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  1. #1
    Yen
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    Rotator cuff injuries: alternative at-home treatments

    It's still raining and I'm on holiday break, and the shopping is done and wrapped ---- So, I Googled "rotator cuff tear" + exercise and found this:
    Aid My Rotator Cuff

    The statements and reviews are impressive. The statement that physiotherapy should begin only when pain subsides, concerns me (my PT began while still in pain, and pain persists). It seems both believable and unbelievable at the same time.

    The heat wrap, cold wrap, and ultrasound tool are an expensive investment (though not nearly as expensive as PT and surgery) but come with a 60-day money back guarantee -- and they can be used over and over again.
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    Yen
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    Sorry to bore everyone else, but thought some of you might find this site interesting too. Some of the text is repetitive but the information appears valid. http://rotator-cuff-therapy-exercises.com/index.html
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    Climbing Above It All BikeWNC's Avatar
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    TheraBands rule. I have 3 different resistance bands tied to the treadmill rail. You can also use light 1lb weights for the internal and external rotation exercises. These will really burn when done right!
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    Don't try to throw a curve ball or a splitter until the pain is completely gone.
    The definition of insanity is doing the same thing over and over and expecting different results.
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    ironically, about 3 weeks into rehab, I started swimming again. It forced my arm up--although at first it was mostly to the side and I swam sort of wobbly. However, the swimming was a great therapy in getting the range of motion back. I had a rotn rotator cuff that was surgically repaired-- this was about 10 years ago or so. I have complete recovery of my motion in the arm--and swim regularly. However, be sure you clear with your doctor. Mine was an athlete, which is something I always look for because they can relate to the need to bike, or swim, or whatever.

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    Lance Legweak HIPCHIP's Avatar
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    Pain free range of motion is what is important. You don't want to go above 90 degrees initially. You'll want to do Wall Walks (taking your fingers and slowly walking them up the wall to help stretch the area). You can also use old tire tubes for resistance, just step back further to increase resistance. Take it easy as the musculature coming from the back to the shoulder passes through a VERY narrow area, so this is why you don't do above 90 degrees. You have to do a shoulder rehab fairly slowly. If you use hand weights, start a no more than 1 lbs, then go to two lbs, etc.

    Take your anti-inflammatory medicines when your exercise is done, and put a baggie of ice on it for 20 minutes then off for at least 40 minutes to allow it to warm up, and you can do this all day to help reduce swelling. If things feel good prior to the workout, take a nice hot shower, or a hot towel and warm up the shoulder for 20 minutes. Do some light, easy stretches, then start your workout. When done, stretch again, then ice. When stretching, find a good stretch and hold it for 30 seconds, relax, then hold for 45 seconds, relax, then hold for 1 minute, then do your ice.

    If you aren't doing it, do pendulum swings: that's where you bend over and let your arm hang, then lightly swing it back and forth 10 times, then side to side 10 times, then back and forth, etc. Finish up with circle left 10 times then 10 times circle right. Later, you can grab light weights and do this. Your physical therapy should have shown you most of these things.

    I wouldn't buy an on-line, inexpensive ultrasound machine. Real ones are not cheap, and there are all different frequency machines, so what you're getting is probably worthless.

    Just go at this slowly. You also have to remember the 90% rule, once everything feels just like it did before, you have full pain free range of motion and your strength feels good, you're at 90%. If you hurt your shoulder at 100%, you'll more than likely blow it back out at 90%, so you need to work for 110%. It's a lot of work, but well worth it in the long run. Modify every exercise to start with, like do wall push ups before you try floor push ups, use no weights, then super light weights before heavy weights, and use less resistance on your bands (old tire tubes) and increase only when things feel good.

    Without seeing and evaluating you, this is just very generic information, but do a search for shoulder rehab programs on line.

    Remember the old joke: Patient: "Doctor! It hurts when I do this!" Doc:" Well, then don't do that!!!"

    PS, I looked at the link you provided. While I didn't read the whole thing, it looks like a giant rip-off. If you want ultra-sound, go see a certified PT. If you are near a college or high school they MAY be nice and if they have an U.S. machine they may do it for you as it only talkes 5 minutes. You might be able to donate something like some towels to the training room in exchange. If you can see a good PT, have them set you up on a program and ask about what you can do at home as you can't afford to come back. They usualy have printouts. You can find all the info on-line searching "Shoulder Rehab" and the only reason for going to the PT is for use of the specific machines you don't have at home.
    Last edited by HIPCHIP; 12-22-10 at 09:54 AM.

  7. #7
    Senior Member retnav94's Avatar
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    he statements and reviews are impressive. The statement that physiotherapy should begin only when pain subsides, concerns me (my PT began while still in pain, and pain persists). It seems both believable and unbelievable at the same time.
    Hmmm, not sure about this. I had my rotator cuff surgery yesterday and the doc specifically insisted I get started on PT tomorrow. I am sure there is going to be large doses of pain involved. Can't wait for that!
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  8. #8
    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by retnav94 View Post
    Hmmm, not sure about this. I had my rotator cuff surgery yesterday and the doc specifically insisted I get started on PT tomorrow. I am sure there is going to be large doses of pain involved. Can't wait for that!
    Your therapy is probably not going to be what you think it is. It will be very light showing you pendulum swings, icing, etc, and evaluating where you are at. With the shoulder you have to be careful to not do too much nor too little, so don't plan on major stuff, just range of motion type of activities and possibly the use of some modalities.

  9. #9
    Yen
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    Wow, thanks for the helpful details.

    The ultrasound device offered at that link isn't (to me) inexpensive; it's a hand-held device and the whole system costs $250.00. The reviews are impressive, and the 60-day money back guarantee makes it worth trying. I tend to be very skeptical about these sites and the products they offer --- however, I also believe there are options out there that actually work. I'm thinking -- what if they're right? My brother is recovering from surgery for a major full-thickness tear along with retracted tendons --- the works, his shoulder was a mess, and the tear couldn't be fixed --- and he might benefit from this as well.

    So far, PT has given me several different exercises, most involving bands, one on a machine, and one on a styrofoam roll. I also do full planks and, a sideways plank (from the knees) if I can tolerate it. The PT says that the ability to do a sideways plank is key to recovery. They haven't shown me the pendulum swing but I remember it from my husband's total shoulder replacement surgery.

    I am anxious about healing as quickly as possible because I'm in training at work on the volunteer Urban Search and Rescue team. At this time, we're learning rescue rappelling and confined-space rescue. Rappelling requires using my arm to brake my descent. I want and need to learn this!

    However, I also understand that these injuries heal slowly, and I should avoid any movements or activities that aggravate or cause pain.

    Quote Originally Posted by HIPCHIP View Post
    Pain free range of motion is what is important. You don't want to go above 90 degrees initially. You'll want to do Wall Walks (taking your fingers and slowly walking them up the wall to help stretch the area). You can also use old tire tubes for resistance, just step back further to increase resistance. Take it easy as the musculature coming from the back to the shoulder passes through a VERY narrow area, so this is why you don't do above 90 degrees. You have to do a shoulder rehab fairly slowly. If you use hand weights, start a no more than 1 lbs, then go to two lbs, etc.

    Take your anti-inflammatory medicines when your exercise is done, and put a baggie of ice on it for 20 minutes then off for at least 40 minutes to allow it to warm up, and you can do this all day to help reduce swelling. If things feel good prior to the workout, take a nice hot shower, or a hot towel and warm up the shoulder for 20 minutes. Do some light, easy stretches, then start your workout. When done, stretch again, then ice. When stretching, find a good stretch and hold it for 30 seconds, relax, then hold for 45 seconds, relax, then hold for 1 minute, then do your ice.

    If you aren't doing it, do pendulum swings: that's where you bend over and let your arm hang, then lightly swing it back and forth 10 times, then side to side 10 times, then back and forth, etc. Finish up with circle left 10 times then 10 times circle right. Later, you can grab light weights and do this. Your physical therapy should have shown you most of these things.

    I wouldn't buy an on-line, inexpensive ultrasound machine. Real ones are not cheap, and there are all different frequency machines, so what you're getting is probably worthless.

    Just go at this slowly. You also have to remember the 90% rule, once everything feels just like it did before, you have full pain free range of motion and your strength feels good, you're at 90%. If you hurt your shoulder at 100%, you'll more than likely blow it back out at 90%, so you need to work for 110%. It's a lot of work, but well worth it in the long run. Modify every exercise to start with, like do wall push ups before you try floor push ups, use no weights, then super light weights before heavy weights, and use less resistance on your bands (old tire tubes) and increase only when things feel good.

    Without seeing and evaluating you, this is just very generic information, but do a search for shoulder rehab programs on line.

    Remember the old joke: Patient: "Doctor! It hurts when I do this!" Doc:" Well, then don't do that!!!"

    PS, I looked at the link you provided. While I didn't read the whole thing, it looks like a giant rip-off. If you want ultra-sound, go see a certified PT. If you are near a college or high school they MAY be nice and if they have an U.S. machine they may do it for you as it only talkes 5 minutes. You might be able to donate something like some towels to the training room in exchange. If you can see a good PT, have them set you up on a program and ask about what you can do at home as you can't afford to come back. They usualy have printouts. You can find all the info on-line searching "Shoulder Rehab" and the only reason for going to the PT is for use of the specific machines you don't have at home.
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  10. #10
    Yen
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    Also... I wonder if there is more damage than the PT suspects, though he strongly suspects a tear and recommended an MRI (I'm still waiting for the call-back from my doc to schedule one). They tell me to NOT do anything that hurts, and use the lightest resistance bands I can use without pain. They seem to know what they're doing and this place treats a lot of athletes. However.... I've noticed more pain since beginning the PT exercises, and I had NO pain while riding the bike until I began PT ---- now, it begins to hurt after about 20 miles.

    My next appointment is this afternoon and I will recommend that I take it easier with the exercises. They've given me 6 so far that I do at home, some with 10 reps. Last night I did half as many reps and felt less strain later.
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  11. #11
    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by Yen View Post
    Also... I wonder if there is more damage than the PT suspects, though he strongly suspects a tear and recommended an MRI (I'm still waiting for the call-back from my doc to schedule one). They tell me to NOT do anything that hurts, and use the lightest resistance bands I can use without pain. They seem to know what they're doing and this place treats a lot of athletes. However.... I've noticed more pain since beginning the PT exercises, and I had NO pain while riding the bike until I began PT ---- now, it begins to hurt after about 20 miles.

    My next appointment is this afternoon and I will recommend that I take it easier with the exercises. They've given me 6 so far that I do at home, some with 10 reps. Last night I did half as many reps and felt less strain later.
    I was a certified athletic trainer (sports medicine), so worked in college training rooms and with lots of orthopedists. A good untra-sound machine costs several thousands of dollars, so something that costs $250 I would be very leery of. The type of ultrasound we use is a deep heating and vibrational massage machine, and is adjustable for each person. If you don't know what you're doing with a professional machine you can actually cause a deep tissue burn, so I'd stay shy of the $250 one.

    I'm surprised they haven't done an MRI yet as that's pretty much the first thing to figure out what exactly is going on. I'm also surprised they haven't shown you the pendulum exercises/stretches yet as that is also one of the first things you do. A good orthopedist, especially a sports orthopedist, will usually have you start a rehab program BEFORE you go in for surgery (depending on the injury, of course).

    You also have to distinguish between pain and soreness, which is not easy to do. If you do anything and you feel a sharp and/or tearing sensation then you want to stop immediately. Any sharp pain is bad, but if it's just a little sore then you should be OK, but your body is telling you to not do too much more. Again, once you are done with your strengthening, even if it's only one rep with a band, do an easy stretch, take your anti-inflammatory (no aspirin as that can cause bleeding) and then do your icing. All this will help. I also had shoulder surgery and it still bugs me, so it may never completely go away, but as long as you strengthen it and stretch it (remember the 90% rule!!!) you should be OK. Same with your husband. Slow, easy buildup in strengthening and stretching. Heat before exercise, ice after. Should get you back on the road. You can always get a stationary trainer for your bicycle and that way you can ride and sit upright so you're not putting pressure on your arm and shoulder and you're still exercising your legs (which is what I need to do this afternoon!).

    Good luck. See what the MRI says, and BUG your orthopedist to find out what you need to do to be active. There is a difference between an orthopedist and a sports orthopedist, same with physical therapists. Also, they will look at you differently if you are a 19 year old athlete than if you are a 40 year old average person, so let them know that you cycle and want to get back ASAP.

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    Yen
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    Hipchip: Thanks so much for the additional information. I'll try to address your points as best as I can.

    Ultrasound: I'll ask the PT today if they offer ultrasound at this facility.

    MRI: I called my doctor again to get an answer about scheduling an MRI before the end of the year (still waiting for the call back). However, today I will ask the PT if he will recommend a sports orthopedist closer to home (mine is on the way to work and not an easy drive on a day off). I strongly suspect that my injury is worse than the ROM tests suggest during the evaluations; almost every exercise I do, they seem surprised if I'm not able to do them without pain, and they work with a lot of other people to give them a basis for comparison.

    Pain vs. soreness: The primary pain I feel is midway between my shoulder and elbow (at the base of the deltoid) and I would describe the pain as sharp. I've been using "mild tearing pain" to describe what I feel. Other smaller pains in the shoulder itself feel like minor tearing sensations. I would describe any of it as dull pain or minor soreness. It seems VERY vulnerable to any activity -- the smallest movements while wrapping gifts, driving (I drive a stick shift). It does not hurt much to sleep on it (the PT says not to anyway).

    Cycling: The PT knows I am a cyclist and I am anxious to start training for upcoming rides next year. At first, he said it might be best not to ride for a few months if riding causes pain. Then, he said if I really want to ride then it will take longer to heal, and that is a trade-off. However, I don't want to forge ahead and cause further damage or delay other activities longer than necessary (e.g. rescue rappelling).
    Last edited by Yen; 12-22-10 at 02:04 PM.
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  13. #13
    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by Yen View Post
    Hipchip: Thanks so much for the additional information. I'll try to address your points as best as I can.

    Ultrasound: I'll ask the PT today if they offer ultrasound at this facility.

    MRI: I called my doctor again to get an answer about scheduling an MRI before the end of the year (still waiting for the call back). However, today I will ask the PT if he will recommend a sports orthopedist closer to home (mine is on the way to work and not an easy drive on a day off). I strongly suspect that my injury is worse than the ROM tests suggest during the evaluations; almost every exercise I do, they seem surprised if I'm not able to do them without pain, and they work with a lot of other people to give them a basis for comparison.

    Pain vs. soreness: The primary pain I feel is midway between my shoulder and elbow (at the base of the deltoid) and I would describe the pain as sharp. I've been using "mild tearing pain" to describe what I feel. Other smaller pains in the shoulder itself feel like minor tearing sensations. I would describe any of it as dull pain or minor soreness. It seems VERY vulnerable to any activity -- the smallest movements while wrapping gifts, driving (I drive a stick shift). It does not hurt much to sleep on it (the PT says not to anyway).

    Cycling: The PT knows I am a cyclist and I am anxious to start training for upcoming rides next year. At first, he said it might be best not to ride for a few months if riding causes pain. Then, he said if I really want to ride then it will take longer to heal, and that is a trade-off. However, I don't want to forge ahead and cause further damage or delay other activities longer than necessary (e.g. rescue rappelling).
    That sounds like a muscle imbalance more than anything. The deltoid inserts at the base of the muscle and goes up towards the shoulder, so if it's going down to the elbow it may be something else. Problem is, there are so many structures in the shoulder area and nerves that can be irritated. Carpel Tunnel, which is in the wrist, can be referred to the shoulder, and even being tested by a neurologist is no guarantee. I had pain in my neck and shoulder. They said it was carpel tunnel, then they said it was thoracic outlet syndrome, then it ended up being a herniated disk in my neck, so it's sometimes really hard to tell. So don't get too frustrated, just keep doing your rehab and keep getting checked and they'll figure out what's wrong. Problem is, the body only has so many symptoms it can use, so they have to figure out which one is what as one set of symptoms could be several different things.

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    Climbing Above It All BikeWNC's Avatar
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    Do you stretch your pectoral muscles? Riding a bike for long distances often in a similar position for long stretches can tighten these muscles and cause the shoulders to roll inwards. That can put traction on other muscles and cause all kinds of spasm. I know I suffer from tight pecs and need to work on getting them to relax or at least back to a more neutral position.
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    Quote Originally Posted by HIPCHIP View Post
    That sounds like a muscle imbalance more than anything. The deltoid inserts at the base of the muscle and goes up towards the shoulder, so if it's going down to the elbow it may be something else. Problem is, there are so many structures in the shoulder area and nerves that can be irritated. Carpel Tunnel, which is in the wrist, can be referred to the shoulder, and even being tested by a neurologist is no guarantee. I had pain in my neck and shoulder. They said it was carpel tunnel, then they said it was thoracic outlet syndrome, then it ended up being a herniated disk in my neck, so it's sometimes really hard to tell. So don't get too frustrated, just keep doing your rehab and keep getting checked and they'll figure out what's wrong. Problem is, the body only has so many symptoms it can use, so they have to figure out which one is what as one set of symptoms could be several different things.
    I probably do have some muscle imbalance. I can't raise my arm to the side or do any external rotation without intense sharp pain; internal rotation is also painful (but less so) with some resistance. Sideways plank (resting on knees) is impossible until I find a good spot, and just getting into that position is painful. I'm not a "pain whimp" but I'm afraid to push things until I know what's going on.
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    Quote Originally Posted by BikeWNC View Post
    Do you stretch your pectoral muscles? Riding a bike for long distances often in a similar position for long stretches can tighten these muscles and cause the shoulders to roll inwards. That can put traction on other muscles and cause all kinds of spasm. I know I suffer from tight pecs and need to work on getting them to relax or at least back to a more neutral position.
    riding a bike, and sitting long hours at the computer at work.... I need to stretch them more. I don't have good posture, so I work on pinching my shoulder blades when I think about it, and I lie on a styrofoam roll to relax my back and force my shoulders back which feels reaeaaaallllllly good.
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    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by BikeWNC View Post
    Do you stretch your pectoral muscles? Riding a bike for long distances often in a similar position for long stretches can tighten these muscles and cause the shoulders to roll inwards. That can put traction on other muscles and cause all kinds of spasm. I know I suffer from tight pecs and need to work on getting them to relax or at least back to a more neutral position.
    Basketball players get the same thing because they are always pushing the ball forward when they pass. They need to stretch the pecs and tighten up the back muscles. If someone looks at you from the side and your shoulders are bent forward then this is a problem.

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    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by Yen View Post
    I probably do have some muscle imbalance. I can't raise my arm to the side or do any external rotation without intense sharp pain; internal rotation is also painful (but less so) with some resistance. Sideways plank (resting on knees) is impossible until I find a good spot, and just getting into that position is painful. I'm not a "pain whimp" but I'm afraid to push things until I know what's going on.
    Again, without examining you in person it's hard to tell, but it sounds like this may be a disk problem. A neck MRI will clear that up quickly. The neck surgery is a pain, but it fixes it. I was able to go back to racing MX after my surgery, then all 5 lumbar disks blew. When the low back is gone, so was the motorcycle riding, but at least I can ride a road bicycle (but not a mountain bike).

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    Quote Originally Posted by Yen View Post
    I probably do have some muscle imbalance. I can't raise my arm to the side or do any external rotation without intense sharp pain; internal rotation is also painful (but less so) with some resistance. Sideways plank (resting on knees) is impossible until I find a good spot, and just getting into that position is painful. I'm not a "pain whimp" but I'm afraid to push things until I know what's going on.
    This is all sounding very familiar. I started to post yesterday, but stopped because I didn't want to be the bad news bear. I went through all the shoulder pain, radiating from the neck, tried PT and so on. The PT was ineffective. According to my Doc, if the PT is going to work, you'll feel some relief almost immediatley, if it isn't going to work, you'll feel worse. I felt worse, more pain, no relief. Because I have a history of neck problems, the Orthopeadist ordered an MRI of my neck. They found nothing ( and that's good). Then they ordered an MRI of the shoulder. THey found a 1/4 inch bone spur that was cutting the muscle every time I lifted my arm. The only option was to operate. I hope this is not happening with you, and I don't want to be the bearer of bad news, but those are the facts regarding my shoulder. Yes, I did the complete rotator cuff operation followed by PT. It turned out pretty good.
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    Yen
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    Quote Originally Posted by HIPCHIP View Post
    Again, without examining you in person it's hard to tell, but it sounds like this may be a disk problem. A neck MRI will clear that up quickly. The neck surgery is a pain, but it fixes it. I was able to go back to racing MX after my surgery, then all 5 lumbar disks blew. When the low back is gone, so was the motorcycle riding, but at least I can ride a road bicycle (but not a mountain bike).
    I appreciate your comments. If this is a disk problem in my neck, then why would the pain be only in the arm and only while using the arm (except for some aches after exercises), but no pain at all when the arm is at rest?
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    Quote Originally Posted by roccobike View Post
    This is all sounding very familiar. I started to post yesterday, but stopped because I didn't want to be the bad news bear. I went through all the shoulder pain, radiating from the neck, tried PT and so on. The PT was ineffective. According to my Doc, if the PT is going to work, you'll feel some relief almost immediatley, if it isn't going to work, you'll feel worse. I felt worse, more pain, no relief. Because I have a history of neck problems, the Orthopeadist ordered an MRI of my neck. They found nothing ( and that's good). Then they ordered an MRI of the shoulder. THey found a 1/4 inch bone spur that was cutting the muscle every time I lifted my arm. The only option was to operate. I hope this is not happening with you, and I don't want to be the bearer of bad news, but those are the facts regarding my shoulder. Yes, I did the complete rotator cuff operation followed by PT. It turned out pretty good.
    I appreciate your input. I'm glad it has turned out well for you. When was your surgery, and do you have 100% use of your arm now?
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    Quote Originally Posted by Yen View Post
    I appreciate your comments. If this is a disk problem in my neck, then why would the pain be only in the arm and only while using the arm (except for some aches after exercises), but no pain at all when the arm is at rest?
    It would depend where the disk is herniated and what nerve it is pushing against. With mine I had severe pain in my deltoids and my arm would go numb when I rode my motorcycle, which is a sign of carpel tunnel or thoracic outlet syndrome, it wasn't until years later they discovered it was a herniated dick and bony protrusions that was causing the problems. The brain doesn't know where the nerve is being irritated, so it interprets it as if it was a normal irritation, when in fact it could be something totally different. That's where the differential diagnosis comes in, weeding out what it isn't so you can figure out what it is.

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    Quote Originally Posted by HIPCHIP View Post
    It would depend where the disk is herniated and what nerve it is pushing against. With mine I had severe pain in my deltoids and my arm would go numb when I rode my motorcycle, which is a sign of carpel tunnel or thoracic outlet syndrome, it wasn't until years later they discovered it was a herniated dick and bony protrusions that was causing the problems. The brain doesn't know where the nerve is being irritated, so it interprets it as if it was a normal irritation, when in fact it could be something totally different. That's where the differential diagnosis comes in, weeding out what it isn't so you can figure out what it is.
    That's interesting... I hope someone else besides me is learning something from this.

    Tonight, at my request, my PT referred me to a sports orthopedist for a second opinion and also to a local facility for an MRI. I'll call both tomorrow to schedule the appointments. There are problems much worse than this.... but..... I am anxious to learn what's going on and get it fixed. I hope to avoid surgery, but willing to do what's best for the best possible results in the long run.
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    Lance Legweak HIPCHIP's Avatar
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    Quote Originally Posted by Yen View Post
    That's interesting... I hope someone else besides me is learning something from this.

    Tonight, at my request, my PT referred me to a sports orthopedist for a second opinion and also to a local facility for an MRI. I'll call both tomorrow to schedule the appointments. There are problems much worse than this.... but..... I am anxious to learn what's going on and get it fixed. I hope to avoid surgery, but willing to do what's best for the best possible results in the long run.
    It's always good to find a sports orthopedist as most orthopedists work with older, more sedentary folks who aren't interested in getting out there and exercising. A sports ortho will push you a little harder with your rehab. I usually recommend contacting the local college or university athletic trainer and find out who they use for the team orthopedist and physical therapist as they are usually more sports oriented. The difference between a sports oriented and non sports oriented is pretty drastic. I.E. If you sprain your ankle most doctors will say stay off of it for three weeks. When you work with an athletic trainer, I'll have you back and walking or running in three weeks. You really get pushed, and the PT is long and tiring, but it will get you back much quicker. Of course I used to work with 19 year olds who were in great shape to begin with, so coming back faster is easier for them.

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    I totally agree. This affliction is relatively minor, but it's enough to disable me from doing some of my favorite activities, especially gardening. I'm an avid gardener and enjoy doing the work myself, including digging large holes in our heavy clay soil, mixing in amendment, hoeing -- the works. I tried digging a small hole a couple of weeks ago, and knew right away it's not something I can do at this time. I want my arm to be 100% again, not just pain-free.

    The sports orthopedist is a shoulder specialist with a focus on sports medicine and a primary research interest in improving the outcomes of rotator cuff repair.
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