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Shoulder injury won't go away, please help!

post #1 of 17
Thread Starter 

Well I hope you guys have time to read this and offer some help or advice.

I am 21 years old.  My right shoulder hasn't been 100% since February when I had an injury snowboarding.  I went over a small
jump and landed badly.  My friends noticed that my injured shoulder was hanging lower than my good shoulder.  I lost my range of motion and couldn't lift my arm very high because of the pain.  I went to the hospital the next day and they took some x-rays to check for a fracture or break, and they said I have a deep bruise contusion, I heard the doc say something about bone separation but the diagnosis was a deep bruise contusion and they told me to rest for 2 weeks with a sling and ice.

A few weeks went by and I started to get my range of motion back, but there was still pain there so I went back for more x-rays to see if it was healing properly.  My doctor ended up telling me I have tendinitis (or inflammation) in my shoulder and I got some anti-inflammatories and was sent to physical therapy (they didn't believe I still had pain and I felt like they were just trying to get me to leave them alone, they were pretty rude about it too).

I already had my range of motion back when I started Physical therapy and when I finished about 5-6 sessions later I didn't feel
like much changed or improved.

***So here I am 6 months later and I am wondering why my shoulder isn't getting any better.  When I get out of bed in the
morning my shoulder is sore from sleeping on my side, it hurts during / after a game of volleyball, and in general feels weak
doing physical labor.  So I was wondering about what's keeping my body from healing completely and when I was getting in the
shower this morning I looked in the mirror and sure enough, my bad arm doesn't look very symmetrical to my good shoulder.  It sort-of droops down instead of being rounded.

Google told me that one of the symptoms of having a dislocated shoulder is "Loss of the normal rounded contour of the deltoid
muscle."  I am going to add a picture at the bottom and I feel it's pretty obvious that there is something out of place there.
It also says, "Patients with a shoulder dislocation are usually in significant pain. They know something is wrong, but may not know they have sustained a shoulder dislocation."

Could my shoulder be dislocated someway, or separated, or something similar; and because the bones or muscle doesn't connect, that's what's keeping me from fully recovering?  When they did an x-ray they checked for fractures or breaks but they never compared it to my good shoulder to see if anything was amiss.

Any help would be greatly appreciated, I don't see how something like a deep bruise or later tendinitis can last 6 months and I
want to get to the bottom of this asap and get my life back!  Should I try to get in with a Orthopedic Surgeon?

PS: If there is a dislocation of the bone, is it too late for them to pop it back? and then let it reheal? What needs to be done?

Thank you!

Viktor

I took some pics, I am standing straight against a wall in a relaxed pose, I just let my arms hang normally.

 

shoulder1.jpg?t=1279157982

 

shoulder2.jpg?t=1279157983

post #2 of 17

Hey Viktor,

 

I suggest you go find a new physiotherapist or better yet, find an athletic therapist. Some manual work on your shoulder is probably required as you probably have a bunch of scar tissue in there - it happens.  You probably also have some weak muscles in there.  Appropriate corrective exercises are key for this.  Again, an athletic therapist can help with that.  

 

A good strength and conditioning specialist can also be very helpful in getting you the right exercises to get the appropriate muscles firing.  

 

Elsbeth  

post #3 of 17

Get better medical attention as evaino suggests. If you can't find it locally, travel, get a plan of treatment from a sports specialist and follow it rigorously at home.

 

Shoulder seps (I've had 3) take a while to heal and it is easy to re-injure them. It has to heal completely before you can use it athletically. One moment of forgetfullness before it is fully healed can send you back to the beginning of recovery. Patience and good therapy and training are essential to get back to 100%. All my shoulder seps were from trauma and apart from re-injury from bike wrecks. Once recovered I was good as new until I wrecked again.

post #4 of 17
Thread Starter 

 

Quote:

 

 

Some manual work on your shoulder is probably required as you probably have a bunch of scar tissue in there - it happens.

 

 

What do you mean by manual work?  Where is the scar tissue supposed to go?

 

 

Could there still be a dislocation or separation?  Does my shoulder need to be reduced or put back into place?

 

My physical therapist gave me a general set of shoulder exercises, should I still opt to see an athletic therapist?

post #5 of 17

You might want to research the differences and similiarities of a dislocated and separated shoulder.  Based on your description you may have symptoms of both (although they are very different) and your doctor should be able to diagnose these from the x-ray.

 

I have personally dislocated my shoulder twice in the past and have recovered fully once and more recently am working towards recovery.

 

The first recovery probably took a full 5 years before the shoulder stopped popping out.  I was always able to pop it back in.

 

The second recovery will likely take longer as I am older now and have obviously re-injured it.  It is possible that it will always be unstable and pop out doing certain activities.

 

Since you are in your 20s full recovery is likely (depending on extent of damage).  Time is of the essence. Take heed of others advice and get that 2nd and 3rd opinion to make sure good recovery practices are started asap.

 

Best of luck. 

post #6 of 17


 

Quote:
Originally Posted by dewood View Post

 

 

What do you mean by manual work?  Where is the scar tissue supposed to go?

 

 

Could there still be a dislocation or separation?  Does my shoulder need to be reduced or put back into place?

 

My physical therapist gave me a general set of shoulder exercises, should I still opt to see an athletic therapist?


By manual work, I mean a therapist who will actually put their hands on you and work at your muscles, fascia, tendons, ligaments etc. Some physio therapists are terrible and all they do is plop a few machines on you, add ice and/or heat, give you a couple of exercises and take your money. Complete waste. Since it sounds like your physical therapist didn't help much, I would assume that the exercises they gave probably weren't worth much either.  Go find a good one who will do a proper assessment, actually work on you, and ideally, also understands exercises so gives you ones that will build local strength in certain muscles but also help you recruit them functionally.

 

The scar tissue could be anywhere and everywhere around your shoulder girdle. Where will depend on what specifically was injured - impossible to say without actually getting hands on and around your shoulder.  Creation of scar tissue is part of the body's natural healing process, but if it's not managed well (by a combination of a good therapist who works on you and proper strength and mobility exercises), then it can cause limitations in strength and mobility.  

 

Could there be a dislocation? Maybe. I would bet it is not. I suspect it just hasn't healed properly.  But I'm not a doctor by any stretch so don't take that as anything other than internet babble. Go see a professional. A good sports medicine doctor would also be a good place to start, and then hopefully they can recommend a good physiotherapist or athletic therapist.

 

Bottom line - your shoulder is not where you want it to be, so go get someone to help you - someone other than the physical therapist you saw before. The internet is not going to give you what you need - you need to go see a pro.

 

Good luck!

Elsbeth

post #7 of 17

 

And... be patient with it. 

 

6 months is a *short* time to rehab one of these.

 

 

 

You don't look like a swimmer, or I'd tell you to stay in the pool until you stop noticing any problem at all.

post #8 of 17
Thread Starter 
Quote:
Originally Posted by evaino View Post


 


By manual work, I mean a therapist who will actually put their hands on you and work at your muscles, fascia, tendons, ligaments etc. Some physio therapists are terrible and all they do is plop a few machines on you, add ice and/or heat, give you a couple of exercises and take your money. Complete waste. Since it sounds like your physical therapist didn't help much, I would assume that the exercises they gave probably weren't worth much either.  Go find a good one who will do a proper assessment, actually work on you, and ideally, also understands exercises so gives you ones that will build local strength in certain muscles but also help you recruit them functionally.

 

The scar tissue could be anywhere and everywhere around your shoulder girdle. Where will depend on what specifically was injured - impossible to say without actually getting hands on and around your shoulder.  Creation of scar tissue is part of the body's natural healing process, but if it's not managed well (by a combination of a good therapist who works on you and proper strength and mobility exercises), then it can cause limitations in strength and mobility.  

 

Could there be a dislocation? Maybe. I would bet it is not. I suspect it just hasn't healed properly.  But I'm not a doctor by any stretch so don't take that as anything other than internet babble. Go see a professional. A good sports medicine doctor would also be a good place to start, and then hopefully they can recommend a good physiotherapist or athletic therapist.

 

Bottom line - your shoulder is not where you want it to be, so go get someone to help you - someone other than the physical therapist you saw before. The internet is not going to give you what you need - you need to go see a pro.

 

Good luck!

Elsbeth


Thank you so much for this.  I will do my best to follow this exactly, greatly appreciated.

 

You were spot on with the physical therapist my doc sent me to.  The exercises he gave me were very plain and had pictures that looked like they were taken 15 years ago.

 

Thanks for everyone's input too, it was helpful, I will check back to see if anyone else has anything to say.

 

comprex: i was just getting into swimming as my primary form of exercise maybe 2 months before I hurt my shoulder.

post #9 of 17
Thread Starter 

Does anyone know if I could possibly be deficient in a certain vitamin or mineral?  I hurt my wrist snowboarding too even before my shoulder and the MRI showed it as a sprain.  I haven't been able to do push ups without pain for the last 7 months (I wear a wrist brace to work). 

post #10 of 17

 

My, you're finding all the spots that are slow to heal, aren't you?  (I'm laughing with you here, not at you).   

 

In your shoes, I'd be looking at improving blood flow to the affected areas, mostly by improving blood flow everywhere, mostly by doing /great unholy gobs/ of aerobic exercise, on the scale of 15-20 hrs per week.

 

If the doc lets you, swimming can be a very useful part of that; you can modify both the catch and the rotation on the crawl stroke to be within the limits of what you can do while exercising the muscle through a large portion of its range.


 

Quote:
Originally Posted by dewood View Post

Does anyone know if I could possibly be deficient in a certain vitamin or mineral?


Unless you're a vegetarian, I doubt it.

post #11 of 17

WHERE are you?  Maybe someone on the board can recommend someone in your area.

post #12 of 17
Thread Starter 
Quote:
Originally Posted by comprex View Post

 

My, you're finding all the spots that are slow to heal, aren't you?  (I'm laughing with you here, not at you).   

 

In your shoes, I'd be looking at improving blood flow to the affected areas, mostly by improving blood flow everywhere, mostly by doing /great unholy gobs/ of aerobic exercise, on the scale of 15-20 hrs per week.

 

If the doc lets you, swimming can be a very useful part of that; you can modify both the catch and the rotation on the crawl stroke to be within the limits of what you can do while exercising the muscle through a large portion of its range.


 


Unless you're a vegetarian, I doubt it.


Thanks, I play a lot of soccer on the weekends but by the end of the game my shoulder is pretty sore.  I will try to get access to a pool again and start swimming as much as I can. 

 

I am in Hagerstown, Maryland area.  Not sure of any sports medicine / therapists here that are any good, I will keep looking though.  Thanks

post #13 of 17

im not a doctor, but I do know shoulder (and knee) injuries range from healable to not so quite healable. A shoulder expert should be able to give you your correct prognosis. The only reason im posting is because I had a pretty bad shoulder ski injury back in March. But here I am 4 months later and 100% recovered and maybe even a bit stronger. Spent a solid month in and out of a sling, lots of ice, and taking about a gram of advil a day (I started this the night of the injury). My arm was pretty much useless. After a month, I started some very very light shoulder exercises and slowly start working in different ranges of motions and weights. It wasnt until a few weeks ago that I was 100% pain free during my heavy lifting workouts and most importantly no muscle pinching feelings. However, I know friends the same age (im 29) who had the same injury yet they feel they never reached 100%. They still have pinching and/or pain. So I kind of consider myself lucky if not overly cautious in my recovery.

post #14 of 17

Dewood, sorry to hear about your injury. Since I am on the the mend from a dislocation I had in February, I feel your pain.

This is the thread I started:http://www.epicski.com/forum/thread/92725/probable-tear-of-labrum-solution-without-surgery 

I had a classic dislocation from my fall - Bankart tear of the labrum caused by the dilocation of the head of the humerus popping out of the glenoid (shoulder joint). Also had partial tear of supraspinatus - one of the ligaments in the shoulder rotator cuff.

Now 5 1/2 months later I am 100% pain free at rest. And no surgery. I did a bit of self directed PT. First order of business was to improve range of motion. I got a cable rig with a pulley that goes over the door jam. Pull on one side of the cable and the injured arm goes up, or to the side, or behind in a passive motion. I also developed a range of motion routine that I do in my car during my 1.25 hour commute to and from work.

After about two months of that with little improvement and direction other than possible surgery, I took things into my own hands and went back into the gym. I have been lifting for 30 years or so (now 54). Just did my same routines but with very light weight. Within a week I had 50% less pain. I have been in the gym five days a week since April. I have regained virtually all my strength and muscle mass. Only problem I still have is with bench press which puts strain on supraspinatus.

I tend to think you did not have a dislocation. You are a young man. Statistically, your chance of redislocating is virtually 90%, even with the slightest activity - like rolling over in bed. The reason is that your young ligaments are very flexible. I had just the opposite problem. My "mature" ligaments are inelastic - and that is where the pain was coming from and why it responded to my lifting routine. Probably had some scar tissue that got busted up with lifting as well.

Can you reach behind your back to tuck in your shirt? Can you reach up over head painfree? If so, not likely a rotator cuff tear either.

Frankly, I would suggest you get an MRI. The shoulder is a very complicated and vulnerable joint. That study is the gold standard for diagnosing pathology there. With those results, you can figure the best course of action. But, at least from my experience, and even after seeing two of the best shoulder docs in my state I only got better when I got proactive and went back in the gym. I do not suggest you run out to your local Golds unless you have that kind of experience because, in your enthusiasm to get better, you could make things worse. But after six months I am nearly 100% better after documented tears from a dislocation. And you are still struggling. And I have more than a few years on you. Get the MRI and then get to a gym with a therapeutic trainer.

Really hope this helps. Know what you are going through.

David

post #15 of 17

totally feel your pain

take a look at my video

 

 

http://www.youtube.com/watch?v=NS4gpRUdTok

 

Definately go to physiotherapist they can do wonders

post #16 of 17

I believe the medical term for that condition is called Bum Shoulder.  wink.gif

 

My right sholder hasn't bee the same since 1975.  

 

Physiotherepy helps.  It will never be completely better.  Exercise will help keep it strong help you do what you need to do.

 

I personally recommend 16 year old scotch.

post #17 of 17

A little late, but did you find a solution to your shoulder problem?

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