3 months of physical therapy - shoulder pain

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.

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

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.

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.

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.

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.

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)?

You should definitely ask for an MRI.

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.

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.

Also, make sure that you're happy with your PT. If the goals of your PT aren't aligning with your goals, communicate that clearly, and then switch PTs if possible. If the PTs office is filled with young athletes, you're likely to have a different experience than if their primary customer base is older/overweight patients.

Another test is how they answer questions about returning to specific "normal" activity, like weight training, or running, or bodyweight strength exercises.

Good answers are "timeline", "about as many as you used to be able to do", "you'll need to go slow and we'll see as you recover"

Bad answers sound like "why would you want to do that"

Over the years, I have had problems in my neck, back, shoulders, hands, hips, knees, ankles, and toes. But only those!

I have tried to develop a consistent approach to pain: I start with ice/heat/advil/rest for a week or two. It it doesn't get better, I report it to my doctor. They decide whether to refer, sometimes to an orthopedist nurse-practitioner that has been very helpful. If directed, I go for imaging. Then we all talk some more. I have been shot up with cortisone a few times, but I have learned that there are risks associated with it, so I wait until there is really no choice. I am happy to visit the PT, where I look for exercises that I can do at home by myself (saves time and money). Finally, I submit to "intervention" (e.g., surgery) when nothing else works.

My main message here is to stay engaged with the medical community, if you can. I am acutely aware that many people may not have access to healthcare, or can't afford all of the associated cost and or time. I'm advising that it can be worth it, if you keep at it.

I decided to have a bone spur removed from a big toe, and that worked out well, for example.

Best of luck!

mitch16 wrote: »

Well, at least that's a starting point... did the second doctor suggest any other options--is there more/different PT that you could do? Is shoulder replacement surgery an option for you? Is it something you would consider?

9 years ago I injured my knee (turned out to be a meniscal tear) and the orthopedist I saw said that "even if it was your ACL, we wouldn't repair it because you're old"... I did PT and returned to all of my activities, and even took up running (half marathons!) after that. 2 years ago I injured my knee again (although I was skiing for both injuries, they are not related and the first injury really had no bearing on the second). This time is was the ACL, and my new orthopedist (whom I adore) felt that the surgery would be better for my lifestyle, but did also inform me that there are plenty of people out there who tear their ACLs and go on to live perfectly normal, athletic lifestyles, but the choice was up to me. Obviously the path would have been slightly different with respect to timelines and physical therapy and such, but they were both options that I was offered.

A lot of this is on Insurance companies.

But just as much can be placed on the Orthos in the US. Some Orthos deal largely with young active healthy patients and are relatively prompt to recommend/perform surgery if PT doesn't do the job. Others deal primarily with older sedentary ill patients and are reticent to recommend surgery or even refer to effective PT.

But the root of the problem in the second group is the patients who don't/won't participate in PT.