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mickg007
18-05-2007, 08:21 PM
Hi

For the past 21 months I have being experiencing pain in my right shoulder. A few months before the pain started, I was playing off a handicap of 6 and decided to change my swing with the help of one of the top Pro teachers in the country. Within a few months of being with him I noticed I was getting a sharp pain (front part of shoulder) through impact - and only through impact. Day to day pain was no existent.

I decided to go to physio where I was given 'External Rotation' exercises to do.

http://www.orthoassociates.com/shoulder1.htm#shldr_exrcs

After a couple of weeks - the pain was on a daily basis and I could no longer do these exercises because of the pain it caused. The whole Shoulder would flame up.

After several different physio's, and sports doctors, last November I had a 'Arthroscopic Subacromial Decompression' done which found Acromial bone spurs and very inflamed bursa - of which both were removed/shaved

2 weeks post op - my new physio therapist put me back on the external rotation exercises and hey presto - pain is back and as sore as ever. Sharp pains front part of shoulder and then the whole shoulder would flame up. Sore when I get up in the morning or when I lie down. Stopped all activity and shoulder is worse then ever

With another physio the past 2 months now and we have just moved up to the 'external Rotations' exercises slowly with yellow elastic band. 3 days in and the pain is back - sharp pains front of shoulder

Any ideas on what this could be or anyone out there with a similar problem

Thanks

Mick

debbie clarke
19-05-2007, 03:46 AM
Hi

For the past 21 months I have being experiencing pain in my right shoulder. A few months before the pain started, I was playing off a handicap of 6 and decided to change my swing with the help of one of the top Pro teachers in the country. Within a few months of being with him I noticed I was getting a sharp pain (front part of shoulder) through impact - and only through impact. Day to day pain was no existent.

I decided to go to physio where I was given 'External Rotation' exercises to do.

http://www.orthoassociates.com/shoulder1.htm#shldr_exrcs

After a couple of weeks - the pain was on a daily basis and I could no longer do these exercises because of the pain it caused. The whole Shoulder would flame up.

After several different physio's, and sports doctors, last November I had a 'Arthroscopic Subacromial Decompression' done which found Acromial bone spurs and very inflamed bursa - of which both were removed/shaved

2 weeks post op - my new physio therapist put me back on the external rotation exercises and hey presto - pain is back and as sore as ever. Sharp pains front part of shoulder and then the whole shoulder would flame up. Sore when I get up in the morning or when I lie down. Stopped all activity and shoulder is worse then ever

With another physio the past 2 months now and we have just moved up to the 'external Rotations' exercises slowly with yellow elastic band. 3 days in and the pain is back - sharp pains front of shoulder

Any ideas on what this could be or anyone out there with a similar problem

Thanks

Mick
HI mick. I can tell you are as frustrated as I am. My shoulder injury is 3 months in and all they found so far was 5mm tear susp tendon and fluid on bursa. i can relate to your pain. I have found it best to get straight out of bed when it wakes me that is why i am here at 3.37am. My shaoulder back and front burns as well - to the extent i cant bear clothing or bedding touching it. My last spec... said my rotation was practically norm and so wan't opting surgery at this stage. The last physio picked up nerve damag and sounds similar to mine - mine is also on shoulder blade as well. I have been told with exercises not to do any that starts off pain or spasms. So take it easy these shoulders are slow healers. ALL THE BEST....

hopeful
19-05-2007, 06:38 AM
it sounds like a frozen sholder

mickg007
19-05-2007, 06:49 AM
HI mick. I can tell you are as frustrated as I am. My shoulder injury is 3 months in and all they found so far was 5mm tear susp tendon and fluid on bursa. i can relate to your pain. I have found it best to get straight out of bed when it wakes me that is why i am here at 3.37am. My shaoulder back and front burns as well - to the extent i cant bear clothing or bedding touching it. My last spec... said my rotation was practically norm and so wan't opting surgery at this stage. The last physio picked up nerve damag and sounds similar to mine - mine is also on shoulder blade as well. I have been told with exercises not to do any that starts off pain or spasms. So take it easy these shoulders are slow healers. ALL THE BEST....

Debbie

I must say I don't have a problem with sleeping - it is just sore first thing in the morning. My sharp pain is specific to the front and then the whole shoulder flames up. What annoys me is nobody can diagnose it - not even the Orthopedic Consultant who in in hind sight didn't need or shouldn't of operated on it. I am laying off the exercises again for a week or so and start even slower .... baby steps

Mick

mickg007
19-05-2007, 06:53 AM
it sounds like a frozen sholder

Before OP in November I had 100% movement without pain - only sharp pain when playing golf, or doing those exercises. Since OP - it has become stiff similar to frozen shoulder, like I can only put my arm 90% up, But I cant exercise on this as it irritates my original problem

angieliu
19-05-2007, 01:14 PM
Before OP in November I had 100% movement without pain - only sharp pain when playing golf, or doing those exercises. Since OP - it has become stiff similar to frozen shoulder, like I can only put my arm 90% up, But I cant exercise on this as it irritates my original problem

It does sound like that you might have a frozen shoulder. They sometimes say that they do not know the cause of a frozen shoulder and that it normally occurs in people who are in their forties or for those who have had sustained a shoulder injury. I can understand your frustration because I have been to see so many sports doctors and physios who have tried to offer me their diagnoses but no proper treatment option. I eventually found a great physio who is trained in manipulative therapy and is a qualified sports physio. He is very good and gets right into the muscle to try to relax the muscles. I also saw a sports doctor/rehab spec who specialises in shoulders. My suggestion would be to ask your physio to do some mainpulative work in the muscle to try to loosen the muscles up. If you are in Sydney I can send you the details of my sports doc if you like.

mickg007
19-05-2007, 05:42 PM
If you are in Sydney I can send you the details of my sports doc if you like.


I am in Ireland - way over in that part of the world :) So dont think I can drop over. I have tried all the deep massage therapy treatments

hopeful
19-05-2007, 09:36 PM
mickg, dont worry, frozen shoulder heal eventually.. albeit it may take a few years...dont even bother with physio or other treatments as it wont get rid of it.. its going to be really really painful.. but as i said.. it will heal and thats all the reassurances you need.

hopeful
19-05-2007, 09:41 PM
one of the things that really helped.. is getting some sort of product similar to a bag o heat...which is like a little beanbag you put in a microwave for 3 minutes and it stays warm for an hour.. it will help u sleep... dont waste money on sports physicans and physios.

rememer that the frozen shoulder comes in stages.. it sounds like its at the first stage now... read more about it on the web...

Ginger
20-05-2007, 09:58 AM
To those who have had mysterious shoulder pain, including those with diagnoses of adhesive capsulitis, frozen shoulder , rotator cuff syndrome ,shoulder 'instability' etc, there is an answer to your problems. It is not usefull to add further insult to your injuries by adding more inappropriate treatment to the shoulder muscles or other shoulder soft tissues. The problem lies not in your shoulders , but in the cervical spine. A common condition where spinal muscles increase in tone , leading to cervical facet joint immobility causes inflammatory irritation to nerve roots. These nerves are , when thus irritated , capable of contributing to the panoply of altered sensations , including pain , of these often misunderstood conditions. The treatment that will most likely work for you , is not to the shoulder at all , but to the cervical spine . The best approach is known as continuous mobilsation . Other mobilisation methods have lesser value, though usefull when applied to C456, in particular , along with the upper thoracic contributors to referred pain and altered patterns of glenohumeral muscle recruitment .
Find yourselves a physiotherapist, ( the most likely being an aussie trained musculoskeletal therapist ) skilled in spinal facet joint mobilisation, they can be found readily in britain , certainly in Oz. Your problems are easily solved. The average in my own practice is one to three treatments for those who have suffered for less than three months , with longer periods likely for those whose problems have gone on for twelve months. It will be very easy for you to find an assortment of "pathology" and intrepretations of 'instability', particularly by medical diagnosticians whose reson detre is pathology . Above all avoid being pushed towards surgery.
Cheers and good luck.

angieliu
20-05-2007, 05:23 PM
I am in Ireland - way over in that part of the world :) So dont think I can drop over. I have tried all the deep massage therapy treatments

Ok so maybe you can't just drop over here. I can understand. There is a great website which I used which I found some really helpful information on various shoulder injuries. The website is www.shoulderdoc.co.uk
There is a article on what is a frozen shoulder which you can read http://www.shoulderdoc.co.uk/%5C/news/article.asp?article=82&artid=627&section=82

It's a UK based website so hopefully u might be able to find a practitioner who may be able to help you. From what I read it is not uncommon for people to get a frozen shoulder after an injury. HEat can be helpful but it can also aggrevate it so see how it feels. My dad used to have a frozen shoulder and he was taught to do some light stretching which was helpful but it eventually just got better by itself.

It may be worthwhile going to see sports doctor and get them to confirm it. They can then offer you some insight as to what you can do with pain management and some alternatives. You could also try an osteopath who does manipulative tissue work might help but given that you have tried a lot of deep tissue therapies it may just be worthwhile to give your shoulder a rest, take it easy and let it heal by itself.

I hope your shoulder starts to get better soon.

debbie clarke
21-05-2007, 02:00 AM
Debbie

I must say I don't have a problem with sleeping - it is just sore first thing in the morning. My sharp pain is specific to the front and then the whole shoulder flames up. What annoys me is nobody can diagnose it - not even the Orthopedic Consultant who in in hind sight didn't need or shouldn't of operated on it. I am laying off the exercises again for a week or so and start even slower .... baby steps

Mick
Have you had mri done on deltoid, bursa or transpesic muscles mick? Just a stab in the dark. I found applying ice packs for 20 minutes then the heat packs for 20 minutes does bring the swelling down. I have swelling on front of shoulder as well. Bad days it is hard as a rock and unbearable. Glad you stopped therapy for a while. Take care.

angieliu
21-05-2007, 02:53 PM
Actually I agree ice for 20 and then heat for 20 should really help. A lot of the times with muscles there is a lot of inflammation which the ice will seem to calm down and tension in the other muscles around the shoulder which the heat should help relax. Magnesium is a very good muscle relaxant and also helps prevents spasms. Best to also keep clear of the magnesium tablets which also have calcium in them because they can increase the likelihood of calcium deposits. My other suggestion after having a think about it is that you could try some acupuncture to get some relief if you shoulder hurts. It will also increase the bloodflow around your shoulder. My shoulder was really bad for a while and I was in constant pain for about 2 months and this was quite awhile after I had hurt my shoulder and I haven't had much pain for quite a few months.

crash
21-05-2007, 11:04 PM
mickg, dont worry, frozen shoulder heal eventually.. albeit it may take a few years...dont even bother with physio or other treatments as it wont get rid of it.. its going to be really really painful.. but as i said.. it will heal and thats all the reassurances you need.

Mick,

Try a hydrodilation, it worked wonders for me. The first symptom 9 months ago was pain through impact. I ignored it for 4 months as the swing deteriorated, then had 3 months of physio, by the end of which I could not swing at all. Went to the sports medicine clinic where it was diagnosed as adhesive capsulitus. Had a hydrodilation, 3 days later it started to improve, and 8 weeks later I could swing again!

Michael Ringland
14-06-2007, 02:11 PM
HI mick. I can tell you are as frustrated as I am. My shoulder injury is 3 months in and all they found so far was 5mm tear susp tendon and fluid on bursa. i can relate to your pain. I have found it best to get straight out of bed when it wakes me that is why i am here at 3.37am. My shaoulder back and front burns as well - to the extent i cant bear clothing or bedding touching it. My last spec... said my rotation was practically norm and so wan't opting surgery at this stage. The last physio picked up nerve damag and sounds similar to mine - mine is also on shoulder blade as well. I have been told with exercises not to do any that starts off pain or spasms. So take it easy these shoulders are slow healers. ALL THE BEST....

As someone who treats shoulders using exercises I can tell you of some fundamentals:
There is no gain with pain -pain indicates the load is excessive, this can be the angle you are holding the arm in to begin the exercises - by that I mean if you are holding the arm away from the body (called abduction) you increase the load on the rotator cuff - can be a good thing but only if its pain free. Another reason is that the actual weight you are exercising with is excessive. I now always use free weights, never stretchy stuff, which the more you pull the greater the load - everything must be standardised - much easier with a 0.5 kg weight, or sometimes just the weight of the forearm. The picture shown on the "link" shows external rotation exercises, but they are dreadful, shocking, and just plain bad. The picture shows you taking the arm away far to far from the belly button, only take it to be in a straight line out in front of you - not pointing out to the side if you understand. Taking the arm to far into external rotation is sometimes painful (quite often actually) and therefore bad. Don't do them.The other thing is not all shoulders need external rotation exercises. This may be news to some physios even! Some need scapula stabilising NOT external rotation. This is done by doing a few things:a) "raise up" your sternum - breastbone b) sort of "pull" your elbow back and downwards - aim just behind your bum, and then get the feeling the bottom bit _ the pointy end - of your shoulder blade (scapula) is firmly being held against your rib cage. This is (sort of) lower trapezius exercises. I advance them as the shoulder gets better by raising your arm up. The end stage is you lying on the side, arm rests on the outer corner of the eyebrow, raise the arm up to point to the sky - NO FURTHER. exercise number 2 is for serratus anterior - wall push up - standing an arms length away from the wall hands on the wall, allow your trunk to come nearer the wall but keep your elbow straight - you will feel your shoulder blades "come away" from the rib cage - now push your arms into the wall and feel your shoulder blades come back to the rib cage - technically this is protraction and retraction. Ther nerve damage - inflammation goes without saying. It is so common with shoulder patients I almost as a matter of routine mobilise the lower cervical spine and thoracic spine. I dont manipulate, I dont think thats a good thing at all to do, but I know2 some who do and swear by it, one mans food anothers poison perhaps good luck.

kjwilkin
14-06-2007, 06:51 PM
Hi there,

You need to be very careful with weights when recovering from a shoulder injury.

Often patients will start off with static exercises and then move onto exercises with theraband before moving onto weights. You actually need a lot of strength to move onto weights.

mickg007
20-06-2007, 06:15 PM
For starters thanks to all you replies on this. I spent ages looking for a good forum and you guys are very helpful. I took a break for a while (so only checked back here now) and back doing exercises just over 2 weeks now.

Week1 - External Rotation Isometric - no sharp pain (only slight muscle pain - would expect)
Week2 - added shoulder external rotation - lying down - no weights just forearm - 2 X Daily - no pain
Week3 - added small wrist band weight to external rotation - 2 days in = sharp pains 2 hours later

Looks like I will have to take it even slower.

'Frozen Shoulder' - I would be amazed if it was. It has only got stiff since the OP (as I had 99% movement pre op) and this is because I stopped doing post OP exercises and it just needs loosening out (which I cant do because it effects my original complaint. My arm does fall asleep at night with tingly sensation down to my fingers, but once up and about it is fine.

If I was to pin point the sharp pain I am getting it would be one and half inches above the armpit, going slight down the arm by an inch or so (and then whole shoulder flames) I have had no one being able diagnose it.

Angieliu/hopefull : when you use ice or heat, which first, before or after exercises. Have a bean bag which I use now and again for heat. With regards to acupuncture, I will have give it another go.

Crash : what is "hydrodilation" any good sites out there as I am getting mixed results

Michael Ringland : I wonder what your thoughts are on the exercises on this link http://orthoinfo.aaos.org/booklet/view_exercise.cfm?Thread_ID=19&topcategory=Shoulder
Some of these are the ones I am doing at the moment

angieliu
20-06-2007, 10:33 PM
Hi mike,

I usually go ice first if it is sore and inflammed and you know you might have over stretched it or aggrevated it. Ice for me is the first thing I do if I know my shoulder is tender.

Heat can be very good if you feel that your neck is very tense or your shoulder muscles at the back. It helps relax the muscles. Acupuncuture has some very good qualities in that if there is some inflammation it can help ease this by increaasing the blood flow and releasing the toxins in the muscles if you have strained it.
Hope this is helpful

mickg007
20-06-2007, 10:55 PM
I usually go ice first if it is sore and inflammed and you know you might have over stretched it or aggrevated it. Ice for me is the first thing I do if I know my shoulder is tender.


Might just continue on and heat before and ice up after exercises - just might get me a bit further in the reps

angieliu
21-06-2007, 08:42 AM
Sounds like a good plan. Make sure that you warm your shoulders up before you go and exercise. I do my stabilisation exercises at the gym before i jump on the weights.

kjwilkin
21-06-2007, 10:22 AM
Hi Mick,

They often recommend to ice your shoulder after doing your exercises and also take some analgesics about 20 minutes before doing your exercises if it's still sore.

Good luck with your rehab !

mickg007
10-06-2009, 05:44 PM
Its hard to believe it is over 2 years since I posted here and going on 4 since my Injury started.

Unfortunately I am not much better off then I was back then. Sharp pains are as good as gone - but shoulder still gets very flamed if i do any decent range of exercises I have being with a very good clinic in Dublin for the past 4 months - doing a very light rehab program. Progression is slow - any time I up the weights or reps at all - it flames up

Next week with the same clinic, we have decided to start a program of 'extracorporeal' or 'Shock Wave' treatment. I have heard it has had fairly good results for tendinitis and impingement syndrome - so heres hoping.

Any else out there have any thoughts on this treatment ?

DierkJethro
26-06-2009, 06:15 AM
You need to have the "Bundle Nerve" extending from your spine to your shoulder examined in detail . It sounds like you have compression of the vertabrae . You might find a decompression ( stretching ) table ( done in a specialists office ) to be helpful . Otherwise the best thing is try to ignore it . I know that sounds dumb but the more you finaggle with it the worse you will make it . Just do stretching exercizes every morning and night , and keep your weight down .