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View Full Version : Rotator Cuff Tendonosis - MRI results enclosed



champs
17-03-2006, 05:26 PM
Hello, I have been dealing with dominate arm shoulder problems for the past eight months following 2 months of stupidly intensive/high volume training. The pain is minor at best (mostly aggravated by odd reaching movements out to the sides at certain angles and to a small degree by exercises like incline DB presses). The problem is it doesn't seem to be getting better.

I've spent alot of time fixing my posture up and strengthening/improving my external rotators and scapular control etc and I think biomechanics wise I am in pretty good shape (also according to physio). The problem is the pain continues (though lessened) and does not seem to be changing. A recent MRI revealed the following....


The rotator cuff and LHB tendons all appear intact. Nevertheless, localised tendonosis signal is noted at the anterior insertion of the supraspinatus tendon and along the distal end of the infraspinatus. Rotator cuff muscle size and quality appears well maintained. The SA-SD bursa shows hyperintensity and mild superior recess thickening over the supraspinatus and infraspinatus tendons. The GHJ shows only a small amount of contained fluid extending into the distal biceps sheath. The GHJ articular cartilage appears grossly intact but localised subchondral marrow oedema is noted at the posterior aspect of humeral head immediately deep to distal infraspinatus tendon. The glenoid labrum appears intact, but localised thickening/scarring is evident in the CHL and SGHL at proximal rotator interval level. The AC joint, acromion process and CAL are all within normal MRI limits.

Impression:
- Intact rotator cuff with evidence of tendonosis at the
anterior supraspinatus insertion and along the distal infraspinatus tendon
- Indirect evidence of subacromial impingement (mild superior
recess SA-SD bursitis)
- Intact glenoid labrum but evidence of old injury in the line
of CHL and SGHL
- Unexplained localised subchrondral marrow oedema at the
postero-superior aspect of humeral head

Could anyone suggest ways I can rehab the supraspinatus and infraspinatus tendons. I have heard good things about eccentric only exercise with high repetitions but I am unsure how to structure such a program and what exercises to use?

Currently I have dropped all heavy pressing movements that involve the right arm, using only low volume single arm pressing with the left. Pushups do not seem to aggravate the injury nor to pullups or most horizontal pulling exercises regardless of loading.

injuryupdate
17-03-2006, 06:21 PM
Drop all of the padding and it looks like you have tendinopathy (or tendinitis etc etc yada yada yada) of rotator cuff tendons.

See a physio for eccentric only strengthening.

See a sports doc for consideration of nitrate patches and possibly a cortisone injection.

You don't need to see an orthopod at this stage.

champs
18-03-2006, 08:47 AM
Thanks, going to see physio Joel Werman in Nthsyd. Sports Doctor did not mention anything regarding nitrate patches etc, how would I go about it?