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Shoulder pain

Okay so here goes to see if anyone from the haus has any ideas. I have been dealinng with right shoulder pain for almost the last year. I doesn't bother me to run or ride (athough while training for CDA this year it would get painful after a couple hours in aero position).

It was painful as I was extending hat arm forward while swimmig for the first couple of hundred yards. Went to my ortho about 12 weeks out from CDA to find out if he thought I could injure it by doing CDA and he said no. Did x-rays and saw my ART specialist weekly before CDA and the pain never got worse.

I figured if it was something that was strain related after CDA I would take time off. Started re-building my run with the guys from PAP and the thing that staarted btohering it was the wall slides with my arms above y head, holding a band. Then it got so I couldn' t put that arm behind my head under my pillow while sleeping witout pain.

So I went back to the ortho and then did a die injected MRI. The end result was a good news bad news story -- the MRI showed nothing wrong. I started going back to the ART specialist twice a week for the last three weeks and the pain appers to be getting worse and now to be "deep" in the shoulder.

I am at a loss and the ortho is going to refer me to a shoulder specialist, but my concern is that he is known to like to use surgery.

So I throw this out there to you all to see if anyne has any ideas and/or things that I can explore?

appreciate any thoughts you may have.

Comments

  • Have you had a physical therapist do a clinical exam? Have you had any PT? Some rotator cuff tears do not show up on MRI. My friend had one but it was negative on MRI. She finally had it scoped for diagnosis and it was almost completely torn through. She had it repaired and is fully recovered. A PT exam can tease out the problem based on ROM, joint mobilization, soft tissue, posture, muscle strength etc.
  • @ Paul , x2 Carrie about a rotator cuff issues cause man it sure smells that way .... Go find a good PT and or a University that teaches ortho guys ,they are very good at these things too.
  • My right shoulder started bothering me in June and I could barely move it for a week after Vegas. The pain I felt swimming was during the recovery/forward extension, not the pull. Saw the doc right after Vegas and he gave me a referral choice between a PT, Sports Medicine doc, and an Orthopedist. I am a firm believer in PT and went that route...an orthopedist would be my LAST choice. The PT doc diagnosed tendonitis with a potential minor rotator cuff tear. Although I could not make it hurt, she moved my arm just so, stuck in her thumb, and ... YOW!! So I've been doing PT sessions 2 x wk the last 3 weeks and I'm swimming without pain and am feeling much better about IMCOZ next month. I'm going to take an EN off season (no swim) to rest it after Cozumel, but the PT approach of strengthening everything around the shoulder seems to be really helping.
  • thanks Carrie, Dave and Paul, I do have a very good PT, but had not gone to him for an assessment. Scheduling it now.

  • Hey Paul...

    Two things of the top of my head. #1, have they checked you for a suprascapular nerve impingement? Not that it's very likely, but possible the way you're describing issues with swimming and the wall slides. Your PT can check for impingement with a simple external rotation test (and you might want to check in with JT Thompson as he had this issue after his crash last year). But given that you're feeling it "deep" in the shoulder, an RC or labrum tear sounds more likely. No "clicking" when you move the arm?

    #2 - You didn't mention if you're having any numbness/tingling down your arm/hand. If you do, where is located? Pinky side, thumb side... forearm, etc...

    Good Luck!!!!
  • I assume your "injected MRI" was an arthrogram and if that is normal, that would show 95% of any kind of rotator cuff or labral tear. So the good news is that you likely don't have a surgical problem. The bad news is there is no "easy fix." I would definitely recommend the refer to the shoulder specialist (orthopedist). I don't think anyone will want to do surgery with an normal arthrogram. And he/she may be able to recommend a PT with good experience with shoulder rehab.

    I'm a pediatrician, and not an orthopedist, but I had/have similar shoulder symptoms and they called it "capsulitis" or a mild form of a frozen shoulder. This can take a couple years to fully resolve and my symptoms are still improving over 18 months. PT can be helpful, but did not help me. Saying "the hell with it" and continued swimming has helped me more than anything. I would stay as active as you can be without too much pain. Also, if you haven't had a steroid injection, the shoulder specialist will likely want to try this to see if it gives you some relief. It may be both therapeutic and diagnostic. It only partially helped me, but (if not done repeatedly) can't hurt to try.
  • @ Jess, did have numbness a couple of times in the last month. Happened at night when I would wake up and my whole hand was numb. I had just assumed it was because I slept on my arm funny,

    @ Rob, yes it was an Arthrogram and yes the ortho gave me his "read" on it as a good new  bad news thing -- it showed nothing as both the good and bad news.

    appreciate all the insights

  •  okay fast forward to today ... ... ... it looks like 

     

    after having issues with my right shoulder for almost a year.  I finally think we have uncovered the issue. Had a die injected MRI and a whole range of other tests, they ruled out rotator cuff issues and a labral tear. Doing PT for last 4-6 weeks. The end diagnosis is a frozen right shoulder. I have been compensating through really good shoulder flexibilities in other parts, but ... at a cost.

    I had my left shoulder freeze up about 5 years ago and after almost six months of PT, they did a non-invasive shoulder manipulation and then another 3-4 weeks of PT and that shoulder has not bothered me since.

    The issue is we (my doctor and I) will be deciding whether or not to do the manipulation on the right shoulder on Friday as we have met our family maximum deductible. The procedure would be on the 20th.

    thoughts/reactions?

     

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