So, my shoulder started to hurt for no apparent reason last October. Pain increasing daily. (BTW I’m a fairly active, skiing, kayaking, hiking sort of 50 something). I finally went to a Doc this past Feb. because it was getting worse, not better. He sends me for physical therapy for a month and things continue to get worse. Last week he injects me with cortisone and says this will make it better. Ummmmm no, it’s now worse, but my next appointment is still 3 weeks from now.
Dr. diagnosed a partial rotator cuff tear based on symptoms but nothing else, and says I’m just getting old, live with it. Where do I go from here? Argghhh it hurts to do anything including just nothing. I am not used to pain on a daily basis.
There are only like 30 places where the rotator cuff can go awry, so it’s hard to guess what sort of advice we should share.
Me personally, I overstretched my AC ligament by unbalanced weightlifting. It plagued me for about 2 years until I got a combination of cortisone and physical therapy. The PT is what really helped. The cortisone just killed the pain enough to help me do the PT. The joint will probably never be what it was when I was 18, but as long as I keep up my PT and don’t try anything ridiculous, I can easily keep up with the youngsters.
I had pain in my right shoulder for years (I first noticed it while bench pressing).
When I got back from Iraq last April, the travel medicine doctor suggested I get it checked out by a sports medicine specialist.
The sports doc gave me exercises, which I did for a couple months, with no improvement. He then gave me the cortisone shot, which alleviated the pain… for a couple of weeks. Then he ordered an MRI, which revealed a major tear (1.5 cm) – he told me I must have a very high pain threshold to have continued lifting the last few years. So I got a second opinion (from a guy who did the surgery on a friend and an ex-boss of mine). This sawbone told me that I needed to get the surgery within the next few months, or risk permanent loss of much use of the arm.
On January 15, I got the surgery. It’s a major disruption in one’s life. (My arm was in a sling for four weeks – I’ll be glad to elaborate if interested). But I am very happy with my progress, and it’s looking like I will be stronger and more pain-free when I recover fully.
Bottome line: I would get an MRI, to find out if the injury is small enough that surgery isn’t necessary. They have some neat, less-invasive procedures in that event (e.g., they draw 2 ml of your blood and inject it into the muscle to help it heal, which helps with the shoulder’s poor blood flow).
If you’re over 30, and something keeps hurting for more than a few months, see a doctor (or two). If I had done so a few years ago, I might have nipped this problem a little earlier.
This is an unacceptable response from that doctor, find a better one. You do NOT have to put up with pain and disfuction for the rest of your life! Both I and my gf have this problem and we’re around the same age as you, BTW.
Insist on an ultrasound, and then a MRI if warranted by it. A course of cortisone (with physiotherapy) is a potential fix, failing that an operation.
Keep going to physio. I got a minor tear playing tennis summer of 2005 (trying to bean my buddy serving as hard as I could). The first several weeks of physio sucked and didn’t seem to help at all, but then one day there was a very noticeable difference.
My racquetball partner had a knee problem and found the same thing. To his great dismay, PT didn’t seem to help, it just seemed to suck and he was afraid it was making things worse. Then about two months into it he started noticing a difference.
For my rotator cuff tear, physio helped straighten out the mechanics and shoulder positioning that caused the injury to begin with (my traps are too big compared to my wimpy chest and everything was out of whack), and now regular resistance exercises help tremendously. I take my resistance tubing to the gym and do the physio exercises regularly even though I finished the PT a year ago. I also do the PT as a warm up and cool down when I’m playing sports that will use my shoulders a lot.
Now I have my full range of motion, almost no discomfort at all. I will admit, I find I have issues with the military press, but I can still play racquetball, canoe and rock climb. But tennis still doesn’t quite work, I get really sore too fast.
Give the PT time. It’s crappy at the start and then does get better.
Oh, and your doctor is an ass. My PT said “as you age, stretch more, take more time for a warm up, and stretch when you’re done.”
My situation was very similar to F. U. Shakespeare except I fell and tore my rotator cuff and fractured my elbow. I didn’t know the extent of my injury until my elbow healed and I was still in pain.
I was also treated with PT, cortisone then surgery. I have to be honest, this happened approximately two years ago and I’m still in pain sometimes. Not nearly as bad as it was though.
BTW, how did he diagnose your tear? There are other conditions that cause similar pain, like bursitis. VERY similar symtpoms.
My sister had bursitis from kayaking way too much one summer. Her shoulder started hurting for no reason, and then hurt all the time. Whereas I’m pretty sure I know exactly which serve did me in, and my shoulder didn’t hurt so much when it was immobilized.
Thanks for the encouraging words all. I think I’m just getting cranky because it just basically hurts all the time. I wake up every morning and want to gnaw my arm off.
At my last appointment the Doc gave me a choice of a)cortisone shot or b) MRI, then a cortisone shot, and strongly recommended a) so that’s what I did. :dubious: He didn’t give me another scrip for PT because it didn’t help, so that’s out for the time being. He said to just do stretching exercises and I’m doing those.
MrSin had a similar problem a couple of years ago and went thru this same protocol, PT, cortisone, then finally surgury with the same Doc. Fixed him right up. What concerns (discourages) me is that the cortisone shot has done nothing to reduce the pain. MrSin’s experience was that the cortisone acted like a miracle drug (at least for awhile) and I’ve heard this from others as well.
If things don’t improve in the next couple of weeks, I’ll opt for the MRI and/or get a second opinion.
Again, thanks for the encouraging words, I think that’s what I really needed.
I misspoke on the cortisone shot… cortisone is not a painkiller, it reduces inflammation. What happens sometimes is the tissue swells up to the point where it gets in the way of the joint, which irritates the soft tissue even more. Generally you need steroids to break that cycle. But there can be other pain points, like cartilage being worn off, etc. The shot I got was actually half anaesthetic and half steroid. I had instant relief, enough to get me through the PT that permanently fixed the problem. But then again that is a classic sign of AC joint problems, your own rotator problem may be elsewhere.
I had shoulder pain, and being very underinsured at the time I went for physical therapy & only seeing the doctor once. The doctor suggested a cortisone shot but added that it might not just be a one-time thing. Three months of physical therapy and I was good as new.
I could trace the pain & stiffness to an injury, but it did not seem like that much of an insult really (I am a klutz, I tripped going down a step I didn’t see and the friend I was with, who coincidentally is a doctor, grabbed my arm to try to steady me…but what I got was a small pain, comparable to a stiff neck, that then continued to get worse until I could barely move my shoulder at all). My PT said that women my age (50s) tended to get what she called “insidious onset capsulitis” and then tendency was to go back from when the pain started and try to attach it to an actual injury, when in fact it was something that just happened and was related to loss of estrogen.
But another PT at the same place seemed to think it might be an actual tear in the rotator cuff.
I never actually had the MRI (underinsured, as I said) although I would have if it hadn’t gotten better with just PT.
For what it’s worth, you can go to a PT without a doctor’s recommendation. One of the therapists I saw was better at mobility, and the other was just great at pain relief–in fact, frankly amazing. I was at a point where it wasn’t so much pain but the feeling was similar to carrying something that’s a little too heavy and wanting to put it down, only it never stopped. That is, I could never “put it down” so I felt this tension all the time. The PT applied very gentle pressure, almost like traction (in fact she called it traction) and in 45 minutes the pain (such as it was) was gone, and it didn’t come back. She called this “calming.”
Yeah, pretty much. Get a new doctor. You don’t have to just “live with it”
My mother had the same thing happen. Corisone shots helped for awhile, but eventually she had to have surgery on her right shoulder. She’s now fully recovered from the right shoulder (done when she was 49, IIRC), but is just now getting over the same surgery on her left shoulder, which she just had about a month ago.
Please don’t misconstrue this as medical advice. I’m not a doctor. But I’m a bit older than you and I suffered a rotator cuff tear two years ago while training for a power lifting competition. There is a form of physical therapy not widely known, but in my experience, more effective than traditional methods. It’s called Active Release Techniques (ART). You can google for it and find plenty of information.
Again, simply in the vein of providing information for you and drawing on my own, admittedly non-mainstream experience, testosterone does wonders for muscle injuries. This is obviously something that should only be done under a doctor’s care. Cortisone is a steroid. There are other steroids that can help. No steroids should be taken lightly, but that doesn’t mean they can’t be appropriate.
BCAA supplimentation - You can find plenty of controversy about BCAAs. They work for me. Do the research and decide for yourself. They can’t hurt, so I think it’s worth a try.
Get thee to a sports medicine specialist. You’re wasting your time and health with the guy you’re seeing now. It’s your body and your life and it’s your responsibilty to make sure you get proper treatment. You need to seriously educate yourself about the injury and ALL the treatment options. Leaving this solely in the hands of any doctor is a huge mistake, IMHO. I’ve come back from very serious injuries because I was willing to learn as much (and more in some cases) than the doctors I went to. The Internet is the greatest health tool ever invented.
Please understand that I’m not trying to “sell” you on any of this. I’m not interested in debating or defending any of my choices. I’m just letting you know about things that have worked for me. Other people will have other opinions. I’m fine with that.
You don’t need a scrip for PT. You sometimes do if your benefits package will only pay for it with a doctor’s note, but even then (at least in Canada), the scrip gets you to see the PT, and it’s the PT who decides the length of the regimen required to fix the problem.
Stretching exercises alone will just not do. You need to strengthen several muslces in order to get the mechanics of your rotator cuff working properly again and to avoid re-injury. If your injury is being caused by an impingement (parts of your shoulder pinching other parts) your condition will never improve unless you can get your body mechanics working so the impingement doesn’t happen.
If your shoulder is killing you all the time you should get a second opinion (it could be bursitis, and the bursa has 20 times the number of nerve endings than the cuff tendons). If the cortisone shot did nothing you should get a second opinion because it sounds like the inflammation isn’t going down (maybe he’s treating the wrong joint component). Cortisone injections provide really noticeable improvement within days and the effects can last several weeks.
MRIs are expensive, but they are much better as a diagnostic tool for rotator cuff injuries. You also might want to see a sports medicine doctor who has a lot more familiarity with diagnosing shoulder impingements and tears.
Having suffered from shoulder pain for many years I can tell you that all the information you’ve heard thus far is correct. I’ve heard it all. Even" you’re getting older" is correct. Sounds like he is saying take it easy for a while. Let it rest.
Face it. You don’t come back from injury as fast as you used to.
My pain finally got to be so bad that I was noticablly weaker and most any movement, even non movement, hurt.
Couldn’t sleep and I was concerned about taking too much ibuprofen and acetaminafen. (read stomach problems).Cortizone was effective for a while.
Anyway I had shoulder replacement surgery 6 weeks ago. Arthritis had set in.
Doing physical therapy now and I can see a difference already.
I’m looking foreward to having the other shoulder done.
best of luck
just
I don’t have rotator cuff issues (yet), but I am sad to say that I definitely cannot push myself at the gym like I used to. About 6 months ago I was able to use 60# dumbells for incline benching, which I thought wasn’t bad for 5’8" 150# 40-something. Then one day I went too far on the downstroke, so that my right elbow was bent at too sharp an angle. I don’t know exactly it happened, I’ve been working out for years and years.
AFter all this time it still twinges a bit, and I’ve resigned myself to using machines for most of my workout. AT least they do have some pretty good ones at my gym.
Couple of points to add to the fine advice so far. You don’t tell us what kind of doc you’ve seen, I would recommend trying to see an orthopedist with a sports medicine practice. Be sure to be clear about what your activity level is, good luck
Thanks again for all of your experiences. This makes me feel much better.
I’m looking into this, because I do want to talk to the PT again. Thanks for the idea, I thought I had to have something from the Doctor to get PT.
Yeah, I guess it was the “you’re just getting old” thing that got to me. Hey, I’m a boomer, we don’t get older, we just get better!! BTW I am taking it easy. Nothing more than office work for the last couple of months.
I’ll be taking it even easier for the next week, laying by the pool in vegas reading a book: yeah spring break!!
Oh and to all that mentioned it, the Doc is THE specialist in sports medicine and in particular shoulders in this town. I know many people who have been helped by him, including MrSin. The rational part of me likes the fact that he is very conservative when it comes to surgery/treatment. The “but I want to be better now” part of me is frustrated. (Also the “but, but, what do you mean I’m getting older” part)
Based on all your advice (and I know this is a message board and YAND’s) I’m planning on chatting with the PT and asking way more questions when I go for my next Dr. appointment.
Thanks again. I’ll be on the road for the next week, and probably won’t be updating again for awhile. But will post when I find out anything new.
I don’t mean this to sound like it’s from left field… it’s just my own experience.
I had chronic pain in my left shoulder for a few years. I had a few cortisone shots, which helped for a while. But, eventually, after having done nothing more than jerking my shoulder quickly, the tendon snapped. Even then it took me a while to get it fixed. This was at age 33.
Root cause: I had developed bone spurs in my shoulder. The doc said that moving the tendon was the equivalent of pulling a piece of bacon over a cheese grater. So when they reattached the tendon, they also sanded off all the bone spurs. 15 years later, that shoulder still works pretty well. The other one hurts, likely for the same reason, but at least the tendon is still attached.
I realize that mine was not a mainstream diagnosis. The main reason I raise this is that in my case the cortisone shots, good as they felt, may have actually weakened the tendon… hastening its eventually snapping. I haven’t seen any mention here of the effects of cortisone overuse, but it may be worth looking into.
Actualy, it was - almost everyone was born with these bone spurs (not developed them) to a greater or lesser degree. One of the reasons for getting imaging done is to see whether they are the cause of the problem; if so then an op to remove them is (part of) the only way forward.
BTW I am taking it easy. Nothing more than office work for the last couple of months.