Cortisone injection in the shoulder

I'm trying to get to the bottom of a nagging shoulder so I can get back climbing w/o any pain. I am just curious who has had one and did it help at all? I had 2 shots done in my left ring finger years ago and I nearly ripped part of the Dr's desk off but never in the shoulder.

Chris

Years ago I had a shot in my wrist. It did help, but it is not so good for the old body. Have you tried seeking physical therapy? I'd do that as a start. There could be a structural issue in your shoulder. I wouldn't resort to cortisone as a first step, however.

Hey Tradster,
I've got a nagging wrist injury (probably a partially torn ligament) and the orthopedic surgeon recommended cortisone and a cast for 4 weeks. Did your wrist ever go back to 100%? PT hasn't helped yet (12 weeks out)
Thanks

Langlois wrote:Hey Tradster, I've got a nagging wrist injury (probably a partially torn ligament) and the orthopedic surgeon recommended cortisone and a cast for 4 weeks. Did your wrist ever go back to 100%? PT hasn't helped yet (12 weeks out) Thanks

Yes, it did go back to 100% but it took about 9 months. If your PT hasn't helped, I'd follow the doc's advice and do the shot and the cast. Have you gotten an MRI of the wrist yet? I wish you the best with that wrist.

A friend of mine had a couple injections in the shoulder about two years ago. They did help for several months afterward and allowed him to climb, but it did not resolve the problem long term.

Three injections per year max should not harm you.

Since conservative treatment did not work, he eventually decided to have surgery (subacromial decompression). I believe this resolved his problems, although recovery is not too fun.

Personally, I haven't found cortisone injections to be particularly painful, even in a small joint space (my toe). A shoulder injection should hopefully hurt less than your finger injections did since the joint space is much, much larger.

Langlois, what kind of wrist injury do you have? The use of a cast as first treatment sounds like you might have TFCC injury?

One big disadvantage of cortisone is that it can weaken the inflammed tissue (tendons) of the affected area. In other words, you're helping to reduce the inflammation but you're possibly damaging the connective tissue, ultimately making the problem worse, at least if you intend on trying to reuse the injured joint. In that sense, it seems really counterproductive.

I say give the area a rest, get some good PT and then see how it feels. Don't let your impatience to get back out there turn what might be a short term injury into a chronic one.

Tradster, I had a MRA done, where they inject dye directly into the joint to highlight everything and have done 2 rounds of PT. My rotator cuff is sound, no tears in the Labrum(from what he could see from the scan) and aggravation is more global in the shoulder than a pinpoint, sharp pain hence why it's nagging. The only thing he found in the MRA is a little arthritis in the AC Joint.The doc says the shot is the next step, he and I both want to avoid surgery unless it is absolutely necessary. I see my doc Tuesday so I will get some more options...hopefully.

Fat Dad and Aerili,

Thanks for the info! He did mention that it can deteriorate the tissue over time but again it is the next step out of the options I have. I'll see what he thinks Tues. Actually, I have climbed maybe a handful of times since the pain developed a couple of years ago so it's gotten plenty of rest.

I would certainly try everything prior to going under the knife. My experience was the shot wasn't painful..just a super warm tingling feeling...like a sports balm was injected into me. It lasted for three or four hours like that.

Tradster I'm glad you got back to 100%. Havent had an MRI, just Xray and physical exam. Aerili, the doc said TFCC was ruled on with the xray + exam (thats what I assumed it was too) I'm waiting until winter to do the cortisone+cast (trying to get the climbing in during these good temps). Thanks for all the info, good luck with your shoulder clemay

Clemay, I'm a little late on this, but I had a recent injection on a shoulder where the differential lead to SA impingement. This was most likely caused from overuse on a climbing trip followed by a gym session to closely. The effect was very rapid and so far after 3+ months, asymptomatic(knock on wood). No discomfort with the injection or sensation. Different story on the other shoulder.

I also had one on the other shoulder 3 yrs. ago from a nasty free-fall on the mtbike. Felt like a 260lb linebacker hitting the upper arm at full speed. MRI Arthrogram showed some labral fraying. The injection worked as well, and climbing seems to help, keeping it stretched. But I suspect that one will become surgical in the future.

clemay wrote:I'm trying to get to the bottom of a nagging shoulder so I can get back climbing w/o any pain. I am just curious who has had one and did it help at all? I had 2 shots done in my left ring finger years ago and I nearly ripped part of the Dr's desk off but never in the shoulder. Chris

I had one in my shoulder earlier this year. I was climbing, and pulled wrong when I did a small tear in my rotator cuff (rotor cuff, or how ever you want to spell it.) It was troubling me for several months when I finally went to an Orthopedic Surgeon about it.

We talked about it, and decided upon getting an injection over an MRI since I had reasonable range of motion and strength. He then told me to take about five days off, and then I could climb again. In those five days, I stayed on anti-inflammatory drugs and also iced the shoulder a lot.
After the five days, he had me start doing shoulder exercises like these:

askthetrainer.com/rotator-c…

I also did a "shoulder raise" which started with a light dumbell with my arm straight down, and raised it over my head with a straight arm at a 45 degree angle. This exercise however, targeted the specific place on my injury; I don't do it anymore since I have recovered.

The key to these exercises is not to use heavy weight, go very light. It's better to error on the too light side than on the too heavy side. I use a 10 pound dumbbell for the raises and for the band exercises, I use the purple Spry band:

amazon.com/SPRI-ES503R-Resi…

I had pretty much a full recovery, every now and then I get a twinge when I pull at an odd position, but it's not pain.

One thing about Cortisone, you don't want to get many shots. My orthopedic would give two at the most, and that's it.

Their web site seems hosed right now, but there is a home gym kit from this company:

monkeybargym.com

They have exercise bands that have caught my eye, along with some "rings" too. Hopefully their web site is just hosed and not out of business, I wanted to order that.

Since my injury, I have adopted a "Russian" style of strength training using kettlebells. The whole philosophy there is to keep a very strong shoulder. I pretty much follow this exercise video:

enterthekettlebell.com/

The video is a little on the cheesy side, but the exercises are very effective. Two other good videos from the site are The Naked Warrior and Relax Into Stretch, by the way.

I guess I tore mine in... Ugh, February or March-ish. I finally went to the doctor around May-ish. And now I am climbing at an all time best. I hit the climbing gym 3 - 4 times a week and outdoors both Saturday and Sunday.

To this day, I still do the band exercises on my shoulder 4 - 5 times a week. The classic, three sets with no rest between exercises.

Climbing involves a lot of pulling, as you probably now. From a fitness point of view, you need to work the opposite range of motion, or pushing exercises. The kettlebells do that along with push ups. Plus they engage your core too. If you only work one range of motion, ie pulling, and not the opposite, you can be prone to injury. Any good personal trainer will tell you this, if you work one motion, you need to work the opposite.

Hope this helps, that's my story about my shoulder.

I suffer from tendon impingement and tried about everything to get the pain to go away. Injections did little and ultimately I ended up with surgery. My recommendation is FINISH your Physical Therapy.

Fat Dad wrote:One big disadvantage of cortisone is that it can weaken the inflammed tissue (tendons) of the affected area. In other words, you're helping to reduce the inflammation but you're possibly damaging the connective tissue, ultimately making the problem worse, at least if you intend on trying to reuse the injured joint.

The risk of this occurring is not that great from one injection, depending on the structure in question and the underlying problem.

You have to weigh the trade-offs and consider the fact that a chronic injury itself is damaging to the joint and can ultimately cause degeneration in the tissues as well.

Squiddo, I went until my PT discharged me which was about 8-10weeks, 2x/week the 2 sessions I did plus what I did on my own but it's been a while since I've done any work with it. Where was/is your impingement and what did your surgeon do to correct it? It sounds like you are still having issues with it.

John, thanks for the story and the links. I have a couple of the spry bands that my PT gave me and have done some of those exercises, just right now I am taking a break from doing them so I don't overdo it.

JSM, glad to hear things worked out with the shots hopefully no surgery will be needed for your other shoulder.

Thanks for all the input!! It gives me a lot to think about.

Chris

Clemay:

Good luck with your shoulder!

Basically the surgeon trimmed back the tendon and cleaned up the surrounding tissue. Also "modified" the joint so as to decrease the change of another impingement, Its much better both after surgery and PT.

I had a "frozen" shoulder and couldn't lift my arm above chest high. The ortho surgeon gave me a cortisone shot which fixed the problem short term right away. The long term problem was that I had a lot of physical therapy to do to stretch the tendons around the shoulder. I have a whole regimen of exercises that I need to keep up with or the problem starts to creep back. Swimming helps, but only after I've stretched and warmed up. Get the shot, but more important, find a good physical therapist that can isolate your problem and kick your ass into keeping up with your therapy.

I've had elbow surgery as well as rotator cuff surgery. The elbow surgery I would avoid like the plague, but I tried to heal it for years with PT and rest (and cortisone) and it never worked. It took me over a year to heal after the elbow surgery. The rotator cuff surgery, on the other hand, went very well and I was climbing again in a few months. It was a good thing I got it when I did as I had already completely severed three of the four tendons that go through the cuff and they were too dead and shriveled to staple back together by the time they got in there. I had felt pain over the years but it always went away sooner or later, go figure. I guess dead, severed tendons don't hurt. Anyway, my point is most rotator cuff surgeries that I've heard of have gone pretty well and it might not always be the wisest choice to not have it done. It certainly wasn't in my case. They widen the opening and smooth out the edges so you don't have those nasty little bone spurs sawing through your tendons. Oh, and Chris, I can relate to the cortisone shots in the fingers. The doctor brought in two nurses to hold me down and told me to get ready for probably the most pain I've ever experienced, and he was spot on.

Keen, glad someone else felt my pain w/the shots in the finger!! Luckily my rotator cuff is OK, both the ortho doc and the PT checked it but thanks for your info on how your surgery went. I know a guy who has had, I think, 2 rotator cuff surgeries done on both shoulders and he still climbing .12's.

Oh sheesh, sorry, I should read through these threads a little more thoroughly before I post. I see now that you said your rotator cuff is sound. Well, hopefully my experience will help someone with their decision making. Best of luck with the shoulder Chris.