Fucked up shoulder

[Dantheman]

Great news. I can't load yet but ROM is great, 180* extension. 8.5 weeks out.

[ghwbuush]

My shoulder is fucked.

It was completely fine. I was driving an old farm truck that doesn't have power steering and it felt like a sharp cramp and then heat radiating through my shoulder and down my arm. My bicep was hot and hard. Most of the pain is in my upper arm, but also shoulder blade, and top of shoulder. This happened in June. Initially, pain was pretty bad and I had very limited motion. The PT could move my arm a lot more than I could on my own but it was super painful. The pain down my arm seemed to follow a rotator cuff injury symptoms according to internet research and PT.

The first ortho said I have frozen shoulder and the stuff on the MRI is subclinical. The PT did not think it was frozen shoulder but felt like it didn't really matter at that point what the ortho thought, it would heal.

I had a cortisone injection and helped a ton, and my shoulder continued to improve until about August. Range of motion as far as lifting my arm up ranges from 140-170 depending on the day and how long its been since the PT has worked on it. I can get it higher if I use a wall to push it up or if I have a loop of band around my wrists and press out, which I guess activates some muscle and makes the supraspinatus not have to work as hard or something. Pain had mostly subsided except when I reached too far or something, but has started to come back even at rest, sometimes throbbing.

They did a second injection 2 months later and I don't think it helped much. The first ortho wants to do one more injection and then manual manipulation under anesthesia if its not better after the third injection. That scares me because the pain is more of an issue than the range of motion at this point.

PT still isn't sold on frozen shoulder because the range of motion isn't that bad. I mean, I could live with the current range of motion, its the pain I cant deal with.

I've been doing PT two times a week and medical massage most weeks.

I wanted a second opinion and the second dr also thinks frozen shoulder but he wrote a bunch of stuff that wasn't on the MRI and some other wrong stuff like he asked if I could sleep on it, and I said I can now, but it was terrible when I first injured it. He just wrote that I said it was super painful to sleep on.

He also said that my other shoulder is frozen. I've never injured my other shoulder and it has never hurt. I'm not very flexible and I have never been and I don't think there is anything wrong with my other shoulder.

he wrote this in his notes...

Exam:
Skin: clean dry intact
Vascular: radial and ulnar pulses intact
Neuro: axillary, radial, ulnar, median intact
Wrist and elbow: have full arc of motion without pain.
The shoulder: has decreased range of motion with limited active and passive range of motion in elevation and abduction due to pain and stiffness. Hawkins' maneuver is positive, cross arm is positive, lift-off is negative. O'brien test is also negative.

Xray shows moderate degenerative changes of the AC joint without high riding of the humeral head.

MRI reveals degenerative changes of the AC joint. Bicep tendon, rotator cuff mild tendonopathy, labrum intact . Decreased caupsular space.

Impression:
1. Adhesive capsulitis right shoulderexacerbated by work injury turning a steering wheel..
2. AC arthritismild


it seems like the imaging doesn't support what he is saying, and hes saying I had frozen shoulder before my injury. My shoulder was 100% fine before I turned that steering wheel wrong or whatever did this.

Im really tired of this and I want my life back.. I can't ride my bike, I can't cast. I cant row my boat. I can play electric guitar but not my acoustic. It sucks. advice?



Ive had an ultrasound, Xray and MRI

RIGHT SHOULDER ULTRASOUND COMPLETEClinical: Pain in right shoulder.Comparison:=========No priors.Shoulder:=========Biceps tendon: Normal intact.Supraspinatus: Heterogeneous. No measurable full-thickness tear.Infraspinatus: Normal intact.Subscapularis: Difficult to see given patients inability to externally rotate.Bursa: Normal.Bone: Mildly irregular.Muscle/Subcutaneous tissue: Normal.Joint: No joint effusion.Impression:=========No rotator cuff tear.

SHOULDER RIGHT 2 VIEWS OR MORE X-RAYClinical: Strain of right shoulder, subsequent encounter.Procedure: Shoulder Right 2 Views or MoreComparison: No prior exam.Findings: No acute bony abnormality.Normal AC joint.Normal glenohumeral joint.No findings of calcific tendinopathy of the rotator cuff.IMPRESSION:Normal radiographs of the right shoulder.

MRI SHOULDER ARTHROGRAM RIGHTClinical: Persistent pain, decreased range of motion, positive drop arm and empty cantests. Evaluate for supraspinatus injury vs. labral tear.Comparison: Ultrasound 5/30/2024, radiographs 6/4/2024.Procedure: Standard MRI sequences were performed with intra-articular contrast.Findings:Glenohumeral alignment: Normal.Humeral head morphology: Normal.Background marrow signal intensity: Normal.No acute fracture.Intra-articular gadolinium present throughout the glenohumeral joint.Biceps anchor: Intact.Biceps tendon: Mild thickening of the intra-articular portion of the long head ofbiceps tendon. No tear. No displacement from the bicipital groove.Glenoid labrum: No labral tear identified given non-arthrographic limitations of thisexam. No paralabral cyst.Glenohumeral cartilage: Normal. No defects, osteophytes or subchondral edema. Noloose osteochrondral body in the joint.Rotator cuff: No full-thickness rotator cuff tear. There is partial-thickness distaltearing of the supraspinatus tendon anterior fibers at the insertion measuring 6 mmin AP dimension within the mid substance of the tendon on series 9 image 11. There isno high-grade partial-thickness tear. There is supraspinatus tendinosis scatteredelsewhere with ill-defined increased intrasubstance signal intensity and mildthickening. The infraspinatus and subscapularis tendons are normal.Acromioclavicular joint: Normal alignment. No significant osteoarthritis with nosignificant osteophyte formation. No os acromiale. No subacromial enthesophyte.Muscles of the rotator cuff: Normal signal intensity. No significant atrophy.Other: Normal distention of the glenohumeral joint. There is some edema withoutthickening at the inferior glenohumeral ligaments. The subcoracoid fat is maintainedwithout effacement.Subdeltoid/subacromial bursa: Trace fluid present.Impression:1. Mild tendinosis and partial-thickness tearing of the supraspinatus tendon greatestat the anterior insertional fibers. No high-grade partial-thickness or full-thicknessrotator cuff tear.2. Mild tendinosis of the intra-articular portion of the long head of biceps tendon.3. Some nonspecific edema adjacent to the inferior joint capsule at the inferiorglenohumeral ligaments without thickening. No additional radiographic signs ofadhesive capsulitis. Appropriate distention of the glenohumeral joint with contrastinjection.

[XXX-er]

I had frozen shoulder so if i lifted my arm straight out to the side from my body at about 45 degrees the entire shoulder joint would lock and to raise the arm any further the entire joint would move if that makes any sense.

it was painful and kept me awake at night , a sport med person said " come back when it unfreezes " but I wanted to do something so i went to a traditional chinese acupuncturist who would stick me with 20 needles all up and down from my my hand to into my hairline and leave in for 45 minutes ( also hooked up to tens ) and that temporarily got things moving, it helped to free up the joint somewhat so I did 14 treatments but I would say acupuncture quit having any effect after about 10 treatments

So really it just took time, the shoulder slowly got better and was 95% at about 2 yrs, so no surgery or anything but the tincture of time, I usually hear about a shoulder getting loose and needing surgery but this seems like the exact opposite

I would say what caused my problem was overuse & getting back into paddling after a marriage induced layoff, also leaning on crutches which can really fuck you up

I don't hear of many cases of frozen shoulder the pro's called it encapsulated shoulder,

[ghwbuush]

Mine stops moving but it can be painfully forced further and that point changes based on the day, how long since the pt has worked on it and unknown reasons.

mine is also not nearly that limited. Even right after my injury I could lift it way more than 45 degrees.

Pt says he’s never seen frozen shoulder diagnosed with someone with as much range of motion as me.

i don’t think I can handle just waiting. Ugg.

[XXX-er]

well yeah thats why I tried the chinese acupuncture dude, after buddy stuck me with the pins I would get another 10 degree of motion out to the side but the next day it was back to where it started from

So the shoulder is OK now, that was maybe 25 yrs ago, I probably could have just waited the 2 yrs and had the same outcome but you don't know what you don't know

in any case thats how it went for me so good luck eh !

[ghwbuush]

I’m frustrated that the Physical therapist said he doesn’t think it’s frozen. I feel like he should have had a discussion with the ortho doctor and then came to an agreement or suggested I go to another doctor. He told me it didn’t really matter… but I can’t stop stressing over it.

[Dantheman]

[SIZE=4][FONT=times new roman]My shoulder is fucked.

It was completely fine. I was driving an old farm truck that doesn't have power steering and it felt like a sharp cramp and then heat radiating through my shoulder and down my arm. My bicep was hot and hard. Most of the pain is in my upper arm, but also shoulder blade, and top of shoulder. This happened in June. Initially, pain was pretty bad and I had very limited motion. The PT could move my arm a lot more than I could on my own but it was super painful. The pain down my arm seemed to follow a rotator cuff injury symptoms according to internet research and PT.

Honestly, I think you need a cervical MRI. Cervical nerve issues can manifest as shoulder pain. The radiating pain and sensation down your arm is a classic symptom of this, especially when backed up by the sudden onset and negative imaging results for your shoulder.

I am not a doctor, but I have heard a top shoulder ortho talk extensively about how it's very common for cervical injury to be misdiagnosed as a shoulder problem. You should definitely get your neck checked to at least rule this out.

[Dantheman]

Go to 1:16:54

[ghwbuush]

The pt has worked on my upper back and muscles along the spine and has mentioned that maybe some of the cause.

when I first injured it the pt has this picture that showed there rotator cuff issues hurt along the arm and it exactly where my pain was.. like that spot on the outside of the elbow.

also when it was really bad it was like my skin was burning. Not like super painful, just a little bit.

now sometimes my arm pain goes to my thumb. It kind of moves around, though.

im super frustrated and will suggest this.

thanks.

[californiagrown]

The pt has worked on my upper back and muscles along the spine and has mentioned that maybe some of the cause.

when I first injured it the pt has this picture that showed there rotator cuff issues hurt along the arm and it exactly where my pain was.. like that spot on the outside of the elbow.

also when it was really bad it was like my skin was burning. Not like super painful, just a little bit.

now sometimes my arm pain goes to my thumb. It kind of moves around, though.

im super frustrated and will suggest this.

thanks.

I think Dan may be on to something. Given you description of initial symptoms being spasm/cramp of you bicep, and then radiating heat/burning down to your elbow (but bicep tendon is totally fine), and now symptoms showing up mostly in your shoulder, it seems like it could be nerve related.

My $0.02 is to not accept a diagnoses from your Dr that doesnt seem to fit, and isnt improving your condition. If you have good insurance, keep searching out 2nd/3rd/4th/5th opinions and make sure they know the full history of the injury, what previous doctors have said, what treatments have worked and what hasnt.

[ghwbuush]

I think Dan may be on to something. Given you description of initial symptoms being spasm/cramp of you bicep, and then radiating heat/burning down to your elbow (but bicep tendon is totally fine), and now symptoms showing up mostly in your shoulder, it seems like it could be nerve related.

My $0.02 is to not accept a diagnoses from your Dr that doesnt seem to fit, and isnt improving your condition. If you have good insurance, keep searching out 2nd/3rd/4th/5th opinions and make sure they know the full history of the injury, what previous doctors have said, what treatments have worked and what hasnt.

the initial pain/cramp/spasm was in my shoulder but residual pain is in the bicep, and there is some fraying or whatever they call it in the bicep tendon.

[Dantheman]

Pain all the way down to your thumb just screams nerve issue to me, but again IANAD.

The other possibility here is that your initial injury is healed but you're still in pain. This may sound slightly nuts but it's very much a thing. Pain is complex and it's entirely possible to have pain without injury and, conversely, injury without pain. If you randomly MRI people over 40 a huge number of them will have asymptomatic bulged discs, rotator cuff tears, moderate OA, etc.

If you have been injured, it's possible for your nervous system to remain sensitized and continue to experience pain after the injury has healed. Look up the biopsychosocial model of pain.

Also, you said you're seeing a PT twice a week, but are you doing a home program the other five days? If not, you need to start immediately. PT works when it's a daily grind, especially with something as ambiguous as frozen shoulder.

[californiagrown]

the initial pain/cramp/spasm was in my shoulder but residual pain is in the bicep, and there is some fraying or whatever they call it in the bicep tendon.

I am not a doctor, and dont have any experience with frozen shoulder. I would highly reccomend that you keep seeking out 2nd/3rd/4th opinions on the shoulder until you get a doctor who presents a diagnoses and treatment plan you are both confident in. And then go whole-hog on that treatment plan. Shoulders are poorly designed stupid fucking joints that are incredibly fragile but also subject to immense loading and torque from 360 degrees in 3D, heal slowly/poorly, and are the least understood major joint by medical science. They are not straight forward, and 4 months is not that much time to diagnose, treat/rehab/ and then heal an injury to the joint. As frustrating at it may be, if you arent happy with the ortho's disagnosis and treatment plan, go find another.



Speaking of frustrating, i went to my first PT appointment today and was basically told there isnt anything for them or myself to do. I am hypermobile, and so im already hitting or exceeding all ROM benchmarks, and im not allowed to do any loading or strengthening for another 2 months while the labrum and biceps tendon heal... so i was basically told to keep ROM where its at and to not push it right now to avoid ending up with a loose shoulder again... and to not do much else. It makes sense that i have to let the stuff heal before i start loading and strengthening (its been less than 2 weeks since surgery), but its really frustrating to not have a new goal to be actively pushing for once i've achieved the ROM goal. Ugh.

[Dantheman]

Flip your script. You're doing great, be happy about it.

[ghwbuush]

I saw the first ortho doctor again and he now says my shoulder is definitely not frozen anymore, thinks maybe I have a slap tear (nothing pointed to that on the MRI as far as I know) but also wants to look into cervical spine possibilities, too, but I have to wait for an IME before anything more can happen and I only have one PT appointment left and they will not allow more at this point.

I'm very tired of this. I feel like I'm just going to be like this forever and this sucks.

[Dantheman]

thinks maybe I have a slap tear (nothing pointed to that on the MRI as far as I know)

True, but IIRC your MRI was done without contrast which makes it hard to see labrum tears, so it's possible. A good ortho can tell a lot from a physical exam (not saying this one is good necessarily).

Sorry to hear about your insurance woes. Are there any cheap private MRI clinics near you? These days it's definitely possible to get a MRI for under $500.

[ghwbuush]

It’s not my insurance, it’s L and I. The MRI used contrast.

the first ortho, the one that is now saying not frozen, maybe slap tear is the best shoulder doctor here according to everyone that has an opinion. No other name has been mentioned.

the reason my PT has been I’m saying that it’s not frozen is that I have more passive range of motion than active. Like I can lift my arm to a certain point and then use my other arm or a wall or someone can move it a decent bit farther.

thats what the ortho pointed to at this last appointment but it’s always been that way. It’s more or less painful depending on the day, though.

also interesting that when he did the obriens test he actually resisted me hard enough to make me not be able to resist him anymore, normally it hurts but I can do it, but he actually made me gasp and stop my arm away. Nobody has pressed that hard to this point.

i kind of wish I would have just had my regular insurance deal with this and paid for it myself.

[Dantheman]

File under: Things that happen when you can't use one of your arms for 3 months.

[californiagrown]

who needs two arms when you have the strength of two, in one?

[californiagrown]

i am 6.5 weeks out from surgery. From about 2 weeks i was able to meet all ROM and unweighted movement standards for the 3 month mark... except lateral raises. PT thinks it is probably just my cuff being super atrophied from years of not firing because i was using my lat and trap to protect my shoulder... but we also cant rule out that the cartilage transplant is a little thick/large and needs to be worn in like a baseball glove... or possibly something else. Its is improving weekly, but slowly, and its painful, and it is really hard to straddle the line between pain i should be pushing through and pain i shouldn't. Going in for my "6 week" post op appoint with the Ortho next week and will try and get him to release me early for strengthening the cuff (PT is fully onboard with starting this early but wants to defer to the ortho).

Still having issues with sleep a few nights per week due to achiness and shifting into a bad position in the middle of the night which then gives me a shot of adrenaline that keeps me up for a while. My muscle atrophy is also starting to show up and the scapula/neck aches are bothersome. Wife is getting a little resentful of how normal i can seem, while at the same time not contributing to certain chores that my PT has really hammered i dont do (anything where i would hold something "heavy" or move my arm/hand fast like washing dishes, sauteing/cooking, certain childcare things i need help with). As with most things in life, the hardest part is just finding the right balance. It would be so much easier to just push hard AF, or to totally take it easy.

Im keeping up with leg workouts, but i am struggling with core stuff a bit as i cant really figure out a way to train lower back (anti-flexion), or rotational stuff in my garage without the use of my arm.

[XXX-er]

i am 6.5 weeks out from surgery.nd it is really hard to straddle the line between pain i should be pushing through and pain i shouldn't. Going in for my "6 week" post op appoint with the Ortho next week and will try and get him to release me early for strengthening the cuff (PT is fully onboard with starting this early but wants to defer to the ortho).

Still having issues with sleep a few nights per week due to achiness and shifting into a bad position in the middle of the night which then gives me a shot of adrenaline that keeps me up for a while. My muscle atrophy is also starting to show up and the scapula/neck aches are bothersome. Wife is getting a little resentful of how normal i can seem, while at the same time not contributing to certain chores that my PT has really hammered i dont do (anything where i would hold something "heavy" or move my arm/hand fast like washing dishes, sauteing/cooking, certain childcare things i need help with). As with most things in life, the hardest part is just finding the right balance. It would be so much easier to just push hard AF, or to totally take it easy.

Im keeping up with leg workouts, but i am struggling with core stuff a bit as i cant really figure out a way to train lower back (anti-flexion), or rotational stuff in my garage without the use of my arm.

Fuck ^^ I didnt get surgery but just recovering from a kacked shoulder was more like 6 months to not have pain at night

and i have never been able to keep a wife for > 10 yrs SO of course I now have lots of money

a ski bud told us he wasn't getting any sex till he could run the vacuum

[Dantheman]

My muscle atrophy is also starting to show up

The atrophy is real. My right arm got noticeably smaller than my left. I'm about a month into strengthening now and it's coming back but has a ways to go.

[Bunion 2020]

Furious masturbation is PT.

[XXX-er]

Furious masturbation is PT.

Depending on which arm that ^^ would feel like somebody else

[californiagrown]

The atrophy is real. My right arm got noticeably smaller than my left. I'm about a month into strengthening now and it's coming back but has a ways to go.

So, whats actually kind of funny is that the bicep tenodesis gave me a very noticeable peak on the biceps on the repaired arm. They basically snip the tendon where it attaches to the labrum, and then reattach the tendon lower down on the humorous, and they generally leave a little slack in it so you arent stuck trying to lengthen a healed tendon to get full ROM back in your elbow. But now, that slack has resulted in my long bicep, now being much shorter (but with the same amount of muscle tissue) so i have this pretty funny peak on my bicep when i do unweighted curls to get a contraction.