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mri

User
12 years ago

*sigh* My right shoulder has been bothering me for a while. Went to the Dr. and they took an x ray, told me to take anti inflammatories for two weeks, and wanted me to head to physical therapy. I insisted on an MRI before PT. The Dr. office and called me this morning with the results and I have a "SLAP tear and mild supraspinatus and subscapularis tendinosis without rotator cuff tear."

So now I'm going to meet a surgeon and talk with them. I was told PT would help strengthen the muscles around it but obviously it isn't going to fix the tear. We'll see. The thought of any type of surgery is very unappealing to me.

I'd imagine this is the result from the TONS of painting I've done over the past year. I didn't have the ladder at the proper height and my arm was constantly above my head. Trim, ceiling, walls, doors, and soon, cabinets (not my house). Oh and let's not forget all that taping. Hanging curtains. My computer set up isn't the best with my arm out and up.

Long story short, my knee's good now after going to a sports medicine (knee) specialist. He confirmed nothing was tore and the cause is my super, duper tight hammies. Along with lots of stretching, I'm now doing 10 min. run/walk intervals twice a week and have a follow appointment soon. Knee feels normal (yay) and my shoulder sometimes hurts when I run. GRRrrrr...

The pain isn't all the time but it's dull and nagging. When it's acting up and my arm is down at my side, it actually feels like it would be better supported in a sling close to me body. There's a weird pulling feeling.

This sucks.

Comments (25)

  • tinam61
    12 years ago
    last modified: 9 years ago

    Ah Shee - I'm sorry!!! Is surgery the only option?

    Glad to hear your knee is better and hope the shoulder is soon fixed up too. Hoping maybe there is something that can be done other than surgery.

    Hang in there!!

    tina

  • User
    12 years ago
    last modified: 9 years ago

    I have torn both of my rotator cuffs....left one was the complete labrum. Surgeon said it would never heal w/o his knife...6 month recovery after surgery...hmm..I don't think so.

    I took chondroitin and glucosamine. I also started very slow rehab exercises that the PT gave me. I figured that if he said 6 month recovery would give it a month or 2 of my treatment and just see. Well it worked. The supplements are what heal tendons and ligaments. My shoulders are both 100% , He was amazed when I saw him in the store and showed him how well it healed.

    I have since had 2 friends do the same thing and they also are completely well. So give it a good 2 months of slow rehab and get the powdered form of supplement not capsules...it seems to absorb faster.Comes in orange flavor mix. You will be better off w/o surgery if you can do it and you are only out 2 months to see if you can heal on your own. Good Luck. c

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  • PRO
    Diane Smith at Walter E. Smithe Furniture
    12 years ago
    last modified: 9 years ago

    Ouch!

    "SLAP tear and mild supraspinatus and subscapularis tendinosis without rotator cuff tear."

    Have know idea what that means but it sounds painful!

    Hope your feel better soon.

  • User
    Original Author
    12 years ago
    last modified: 9 years ago

    Trailrunner - That's great news and I was really hoping to hear something positive like that!
    You're talking about the Knox gelatin, right? I've been taking Glucosamine Condroitin for a few months now (GNC brand) but a while back I did buy beef gelatin - the gross stuff you have to dissolve in hot water and drink. I originally bought them for my knee. I'll look into the Knox brand. I think I remember reading something negative about the Knox but I don't remember off hand. I'm so glad it worked and it's worth a try.

    Tina & Dee - Thanks! Ha, I copied that description off the MRI report and don't fully understand it all yet.

    I'm going to see about fixing it without surgery.

  • Oakley
    12 years ago
    last modified: 9 years ago

    DO NOT do PT until you get the tear fixed. I know from experience. Both my husband and son had shoulder surgery, with PT afterwards.

    My son tore his labrum catching a ball on first base. lol. The first doctor we took him to immediately had him do PT. On the first PT visit, my son (all of 13 at the time) said, "I'm not doing it, it hurts too bad." And he's a tough cookie. But I remember his shoulder and arm drooping down his side until it was fixed.

    We took him to another ortho, who was one of the doctors for the University of OK. at the time, and he said the worst thing ds could do was exercize with the torn labrum. So he had surgery during the summer and had PT the rest of the summer. His shoulder is great now.

    Except he suffers from Tendonitis which is normal after injuries in a joint. Ibuprophen.

    I've had a torn Rotator Cuff going on two years now. I've learned to live with it and not raise my arm out and up or I get intense pain.

    My SIL told me it would heal. But it hasn't. Did the doctor say it would get better without surgery?

    Poor Shee. :(

  • natal
    12 years ago
    last modified: 9 years ago

    I've never had a tear, but have dealt with various shoulder issues. Mine healed with PT and NSAIDs.

    I take GC orange chews for my knee. Earlier this year I could barely kneel down, now I can stoop down with no problem ... except very early morning.

    Here is a link that might be useful: GC chews

  • DLM2000-GW
    12 years ago
    last modified: 9 years ago

    Sorry you are dealing with this, Shee. I'm in the *do whatever you can do to avoid surgery* camp. There are times when surgery truly is the best fix (I've had back surgery, myself), but unless you are totally incapacitated it's worth exploring less invasive options first.

    If you can locate a sports medicine doctor, they will have physical therapists who can work with you more effectively than most.

    Doesn't sound to me like trailrunner is talking about Knox - maybe, but wait till she chimes in again. My son has had 2 knee surgeries and a dislocated collar bone. His surgeon is a sports medicine specialist and she recommeends a liquid form of Glucosamine/Condroitin. It's considerably more expensive than pills but compared to surgery.......

  • tinam61
    12 years ago
    last modified: 9 years ago

    I'm interested in hearing about the GC also. Anxious to hear what Fly has to say. Might be a good thing for my dad.

    Oakley, why would you not have your shoulder repaired?

    Shee, could the same doc who helped with your knee help with your shoulder?

    tina

  • mitchdesj
    12 years ago
    last modified: 9 years ago

    I can't take glucosamine because of a shellfish allergy, it's made out of the shells. It's always good to weigh your options and not jump in too fast for surgery; but a tear is a tear, sometimes you have no choice.

    Here's a few articles to read about the chondroitin and glucosamine, I had bookmarked those when I was looking to soothe my aching knee. My trainer makes me reinforce other leg muscles and it helps my knee.

    There's a store that sells natural products and they often have vegetarian options for supplements, I'll check with them about shellfish free glucosamine, I'm still wanting to give it a try.

    Here is a link that might be useful: opinions on arthritis treatments

  • judiegal6
    12 years ago
    last modified: 9 years ago

    I had rotator cuff surgery 10 years ago after years of lifting and 6 pregnancies. (looks like back surgery may be in my future but not yet). The shoulder surgery was successful, but it took about a year for full range of motion to return. I've been taking joint supplements such as glucosamine and condroitin for years, never helped ME, so I've given up.

  • User
    12 years ago
    last modified: 9 years ago

    Just checking back. Of course there are always many different circumstances. I used the Amerifit product linked below. I had great success with it for the shoulders and once for my right ankle/foot. I do not take it on a regular basis....a) I don't need it b) I think it "shocks" everything more when you don't take it all the time.

    I had a complete labrum tear and my arm hung limp at my side. I had been mountain biking and hooked a tree with the handlebar. I had the painful contrast dye injection /MRI. I had absolutely nothing to lose by giving it a couple months to heal w/o surgery. I have taken care of so many elderly patients , in my home health practice, and they all had poor outcomes with surgery and couldn't ever get back full ROM and had to lift their arm only in certain ways for the rest of their days.

    I started the GC and PT with great hopes and very carefully. Very carefully. Of course it hurt but I didn't do any exercise that was not tolerable discomfort..in other words I used good sense and judicious exercise/rest/heat on the shoulder. It was not a fast recovery but it was slow and steady. At the end of the 2 months I had allowed myself I was probably 75%.

    Any PT that is seeing a patient and is using techniques that are that painful is doing something wrong. There is a huge difference between therapy and torture.

    It sounds like you have an overuse injury. If you stop what caused it and give yourself time and apply good sense you should have a good recovery. If after 2 months of sound effort on your part and you aren't at all better then you still have the option of surgery...it isn't going to get worse. But if you leap into surgery you won't have any options at all.

    Only one other thing...I hesitate to ever give advice to someone ...I am not an MD. If I had not seen the response in others and myself and thought it was such a profound recovery I would not suggest it to you Take it for what it is worth...get another medical opinion....try this....just be careful before having surgery. c

    Here is a link that might be useful: Amerifit GC

  • lizbeth-gardener
    12 years ago

    Shee,

    Google SLAP tear and read the different articles. I went to several different sites, but have had knee surgery by an orthopod from the Rothman Institute, so was interested in what they had to say. Many/most recommend a conservative approach first, that being anti-inflammatories and PT. Then surgery if that doesn't work.

    You might also consider an appt. with a Physiatrist (not Psychiatrist) in an orthopedic office. They are rehabilatation physicians.

  • Oakley
    12 years ago
    last modified: 9 years ago

    LOL, Trail, I think my son saw it as "torture." He was in so much pain and literally couldn't use his arm, had to stay in a sling until surgery.

    Tina, I don't want to mess with surgery plus going through PT. Now if it got to the point where it was in constant pain and the shoulder became immobile, you betcha I'd have the surgery.

    The other day a friend was telling me her mother had surgery for her rotator cuff. Since I haven't moved my arm in the position where it hurts, I did it on purpose to see how bad the pain was, and to see if maybe it got better.

    Nope. I was in severe pain the following 24 hours! I'm so used to not using my arm going out and up it doesn't even bother me anymore. As long as I don't use it. But you know, we don't lift our arms out and up for many things at all, except for excersizing or doing jumping jacks. lol

  • liriodendron
    12 years ago
    last modified: 9 years ago

    " SLAP tear and mild supraspinatus and subscapularis tendinosis without rotator cuff tear." BTDT, exactly. And in my case with resulting completely frozen shoulder as a consequence of my first instinct to rest it.

    My arm was hanging vertically with no voluntary range of motion and intense pain when I, or somebody else, tried to raise it in front or back or to the side. I couldn't even do simple things like stick my arm in a winter jacket or wash my hair.

    Surgery was what the orth surgeon said was only course. Followed by lengthy PT (started on same day as surgery, ouch!)

    Decided to try "regular PT" and it was a total waste of time, and often very painful with no results.

    Quit and just nursed my arm, but pain was so awful I was considering surgery. A client suggested trying myofascial PT, and I hunted down a good practioner. We worked every day at first (couple of weeks since I was in so much pain to start), then 3 days per week for three or four months, then once or twice a week for another couple of months. At first I was instructed to do no additional at-home stretching but towards the end I did some specific movements every day.

    The following Christmas I sent the surgeon a Christmas card. It was a picture of me holding a huge holiday wreath, using only the my injured arm, over my head.

    It was a lot of work, and sometimes the myofacial techniques were flirting at the edge of pain, but not hard burning jolts, just little nudges, followed by soothing, relaxing movement/stretching by the PT. It was a bore going every day, but at least at the end of every session I was pain-free for an ever-lengthening period. Once I was completely pain free (when at rest), but still unable to move the arm or shoulder, the work was a little harder. But as I told my PT, I really wanted my damn arm back! And I was willing to put up with some discomfort to do that.

    Three years later, I remain completely healed. With full range of motion, no pain and no weakness. And I live on a farm and spend time renovating my old buildings. Two weeks ago I was up the roof repairing slates.

    I think you've got little to lose by trying myofascial PT. I hope it works as well for you a it did for me.

    L.

  • liriodendron
    12 years ago
    last modified: 9 years ago

    It's possible you have had the SLAP tear (which happens as a result of a sharp deceleration against something) for awhile but it has been asymptomatic. But the bout of painting and the need for accomodating the weakened area around the tear has resulted in the tendonitis, etc.

    That's pretty much what happened to me. I was out walking briskly in my own garden one night in early January and forgot that I had laid down a fence a few days before. As soon as my sneakered foot met the chicken wire the sole's treads caught in the mesh and I was ass over tea kettle almost before I knew it. I had just enough time (unfortunately) to raise my right arm and as a result landed on it first on the frozen earth, which created the tear. Although it hurt incredibly when it happenned (I howled in pain), after a day or two it calmed down and I began doing a lot of painting a few weeks afterward. Which caused a cascade of compensatory stresses that, in turn, resulted in the tendonosis which was excruciating, even when at rest. Then I babied my sore shuolder too completely which eventually resulted in it freezing up.

    I think if I had another radiographic look now, the tear might still be visible, but as long as it creates no pain, no functional disequilibrium nor long-term consequences I plan to just leave it be. My myofascial PT told me that small to moderate tears can stabilize themselves, or at least heal in enough to no longer matter. Now, of course, clear rotator cuff injuries or tears are a whole other ball of wax. A SLAP tear is often much less involved. (I believe the term "SLAP" is not part of your anatomy, it's the name for the mechanism of injury.)

    Anyway, it's possible the SLAP tear happened awhile ago, and with myofascial PT you can heal around it satisfactorily, w/o needing to repair it surgically. I certainly hope so!

    Good luck to you.

    L

  • User
    Original Author
    12 years ago
    last modified: 9 years ago

    Sorry it took so long for me to get back to this. I wanted to respond when I had more time to read over everything better.

    Oakley - With the MRI first I was hoping they could better direct the PT without causing more harm. I didn't talk directly with the Dr. about my results and I'm scheduled to meet with the surgeon in a few weeks. That rotator stuff sounds terrible!

    Natal - Thanks for the link! I'm adding it to my list of options. "Earlier this year I could barely kneel down, now I can stoop down with no problem." That's great!

    Dlm - The knee surgeries sound bad but the collar bone..hooboy. I remember a guy in school broke his collar bone during a soccer game. That just sounds like a really bad area to break. I've been hearing better things about liquid glucosamine/condroitin vs. the pills too. Thanks!

    Tina - Actually I'm scheduled to see the same Dr. that I'm seeing for me knee. - On the same day as my knee appointment! Come to find out he does lots of shoulders too.

    Mitch - Thanks for the article. I've also heard it doesn't work. I didn't realize until recently about the shellfish. Does your knee still bother you or did/does strengthening the other muscles work pretty well?

    Judiegal - I'm sorry to hear about your shoulder and your back. Is your shoulder pain free now? It's interesting how I've noticed in the past year how I've taken my health for granted. I never realized how much I actually use my knee or shoulder until I started having pain.

    Trailrunner - Thank you for the link. Yeah, I didn't think PT was supposed to actually hurt. I never had any major surgeries so I don't know, I guess if you were cut open and start therapy it's not going to feel real special but when I was going for my knee the Dr. kept asking and stressing how I shouldn't be feeling any pain during the exercises. Maybe just due to my specific circumstance. ?

    Liz-beth - I'll look into the Physiatrist. LOL I'm glad you clarified because I didn't catch that at first. :) Thanks!

    Liriodendron - Wow, PT on the same day as surgery doesn't sound appealing to me either! I'm going to look into the myofascial PT. I have pretty good insurance but I wonder if that's covered or if I'd have to go to regular PT first. I did some quick reading about it (plan to do more) but it sounds like it involves more stretching thank regular PT. I like that you sent a Christmas card to the surgeon! :) You don't have to continue some type of regular home routine for your shoulder?
    "My myofascial PT told me that small to moderate tears can stabilize themselves, or at least heal in enough to no longer matter"
    Good to hear! I just dug out my report thinking it said the SLAP tear was mild but that was regarding the tendinosis. One of the things in the reports says "There is abnormal linear intrasubstrance signal within the superior labrum, oriented in the superolateral direction, extending posterior to the biceps-labral anchor, compatible with a SLAP tear." Yeeah, I wish somewhere the whole report was in simple terms so I didn't have to look up so much, lol.

    I was doing some thinking trying to figure out maybe what exactly I originally did to cause the problem. I can’t think of anything but I do remember wiping out in the middle of the store a few months ago and doing down hard. I'm sure that didn't help You know, both feet in the air; purse flying. Of course, a lady saw me. I remember why I don’t wear those shoes anymore and they went in the trash as soon as I got home.

    Thank you everyone who took the time to share your stories and thoughts. I have more digging around to do and I'm putting together a list of questions to talk with the Dr. about. I like looking at different options. I've been saying this for some time now but we're planning on starting a family soon and that's another big reason I don't want surgery. I'm sure I'll need my arms a lot!
    Thanks again and I'll keep you all posted.

  • kitchendetective
    12 years ago
    last modified: 9 years ago

    I'm joining the club. Had an MRI of shoulder yesterday. Received message from doc's office, "I want to see you in my office ASAP." Going in tomorrow first appointment. Dreading diagnosis.

  • abundantblessings
    12 years ago
    last modified: 9 years ago

    Shee et al, I can attest to liriodendron's recommendation to try myofascial therapy. When we lived in Chicago, I was able to regularly see a Russian MD who did not want to sit for the boards here or whatever she'd would have needed to undertake to operate as a physician in the US. She instead opened a holistic office that offered myofascial PT, message and herbal treatments. I wish I still had access as she worked wonders. Many years and cities later, I had a SLAP. For more than a year, suffered pain that might awaken me some nights and limited range of motion in my right shoulder, which I typically stress when walking my dog. I finally got a bit of myofascial therapy. That, and walking my fingers up the wall at home provided slow relief. On Christmas day that year, I tried the finger walk and Lo! no pain, totally healed after such a long time. Best present ever!

    While every case is different, one thing is certain. Surgeons perform surgery. Not that there is anything wrong with that option when necessary, and thank God they are able to assist many in need of healing. But sometimes our biases limit us from considering other options, and many surgeons are no different in that respect.

  • User
    Original Author
    12 years ago
    last modified: 9 years ago

    I went for my knee follow up and my shoulder and am rather frustrated.

    My knee has been pretty good overall. It does start to hurt if I don't stretch as much. Occasionally after working out it will feel fat inside and hurt. I got out the ice out the other night.

    I asked him some questions regarding the MRI (worn cartilage/inflammation) that I should've asked the first time and he acted like they were no big deal. That popping in my knee when I bend it is inflammation... Well then it's been inflamed for over a year! I'm not going to live off ibuprofin.

    Something that took me back was when he mentioned I need to strengthen my quads. What? The first appointment he kept telling me how strong they were and my tight hams were the problem. So for 2 MONTHS I only did the twice a week intervals that he recommended. 2 MONTHS wasted in that regard. I didn't point that out. He also recommended PT and I reminded him I did that for 6 weeks. - Although the exercises weren't focused on my quads.

    He said the cartilage is torn in my shoulder and asked if I wanted surgery yet. Says I'll need to deal with it at some point. He wanted to focus on my knee right now instead of the shoulder. I asked him his thoughts on myofascial PT and he didn't have any. I'm not sure he knew what it was. I asked if PT would help my shoulder and he felt it would (what was he going to say).

    Now that it's over with I should've asked more questions. I did actually have paper with stuff wrote down! We didn't talk about the tendonitis. He didn't talk about the type of slap tear.

    Any questions I asked like - can I lift for my upper body? He was vague and basically said do what I think I can handle. I've read things online that say you shouldn't lift with a slap tear.

    Someone mentioned above to remember he's a surgeon so maybe I'm expecting too much. I've come to the conclusion he will be of no use to me unless I'd need surgery. I'm to go back for a follow up in 6-8 weeks.

    I'm going to look into myofascial PT before I call about regular PT. Does PT help anyone? I don't usually hear positive things about it.

    Guess I shouldn't be painting anymore.. I have lots trim and doors to paint in the basement and I'd really like to repaint the foyer/hall area. *sigh*

  • texanjana
    12 years ago
    last modified: 9 years ago

    I was in a car accident last October, and my Peroneal tendon in my ankle was torn. I have had PT, worn an aircast, done exercises, and gotten 2 Cortisone shots (ouch) so far. It seems to improve, and then the pain and swelling starts again. I had already decided with my ortho to get the surgery soon, and I saw this thread. I wanted to say thanks for the supplement and alternative therapy recs. I am going to try them before committing to surgery.

    Good luck to all who are dealing with these injuries. It is no fun.

  • User
    Original Author
    12 years ago
    last modified: 9 years ago

    I wrote my last post when I was pretty upset still. DH tells me not long after that two of his coworkers were in a bad car crash. The one has a broken jaw and is going through cat scans and stuff right now. The other was put into an induced coma and has two broke hips, surgery on his arms and shoulders, 60% of his spleen is in bad shape.... not good. Please say a prayer for them both. I'm thankful to be healthy overall.

    Jana - That sounds really painful! I hope the suggestions above help and you don't need surgery.

  • nancybee_2010
    12 years ago
    last modified: 9 years ago

    hi shee, I'll say a prayer for them both- hope it turns out okay.

  • stinky-gardener
    12 years ago
    last modified: 9 years ago

    Shee, good luck on your quest to find treatment. Sorry you have to go through all this...at such a young age too! I had very painful tendonitis in my forearms for two months. PT & medicines didn't help much. It just faded on its own eventually, but was excrutiating at its worst. I think a lot of these things are exacerbated, maybe even caused by, stress. I agree with Texan, try all alternatives before surgery!

    TexanJana, so sorry for all the pain and hardship you've had to go through. Bless your heart.

    Shee, will also be praying for your DH's coworkers.

  • liriodendron
    12 years ago
    last modified: 9 years ago

    Shee,

    I think it's important when looking for a myofascial therapist to get one that uses that technique almost exclusively, or at least primarily. What I mean is you don't necessarily want a "regular" PT who has been to a workshop or two and "does myofascial" kind of as an add-on to their regular work. My own myofascial PT has a Master's degree in conventional PT, but then did a lot of additional training in Myofascial work, so I had the best of both worlds, even though her technique now is almost wholly myofascial.

    The two approaches are quite different. True myofascial work is about freeing the internal muscle and tendon layers from each other, not just in making the joints work better by stretching them. It's a slower technique in a way and I don't believe it should hurt much, if at all, while doing it . It is the antithesis of the "no pain, no gain" theory. It is also a very hands-on technique with the therapist doing the movements, not the pt.

    I think there are some Myofascial PT professional organizations so that might be a way to start to get a referral. From my experience, it is so much better than conventional PT for what you describe that I think it would be worth some trouble to find the right therapist. Even though I did not capture full joint range of motion immediately, I did get pain relief pretty quickly. At first the pain relief was pretty transitory (for just a few hours after each appointment), but within a couple of weeks it was almost continuous, w/o meds. My therapist also showed me some self-treatment techniques that helped when I had a little pain breakthrough at home. That helped as I was eager to return to activity.

    Hope you feel better, soon.

    L>

  • liriodendron
    12 years ago
    last modified: 9 years ago

    Shee,

    I tried to find a link for you to look up a local Myofascial PT, but it was heavy going. I have no idea where you are, either.

    So I'm linking below to my own myofascial PT who lists all her courses and accreditations in the hopes that the info on her website will lead you to one near you. In looking over them, I recalled that she highly valued the training she had with John Barnes, so that might help you find a good therapist by hunting up referrals from his training programs. Unless you are near Albany, NY in which case call her and make an appointment, pronto!

    HTH,

    L

    Here is a link that might be useful: Excellent Myofascial Physical Therapist in Albany, NY