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Ok so i had a ultra sound turns out no tendon isues but i do have a thickening of the subdeltoid bursa that is echogenic. The doc is getting me to get a injection of marcaine celestone chronodose. Whats the thoughts get dont get other options for treatment???
Regards
Luke
How long ago did you get it? Is it sub-deltoid bursitis?
If it doesn't go away on its own via RICE/NSAIDS, then it has to be drained, yeah.
yeh its sub deltoid its a few years nw i took 6 months off training completly but not much change i had alt of physio acupuncture yada yada my shoulder is def alot stronger its just inflamed now.
If you have had this issue for a while now i would say that you are not resting as much as you are letting on. Even if you are not training you are still doing things to agrravate the problem. Its a real challenge when you have bursitis because you have to make sure you dont use and overuse your arm in ways that will aggravate the situation, that means no heavy lifting and no bringing your arm up over your head or rotations with your arm. No hitting things because the impact of that just makes things worse. You have to take it easy and get the injections if the pain is too much. PLus i reccomend massage therapy for your whole shoulder girdle,but make sure you get a structural body worker who understands about bursitis and who wont re-injure you. The massage therapy is not going to cure your bursitis but it will help relieve the tension and provide circulatory refreshment to your shoulder girdle as you heal.
Peace,TWS
forget about speculating as to what you should or shouldn't do, or sort of treatment will work, because you obviously have not had anyone get to the root of the issue - what needs to be done first and foremost is understanding why the shoulder is being subjected to excessive loading such that the tension on the bursa is causing chronic inflammation; otherwise, you can treat all day long with any modality and get nowhere
meaning that, it's either structural, functional or (most likely) some combination of both; if it were me doing the investigating, I take a detailed history about usage and incidence of flair-ups so as to determine what sort of pattern underlies the flair-ups; then I would look at a number of things: thoracic spine / rib cage / scapular / glenohumeral joint / respiratory diaphragm mobility (if one or more of these are restricted, it will definitely impact shoulder use, and if you don't get these cleared it is possible that the bursa will continue to be under undue tension in perpetuity); also, it's important to analyze the relative muscle balance and function of subscapularis, latisimuss, upper traps, pecs/biceps as compared to lower traps, serratus anterior, triceps and infra / supra spinatus, because the former group usually "over powers" the latter (flexors / internal rotators "stronger" than extensors / external rotators) and creates imbalance at the shoulder leading to anormal lines of tension during abduction, and subsequent bursal irritation; and there might also be some considerations regarding the hips / pelvis (same or opposite side, it can depend), because they have a direct relationship to shoulder function; and I'd look at your usage in terms of what you are doing and how, and set up a rational plan for training that keeps you under the "flair-up" thresh hold;
the trick is finding someone who looks at it comprehensively and critically: now, they may not take the same exact path that I described, but the approach would be based on really figuring out what is going on, not just rubbing your shoulder a little and giving you a hot / cold pack (choose one); it may take some efforts to find someone, but at least you can (and should!) ask them what their approach is like, and get a reasonable time frame for relief (for me, most of the time, if I get you no real change in 3 to 4 sessions, it ain't working, time to refer out to something else)
good luck
no i rested it plenty 6 months no training of any kind and the physio did little. Ill have to find someone else to do it. im getting a shot soon. The doc recons thatll realli help me alot ive done a crap load of lat work i used to b **** at pull ups now i love it.
sounds typical for a recurrent inflammatory problem: you can rest all you want, it doesn't need to be rested: it needs to be able to move correctly; and unfortunately a lot (most?) of ortho OP physio is garbage - shake and bake mills and all that, really embarrassing for the profession...Quote:
Originally Posted by viper
I'm not sure if you are still doing lat work, but in my experience, shoulder issues similar to what you describe involve lats that are hyperfacilitated and therefore shouldn't be worked; that may not be the case w/you, just mentioning it is something i commonly see
ok so what should i do to help it move easier. instead of lats what should i target
Should i focus alot more on stabilisers etc or traps etc
Quote:
Originally Posted by viper
I'm not suggesting what you should or should not do, because since i haven't examined you I have no idea what would be appropriate; I was simply stating that in my experience, in cases I've had that appear similar to what you describe, lats were an issue; meaning that it's something for you to consider in context of working with someone who is able to analyze your situation along the lines i described earlier - that is, comprehensively and critically, as opposed to just treating locally where the pain is, which, except in the case of direct trauma, will often get you no whereQuote:
Originally Posted by viper
now, IN GENERAL, the people who talk about lats being hyperfacilitated (Janda, Levitt), will recommend lengthening them in a manner similar to this, but - I AM NOT RECOMMENDING YOU DO THIS, IT IS SIMPLY FOR ILLUSTRATIVE PURPOSES - especially as the directions are actually more complex, and it is a difficult "stretch" to get just right;
also, they talk about stretching pecs as well, also in a way more specifically than the typical "door frame" stretch, which is also very non-specific;
they will talk about strengthening lower traps as well, which is fine, unless you have a restriction o the mid thoracic spine which needs to be mobilized / manipulated first (and possible be cleared of a primary soft-tissue restriction elsewhere that caused it so as not to have it reoccur), otherwise you won't have a proper lever arm off of which to work LT's appropriately
again, I tell you this a a way of illustrating that sometimes (maybe in your case, maybe not, I don't know), non-resolving "shoulder" issues can require investigation and treatment elsewhere in order to resolve; meaning that, if you go looking for someone who approaches things in a comprehensive manner, you might inquire along similar lines as to what I have posted - if they look at you like you have 3 heads, thank them politely and move on (see? I save you time and $); if they nod and basically agree with you, then you may have found someone worth your efforts
good luck
your advice is very much apreciated and understood all i have to do now is find a physio that sees me as a unit instead of singular issues.
Regards
Luke
Pity ur not in bris aus id come see ya