biceps tendon problems

I had a biceps tenodesis, subachromial depression and debridement of my left shoulder in October of 2011. Despite a few painful weeks immediately following the surgery, I am now 3 months out and very happy with my results. I am basically completely pain-free in my left shoulder and have been skiing and carrying a heavy pack on hikes for the last month or so. I went on a hut trip over New Years and climbed uphill on skis about 2000ft each day and my operated shoulder felt great...a little sore but I nothing even worthy of ice or NSAIDs. I still have a ways to go to get my full ROM and strength back but overall this surgery was way easier to recover from than I had ancitipated. The MRI before surgery found a labral tear but the labrum was actually completely in tact when the surgeon (Dr. Millet at Steadman Hawkins in Vail) went in. That was a huge relief.

BUT, my problem and the reason for this post is about my other shoulder. Now that my bad one is fixed the other one has become much worse as often happens. My right shoulder was mildly symptomatic before but has now started to bother me on a daily basis and hurts/aches at rest. I am fairly certain that I've got similar stuff going on - biceps fraying and some impingement, maybe a little RC fraying. My right shoulder clunks and sometimes makes a bit of a cracking noise - I'm not sure whether its the tendon or the labrum or what. In any event, I'm now at the point where doing PT on my operated shoulder is aggravating the shit out of my unoperated shoulder. I tried a cortisone shot in the subachromial space but I can't really say its done much at all.

I suspect that I will need to bite the bullet and have surgery on this arm too but for various reasons I cannot even think about it until late spring or summer. I would be more hesitant to sign up for surgery except that I had such good results with the first one that I don't see much point in waiting until it gets even worse. Does anyone have any tips for managing biceps pain/tendonitis in the meantime? Should I try to get an injection right into the tendon instead of just the joint? I don't want to rely on injections but I just need to buy some time.
Better yet, did anyone find that the pain in their nonoperative shoulder went away eventually when the operative shoulder became 100% again? I suspect this is really wishful thinking.

Amy

I think asking for medical advice on the Internet is a mistake! What does your doctor/orthopedist recommend?

My right shoulder clunks and crackles - severe arthritis/degenerative joint disease. "Partially frozen shoulder."

Well I definitely am not seeking medical "advice" so much as just tips, suggestions, comments, etc. I don't think there would be much point to an "Injuries" Forum if we couldn't do at least that much...other than bitch about our injuries of course:-)

The surgeon said basically he thinks the cortisone shot will clear it up and I won't need surgery. I really doubt that as I have been dealing with this for the last year now and it hasn't gotten any better and has recently gotten worse. I'm waiting the mandatory few months to demonstrate to him that his beliefs are in fact not correct. In the meantime, I need some pain-relief.

As for arthritis/degeneration - I have always been confused about the cause of that in the shoulder as it is not a weight-bearing joint. Is it typically related to an initially traumatic injury? Can one develop arthritis in their shoulder simply by wear and tear? I guess I would think that if I didn't have any arthritis in my left shoulder I probably don't in my right but stranger things have happened!

Hey Amy,
Sure is funny to read your initial posting about your experiences. I had the exact same procedure done at Steadman-Hawkins by Dr. Hackett April 2011. I skied (mostly toured) in the BC at 6 weeks and did my first climbing at 8 weeks! I was very diligent with my PT but I was subconsciously compensating with my posture to find comfort which drove my thorasic spine bonkers. I had some trigger point needling done which I believed help relax some permanently flexed muscles and began doing my exercises on both shoulders. Now, I continue to do a lot of my cable exercises with both arms and find that I have stability in both shoulders. I know my therapist had bad shoulders and he would strengthen the muscles to create stability in the joint. I think focusing on the thorasic spine helped me significantly though, and I do recall there being a period of time where I felt a brief plateau in my recovery (non-operative shoulder played part in this) but continued focus on the PT brought me out of it and to where I am today. I feel that my surgery shoulder is stronger than ever and my posture is better as well. Good luck!

Amy Stengel wrote:As for arthritis/degeneration - I have always been confused about the cause of that in the shoulder as it is not a weight-bearing joint. Is it typically related to an initially traumatic injury? Can one develop arthritis in their shoulder simply by wear and tear? I guess I would think that if I didn't have any arthritis in my left shoulder I probably don't in my right but stranger things have happened!

As I understand it, arthritis is a loss of cartilage. That simple.
My orthopedist said they don't know what causes it, whether it's a virus, genetic or wear and tear. Apparently, there is no definitive cause. I thought it came from years of racquetball, but other people play for years and don't get it. He quickly diagnosed it when he saw the X-rays of my shoulder.

Good luck with your shoulder. My shoulder obviously is limiting to my climbing, but I still have fun and work around it!

I once had a cortisone injection in left elbow for tendinitis. Felt good for a month, then severe pain returned. I think going cold turkey for a few months is a better treatment of tendinitis. My shoulder arthritis developed from wear and tear aggravated by injuries. At present, growing new cartilage is impossible, and glucosamine is therefore a placebo. I had three replacements, and I'm climbing well, considering the injuries my shoulders have endured. I warm up slowly on easy routes, so my elbows remain free of tendinitis and my shoulders relatively flexible. Sometimes I ice after climbing or work out.

amy, were you doing your exercises on both shoulders, or just the previously injured shoulder?

I try to do my PT exercises on both sides following surgery on my left. On days when my unoperated shoulder was really sore I just left that side out. I have a small baby that I carry around in my right arm all the time so it was already getting worked from that.

I'm trying to strengthen the RC muscles to stabilize the joint but my feeling is that the biceps is continuing to fray and pull on the joint so its really not something that is going to be fixed by PT unfortunately.