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Shoulder woes please help!
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Hey everyone, I'm looking for a bit of help/advice with my shoulder.
Had one season of tri under my belt and fell in love with it. This past fall (full 12 months ago now) I injured my left sboulder doing some demo work (I'm a carpenter).
After talking with sports medicine they suggest an MRI. This was the outcome:

There is a partial-thickness tear of the distal infraspinatus tendon without full-thickness tearing. There is tendinopathy of the supraspinatus and the intraarticular segment of the biceps tendon. There is a possible focal tear of the labrum versus an artifact that is seen on only one slice. From a clinical standpoint, I do not think this is playing into his symptoms at all, and there is a little bit of nonspecified bone marrow edema in the glenoid. In reviewing, Dr. Collins' notes, there is no underlying fracture or mass lesion. It is of uncertain significance. He notes this could represent a stress reaction, and if clinical suspicion is high for an osteoid osteoma, then a thin section CT should be considered. I have reviewed the case with Dr. Laskowski. Both of us agree the story is consistent with rotator cuff tendinopathy. We will rehab him, see him back in 1 month and if no better, consider a SASD bursa injection versus additional workup with CT of the glenoid.

Since....I've been rehabbing the shoulder 3 to 6 days a week. Followed all the exercises ect.
Still have pain. I've completed stopped swimming.
Should I try a cortisone shot or is it to detriment in the end game?
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Re: Shoulder woes please help! [JCachiaras] [ In reply to ]
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Hi, sorry about your shoulder. It really stinks.
I can only share my experience. I injured my left shoulder, tried to let it heal on its own with my own version of "PT." This didn't work so finally, after losing almost complete range of motion, I couldn't really even sprint because I could hardly swing my arm. Went to doctors dx: rotator cuff injury with nerve impingement.

Dr. was conservative so ordered 6 weeks PT I went 2-3 times a week. This barely put a dent in recover. Finally got one cortisone injection (I was extremely leery of this) and it was like a miracle. Seriously I could literally feel the inflammation decreasing.

I went back to my physical therapist the next day (didn't tell him I was getting injection) and he was so excited seeing "how much progress we finally made."
I continued PT and basically recovered fully. I am not saying everyone has this experience w/cortisone injection but it sure helped me. Frankly I wish I had gotten one much earlier in the game. Good luck to you.
Last edited by: Pat0: Oct 21, 16 17:01
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Re: Shoulder woes please help! [Pat0] [ In reply to ]
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Pat0 wrote:
Hi, sorry about your shoulder. It really stinks.
I can only share my experience. I injured my left shoulder, tried to let it heal on its own with my own version of "PT." This didn't work so finally, after losing almost complete range of motion, I couldn't really even sprint because I could hardly swing my arm. Went to doctors dx: rotator cuff injury with nerve impingement.

Dr. was conservative so ordered 6 weeks PT I went 2-3 times a week. This barely put a dent in recover. Finally got one cortisone injection (I was extremely leery of this) and it was like a miracle. Seriously I could literally feel the inflammation decreasing.

I went back to my physical therapist the next day (didn't tell him I was getting injection) and he was so excited seeing "how much progress we finally made."
I continued PT and basically recovered fully. I am not saying everyone has this experience w/cortisone injection but it sure helped me. Frankly I wish I had gotten one much earlier in the game. Good luck to you.

Yup pretty much the same for me. I diligently followed the exercises given to me by my physio, I kind of think they made my shoulder worse, it certainly didn't improve very much, neither did rest. Very slight improvement, but I would imagine a 3 month lay off at least at the rate it was going. A cortisone shot into the bursa got me up and going in a week.
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Re: Shoulder woes please help! [zedzded] [ In reply to ]
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Anyone else had positive or negative experiences with cortisone shots to the shoulder?
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Re: Shoulder woes please help! [JCachiaras] [ In reply to ]
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Injured shoulder back in college playing pick up tackle football ... Never got it fixed

Docs say likely torn cuff

Susceptible to impingement.... Cortisone shot about a year ago plus diligent rehab / prefab (cords, shoulder dislocates with pic pipe and dead hangs from pull up bar) have fixed all my issues
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Re: Shoulder woes please help! [JCachiaras] [ In reply to ]
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Hello JCachiaras and All,

I had a shoulder injury and could only walk my hand up the wall with my fingers .... to shoulder height.

First visit to Dr. and he said I had a bursa impingement .... gave me a cortisone shot .... hurt like hell sticking the needle in ..... I thought the needle was going to come out the other side ....... it didn't .......1 day later was much better and in a week it was well without any lingering trauma.

Doctor told me some people have a bone spur that causes recurrent problems but my x-ray showed no major bone spurs.

Doctor said single cortisone injections were not a risk for heart damage.

Cheers, Neal

+1 mph Faster
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Re: Shoulder woes please help! [JCachiaras] [ In reply to ]
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Cortisone injections are not miracle cures. They are part cortisone and part lidocaine (anesthetic). Therefore you will feel better after injection. You have several things going on, but nothing on MRI or CT or X-ray actually proves that any particular structure hurts. Degeneration and tearing of the rc structures is normal. It is entirely likely you had as much tearing and degenerative changes the day before your shoulder began hurting. You have yet to rule out referred neck pain as a cause and have not seen a PT for therapy. The unfortunate thing about imaging is that it is ordered by surgeons who want to do surgery. You are now at an increased risk for rc repair surgery, which research shows 50% of them re-tear within a year. Find a Mackenzie PT, don't get an injection and consider the possibility of an internal derangement of the shoulder or neck.
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Re: Shoulder woes please help! [Calvinbal6] [ In reply to ]
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Dr says I have shoulder dyskinesis, so my left shoulder blade wings out, making the shoulder joint susceptible to injury. Likely the reasonext in part I was injured.
Been working with PT to adhere the scapula and get the rhythm back in balance. I have progressed some for sure.
Still pain especially free spending any time with my arms overhead...or swimming of course.
I do have what seems to be an overactive upper trap. Which Im sure contributes to things. Dry needling calms it down for a while, then gets tense after about a week or 2 (mostly noticeable doing shoulder rehab exercises, ext rotation ect).
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Re: Shoulder woes please help! [JCachiaras] [ In reply to ]
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It's kind of a lame diagnosis. I bet you have significant difficulty reaching your arm behind your back. Keep working with your PT, my guess is stretching behind the back may make reaching overhead better. Don't forget to avoid doing what hurts! Scapular dyskinesia by itself doesn't hurt.
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Re: Shoulder woes please help! [Calvinbal6] [ In reply to ]
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Actually no pain reaching behind my back.
Only when I have my arms overhead for a while, doesn't start hurting in the exact moment.
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Re: Shoulder woes please help! [Calvinbal6] [ In reply to ]
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No, but scapular dyskinesia can cause impingement which does hurt.
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Re: Shoulder woes please help! [HomerJSimpson] [ In reply to ]
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Impingement as Neer described it doesn't actually happen. Most rotator cuff tearing begins as articular side and is not full thickness. That is why it is likely degenerative in nature and not as a result of jamming into the acromion. Most of the time this tearing is not painful and not pathological. Decreasing loading of the rc complex is somewhat possible through increasing scapular kinetics. As with most tendonopathies though eccentric loading of th tendon over the course of 3-6 months is what improves tendon composition, strength and possible pain. No rehab program is complete without relative rest and avoidance of provocative positions regularly.
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