; omitted a few exercises (dips, decline press); shoulder pain considerably worse by the end of the month.

Early-January: Discontinue all pushing exercises.

Mid-January: See doctor; diagnosed with tendonitis and treated with over-the-counter NSAIDs.

Mid-February: No improvement; see new doctor; treated with cortisone injection and referred to physical therapy (PT); a few days later, cortisone injection has proven ineffective.

February - March: 6 weeks of PT; no improvement; schedule arthrogram.

Present: Results of arthrogram show no sign of any serious trauma; previous measures taken have ruled out tendonitis; treated with one more cortisone injection in a slightly different area and instructed to report back to doctor in one week.

My question now is: what could this possibly be, and where can I go from here? The pain goes from my shoulder to my upper-bicep, and I can only feel it when doing pushing exercises or lateral raises. I've tried everything from cortisone injections to intensive PT to ART and nothing has helped at all.

Any advice is sincerely appreciated, as I'm totally at a loss here.

Thanks,
C10

[RyanGrob]

Arthrogram was negative for labrum tear?

[CoQ10]

Arthrogram was negative for labrum tear?

Yes, sir. I can't tell if that's a good or bad thing. On one hand, it looks like I probably *won't* be needing surgery; on the other, what the hell am I supposed to do now? The only thing I can think of is complete inactivity for several more months, but considering a month of inactivity did absolutely nothing, I'm not sure this is the optimal solution...

Thoughts?

-C10

[King Viscera]

If I had to guess, it sounds like the long head of the bicep tendon is being pinched between the acromion and humerus.


Did the dr. diagnose you with shoulder impingement syndrome? If that is your problem and all conservative treatment has failed, some people can benefit from arthroscopic subacromial decompression.

[Bierce]

If I had to guess, it sounds like the long head of the bicep tendon is being pinched between the acromion and humerus.


Did the dr. diagnose you with shoulder impingement syndrome? If that is your problem and all conservative treatment has failed, some people can benefit from arthroscopic subacromial decompression.

X2. Also, a good chiropractor may be able to greatly rectify the impingement so that at least everything is back where it belongs and you can rest/heal.

[Dr Clay]

I'm surprised ART along with PT didn't help. If it is impingement, which it seems the shoulder probs of most lifters are, then balance out the cuff muscles (and those around/associated with the shoulder) along with ART on the affected muscles is pretty much all there is to restoring normal shoulder function (assuming there is no tear, etc...)

I would try to find another ART doc (chiros typically make great ART practioners) and give it another go.

[JerG]

Yup, sounds like impingement. Has your should improved at all since january?

[dsharp9000]

Here is my own experience with a shoulder problem i had that would not go away. It was an impingement . At first i stopped all the lifting exercises that caused my shoulder any pain. I waited and waited for it to go away; but it did not even after a couple of months and my dr said i should not really lift again until the pain went away....

Well, eventually, i started lifting again and going with really light wieght... any shoulder exercise as well as bench had to be done ultra light. I also made sure i did an equal number of pulling and pushing exercises; such as rows and pullups as i had read that an imbalance can happen in the shoulder if you dont do equal numbers.

After about a month or so, i could add some wieght to the lifts; please note i had a slight discomfort in my shoulder when lifting even the i was lifting light; but it was not the type of discomfort that i felt that was making the injury worse....

After two months, my shoulder finally seemed almost healed; and a short time later it fully recovered (though i think if i let myself detrain; that injury still maybe there).

I must say i do not know if my shoulder would of ever healed without this light training... i do not know if your injury is even comparable to mine; but though my own experience might be worth something to you.

One thing i do know now; is i probably should of been seeing a dr. that specialized in sports rehabilitation as this is what i really needed..maybe you should think about seeing a dr that specializes in sports rehabilitation because most rehabilitation doctors will actually prescribe a workout program that help heal your injury... and i suspect that is what you need...

[ccs77]

Hey Everybody,

I had some shoulder pain gradually creep up on me last winter, and finally had to stop most upper-body work in early-January. Here's a brief history:

November - December: Mild shoulder pain; omitted a few exercises (dips, decline press); shoulder pain considerably worse by the end of the month.

Early-January: Discontinue all pushing exercises.

Mid-January: See doctor; diagnosed with tendonitis and treated with over-the-counter NSAIDs.

Mid-February: No improvement; see new doctor; treated with cortisone injection and referred to physical therapy (PT); a few days later, cortisone injection has proven ineffective.

February - March: 6 weeks of PT; no improvement; schedule arthrogram.

Present: Results of arthrogram show no sign of any serious trauma; previous measures taken have ruled out tendonitis; treated with one more cortisone injection in a slightly different area and instructed to report back to doctor in one week.

My question now is: what could this possibly be, and where can I go from here? The pain goes from my shoulder to my upper-bicep, and I can only feel it when doing pushing exercises or lateral raises. I've tried everything from cortisone injections to intensive PT to ART and nothing has helped at all.

Any advice is sincerely appreciated, as I'm totally at a loss here.

Thanks,
C10

This is exactly what happened with me...even down to the dates. I'm having surgery to relieve impingement in 2 days. Having your shoulder scoped is the only 100% sure way to make sure nothing else is wrong and they can fix it while they are in there. Unfortunately you have to go through all the hoops you just went through to get what you need.

[CoQ10]

Thanks for the feedback, everyone.

In regard to the impingement theory - one of my clients and good friends is a chiropractor, and has been really cool about providing treatment. First he tried ART on me, followed by light therapy, and then referred me to another specialist who tried a couple of other similar treatments. Nothing has helped, and I assume if it truly was impingement, they would've fixed me up by now. He gave me the number of one more chiropractor who I'll be working with next week. He's going to use a device that helps detect and repair nerve damage; I forgot what it's called, but it starts with a "F," if that helps. I feel really grateful that he's done all of this for me free of charge, but unfortunately everyone's efforts have thus far proved fruitless.

DSharp - my PT put me on a routine of daily scapular retractions, light external rotations, and stretching of the biceps tendon and posterior capsule. He also recommend I try horizontal pulling exercises. Unfortunately, after 6-8 weeks of following his instructions, there was no improvement in my shoulder; instead, I developed a case of elbow tendonitis that still hasn't gone away. I would imagine this is from the strain of the seated rows, etc...

King Viscera - what exactly does arthroscopic subacromial decompression involve? He did mention scoping the area, but would like to avoid it if at all possible due to potential complications.

Any other ideas? I really, sincerely appreciate everyone's help. You guys are a bright bunch, and I'm optimistic that you'll be able to think of something that perhaps the doctors, chiropractors, and PT's haven't.

Thanks for everything.

-C10

[CoQ10]

This is exactly what happened with me...even down to the dates. I'm having surgery to relieve impingement in 2 days. Having your shoulder scoped is the only 100% sure way to make sure nothing else is wrong and they can fix it while they are in there. Unfortunately you have to go through all the hoops you just went through to get what you need.

CCS - thanks for the info, and good luck on your surgery. What have they told you about recovery time?

-C10

[CoQ10]

One more thing:

Have you heard of using IGF-1 to repair tissue damage? If so, might that help in my situation, and can you get it through a doctor or does it have to be purchased through other countries?

Thanks again,
C10

[ccs77]

King Viscera - what exactly does arthroscopic subacromial decompression involve? He did mention scoping the area, but would like to avoid it if at all possible due to potential complications.


-C10

That's where they take a portion of your acromial bone away to make more room for your Spr. tendon. I think they also remove the Bursa and Coracoacromial Ligament. Once they do all that there is nothing to compress the nerves, tendons, soft tissue that hurts so they call it a decompression. this is what I am having done in 2 days.

[ccs77]

CCS - thanks for the info, and good luck on your surgery. What have they told you about recovery time?

-C10

Thanks...I'm told active people like us with good regimins to apply towards PT, recovery can be as little as 4-6 weeks. With others is can be months.

The good thing about this condition and treatment is your not having any soft tissue repaired so there is nothing to retrain or really re hab for. Don't get me wrong I plan on training shoulder cuffs for ever, I'm never having a shoulder issue stop me again. <----knocks on wood.

I have no idea how it's going to work in real time...On paper it looks pretty routine and pretty easy to recover from. It's probably going to suck.

[CoQ10]

Thanks...I'm told active people like us with good regimins to apply towards PT, recovery can be as little as 4-6 weeks. With others is can be months.

The good thing about this condition and treatment is your not having any soft tissue repaired so there is nothing to retrain or really re hab for. Don't get me wrong I plan on training shoulder cuffs for ever, I'm never having a shoulder issue stop me again. <----knocks on wood.

I have no idea how it's going to work in real time...On paper it looks pretty routine and pretty easy to recover from. It's probably going to suck.

That doesn't seem too bad at all; 4-6 weeks is a drop in the bucket compared to all the time we've already spent sidelined!

I'll mention this to my doctor, and see if he thinks that I may be suffering from the same condition. Best of luck on everything, and please keep us posted!

Thanks,
C10

[x10fire]

Ive been having a shoulder problem for over a year and a half. When it started I immediatley went to my PT for a diagnosis and treatment. I was told I had a shoulder impingement. We worked on it for about 3 months with little change; this included stim therapy and ultrsound then progressed to SITS training and alot of rotator cuff exercises. I stopped all chest excersises and shoulder work. It did well for about 3 weeks then it came back after I started chest again. I went to an ortho doc and he did an mri (no indication of any tears or damage). He injected the AC joint. This helped for 4 weeks then it came back. I went to my chriopractor who lifts also. We worked on it and it did well for awhile but it would just keep coming back. So back to the ortho doc for another shot and this time he said if this didnt work I should think about surgery. well it worked for 6 weeks then came back, all along Im still doing sits work for my rotator cuff. So ive been seeing my chiropractor again and doing alot of streaching for my upper traps, ac joint and upper pec area. It works to alliviate the pain some but it still hurts when I wake up and do chest or barbell curls. I hate the idea of surgery but I got a second opinion form another PT that specializes in shoulders and she advised that after that long with all the work that has been done to stabilize that area and the shots, that I should think about the surgery (unless I like living with pain). Sorry for being long winded but this is a constant problem in my lifiting routine that has kept me from meeting my goals and my chest is really lagging. So get second and third opinions but do not omit surgery as an option, I just know surgery is my last option and I still havent made that decision yet. I will continue to work with my PT and chiropractor but I might go with the surgery. I would like to know how ccs77's surgery turns out.

[Taxguy]

Have they ruled out a rotator cuff tear? My shoulder hurt only doing chest pressing movements (not shoulders), dips, and lateral raises and I had a partial cuff tear.

[CoQ10]

Taxguy -

The arthogram showed no tears, and I have no problem with internal or external rotation, so I doubt it's an RC tear.

x10fire -

What did they inject you with? Cortisone injections have done nothing for me thus far, so I'm a bit apprehensive to adopt this approach again.

Any other ideas?

Thanks,
C10

[x10fire]

Taxguy -

The arthogram showed no tears, and I have no problem with internal or external rotation, so I doubt it's an RC tear.

x10fire -

What did they inject you with? Cortisone injections have done nothing for me thus far, so I'm a bit apprehensive to adopt this approach again.

Any other ideas?

Thanks,
C10

C10,

It was a triple cocktail, Its funny you asked me that because I called the ortho today to get some info and she told me what medicines they were but I was half asleep (going in on night shifts) I do know she said cortizone and something that started with a "T" as for the third medicine im unsure. It helped for about 6 to 8 weeks then the pain started again, sorry I cant help with more than that. I will add that I just took 2 weeks off from any lifiting and the dang thing didnt get any better. Good luck and keep us posted.

[Al Swearengen]

Taxguy -

The arthogram showed no tears, and I have no problem with internal or external rotation, so I doubt it's an RC tear.

x10fire -

What did they inject you with? Cortisone injections have done nothing for me thus far, so I'm a bit apprehensive to adopt this approach again.

Any other ideas?

Thanks,
C10

my arthrogram mri showed no tears either, but there was one in my supraspinatus. maybe ask about some arthroscopic surgery to go in and look around for anything which is what i opted for. it is nothing to go through unless they find something then they should fix it and that will take rehab time.

[ccs77]

I just got scoped today. My MRI was negative for a tear, so I was just in for subacromial decompression. Turns out he found a tear while he was in there. Who woulda thunk....

[CoQ10]

Thanks for the feedback and updates.

Al - if I ask them to scope the shoulder, but they don't actually make any repairs, what am I looking at in terms of recovery time? I'm running out of options here, so I may have to consider asking them to go in and take a look some time soon...

CCS77 - glad to hear you made it! How are you feeling now? It seems you're typing, so I take it your arms not in a sling? Was the surgery painful? How long until you can begin PT?

Thanks again!

-C10

[CoQ10]

Update:

The cortisone injection actually helped a little bit for the first few days, but now (four days later) the pain is back 100%. What might this mean?

Thanks,
C10

[ccs77]

I'm typing one handed....I'm slinged up. I've had ligament surgery berore and as far as pain post op goes this is a breeze in comparison. I'll be starting some small ROM stuff next week and PT in 2 weeks. I hear PT is a bit painfull, we'll see...

Thanks for the well wish and good luck!

[RyanGrob]

Update:

The cortisone injection actually helped a little bit for the first few days, but now (four days later) the pain is back 100%. What might this mean?

Thanks,
C10

Means either the cortisone didn't work, or your problem lies with something deeper than inflammation. My guess sways to the second part.

[Al Swearengen]

Thanks for the feedback and updates.

Al - if I ask them to scope the shoulder, but they don't actually make any repairs, what am I looking at in terms of recovery time? I'm running out of options here, so I may have to consider asking them to go in and take a look some time soon...

CCS77 - glad to hear you made it! How are you feeling now? It seems you're typing, so I take it your arms not in a sling? Was the surgery painful? How long until you can begin PT?

Thanks again!

-C10

very little after just a scope other than 2 stitches in each of probably three 5mm holes and little to no rehab with a quick recovery, but if they find a tear it will be a long rehab you need to be ready for, probably 3 to 4 months minimum.

[Roke]

If it were me I'd take a light multi-vitamin to make up for deficiencies. Copper in particular is very important for ligaments/tendons.

I just recently began it and hope it heals my 7 week long rc injury. It's a minor injury, but it lingers on.

Also msm and evening primrose oil are supposed to help with tissue repair.

[scripturememory]

An extremely affective yet inexpensive treatment is alternating hot and cold packs on the shoulder and upper arm by way of 3 minutes / 30 seconds. Try the Large Universal Hot and Cold Compress by MediTemp at Walmart. Get two packs; heat one up on the microwave, and freeze one in the freezer. While you're alternating with the frozen pack for 30 seconds, nuke the hot for 30 more seconds to get it ready. Do three cycles at least, end on cold, three times a day, and you will see results.

Abstract: Blood flow removes toxins from organs. Heat expands blood vessels and brings fresh blood. Cold constricts, and forces blood full of impurities from the damaged area to be filled again when hot is reapplied. The key to perfect health is perfect circulation.

[CoQ10]

An extremely affective yet inexpensive treatment is alternating hot and cold packs on the shoulder and upper arm by way of 3 minutes / 30 seconds. Try the Large Universal Hot and Cold Compress by MediTemp at Walmart. Get two packs; heat one up on the microwave, and freeze one in the freezer. While you're alternating with the frozen pack for 30 seconds, nuke the hot for 30 more seconds to get it ready. Do three cycles at least, end on cold, three times a day, and you will see results.

Abstract: Blood flow removes toxins from organs. Heat expands blood vessels and brings fresh blood. Cold constricts, and forces blood full of impurities from the damaged area to be filled again when hot is reapplied. The key to perfect health is perfect circulation.

Thanks! I'll pick up some compresses tomorrow and try it in the evening. I'll post an update in a couple days and let you know how it worked.

-C10

[scripturememory]

Additional directions -

Hot pack:

When you put one pack in the microwave, you're aiming for about 2 minutes or whatever it says on the gel pack. You'll want to get it hot but watch through the microwave window so it doesn't swell much. It could leak as some microwaves are powerful. If it leaks, mark the time, don't do it again, bring it back to Walmart, tell them you stuck it in for the recommended time (see container directions) and get another. Use the sleeve included for the hot or a thin washcloth if you can't find the brand I mentioned. Remove the washcloth when pack feels less than maximum.

Cold:

Have the cold pack completely frozen, and don't bother using the soft sleeve for it, as 30 second intervals is not going to hurt the skin. (However, again, use the sleeve for the hot).

Do it as much as you have time for, and don't stop your PT / whatever else you're doing, even if it takes pain away. I would also do hot in the shower and completely cold on the whole arm, as you're doing with hot packs, for three cycles of 3 min. / 30 sec. A detachable shower head is helpful for this, but unnecessary if you can handle cold water.