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  1. #1
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    Shoulder pain problems

    I've had several crashes over the past 6 months. One in Feb when I fractured the greater tuberousity and damaged the supraspinatus/bursal surface in my shoulder. I didn't find that out until 6 weeks later when I finally got x-rays and ultrasound. Apparently I have a high pain threshold. Then I got it caught up in vines falling down a 12 foot bank around maybe 8 weeks ago. Anyway the pain hasn't gone away. Been going to chiro since November for other things but got refered to Physio for 2nd opinion. Physio says I have been compensating for a possible supraspinatus (rotator cuff) tear as I can not abduct it without serious pain and rotating my shoulder around and my scapula (shoulder blade) is now not functioning properly and is sticking out. I've also lost muscle tone and one shoulder is lower than the other.This is causing the tendon to be inpinged under the acromian which is making it more painful and the cycle continues. Both have told me I need to take time off work so I can get the inflammation down so they can work on it. I have also been refered for another ultrasound but that won't be for another 4-6 weeks. I am not sure when to take time off and how long it will take for the inflammation to go down so someone can work on it. I only get one shot at time off but am worried the pain won't go down in time for someone to help me before I have to go back to work again and they still won't be able to help. I've tried Dyclofenac and Neurofen etc but they do absolutely nothing for my pain. Has anyone had chiro for this. I've heard that you need to get the chiro to sort out the nerves first then physio to build up the muscles. I also get deep tissue massage and that gives me some relief in the middle of the shoulders but not directly on the shoulder injury itself as it has been to tender to even touch. I'm lost. Should I wait till the scan or just go for it now. Can they still help if it is painful but I just suck it in and don't tell them or is that not achieving anything. How long does it take for inflammation to go down. The chiro has keep me from going offroad for 6 weeks now, so that's not the problem as I've only been onroad. Only thing is work which is overhead and heavy lifting. Just feeling a bit helpless at the moment.
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  2. #2
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    Quote Originally Posted by Amber
    ...possible supraspinatus (rotator cuff) tear...
    "Overhead and heavy lifting"--tough.

    I just wanted to contribute what I have found to be a beneficial low-stress rotator strengthening exercise. I like it because it seems to bring immediate relief to some degree and because it seems unlikely to cause further injury:

    Standing, arm straight down, hold a 2-3 pound weight and describe small circles with it.

    Perhaps it will bring you some relief as it has me.

    Best wishes.

  3. #3
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    Quote Originally Posted by BadHabit
    Standing, arm straight down, hold a 2-3 pound weight and describe small circles with it.

    Perhaps it will bring you some relief as it has me.

    Best wishes.

    This doesn't stretch your rotator cuff. I always see guys in the gym doing this and I can't understand why.


    Here are 2 ways to stretch up ur rotator cuff with gentle pressure.

    rotator cuff stretch.JPG

  4. #4
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    my xgf went through similar ordeal. after suffering through ignoring it, PT, chiro, PT, ignoring it, finding an orthopedic surgeon, PT, surgery and then more PT, she was fine a year and a half later. get ye to a doctor, get an MRI and get it fixed.

  5. #5
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    I agree with endoh. After broken collar bone, rotator cuff tear, grade 3 separation and 2 dislocations resulting in surgery it has been my experience you are just wasting your time by not going to an ortho. You said you've already been off the bike for 6 weeks and have seen no improvement. Even after the dislocation surgery I was back on the bike sooner then that.

  6. #6
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    Cheers people. I'm getting a scan in a couple of weeks. Been off work this week and will be next and already the constant pain has died down but the twinging and grinding is still there. The scan should tell them whether I need to see the specialist I guess so I'll wait till then.
    Thanks again.
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  7. #7
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    Something to consider

    Amber,

    Generally when falls occur, numerous muscles can become tight and become the source of pain, often away from the site of the pain. When muscles become tight this can disrupt the balance that they should have and in response, a host of surrounding muscles also become tight to compensate for the imbalance. This begins a vicious cycle of cumulative injury. As a consequence fluid movement is shown the door only to be supplanted by pain, hesitance, and doubt. It's no surprise that the relief you felt from the meds was temporary. Traditional protocols usually deal with the symptoms and not the cause. True resolution of your issue would mean a return to fully functioning activity without a recurrence of pain. If you've found relief then rock on. If you haven't, my suggestion to you would be to try ART. Check it out. www.activerelease.com/providerSearch.asp

    Keep it pinned.

  8. #8
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    If PT don't help, you may need to have that repaired. I let my shoulder go for years with injury after injury til I wound up with a full blow out which left me in a bad position. I nearly had to have a replacement. I wound up with an open (translate to huge incision) reconstructive surgery, more metal bits and pieces, brutal rehab...it's not worth it...

  9. #9
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    Geez, it's been a year now and I'm still struggling with this injury. Had MRI's, showed bursitis and a partial delaminating type supraspinatus tear. Had nerve testing early this month that showed the nerves to the Rhomboids have increased insertional activity, a few fibrillations but still a reasonable amount of EMG activity on voluntary movement. In the serratus anterior there is also increased insertional activity, fibrillations 2+ with a reduced number of muscle units firing in response to voluntary activity but at least some activity. There are also positive sharp waves.
    Haven't been back to see the Ortho Surgeon yet as the waiting list is so long. Getting a bit worried now as the only slight relief from pain I can get is Chiro once a week for the stiff neck and upper back that keeps on going out or seizing up or something and some massage maybe once a month when I can. I don't get much sleep either like 11pm till 3am and then I come down big time and crash nap during the day or start dragging my feet and having a hard time. I do get relief though during biking as I'm fully concentrating on what I'm doing and the adrenaline helps out and I tend to feel worse if I haven't gone for a ride like today as it's raining. I still feel I need to go now, but can't risk any extra injuries as I'm going overseas in a couple of days. I will be off the bike for the next 2 weeks but plan to find one to rent so who knows, we'll see if it makes any difference. What sort of surgery would they do if they do and do ortho's do nerve injurys if everything looks structurely sound? Man, I'm so over this right now.
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  10. #10
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    Wow, good luck with a fast and full recovery. Hope you're not off the bike for too long.
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  11. #11
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    shoulders suck. i have type 3 acromia, which has been surgically corrected in my right shoulder (back in 99). basically the condition causes part of what you're experiencing, impacting of the tendon, leading to further inflammation and evenaually (in my case) a ruptured tendon. You're really going to need to some time off from the overhead work in order to make a recovery methinks.
    Oh noes. I'm going to drink the Kool-Aid.

  12. #12
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    Quote Originally Posted by Ray Dolor
    I feel yer pain. I'm set for surgery on the 20th of this month for a completely ruptured supraspinatus and almost total infraspinatus. Also, a partial tear on the tendon of the long head of the biceps. Oh, and a sub-acromial bone spur too.

    I have had several injuries to this shoulder over the past 30 years, but the over the bars from a month ago today was the straw that broke the camel's back, in my case.

    I'm just glad I'm one of that minority of Americans that still has decent health insurance.

    The reason I'm replying, tho, is to make the simple point,that if a full-thickness tear, or complete rupure, is involved, then the ONLY way it ever has a chance of full recovery is by being surgically re-attached.
    Sorry, wrong post
    BoiseBoy

  13. #13
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    Amber and Ray, i sympathise, and wish you both a quick and full recover to your problems. i have just had athroscopy for a Bankart and Slap lesion repair, thankfully 3 weeks post op out of the sling and now on the road to recovery. First static ride today, feels great!

    Bottom line as others have said is to get this sorted, only a surgeon can repair that kind of damage. If they go in with the scope this aids recovery time.

    I wish you both luck

    Jez
    Last edited by jezhkrider; 03-20-2008 at 12:57 AM.

  14. #14
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    My partner at work had a similar injury last year, with open surgery, he had a 10 week recovery time, and still complains of weakness, but at least the pain is gone. I tore my rotator cuff about 3 weeks ago in a skiing accident. I've seen improvement in my range of motion and the pain is improving if I'm resting. The joint is still weak, a short ride yesterday and I could barely lift my front wheel. Doctor says arthroscopic surgery may be a last resort, I definitely don't want to deal with this for a year like you have. Swinging my arm in circles with a light weight has helped the stiffness. I've also been using a ski pole to hold my arms parallel and lifting them over my head repeatedly.

    Good luck with your recovery.

    I'm just glad I'm one of that minority of Americans that still has decent health insurance.
    You're lucky, I get to treat people for all kinds of injuries and, but don't get any coverage for myself - but that's a different topic all together.

  15. #15
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    Just seen the surgeon again and he is giving me another 2 months to attend a gym based strengthening program for the remaining muscles that are working and try to strengthen the serratus anterior too. Not to keen on surgery in the short term as there is some volunteer movement so may come right and being a lady it alters your curves a little because they take muscle from the front and put it on the back or something. I've also been refered to a pain clinic but not to keen on Codine as I'm still working in the Engineering field. So guess I'm just going to put all my effort into weight training which will be good for the upper body and not just the legs from biking.
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  16. #16
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    Quote Originally Posted by Ray Dolor
    Amber, if there is no full thickness tear, there is always the potential for the partial tear to be healed up.

    Weighttraining, therapeutically, is a must. I have also seen acupuncture work effectively at speeding the healing time in tears, from muscle tears to advanced Grade 2-type ligament and tendon tears.

    You might want to look into that as a possibility. One or two sessions per week for 4 weeks ought to tell you if things are getting better.

    Believe me, you DON'T want to go the surgery route, unless it's ABSOLUTELY necessary.
    A torn cartilage or Ligament do not heal! You can only make the muscles around it stronger.
    Fly Rider

  17. #17
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    Well, just been given 2 months off work. Not allowed to continue with any physio exercises till I can get the pain levels down and then I can start on exercises in the no winging range.The trouble is not so much the tear but that the nerves are partially denervated so the muscles aren't being told to fire properly as in barely and not at the right time so I guess it's just a time thing and avoiding any lifting in the winging range till I have some control back. I'm still allowed to ride though as that doesn't tend to stir it up and I actually feel better afterwards. I just have to stay upright and on it. Hard to do sometimes.
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