3 months of physical therapy - shoulder pain

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Alidecker
Alidecker Posts: 1,262 Member
in Health and Weight Loss
I went to the orthopedic for shoulder pain in October, he did an x-ray (which really won't tell much), he gave me a cortisone shot and sent me to physical therapy. The cortisone shot made it able to actually lift my arm up. I don't have constant pain anymore, it doesn't keep me up at night, but I still can't do a lot of things and randomly will have horrible pain if my shoulder gets in the wrong position. Last night I picked up an armload of laundry off the floor and it was horrible. I iced it, seems mostly better.

So the question is, would you continue with PT or go back to the doctor and have him do more?
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Replies

  • mom23mangos
    mom23mangos Posts: 3,070 Member
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    I've been fighting shoulder impingement, but am hesitant about going to PT because I know they are just going to give me exercises to do at home and I'm already doing them. And it seems that Dr's don't really do anything unless bone is involved. So I'm not really sure which would be best for you.

    I will tell you a great trick to help with the immediate pain if you have the same thing. Sit in a chair and grab hold of the bottom. Then lean to the side and really pull that arm for 30 seconds or so. Whammo, no pain. Not a long term solution however.
  • spiriteagle99
    spiriteagle99 Posts: 3,683 Member
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    I injured my shoulder a year ago. The doctor said either bursitis or torn rotator cuff. We tried shots, but they did little to help, so I went to PT. I was able to gain a lot more range of motion, but then improvement seemed to stop. I quit going to PT but continued to do my exercises, though not as frequently as before. The pain is gone for my every day activities, but I still feel it occasionally when I reach in the wrong direction or lie directly on the sore area. It's not bad enough for me to want to do surgery, especially since that requires another year of PT afterward. I just decided to live with the pain and continue to try to regain strength and mobility on my own. Torn rotators take a very long time to heal.
  • rsergeant79
    rsergeant79 Posts: 45 Member
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    Hi! I feel your pain! I had a shoulder issue and scans came up clear and I was sent to PT - after a year of this and cortisone shots I was referred for surgery - I would press for further intervention
  • Alidecker
    Alidecker Posts: 1,262 Member
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    I am trying to stay away from surgery, but I also hate not doing my full workout. I am thinking of going and having the doctor dig a little further than an x-ray, so at least I know the problem. @spiriteagle99 I am the same way, my range of motion got better quickly with PT, but now I feel like I have stalled.
  • me0231
    me0231 Posts: 218 Member
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    You should get an MRI to look at the ligaments. I've dealt with impingement/bursitis and later managed to tear the long head of the biceps. Shoulders are tough joints to heal because of the range of motion. I'd want to make sure nothing is torn before doing a ton of PT and potentially more steroid shots.
  • RAinWA
    RAinWA Posts: 1,980 Member
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    What does your physical therapist suggest you do? We initially thought I just had inflammation in my shoulder after a car accident but after a couple of weeks of PT she wanted me to go back to the doctor for more evaluation (i.e. MRI). Turned out I tore my rotator cuff.

    Your PT should be able to tell you if you are progressing as expected and if they are concerned you aren't they should refer you back to the doctor.
  • Alidecker
    Alidecker Posts: 1,262 Member
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    RAinWA wrote: »
    What does your physical therapist suggest you do? We initially thought I just had inflammation in my shoulder after a car accident but after a couple of weeks of PT she wanted me to go back to the doctor for more evaluation (i.e. MRI). Turned out I tore my rotator cuff.

    Your PT should be able to tell you if you are progressing as expected and if they are concerned you aren't they should refer you back to the doctor.

    Due to the range of motion getting so much better and the fact that I am not in constant pain and it doesn't keep me from sleeping, she think I am doing good. She is against surgery unless it is a last resort.
  • brznhabits
    brznhabits Posts: 126 Member
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    I second consulting with your PT. Ask them if you are progressing as expected and also tell them it isn't meeting your expectations. Then consider going back to your Dr. I also recommend exploring alternative healers, chiropractor, sports massage therapists and/or acupuncture.
  • Maxxitt
    Maxxitt Posts: 1,281 Member
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    I went through impingement on one shoulder which led to "frozen shoulder." I figured out that it was an over-use injury as I had started swimming regularly and I learned I needed to adjust my crawl stroke. I suffered with it for months before seeing my dr who eventually gave me a referral to a PT. It was about 3 months of PT before I was pain free. The second time I had severe shoulder pain (other side this time) I went directly to a sports med dr who noted that I was pretty loosely strung and and been having partial shoulder dislocations (horrid pain). Another few months of PT and some instruction about how to handle physical activity moving forward. Long story short, the only treatment that worked for me was PT. I would stick with it.
  • Alidecker
    Alidecker Posts: 1,262 Member
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    Maxxitt wrote: »
    I went through impingement on one shoulder which led to "frozen shoulder." I figured out that it was an over-use injury as I had started swimming regularly and I learned I needed to adjust my crawl stroke. I suffered with it for months before seeing my dr who eventually gave me a referral to a PT. It was about 3 months of PT before I was pain free. The second time I had severe shoulder pain (other side this time) I went directly to a sports med dr who noted that I was pretty loosely strung and and been having partial shoulder dislocations (horrid pain). Another few months of PT and some instruction about how to handle physical activity moving forward. Long story short, the only treatment that worked for me was PT. I would stick with it.

    You sound a lot like me. I grew up swimming on swim team and added it to my fitness routine, but only once a week or so. This summer I trained for a 1.2 mile open water swim, so I went from once a week to twice a week and more distance each time. I also do some boxing, so I don't think swimming in the morning and boxing in the evenings was a good idea since I was adding in distance too. I also dislocated my shoulder years ago, it was not pleasant.
  • EHollander89
    EHollander89 Posts: 169 Member
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    My boyfriend whose main form of exercise is boxing has had surgery on both of his shoulders in the past few years. I have learned so much about the shoulder, and how complex it is, just be being there with him throughout the process. He went through a series of resting, physical therapy, cortisone shots, PRP injections, MRI, etc. His surgeon wanted to try everything before doing surgery. He ended up having a biceps tenodesis on both shoulders. He carefully followed his PT exercises and is back to 100%.

    I would ask about other options. It seems like you aren't satisfied with your current treatment plan progress.
  • Alidecker
    Alidecker Posts: 1,262 Member
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    EHollander89 wrote: »
    My boyfriend whose main form of exercise is boxing has had surgery on both of his shoulders in the past few years. I have learned so much about the shoulder, and how complex it is, just be being there with him throughout the process. He went through a series of resting, physical therapy, cortisone shots, PRP injections, MRI, etc. His surgeon wanted to try everything before doing surgery. He ended up having a biceps tenodesis on both shoulders. He carefully followed his PT exercises and is back to 100%.

    I would ask about other options. It seems like you aren't satisfied with your current treatment plan progress.

    I'm impatient and I know that, but at the same time if I am not progressing how I should, I need to do more. I like my PT, just itching to get back to working out how I used to. I miss it and getting bored.
  • lorrpb
    lorrpb Posts: 11,464 Member
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    Cortisone shots do not last forever, so if you had it in Oct, it might be time for another. Sometimes they give a couple shots close together and then they last longer. Do you think the PT helps at all? What instructions did your doctor give you regarding follow up and future options? What does your PT say?

    You say you can't exercise because of your shoulder. We tend to focus on what we "can't" do at the moment. There are still a lot of exercises you could do besides ones that aggravate that shoulder. Maybe you could research that angle. Ask PT to show you modifications to your usual routine that accommodate your shoulder.
  • eptanubrata
    eptanubrata Posts: 13 Member
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    If you find you've hit a plateau, it may be worth it to consult a different PT. If your current one has not changed their treatment program and keeps repeating the same things over and over, you won't see new results. Not all PTs are equal.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
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    Alidecker wrote: »
    I am trying to stay away from surgery, but I also hate not doing my full workout. I am thinking of going and having the doctor dig a little further than an x-ray, so at least I know the problem. @spiriteagle99 I am the same way, my range of motion got better quickly with PT, but now I feel like I have stalled.

    If you want to stay away from surgery, what do you want the doctor to do? What did the doctor say was the problem?

    I've had 6 shoulder operations. In the US the protocol for many insurance companies is PT/cortisone for x amount of time before they will pay for extensive scans and or surgery.

    If you want to get educated on the shoulder, read some stuff from Eric Cressey. My orthopedic surgeon and several therapists I have worked with follow him

    https://ericcressey.com/

    Also, talk to the PT. Can he/she be more aggressive with treatment in the office and what they send home with you (obviously without going to Stupidville)?
  • Fflpnari
    Fflpnari Posts: 975 Member
    edited January 2018
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    I am in PT currently for my shoulder. I would talk to your PT, and your doc. I personally would want to avoid surgery if I could
  • sgt1372
    sgt1372 Posts: 3,987 Member
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    You should definitely ask for an MRI.
  • mitch16
    mitch16 Posts: 2,113 Member
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    Did you doctor actually give you a diagnosis, or was it more like, "I don't know what's wrong, but try some PT..."? Did he (or your PT) give you a reasonable expectation of what your healing process would look like, and what the PT would actually accomplish? If not, then I would consider either going back and getting that information, or getting a second opinion.
  • RAinWA
    RAinWA Posts: 1,980 Member
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    Alidecker wrote: »
    RAinWA wrote: »
    What does your physical therapist suggest you do? We initially thought I just had inflammation in my shoulder after a car accident but after a couple of weeks of PT she wanted me to go back to the doctor for more evaluation (i.e. MRI). Turned out I tore my rotator cuff.

    Your PT should be able to tell you if you are progressing as expected and if they are concerned you aren't they should refer you back to the doctor.

    Due to the range of motion getting so much better and the fact that I am not in constant pain and it doesn't keep me from sleeping, she think I am doing good. She is against surgery unless it is a last resort.

    Shoulders can seriously take months to heal after an injury according to my surgeon, even without surgery. He said the biggest problem is that people get impatient and want to rush things leading to more problems.

    If you are concerned you aren't healing up like you should, certainly see your doctor for further evaluation. There could be something more wrong than originally thought or you could just be impatient. I totally get being exasperated with how long it takes to heal and get back to doing everything - patience is NOT one of my many virtues. :)
  • Azdak
    Azdak Posts: 8,281 Member
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    The problem with going to an internist or GP is that they know pretty much doodley about this type of injury. Going to an orthopedist can be tricky because many of them want to cut first and ask questions later.

    Usually, PT is a better option, but that also depends on the therapy practice. If you have surgery, full recovery can take a year, so it's usually worth spending some time in therapy.

    If you can, I would look for a sports medicine ortho who is associated with a university or teaching hospital, and who specializes in shoulders. Usually they are less quick to cut and may also have some indepedendent research information

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