Bursitis and small tear

[Panangga]

Recent ultrasound report said : "subtle small deep surface tear of the supraspinatus but without loss of the overall contour of the tendon. Moderately extensive fluid within the subcranial bursa."

I'm resting from tennis - 15 days now - who's counting. ha ha. Icing, heat, etc.

The doctor said it would heal itself - is she be right?

 

[Veninga]

I had almost the same.

For me 6 weeks total rest helped a bit. Then started to play again and the tendon got inflamed. Now, 3 months later, after loads of exercises/stretching by a physiotherapist i am able to play again. but still mis 10% of my motion in both ways.

2 tips.

- make sure you really dont stop using your arm. so get that cup, do the laundry etc. worst effect will be that you develop an minor/major frozen shoulder. then you are even further away from the tennis court.

- icing, but also ibrupofin or something when it inflames. without any hesitation. it leads to impingement and that is really nasty..

good luck

 

[Panangga]

Many thanks for reply Veninga. I'm glad you are able to play again.

I'll continue the icing etc. and try to be patient. Thank you for the tips.

All the best.

 

[Chas Tennis]

There are many threads on shoulder injuries.

Search terms:

shoulder injury tendon healing time CharlieFedererer impingement

Search: Todd Ellenbecker video shoulder impingement 8 minutes

An inflamed bursa sack can swell and increase the chance of impingement.

I believe that Pacific Lefty had an inflamed bursa sack and and an irritated supraspinatus eventually treated by surgery. Search her threads for a similar injury.

Determine how long it takes for a tendon to heal. 2 weeks is not nearly enough.

Maybe you have impingement so make certain to see the Ellenbecker video and the advice for shoulder orientation on the serve to minimize the risk of impingement.

 

[Panangga]

All this rest from tennis and not much improvement in the shoulder. No discomfort until I use the shoulder, as in vacuuming, mopping the floor.

I've started hitting against a wall using my left hand - has anyone successfully mastered this? I feel I am improving! Where are those "patience pills".!!

 

[charliefedererer]

We've all seen skin wounds heal fairly quickly.

But the skin is made to heal rapidly - it's our protection from the outside world, even if it is fairly flimsy.


Tendons on the other hand are strong - but take a LONG time to heal because they heal in a totally different way than skin.

Tendons heal by the body laying down protein strands that look like a spider's web.

It takes a long time for cross links to form to convert those wispy strands into the strong tendon that existed before the injury.

If you return to tennis - or even too much stress from every day activities - you pull those strands apart, and the body has to start all over again.


Most start to "loosen" the shoulder by doing "range of motion" movements rather than exercises that are intended to actually "strengthen".

Only after they can do these "movements" do they move on to actual "strengthening" exercises like the "Thrower's Ten": http://www.muhlenberg.edu/pdf/main/athletics/athletic_training/throwers10.pdf

And tennis with that shoulder should not happen until the above exercises can be done without pain.




As to using your left hand - many here have done it rather than waiting through the whole process.
(The frustrating thing is that it is takes an awful long time to be anywhere near as good as with your dominant hand.)

 

[Panangga]

That's very thoughtful of you CharlieFed sending that information. Thank you.
I was starting to feel quiet despondency, but now I have renewed faith!!

I shall include some of those exercises with the ones I am already doing.


Yes, it's pretty dismal playing with the left hand but gradually improving; the serve is weird though and like you say, will never be as good as with the right hand.

Many thanks once again and all the best.

 

[Chas Tennis]

Todd Ellenbecker Video on Shoulder Anatomy, Injury Risk on the Serve

Here's the Todd Ellenbecker video on the shoulder. At minute 8 he describes the one-up one-down shoulder orientation and alignment to use on the serve to minimize impingement.

http://www.tennisresources.com/index.cfm?area=video_detail&vidid=3712&ATT=&reso=lo

Consider if you have impingement AND the tissue at that location is also swollen.

When I had a supraspinatus tear on my non-tennis arm, a physical therapist looked at my shoulder posture and selected light shoulder exercises to improve the position/posture of my shoulder blade/scapula. He carefully supervised how I did the exercises. I believe, but do not know, that I injured my supraspinatus at the gym by using too much weight for the well-known rotator cuff preventive exercise - external shoulder rotations. I did not understand that these are lighter weight exercises. I was using 25 lbs and more on pulleys. Now, I use light resistance bands (Theraband yellow).

 

[Chas Tennis]

Be sure to understand this Todd Ellenbecker video on the shoulder and impingement risks for serving. There is a shorter video by Jim MaClellan but this one has the details plus preventive conditioning.

Here's the Todd Ellenbecker video on the shoulder. At minute 8 he describes the one-up one-down shoulder orientation and alignment to use on the serve to minimize impingement.

http://www.tennisresources.com/index.cfm?area=video_detail&vidid=3712&ATT=&reso=lo

Consider if you have impingement AND the tissue at that location is also swollen.

When I had a supraspinatus tear on my non-tennis arm, a physical therapist looked at my shoulder posture and selected light shoulder exercises to improve the position/posture of my shoulder blade/scapula. He carefully supervised how I did the exercises. I believe, but do not know, that I injured my supraspinatus at the gym by using too much weight for the well-known rotator cuff preventive exercise - external shoulder rotations. I did not understand that these are lighter weight exercises. I was using 25 lbs and more on pulleys. Now, I use light resistance bands (Theraband yellow).

 

[Panangga]

Thanks ChasTennis. Yes I watched the video - it's great. some good advice there.

I'm starting with 1 kilo weight!

All the best .

 

[Panangga]

If you are supposed to rest from tennis to help heal a tear, surely all these exercises would detract from the healing?

On the other hand, I'm still doing them and feel a very slight improvement - very slight! Not enough to get back on the court.

 

[charliefedererer]

"Most start to "loosen" the shoulder by doing "range of motion" movements rather than exercises that are intended to actually "strengthen"."

I wrote this above, and what I meant was that these movements put very little stress on the tendons compared the the great force of bashing a tennis ball.


As the tendons heal over time, using light dumbbells and elastic tubing can start to strengthen the muscles very gradually - again without the force of actually playing tennis.


Only when the thrower's ten exercises can be done without pain is it time to try a short hitting session.

 

[SimonSays]

I had bursitis before and it was really really bad... I had to stop from playing tennis and biking, which was depressing. I've tried different medications and consulted to different doctors. I was told by my coach to go for stem cell treatment, which I tried with my orthopedic surgeon, Dr Grossman. The therapy went fine and it was more than a year now, never felt pain on my right shoulder again..