Shoulder Rotator Cuff Injury

[Waynester]

I injured my right shoulder 15 years ago in the Police, the pain has worsened over the years with it now being constant. I had a steroid injection 6 months ago which really helped but my GP won't perform another...something about the steroid causing degradation to the cartilage?

I have a referral for a scan, physio etc.. I just wondered if anyone else has had similar, how treatable is it, & how quickly was the recovery? I have been training regularly down the gym, and swimming lots..which I know is aggravating it. I have made good gains in the gym..so having to stop and rest the shoulder is frustrating!

[Waynester]

Thanks for the advice chaps, common sense has prevailed and I have eased back on the weight and the exercises that aggravate the condition until I have had it scanned. As I said, it's just frustrating.

I do always warm up thoroughly though and strangely enough during my workouts there is very little pain, it's when I stop that I pay for it. Night times are the worst, I can't sleep on my right side at all now.

I will update once a professional has assessed my shoulder.

[Waynester]

MurderousCrow said:

OP - glad you're going to get it assessed. Clinical tests such as MRI can reveal a lot and can inform and guide treatment, even so I'd emphasise the value of a good sports physiotherapist in any treatment pathway. In my opinion it's worthwhile seeking out (and likely paying for) a reputable practitioner, and following their complete treatment plan to the letter before looking into any further interventions. Many rotator cuff injuries can be rehabilitated successfully with a targeted strengthening regime along with appropriate mobility / soft tissue interventions. Regardless of whether this service is paid for by you or not, you must establish with your medical provider / therapist that your aim is not 'good enough' treatment... you actively want full restoration of function to allow you to improve (and not just maintain) your physical well-being. A sports physio will understand this imperative, and may be able to offer alternative exercises, potentially allowing you to maintain your hard-won gains.

Thanks MC, that's exactly what I'm looking for...good enough is not 'good enough' I want to be able to continue training at the same if not a higher level, but not at the expense of further injury of course. I think I'm being referred to a specialist physio dept for assessment and MRI scan, so I'll know more then and can discuss with the therapist.
Thanks again for the advice, much appreciated.

[Waynester]

Chris Stott said:

I'd strongly advise you push for an MRI ASAP... shoulder pain isn't always as simple as a bit of ligament inflammation.

I suffered from a slight pain in my shoulder for a year or so that eventually became so bad I was only getting 2-3 hours sleep a night. Eventually went to the doctors, and although he wanted to give me a cortisone injection, he agreed to refer me when I told him I had private health cover with work.

Went to the referral, and the specialist sent me for an MRI. As well as the usual rotator cuff junk that needed clearing out, the MRI also showed up an almost severed tendon, which if I hadn't had fixed, would have snapped and caused all sorts of problems. I was in for surgery less than 2 weeks after my 1st doctors appointment.

Recovery for me was a month with my shoulder fully immobilized, followed by 6 months of physio. Took well over a year to get the full range of movement back, but it's tip top now.

Edited by Chris Stott on Sunday 21st June 19:11

The 'almost severed tendon' sounds a bit scary! Really hoping I haven't done anything quite so bad to my shoulder, but I am worried as the pain has become constant. There is no comfortable position for my arm, and at its worst the pain radiates down my arm. Not a good sign. Night times are as you described..disturbing. I'm fed up with it tbh, the sooner I get it checked..the better!

[Waynester]

craig1912 said:

Had a problem with mine for over 12 months. Specialist said I didn't need a scan as he knew want was wrong with it. I have had 30+ sessions of Physio and whilst it has improved I am still unhappy. I insisted on an MRI scan which I had a couple of weeks ago and will see the specialist next week. Very frustrating as I haven't been able to do a lot of stuff and my are shoulder feels weak and occasionally painful.

I'm surprised they didn't want to perform the scan..I think like you, I would prefer they didn't assume, and checked it for sure with the scan!

[Waynester]

MurderousCrow said:

OP - don't panic yet. Nothing can be excluded at this stage without a. a full clinical assessment by an experienced professional and b. possible further investigations e.g. MRI. MRI is arguably the most reliable test for diagnosing both complete and partial ruptures of the rotator cuff. Even so a known disadvantage is highlighting seeming abnormalities which in fact have a very limited effect: don't be disheartened if your MRI results seem terrible (e.g. degenerative changes, wasting etc.), as working with and restoring your real-world functional capability is the most important factor.

MRI can help to establish candidacy for surgical interventions, but I'd stress that most chronic (and many acute) shoulder injuries can be successfully managed conservatively with rest, ice, NSAIDs and a targeted rehabilitation program once pain is controlled. Bear in mind on the basis of probability you're unlikely to have a ticking time bomb in there. NICE recommends referral to orthopaedics on the basis of a number of different criteria - which you may fulfill. Even so in the absence of red flag signs (including those pointing toward an acute rotator cuff tear as opposed to an impingement syndrome) it is likely your care providers will try conservative management and physiotherapy first. Generally, if this is not making headway within three months or so, further interventions such as surgery may be warranted.

Every case of painful shoulder is different - there's little value in comparing yourself to others, even those with similar symptoms. Be positive and determined in your approach to getting better, and comply as best as you can with the recommendations made. If the therapy prescribed is unsuccessful you are then in a strong position to demand further investigations / interventions - or look elsewhere.

HTH,

Luke

Thanks for the advice and reassurance Luke, much appreciated. I'm keen to get it looked at as soon as possible, but being NHS it may take a while. Im hoping it's something that can resolved through physio alone.

[Waynester]

SHutchinson said:

Just out of interest, what type of exercise have you been doing?

Usual gym work, free weights/cable..bench press, incline D/B press, flys etc.. But since the pain has increased I have been trying to swim more than lift, mainly breast stroke as the front crawl hurts like hell. I think now though, until I get my shoulder checked out I need to avoid the weights.

[Waynester]

Quick update on this thread.

Had my first physio appointment today for my right shoulder/rotator cuff pain. After examination and some basic exercises it seems my shoulder blade/back muscle area are not doing very much work when I lift my arms above my head. Seems that my pec muscles are over compensating and therefore pulling my shoulders forward which is stressing the joint. Apparently.

So I have been given some specific exercises to do 3 x per day, with a follow appointment in 2 weeks time. I'm quite pleased with this as it sounds like something that can be relatively easily corrected through physio.

[Waynester]

Thanks, I will do.

Will update progress in 2 weeks time.

[Waynester]

andycambo said:

Waynester said:

Had my first physio appointment today for my right shoulder/rotator cuff pain. After examination and some basic exercises it seems my shoulder blade/back muscle area are not doing very much work when I lift my arms above my head.

After having 6 weeks worth of aching / pain with my shoulder and back after falling over when spraining my ankle when running I eventually went to see the doctor who told me to go and see another doctor who is more of an expert in joints and muscles...

There was a two week period I had to wait so in the meantime I went to see a Chiropractor to see if they could help. They've been great and told me something very similar to what you've mentioned and now I'm more aware about what my body is actually doing, it's pretty bad!

After getting another appointment last Monday I saw the doctor and gave me a Cortisone injection and told me to continue with the Chiropractor and rest saying it could be months till the pain goes away - gutted.

Anyway, if you get the chance could you share some of the simple exercises? I hope you get better soon!

Unfortunately it does seem to take time to recover, the physio exercises are helping I think...but the pain seems to fluctuate.
I'm finding it hard to sleep on my right side which is annoying as it's my preferred position.
I also had to reschedule my physio appt as I forgot my car was in for a service/mot yesterday. Appointment is now next week, so I will update with what the Physio therapist suggests next.

Here's the exercise sheet I was given.