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.
Get to a doctor ASAP. I had a slightly torn left shoulder rotator cuff from throwing snow balls at a tree with my son (stupidly, trying to re-live little league glory days when I was a pitcher); I throw lefthanded, golf right handed. I lost a year of golf in the early 90's because I was too stuburn to go see a doctor right away. After a few months of sleepless nights, I couldn't take it anymore. See a professional .
Whew, we have a lot of similar and different opinions and experiences; all valid and still confusing when you're the guy in pain. An MRI will help to put your mind at ease and will give you clarity on choosing your course of action for sure. Follow your heart on this one. Most trainers hate cortisone injections but just like your mind needs to be at ease I find that in highly acute cases the constant pain and inflammation is as big a detriment to recovery as the injury proper. So I agree with Julian that if you are using a holistic approach to good science cortisone can be a useful tool to allow for gently and methodical healing protocols. Let's not forget good old fashioned rest for a few days.
Ofcourse you know from reading anything I write that you need to look at your basic postural alignment and begin some corrections on the foundation while you're making your choices.All the joint specific and sport specific training will not help you avoid an injury if your alignment allows for misagreement in the way your muscles do their job of providing your mobility.
This would all be easier if any two of us had the same genetic, lifestyle, swing style, and historical backgrounds. But alas, the mystery continues to call for group query.
All good recommendations but after you see the doctor, get multiple cortisone shots, physical therapy, stretch bands, etc. and still can't throw a ball (as I experienced). Get yourself a hard rubber ball(lacrosse or large super ball), a wall and read Http://www.mypressureproducts.com/pa...ence_chart.htm.
Start working the trigger points several times a day with the ball. Once the trigger point pain resides and your arm feels better buy a speed chain and start exercising the rotator muscles. Figure eights, circles, tennis backhands, overhead throws. Your rotator muscles will be stronger than ever.
I agree that one should concentrate on physical therapy as suggested.
My original post was just to point out that if symptoms are ongoing despite well advised/instructed therapy then getting the corrct diagnosis is a key.
Its very similar to the golf swing, its much more likely you will be able to fix what is wrong if you are sure you know the fault you are trying to correct.
Perhaps think of seeing a heath professional as seeing an AI, getting imaging like xrays and MRI as having your swing videoed.
Never let anyone give you more than 2- 3 steroid injections less than 6 weeks apart within a year peroid. If one steroid fails to provide symptom relief you need to consider other options.
Rotator cuff tears do not heal themselves however strengthening other parts of the cuff can make them clinically irrelavent. In fact many asymptomatic people have tears of their cuff that dont even know about.
The problem with a massive tear is that the longer it is left the more the muscle gets replaced with fat and the harder a surgical repair becomes.
Hence - make the correct diagnosis so you can select the best tratment option for you
Vickie, out of interest steroid in New Zealand has a bad name and this is probably as a result of inappropriate use. Why do you think trainers hat steroid? Is it for the same reason (they have seen it used incorrectly) or are there other reasons. (by the way I dont manufacture steroid or have shares in a drug company, just interested in you thoughts
Julian, I have to say that there are usually three excuses against good sciene that come up with trainers in regards to cortisone use.
The first is probably good old fashioned ignorance. Most trainers, even degreed professionals, don't know enough about their business beyond their specific physical applications.
The second is that cortisone masks the pain of the injury which is the sensory input that makes the injured party take notice and take treatment. Often, truly, once the pain is gone the individual goes on with their usual activities and causes further damage. This is where good education and prescriptive exercise requires the smart injured person to comply. Unfortunately we are all so 'human' and just like to get back to life.
The third reason, and this will sound like bashing, is that trainers often want to believe that they possess the true and maybe only solution. I must say that we see this type of consciousness in many, maybe most, industries but especially in the medical field; and I do consider physical training a critical part of positive medical protocol. I don't think it's so much arrogance as it is a firm, unyielding, belief and committment to the work they are doing. The higher option, in my humble opinion, is that we marry all of these good sciences to allow for the greatest ease through the healing process.
Most of my clients come referred by orthopedics or chiropractors and we have some extremely heated conversations, friendly though they may be. In the end I think their patient / my client wind up with a well designed, and usually unconventional, approach to their successful recovery.
I am really glad you asked the question. I just answered a post from Trig and suggested that I am struggling to do some writing about fitness and want to include these types of considerations. As we 'grow up' we are all going to be facing more challenges. The better educated we become about health care protocols, beyond hearsay fears, the more elegantly we can maintain our lifestyles.
I wanted to add that mb6606 did provide a great link to learn about pressure point therapy. I also think the product they are promoting is very good! Sport massage is all about pressure points and this is a way for you to apply your own. The page that links up is right on and the pictures are actually very similar to a product I am developing in that they are simple and to the point without a lot of unnecessary detail. There is power in numbers of participants. I am very happy to learn about this site. Thanks mb. Vik
Briefly, I got my Australasian Tour Card at the end of '04 and never got to use it. My left shoulder forced me to stop playing in FEb '05. I had x-rays, bone scans, MRI, Ultrasound and the list goes on but nothing really showed up. Had physio 3 times a week with no improvement and then got referred to a surgeon.. My story has a little update at each stage after that...
My advice for any golfer is when you first get injured don't just think it'll be ok with a little rest... yes most will be but some don't. Then you try and play more or do something else with it and before you know it you've damaged it worse. Nip these things in the bud and seek professional advice early. Easier to treat a little strain or tear than a full tear or something worse. Better to spend $100 to be safe in the beginning or end up $8,000 out of pocket like me and not play golf for 14 months.
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