Anyone have the beginning to end prognosis of this sort of thing?

I've had problems with my left shoulder for years........but this past thursday I really injured it good...and it wasn't from pulling wrenches.

I fast-walked down a steep hill at a 45 degree angle and the momentum of my body hurried my movements; when I hit the flat blacktop it jerked my upper body really hard.....sounded like that sound when you rip the shuck off an ear of corn at the same time I heard a loud pop.

Can't raise my arm if it is extended away from my body......only close. Went to the chiropractor friday and awaiting x-ray results. Did a neck manipulation and sent me home with bio-freeze and gel pack, sling.

Got no health insurance yet and I'm not going to start the process unless I really don't rebound from this any time soon.

It's not too awful bad because I worked all day friday within reason.....stilll was difficult working one-handed.

I'm going off what the chiropractor has to say as I have a good working relationship with him and he will not step out of his boundaries with his profession.

He did say that I will need to do exercises/therapy to get my arm back in shape; otherwise I'll be permanently damaged. Surgery is out of the question as I keep getting the resounding horror story of the down time and pain in therapy months after.

I do very physical work so it's not like I'm dealing with an injury and got my arm in a sling like I should. I did however take the weekend off, losing about $500 a day in service calls so I'll be worth something come monday, I hope.

 

sorry to hear about the injury. being blue collar is a pain sometimes.

if you have a rotator cuff tear, working it can be very bad as it is a tear in the muscle and if it is going to heal, it need tender loving care. Overuse or therapy is the wrong initial activity.

Now, since you cannot have an accurae dx yet, your injury may be of the type that requires therapy but doing one when the other is needed is going to cause you more problems.

You do want to prevent the joint from freezing up but you do not want to cause greater injury.

Bad news about no insurance. If/when you do get insurance, this injury is now a pre-existing condition and probably not covered.

A torn rotator cuff is not something an x-ray will pick up. X-rays don't do well with soft tissue imaging.

I hate to say this but going to a doctor and getting a proper dx is very important in the outcome of this situation.

 

I'll tell you what I know from personal experience. I used to be a bodybuilder, so I was always tearing and pulling ligaments and tendons, etc. I did go to therapy several times and found it to be useless. It's good for keeping muscles strong and toned as a preventive measure, but not for a cure. In my experience there was only two things, besides surgery, that worked. One was to get a cortizone shot, and I've had several, which cured it almost immediately. You do have to go to an Orthopedic doctor to get one, and I believe it was about $100 for the visit and $125 for the shot, so not real cheap but affordable enough. The other was rest, plenty of it, and unfortunately most people don't have that option.

 

cortisone is an anti-inflammatory. It doesn;t help the healing as much as it helps diminish pain.

actually just about any doc can shoot you with cortisone. My GP provided my wife with injections to her shoulder several times.(not rotator cuff tear)although the price was about the same as shadie listed.

the part of therapy I was recommending was not to tone the muscles or prevent atrophy from disuse but to prevent the joint from freezing due to disuse.

When a person is injured, they have a tendancy to limit the use of the involved body part. A therapist is trained (hopefully) to cause and teach you how to keep the involved body part from freezing while not causing additional damage.

the therapy is not intended for a cure per se but as treatment to either prevent a situation or treat the result of the injury (such as freezing joints) or keeping concerned muscles from experiencing atrophy or wasting from disuse or building them back up after atrophy has taken place.
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as I posted prior, until you have an accurate dx, it is impossible for anybody to rx a proper treatment.

If I were in your situation, I would use anti-inflammatories (aspirin, ibuprofin) to help relieve the pain. Gentle therapy (self designed or cruise the web for flexation exercises). Try to avoid re-injury if possible (that's a no brainer). Warm compresses (or hot showers) in the morning along with flexation therapy to warm up the muscles and provide movement for the joint before undertaking possibly damaging heavy work.

Cold compresses after work to reduce swelling which also helps improve blood flow. (swelling can restrict blood flow as it compresses the veinous system)

then when you can, get to a doc for a proper dx and treatment.

be forewarned though, as I posted before, this is now pre-existing and most insurance companies will not cover it.
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Sorry to say but you will need an MRI to determine whether you have a torn rotator cuff. It is difficult to determine from exam only. If you have a tear you will either have to live with it or have it surgically repaired. Cortisone will not help if it is a tear. Make sure you maintain as much range of motion as if you keep your arm down for even a few days you may get a frozen shoulder. You may have to have someone else help with this. Hopefully from your description it is just strained although the sudden jolt could just be the straw that broke the camel's back. Your chiropractor really can't do much for this. See a doctor either Family Practice or ortho. Stay away from walk ins they will bleed you dry. ER expensive. Find a doctor

 

I think Dunbar probably just "pulled" it rather than tore it, but a regular doctor would know right away.

 

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With his description (expecially including the sound of "husking corn" and a "pop"), I am hesitant to say a mere pull. From my laymans knowledge, I can't see a rotator cuff causing a "pop" although the tearing sound, maybe. I would tend to think more of a tendon or even ligament. If you tore a ligament from its attachment, no amount of rest is going to cure it. It either gets surgically repaired or it just doesn;t work. A tendon on the other hand would be responsive to rest as a treatment unless it was severe damage, then its surgery.

Since you have already lost near $1k and if it doesn;t heal, I would imagine there will be more losses involved, it may be more fiscally wise to get it dx'd and treated.

I, personally, would wait maybe a week or so (I tend to delay the inevitable myself) but any time using an injured shoulder could be making it worse, depending on the actual type of injury. What could be a "rest now" thing could turn into a "surgery is the only treatment thing".

 

The sound you describe sounds eerily similar to the one I heard when I separated my shoulder falling out of an attic

I went through a couple of months of therapy that did help a little, especially the little bicycle pedal thing that you turn with you hands.

A year or two later it happened again, because it never really healed in the first place
This time I went to a Viet doctor and he just shoved his thumb under the ball of my shoulder and popped it back in

Another year later it came out again this time he gave me the cortisone miracle shot
I have had then in my knees and shoulders so far and they do cure the problem by reducing the swelling and allowing things to go back where they are supposed to be

The shots were about three years ago and I have never had a major problem since then

I cried a little when I got them, but nobody saw me and it was worth it

If the shoulder is separated you can see it in the mirror
Pretty cool looking

 

I had something similar happen last fall while playing football with some friends. As I fell forward with my arm bent, my elbow hit the ground first, then my torso came down after it, which gave my shoulder a quick snap! It was sore, but not excruciating. A couple weeks later, playing football again, it REALLY began to hurt when I'd jump up to block a pass with that same arm. And again this spring I jumped up to hang by my arms on something and felt like I pulled it out of the socket again. (hurting more each time).

I've also been afraid to go to the doctor to have it looked at, and since I'm not in as bad of shape as our friend Dunbar Plumber, I doubt I will go unless it keeps getting worse.

Since there are varying degrees of shoulder separation, a Google search seemed to indicate that I'm experiencing a type 1 shoulder separation, which is the least serious, and usually only needs rest and some therapy (along with anti-inflamatories and ice as needed, I assume.) Unfortunately, I can't keep my arm in a sling for 6 months either. So I'd be open to hearing any suggestions for light exercises that might help strengthen it.

It seems like it will raise up and down just fine if I keep my arm out in front of me. But it's when I extend my arm out to the side and raise it or rotate it that it's uncomfortable.

I've been wondering about the cortizone shots too. Someone else I know also recommended accupuncture, but that sounds scary.

 

look into ACTIVE RELEASE TECHNIQUE. I hurt my shoulder in an auto accident and got no relief from many therapists and Chiropractors over a year and a half of treatment. I found a Chiropractor referred to me by a personal trainer. This was the most amazing thing after so long in pain and not even being able to comb my hair. The first treatment gave amazing results. Proper diagnosis and proper treatment is the answer or we completely waste our time and money!!!!

 

I tore my rotator cuff not too badly while climbing and didn't have someone look at it until after one day of activity I was in so much pain I couldn't move my arm (about 2 years later). Went to a physical therapy clinic, they did ultrasonic therapy, gave me exercises, massaged it gently. It nearly completely healed - sometimes it flares up but not badly.

I have been through PT for another injury that was much harder to diagnose, mostly because it wasn't something I had done, it was a poorly developed muscle in my lower back. This kept me from walking downhill in any capacity - my knee would totally give out walking down shallow stairs! I had to try two clinics until I found the guy who spent time and effort really tracking things down (which took about 3 hours). Went back for the next appointment, he gave me 4 exercises to do, and said if I did them faithfully he would be very surprised to see me for the problem ever again... and he was right.

In short, seek out a diagnosis and a good PT. Spend the money and time to repair your injury properly. While you may be losing money now, can you really afford to lose money now AND in the future if you don't address the problem properly? (Same theory as home improvement - take the time to do it right or spend twice as much time and money having to fix the problems later.)

Good luck with your shoulder!

 

Here's an update to how I "normally" take care of myself in situations like these:

I took off one day....and that was it as losing money is a bad thing in business and I made money all week, can't deny what makes the wheels spin.

I'm still dealing with pain with the shoulder but no where near as bad as when first happened. I have mobility out of the arm as when clutched close to my body, I'm okay. If I reach out in front of me I cannot even lift the weight of my arm.

I truly believe that my going back to work has helped tremendously within reason in building back motion through the arm. I've been to the chiropractor 3 times but cancelled friday's appointment due to heavy workload the day before.

I've done the "wait and see" method all my life. With or without insurance. I get a internal sense when I feel that something of true urgency is warranted (kidney stone) and I did not feel it on this one. By no means is this a rule to follow but you think of the thousands I could of spent easily by jumping the idea to go and get doctor's visits and mri's and different follow-ups......I can mount bills quite easily.

As long as the arm doesn't fall off and I'm slowly building mobility back.....I'm going with what I have to work with. I don't recommend it to anyone but I say that down time between occurrence and reaction are crucial.

I've darted from drain cleaning calls the most. But then again....that forcing to use that shoulder in that method may of actually helped my injury recover.

I'll post back in a few weeks to give what percentage of motion I have to go to get back to full mobility.

 

best of luck to you. I don;t agree with your treatment but it is your shoulder.

 

I don't agree either, but good luck. FWIW, in my case, only one visit to the doctor was required.

 

I also have problems with my shoulder-- not as bad as you though- But I also have a long time friend that is a chiropractor--- he gave me ultrasound on my arms and massaged the heck out of it-- he also gave me exercises to do-- like take a towlel and hold it behind your back and keep the good arm overhead and the bad arm below and raise the towel --up slowly-- no jerking motions- and if you feel pain DO not work thru it-- this is a tear and pain means stop. Also take a very very light weight and lye on your side and raise the bad arm up while holding the elbow against your side-- If you type in shoulder probkems and exercises you can find them online- Hopefully these will strengthen the muscles around the rotator cuff to make it liveable. Like I said I had it also-- I was playing football and made a very sharp turn to rach for the ball and I hit the ground like a ton of bricks- I could not breathe it hurt so bad-- But now I am decent-- still cannot throw a football or for that fact a softball without some pain- I throw by keeping my elbow in and do not do a complete windup. We just have to adapt... Good luck

 

My suggestion is to visit a sports doctor. Many have physical therapy right in the building, and they see these types of injuries all the time. You are looking at maybe $100-$250 depending on what's needed, but since you have already lost much more than that in wages, it would be money well spent.

 

I have been reading this thread but held off adding to it because I don't like trying to diagnose someone who's not sitting in front of me. However, I need to add emphasis to pendragon's post that the cost of a doctor visit that gets you back to work more quickly may actually be a savings if compared to the cost of lost work.

 

Well that's the thing, I've been working every day except for one day, two days after I actually injured the shoulder.

In just the span of days, I'm getting quite a bit of range out of my shoulder and arm movements. I'm not guiding my arm as much and I know that a few simple things like trimming a large bush out in the yard and purposely raising my hand up, slowly letting it down is therapy because the pain is leaving and the mobility is coming back.

If I would of harnessed this arm, took off work, to this day and beyond, we're talking a couple thousand dollars of income easily, then some. I'm guarded in my movements using the arm but not using it at all would of had me with an arm with no mobility till I follow the ranks of treatment which I'm sure would be 6 to 8 weeks, time off work and tons of money spent.

As I repeat, not in my best interest to go at it alone basically but you're responding to a plumber who was diagnosed with Advanced Degenerative Disc Disease and that I need to get out of plumbing, completely.

7 years later and running a successful business, maintaining a low level pain management ritual on narcotics, I'm proof that beyond diagnosis and what limitations "others" put against me, I'm my own driving force to keep going on because I love what I do, I can't find any job that will make me $150 for 10 minutes to replace a leaking angle stop on a toilet @ friday night, 3am in the morning.

The doctors wanted me to move to a sit down computer job for 8 hours a day, all but limiting my physical activity, and we all know how arthritis grows when inactivity is part of your daily routine.

If I stop being physical in my work, I'm expected to fall like a deck of cards. The physical/strenous activity is what is keeping me limber, shoulder included.

I still think your all's advice is very sound......I just can't ring up $5000 worth of bills knowing the arm *is* getting better and I've lost maybe 5 calls total so far.

 

First off I am not trying to give med advice and doing the wrong thing can do the wrong thing, but
It was almost a month before I went to the doctor with my arm.
I found that if I kept my hand in my pocket it did not hurt.
I was a commissioned employees so even with workman comp I lost money
I was told at 25 that I would be a cripple by 50 because of serious knee injuries, my job now requires me to run rafter in hot attics most of the day.
At 40 my doctor told me that what most people consider pain I have to consider the price of waking up in the morning.
I can't take any medication for it because I developed a strong infatuation for certain pills back in 85 when I broke my back and am terrified of a reoccurance
so I know where you are coming from

I only say this because only people like us know about people like us

One of the exercises that they gave me to do was something like a bicycle that you pedaled with your hands instead of feet. It seemed to be the most effective

I tried using a ten speed with the rear wheel removed for a while until I found that rolling a hose reel had the same effect and I could get paid for that.
I just had to take it slow at first, in this case real pain means stop for a minute.

They also had me doing a series of exercises with rubber bands that looked about the same as strips of bicycle inner tubes.
Cutting the bike tubes at different widths and/or doubling up gave different resistances.

If ligaments were torn there is the very real possibility of them fusing and limiting your range of motion.
If there is a separation it will never get better until it is put back
An old army field trick was to lay on a brick wall with your arm hanging down holding a five gallon can of water while someone massages it.
This work fairly well for me but I didn't have the masseuse
One method that is working for me is sleeping on the couch with my opposite hand propping me up by the shoulder ball

Again the best medicine is to go to someone licensed to practice medicine

Forgot to mention
My 60 year old back hills West by God Virginian step father had a separated shoulder and torn cuff for months
It never slowed him down to much
He built custom sheds for a living and carrying 3/4 plywood was a daily part of his life
He said that one day he noticed that it hadn't hurt for awhile.
So sometimes they do just fix themselves, on tough people

 

I am a surgical tech at the local hospital. (I pass the tools to the surgeons). I have done a lot of surgerys with rotator cuffs. I have seen some really really bad ones. Some were un repairable. Just clean up some of the soft tissue or inflammed tissue and close the wound.
PT is an idea but rarely helps. You can try but in the end might be a waste of money. Shots into the joint space will help with the pain and can last a while, depends!!

If you are getting mobility back and less pain there are excersies you can do. I got a sheet from a sports med doc and that helped to strengthen my shoulders. I am 27 and I hear mine pop once and a while and also have pain when I lift heavy things past a 90 degree angle to my body(shoulder height). The popping noise you hear was probably your torn cuff getting caught on the acromium(bone in your shoulder). That is the noise it makes. That is why when you have surgery on your shoulder they routinely do Acromioplasty's plus repair the tear.

If I wear you make an appointment and pay the doc for their half hours work. You keep letting this go and go you'll end up with a bionic shoulder. (total shoulder replacement) Which by the way is a pretty cool procedure.

The way you talk you make very good money so this would be a great thing to spend it on!!!!

 

I'm at 80% at this point with considerable pain at certain times. The pain radiates through my arm down to my elbow/wrist/finger and who knows if that is separate or considered part of the entire problem.


I've got full mobility in motion of the arm but I am very sensitive to all movements in motion. I catch myself sometimes using my right hand to guide the left to open the door or catch myself fighting to put deodorant on with that injured shoulder.


I've happened to come across a significant amount of people along with the gathering opinions on this site of what options I should employ.

I'm real curious to know what a month from now has in store for me as far as the pain level I'm involved in right now.

I'm able to perform all work duties in all aspects in regards to this injury. Whenever I work hard, really hard and use the motion of the arm in a way where it hurts the worst, the next day the mobility of that injury improves a little.

I've always been leery of moving forward towards doctors when things first happened; very easy to find someone who will cut on you for a fee.

If anyone knows this, that ability to throw your arms back and make the shoulders "pop"? I can finally do that in the past week to loosen up my shoulders and it feels so good to be able to do that again. I'm sure someone will tell me that is a bad habit but it's similar to popping your knuckles when they hurt so much.

I'd like to see the exercises you mention in regards to the injury I have; I bet money that some of them are very similar to the motions of some of the work I do in my day to day operations.

TIA