Shoulder Issues -- Therapies, Surgeries, Etc.

Discussion in 'Health & Fitness' started by Spittle, Feb 3, 2008.

  1. Kaptain Karl

    Kaptain Karl Hall Of Fame

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    And please use sufficient amounts of ice when you do. A 10-gallon (or is it 15?) trash bag filled "loosely" with real ice and wrapped all around the shoulder is better than the cheesy pre-manufactured "cold paks" IMO.



    Very interesting. Many years ago it was actually my CMT (massage therapist) who noticed my similar problem. Her test was simple.

    She had me stand "comfortably" before a full length mirror. Notice where your hands hang in relation to your torso. (They should hang at your sides.) Mine hung by my front pockets ... more in front of me than beside me.)

    Doing this makes you very self-conscious (and finds you "making" your arms hang right) so she'd have do a squat in front of the mirror with my hands hanging limply ... and stand up. Wow! My hands would be at my pockets again.

    More attention to the Rotator Cuff exercises and Lats and Rowing weight training ... AND ... conscientious attention to my posture at all times ... and about six months later the poor posture / arm hang seemed to be fixed.

    See the top of this post of mine.

    - KK
     
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  2. El Guapo

    El Guapo Semi-Pro

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    Very common problem. Be sure that you go to a different PT this time because your last one was almost criminal to have missed that.
     
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  3. bronco_mba

    bronco_mba Rookie

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    Spittle,

    Sounds like you're on the right track. I was told to develop my back muscles as well, but I had a bone spur in the acromioclavicular joint that was a greater contributing factor.

    As for the cold pack, I worked with a gigantic reusable ice pack, purchased from the drug store in conjunction with a simple ace bandange.
     
    #53
  4. TTECHH

    TTECHH New User

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    #54
  5. Spittle

    Spittle New User

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    I'll try to describe the exercises the best I can.

    The most important part in all the exercises below is to 'set your scapula' before every exercise and every rep. This, unfortunately, is actually the hardest part to master because it's pretty much foreign to those of us that have hunched our shoulders forward all these years. It consists of forcing your shoulders/shoulderblades downward almost as far as you can *and* forcing your shoulderblades together 90% of the way. 100% of the way will feel unnatural but a slight release from that will be the ticket. And, all of these exercises should be done with good posture and a firm core.

    Seated Rowing
    - Sitting on an exercise ball, face a wall where tubing has been affixed at shoulder level. Bring arm out to 90 degrees in front of body and hold tubing with palms down. Pull arms back, squeezing shoulder blades together - but keep arms straight throughout the exercise. Slowly return to starting position.

    Prone Extension
    - Lie on exercise ball, face down, with a 2lb weight in the hand of the involved arm. Raise arm straight back until even with your body, then lower slowly. (Explaining these w/o pics is tough)

    Internal Rotation at 0 degrees - Abduction
    - Standing with elbow at side fixed at 90degrees and shoulder rotated out. Grip tubing handle while other end of tubing is fixed. Pull arm until perpendicular to body keeping elbow at side. Return to starting position slowly and controlled.

    External Rotation at 0 degrees - Abduction
    - Stand with involved elbow fixed at side, elbow at 90degrees. I do isometric holds here where I keep my elbow/arm fixed at the side of my body/90degrees and pivot my entire body to put strain on the lower shoulder muscles (instead of actually reaching across my body and using the arm itself to pull the tubing taut).

    I'm hoping you'll be able to google on some of these terms and figure out what will work for you. I also do a Prone Horizontal Abduction exercise and a stretch called 'Sleeper in 90deg of forward flexion'.

    You asked! :)
     
    #55
  6. TheShaun

    TheShaun Hall of Fame

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    Yes, the setting of the scapula is the hardest part by far. an easy explanation of it given to me by my PT is, "Picture pulling your shoulder blade down towards your opposite back pocket." So your right shoulder blade back down towards your left back pants pocket.
     
    #56
  7. Chauvalito

    Chauvalito Hall of Fame

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    Great thread, and informative posts.
     
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  8. bronco_mba

    bronco_mba Rookie

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    I've started using the USTA Player Development exercises post-op/post-PT to continue building strength in the shoulder:

    http://www.playerdevelopment.usta.co...inewsid=249182

    There are a number of shoulder/back exercises. The best part of the routine, as a non-gym member, is that I can do the entire routine with exercise tubing and a medicine ball.

    This may provide some guidance/suggestion for those not already on a physical therapy program for shoulder issues.
     
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  9. TTECHH

    TTECHH New User

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    Spittle,

    Thank you so much for the posts, you are a great asset to this site and this has to be one of the best threads running...maybe a admin will tact the thread to the top.

    bronco and others, great posts as well and thanks for the info.

    TTECHH
     
    #59
  10. Spittle

    Spittle New User

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    It has definitely been a community effort! I'm talking to the best folks I can find for this shoulder issue and I really really REALLY hope it gets resolved soon. So far, all the exercises are doing is aggravating those tendons a wee bit. They don't hurt *while* I'm doing the exercises, but certain arm movements afterward give me jabs of pain now and then.

    The link from bronco's last post didn't work for me, so I'll repaste it here :

    http://www.playerdevelopment.usta.com/news/fullstory.sps?inewsid=249182
     
    #60
  11. bronco_mba

    bronco_mba Rookie

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    Sorry about that Spittle! Thanks for reposting the link. I sincerely hope the PT is able to help you achieve long-term results. Keep the boards updated!

    I retained a personal trainer (also a staff member in my Physical Therapist's office) to design/implement a strength and conditioning program to help improve my overall fitness and specifically improve the strength and ROM of my shoulder. I asked for an emphasis on plyometrics and tennis-specific movements (i.e. not a bunch of bench presses and shoulder presses). I'll post the program here; hope it gives some TT'ers in a similar situation some guidance.

    I'm continuing to do well, now about two months post-op. Most of the pain is gone, but I can really only serve about a set (singles) before the shoulder starts to get sore and tired. Progress has been slow but steady.
     
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  12. dtd82

    dtd82 Rookie

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    update

    Off topic, but an ankle update.....been 4 weeks all-in, and I'm now out of the cast, and walking normally - tender, but fine. Pain is only the incision healing and the area stretching out. I figure in a month or two, back to complete normal movement. The initial diagnosis was a longitudinal tear in the peroneus brevis tendon - once the surgeon was in, the actual problem was a complete rupture of the peroneus longus tendon. The only repair option was to cut the shreaded part out, and attach the remains to the brevis tendon, so it's movement would continue to pull-on/move the longus tendon, thus keeping the calf muscle it's attached to working. He took pictures -gleefully said it was the worst he'd ever seen - showed them to me like a tourist shows pictures of buildings...ugly. Anyway, alls fine in the end, I (supposedly) won't notice anything weird once everything's healed.

    Now, springs breaking, most of my parts are working, I can't wait to get out and run around and hit a few balls - figure I'll play and enjoy the summer, address the shoulder in the fall.

    Kinda thinking about one thing - the MRI on the ankle showed problems, but in the end was pretty far off what was actually wrong inside. Makes me wonder about my MRI on the shoulder, or perhaps MRI's in general. I know theres a mess in the shoulder, but I'm alittle less quick to accept the reading of the MRI now. I'll be curious to see what the Specialist/Surgeon says/does when I attack this in the fall.

    Bronco/Spittle, glad to see your fun's working out - keep posting in, makes for very interesting reading.
     
    Last edited: Apr 4, 2008
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  13. Spittle

    Spittle New User

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    Jeez! You've definitely had a rough run of it lately, dtd82.

    Ultimately, you should end up having a normal xray, an arthogram xray (they pump your shoulder full of dye and xray you real-time), and an MRI on your shoulder. Each one tells the doctor a little bit of the whole story. However, it will probably come down to how the doctor interprets what he sees or doesn't see on the MRI. Once you get an MRI done and have your first surgeon look at it, borrow those exact MRIs (they should let you) and find another surgeon for a second opinion. If they both come up with the same interpretation, then I guess it has a better chance of being correct.

    Best of luck and I hope things get better for all of us!

    I'm starting to think we should all have our age in our thread signatures! :)
     
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  14. Kaptain Karl

    Kaptain Karl Hall Of Fame

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    Yikes! What'd you do to tear your calf tendon like that???

    - KK
     
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  15. dtd82

    dtd82 Rookie

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    Yeah, it's been a rough year so far, - but I think it's ending! Spittle, thanks for the lay-out of the process - I'll keep it in mind as I go through it. I have a CD with all my MRI of the ankle and shoulder - I looked at them but lord knows how anyone can read them. Obviously, the skill of the reader is key to the whole thing, as is the skill of the surgeon......

    Karl, the surgeon figured I'd been tearing the tendon for years, and it's blowout while playing was just the last straw....seems the way my feet are structured - very high arches - causes a lot of pressure on the tendons and other structures, and they're prone to tear. However, a complete rupture is very rare, so guess I won the brass ring.

    I'm aiming for late April to try to play a bit - gonna be in Florida with the kids for Spring break, and I'll get a chance to "lightly" play some golf and tennis......I've been walking "normally" on it since the cast was removed Friday, and while it's stiff and tender, all seems ok.....but I'm not pushing nothing!

    Oh, another annoyance......back 'bout October, when I was reviewing the status on both the shoulder and ankle with the doc, we went for a cortisone shot in the shoulder to help with the pain....it worked, so I played (hard, to test it) for a week...woke up one morning with a nasty elbow pain.....seems my arm wasn't up to the effort, so add in to my frustration tennis-elbow....which, combined with the non-recovering ankle, kept me out from Nov 'till now.....thankfully, the elbow's feeling better, but not gone....so, probably stupidly, but hell I'm a tad desperate, got a shot in the elbow during the visit to remove the cast. It's made a difference in the sharpness of the pain, though I still feel the twinge......

    I'm sure of the ankle recovery, know I can manage the shoulder, but the elbow, well, it scares me.....feels a bit like a betrayal of an old friend - guess I'd always taken the arm for granted, and now I have to work on it. Started some light exercises on it this week-end, and I'm gonna focus on getting the arm, shoulder, back, etc back into shape and stronger so when I hopefully play with some level of effort in the summer, I don't fall apart again!!!

    Oh, and as for age.......48.....
     
    Last edited: Mar 30, 2008
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  16. bronco_mba

    bronco_mba Rookie

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    My doc noticed some partial fraying of the labrum which didn't show up on the shoulder MRI during surgery, so I can attest that it happens. As good as diagnostic equipment is these days, there really is no substitute for a pair of trained eyes actually looking inside to see what's going on.

    The upside is that once the doc has you opened up during surgery and sees something that didn't show up on the MRI, they are in a position to take corrective action - versus conservative treatment where the doc never knows the actual extent of the injury.
     
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  17. Hokiez

    Hokiez Rookie

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    Depending on what kind of shape your in, I could also recommend doing a ton of high rep, low weight full body training, gently easing into the shoulder portions a small amount at a time. I hadn't been doing much training other than playing and had pain for over a year and took up these classes about 3 months ago and can now play pain free. I still have a small amount with certain movements, but even that is diminishing a little every week.
     
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  18. Kaptain Karl

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    Yikes! That reads like the surgeon's attorney wrote it.

    I'll continue to take the conservative route first....

    - KK
     
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  19. bronco_mba

    bronco_mba Rookie

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    Oh, dear...now everyone will know what I do for a living...
     
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  20. dtd82

    dtd82 Rookie

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    Well, things are moving nicely on the ankle front...roughly one week, and it's much looser and a bit less tender - funny thing, I've been limping since July, now I have to actually think how not to! Haven't tried any quick or running-ish movements yet, but it feels like that will react ok in another couple of days.

    Hokiez, I agree on the low-weight, high reps for getting the whole body back into shape - I started just that about three weeks ago - concentrating on the upper body as I had the cast on, etc.......course, seems I have to finally give in to age/condition and admit low weight has now become high weight!

    Bronco, did they clean out the frays when they found them? And how are you feeling - it's nice to read when things are recovering well......

    Oh, and I picked it up when you "retained a personal trainer"... heck, at least it's not banking...!
     
    Last edited: Apr 4, 2008
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  21. bronco_mba

    bronco_mba Rookie

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  22. kenshireen

    kenshireen Professional

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    Question About PT and Playing at Same Time

    I posted earlier... had an MRI and have a low grade tear of Supraspinatus tendon... Ortho recommended PT. I have been going for 3 weeks but also playing tennis... Serve motion at full speed causes some tringing....

    I have not received a clear answer from anybody as to whether I should NOT play while having PT. Any input from somebody who has gone through a similar experience would be appreciated

    Ken
     
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  23. Spittle

    Spittle New User

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    I went through 6 weeks of PT back in Nov/Dec 2007 while still playing tennis and never felt ANY better. I've since attributed the fact that my shoulder (impingement) got worse due to the general ineptness of my first therapists and the fact that I continued to play tennis sporadically during treatment.

    This time around, I'm 2.5 weeks into PT with therapists that seem to be on the ball and I haven't played tennis in almost 2 months. Even though my issues aren't completely resolved (I still hurt), I can sense that I'm finally on the road to recovery.

    For the best results, I would recommend laying off tennis for a bit while you do PT. If you're stubborn like me, try only doing motions that don't hurt at all - like groundstrokes. Serves and overheads really hurt like crazy for me and I should have stopped doing them before the pain became unbearable (and damage became that much worse). My new general rule of thumb is : if it hurts, don't do it. It won't heal if you keep aggravating it.

    Good luck!
     
    #73
  24. Z-Man

    Z-Man Professional

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    This is a great thread. Thanks everyone for taking time to post your stories. A few years ago I had the exact same problem many of you are talking about. Inflamed tendon in the shoulder, cortisone shot, MRI, etc. The doctor (one of my tennis buddies), said I could get the acromion bone shaved down if I wanted to. I took celebrex for a while, and that helped a little, but I was eventually able to heal myself. Thank God. At one point I thought I'd have it forever. It was a really hopeless and depressing feeling. I know that you guys know what I mean.

    Here's what I did: I started using a racquet that was headlight, heavy, and flexible, and I reduced the string tension. This racquet (POG LB) also happened to be longer, so I didn't have to swing as hard. And here's the most important thing: for about a year, I NEVER tried to hit any ball hard that was over my head. I just laid the serve in. I never attempted flat serves, and I never practiced the serve. When it was really bad, I started my service motion with my racquet behind my head. I went for placement, not power on overheads. Finally, it started to get better. It was a slow process, but I never stopped playing, I just changed the way I play. After several months, it finally got better. At the same time, I learned how to use my body better to generate pace.

    Now it has healed completely, but I'm still careful not to stress my shoulder. My game doesn't depend on a big serve, so I can get by. Good luck to everyone dealing with this problem. It's awful, but you can get through it--it just takes time--and for some, medical treatment.

    Now I'm dealing with a bum wrist. Never had wrist trouble in my life until I tried some poly. That stuff is evil.
     
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  25. Z-Man

    Z-Man Professional

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    Here's one more thing anyone with shoulder pain should consider: A Tempur-Pedic mattress and/or a bigger bed. I really do think this helped me a lot. I would play tennis after work until 9:30, then go home and sleep on my inflamed shoulder. The Tempur-Pedic allows your shoulder to sink in, so the blood flow isn't cut off. The bigger bed allows you to move around more so you don't spend all night sleeping on your injured shoulder.
     
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  26. TheShaun

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    has anyone ever had an ultrasound done on their shoulder? i've just come back from the doctor and she has referred me to have an ultrasound done at a sports medicine clinic.
     
    #76
  27. Spittle

    Spittle New User

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    If you're talking about the ultrasound therapy (not diagnostic ultrasound, but therapeutic ultrasound), yes I have. In my cases, they typically slap a bunch of gel on the end of a wand that is attached to an ultrasound machine. The therapist runs it around on your painful areas for 10 minutes or so. It doesn't feel like anything - no electrical zaps, no vibration, etc.

    To be completely honest with you, I can't really tell if it's doing anything at all. But, for all I know, it's a major contributor to my recovery! :)

    As far as my shoulder issues go, they're slowly getting better. The muscles under my lower scapula (that I've been doing exercises to strengthen) ARE actually altering the resting state of my arm - no more arching forward. From what I gather, it will take a while for the aggravated tendons to un-inflame. That will be a magical moment for me, for sure.

    Good luck with the ultrasound, TheShaun!
     
    #77
  28. TheShaun

    TheShaun Hall of Fame

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    i'm hoping it's the diagnostic type. the doctor said she would schedule two appointments for me, one for ultrasound and one for therapy. i didn't know there was ultrasound therapy till i came home from the doctor's office and googled ultrasound.
     
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  29. f1 tech

    f1 tech Semi-Pro

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    I've got the same treatment as you in my PT. I've done 6 weeks and I've notice a big difference. I have also changed to a more flexible racquet. Overall, my shoulder feels a lot better. My serves are more consistent and I'm not afraid to follow through. I also make sure I ice it down after playing which helps a lot.
     
    #79
  30. bronco_mba

    bronco_mba Rookie

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    I had something similar done during my first bout of PT before the surgery. I could never discern whether it was helping at all.

    I assumed (incorrectly?) a diagnostic ultrasound would be too low resolution to really visualize the shoulder like an MRI???
     
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  31. TheShaun

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    going for my ultrasound tomorrow morning...
     
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  32. bronco_mba

    bronco_mba Rookie

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    Good luck Shaun. Let us know what they find.
     
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  33. TheShaun

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    had my ultrasound the other day and will get the results when i see a sports medicine doctor on the 13th. ahhh, the joys of universal healthcare. gotta wait two weeks before i learn anything. if they say i need surgery, i should be able to get that done sometime around 2020 :)
     
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  34. Spittle

    Spittle New User

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    Ahh, sounds like you did have a diagnostic ultrasound after all. Hopefully you can get a straight answer and the doctors will get you on the path of recovery soon.

    As for my issue (I'm the original poster), I don't know what to think. I've completed 5 weeks of daily physical therapy with my second set of physical therapists (my 6 weeks with the first set actually made me worse). I see the shoulder surgeon again on Tuesday for a re-evaluation as to whether therapy or surgery is the best course of action for me.

    The therapy has, in fact, strengthened my shoulder and is helping my shoulder 'set' where it needs to (instead of slouching forward and impinging various tendons). However, it seems that I have a second issue that has tentatively been diagnosed as bicep tendonitis (on the front of the arm, hurts to reach across body,etc).

    After complaining enough about it, I am now being injected with Dexamethasone Sodium Phosphate (a corticosteroid) via a method called iontophoresis that is supposed to decrease the inflammation and stop the friggin' pain. Iontophoresis is a way to deliver a medication to a patient through the skin using an electrical current. It is based on the principle that like charges repel. With a direct current, an electrical charge can be applied to an ion of a drug with the same charge and the drug ion will be pushed away through the skin. I can't tell a difference yet. But, from what I've read on it, it'll take 4 or so applications.

    So, as far as my case goes, I'm still unable to play tennis and getting grumpier every day because of it. :)
     
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  35. Kaptain Karl

    Kaptain Karl Hall Of Fame

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    Spittle, have you considered getting a weaker friend or family member to hit with you ... while you teach yourself to play with your "off" hand? (Merely as an "in the meantime" measure. But it does keep your head in the game.)

    - KK
     
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  36. Spittle

    Spittle New User

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    That's a good idea! I'm just not sure I have the tolerance for it, unfortunately. Plus, my playing tennis with my off-hand would be a truly ugly sight. :)

    I'm going to have to do something soon though. Maybe let a teammate practice serves on me and just get the racquet where it needs to be (with left hand) and try rallies that way. At the very least, I'll get some aerobic exercise.

    Thanks for the idea, Karl!
     
    #86
  37. TheShaun

    TheShaun Hall of Fame

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    Spittle,
    I found that the PT did help, but only in recovery time. I'm only able to hit about 10 medium speed serves before the pain sets, which has been the case since the beginning, but now it takes 1-2 days to feel ok again rather than the 5-7 days of before.
     
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  38. Kaptain Karl

    Kaptain Karl Hall Of Fame

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    You're welcome. It came from personal experience.

    I wrecked my shoulder in HS and college. I taught left-handed for two years ... and actually got to where I could hang with low Intermediates.

    Give it a try. You never know, you may enjoy tennis before you thought....

    - KK
     
    #88
  39. Vision84

    Vision84 Hall of Fame

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    I have a messed up shoulder and after a few months the trainer finally decided I need to see an orthopedic about it as it hasn't gotten better. I won't go into detail about it now but it seems my shoulder has been pushed forward and when i try to move my arm upwards this way it hurts especially to the side with the palm down. I get a lot less pain when i pull my shoulder back and move my arm around. How do I go about getting my shoulder to rest further back again where it should be?
     
    #89
  40. Spittle

    Spittle New User

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    The exercises I've been doing for a while now are meant to remedy that exact problem (shoulder pushed forward, as you mention). My orthopedic surgeon directed me to do another 6 weeks of physical therapy targeting the muscles below and around my scapula (shoulderblade). The thinking behind this is that those muscles will strengthen and pull your shoulderblade down, which will open up the area on TOP of your shoulder so you have less chance of impingement.

    My first 6 weeks of therapy was with a gaggle of idiots that had no idea what they were doing. So, I had no improvement and actually aggravated the shoulder even worse. However, this second set of physical therapists are approaching the exercises in the right manner (small steps, NEVER work 'thru the pain', do slightly more weight and different exercises as you progress) and I am seeing results. Right now, my shoulder sets farther back (not slouched forward) than it probably ever has in my entire life. The pain is slowly disappearing and is taking longer than I'd like, but at least I'm seeing some improvement.

    The orthopedic doctor you go to *should* recommend physical therapy before wanting to do arthroscopic surgery (google it). In the meantime, don't aggravate the shoulder by serving, doing overheads, high volleys, etc. You may still be at the point where groundstrokes don't really hurt. If that's the case, whether you hit some is up to you. However, it's awful hard to force yourself not to hit the UBER OVERHEAD VOLLEY SMASH when the opportunity presents itself. :)

    Good luck, Vision84!
     
    #90
  41. Vision84

    Vision84 Hall of Fame

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    Thanks for the info Spittle. I think i should start to get better now as I quit tennis completely so I can concentrate on my rehabilitation with stretch bands. I saw a physical therapist about it in January who gave me some different exercises to do. Hopefully my shoulder will slot back in place, I will regain my lost strength and my muscle or whatever it is that feels strained will heal up.
     
    #91
  42. Spittle

    Spittle New User

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    Well, I don't know what to do...

    I just completed another 6 weeks of daily physical therapy (each session takes me about 45mins) using stretch bands, weights, isometrics, stretches. My shoulder itself is a good bit stronger and sets farther back than it ever has. One of my litmus tests (palms down, raise arms to side as if 'flapping wings') has a bigger chance of being pain-free if I'm careful about it.

    However, all the pain is still here. I may be able to do most of my exercises well and pain-free. But, day-to-day activities such as washing my own hair, stirring a pot of food, and putting on a coat still hurt just as bad as they did. Additionally, it seems that the bulk of my pain is coming from the front part of my shoulder (have been getting ionto steroid treatments for it with no positive result) which seems to be something that the physical therapy exercises isn't even targeting.

    I go to the shoulder surgeon tomorrow (world-renowned, works on the Braves pitchers) for my 6-week followup and I don't know what to say or think anymore. The therapy guy believes that, with time, I can still progress by conservative means. However, I have had absolutely NO relief from the pain in any way. Sure, I have strengthened my shoulder a good bit and am able to do the therapy exercises easier. But, I still hurt doing day-to-day things and I still hurt just as bad as I did a few months ago.

    Not sure why I'm babbling here on the forum about all this. I just want to finally be embarking upon the road to recovery. I've had two 6-week stints with PT. I haven't played tennis in about 3 months. What more can I do, conservatively, before I need to really consider surgery?
     
    #92
  43. bronco_mba

    bronco_mba Rookie

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    KK probably has some ideas, i.e. ART, chiro, which I don't think you've tried yet.

    My two cents? It's time for your Ortho to rethink his initial opinion that PT would take care of the problem and start exploring more invasive (surgical) options. At least have the conversation as to what he thinks you could gain from the procedure. The recovery time (assuming arthroscopy) is small (about two weeks before you have back most day-to-day functions; 1.5 months before you start to feel normal again) and the benefits could be lifelong.

    You sound like you're at the point I was at when I finally got over the hump and went for surgery. Rest failed, physical therapy failed, cortisone injection failed, MRI revealed impingement, nothing else was working, etc.

    I'm now just about three months post-SAD/DCR. I can serve all out and play hard with little fear of pain. I've been back playing for about a month and half now. I do get occasional soreness (like when I play two matches in one day), but it goes away quickly and is muscle-related, not the sharp, searing pain I had before the surgery, which was bone and tendon related.

    Keep us all posted. I'm sure others are going to have different advice.
     
    #93
  44. ivanovic-lover92

    ivanovic-lover92 New User

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    God you guys have much worse injuries than me and i thought I was badly off! My shoulder/back often has spasms and I get extremely sore pain sometimes and I'm only 15! Getting Orthotics for my feet has helped though as it imnproves your posture and alignment, so if any of you havn't tried that you might aswell! Looks like i'm in for a life of injuries anyways :(
     
    #94
  45. Ano

    Ano Hall of Fame

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    Guys, one of many things that you should do when you have shoulder issues is to learn to “reset” your breathing pattern.

    Do this simple test.

    In the front of a mirror, take a deep breath.

    Seriously, go ahead, take a deep breath.

    Did your shoulders rise when you took that deep breath? I'm willing to bet they did.

    Essentially, what you're doing is telling your levator, upper trap, and rhomboid muscles (all of which elevate the scapula) to fire... over and over and over and over.

    What you need to do is "reset" your breathing pattern to do more diaphragmatic breathing (breathe through your stomach).

    Now take a deep breath again, but this time through your stomach (fill the air to your stomach). Your shoulders will not rise.

    Make a habit to take breaths through your stomach that do not rise your shoulders.

    I learned this from Gray Cook, a very smart Physical Therapist. He is the Author of ATHLETIC BODY IN BALANCE.

    http://www.amazon.com/Athletic-Body-Balance-Gray-Cook/dp/0736042288
     
    #95
  46. dtd82

    dtd82 Rookie

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    Comes the time.....

    Spittle, you've certainly fought the good fight - comes the time when there's no other choice but the knife. The Ortho will be the final arbiter, but....

    I took from July to March to see if my ankle tendon would heal - didn't, came time; I'm now roughly 8 weeks past surgery, and while it's still tender, everything works properly now and it doesn't hurt. I played a couple of rounds of golf last week, first anything since July, and had no problems at all. So while this isn't a one-to-one comparison, I'd say it's time for you to look at getting fixed, and you'll be happy with the recovery time frame versus continued rehab.

    And keep us posted - while I've gotten one problem fixed, I've done something to further aggravate my shoulder; at this point, I can't handle any force either lifting or pushing outward - ie, either my serve or backhand. So, back to the surgeons for me.

    Bronco, you're still my inspiration!
     
    #96
  47. Kaptain Karl

    Kaptain Karl Hall Of Fame

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    Spittle, I hope you figure this out ... faster than I did.

    bronco is right about my point of view, but you've already seen that (top of page 2, this thread).

    This may surprise those who think of me as the "Alternative Health kook," but my only encouragement is ... remember all these "experts" you are seeing -- all of them -- are merely "hired help." You are the one who makes the final decisions on what should be done. Do not allow anybody in whom you don't have complete confidence to "run" your treatment. Listen to their opinions, conclusions and recommendations ... and YOU make the call on how to proceed.

    I pray you get excellent counsel and make good choices. Good luck with your recovery.

    - KK
     
    #97
  48. Spittle

    Spittle New User

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    Thanks for the tips and help, folks. It has really been appreciated!

    According to the doc (and the physical therapist), I have two problems with my shoulder. One is your typical impingement syndrome that I'm treating with the PT exercises - and it IS working. I definitely have farther to go, but I am progressing. My other issue is a severely inflamed bicep tendon (the pain on the front of the arm I mentioned). This is caused, according to the doc, by my bicep firing far too much in order to keep my 'loose' shoulder where it needs to be as I use it. Again, according to these folks, PT can help this but it will take time.

    The orthopedic surgeon said that he could go in arthroscopically and 'tighten' up my shoulder (basically shorten-by-cutting various tendons/ligaments, allow them to scar over) but the rehab time for that is between 4 and 6 MONTHS. He told me that I could expect to work on moving my arm another 10 degrees each week for up to 6 months before I can even touch a racquet.

    SO, I decided that I'm going to continue the physical therapy for another 9 weeks (when the next ortho doc appointment is). The surgeon recommended ramping up my PT a bit as well. I *WILL* beat this damnable problem if it's the last thing I do!

    In the meantime, I think I will try to play some tennis left handed to just keep in the game and, at least, keep the cardio/footwork part going. It's just going to be quite hard to NOT switch to the right just to "try it out".

    Wish me luck!
     
    #98
  49. bronco_mba

    bronco_mba Rookie

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    I wonder what the doc means by "tighten" or "shorten" the shoulder? When I had my procedure done, the doc cut through a ligament in the shoulder (I believe it was the acromioclavicular ligament), which in effect "raised the roof" on my shoulder, giving the humerus more room to move in the shoulder joint.

    My understanding is that decompression surgery involves shaving down the bone on the underside of the acromion to create more space for the humerus. Some bone grows back, but the end result is that more space is created, thus removing the "impingement." You get more room as a result of the surgery, not less. Maybe I am misunderstanding things.

    In any event, good luck Spittle with your PT and keep us updated.
     
    #99
  50. dtd82

    dtd82 Rookie

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    Spittle, faced with that explanation from the doc, continued PT seems best.....don't you wish this stuff would get easier?! Good luck, keep us posted.
     

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