Chronic Rotator Cuff Impingement Syndrome

[siamsam]

I injured my right shoulder about 3yrs ago lifting weights in los. Regretfully, partly due to ignorance I didn't take care of it at the acute stage and it's now chronic. I've had a few false starts with my training but the injury kept knocking me back. Now I've rested it for a good few months but it's still the same. Doc gave me corts', anti - inflams. Physio prescribes re'hab and stretching. Now I'm seeing a sports chiropractor who suggests that the cause of the impingement is coming from faulty functioning of my neck and he's got me re'habing my neck. The ortho surgeon has arranged for a mri next month and if required he'll preform an arthoscope, but this can have a negative outcome my research suggests. It's probably a rotator cuff tear with scar tissue etc causing the impingement the surgeon says. This conflicts with the chiropractor who advises strongly against the scope operation and is confident in the neck re'hab, which I've only just started. Any suggestions or experiences? Thanx in advance.

[joinme2leave]

huuuh! Rarely did not understand ONE SINGLE word you say (yes, I am NOT british, neither american...) but -as far as I can ASSUME your problems- ...why don't you try to see a REAL doctor "back home" ?

[Pepe']

Screw the chiropractor.

You need first a series of xrays 4 to 5 views per series to check the degree if any of acromial hooking leading to impingment syndrome.

The gold standard is a mri. X ray can often look completely clear even though there is substantial damage.

At least 50% of adults have rotator cuff tears that are not dianosed! The most common being tear of the supraspinatus muscle and or ligament.

Still not a good idea to scope the joint until you have got a clear diagnosis first.

Ortho-neuro resistance testing is usually a good indicater followed by an MRI/.

Good Health

[KevinN]

You keep fukin with a chiropractor and he will have you in a wheelchair and someone else will be wiping your ass for you because you will be a quad.

Don't know why anyone will put any faith in a witch doctor. Ortho Dr.s is the only ones to trust.

[griffer]

are you in bangkok??

an MRI at Bumrungrad is only just over 10,000 baht...surely a sound investment?

only takes 45 mins and the results should certainly help with diagnosis.

[c89109]

This is a sad result of bench pressing with a fixed bar I would assume. I have seen many cases like this which result in shoulder impingement. A good lesson to be learned for others. Use dumbbells instead of the fixed bar for chest press exercises. Save unnecessary stress to your ligaments by using dumbbells which are free from the stress of the fixed bar on the shoulder joints. Week after week, month after month, year after year of using the fixed bar in bench pressing exercise will cause damage to the ligaments.

[thailandfool]

Who is the chiropractor you are using?

I'd definately get an MRI. If it's a problem in your neck (perhaps a disc), you should get an MRI on that again.

Given a choice, I would highly recommend chiropractic treatment over anything invasive. A few years ago, I had a herniated disc in my neck but most of the pain was in my shoulder and upper arm. Doctors at the hospitals wanted to operate (remove the disc and fuse the spine).

After a couple months of chiropractic treatment, the problem was mostly gone. Much cheaper and safer than the surgery.

[Pepe']

You were lucky and /or might have had the wrong dianosis in the first place.

Chiros can help with protruding/bulging disks.

Once they're herniated 9.9 out of ten time it's a surgical fix.

Anyway glad you're feeling better

[thailandfool]

It was definately a herniated disc. The reason I am sure is I just had to visit a chiropractor for the first time in 3 plus years and I brought along my MRI and radiologist report. While the diagnosis could be wrong, it was (after viewing the MRI) given by the radiologist, an orthopedic surgeon, a neurosurgeon, and three chiropractors.

What I was told by the chiropractors is that they can often help with herniated discs (depending on the degree of damage and the time since injury), but you are pretty much ######ed with a ruptured disc. The first chiropractor who helped me said my injury had been going on for too long (5 weeks) and if he could not restore sensation to my fingers in a week, the nerves would then die (permenently) if I did not get surgery. I got lucky and after a few days of intensive treatment, my nerves started tingling. I had already booked surgery.

Frankly, I had veiwed chiropractors as witch doctors but not anymore!!!! To me, the only thing more scary than having a guy adjust your spine is having someone cut into your flesh. Anyone I know who has been through an adjustment can testify to the relief it can bring, particularly if combined with heat or cold treatment, ultrsound, ultraviolet, and massage. Find a good chriopractor and you will find he is booked from dusk till dawn. ###### of alot cheaper than most doctors, particularly if you are getting hit with physical therapy, drugs, and surgery.

If you do any research about spinal fusion surgery (and many other similar types), once you have it, you are setting yourself up for a second operation in 10 to 15 years when the surrounding discs get damaged from the additional stress they must absorb.

While a Chiropractor cannot solve a lot of problems, I would not discount them just because the AMA tried to discredit them for so long.

[waldwolf]

From my experience with a herniated disk about 8 years ago (lower back L4-L5 & S1) the most relief I got came from a combination of heat & traction, adminstered by a physical therapist 3 times a week, for 6 months (VA hospital). On viewing my MRI, the spinal cord looked like a question mark, where the "inner-core" had extruded directly against the nerve.

It is my understanding the sheath containing the spinal nerves has a long memory, and will radiate pain long after the pressure of the herniation has been removed. I still have periodic numbness and tingling in legs and toes.

From your description (arm pain & finger numbness) would appear your herniation occured in the Cervical Spine area, most common being C5-C6 or C6-C7 (neck). There is also a condition called Foraminal Stenosis (a narrowing of the cervical disc space) which may arise without any disc herniation. (Yep, I have this too.)

Today, there are many alternatives to spinal fusion. In the majority of cases, arm pain from a cervical herniated disc can be controlled with medication, and other (non-surgical) treatments.

(On a personal note, I would not recommend nor seek treatment for this type injury from a Chiropractor, unless he was also a qualified, licensed MD.)

I know what your going through and hope you have a full recovery, soon.

Cheers

[ProThaiExpat]

buddaboy: Back to the original topic, rotator cuff tear.

The dynamics of injury point to the ultimate diagnosis. I was knocked off my feet by another skater and landed on my left side with my arm fully extended over my head.

Very immediate strong pain which gradually disappeard over the next six months. However, I was chronic with pain upon lifting my arm above shoulder level.

Went to a world class orthopedist who specializes in shoulder surgery, son of the L.A. Rams team ortho, who said rotator cuff but lets confirm with MRI. Did so and it was a massive tear.

Doctor said he was very reluctant to operate since the tear was at least six months old and he had little success is operating on "old" tears. He further pointed out, as Pepe has, that prior to MRI, almost every rotator cuff tear went to the grave untreated.

He explained how the shoulder is built, what other muscles, other than the one I tore, worked, and basically advised me to work out and strengthen the muscles in the shoulder to support the torn one, and even strengthen it in the process.

Did so, and now ten years later, I am virtually symptom free. I have a home gym and work out regularly, doing all shoulder exercises without difficulty. If I lift real heavy dumb bells in an abduction motion above shoulder level, I can generate mild discomfort.

Looks like I will be another torn rotator cuff that goes to the grave untreated.

Referred pain is one thing, but rotator cuff tear pain is fairly specific and my view is that a herniated disk in the neck would not be producing pain that is similar to rotator cuff tear pain.

Herniated discs in the neck almost always produce radiculopathy, a radiating type discomfort down the extremities that follows a pattern known as a dermatone. Your orthopedist should have no difficulty ruling out a cervical disc as part of his differential diagnosis.

I believe in Chiropractic as physical therapy and adjustment for true subluxations, but if the Chiro doesn't make you feel better in three treatments, and almost well in ten treatments, stop.

They are not called "disc jockeys" for nothing.

When injuring during heavy gym workouts, muscle strain and sprain are more likely than a rotator cuff tear, unless you weren't doing the exercise properly.

I would certainly rely on the MRI to reach a diagnosis and then seriously consider having the ortho give you the proper excercises to strengthen the shoulder muscles in the area of the tear. From what I have learned in my case, I would not recommend surgery for a rotator cuff tear unless you are a young athlete, with miraculus healing capacity, who needs the surgery so you can return to a lucarative sports career.

[antony77]

Who is the chiropractor you are using?

I'd definately get an MRI. If it's a problem in your neck (perhaps a disc), you should get an MRI on that again.

Given a choice, I would highly recommend chiropractic treatment over anything invasive. A few years ago, I had a herniated disc in my neck but most of the pain was in my shoulder and upper arm. Doctors at the hospitals wanted to operate (remove the disc and fuse the spine).

After a couple months of chiropractic treatment, the problem was mostly gone. Much cheaper and safer than the surgery.

Same thing with me. Doc. wanted to operate. chiropracter fixed it. (dr don nakoya) Bioenergy