Some advice plz on shoulder injury!!!

[Rexdog84]

This seems to be a popular place to get some good advice on what may be going on.....so...6 weeks ago I was playing basketball game for a league through my university when I took a dive for a live ball. I landed with my arm extended in an attempt (successfull lol) to save my face from hitting first. Felt a giving sensation, but it wasn't quite like a seperation or dislocation. My main complaint was that I had an enormous amount of weakness immediately, the pain did not set in until I got off the floor and calmed my heartbeat. Any movement for the first 10 days was hindered by an unimaginable amount of pain. First attempt to see the doctor in the ER was unsuccessful, I just got dismissed with a possible rotator cuff tear and some ibuprofen...lol. Went to my regular doc and he ordered and MRI and Arthrogram. In the meanwhile, pain subdued (never had any tenderness, only had a pain deep inside shoulder), restored movement. Any outward (sideways) motion causes tremendous pain at about 30degrees. I am able to lift my arm frontwards with some pain....however when lowering my arm to the side it catches badly and is relieved with a pop. MRI and Arthrogram results just got in....6 weeks down the road due to scheduling dillemma. It showed a labrum tear.....SLAP tear (biceps tendon still attached) and a partial thickness supraspinatus tendon tear. Doctor told me that it is standard for Physical Therapy to be first option, however surgery is optional. I have been doing exercises to maintain motion, and frankly have no faith in Physical Therapy due to past injuries. I am not discounting the need for PT specialist, however, I am a 21 yr old athlete, who has no problem restoring strength, provided my pain is minimal. I had a Knee partial reconstruction, MCL replacement with ACL reco., Meniscal repair, LCL recon. and did all the therapy myself, once the problem was fixed.

However....I am no shoulder expert. As I stated, my concerns are returning to an active lifestyle asap. Should I attempt to try PT, or opt for arthroscopic surgery for quick return to normal activity.

Please....any responses welcome, also anyone with a similar injury please contact me with your status...opinions.....etc...

Thanks....

[Rexdog84]

please any advice:confused:

[kjwilkin]

This seems to be a popular place to get some good advice on what may be going on.....so...6 weeks ago I was playing basketball game for a league through my university when I took a dive for a live ball. I landed with my arm extended in an attempt (successfull lol) to save my face from hitting first. Felt a giving sensation, but it wasn't quite like a seperation or dislocation. My main complaint was that I had an enormous amount of weakness immediately, the pain did not set in until I got off the floor and calmed my heartbeat. Any movement for the first 10 days was hindered by an unimaginable amount of pain. First attempt to see the doctor in the ER was unsuccessful, I just got dismissed with a possible rotator cuff tear and some ibuprofen...lol. Went to my regular doc and he ordered and MRI and Arthrogram. In the meanwhile, pain subdued (never had any tenderness, only had a pain deep inside shoulder), restored movement. Any outward (sideways) motion causes tremendous pain at about 30degrees. I am able to lift my arm frontwards with some pain....however when lowering my arm to the side it catches badly and is relieved with a pop. MRI and Arthrogram results just got in....6 weeks down the road due to scheduling dillemma. It showed a labrum tear.....SLAP tear (biceps tendon still attached) and a partial thickness supraspinatus tendon tear. Doctor told me that it is standard for Physical Therapy to be first option, however surgery is optional. I have been doing exercises to maintain motion, and frankly have no faith in Physical Therapy due to past injuries. I am not discounting the need for PT specialist, however, I am a 21 yr old athlete, who has no problem restoring strength, provided my pain is minimal. I had a Knee partial reconstruction, MCL replacement with ACL reco., Meniscal repair, LCL recon. and did all the therapy myself, once the problem was fixed.

However....I am no shoulder expert. As I stated, my concerns are returning to an active lifestyle asap. Should I attempt to try PT, or opt for arthroscopic surgery for quick return to normal activity.

Please....any responses welcome, also anyone with a similar injury please contact me with your status...opinions.....etc...

Thanks....

Hi there,

I'd definitely try the physio option first. You will need to get your shoulder strong regardless if you need surgery or not.

Shoulder surgery of any description is very painful.

I suffer from shoulder instability and having been doing conservative treatment for a long time. In 2 weeks I'm due to go and see my shoulder surgeon.

Is the doctor you're seeing a specialist sports physican or doctor ? It's really important that you go to someone such as that as they have a much better understanding than a GP. I stopped seeing a GP about joint related problems a long time ago as they had no clue !!

You could also try doing clincal pilates. It has helped me a lot and you can do the range of movement you are comfortable with.

Good luck !!

[Rexdog84]

Thanks for the reply.....
The guy that I saw was my primary care Dr......he phoned a friend in the Ortho department, who told him that right away....."it would not be an easy recovery due to two different injuries at the same time" From what I understood, I was fighting two battles at once. Therefore, surgery is a possible option right off the bat. Physical therapy has told me, within my first few visits, that due to my athletic history.....my other muscles surrounding the shoulder are strong enough to function the arm by themselves.....basically, they are compensating. Also, I have the strength to move in nearly all directions....when it locks from lowering the arm downwards in a side motion....I am able to power through it.....Obviously, I don't do it if it hurts.....so I avoid it at all costs...

My main prob....I am young, very athletic, fast paced lifestyle (school all day, work all evening, and go out at night), I have had significant injuries in the past....(knee repair, wrist/hand repair) and in all cases, the physical therapy was waste, the exercises seemed more guided towards older patients who's unactive lifestyle did not promote such strengthening that would be needed in a rehab....

Also, I have seen lots of torn supraspinatus inquiries and lots of torn labrum inquiries......but not much info. on a combination of the two... Is it likely that this was caused by two seperate traumas.... (if so, I can only recall one significant fall)

Thanks in advance to any replies.....any info from similar injuries still welcome!

[angieliu]

Thanks for the reply.....
The guy that I saw was my primary care Dr......he phoned a friend in the Ortho department, who told him that right away....."it would not be an easy recovery due to two different injuries at the same time" From what I understood, I was fighting two battles at once. Therefore, surgery is a possible option right off the bat. Physical therapy has told me, within my first few visits, that due to my athletic history.....my other muscles surrounding the shoulder are strong enough to function the arm by themselves.....basically, they are compensating. Also, I have the strength to move in nearly all directions....when it locks from lowering the arm downwards in a side motion....I am able to power through it.....Obviously, I don't do it if it hurts.....so I avoid it at all costs...

My main prob....I am young, very athletic, fast paced lifestyle (school all day, work all evening, and go out at night), I have had significant injuries in the past....(knee repair, wrist/hand repair) and in all cases, the physical therapy was waste, the exercises seemed more guided towards older patients who's unactive lifestyle did not promote such strengthening that would be needed in a rehab....

Also, I have seen lots of torn supraspinatus inquiries and lots of torn labrum inquiries......but not much info. on a combination of the two... Is it likely that this was caused by two seperate traumas.... (if so, I can only recall one significant fall)

Thanks in advance to any replies.....any info from similar injuries still welcome!

Hi there,

I actuallay recently saw a specialist abut my shoulder as they suspected that I had a SLAP lesion and he said that most cases he would advise conservative treatment. With surgery all they do is go in and clean up the frayed cartillage in the capsule. Recovery is long for surgery and you still have to go through physio therapy.

So my advice would be to first try conservative treatment and find a physical therapist who specialises in shoulders and then consider surgery. I also have the same problem with my other muscles over compensating and so I have very tight pec muscles and my first rib is just so tight it causes quite a bit pain. So physio therapy or seeing an osteo is good in that sense because they can get in and try to release the tension.

I'd also suggest that you also go and see a sports physician who will be able to give you more advice about options for treatment of your shoulder.

Angie

[Rexdog84]

Does anyone have understand what a SLAC (Superior labrum, anterior cuff) lesion that involves an association of anterior-superior labral tear with a partial supraspinatus tear actually is? How it is caused? I have recently been notified that this may be what happened to myself....as described above? How it is best treated.....? The only thing that I really do understand is that it is associated with throwing athletes....which is odd because I was pretty sure that I haven't done alot of throwing in my time,,,....especially with my non-dominant arm.....however....the Dr.....thinks it may be what is going on.
is there any different treatment than the typical SLAP lesion????? I do know that my acomion, which seems to contribute to such an injury, is flat on the undersurface, however it was noted that it has an exagerrated angulation toward the posterior side....which could cause some bad contact with my partial thickness torn supraspinatus at the critical zone.....let me know what yall think...?????? thanks in advance

[RCheesley]

Does anyone have understand what a SLAC (Superior labrum, anterior cuff) lesion that involves an association of anterior-superior labral tear with a partial supraspinatus tear actually is?

This describes an injury to the labrum (the anterior-superior, or front-top part) with associated damage - usually a full or partial tear - of the anterior cuff (in this case the supraspinatus muscle. Read here (http://www.sportsinjuryclinic.net/cybertherapist/shoulder_injuries.htm)for more information on shoulder injuries - the instability article makes reference to the labrum and its different parts, and the shoulder anatomy article might help you visualise what they are talking about!


How it is caused?

Usually tends to be traumatic - but not always sports related. Can be due to a heavy fall onto an outstretched arm, falling off a bike onto the shoulder, a whole range of things. Labrum tears usually tend to take quite some force, unless there is an exisiting weakness.



I have recently been notified that this may be what happened to myself....as described above? How it is best treated.....? The only thing that I really do understand is that it is associated with throwing athletes....which is odd because I was pretty sure that I haven't done alot of throwing in my time,,,....especially with my non-dominant arm.....however....the Dr.....thinks it may be what is going on.
is there any different treatment than the typical SLAP lesion????? I do know that my acomion, which seems to contribute to such an injury, is flat on the undersurface, however it was noted that it has an exagerrated angulation toward the posterior side....which could cause some bad contact with my partial thickness torn supraspinatus at the critical zone.....let me know what yall think...?????? thanks in advance

The best bet is to speak to a doctor who specialises in shoulders. They are very specific about who they will and won't operate on, so ultimately they would be able to give you more information about your specific condition. Having not seen your scans, I can't comment on whether the shape of the acromion has anything to do with the injury, but as the article says, it is quite common that anatomical shape affects the stability of the shoulder, if your shoulder is less stable and you did take a blow, it might be more likely to cause a problem?

Hope you get it sorted!

[Rexdog84]

thanks so much for the input.....Right now I am just playing the waiting game! I have about three more weeks to the next appt with the shoulder doc.

I wish I could post the scans that were done, however, I don't have them! I only have a typed description of the detailed findings.....soo....we'll see what happens .......soon enough LOL

[Rexdog84]

OK.....so I gave in and tried the conservative treatment......I did physical therapy (first at a clinic...until I figured out that it was a waste of time...then at home), plus I got a cortizone injection into my shoulder capsule back in April/May time period. The cortizone was great....didn't hurt at all....plus, I felt an almost immediate relief....despite the catching. I still felt the catching...but it was in an uncomfortable numb kind of feeling. Throughout the next couple of months...I eased back into my normal lifestyle (working out...and playing sports) Realistically, this injury was the perfect opportunity to focus more on cardio exercising. Unfortunately, over the past month or so....I have experienced a come-back of all my symptoms. It hurts like no other to lift my arm straight forward...or outward....and catches (very painfully) when lowered back down. I had heard through many sources that a corizone shot is only temporary....and now see why. My questions now are....
1. Are there going to any other negative consequences from accepting this cortizone shot....besides a return to pain.??? structurally??
2. Where do I go from here? do I go see the dr. again...so he can just give me another miracle shot??? or demand more aggressive treatment???
3. Has anyone had similar experiences???

Please let me know...all responses are welcomed...and thanked!

[steve_q]

I had a similar accident when I was 17 years old with my bicycle, I fall over and I landed with my right shoulder, in I hit the ground with my right Deltoid. For several weeks I could not lift my arm sideways without pain. I could lifted only until 30deg with lot of pain too.
The doctor told me just to rest it for some weeks, I did not keep it in a sling and after about a 3 weeks the pain disappeared.

I had an other accident 8 years ago when my arm was over extended and the bicep tendon was overstreached. For several weeks it hurt me a lot. I did not do anything apart from resting and avoid using it and gradually the pain went away.

Cortisone is bad for your tendons long term, you can have 1-2shots but no more because cortisone weakens the tendons.
Last year I had a severe shoulder dislocation with a RC tear, the pain was enorme nevertheless I did not have a single shot of cortisone.
Believe it or not the pain is beneficial, your organism must feel the pain in order to activate the healing process otherwise there is no way to inform your brain that something is wrong with your shoulder and your body does not react

[ah-oh]

Hi Rexdog84.
My OS (& physio) say cortisone weakens tendons (max 3 shots over 12mth period - OS). It does NOT fix the damage to the tendon, rather it dramatically reduces swelling (ie of the bursa & tendon I think) and hence pain and can therefore help with ROM. The idea is to strengthen the surrounding muscles to make up for the injured RC muscles while the cortisone is effective.

Therefore you need to be a bit careful because the pain may go but the injury is still there. Like steve-q mentioned, the pain is your body telling you there's a problem that needs to heal.

I had a supraspinatus tear in January 07, one cortisone shot in April (to treat the bursa), physio from time of injury (& rest from offending activities) but ended up having the op (Aug/Sept) which seems to be going pretty well - though too early to tell yet I guess.

Like you, the cortisone gave me immediate relief painwise and to an extent more ROM, but after a couple of more months physio, the strength I wanted for my sporting activities wasn't going to return, ROM was still limited in the particular range I needed for the sport, it kept catching and I didn't want to be icing and rehabbing every time I exerted it the slightest bit. Also didn't want to close option of surgery by having too much cortisone.

BTW every professional I've spoken to has emphasised the importance of strengthening supporting muscles and also developing good posture to position the shoulder (back,neck, head) whether you have surgery or not. Been working hard on that one. Think they're trying to tell me something.

[dislocation queen]

hey!

Well the funny thing that happened to me is that the same injury happened whilst I was playing a championship game of Touch-rugby...lol...

When i went to the dr he just said it may have been just ligament damage but your description it probably was the same damage as yours.

Im gonna keep it short and sweet, I hope all goes well with recovery!?!

[rosecoloured64]

Hi Rex,
70% Supraspinatus Tendon repair. I had the cortisone injection and it did nothing for me and they will only allow 3 max I was told & was no way going back for another. Called a hydradialation or something, done with the guidance of ultrasound into the tendon. It was one of the most painful things I had ever had done! I have had 2 shoulder operations, 2002 & 2006 and I am heading for a 3rd because the tendon has torn again! I have a frozen shoulder and they removed my bursa & cut the scar tissue to free it up and did a manipulation while I was out to it in the 2nd op. The tendon is now different textures and has torn again. Avoid surgery if possible. Physio is tedious and slow but your shoulder will never be the same after being surgically enhanced. I believe I had a fantastic physiotherapist (has just got back with the oolyroos & was a physio for the soccerroos)
Good luck
Rose

[cjennings]

Hey,
I go for shoulder surgery in one week for a full thickness tear of my posterior labrum. I know this is rare but I am just hoping for a little feedback as to how to prepare? what to prepare for? and success or failure stories of similar surgey. My shoulder dislocates approximatley 100 times a day, does this sound like anyone elses symptoms? I am getting this surgery because a pallet with around 900lbs on it fell 2 feet on to my extended arm. Does anyone have any input please.

[deeKnee]

My fiance has been recommended an arthro shoulder rotator cuff repair by Dr. Tim Burrows in Sydney. According to the ultrasound and the movements he has at the moment, it seems like a big tear in one of the ligaments.

Has anyone on this forum has this surgery before? Anyone heard of Dr. Tim Burrows?

[kjwilkin]

Hi Deepa,

Not heard of that surgeon before.

In Sydney I believe that Desmond Bokor and Jerome Goldberg are two of the top surgeons for shoulders. It is imperative that your fiancee finds a surgeon that specialises in shoulders. It makes a massive difference.

I've had both shoulders operated on had Greg Hoy in Melbourne for my last shoulder operation. He was awesome !