I went to doctor today: shoulder update

[John Stone]

Here's an advance look at what I will be posting in tomorrow's "Daily News" for those who are interested in what happened at the doctor today.


As most of you already know, I went to the doctor yesterday for further treatment on my rotator cuff injury. I saw a different doctor this time around, and I'm glad that I did. I really liked him. I had a very good visit, and I feel pretty good about my options at this point. The first thing he did was ask a bunch of questions, then he tested my range of motion and poked around, none of which hurt too bad. The next thing he did was take some x-rays to determine if there was any problem with my bones. The x-rays were negative and, because I have full ROM, it definitely looks like a partial rotator tear.

I brought up the possibility of seeing a sports doctor, and he was very willing to go that route and give me a referral if that's what I wanted. He felt strongly that surgery would not be needed--at least not yet--and suggested that I consider a cortisone shot, combined with more Naproxen (which is the anti-inflammatory I've been taking) and a few more weeks of rest. He said that the Naproxen alone may not have been strong enough to relieve the inflammation enough to allow for a full recovery, and that a cortisone injection administered directly into my shoulder might provide enough relief to allow the injury to finally heal. I decided to go with the cortisone shot and Naproxen. He did the injection right there, and said I should feel relief within a few days to weeks.

No matter how good I feel in the coming days, I'm going to wait at least a month before I lift again, and even then I will probably only do light weights for a month or two. If all is well after that, then I can resume heavy weight training. If after 4-6 weeks I am still experiencing pain, I may go back for a second and final cortisone injection, or I may just go see an orthopedic doctor, at which point an MRI will be done and more options presented. I'm hopeful that it will not come to any of that. My doctor believes that the injury can heal on its own, and I really hope he's right!

[Rockman]

John, you are officially now a ROIDER!

but seriously, good news. Hope it all works outs for you sooner than later.

[gravityhomer]

Originally Posted by John Stone

If after 4-6 weeks I am still experiencing pain, I may go back for a second and final cortisone injection, or I may just go see an orthopedic doctor, at which point an MRI will be done and more options presented. I'm hopeful that it will not come to any of that.

Maybe just go for the MRI now, no? You will see how the injury looks right now. Then you can check again in 4-6 weeks and see if anything changes in the MRI pics. When the tendenitis in my knee was at it's worst, I had an x-ray and MRI done the same day. The x-ray of course showed nothing, but the MRI showed several deep tissue bruises. In a few months I may get a second MRI to make sure these are healing. If you're covered on the MRI could be good to get a baseline.

[tankhead]

Why haven't you had the doctor write you a script for physical therapy? They could be treating you with weekly ultrasound with topical cortizone, phonophoreisis, ice message, heat and strengthening exercises for the other three rotator cuff muscles that are not partially torn. Seems like an awfully long time to be nursing an injury that could be healing faster with more aggressive treatment. Just a thought?

[John Stone]

gravityhomer & tankhead,

Good suggestions from both of you. I wish you guys had posted some of that BEFORE I went to the doctor and not after.

I guess because this is the first time I've ever had this kind of injury I don't really know what to ask for or what to do, and am relying on the advice of my doctors. In fairness, he did offer to refer me to a sports doctor, but he felt that the cortisone would be sufficient and I trust him to know what he is talking about.

I am already doing strengthening and rehabilitation exercises, and I asked about ultrasound while I was there and he said the sports doctor would be the one to talk to about that.

My shoulder feels really, really good this morning. It may be that the injection is going to be just the ticket to let it finish healing. If it's not healed and I do wind up going back to the doctor in a month, I'll be sure go straight for the sports doctor.

Thanks for the helpful advice. Live and learn!

[LaTouche]

I have had 2 cortisone injections in my shoulder due to rotator cuff injuries because of tennis. You may feel discomfort in your shoulder or even pain in the next couple days. It should get much better after the 1st week but like you said make sure you wait at least a month before you lift again. The reason i had two injections was because i started hitting serves way too quickly. Cortisone is usually the last option before surgery, so make sure you make the best out of it. i would recommend you see a physiotherapist so you can get STEM and ULTRASOUND treatment on your shoulder and also rotator cuff strenghtening excercices on machine that most physiotherapy clinic have.

Good luck, and i hope you get over that nagging shoulder injury....

[gravityhomer]

Originally Posted by John Stone

gravityhomer & tankhead,

Good suggestions from both of you. I wish you guys had posted some of that BEFORE I went to the doctor and not after.

Yeah, I know, things you could have told me yesterday. It hadn't ocurred to me until I read your post. I also just had my first visit at the Physical Therapist on tuesday, so I think my injury awareness is extra heightened.

The most important thing is that you feel you have a plan. Which it seems like you do, as you really liked the doctor. The first doctor I saw about my knee, said this is what it is, rest for a few days, here are some stretches you can do, take anti-inflammatories and ice every so often, and then practically pushed me out the door. We talked for probably less than 5 minutes. I had to track him down in another room to ask him a final question and only then did he think to give me an ace bandage for extra support.

When I saw a different doctor a week later, he set up an x-ray, an MRI and gave me a referral for Physical therapy. And discussed my problem with an orthopedist. Now I feel like I had a plan, more than just the wait and see approach.

My first appointment with physical therapy was AWESOME! She spent nearly an entire hour with me. She listened to my whole story of how the pain progressed. Asked me tons of questions. She then checked my alignment from my feet all the way up to my hips. She checked the flexibility and development of all the relavant muscles and tendons. Took me through the stretches she wanted me to do. Her diagnosis was that my feet are pretty asymmetric so while I probably did too much too soon on the treadmill, I'm also prone to this injury.

Basically my point is now I feel like I have a plan for how to heal. When I go to the doctor I usually don't think to ask questions about other options, I just listen to whatever they say and take their word for it. Now I am going to be more wary, because it seems it all depends on who sees you. Anyway heres to everyone healing their injuries.

[daveo]

Originally Posted by John Stone

My shoulder feels really, really good this morning. It may be that the injection is going to be just the ticket to let it finish healing. If it's not healed and I do wind up going back to the doctor in a month, I'll be sure go straight for the sports doctor.

Considered going to the doctor before starting lifting again? I couldn't tell if that's what you had in mind or not, but I'd suggest it. There's no point in lifting on an almost healed shoulder when waiting a few more weeks would finish off the process.

I mean, I'd get the complete OK from the Doc (sports doc in your case), with the MRI if possible, before I started lifting.

My $0.02

[jtelling]

I've had a number of cortisone shots in various joints because of rheumatoid arthritis, and I gotta tell ya, each time they did wonderous things for me. they would usually come after a joint had been drained (180cc from my left knee at one point). since my rheumatoid arthritis is a disease, the shot only helped for so long. in your case, with it being an injury, I can almost guarantee that it'll greatly help your recovery.

you're doing the right thing john, keep it up man.

[pablo]

Hey John,

I'm not to the forums and am not sure what different treatments you have tried for your shoulder. But there are a couple things which I've found helpful for shoulder injuries and injuries in general. The first is trigger point therapy. There's a couple books, 'The Trigger Point Therapy Workbook' by Claire Davies and 'Myotherapy' by Bonnie Pruden which are both worth checking out. I got turned on the trigger point therapy in Stuart McRoberts, 'Beyond Brawn'. You may want to look at that as well. All are available on Amazon.

More closely related to your shoulder problem is the seven minute rotator cuff solution. I think this one is a must! Also I remember reading an article in mens health by Owen Mckibbin which outlined a very light-weight shoulder routine he does just for shoulder health. It seemed to be based around a curl press movement done with light weight dumbells. I did that routine for a while and found it helpful. You might see if you can find it buried in the men's health site. I know he's written a book as well though I haven't checked that one out. He might be a good resource as he has suffered a similar rotator problem and seemingly is completely recovered.

Lastly, I've read a couple thing about 'ART' therapy which sound very promising. I know very little about this other than what I read in men's journal awhile back. Here's a link. art therapy . I've also had good luck with some of the routines from a book, 'The Egoscue Method of Health Through Motion'.

Good Luck
-Pablo

[rboit]

John,

Sounds like your doc is pretty sure that this is a cuff sprain or partial tear. If so then you probably don't need an MRI. You know, of course, that the anti-inflammatories will not only decrease the inflammation and thus promote healing but they will also mask some of the pain. Be sure to start off very lightly when you resume upper body work, preferably starting with cuff strenghtening exercises using ridiculously light weights at first. If I were you I'd ditch the Max OT, at least for anything that might work the shoulders.

Good luck!

[Fudgam]

Something that I see as being negative when taking the painkillers, is you are more likely to do more damage. If you cant do light weights without painkillers, then you shouldnt be lifting. Just more caution to not overdue it. My $.02

[John Stone]

Originally Posted by daveo

Considered going to the doctor before starting lifting again? I couldn't tell if that's what you had in mind or not, but I'd suggest it. There's no point in lifting on an almost healed shoulder when waiting a few more weeks would finish off the process.

I really had not, but that's really not a bad idea. I might just do that. I am at least going to stop taking the anti-inflams a week before I lift to that I can make sure the inflammation is gone on its own.

[John Stone]

Originally Posted by pablo

Hey John,

I'm not to the forums and am not sure what different treatments you have tried for your shoulder. But there are a couple things which I've found helpful for shoulder injuries and injuries in general. The first is trigger point therapy. There's a couple books, 'The Trigger Point Therapy Workbook' by Claire Davies and 'Myotherapy' by Bonnie Pruden which are both worth checking out. I got turned on the trigger point therapy in Stuart McRoberts, 'Beyond Brawn'. You may want to look at that as well. All are available on Amazon.

More closely related to your shoulder problem is the seven minute rotator cuff solution. I think this one is a must! Also I remember reading an article in mens health by Owen Mckibbin which outlined a very light-weight shoulder routine he does just for shoulder health. It seemed to be based around a curl press movement done with light weight dumbells. I did that routine for a while and found it helpful. You might see if you can find it buried in the men's health site. I know he's written a book as well though I haven't checked that one out. He might be a good resource as he has suffered a similar rotator problem and seemingly is completely recovered.

Lastly, I've read a couple thing about 'ART' therapy which sound very promising. I know very little about this other than what I read in men's journal awhile back. Here's a link. art therapy . I've also had good luck with some of the routines from a book, 'The Egoscue Method of Health Through Motion'.

Good Luck
-Pablo

Thanks man, very good stuff there - I'll check it out in detail this weekend. I am already doing a number of rotator cuff strengthening and rehabilitation exercises, and they seem to be helping a lot.

[John Stone]

Originally Posted by rboit

John,

Sounds like your doc is pretty sure that this is a cuff sprain or partial tear. If so then you probably don't need an MRI. You know, of course, that the anti-inflammatories will not only decrease the inflammation and thus promote healing but they will also mask some of the pain. Be sure to start off very lightly when you resume upper body work, preferably starting with cuff strenghtening exercises using ridiculously light weights at first. If I were you I'd ditch the Max OT, at least for anything that might work the shoulders.

Good luck!

Yeah, I'm done with MAX-OT for the foreseeable future (at least as far as my upper-body is concerned). I'll go pretty light for a couple of months after the shoulder is healed. At this point I'd be happy just to be able to lift anything heavier than a protein shake.

[John Stone]

Originally Posted by Fudgam

Something that I see as being negative when taking the painkillers, is you are more likely to do more damage. If you cant do light weights without painkillers, then you shouldnt be lifting. Just more caution to not overdue it. My $.02

Just to be 100% clear, I'm NOT taking pain killers, and never have. I'm taking medicine that reduces the inflammation so that the injury can heal. That's it. Also, I'm not lifting again until the injury is fully healed, and even then it will be strictly light weights for a couple of months.

Thanks again everyone for all the support, help and encouragement. This injury has forced me into a pattern of frustration and stagnation. When I can lift heavy again I'm going to make some damn good gains.

[akm3]

I'm glad it is healing! I understand your frustration but as you are aware sometimes taking a break is the best way to make gains

After all you've barely made ANNNNNNNYYYY progress -- NOT.

-Allen