MRI Results

[Oso]

ok, posting here instead of the main board 'cause I'm looking for advice and not 'atta boy, tough it out'

I have 2 issues it seems

A - a bone spur in the shoulder joint.

B - 3 different tendon tears in the shoulder, all small, but difinitive.

2 of them are tendons associated with the rotator cuff.

I meant to ask, but forgot due to the hot receptionist, for the transcript from the MRI so I could give the specific names of the tendons. Way too multi-syllabic for me to remember.

The Ortho wants to try 4 weeks of PT before determining that he needs to cut. Basically, I'm in agreement.

But, I'm going to be curious at to exactly what the PT is. I surely don't have the strongest shoulders in the world but they aren't week and I feel I get lots of regular work on them by way of the 'fu.

He also gave me a shot of cortizone today, another first for me.

so, looking for advice/commentary from guys that may have gone through the same thing.

[rubthebuddha]

:(

sorry bro. i hope this doesn't mean margarita night is off. :(









wait, did i say night? i meant margarita week. :D

[rubthebuddha]

now for actual advice -- don't take anything you hear as the end-all be-all for what to do. ask around, harass merryp (going through shoulder rehab himself), talk to some judo folks (their shoulders wear out frequently on account of being such wankers :D), etc.

just get lotsa information on what you can do, what is most likely, what the average results of such treatments will be, etc. just like buying a car -- being informed is key, otherwise, you may end up with a daewoo for a shoulder. :eek: :mad: :(

[Toby]

Originally posted by Oso
A - a bone spur in the shoulder joint.Is this like me - osteolysis? That's exactly what my x-rays show - a spur on the AC joint. What are my symptoms? Occasional dull shoulder pain now that I've managed to change some things. When I do make it worse (like from too much chi sau or too heavy bench press), it aches for a while but gets better quickly. My specialist said that this is a good thing and shows my body's coping well with it, but it will never get better by itself. It's too bad in my case.

He advised against surgery and gave me a nice program of PT that works well IMO. But still, after a long stint of chi sau I notice the left shoulder is weaker, and it ****es me off. There's also a large visible lump there. So I've sorta made up my mind to get arthroscopic surgery - I haven't planned it yet, but I will get it done eventually. PT will help me manage the problem, but not improve. Arthroscopy (or even open surgery) gives excellent results in most cases and returns full functionality. The third option is curtailing activity, which isn't an option IMO (no weights, no MA).

PT for me? Three main exercises:
(1) Stand up with arms slack. Try to tense just the lat while keeping the pec relaxed. You can reach around with the other hand to feel what's happening while you're learning.
(2) One handed "push-ups". From the pushed-up position (straight arm), push just the shoulder back. The action is similar to if you were standing up and trying to push your chest forward and your shoulders back. From that position, rotate your body away from the pushing arm so it ends up about a 135 degree angle (more or less). Then back to the start. You can start doing these "push-ups" against a wall, then inclined on a couch etc, then finally on the ground if your shoulder can handle it.
(3) Hold a jug of water in one hand. I use about 3L of water. Do a lunge forward, and with the opposite hand, reach down towards the ground (and forward). Back to start. Repeat, each time reaching up, down, sideways, all sorts of angles. When you come back from each lunge, also vary where you hold the jug. Right next to you, out to the side, up a bit, down, whatever.
*** The most important thing with these exercises is to KEEP THE SHOULDER DOWN. I subconsciously raised mine, and that aggravated my injury. Now I've learnt to keep it down, and strengthened supporting stuff somewhat too. To help remind you, there are things you can do. E.g. with the "push-ups", before each one lift the shoulder up (shrug) then down, then do the pushup. After a while only do the shrug once every few pushups. With the water jug, lunge then do the shrug check in the lunged position to make sure your shoulder is as far down as it can naturally go. My problem wasn't when I lunge and reach low, but definitely when I'd lunge and reach high. The doc showed me that shrugging doesn't add any extra reach (e.g. if you're reaching to a high shelf) so why do it?

As to surgery - MP was advocating it pretty heavily recently. You might want to PM him and ask his experiences or do a search on the main board. He doesn't visit here much.

Hope that helps - good luck bear man.

[GunnedDownAtrocity]

i'm a *****

http://www.shoulder1.com/community/forums30.cfm/1205

[IronFist]

Sorry dude I don't really know anything about that so I can't really help, but I hope you get better soon. :)

[Merryprankster]

Oso,

The idea behind PT is to strengthen your rotator cuff to take stress off the tendons. This will theoretically allow them to heal.

Tendons, however, are low on blood, but not as bad as ligaments, and don't always heal so hot.

The shoulder is a complicated joint and lots of different movements may be involved. Arm raises, rotations, etc., in a bewildering variety of angles and articulations.

w/regards to surgery, what I had was a glenoidal labrum tear and it was a bad one. No rehab on the planet would fix it. In fact, my rotator cuffs were so stable they were the only thing keeping my shoulder in place. The doctors were a bit surprised that all I had was pain in certain motions caused by the instability. I jumped on the rehab right after the injury to strengthen the shoulder and this, in fact allowed the labrum to heal....too low. It didn't heal back in place - wouldn't have anyway. They also removed a bone chip while they were in there.

I got surgery because it was the only way to do what I wanted to. I advocate surgery if that's the difference between doing what you want to do and not. There is no way I could ever have competed again or even trained, really. If PT would have fixed it, I would have left it at that.

Do not be scared of surgery. Find a doctor you can trust and go for it, if that is what is required.

I did NOT have a rotator cuff tear. It turns out that younger people, with more flexible tendons, usually tear their labrum because the bone moves more easily. Older folks with less elastic tendons have those as their weak links and blow them out instead.

Sooooo....

If it's not better after re-hab and you can't do what you want, don't be scared of the surgery. It's not the horrible hell-hole the herb eating chi-hippies claim it is.

[Oso]

Went to PT for the first time yesterday. The guy didn't even take me through anything. Just asked questions about where pain was on what movements. Did some strength tests...which he, like the doctor, said was great...and he gave me a sheet with 6 exercises on it and said do it 3 times a week.

I'm not sold on the exercises. I did them today and while I'm certainly not a PT, I do feel like I know when something is affection my body and I didn't feel like these were doing squat with the weight I was able to use. And if I went for more weight then I got pain. I feel like up to the point that pain sets in, I'm not using enough weight but the threshold for the pain is immediate at a certain weight level.

Basically they are delt raises to the front, front 45, side, rear 45 and rear. Plus the one where you lay on your side and kinda just hinge the shoulder up and down, and. The rule is to do them with weight but not enough to hurt the shoulder. Makes sense basically but I feel I do plenty of soft, small movement stuff that I don't believe that the small muscles these exercises are trying to target are that weak. Our stance training set isn't just legs but the arms are held in different postures as well and I do that 3 days a week for 8 minutes at a time. Not to mention two person arm drills that work every conceiveble ROM.

so, am I just being hardheaded????

Toby, I've got the dull pain like you describe but also sharp pain in the very front and the very back of the shoulder joint.

Those exercises sound better than what I was given.

MP, I'm not worried about the surgery. I went in sort of expecting that call and with 3 separate tears I thought that's where he would go.

I'm gonna give the PT this week and next but I don't want to waste a month on the front end of surgery when I feel like that's going to be the end result.

Basically, I would rather go in and have the surgery and then work through PT afterwards.

thanks for the feedback.

[rubthebuddha]

so, am I just being hardheaded???? um, you ARE oso, right? :D

regardless, just stick with the exercises at first -- gotta get a good base in them before you build the house, even if you already had some good strength before.

[Oso]

:p


I know, I know...that's why I'm allowing for the possibility that I'm just being hard headed.

but still, don't you know wether something feels 'right' to you or not?

[rubthebuddha]

yep. when i found a mod last week for one-arm pushups that just felt magical. haven't found it again yet. :mad:

[Merryprankster]

Oso,


Stick with the PT. You are getting stronger, even if you can't really feel it. The thing is, the movements you are doing aren't designed to really blast your major muscle groups there. You're trying to hit small stuff in different ways than you may be used to.

I anticipate you'll need surgery though :)

[Oso]

ok, chalk another one up to me being stubborn.

I still think I'm hitting everything that the PT is targeting in my normal fu workout.


thanks

[rubthebuddha]

ok, chalk another one up to me being stubborn. thank you, captain obvious. :D

is ok bud -- the idea of wanting to do more and thinking you can without problem is normal. and it ****ing sucks, too. :mad:

[Oso]

:D

[rubthebuddha]

side note -- went to the houston zoo today. walked through the bear exhibit, which was labeled "bears/osos." wondered if oso was gonna make a cameo. :cool:

[Oso]

nope, it's getting cold here, I'm starting to den for the winter.

bears in cages depress me, even more so than any animal in a cage.

actually, the most depressing one I've ever seen was the silverback in the NC zoo. He was sitting against the lexan veiwing panel and I went right up to him. He turned to look at me and I was immediately struck by the humanity in his eyes.