Rotator cuff tendinitis
 

I hope this isn't too OT, but this is related my ability to alert riders behind me about debris on the road.:p

About a month ago I was diagnosed with rotator cuff tendinitis/tendonitis (spelling varies) in my right (dominant) arm. The pain feels like a very bad bruise, right at the base of my deltoid muscle about halfway between my shoulder and elbow. The pain started out of the blue when I raised my arm to get something. It has not improved, and in fact has spread a little to include "twinges" of pain above and below the original site.

The doc (an excellent orthopedic surgeon who did both of Hubby's shoulder replacements) told me to take 2 Advil 2x/day and avoid any activity that causes pain. I took the Advil for about a week, then stopped because I felt no relief. I have a very conservative view of taking meds and prefer not taking such large doses for very long, so I started taking 1 or 2 a day. Still no relief, so I started ice packs which do help but it's hard to keep an ice pack on my arm every hour while at work.

Since this is common in 50+ folks, I'm wondering if anyone has experience with this and can offer any advice with respect to where to best seek treatment --- e.g. orthopedic doc vs. physiotherapist --- and how long it took to heal.

Some years ago I played tennis 2-4 times a week and competed in local tournaments on weekends. As a consequence of many hours practicing the serve I developed a very sore shoulder that plagued me for about a year. On a visit to a chiropractor for a sore lower back, I mentioned to him about the sore shoulder. This guy was also a body builder with, I assume, an extraordinary interest in anatomy. He gave me a series of two exercised and to my amazement, the soreness was gone in a few days and never came while continuing to play and compete. My suggestion is to find health care people who are also athletes. Maybe even find the tennis pro at several local clubs and ask if they can recommend someone a physiotherapist .

From my experience I would get myself over to a Good Physical Therapist. It is amazing what a PT can do to restore function by using their tools and giving you instruction on proper exercise. Also, I would get a second opinion from another orthopod. Even the best don't always have the correct answer. Ask the second opinion person to show you the pictures and explain things to you.

Sometimes my rehab has taken a few weeks and sometime a couple months. But, self-education and PT has always solved the problem so far.

Yen, I have the same thing. My doctor taught me some simple exercises using resistance bands that help strengthen the surrounding muscles to ease the discomfort. They work well, but if you lay off them for any period of time, the pain comes back.:(

+1

I went from PAIN and poor function to the bands and then to doing lots of shoulder and upper body exercises with free weights and no pain. But, if I lay off for any period of time I go backwards very quickly. Since I cycle now and don't have the need for much strength I've scaled back to 25-40 pound free weigts for flys, extension, military presses, curls etc. Your PT will show you.

But it is a permanent life style change if you want to maintain.

I've had it twice, once from racquetball, the other from crashing on my mountain bike.

Physical therapy helped a lot. Each time it took about two years for it to clear up. YMMV.

Rotator cuff tendinitis

"I hope this isn't too OT, but this is related my ability to alert riders behind me about debris on the road."

I don't get it. How are these related?

Good question. :) The doctor said "I don't want you to raise your arm out like this." (while lifting his arm out to the side). I sometimes do that to point out debris to the right of me in the road, and that hurts. Or lifting my bike into the truck -- that hurts.

Thanks everyone. I think I will seek a physiotherapist or PT. I believe in PT, it works (if done right).

I'd been working out at the gym for the past several months doing upper/lower body workouts 2x/week, in addition to cycling and other cardio work. I had 12 sessions with a trainer who is a retired PT. I might have done too much, too soon, but nothing hurt and I was feeling great, getting stronger, seeing the muscles shaping up. The rotator cuff is not a muscle group to reckon with, and I want this to heal.

At work I am in training on the Urban Search and Rescue (USAR) team. Currently we're learning rescue rappelling, which sometimes requires pulling hard on the rope to brake my descent. If my arm doesn't heal, I may not be able to do this at all.:(

About 2 months ago my bike slid out from under me on a hairpin turn. Wet ground, debris. Anyway my shoulder has ached badly since. Ortho Doc was going to give me a shot but sent me for an MRI and said most likely surgery was needed. Still need the MRI, first time around I was too fidgety and the nurse said I need to return with a sedative. :) Not looking forward to the MRI or the surgery but need to take care of this. It does start to ache when I ride for more than an hour. I also don't dare go off road. Every time I go around that corner now I take it at a crawl...I am such a baby. You may want a second opinion from another ortho doc.

I had one shoulder repaired from a tear and the other has impingment that caused me to quit climbing. I've been to PT for rehab after the surgery and several times for the impingement(the real fix is surgery on that shoulder too). A good therapist will get you to the point were you are no longer in pain but if you are prone to it, as you probably will be now, you should do regular exercises.
Download this book and follow the exercise program. Almost every exercise that the PT will have you do which doesn't require some special machine are in this book
http://www.irongarmx.net/Articles/7_...f_solution.pdf

I've suffered through a few bouts of tendonitis, both shoulder and elbow (not simultaneously).

My Doc explained it like this:
*We injure (inflame) the tissue somehow,
*Eventually the inflamation progresses to the point that we notice it (our individual pain threshold),
*We treat the inflamation..Ibuprofin in my case...for a prescribed period of time,
*Eventually the Ibuprofin stops the progression of the inflamation and the pain decreases, and then goes away completely.
*He insisted I continue to treat the inflamation for the prescribed time period as the injury will not be resolved at the point where the pain ceases.
* Preventitive activities then follow.

I chose the Ibuprofin route. It generally takes a couple of weeks and I'm good to go.

It's right for me though it's not the only route to take, for sure. Here's hoping that you are comfortable and on the mend soon.

About 9 months for mine to clear up..Now, when I do my daily exercises, every other day, I do specific exercises to strengthen the muscles around the rotater cup.. that is a delicate place to get out of whack, and just The Weak Link has stated, and I concur, the rotator cup takes it own time healing...

Wish the OP a speedy recovery...

A lot of docs really don't understand what a PT does, how they can diagnose an injury and how much it can help - even orthopods. Find yourself a good physical therapist - they vary in quality and training, also.

Good luck.

My doc told me to take the NSAID's and ice for about an hour twice a day if possible for two weeks and when the imflamation went away to use heat for a couple of weeks to help relax the tension on the tendons. This was for an elbow tendintis but it will work for shoulders too since I have tendonitis in both shoulders I have used this method on them. Time will help and strengthening the muscle group around the affected area and it sounds like you are on the right track. Good luck/

I got taken out by two low water crossings in a span of 3 miles in the spring of 2010. Yep! Went down in both of them! (fool me once. . .) Anyway, after the thigh bruise healed, the shoulder started. What I thought was a torn rotator cuff turned out to be just a strained one, but still in PT after 3 months. It gets better then worse, but I keep on riding, which probably isn't the best for it, since lots of weight rests on my arms. Keep on doing PT! I had the impingment surgery on my other shoulder and it worked fine. But I don't treasure the idea of doing it again, or laying off the bike. So its' PT (and Advil, or Motrin, or Aspirin) for me!

Thanks, Everyone. I'm considering whether to cancel my next appt. with the ortho doc next week and find a PT, or postpone the appt. to give it more time. I don't want to go back and say I didn't take the Advil. Got a new ice pack today --- it's a gel pack that wraps around the extremity, and stays put with a strap that wraps around it. Now I have an ice pack that will actually stay on my arm so I can work with both hands!

It's a little discouraging to see the comments about long recovery and recurrence without continuing the exercises.... hopefully, I did not wait too long before seeking treatment.

Fortunately, it doesn't hurt a bit to ride, or climb. :thumb:

Coincidentally, in the same week I got the diagnosis my brother had surgery on his left shoulder to replace a full-thickness RC tear, remove bone spurs, repair what could be fixed of severe tendinosis, and reattach a retracted tendon. His injury was much more severe. He's in good shape and has been working out for years, and is no newbie to the gym. I wonder if he and I share a genetic weakness in this area.

I have a rotator cuff tear. I don't know whether they can rule out a tear without a specialized type of ultrasound, but the treatment might be the same as for tendinitis. Anyway, I got the tear a year ago from lifting my suitcase into the overhead bin on a train. It was not a particularly heavy suitcase and I would think my upper body strength was perhaps the best it has ever been because I was going to the gym and had a personal trainer. I was told it was a partial tear but significant, though not enough to warrant surgery. I am free of pain and have almost complete freedom of movement because of the physiotherapy I have been doing. I will have this tear for the rest of my life.

I am told to not do any heavy work over my head. I also no longer do any weight training that requires me to push up with my arms. So much for being in the best upper-body strength of my life.

I wouldn't get discouraged until you know for sure the issue will be difficult to deal with. Some skeletal joints are complex. Ball and socket joints such as hips and shoulders have numerous layers of criss-crossing muscles and tendons to make possible rotary motions. Some of these muscles are very weak because they are seldom used. This weakness was evident to me by the very light weights (3 lbs.) prescribed to me for the exercises and the unusual position needed to work the effected muscles. As I said, tendonitis for me cleared up in days and it may well be the same for you.

Just be sure your pain is not due to a bone spur. If it is, the only corrective action that works is surgery to remove the spur. It's a very painful operation, but very effective.

+1 on the PT thing,I had the same problem, and the trainer at the gym gave me some very simple exercises to do 3 or 4 times a week, I went from not being able to lift my arms to normal in a couple months, I stopped after a while, for 5 or 6 months, and it came back, started again, and few weeks later ,gone again...Have not stopped since....
Bud

I can't comment on shoulder surgery but an MRI is trivial, non-invasive, and painless. It is noisy and time-consuming (a.k.a. semi-boring) but not otherwise hard. If a doc prescribed one then it is probably worth doing. It lets you and the doc know the extent of any real injury as compared to irritation that can be made to go away eventually.

Great conversation. It's clear that as we age, most of us need to do complimentary exercises in order to maintain the muscles, tendons, joints... that we stress during activity. Some of these are reasonably simple to figure out, riders need to work on hamstrings as peddling doesn't develop the back of the leg and all should be in balance. This discussion of shoulder and elbow problems is a great example.
Anyone know of a good book or program for bikers or anyone who wants to stay in overall good shape?
Anybody want to write one?

I'm a believer in good PT, and you've convinced me even more. I called my gym trainer (a retired PT) to ask for a referral, preferably a sports PT. Our gym (actually, a community center with a gym and much more) has an associated PT department. I will postpone next week's follow-up appt. with the ortho doc and see if this is any better in a couple of weeks... I don't want to see him next Tuesday and say it's worse and I've not been taking the Advil as often as he recommended.:o

I am very encouraged by the reports here about exercise being key to recovery. I'm already motivated (was already doing that when the pain started).

Glad I started this conversation -- I appreciate all the advice/comments so far, and I hope it benefits someone else.

Agreed, however, one nasty little issue....Claustrophobia! Don't remember it being an issue when I was young but all of a sudden I can't stay still. I think it is more a problem with immobility than confined space. I will get over it.