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Rotator Cuff Hurts! (1 Viewer)

Beef Ravioli

Beef Ravioli

Footballguy
I’m nearly 49 and have not been physically active beyond some walks and a little bit of golf for the last several years. I am not obese but could stand to lose 15lbs (6’1” and 210lbs).
 

I see some jr high kids that I know this past Friday afternoon. They are tossing around the nerf football and I join them for a few minutes. I threw the ball four times, about 25 to 30 yards, but sky balls. I feel no pain and they were beautiful throws. I tell the kids I’ll see them later. 
 

Saturday morning, arm feels tight and starting to feel like I “threw my arm out” back in my baseball days. By Saturday night, I am in excruciating pain and hardly sleep. Miserable all day Sunday. Can’t hardly move my arm without screeching in pain. I have the day off today and go to my dr. She tells me what I already know. I damaged my rotator cuff to some degree. 
 

I’m supposed to do exercises for two weeks. If no better, therapy for two weeks. If no better, cortisone shots. If no better, I don’t know what they do. 
 

So I start these exercises today and I am so far away from being able to do what they want me to do, it’s not even funny. If what they want requires finishing at a 10, I am at 1.5 at the moment. 
 

For those that have been down this path, my question is, do I push myself and my shoulder/arm pain to get the range of motion or do I just try to do a little bit more each day? Second question, is this thing going to hurt like this the entire recovery? It’s awful! 
 

Getting old isn’t for sissies! 

 
Do the PT and give it some time. It will get better. Let pain be your guide as to how hard to push.

Cortisone is OK as a quick fix, but it may ####### healing and weaken the tissue if used repeatedly.

ETA re ####### is a bad word, apparently

ETA2 t a r d, too

 
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I had an impingement and was prescribed the same steps as you.  My injury was almost exactly the same - I don't remember doing anything bad to my shoulder, but one day I was sore and then very soon after that I couldn't move my arm without excruciating pain.  Ultimately I had to get surgery.  I took the post-surgery physical therapy seriously, and now that shoulder is the stronger/better feeling shoulder.  It doesn't sound like you exerted yourself much to cause the injury, so I would get x-rays or an MRI to make sure you fully know the cause of the injury.

 
Terminalxylem said:
Do the PT and give it some time. It will get better. Let pain be your guide as to how hard to push.

Cortisone is OK as a quick fix, but it may ####### healing and weaken the tissue if used repeatedly.

ETA re ####### is a bad word, apparently

ETA2 t a r d, too
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Are you speaking from personal rotator cuff experience? I want what you typed to be true!

 
Do not push yourself to get more ROM if you don't have supervision by a professional doing it. It's not just about range, but also quality of range and the type of pain that accompanies it. 

 
As someone who blew out their shoulder and never properly got it diagnosed until later in life.  Do the PT.   I have enough motion to have a catch and golf without pain but I can no longer put zip on a ball or throw it more than 80ft.  Ended my baseball career

 
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flapgreen said:
Do not push yourself to get more ROM if you don't have supervision by a professional doing it. It's not just about range, but also quality of range and the type of pain that accompanies it. 
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I didn’t push it today much as it was my first day to try any exercises. It was just so little of range before I was hurting, that I wondered if it’s even helping. Going to try an increase a little each day. 

 
Beef Ravioli said:
I didn’t push it today much as it was my first day to try any exercises. It was just so little of range before I was hurting, that I wondered if it’s even helping. Going to try an increase a little each day. 
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It's so tough to do on your own when you don't know exactly what you're doing. I'm a PT, so I'll offer as much help as I can. 

 
did you have an MRI or did you just go on you have a rotator cuff problem?  how about a CT with contrast?  one thing to have a tear, but do you and why?  i discovered my acromion was digging into my cuff and tearing it.  no amount of PT would help without having it shaved.  i just think you have options before donating time and money to PT.

 
Chemical X said:
did you have an MRI or did you just go on you have a rotator cuff problem?  how about a CT with contrast?  one thing to have a tear, but do you and why?  i discovered my acromion was digging into my cuff and tearing it.  no amount of PT would help without having it shaved.  i just think you have options before donating time and money to PT.
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I saw the doctor and told her my symptoms and she said it sounds like I strained my RC. She said, let’s start with at home exercises (she gave me a list). If that doesn’t work, then some PT would be the next step. If still hurting, she mentioned cortisone and further examination. 

 
Beef Ravioli said:
I saw the doctor and told her my symptoms and she said it sounds like I strained my RC. She said, let’s start with at home exercises (she gave me a list). If that doesn’t work, then some PT would be the next step. If still hurting, she mentioned cortisone and further examination. 
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get a new doctor.

 
Beef Ravioli said:
I saw the doctor and told her my symptoms and she said it sounds like I strained my RC. She said, let’s start with at home exercises (she gave me a list). If that doesn’t work, then some PT would be the next step. If still hurting, she mentioned cortisone and further examination. 
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I just went last week due to some pain in my shoulder. Landed on it diving at 3B for a parents vs daughter softball game.

Felt weird and uncomfortable. Then kinda hurt putting on a shirt. That was July. Never got better. At my physical last week I had also scheduled a visit for the sports doc (same guy who did my physical) he ran a bunch of range of motion tests and the. Walked me down the hall for an ultrasound. 

Slight tear in my muscle or something. 

Got a rx for a xray and MRI he thinks ins will not allow mri without all the self help stuff at home.

So I am doing that for now.

If xray/MRI reveals more damage next step is something where they draw blood spin it and reinject back into my shoulder to expidite healing. Cortisone maybe down the road.

But yes, kinda surprised you get sent home with just getting poked and some pamphlet on how to stretch. 

 
comfortably numb said:
I just went last week due to some pain in my shoulder. Landed on it diving at 3B for a parents vs daughter softball game.

Felt weird and uncomfortable. Then kinda hurt putting on a shirt. That was July. Never got better. At my physical last week I had also scheduled a visit for the sports doc (same guy who did my physical) he ran a bunch of range of motion tests and the. Walked me down the hall for an ultrasound. 

Slight tear in my muscle or something. 

Got a rx for a xray and MRI he thinks ins will not allow mri without all the self help stuff at home.

So I am doing that for now.

If xray/MRI reveals more damage next step is something where they draw blood spin it and reinject back into my shoulder to expidite healing. Cortisone maybe down the road.

But yes, kinda surprised you get sent home with just getting poked and some pamphlet on how to stretch. 
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The only thing I can think is that from my description of what happened, it makes sense to her that it’s a strain and will most likely get better with some exercise and time to heal???  I didn’t fall on it, I only threw a nerf ball four times. It was not alarming to me that I didn’t get any xrays today. 

 
Chemical X said:
seriously, get a shot, ice it for 36 hours then some hot showers.  if that doesn’t help, PT won’t.
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Cortisone just limits the inflammation, and controls pain in the short term. PT can stabilize the joint and correct things like bad posture which contributed to the injury in the first place.

Depending on the diagnosis, rehabilitation is possible from PT alone. The shot ain’t curing anything.

 
Beef Ravioli said:
I saw the doctor and told her my symptoms and she said it sounds like I strained my RC. She said, let’s start with at home exercises (she gave me a list). If that doesn’t work, then some PT would be the next step. If still hurting, she mentioned cortisone and further examination. 
Click to expand...
She didn’t examine you? A good physical exam is often enough to diagnose the cause of shoulder pain. MRI (or any diagnostic imagery) may not be necessary - this is part of the reason our healthcare costs so much.

 
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Beef Ravioli said:
She had me raise my arm, put pressure on my arm as I tried to push or pull. That kind of stuff. 
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Yeah, those are the kinds of exam maneuvers I’m talking about. Any decent FP or internist should be able to make a diagnosis, or at least exclude stuff that requires more urgent evaluation by sub specialists or advanced imagery. 

 
I had shoulder problems (and nerve impingement down through elbow/fingers) on and off for a year that I was in and out of PT for.  It turned out to be bursitis (took forever to diagnose) and I had the bursa removed via arthroscopic surgery this summer.  Did physical therapy and they were surprised how quickly I got range of motion back. Finished all my PT sessions (20?) but still had tightness / pain.  Went and got a massage with cupping (suction cup things increase blood flow) and that helped.  Went back weekly for 4 weeks and have just spaced it out to two weeks.  I've also been going to a chiropractor and he's been helping too, just got stretches from him today to help stretch it out and get muscles to release.  Finally optimistic but it was miserable since last summer (2018).

By the way, I'm a righty and it was my left shoulder, weird stuff.

 
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Been dealing with an inflamed RC for months now. Got a few steroid packs that helped. And I'm still doing the strength and stretching exercises at home. I think its finally turned the corner.

 
I started my exercises Monday evening and man was it painful! I had hardly any range of motion or strength in that arm. 
 

I would say I have about 60-70% of my motion back as of today. My pain is just about gone unless  I really stretch the arm. 
 

It appears that the exercises and giving the shoulder time to heal is working for me. 

 
Chemical X said:
get a cortisone shot, wa la, pain gone.  your welcome.  signed, someone who has had 20+ shoulder shots.
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Yup. I had the same thing, put up with it for like a month, could barely lift my arm past horizontal, finally went to the doctor. Cortisone shot and fine by time I left the office.

eta: that was probably 5 years ago and no problem since.

 
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I hurt my shoulder lifting weights like a jackass. After 6+ months on the shelf with no real improvement, I heard a podcast or read an article or something by some doc who says that hanging is one of the best things for your shoulder joint. Within just a few weeks, I was back to lifting again. Even now, 8+ months after I felt better I still get sore in that shoulder if I sleep on it wrong or have it sitting on my desk a lot while I'm at work. A minute of hanging fixes me up every time. Just hang from a pull up bar. It sucks at first, but like anything you can build yourself up.

I only use it as a warm up on days that I'm working out or if I feel it starting to hurt on off days, but I should mix it in every day. I have no expertise and just read/heard someone who claimed to know what they're talking about ,but it helps me.

 
Beef Ravioli said:
I started my exercises Monday evening and man was it painful! I had hardly any range of motion or strength in that arm. 
 

I would say I have about 60-70% of my motion back as of today. My pain is just about gone unless  I really stretch the arm. 
 

It appears that the exercises and giving the shoulder time to heal is working for me. 
Click to expand...
Patience, my friend. The body does a remarkable job healing itself if given time. Just gotta maintain ROM and work on strengthening/stabilizing the rc muscles.

 
Rirruto said:
I hurt my shoulder lifting weights like a jackass. After 6+ months on the shelf with no real improvement, I heard a podcast or read an article or something by some doc who says that hanging is one of the best things for your shoulder joint. Within just a few weeks, I was back to lifting again. Even now, 8+ months after I felt better I still get sore in that shoulder if I sleep on it wrong or have it sitting on my desk a lot while I'm at work. A minute of hanging fixes me up every time. Just hang from a pull up bar. It sucks at first, but like anything you can build yourself up.

I only use it as a warm up on days that I'm working out or if I feel it starting to hurt on off days, but I should mix it in every day. I have no expertise and just read/heard someone who claimed to know what they're talking about ,but it helps me.
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Be careful with this. You still want to engage some muscles while hanging. I'll find a video that shows what I mean.

 
Dr. John Kirsch is what I was thinking. His book is "Shoulder Pain? The Solution and Prevention." Here's an article + video that explains him and his basic protocol. Here's another that talks about Kirsch and when active/passive hanging is safe and not (spoiler: you don't want to do a passive hang if you're doing pullups/swinging/moving).

The Kirsch method calls for passive hanging. So the full hang with your shoulder relaxed and up by your ears. I don't know if it's woo or not, but it worked for me.

 
Rirruto said:
Dr. John Kirsch is what I was thinking. His book is "Shoulder Pain? The Solution and Prevention." Here's an article + video that explains him and his basic protocol. Here's another that talks about Kirsch and when active/passive hanging is safe and not (spoiler: you don't want to do a passive hang if you're doing pullups/swinging/moving).

The Kirsch method calls for passive hanging. So the full hang with your shoulder relaxed and up by your ears. I don't know if it's woo or not, but it worked for me.
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I stopped reading at “eliminates 99% of shoulder pain”. That’s a preposterous claim that no legit doc would make.

Glad it worked for you though.

 
Terminalxylem said:
Cortisone just limits the inflammation, and controls pain in the short term. PT can stabilize the joint and correct things like bad posture which contributed to the injury in the first place.

Depending on the diagnosis, rehabilitation is possible from PT alone. The shot ain’t curing anything.
Click to expand...
What is your opinion on Cortizone shots for an arthritic elbow? Last winter I had pain in my right elbow(same elbow that was broken when I was hit by a motorcycle in 2nd grade) that caused problems with my bicep curls, push-ups and  the pull part of the clean and press.  No problems with pain in the summer...🤷‍♀️

 
Oracle said:
What is your opinion on Cortizone shots for an arthritic elbow? Last winter I had pain in my right elbow(same elbow that was broken when I was hit by a motorcycle in 2nd grade) that caused problems with my bicep curls, push-ups and  the pull part of the clean and press.  No problems with pain in the summer...🤷‍♀️
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Are you sure it's arthritis, as opposed to tendinitis? Or bone pain along the prior fracture line? Steroids like cortisone help with acute inflammation, and pain caused from it. Of those three possibilities, they'd most like help with pain from tendinitis (tennis or golfer's elbow). But like shoulder pain, it may be more important to do PT and work on your exercise form (and probably lay off the heavy lifting for a while). They'd be less likely to help post-traumatic arthritis, or bone pain.

Full disclosure: I've had two cortisone injections over the years for elbow tendinitis/osis. The first (from my sports med friend) helped almost immediately. The second, from an orthopedist, didn't. Ultimately the pain has subsided with a lot of rest, physical therapy and avoidance of activities which cause it to flare.

 
Terminalxylem said:
She didn’t examine you? A good physical exam is often enough to diagnose the cause of shoulder pain. MRI (or any diagnostic imagery) may not be necessary - this is part of the reason our healthcare costs so much.
Click to expand...


Beef Ravioli said:
She had me raise my arm, put pressure on my arm as I tried to push or pull. That kind of stuff. 
Click to expand...


Terminalxylem said:
Yeah, those are the kinds of exam maneuvers I’m talking about. Any decent FP or internist should be able to make a diagnosis, or at least exclude stuff that requires more urgent evaluation by sub specialists or advanced imagery. 
Click to expand...
I had 10 years of pain which included multiple exams (from multiple doctors) and multiple x-rays and MRI's that didn't show my tear.  There was multiple exams and cortisone shots (that did nothing to alleviate the pain).  I was prescribed PT many times to strengthen the area and that helped but never stopped the pain completely with certain activities (throwing being the primary one).  The pain got to be so bad it prevented me sleeping so I eventually opted for arthroscopic surgery to explore and they found a torn labrum and impingement on the rotator cuff.   Those were repaired and I am pain free now. 

The shoulder is a very complicated joint and MRI's/X-rays may not show was the issue is if the cuts for the pictures (MRI) are in line with the tear or other things block the views. 

 
Terminalxylem said:
Are you sure it's arthritis, as opposed to tendinitis? Or bone pain along the prior fracture line? Steroids like cortisone help with acute inflammation, and pain caused from it. Of those three possibilities, they'd most like help with pain from tendinitis (tennis or golfer's elbow). But like shoulder pain, it may be more important to do PT and work on your exercise form (and probably lay off the heavy lifting for a while). They'd be less likely to help post-traumatic arthritis, or bone pain.

Full disclosure: I've had two cortisone injections over the years for elbow tendinitis/osis. The first (from my sports med friend) helped almost immediately. The second, from an orthopedist, didn't. Ultimately the pain has subsided with a lot of rest, physical therapy and avoidance of activities which cause it to flare.
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Thank you!  I had not considered this potentially being other problems.   I guess that age (late 40’s) along with the location of the pain made me think arthritis from prior injury.  If this flares up again, I will seek out a doctor  👍

 
Gally said:
I had 10 years of pain which included multiple exams (from multiple doctors) and multiple x-rays and MRI's that didn't show my tear.  There was multiple exams and cortisone shots (that did nothing to alleviate the pain).  I was prescribed PT many times to strengthen the area and that helped but never stopped the pain completely with certain activities (throwing being the primary one).  The pain got to be so bad it prevented me sleeping so I eventually opted for arthroscopic surgery to explore and they found a torn labrum and impingement on the rotator cuff.   Those were repaired and I am pain free now. 

The shoulder is a very complicated joint and MRI's/X-rays may not show was the issue is if the cuts for the pictures (MRI) are in line with the tear or other things block the views. 
Click to expand...
Sorry you had such a delay in diagnosis, but no test is perfect. MRI is supposed to be ~90% sensitive, so that means 10% of tears will be missed. There is some variability due to the type of MRI and radiologist's experience, but persistent severe pain should have warranted an arthrogram followed by arthroscopy if the diagnosis remained obscure.

 
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