3 months of physical therapy - shoulder pain

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  • stanmann571
    stanmann571 Posts: 5,728 Member
    edited January 2018
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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.

    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"
  • Alidecker
    Alidecker Posts: 1,262 Member
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    Thanks for all the input, especially the personal experience with shoulder pain.

    lorrpb wrote: »
    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.

    I do still exercise, I just can't exercise the way I had been prior to the shoulder pain started.

    I am impatient, I have PT again on Thursday I will talk to her a little more. I am happy with her, she understands that I want to get back to my workouts and she gives me exercise that help replicate the motions and what imitates what I would be doing. The orthopedic looked at an x-ray and said I think it's tendonitis, go to physical therapy. I don't want to have surgery, but if it is necessary I would. I don't want to waste 6 months in physical therapy if it isn't going to fix the problem enough to go back to the workouts I enjoy. I am all for modifying. even long term, but within reason.
  • Jthanmyfitnesspal
    Jthanmyfitnesspal Posts: 3,521 Member
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    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!
  • lorrpb
    lorrpb Posts: 11,464 Member
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    Alidecker wrote: »
    Thanks for all the input, especially the personal experience with shoulder pain.

    lorrpb wrote: »
    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.

    I do still exercise, I just can't exercise the way I had been prior to the shoulder pain started.

    I am impatient, I have PT again on Thursday I will talk to her a little more. I am happy with her, she understands that I want to get back to my workouts and she gives me exercise that help replicate the motions and what imitates what I would be doing. The orthopedic looked at an x-ray and said I think it's tendonitis, go to physical therapy. I don't want to have surgery, but if it is necessary I would. I don't want to waste 6 months in physical therapy if it isn't going to fix the problem enough to go back to the workouts I enjoy. I am all for modifying. even long term, but within reason.
    You are not alone in your impatience. Most of us are impatient about healing/recovery, especially when other goals are at stake. Patience can be hard to learn and accept, but working on this outlook helps reduce the frustration. There are no guarantees about what PT, surgery, or most other medical treatments will or won't fix or to what degree the outcome will meet our expectations of "workouts you enjoy". I don't want to discourage you or sound negative--certainly we all need to push for what we want--just trying to temper the outlook if needed, speaking from my experience and that of others.

    Just a note to clarify that it is highly unlikely that an x-ray "shows" tendonitis. Probably what the doc really means is that there is no identifiable injury to the structures that can be visualized on an x-ray (which does NOT include tendonitis) so defaults to tendonitis as a catch-all dx. Tendonitis is inflammation and can be from mild to severe, and depending on exactly which tendons involved can affect a person in vastly different ways. Good luck with your treatments, I hope they help.

  • Alidecker
    Alidecker Posts: 1,262 Member
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    Well, went to two doctors since one didn't explain anything to me or really do anything. The second one did another x-ray and ultra sound in the office. It is arthritis, small tear in the rotator cuff, bone spurs and some other things he described as odd when looking at the ultra sound. Now trying to figure out how to fix it or if to fix it are the issues. The second doctor said most doctors wouldn't suggest surgery at this point because it is messed up enough that it would most likely need shoulder replacement. Of his options for treatment, he suggested stem cell therapy, which is a big decision since insurance doesn't cover it. I can say I am happy to know, but not happy about the outcome and the activities he said he would suggest I give up...
  • mitch16
    mitch16 Posts: 2,113 Member
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    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.

  • stanmann571
    stanmann571 Posts: 5,728 Member
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    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.
  • Alidecker
    Alidecker Posts: 1,262 Member
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    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.
    Shoulder replacement could be a possibility, but not recommended at this point. Kind of in the bad, but not that bad category and I am younger than they like to do it on. Orthoscopic surgery is in the we could do it, but you aren't a great candidate for it and the results would be less that optimal. I am not ready to go through the shoulder replacement surgery yet.

    I can still lift weights, which is the good news, in fact he encouraged it and said the more strength in the shoulder the better. He did say to try and keep the push lifts to a lower weight. This doctor was more optimistic about these things. The other doctor makes me feel like I should just go for a walk and call it a day, I used to be that girl, but 9 years ago I decided to lose weight and get fit and it no longer fits the lifestyle that I enjoy. Of course the two forms of cardio I have been doing in the last few years are swimming and boxing/kickboxing - neither of those are great for a bad shoulder.


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