Shoulder Injury ... HELP

A snowHead

My shoulder has got damaged and has been painful for months. No specific event AFAIK but I play a fair bit of tennis and golf and swimming and started hurting late summer and has got progressively worse to the point where I cannot play tennis as too painful - serve and smash are agony ! I can still play golf at 80% with occasional stabs in the shoulder when I mishit and I can swim ... breaststroke OK and a bit of gentle crawl.
Went to physio back in November ... mix of private physio with manipulation and shockwave and now on NHS physio having made it through the waiting list.
Just been referred to Muskeletal clinic ...
Had private Ultrasound which said intact rotator cuff and long head biceps tendon, fluid in subacromial bursa and prominent fluid in biceps tendon sheath. Mild osteoarthritis of AC and SC joins but no synovitis. Normal appearance of posterior aspect of glenohumeral joint. Also had NHS Xray which said only mild wear and tear of joints.
I'm doing lots of strength building stuff and trying to swim most days.
It's a pretty much constant ache in shoulder and upper and sometimes lower arm and back and neck ... really hard to sleep too. When I push it it's agony ... searing burning pain through shoulder and arm.
Skied in January and thinking about EOSB ... but I'm pretty cautious in everything I do as don't want to fall or bang it.
The Muskeletal clinic is Thursday and I need advice on merits of MRI and Cortisone injections ... both of which are potential next steps.
I know there are some shoulder experts on here so would appreciate views and guidance.

A snowHead

I am not a shoulder expert. However, have one personal experience to share.

I had an injury. Like yourself, no specific trauma that I recall that triggered it but I was playing and still do play a lot of volleyball. I only really felt it when doing certain actions, it wasn't constant. The actions (pulling my arm back to serve for example) would cause shooting pain. I tried resting it a little bit no change. So I went to my GP. I was fortunate at the time that I had a good GP who actually took an interest in sports injuries.

The GP said, in very layman terms, there was an inflammation of a tendon, that never got to heal because the inflammation was causing it to catch (on a bone, something else). Essentially a catch 22 situation. He suggested a Cortisone injection. He said that if his diagnosis was correct and that he injected the right tendon, along with rest, I should see an improvement. If there was an improvement he could give me a second injection. If there was no improvement he was wrong or injected the wrong place and it was back to the drawing board a bit.

As I understand it, certainly at the time, nobody understands fully why Cortisone accelerates healing.. but it does. And for me that one injection worked it's magic and after a few weeks I resumed sport and have not had a problem since.

I've seen/spoke to other players with similar injuries and they do seem to be hard to diagnose, recover from. I've told them my story as above but I don't know if any of them had similar success with Cortisone injections.

Well, the person's real but it's just a made up name, see?

as this reel in instagram says "sometimes good, sometimes sheet"
This is exactly with the Corti Injections. Maybe the doc / physio plays a role? maybe the position of the inflamation? maybe other factors?
I have als the same experience with injections. One year the doc made a couple, with no effect, then the pain got away after too much physio etc
After a couple of years the same problem, another doc made the injections, and i saw resutls after a couple of hours.

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Fixed mine by doing bodyweight hangs, for as long as possible, as often as possible.

Anyway, snowHeads is much more fun if you do.

My personal preference is to see a shoulder specialist. I’ve had GP’s ignoring my issues for ages until it got much worse. Fortunately no permanent damage due to the delay. But why suffer when there may be a solution?

Physical therapy is the always the first try. But the physio need help to figure out what to treat. That’s where the right doctor and right image comes in useful.

I too, had excellent result with cortisone shot. There’re also different kind of medication used in the shot, plus the skill of the doctor putting it in the right spot. I’ve had cortisone shot by GP did nothing but the shoulder specialist gave another shot that did wonders. Don’t know if it’s the different medication or putting it on the right spot that did the trick.

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Not sure if there is such a thing as a "shoulder specialist" in medicine is there? Wouldn't it be a muscle/tendon specialist - Orthopaedic maybe?

Not sure if in the UK a GP would make that referral given they should be able to do with this themselves... but as above GP's vary.

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Thanks ... mainly as expected but I'll try the bodyweight hang as that worked several years ago for a frozen left shoulder.
I have spoken to GP on phonecall ... but not seen him ... seen 2 physios and 1 Doctor/Radiographer ... he's the one I'm planning on getting the shot from as he does ultrasound guided injections as his main job. GP offerred to do it ... but I think the private guy is almost certainly more experienced and it's not that expensive.
I'm using a mix of NHS and Private ... which I'd rather not be ... but didn't want to wait ... I do feel slightly awkward in the NHS consultations as I'm updating them on what has been done privately and expecting them to confirm and support it.

After all it is free

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snowHeads are a friendly bunch.

There are sub-specialist orthopaedic surgeons (and physios for that matter) for just about every major joint or bony area - shoulder / elbow / hip / knee / ankle / foot / spine / hand. One of the advantages of the UK “refer up” system is that YOU don’t need to know who they are in your area. Your GP does and will refer you to someone suitable if needed.

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Lose weight (if fat).

Cortisone shots can hit bone or nerves. It hurts.Tread carefully.

I’ve got munted shoulders - common for old surfers - repeated dislocations of one side.

Cortisone helped a lot but I’m basically in twice a week physio for 4 months every time I re injure one and daily stretching exercises to keep it all moving. Trying to avoid surgery as long as possible on the advice of the shoulder specialist. Golf won’t be helping.

You know it makes sense.

Otherwise you'll just go on seeing the one name:

Im probably quite young compared to most on here but I have had some joint issues. I played club and school football and rugby and developed something called osgood schlatter. Is where the tendon keeps peeling away from the tibia and cartilage grows to attach it and you end up with a ball under the knee that gets bigger and bigger until you rest it and allow it to fully heal. Well because the coaches didn't want to rest me and my parents didn't have time to insist that I did it got bigger than my knee. I cant kneel normally and have to spread legs and kneel on inside but apart from that I don't have have issues other than it feeling sore after sports sometimes. I recently got plantur fascitis and then it went to other joints in body and it started to get a bit worrying. I complained about it to a polish chap at work one day who was an ex bodybuilder, he immediately said I was lacking collagen in diet. He said that he had been cutting and having absolutely no animal fats for a long time and he started having exactly the same problems. Once he started making bone broth and drinking it, he could cut and the joint problems stopped. No chance I was cooking up bones so I ordered some mixed with tumeric. Three weeks later after taking it my joints were all painless and I have taken it ever since with small breaks between. I only take half measurements of recommended amount and it works out at about 50p a cup. I certainly feel the benefits from it. Worth a try for what it costs.

A snowHead

@Layne, shoulder specialists definitely exist.
@abc, @KNoceros, I googled 'shoulder orthopaedic specialist', found plenty of results, mostly on private health co websites.
Pretty easy to find someone local and suitable (although I'm in London)... Based on reading their bios and interests.
Turns out my ACJoint was only a grade 2, so doesn't need surgery.... Now to find a good physio!

A snowHead

Well, the person's real but it's just a made up name, see?

Like @Layne I am also a volleyball player. My shoulder is a bit of mess with missing cartilage, some osteoarthritis and tendonitis. However, after a mixture of cortisone, hyuralon (into the capsule) and also some MBST it is much improved. The latter is not clinically proven but there is some anecdotal support and it did seem to help me.

The net effect of all of these is that I am able to continue playing volleyball and have full power and mobility; it still hurts a bit but not enough to stop me playing.

Good luck.

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The strength stuff is just latex band stretches … internal and external rotation etc and a bit of lifting light 1kg weights. They say it strengthens rotator cuff etc … nothing too strenuous! Cat stretches and overhead reach stuff too.
Can’t say it’s made much difference so far and generally feeling weaker as not doing as much as I used to as just too painful.

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FWIW, on my hunt for help and advice for my fractured humeral head, I can across this website. Www.theshoulderdoc.co.uk. I’ve just googled the Doctor named (Leonard Funk) - possibly just the sort of person you might want to consult.
https://www.topdoctors.co.uk/doctor/lennard-funk#:~:text=Professor%20Lennard%20Funk%20is%20a,with%20shoulder%20injuries%20and%20diseases.

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I have had a lot of joint problems, starting at age 16 with recurring shoulder dislocation...and continuing now in my mid 50s pondering a new knee, as well as a persistent bulging disc. There are specialists for every joint -- I have a hip guy I'm seeing now but in the past I had a hip/knee guy as well as a shoulder/hip guy...so I would try to find a shoulder specialist. I also had a mild rotator cuff tear, well, not quite a tear is how it was described, and the pain was constant. That was happily fixed with rest and rehab.

I've had a number of cortisone injections. My experience...yours may vary...is that, done right, they can relieve pain for many months. To the point where you think "Wow, so THIS is what it's like to be pain free."

But, also IME, the pain will recur unless you are able to do something in those pain-free months to fix the problem -- it could be an advanced physio program specifically tailored to your problem. And you have to diagnose the problem, too. So that could mean an MRI with a contrast dye injection, for example.

I would say there's likely no harm in a cortisone shot, and potential good. At worst, you'll probably see no difference. At best it could give you crucial time to tackle different therapies without shooting pain.

@hang11, I've surfed for 40 years. 35 of them on a surgically repaired shoulder after multiple dislocations. Get surgery, you won't regret it. I have a big scar and a long pin but I understand the procedures are much tidier now.

After all it is free

@Pasigal, I will get surgery one day but it’s the recovery time that bothers me most - puts a stop to the fun so I’m waiting until it has to happen or something else puts me out of action for a while.

My first dislocation was when I was 19 trying to hold my board up in the air whilst getting dragged over rocks. Wisdom these days tells me that a new board would be a preferable option Very Happy

. Nowadays a heavy trip over the falls can easily pop it out. I’ve done it snowboarding a couple of times now, and last time I did a pond skim I dislocated it badly. Learned my lesson there.

@hang11, You're a stubborn one!

The recovery time is several months, plus rehab. I had mine done at Christmas and i was back in full action by March-ish, if I remember. But that was in 1989! Not a single dislocation since. It was to the point where I would dislocate it if I slept on it funny. I once dislocated it reaching for a box of cereal.

The final straw was during a squash game and it wouldn't go back in. Nothing like a bumpy ride to the hospital with a severe dislocation to make me come to Jesus and have the surgery.

Edit: I see you're in EnZedd. The coldest surf I ever had was in Dunedin.

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funny enough, I have a shoulder pain right now, going to a doctor today. Yesterday I was reading through our country's "patient's handbook" which is pretty great with description of different injuries and excersises - and this "handbook" is where our doctors send us to anyway.

I noticed there is a special kind of injury for tennis (volleyball etc) players like you (and I have a similar pain despite I'm not playing those sports)

- A nerve (n. suprascapularis) can get pinched at the shoulder joint. Happens, among other things, in athletes, e.g. volleyball players, swimmers, throwers and tennis players
- Gives reduced power with certain movements and pain in the back of the shoulder
- The treatment is relief and training with exercises. If there is no effect within 6-12 months, surgery can be considered Shocked

I've also read that shoulder pain happens in 1/4 of all "elderly" people, so it's not uncommon at all. We'll all be there...

Speedy recovery!

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Thanks all … musculoskeletal expert says it’s probably stage 1 Frozen Shoulder. No specific damage on ultrasound scan or X-ray … just general inflammation… stiff and sore.
Recommend cortisone to calm inflammation reduce pain and allow physio … next Friday I have ultrasound guided injection… not looking forward to it.
They say Stage 1 is worst of 3 stages … can take 3 years to fully recover.
Hope it’s a lot quicker than that.
Can still carefully ski, cycle, swim and golf so could be worse !

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I’ve had frozen shoulder twice. In both cases, it took approximately one year to regain full range of motion, and it hurt a lot getting there. I’m not aware of another way. Basically, you just force the range of motion to increase, and that hurts. Eventually, progress occurs, sometimes in a big chunk. There can be adhesions/scar tissue and that’s part of the reason it hurts so much. But it will get better if you put in the work. Good luck.

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Shoulder Injury ... HELP

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