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OT - Medical Experts during Lockdown

LeafOfFaith

Well-known member
So a few months ago, I hurt my shoulder really badly doing pilates of all things. It was a really awkward pose where all the weight was on my hands, and something just twisted out of place. I figure it was no different than any other injury I've ever had, and would heal within a week or so. So I kept going to pilates, I kept playing hockey, and I kept exercising at home. After several weeks, it wasn't getting better. It's fine in the rest position, but certain other things, like taking my jacket off, or taking a sweater off, were excruciating. Like my shoulder trying to detach from my body. So I stopped going to pilates, but kept going to hockey. Then after another several weeks of zero progress, I stopped going to hockey.

So like 6 weeks ago, I went and saw a sports injury doctor, who says I've fucked up my rotator cuff. For some reason, which I didn't question at the time, he said he didn't want to do an MRI yet and wanted me to go to physical therapy. I'm not exactly a believer in PT being able to fix something that feels so broken, but I was going to give it a shot. And then corona hit and the shutdown was in place before I could get a session in. And now another two months or so later, still basically zero improvement. There are times when it feels like it gets like 25% to 50% better, and I get encouraged that maybe it's finally healing, but then it goes to shit again.

Anyone here dealt with rotator cuff injuries and have any experience to pass along? Maybe I can do exercises at home? Maybe I shouldn't do anything and just keep waiting? How did PT go for anyone? Did anyone have surgery? Tell me.
 

MindzEye

Wayward Ditch Pig
Without an MRI it's impossible to know if there is structural damage, and the rotator is a delicate little bitch of a muscle. Rest, and anti inflammatories (try CBD, if it doesn't work then move on up the ladder) are your best bet until you can see professionals.
 

trujaysfan

Well-known member
Ive had some shoulder issues since i was 15 (used to be a competitive tennis player). Physio that focused on range or movement and strength did help but i never tore it.
 

LeafOfFaith

Well-known member
Yeah I’ve been kinda puzzled as to why he wouldn’t tell me to get an MRI before having anyone mess with it. If it’s torn, wouldn’t PT just decimate it?
 

Preston

Well-known member
In all seriousness rest/time is often the best medicine in my experience. A lot of PTs use some archaic techniques that are placebos so I would do my research on some of the methods they use. I would question anything that isn't strength building (after the initial period of rest.. you have to be physically ready for that). As a competitive hockey player for ~20 years my shoulders are completely shot. I tore my rotator cuff on both shoulders. PT never worked for me. I rolled with it for several years but I can't say it did anything for me other than rebuild some strength after my shit healed. Rest kinda helped make it manageable but I've accepted that my shoulders will never be the same again.
 

MindzEye

Wayward Ditch Pig
Yeah I’ve been kinda puzzled as to why he wouldn’t tell me to get an MRI before having anyone mess with it. If it’s torn, wouldn’t PT just decimate it?

Well, if it was torn your other shoulder would have damage by now from carrying around the bucket you would be puking into 6-7 times a day from the pain. So it's probably not torn. But yeah, your doc probably should have wanted to rule that out regardless. It's a slow healing, delicate AF muscle.
 

MindzEye

Wayward Ditch Pig
In all seriousness rest/time is often the best medicine in my experience. A lot of PTs use some archaic techniques that are placebos so I would do my research on some of the methods they use. I would question anything that isn't strength building (after the initial period of rest.. you have to be physically ready for that). As a competitive hockey player for ~20 years my shoulders are completely shot. I tore my rotator cuff on both shoulders. PT never worked for me. I rolled with it for several years but I can't say it did anything for me other than rebuild some strength after my shit healed. Rest kinda helped make it manageable but I've accepted that my shoulders will never be the same again.
MAT is the only technique I came across over 7 years of physio that works and made some sort of biologic sense as to why it worked. Everything else seemed like a mixture of fitness and voodoo at the time, and worse in retrospect.
 

Preston

Well-known member
Yeah I’ve been kinda puzzled as to why he wouldn’t tell me to get an MRI before having anyone mess with it. If it’s torn, wouldn’t PT just decimate it?
In my experience, if it's torn they will never turn you down. They'll do some electromagnetic therapy or "ultrasound therapy" that has no proven benefits. They won't actually get you to rebuild your strength until you're physically capable though so you won't get fucked up at least.

Many patients get better after those therapies after a few weeks, but not because of the therapies themselves. It's because of either the placebo effect or simply the additional time to heal. As Doug Ford said best, many PTs are a bunch of yahoos.
 

Wayward DP

Well-known member
So I don't have any direct experience with this kind of thing, but I have plenty of clients with shoulder issues, including a variety of different tears.

And yeah, if there is a tear, PT can make things worse. In my experience, it is also possible that you will be able to recover fully without surgical intervention. I've also seen cases where there is a tear but surgery is not recommended. But without imaging, pretty much impossible to know with any certainty what is going in there.
 

LeafOfFaith

Well-known member
What’s MAT?

So I guess we’re saying that if the damage was severe, I wouldn’t be able to carry on like I have, carrying a bag, opening doors, etc.?

Then it’s something less, like a strain? It’s most evident when I reach back to take my jacket off. The test he actually did was tell me to reach back with both arms and try to scratch as far up my back as I could. One arm can reach all the way and get above the center of my back. The other barely can get above my waist behind me. And trying to get it to go higher is insanely painful, won’t even go if I were to just force it. If it’s not a tear, what is it?

Also it happened maybe in December so it’s been half a fucking year already. Though only two months since I stopped all activities. The problem is the slightest awkward move makes it feel like it came out of its socket again, so there’s these setbacks too. How long should something like this take to heal?
 

LeafOfFaith

Well-known member
So I don't have any direct experience with this kind of thing, but I have plenty of clients with shoulder issues, including a variety of different tears.

And yeah, if there is a tear, PT can make things worse. In my experience, it is also possible that you will be able to recover fully without surgical intervention. I've also seen cases where there is a tear but surgery is not recommended. But without imaging, pretty much impossible to know with any certainty what is going in there.
So the best thing is to do nothing? How long a timeframe? Are you in the therapy biz?
 

Preston

Well-known member
And don't go to a PT to get a diagnosis. I once had an injury that, in fairness, was kind of complex and not all that common.. But I went to three different PTs to get different opinions and each and every one came up with a different diagnosis and treated me based on that diagnosis; all very different treatments. They did push me to get tests and imaging done in the meantime to confirm their diagnosis, but I don't know.. that's one of the many things that broke my trust in these guys.
 

Wayward DP

Well-known member
So the best thing is to do nothing? How long a timeframe? Are you in the therapy biz?
I am not in the therapy business or in any way trained medically :p

I mean my personal advice would be if the physio exercises seem to be helping, stick with them. And if not then try to rest the shoulder and avoid doing anything that aggravates it. I'm unsure how easy it is to get an MRI where you are, but I think this should be a priority.

It is possible you have only a small tear. If that is the case, surgery is probably unnecessary, just need to find a good physio who you can work with.
 

WellPlayed

Well-known member
I've been rehabbing my fucked up shoulders lately, and this is what helped. Take this as one guys experience and definitely not medical advice obviously.

Checkout youtube for how to test for shoulder impingement. From what I understand, its possible to have both damaged the rotator cuff AND have impingement, especially if the shoulder is out because that's how badly you've damaged the cuff. Anyway a torn cuff is more serious business. If its only mildly damaged this may still work.

Anyway I believe I had bad impingement from my left shoulder being stuck/rotated forward. Couldn't go to PT. Was painful to do almost everything with my left arm. This lasted a few weeks until I finally found some relief. What helped:

Short-term
Lacrosse ball - youtube this. I recommend Kelly Starrett. But basically the best one that worked for me was arm behind the back (think handcuffs) while laying down on the lacrosse ball on your back. I found a line of muscle running vertically near where the arm meets the shoulder blade that was LOCKED and excruciating. After about 5 minutes of rolling this out, retracting/release the muscle, crying and whimpering etc. I got up and after weeks of pain it was just gone. Allowed my shoulder to roll back to where it was supposed to be. Should also focus on the front (pec minor and delts) to try and unlock these as they could be tight and pulling the shoulder forward.

Relaxed "hangs" like this

There is some ortho surgeon that has a short book on this and made it kind of famous https://www.amazon.ca/Shoulder-Pain-Solution-Prevention-Kirsch/dp/1589096428 . But basically the idea is that we're apes, and apes' shoulders are designed to hang from trees. Except we don't do that anymore. I try to do this everyday now, and it seems to put my shoulders where they belong in the socket.

Long-term
Along with those hangs and lacrosse ball work, if you want to bullet-proof your shoulders, you need to focus on the small muscles that provide exterior rotation of the shoulder, and retraction of the shoulder blades. Everything we do now, especially if you're a desk jockey, rotates the shoulders forward. I had lost the ability to properly retract my shoulder blades. Tons of youtube videos on this, but they're small muscles so we're talking strength-band training mostly. Helps stabilize and keep shoulders where they're supposed to be.
 
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anne25

Active member
I had a shoulder problem were I couldn’t move my arm toward the back (putting on a coat caused extreme pain) or lift it above shoulder height without the pain. At rest it was fine. The advice from my Dr. and physiotherapist was to make sure I used that arm to prevent developing a frozen shoulder. Exercise the shoulder by raising the arm above the shoulder height until the pain becomes uncomfortable and hold for a couple of minutes then lower and repeat. When you have no pain at one level go higher. I use a wall and did what they called walking your fingers up the wall. Make sure you do to the side and the front.

It took about three months to get full range of motion back but I’ve had no problem since.
 
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