Shoulder - Braces/Supports - Bowen Therapy

[AnonyMouse]

Hi all.

10 weeks ago I sustained a heavy fall directly on to the point of my shoulder. Fortunately it was onto a dojo mat, but even so it was still a pretty good whack as my whole 100 kg was behind it.

It hurt like hell, then and after, but X-rays showed no broken bone, and ultrasound didn't reveal any obvious tearing, though there is some question about this. The sonographer couldn't detect any tearing, but a doctor who consults to Southern X-Ray thought that *maybe* she could detect some thickening of a tendon indicative of a healing tear.

After a couple of weeks I volunteered for a cortisone injection, which had the desired effect pain-wise.

Anyway, after reviewing the various images nobody, including my own doctor and a physio, considered there was anything wrong that wouldn't heal with time.

But as I said, it's now been 10 weeks and my shoulder is still tender and doesn't like certain positions. My training is severely compromised because I am terrified of hitting it again before it's fully recovered. Although it's nowhere near as sore as it was originally, it doesn't seem to have improved much over about the last three or four weeks.

OK, that's the background to my two questions...

1. Does anyone know of a store in Brisbane that stocks a range of shoulder supports/braces? Somewhere I can see a few different types and try them on for size.

2. Physio treatment offered some relief early on, but doesn't seem to have done much for me over the last few weeks. A training colleague mentioned something called Bowen Therapy. I have researched it online and I find mainly knockers who haven't tried it but say it can't work because XYZ, and a few ravers who claim it worked marvellously for them. So without further ado, anyone had experience with it?

Thanks in advance.

[notadoc]

sorry for your experience anonymouse. it doesn't sound like it's been a whole lot of fun. while i can't address either of your questions too well, i might suggest a course of action.

while imaging providers don't like to tell you this, the success of an ultrasound in locating relevant pathology is highly dependant on the skill of the sonographer. most standard imaging providers find that the majority of their sonography is not musculoskeletal and therefore the experience of their sonographers reflects this. while it is the radiologist that reports on the images provided, they can only provide info on the images that the sonographer has produced - if these are not adequate for your particularly complaint, even the best radiologist will struggle to explain your condition.

that said, ultrasound is an excellent way to image shoulder conditions - if you can access a location that deals with a lot of musculoskeletal imaging then you could certainly try a second ultrasound.

if you'd rather skip it - and who would blame you - it could be a good idea to go straight for an MRI. i've had experience being scanned by QScan up there, and they were excellent at last check. mri will locate any pathology that may exist.

in regards to bowen therapy, all i can suggest is that it's hard to recommend a particularly therapy prior to knowing what is wrong with your shoulder. my limited, second-hand knowledge of this treatment isn't positive and i wouldn't be in a rush to recommend it over physiotherapy by a skilled practitioner (preferably post-grad, musculoskeletal).

a sports physician + mri might be a good way to proceed here. best of luck!

[angieliu]

Hi there,
Sorry to hear about your injury. I can't recommend any places in Brisbane where you can try shoulder braces. The place I bought mine is called sportstek (www.sportstek.net.au). I bought a brace for similar reasons to yours, a possible tear but hard to diagnose so I bought one which would offer me the most support. I use the REhband Acro support brace. It's really good and I think the most important thing is that it keeps the shoulder warm which essentially promotes blood flow.

Bowen therapy can be useful for shoulder injuries. It's less invasive and if your body is not responding to physio then it may be worth a try. I'd seriously consider getting a second opinion maybe a sports doctor can help point you in the right direction. Osteopathy can also be very useful. I've found it has really helped. For me, I tried most therapies and I think a combination of osteo, physio and acupuncture really helped. TRying to get your strength back and positioning of your shoulder is important so I'd give pilates a go. It's very good at making you think about the positioning of your muscles and strengthening the core which is particularly essential when you have a shoulder injury.
I hope this helps.

[kjwilkin]

Matt Hislop, a Sports Physician is meant to be very good. A friend saw him and found him great. He is based in Hawthorne in Brisbane.

[AnonyMouse]

Thank you all for your input; most helpful.

The current situation:

I have had an MRI and made an appointment to see an orthopaedic surgeon who specialises in sports injuries of the knee and shoulder.

Can't see him until January, so it has been recommended that I try interim treatment by getting an earlier appointment with an osteopath. I rang a recommended practice yesterday and am currently waiting for a call back from them about an appointment time.

[angieliu]

Hi Anonymouse
I think that osteo is a good place to continue getting treatment. In my experience, I've noticed benefit from some types of physio and others no so much. It's important though to tell your physio what works and what doesn't. I've found that osteo has been really helpful particularly cranio sacral work being done. It basically helps balance the tension between the base of your head and your sacrum. Often imbalance results in pain and tightness in your body.

Best of luck with the MRI. My experience with diagnostic work is that unless you have an experienced radiographer and radiologist reviewing what is going on, then there's a possibility that they miss out on the minute detail. I haven't had any experience with bowen but know that it has worked for people who do not respond well to hard soft tissue work. Also with the brace, I ended up buying one because it helped with stability and kept my shoulder warm. The shoulder doesn't have good supply and is probably compromised when it's injured so not a bad option.

All the best

[AnonyMouse]

Well folks, finally an update -- and it's all good news. I'll explain the circumstances because my experience might help somebody else in a similar situation

I got the MRI, and the accompanying report didn't really mention anything that hadn't been stated or alluded to in the Ultrasound and X-Ray reports.

Osteo and physio both produced very moderate improvements, but didn't go anywhere near fixing the problem. But to be fair, those practitioners were basing their treatment on the reports from the various scans, and as I'll explain momentarily, they were in fact being misguided.

By the time my appointment with the orthopaedic surgeon came round, all of 4.5 months had elapsed, and I was still in pretty poor shape. I was becoming more and more convinced that something had been missed, and as it turned out that was exactly the case.

I took both the report and the MRI DVD in to the orthopaedic surgeon and asked him to see if he could find anything in the scans that had been missed.

The cortisone injection I had received early in the saga was to reduce inflammation that had been detected in the subacromial bursa. As I reported earlier there was some reduction in pain after that.

When the orthopaedic specialist studied the scans he said that the inflammation of the bursa may have been a minor contributing factor, but my real problem was significant inflammation deep in the AC Joint. Now, there had been brief mention of the AC Joint in earlier reports, but it was more or less dismissed as minor age-related degeneration. Apparently that was way off the mark, and the orthopaedic specialist assured me that a cortisone injection directly into the AC Joint would see me much improved within a week.

I got injection immediately and the improvement was almost startling -- even overnight it improved significantly, and now, a couple of weeks later, I'm about 98% of my old self again. Will see the surgeon again in another week or so to see if the inflammation needs one more kick.

The lesson is that there is no substitute for a genuine specialist assessment. You might think the circumstances odd, but the explanation is that I got the original MRI referral from another specialist (not orthopaedic) who I see regularly for an unrelated condition. My thinking was why should I pay $200 to another specialist to get an MRI referral, when I was already seeing a specialist and could get a referral for no extra money. That still makes sense, but I should have requested an MRI much earlier and taken the scans directly to the right specialist. I know from dealings with other specialists that they can see things even in an x-ray or an ultrasound that anyone not a specialist in that field will miss.