Another Shoulder Question

I finally bit the bullet and asked the doctor about my shoulder pain. I had feared the worst (rotator cuff tear/damage) but he thinks it’s probably just tendonitis. I’ve been on anti-inflammatories for several weeks now with little to no pain (other than that weekend I went out of town and forgot my medication!). He told me that if the anti-inflammatories didn’t do the trick he could give me a shot in the shoulder for pain relief. For those of you that have tried both, does the shot provide more relief than the pills? How long does it typically last before another treatment is needed? Has anyone experienced any ill effects associated with the pills or the shots? Can you build up a resistance to them (either the shots or the pills)? Note: My particular medication is Nabumetone 500mg. Thanks!

Badly Bruised Rotator
I had a badly bruised rotator cuff and got the cortizone shot. The pain went away (after a couple of days) and never came back.

Will definitely alleviate the pain in the short term, but be careful with that. If there truly is damage that has been done, it can mask continuing damage, as you’ll feel fine…until you don’t.

I had the cortisone injections in one shoulder, and after a time, the pain came back. Discovered that I have two shoulder spurs from years of heavy overhead military pressing which exacerbated impingement syndrome in both shoulders. Now I take care to warm up completely, and keep the smaller stabilizer muscles strong. Even so, sometimes the inflammation still rears its painful head, like last week when I went too high angle in the cold weather without properly warming up. Both are aching now, and it’s anti inflammatory time.

time heals
my left shoulder was so toasted that i gave up paddling for a while, it all came back with some time and patience.

PT ?
Consider getting some surgical tubing (or old bicycle innertube) & working that injured area against some resistance every AM. Keep @ it & good luck ! Injuries take much longer to heal as one ages

Shots are Short Term Cure
You have what my Ortho Doc calls a shoulder impingement. Acts like a torn rotor cuff without the sever damage. I know-I’ve had one for a couple of years. Was bad enough that I had to quit paddling for 9 months while I rehabbed it.

The cortisone shot was a short term treatment and because it is really a steriod only a couple of a year were used. The greatest healer was PT with resistance exercises (surgical tubing as GlenL stated, wall push aways, and weighted (5 lb) arm lifts).

I still have occasional stiffness/soreness in the shoulder (hey it’ll be 61 next birthday) so I pop an occasional APC. Or, as I pass the bookcase where I have a tube hanging, I’ll do 20 or 30 resistance pulls. Work for me.

Any day on the water is a great day,


check your bed
I had shoulder pain off and on for two years and agree with all the posters on alleviating the pain. During re-hab I spoke with many folks that had shoulder surgery and it sounded like only half were happy with the results. Yikes! Good news was a new bed really helped a lot. Turns out that if you sleep on your side (I always do) even if you are only 130 lbs like me, you pressure the shoulder into misalignment. New bed=no more shoulder stiffness! BTW-we deep sixed the Select Comfort one we had. It was a huge mistake, neither of us liked it. Always remember my doc told me, cortizone shots are just a band aid to keep you going and can make it worse. He avoids them and looks for the cause.

Impingement? Me too for most of my life

Shoulder impingement? Me too for most of my life.

Shoulder problem came to light after a work injury when I was very young. But the actual cause and correct treatment took years and years to find.

Best treatment I have found is Exercises and time. Find a good physical therapist and/or trainer. The therapist always did much more for me than the doctor. The doctor’s main job was diagnosing, helping me decide on a course, and pointing me to a good therapist.

The pills are fine, but be careful with the shots! They can mask the pain to the extent you do more damage by doing too soon. There is also little flow of fluids through dense tissue like tendons. Shot of cortisone can reduce or block this flow and somewhat impede healing.

Many say surgery is the way. Personally I have always avoided it, especially since the surgeons could never tell me for sure what was wrong or that they could fix it. Xrays and such show nothing wrong, “but let us cut it open and we will find something.” I don’t think so! Finally after decades my dad mentioned he had pain off and on thought his life in his shoulder. Soon after my son said he was having shoulder pain from an old La Crosse blow. All of us the right shoulder. Asked them each a few questions about exactly where the pain was, how was the pain at certain movements, etc. Then asked the doctors about it all. Inherited impingement was the verdict, just as I suspected. Surgery might have or might not have helped, but would have been risky for arthritis and other possible collateral damage as well.

So Exercise and Time. In the long run, unless they can show you something concrete and have a very high percentage fix, Exercise and Time.

Do this simple test: With your palm down slowly raise your are to shoulder height. Now slowly above shoulder height. Ok, down. Turn your palm up and repeat. Did you have pain with palm down; a little below shoulder height and more above shoulder height? That is the simple test for an impingement with (and even w/o) the tendon inflamed (too little clearance between the bones in the shoulder, especially for an swollen tendon.) Fix for me was: Keeping the arm down near my side throughout sleep as out and overhead aggravated problem. Exercises building up the muscle holding the shoulder area in and up. Exercises to level the shoulders as with shoulder pain one tends to drop that side making the problem worst by weakening and displacing it.

I have posted the exercises here before. If need be I will post them again. Let me know.



Adjusting Daily Routines
I can well sympathize with the sleep issues as well. Palms up/palms down is an excellent quick test for impingement; whenever raising anything (grocery bags, etc.)just remember ‘thumbs up.’ Dumbbell flyes at the gym are always thumbs up-avoid lat pulldowns like the plague-do one arm dumbbell rows instead.

Living with impingement, you also naturally adjust your day to day activities so as not to aggravate. Raking leaves today, did most of the raking arms in close to the body, and moving large leaf piles arms slightly bent and locked, rotating with the torso. Same goes for snow shoveling, either low angle or high angle with extreme torso rotation. Proper wing paddle technique works here. May I suggest using a wing paddle as a training regimen for raking and shoveling? One must prepare for these seasonal ‘sports,’ to assure peak performance level. (I’m thinking a series of niche instructional videos here: ‘Performance Raking…’ ) :wink:

Echo that the PT can be a miracle worker. Stretching slowly and working the shoulders through the range of motion as a good PT will do brings flexibility lost back into the joint, as we avoid raising it/moving it for fear of pain and inflammation. To date however, I’ve not yet convinced my wife that this something that needs to be done daily-she eschews the ways of modern science and medicine, holding firmly to the old school ‘suck it up’ belief system.

I agree with Glen L…
About this time last year a brace in a storm did something to my shoulder, thought I’d torn the rotator. Doc called it Bursitis and I’ve been doing the bunji stretches religiously since early spring. Some arm motions still result in a tender ‘moment’ but for the most part my shoulder is pain free and getting stronger. Stick with it and you may just work through it in time. It took me over 8 months, but I’m paddling fairly strong and hard again. Good luck!

Micks exercises worked on my shoulder
My Doc thought they were a bit ‘odd’ but they work, along with a mild dose of Ibuprofin and religious Bunji stretches.

Yep. I’m odd ;^). Glad they worked again

– Last Updated: Dec-10-06 9:20 PM EST –

Thanks for sharing that.

That was kinda the YMCA trainer's reaction when I discussed some with him, but after a few motions with his body seeing what muscles were effected he said the exercises I described accomplished the same as some of his expensive machines. A lot more portable as well.

Some of the exercises were learned from therapists. Some I devised so I could do them anywhere and not need the treatment room or the gym. But all were cleared through the therapists and doctors.



Exercise post
Mick, please post your exercise routine again. I have spent a half hour looking for it - in vain.



Bed? I like Select Comfort the best.

– Last Updated: Dec-12-06 7:55 AM EST –

Everyone is different. I've had very soft beds: feather mattress and water beds. Very hard; extra, extra firm, and 3" of foam on plywood. The best for me and mine has been the Select Comfort. Important that each person controls their own side as have never heard of a couple that is truly comfortable at the same setting. Sleep is not the place to comprimise. It has helped with shoulder, back, and hip pains in our family. We are on our second Select Comfort. After 12 plus years the old one is a guest bed. Being able to adjust them to be any degree of firmness has been a blessing. My body is not always in the same shape or weight. I have always varied the pressure settings a bit. Especially helpful if staying in bed extra long. Just adjust a little, change the pressure spots to more comfortable, and sleep on.



Ok Adrain, I will work on getting

– Last Updated: Dec-12-06 9:40 AM EST –

something posted about the exercises and care. I will try to post all that have helped me, not just the "controversial" one I (and stickman?), like best.

My personal treatment and prevention of inflammation and pain for Shoulder Impingement. First steps follow:

1. Sleeping Comfort and Healing: If we are talking shoulder impingement and the tendon is currently inflamed the first step is to allow it relief. especially while sleeping, to help it heal. See the impingement test in post(s) above if you are not sure. Share results with your doctor. Please see your doctor for the proper medications and to clear any self treatment you are going to adopt. Having the arm straight out or over the head tend to aggravate the inflammation of the tendon. So, tie it down. I know this makes you feel silly and probably look sillier, but it works! I did get a few chuckles from the wife. I used a cloth, the same cloth the Army used to make a temporary sling. It is a square cloth folded once to make a triangle. The two long ends are tied together and this part of the sling is put over the head while cradling the arm inside the large end of the triangle. Now for our use in treatment while sleeping the sling is placed around your body and the arm with the effected shoulder. This is not tight, but not too loose either. Strange feeling at first, but I adapted quite quickly and have always slept well when ever I needed this. I used this method for several weeks and found I had trained myself not to sleep with my arm above my head. I have only had to use it again as a reminder, to retrain myself, a very few times in the 30 years since I first used it for those several weeks.

2. Normal Movements: The basic palm up, palm down (and thumb up too) movements rules are good guide lines. A few therapeists and trainers told me that basically every 15 degrees you turn your apendages you pick up a different set or a different combination of muscles. It only makes since then to use the combinations or set that will best do the job with the least chance of injury. Check it out yourself by using the 15 degree turn, movement, and check method. So I have made it a pretty hard and fast rule to only raise my arms above my shoulders with my palm in the facing up position. Your shoulder will thank you. :^)



Exercises for the shoulder, parts 3 & 4.
Parts one and two are under the heading “Ok Adrain…” above.

3. Therapist’s Further Evaluation: The evaluations performed by the therapist’s were normal range of motion and pain evals, including the palm up and palm down movements. The one that stuck in my mind and seemed to be the basis of the reasoning behind most all exercises given me, modified, or later devised. The therapist had me strip to the waist, stand facing a full length mirror, close my eyes, bend over to touch my toes, and then slowly straighten back up to full standing. After the therapist walked around and looking I was asked to open my eyes and look. Wow! I was crooked. The shoulder in pain was carried much lower than the other, over an inch! Told this was what normally happens, the bad shoulder is favored. This in turn makes the shoulder weaker, causes more pain, more favoring, weaker, more pain, favoring … you get the picture. You do not need a full length mirror to do the check above, but you do need a mirror that will at least show from mid hip up. As I was told should be checking the hips (hip bones) for level as well.

4. Exercise to Level the Shoulders: This exercise is easy, but needs to be done in front of a mirror big enough to see your reflection from below your hands with arms hanging straight down to above the shoulders. The other piece of equipment needed is a straight piece of broom stick long enough to stick out a foot or so on either side when held in hands with arms at sides and straight down. Face the mirror and put the stick in the starting position just mentioned. Level the stick by leveling your shoulders. Keep shoulders and stick level at all times. Slowly raise stick to eight of shoulders. Slowly lower all the way down again. Keeping the stick straight, right? Repeat about a dozen times both morning and evening. How long? How long does it take for you to carry your shoulders level?

More to come.



Shoulder Problems
To make a long story short. I developed shoulder pain after daily swimming. A chiropractor friend said “Make sure you breath on both sides”. I did that and the pain left. The moral: Your body likes symmetry so don’t walk with your bag on the same shoulder all the time.

Had a friend that was an archer. His
wife a chiropractor. When he came home from shooting she would ask him how many arrows he shot. She would then make sure he pulled and held the bow that many times with the other hand to keep his body in line.