MRI or Ultrasound- Shoulder injury

[stubuzz]

I threw a ball 2 months ago and hurt my shoulder. The doctor took X-rays and said i have sprained/stretched the muscles. I am still having some aching pain and If i am not careful getting dressed,it will hurt for a few hours.

So, I am looking at getting some more tests done to see if i have torn something. Would an ultrasound do, or should i get an MRI? Any idea of the cost?

I am East/South East of Bangkok.

Edited February 18 by stubuzz

[JensenZ]

Some very light mobility work might help - to get blood circulating through the injured area. Total rest for 2 months is not the best approach to heal joint/tendon/ligament/muscular injuries.

[Yellowtail]

I would go see Dr. Mason at Bumrungrad for a consultation.

 

Don't sleep on it. 

[scubascuba3]

I had an MRI with contrast, but time is maybe all you need, the op i was going to have was estimated to have a 50% success rate, so i didn't bother 

[Yellowtail]

2 hours ago, scubascuba3 said:

I had an MRI with contrast, but time is maybe all you need, the op i was going to have was estimated to have a 50% success rate, so i didn't bother 

I had rotator cuff surgery, and while the recovery was a PITA, my shoulder has been perfect for 15 years. 

[scubascuba3]

41 minutes ago, Yellowtail said:

I had rotator cuff surgery, and while the recovery was a PITA, my shoulder has been perfect for 15 years. 

Depends on the surgery, my UK specialist said for a labral tear it's 50% successful, that means for 50% it isn't plus PITA recovery

[Sheryl]

11 hours ago, stubuzz said:

I threw a ball 2 months ago and hurt my shoulder. The doctor took X-rays and said i have sprained/stretched the muscles. I am still having some aching pain and If i am not careful getting dressed,it will hurt for a few hours.

So, I am looking at getting some more tests done to see if i have torn something. Would an ultrasound do, or should i get an MRI? Any idea of the cost?

I am East/South East of Bangkok.

Do not self-prescribe a test, as you may waste time and money.

 

See this excellent, Harvard-trained shoulder specialist:

 

https://www.bumrungrad.com/en/doctors/mason-porramatikul

 

He will know if more tests are worthwhile (e.g. likely to affect treatment plan).  Sometimes physical exam alone is enough.

[stubuzz]

25 minutes ago, Sheryl said:

See this excellent, Harvard-trained shoulder specialist:

 

https://www.bumrungrad.com/en/doctors/mason-porramatikul

 

He will know if more tests are worthwhile (e.g. likely to affect treatment plan).  Sometimes physical exam alone is enough.

Thank you. Any idea of the cost?

 

[Sheryl]

2 minutes ago, stubuzz said:

Thank you. Any idea of the cost?

 

For consultation - about 2,000 - 2,500 baht inclusive of hospital surcharge

 

Do not buy any medications (if prescribed) at the hospital

 

If he recommends MRI go to mrithailand.com

 

[stubuzz]

1 minute ago, Sheryl said:

For consultation - about 2,000 - 2,500 baht inclusive of hospital surcharge

 

Do not buy any medications (if prescribed) at the hospital

 

If he recommends MRI go to mrithailand.com

Thanks again.

[BigStar]

Not to take away from the usual suggestions to run to the doc, you might first try a physical therapist. One or two visits might be sufficient, just follow the routine a few months thereafter.

 

Sounds like you haven't done any active rehab. Unfortunately, these tendon problems (assuming) won't clear up entirely without a bit of work to get things in balance, so to speak.

 

Youtube has a lot of advice re: diagnosis and treatment. I've fixed several problems just following suggestions there--for a few months, diligently.

 

But paying good money for advice tends to make one take it more seriously. Of course, it is personal and professional. 🙂

[Yellowtail]

34 minutes ago, BigStar said:

Not to take away from the usual suggestions to run to the doc, you might first try a physical therapist. One or two visits might be sufficient, just follow the routine a few months thereafter.

 

Sounds like you haven't done any active rehab. Unfortunately, these tendon problems (assuming) won't clear up entirely without a bit of work to get things in balance, so to speak.

 

Youtube has a lot of advice re: diagnosis and treatment. I've fixed several problems just following suggestions there--for a few months, diligently.

 

But paying good money for advice tends to make one take it more seriously. Of course, it is personal and professional. 🙂

Physical Therapist do not (or at least should not) diagnose. They should follow the doctor's prescription. 

[Yellowtail]

2 hours ago, Sheryl said:

Do not self-prescribe a test, as you may waste time and money.

 

See this excellent, Harvard-trained shoulder specialist:

 

https://www.bumrungrad.com/en/doctors/mason-porramatikul

 

He will know if more tests are worthwhile (e.g. likely to affect treatment plan).  Sometimes physical exam alone is enough.

 

2 hours ago, Sheryl said:

Do not self-prescribe a test, as you may waste time and money.

 

See this excellent, Harvard-trained shoulder specialist:

 

https://www.bumrungrad.com/en/doctors/mason-porramatikul

 

He will know if more tests are worthwhile (e.g. likely to affect treatment plan).  Sometimes physical exam alone is enough.

I think you may have recommended Dr. Mason to me when I had my surgery, if so, thanks!

 

I had surgery on my right shoulder, and it's been perfect since. I had a similar problem with my left shoulder a few years later and thought I would need another surgery, but after a five-minute exam he gave me a few exercises to do, told me to not sleep on it and come back in a month. It's been perfect since as well. 

 

Thanks again! 

[BigStar]

4 hours ago, Yellowtail said:

Physical Therapist do not (or at least should not) diagnose. They should follow the doctor's prescription. 

 

In a hospital setting, typically, the doc relates the nature of the problem and then PTs decide what therapy is applicable. Been through that process a couple of times. Found better therapy on the 'net than in Thai hospitals, BTW.

 

But good standalone PTs, as we have in Pattaya, will perform the usual physical tests and make a basic diagnosis (rotator cuff, impingement, etc). Then, as PTs do, they recommend exercises and/or stretches. For example, a couple of famous PTs on the internet:

 

What is Causing Your Shoulder Pain? Tests You Can Do Yourself, Plus Self Treatment (Updated)

 

And then

 

7 Simple Exercises for Shoulder Pain That Really Work (Impingement, Tendonitis, Arthritis)

 

OP's problem doesn't sound very serious, X-ray was good (YES! I know it wasn't an MRI), and it's been getting better. Doc said probably a strain or overstretch. Pain from throwing a ball sounds like classic rotator cuff tendonitis common in the sport. YES, it could be MORE. 

 

Just resting won't work, or, if it seems to, then the problem will be ready to recur.

 

16 hours ago, JensenZ said:

Some very light mobility work might help - to get blood circulating through the injured area. Total rest for 2 months is not the best approach to heal joint/tendon/ligament/muscular injuries.

 

True. So, me (being me), I'd TRY working on it at home first (OP hasn't done any work yet). Takes discipline and regular schedule, however. No discipline, then get the meds and surgery, like the obese who resort to bariatric surgery rather than diet. YES, may need surgery anyway, but that seems doubtful, at first glance. Dr. Mason is the best, has a sterling rep, and is 100% trustworthy; whatever he says will be useful.

 

[stubuzz]

46 minutes ago, BigStar said:

Just resting won't work, or, if it seems to, then the problem will be ready to recur.

I have tried some light exercises. They made the pain worse.

[BigStar]

5 minutes ago, stubuzz said:

I have tried some light exercises. They made the pain worse.

 

Not just any old exercise will do, notably ones that somehow mimic the motion that created the injury. Gotta find the right exercises and do them correctly.

[stubuzz]

1 hour ago, BigStar said:

Not just any old exercise will do, notably ones that somehow mimic the motion that created the injury. Gotta find the right exercises and do them correctly.

I have watched many physical therapy YT videos and they point towards  a problem with my Subscapularis muscle. However, i will let a specialist take a look before i make things worse.

[BigStar]

7 minutes ago, stubuzz said:

I have watched many physical therapy YT videos and they point towards  a problem with my Subscapularis muscle. However, i will let a specialist take a look before i make things worse.

 

Good idea.

[Yellowtail]

3 hours ago, BigStar said:

In a hospital setting, typically, the doc relates the nature of the problem and then PTs decide what therapy is applicable.

That has not been my experience at three hospitals in the US and four hospitals in Thailand. 

3 hours ago, BigStar said:

Been through that process a couple of times.

I've been through it probably a dozen times. 

3 hours ago, BigStar said:

Found better therapy on the 'net than in Thai hospitals, BTW.

That has not been my experience either. 

3 hours ago, BigStar said:

But good standalone PTs, as we have in Pattaya, will perform the usual physical tests and make a basic diagnosis (rotator cuff, impingement, etc). Then, as PTs do, they recommend exercises and/or stretches. For example, a couple of famous PTs on the internet:

 

What is Causing Your Shoulder Pain? Tests You Can Do Yourself, Plus Self Treatment (Updated)

 

And then

 

7 Simple Exercises for Shoulder Pain That Really Work (Impingement, Tendonitis, Arthritis)

 

OP's problem doesn't sound very serious, X-ray was good (YES! I know it wasn't an MRI), and it's been getting better. Doc said probably a strain or overstretch. Pain from throwing a ball sounds like classic rotator cuff tendonitis common in the sport. YES, it could be MORE. 

 

Just resting won't work, or, if it seems to, then the problem will be ready to recur.

 

 

True. So, me (being me), I'd TRY working on it at home first (OP hasn't done any work yet). Takes discipline and regular schedule, however. No discipline, then get the meds and surgery, like the obese who resort to bariatric surgery rather than diet. YES, may need surgery anyway, but that seems doubtful, at first glance. Dr. Mason is the best, has a sterling rep, and is 100% trustworthy; whatever he says will be useful.

 

Great

[TheFishman1]

I have an MRI and it’s showed that my shoulder had a few problems and I had surgery in six months later my shoulder feels 100% brand new TIT

[JensenZ]

14 hours ago, BigStar said:

 

In a hospital setting, typically, the doc relates the nature of the problem and then PTs decide what therapy is applicable. Been through that process a couple of times. Found better therapy on the 'net than in Thai hospitals, BTW.

 

But good standalone PTs, as we have in Pattaya, will perform the usual physical tests and make a basic diagnosis (rotator cuff, impingement, etc). Then, as PTs do, they recommend exercises and/or stretches. For example, a couple of famous PTs on the internet:

 

What is Causing Your Shoulder Pain? Tests You Can Do Yourself, Plus Self Treatment (Updated)

 

And then

 

7 Simple Exercises for Shoulder Pain That Really Work (Impingement, Tendonitis, Arthritis)

 

OP's problem doesn't sound very serious, X-ray was good (YES! I know it wasn't an MRI), and it's been getting better. Doc said probably a strain or overstretch. Pain from throwing a ball sounds like classic rotator cuff tendonitis common in the sport. YES, it could be MORE. 

 

Just resting won't work, or, if it seems to, then the problem will be ready to recur.

 

 

True. So, me (being me), I'd TRY working on it at home first (OP hasn't done any work yet). Takes discipline and regular schedule, however. No discipline, then get the meds and surgery, like the obese who resort to bariatric surgery rather than diet. YES, may need surgery anyway, but that seems doubtful, at first glance. Dr. Mason is the best, has a sterling rep, and is 100% trustworthy; whatever he says will be useful.

 

I know exactly where you're coming from, and how you're trying to be as civil as possible here so as not to upset anyone (unlike your more combative J6-pack days).

 

Having surgery would be the absolute last option for me for a sore shoulder. An acquaintance, who had a motorcycle accident, had surgery on his knee by the "best" (touted as the best) orthopedic surgeon in Thailand (don't know his name - is Dr Mason an orthopedic surgeon?). They f*****d up his first surgery - operated again for free, now he's a cripple with a leg that can't be fixed. He can't even get a replacement knee as the bone (tibia) has degenerated (due to multiple surgeries) to the point it cannot support an artificial knee.

 

Surgery comes with significant risks. If the OP is an untrained individual with weak musculature, whatever caused the injury the first time will likely cause injuries again in the future, even after surgery. In this case, throwing a ball caused the injury, which indicates poor shoulder strength/health.

 

I've been lifting weights for 50 years and had my fair share of shoulder injuries, mainly caused by ignorance and overdoing it in the gym. I've always managed to self-treat my injuries and have never seen a doctor. Now, with more intelligent training, at the age of 65, I manage overhead presses and lateral raises with no shoulder pain. I always pay attention to keeping the rotator cuff healthy and strong.

 

There are some very talented doctors and physical therapists available on YouTube including, but not limited to, Bob & Brad that you linked. I'd trust them a lot more than I'd trust an orthopedic surgeon or any other type of surgeon.

 

 

Edited February 20 by JensenZ

[Iron Tongue]

If the first doc said you have sprained muscles, then start from there.

Just throwing a ball, the motion isn't as injurious compared to a fall, or some sort of impact injury.

If it's just a sprain, you are likely dealing with an inflammation of the shoulder joint area.  If this is all, a couple of cortisone injections might be all that you need.

[Letseng]

On 2/19/2024 at 12:07 AM, Yellowtail said:

I would go see Dr. Mason at Bumrungrad for a consultation.

 

Don't sleep on it. 

If I had followed Mason's advice to have a knee op I would have been 250K poorer with no improvement.

Got 2nd opinion in Singapore. Physio treatment fixed it. Advice was not to operate. I cycle, I walk, I climb stairs, swim. No problem.