left shoulder pain

Vickie,

I have all the symptoms of rotator cuff problems in the left shoulder. I feel pain after sleeping a few hours. Some movements produce a sharp pain but most of the time I feel a dull ache but still can maintain a wide range of motion. I can lift my left arm straight to the ceiling and rotate 360 degrees but do feel some discomfort. No pain when swing a golf club. From what I've read it seems unlikely that I've experienced a serious tear but I do wish this d***ed thing would go away.

What excercises/stretches do you think would help??

Originally Posted by fdb2 Vickie,
I can lift my left arm straight to the ceiling and rotate 360 degrees but do feel some discomfort.

Yeah, 360 degrees of rotation might be your problem.




Just kidding, I realize you are probably referring to the movement of circumduction.

Maybe I can give you some information (you may already have this)

Shoulder pain felt in the deltoid region ( outer shoulder ) is often a result of rotator cuff pathology.

The main pathologies are impingement where the cuff gets inflammed and rubs on the acromion bone, tendinitis/tendinosis which are micro cuff tears or strains and finally cuff tear

The most common pathology is impingement associated with a painful arc at 90 degrees elevation and difficulty lying on the side at night. Common treatment includes phsiotherapy to strenghten the muscles that depress the humeral head, anti-inflammatories and corticosteroid injection. Surgery is an option if these fails.

The treatment for tendinosis is similar

Cuff tear is more serious and is manifest as weakness especially to external rotation of the shoulder which indicates a larger tear. It is corrected surgically if weakness is a major issue

You sound as if you have impingement. I would suggest you see a doctor and have a radiograph to exclude other pathology, confirm the diagnosis and arrange appropriate treatment. Sometimes rest will improve the condition but if symptoms have been greater than 4-6 weeks I would see a doctor

Hope this helps

Julian

Fdb2, Well you got some good information already; and yes if this is acute you should get a picture to make sure your problems are not more dire. I will be off line until tomorrow but if you look at a thread dated 10-20 Right Upper Arm that was started by Martee you will find exercises on page one to begin and page two to begin to move you to recovery. I think you will also find a followup by Martee where he indicated his success due to his willingness to do the exercises. It takes a few weeks before you see significant relief but just keep showing up. Be patient and be consistent and I think you'll be pleased with the results. Look forward to checking in on your progress. Let me know if you need clarification on any of these movements. Vickie

Thanks,

A doctor may not be in the equation just yet but I do appreciate the commentary.

Does anyone have opinions on Pete Egoscue and his approach??

Originally Posted by Julian Maybe I can give you some information (you may already have this)

Shoulder pain felt in the deltoid region ( outer shoulder ) is often a result of rotator cuff pathology.

The main pathologies are impingement where the cuff gets inflammed and rubs on the acromion bone, tendinitis/tendinosis which are micro cuff tears or strains and finally cuff tear

The most common pathology is impingement associated with a painful arc at 90 degrees elevation and difficulty lying on the side at night. Common treatment includes phsiotherapy to strenghten the muscles that depress the humeral head, anti-inflammatories and corticosteroid injection. Surgery is an option if these fails.

The treatment for tendinosis is similar

Cuff tear is more serious and is manifest as weakness especially to external rotation of the shoulder which indicates a larger tear. It is corrected surgically if weakness is a major issue

You sound as if you have impingement. I would suggest you see a doctor and have a radiograph to exclude other pathology, confirm the diagnosis and arrange appropriate treatment. Sometimes rest will improve the condition but if symptoms have been greater than 4-6 weeks I would see a doctor

Hope this helps

Julian

A torn labrum (sp?) has similar pain symptoms. One of these days I'll get mine taken care of. Luckily it is my right shoulder, so it doesn't bother my swing.

A torn labrum can certainly give similar symptoms although is less common

The labrum is the rim of tissue around the cup of the shoulder socket. The long head of biceps anchors off the superior labrum.

Labral tears are also known as SLAP lesions (superior labrum anterior posterior) or biceps anchor lesions

Diagnosis of SLAP lesions is best made arthroscopically (keyhole surgery) or with an MRI scan

MRI is also the modality of choice for a cuff tear.

Often labral lesions (superior) can remain untreated. In fact they are recently relatively new diagnosis secondary to the advent of shoulder arthroscopy and MRI

Julian

I'm in agreement with Julian's first post---you need to see a physician and get a diagnosis first, THEN decide what treatment is appropriate. I think you are working at this in reverse! My 2 cents! Dr Dave

Originally Posted by fdb2 Vickie,

I have all the symptoms of rotator cuff problems in the left shoulder. I feel pain after sleeping a few hours. Some movements produce a sharp pain but most of the time I feel a dull ache but still can maintain a wide range of motion. I can lift my left arm straight to the ceiling and rotate 360 degrees but do feel some discomfort. No pain when swing a golf club. From what I've read it seems unlikely that I've experienced a serious tear but I do wish this d***ed thing would go away.

What excercises/stretches do you think would help??

All friendly advices are good (but not necessarily competent!!!)
So let me give you a friendly advice: pain is ALWAYS an alarm signal, and try to overcome this fact with painkillers (including cortisone) is not a good idea.
A lot of publications prove that a good diagnosis (doctor's job) is the first point.
Physiotherapy is very effective, specially in shoulder's problems (as writen by Vickie).
I paid THE price when using steroids infiltrations for an elbow problem, just to relieve pain and continue to play golf...
So be confident with a good medical advice, and don't forget to RESPECT YOUR BODY SIGNALS
Friendly
PM

Originally Posted by Julian A torn labrum can certainly give similar symptoms although is less common

The labrum is the rim of tissue around the cup of the shoulder socket. The long head of biceps anchors off the superior labrum.

Labral tears are also known as SLAP lesions (superior labrum anterior posterior) or biceps anchor lesions

Diagnosis of SLAP lesions is best made arthroscopically (keyhole surgery) or with an MRI scan

MRI is also the modality of choice for a cuff tear.

Often labral lesions (superior) can remain untreated. In fact they are recently relatively new diagnosis secondary to the advent of shoulder arthroscopy and MRI

Julian

It is usually right around the time that I think to myself "hey, I don't need surgery" that I overdo something and it acts up again.

Or if I sleep on a bed that is too firm on my side.

Thanks for the info.

Darn frisbee golf! I remember exactly when I tore it too... ouch!

Well, as you keep hearing, a pictures worth a thousand words. A good look at your shoulder would help you make clear and the most effective protocol for treatment. I still always recommend appropriate training to strengthen the problem from it's origin and not just treat the final symptom/injury. I've seen many good surgeries only to manifest a different problem if the training/rehab wasn't complete. Good luck. Man I haven't heard anyone talk about frisbee golf in years; thanks for the memories. Vickie

I agree with Vickie that it is important to train correctly to prevent re-injury or making the problem worse. Almost all medical treatment benifits from maximal conditioning of muscle groups and also stretching to maintain mobility.

Corticosteroid has a bad name in the US and on the internet but if used correctly can be an important diagnostic tool and treatment.

It is not only a painkiller (analgesic) but also an anti-inflammatory. Interestingly it is often used successfully in non-inflammatory conditionss such as cuff tendinosis and tennis/golfers elbow.

The key to steroid is to avoid repeated doses at short interval as they can weaken tissues.

The problem is often the steroids only work temporarily and are then repeated too often causing damage.

Often the condition can get worse in spite of steroid and people often balme the steroid for a deterioration which may have occured anyway.

It is interesting the labral lesion occured suddenly, this is usually the case as is a major cuff tear. Impingement on the other hand often comes after repetitive above shoulder arm use (pay someone else to paint your ceilings)

In summary my advice is try exercises and if non improvement see an expert and have a diagnosis made. Then proceed from least invasive treatments to most invasive until the problem is resolved satisfactorily.

Cheers

Julian