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shoulder soreness/weakness
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By NickinCO
From colorado
Apr 27, 2011
after the hard stuff, into cruiser hands.
So a few months ago I injured my shoulder when I slipped off an arch and caught myself with just my right arm. At the time of the fall nothing hurt but later that day I noticed my right shoulder was pretty sore. I stayed off overhanging routes for a couple weeks and it appeared to heal. About a week ago I was working a route on the arch again and now my shoulder is sore constantly. I've already decided to take a couple weeks off of climbing. Without going to the doctor I think it might be a grade 1 AC separation. There is no swelling/shooting pain/bruising/pain to touch. It's just a pretty constant soreness, and it feels a little weak at certain ranges of motion, this feels like it's right in the center of my shoulder at the joint. It doesn't hurt any worse when climbing or doing any other activity either.

I borrowed my buddies latex physical therapy bands and I have a list of shoulder exercises from a PT for shoulder injuries. I was planning on giving it a week of no activity but I've read online that it's good to start working the shoulder lightly with the bands right away as long as there is no serious pain.

Thoughts?

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By Old and Busted
From Centennial, CO
Apr 27, 2011
Stabby
Get it looked at professionally so you know what it is and stop guessing. With how you hurt it a SLAP tear is possible, but who knows.
Welcome to the club, we all have hurt shoulders.

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By Ted Farley
From Bozeman, Mt
Apr 28, 2011
Bellying on the Wedge.
Nick,

Bummer. I had my shoulder partially thrown out skiing bumps. My shoulder hurt pretty bad for about a week or so but the pain tapered off.

I noticed that my injured shoulder was much higher than my uninjured shoulder for a while, even to this day. The deep soreness in my shoulder came after climbing in the gym, especially from overhanging routes.

I never got officially diagnosed because MRIs are really expensive but after about 3 months of PT I noticed I was like 80% better. Occasionally said deep soreness will arise from the dead after a lot of steep climbing but band exercises worked wonders for me.

Sounds like you're doing all the right things, good excuse to maybe work on those lower angle routes. Good Luck

Ted

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By Evan1984
Apr 28, 2011
Mike Lane wrote:
Get it looked at professionally so you know what it is and stop guessing. With how you hurt it a SLAP tear is possible, but who knows. Welcome to the club, we all have hurt shoulders.


Amen, and welcome to the club! It's large and not very exclusive.

The thing with joint injuries is that they start to feel better before they are back to full strength (it never will be, likely). Get it looked at because listening to any of us is worse than diagnosing yourself on webMD. The doc may tell you that rest is the remedy or schedule you for surgery. The point is we can't tell you which it is, so you could be delaying your recovery or injure yourself worse in the meantime.

Good rule of thumb is that if its bad enough for you to post about it, you should make an appointment.

The strengthening excercises will help, but don't push yourself. If you injure it worse, you're out for a good while.

Evan

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By NickinCO
From colorado
Apr 28, 2011
after the hard stuff, into cruiser hands.
You guys are just repeating what I already know... I guess I feel like it doesn't hurt that bad so it can't be injured that bad. I admittedly don't know much about joint injuries though. I made an appointment today, I'll report back this afternoon.

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By John Farrell
From Phoenix, AZ
Apr 28, 2011
Having fun at the Enchanted Tower.
I hurt my shoulder back in the end of Feb while climbing. I rested it for about two weeks and resumed climbing light on it. There was discomfort in it, but not a serious pain, so I didn't think it was injured too bad. Two weeks ago, the shoulder was feeling great and strong again, so I started climbing at my regular grades. The pain started coming back, keeping me up at night, when driving my car, and other daily activities. I finally went to the doctor and got an MRI with contrast. The news was broken to me two days ago, I have a "significant" SLAP tear. The Doctor was amazed I was able to climb on it. Next month I go in for surgery, which will have a six to eight month recovery time.

Even right now I am still in shock and denial over how serious the injury was because it really never hurt that bad and I could still climb on it. There was never any swelling, bruising, or soreness to the touch.

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By NickinCO
From colorado
Apr 28, 2011
after the hard stuff, into cruiser hands.
John Farrell wrote:
I hurt my shoulder back in the end of Feb while climbing. I rested it for about two weeks and resumed climbing light on it. There was discomfort in it, but not a serious pain, so I didn't think it was injured too bad. Two weeks ago, the shoulder was feeling great and strong again, so I started climbing at my regular grades. The pain started coming back, keeping me up at night, when driving my car, and other daily activities. I finally went to the doctor and got an MRI with contrast. The news was broken to me two days ago, I have a "significant" SLAP tear. The Doctor was amazed I was able to climb on it. Next month I go in for surgery, which will have a six to eight month recovery time. Even right now I am still in shock and denial over how serious the injury was because it really never hurt that bad and I could still climb on it. There was never any swelling, bruising, or soreness to the touch.



ouch man that REALLY sucks. I really really hope it isn't that bad. I don't have anywhere near enough sick time at work for something like that.

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By Evan1984
Apr 28, 2011
Nick Mardirosian wrote:
You guys are just repeating what I already know...


That's the point.

What did you expect to happen? Did you think an MD would hop on, diagnose you without any examination or imaging, recommend you a course of treatment and mail you a prescription?

Look, nobody wants to go see the doc, but its the only sure option.

I do hope it goes well for you and you find out its a simple fix.

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By Gif Zafred
From Pittsburgh, PA
Apr 28, 2011
Gif on Bimbo Shrine, Kaymoor
Shoulder injuries don't always hurt. I've dislocated both of my shoulders several times. I've had surgery in them both and they have since been good to go. Before, when I would dislocate, it would hurt for a couple days. Not bad pain but just good and sore. Then it would go away. However, they were wrecked and I had a bankart lesion in both.

Just because it doesn't hurt, don't think they are good to go. Get an MRI with contrast and see an ortho.

To add to John's post, I don't know his situation, but I had 6 month recovery. I was in a sling for 4 weeks, then it took another 5 months of PT to get it back up and running. Takes about a year to get full strength and mobility back to "normal".

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By Paul Davidson
Apr 28, 2011
You asked
Nick Mardirosian wrote:
Thoughts?


then complained:
Nick Mardirosian wrote:
You guys are just repeating what I already know...
when you got thoughts.

Seems to me those thoughts got you to pony up and see an MD and perhaps save you a lifetime of shoulder issues. You don't want to screw around with injuries to major joints unless you really to want to pay the piper when you're older.

I injured a shoulder very similar to yours. After 3 months it still hurt, never bad. Finally saw the Doc who referred me to PT and that made all the difference. I just wish I hadn't spent time waiting to see if it was a "real" injury.

Sounds like you're on the right path. Best of luck.

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By Amy Stengel
From Boulder, CO
Apr 28, 2011
I was diagnosed with a superior posterior labrum tear (similar to a SLAP tear but just in a different spot on the labrum) in February after a month of increasing pain when I was nordic skiing. I'm not sure of exactly when it happened but regardless the PT didn't help nor did cortisone, NSAIDs or a bunch of other stuff I tried. I am now scheduled for surgery in July and my shoulder seems to get worse each week. I have signficant soreness in the mornings when I wake up and I wonder if there is tendonitis that is aggravating things more because the SLAP tear shouldn't really be so painful.
In any event, definitely get it checked out - it never makes any sense to do general PT exercises for a joint if you don't know exactly what is injured and exactly what motions/exercises are going to aggravate it.
Seems like the standard recovery time frame is 6 months though most are fairly active with non-shoulder activities by 3 or 4 months. I've heard that shoulder surgery is one of the more painful initially but that within 2 weeks the acute pain from surgery should diminish and you're just left with a lot of weakness and loss of ROM until you get that back through PT.

Good luck.

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By NickinCO
From colorado
Apr 28, 2011
after the hard stuff, into cruiser hands.
Paul Davidson wrote:
You asked then complained: when you got thoughts. Seems to me those thoughts got you to pony up and see an MD and perhaps save you a lifetime of shoulder issues. You don't want to screw around with injuries to major joints unless you really to want to pay the piper when you're older. I injured a shoulder very similar to yours. After 3 months it still hurt, never bad. Finally saw the Doc who referred me to PT and that made all the difference. I just wish I hadn't spent time waiting to see if it was a "real" injury. Sounds like you're on the right path. Best of luck.


I wasn't complaining. I did see the ortho doc today. X-rays came back normal although I do have rotator cuff impingement (and horrible posture with not enough musculature in my lower deltoids apparently). He set me up with an MRI on monday and 2 rounds of PT next week. Fingers are crossed it's just tendonitis. I should know the results of the MRI tuesday morning.

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By NickinCO
From colorado
Apr 28, 2011
after the hard stuff, into cruiser hands.
Amy Stengel wrote:
I was diagnosed with a superior posterior labrum tear (similar to a SLAP tear but just in a different spot on the labrum) in February after a month of increasing pain when I was nordic skiing. I'm not sure of exactly when it happened but regardless the PT didn't help nor did cortisone, NSAIDs or a bunch of other stuff I tried. I am now scheduled for surgery in July and my shoulder seems to get worse each week. I have signficant soreness in the mornings when I wake up and I wonder if there is tendonitis that is aggravating things more because the SLAP tear shouldn't really be so painful. In any event, definitely get it checked out - it never makes any sense to do general PT exercises for a joint if you don't know exactly what is injured and exactly what motions/exercises are going to aggravate it. Seems like the standard recovery time frame is 6 months though most are fairly active with non-shoulder activities by 3 or 4 months. I've heard that shoulder surgery is one of the more painful initially but that within 2 weeks the acute pain from surgery should diminish and you're just left with a lot of weakness and loss of ROM until you get that back through PT. Good luck.


Did they make the diagnosis through an MRI or was the doc pretty confident right away? I've only kept myself inactive since this last saturday. On a 1-10 my pain is a 1 and would be described as just soreness. I end up sleeping on that shoulder at night and I actually feel better in the morning. The soreness starts as soon as I start moving around but it never really gets worse. Range of motion tests with the doc today didn't reveal any pain either just limited by 4-6" on the test where you reach your thumb as high as you can up your back. The doc said with the limitation a posterior SLAP is a possibility but the MRI will say for sure.

When I asked him about the SLAP injury he gave me the impression that even if it is that most don't require surgery and PT will bring me back to normal because I'm not in any extreme pain.

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By Amy Stengel
From Boulder, CO
Apr 28, 2011
My tear was diagnosed with an MRI/arthrogram (contrast dye). There is really no other way to diagnose a labral tear except with an arthrogram . My clinical exams were all negative for either an RC tear or a SLAP tear and all of the surgeons (I saw 3) who have evaulated me were perplexed because they could not ever elicit any sharp pain, loss of ROM or weakness with the clinical exam. That is why it is important to get an MRI even given the cost - symptoms vary so much from patient to patient that you don't want to rely on someone's opinion. I learned the hard way with a different injury -- I had a labral tear in my right hip that went undiagnosed for 8 months even after an MRI (it came up negative) because I let various PTs and doctors tell me that it was just a strained psoas muscle. Now I am super anal about getting multiple opinions and making sure I get an MRI right away. As with most sports joint injuries, arthoscopy is actually the true gold standard for diagnosis -- so often the MRI does not really show the whole picture, shows things that aren't really there or doesn't show the true extent of the damage. My MRI also showed a partial tear of the Rotator Cuff which I find odd because I don't have any symptoms of that either.

As for surgery, if your pain is not really limiting you and you don't have pain with daily activities the way I do than surgery probably isn't worth the down time and risk. My sense is that alot of people try to manage labral tears for 6-8 months and sometimes longer and then throw in the towel and get the surgery because they are frustrated with the limitations on their activities. The tear will not heal by itself but it can become less symptomatic through PT for some people. I really think it depends on the location of the tear and the other stuff going on in the shoulder because for me the theraband and RC exercises just aggravated the shit out of my shoulder. I'm not really doing any PT on it now and just waiting for surgery because the pain I would get the next day after trying to do the exercises just put me in a foul mood.

When the tear first happened I definitely did something to strain it or push it over the edge to the point of it becoming symptomatic -- I'm not sure whether it was too much aggressive skate skiing or a fall I took while I was skiing. I let my shoulder rest for a few weeks and the pain really subsided and I thought it was just a strain. Then when I gradually started to get back into stuff the inflammation just seemed to keep building...about 2 months after the injury I tried to go for a 5 mile run and even though I had no significant pain during my shoulder was killing me later and the next day. It seems with labral tears that the inflammation gradually increases over time even if you don't have any sharp pains with activity.

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By NickinCO
From colorado
Apr 28, 2011
after the hard stuff, into cruiser hands.
Amy Stengel wrote:
My tear was diagnosed with an MRI/arthrogram (contrast dye). There is really no other way to diagnose a labral tear except with an arthrogram . My clinical exams were all negative for either an RC tear or a SLAP tear and all of the surgeons (I saw 3) who have evaulated me were perplexed because they could not ever elicit any sharp pain, loss of ROM or weakness with the clinical exam. That is why it is important to get an MRI even given the cost - symptoms vary so much from patient to patient that you don't want to rely on someone's opinion. I learned the hard way with a different injury -- I had a labral tear in my right hip that went undiagnosed for 8 months even after an MRI (it came up negative) because I let various PTs and doctors tell me that it was just a strained psoas muscle. Now I am super anal about getting multiple opinions and making sure I get an MRI right away. As with most sports joint injuries, arthoscopy is actually the true gold standard for diagnosis -- so often the MRI does not really show the whole picture, shows things that aren't really there or doesn't show the true extent of the damage. My MRI also showed a partial tear of the Rotator Cuff which I find odd because I don't have any symptoms of that either. As for surgery, if your pain is not really limiting you and you don't have pain with daily activities the way I do than surgery probably isn't worth the down time and risk. My sense is that alot of people try to manage labral tears for 6-8 months and sometimes longer and then throw in the towel and get the surgery because they are frustrated with the limitations on their activities. The tear will not heal by itself but it can become less symptomatic through PT for some people. I really think it depends on the location of the tear and the other stuff going on in the shoulder because for me the theraband and RC exercises just aggravated the shit out of my shoulder. I'm not really doing any PT on it now and just waiting for surgery because the pain I would get the next day after trying to do the exercises just put me in a foul mood. When the tear first happened I definitely did something to strain it or push it over the edge to the point of it becoming symptomatic -- I'm not sure whether it was too much aggressive skate skiing or a fall I took while I was skiing. I let my shoulder rest for a few weeks and the pain really subsided and I thought it was just a strain. Then when I gradually started to get back into stuff the inflammation just seemed to keep building...about 2 months after the injury I tried to go for a 5 mile run and even though I had no significant pain during my shoulder was killing me later and the next day. It seems with labral tears that the inflammation gradually increases over time even if you don't have any sharp pains with activity.



interesting, thanks for sharing your story! It sure sounds like you've gone through a lot. My prescription for the MRI actually says without contrast which kind of surprises me from everything I've read. My should is actually feeling a bit better today. I haven't had any swelling at all ever either. I should hear the results of my MRI monday afternoon or tuesday morning. I'll post the results then. If it is something that requires surgery I'll probably put it off until next winter if anything just to allow me to build more sick time at work. Your story gives me a bit of hope, I'm a firefighter by profession and yesterday I was dragging around a 150lb dummy, wearing a 30lb air pack, climbing ladders and breaching 1/2" plywood walls with hand tools (axes, etc) and it actually feels better today. My fingers are crossed....


I'll definitely get a second opinion too if the MRI shows something. Thanks again for sharing your story.

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By NickinCO
From colorado
May 2, 2011
after the hard stuff, into cruiser hands.
Had the MRI done this morning, the doc will get the results tomorrow. Also had PT this afternoon and she seems to think it's a bad muscle strain. I asked her about it being a SLAP tear and she said with my symptoms she thinks it's highly unlikely. Fingers crossed for the MRI results tomorrow. I had two trips to the Red planned this month, she seems to think if I adhere to my PT I might still be able to make the second one. Fingers crossed!

(and I'm questioning my manhood for thinking this was worse than it possibly is? lol)

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By Amy Stengel
From Boulder, CO
May 2, 2011
Good luck Nick. I'm wondering why they are not doing an MRI/Arthrogram to check for a SLAP tear? Usually a regular MRI only shows soft tissue damage like muscle strains. I've heard that a regular MRI is good for detecting full and partial tears of the rotator cuff tendons but not usually cartilage like the labrum. I hope you get a good answer to match your symptoms. I was about 80% certain I had a SLAP tear before the arthrogram because I was very familiar with labral tears after having them in both hips and just generally knew how the pain from a tear manifests. It was nice to have the arthrogram confirm that I wasn't just a crazy hypochondriac:-)
Be sure to post your results.

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By John Farrell
From Phoenix, AZ
May 2, 2011
Having fun at the Enchanted Tower.
Hopefully nothing is torn and PT will have you back to normal in no time. I was convinced my pain was bursitis and nothing serious, and unfortunately it was a SLAP Tear.

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By NickinCO
From colorado
May 2, 2011
after the hard stuff, into cruiser hands.
Amy Stengel wrote:
Good luck Nick. I'm wondering why they are not doing an MRI/Arthrogram to check for a SLAP tear? Usually a regular MRI only shows soft tissue damage like muscle strains. I've heard that a regular MRI is good for detecting full and partial tears of the rotator cuff tendons but not usually cartilage like the labrum. I hope you get a good answer to match your symptoms. I was about 80% certain I had a SLAP tear before the arthrogram because I was very familiar with labral tears after having them in both hips and just generally knew how the pain from a tear manifests. It was nice to have the arthrogram confirm that I wasn't just a crazy hypochondriac:-) Be sure to post your results.


I spoke to the therapist about slap tears and she said based on my symptoms (no pain just soreness and lack of any "clicking" she said she would be really surprised if it was a SLAP tear.

She just called with MRI results- Tendonopathy of Rotator Cuff and arthritic changes of AC joint. No major tears. Treatment will be NSAIDs, ice, and therapy. Hopefully a couple weeks and I'll be good to go. I'll ask about why no dye in the MRI on wednesday. The two days I've done so far have already made a difference, I hope progress continues this fast!

edit:

She actually just called back and I asked her about the MRI with/without dye and identifying a labrum tear. She said they are able to diagnose labrum tears routinely without dye but she would bring it up to the doc tomorrow.

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By Amy Stengel
From Boulder, CO
May 2, 2011
Well it sounds like a good diagnosis if there are no discreet tears. I had no clicking/popping/locking or any clinical signs of a tear but one showed up on the MRA but I definitely had pain and that was my primary symptom.

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By NickinCO
From colorado
May 2, 2011
after the hard stuff, into cruiser hands.
Amy Stengel wrote:
Well it sounds like a good diagnosis if there are no discreet tears. I had no clicking/popping/locking or any clinical signs of a tear but one showed up on the MRA but I definitely had pain and that was my primary symptom.



It sounds like that's the main ingredient I'm missing. I'm pretty much pain free, I just have a mild soreness at certain extremes of my range of motion. I'm trying to be really aggressive with the therapy and icing so hopefully it gets back to normal soon.

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By NickinCO
From colorado
May 4, 2011
after the hard stuff, into cruiser hands.
To clarify further for anyone else that finds themselves with this type of injury:

I did some reading last night, tendinopathy is a general term for an injury of the tendon. Tendinopathy can refer to both tendinitis and tendinosis. The suffix "itis" refers to inflammation which is what I have. Average recovery time of tendinitis in the rotator cuff is 2-4 weeks.

Tendinosis on the other hand is a chronic failure to heal and the pain is caused by repeated micro tears. Recovery time for one to produce more collagen (tendon) is on average 100 days and some say it never is as strong as it was before the injury. NSAIDs and ice won't do much for the injury because it's not caused by inflammation. The only thing that really helps is stretching the tendon across the grain and having patience.

I stopped working out about 6 months ago because I thought climbing was enough of a workout. This was where I went wrong although my posture has been bad long before this. I was working my front upper body muscles while climbing all the while the musculature around my scapulas became non-existant. This allowed my the head of the humerus to slide forward in the socket and cause the tendonitis from repeated use of my arms over my head.

The healing process they have me on for the tendonitis is first and foremost to correct my posture and build back muscles. Every other day I'm doing band workouts to strengthen the shoulder and improve flexibility in the rotator cuff (compromised of 4 tendons). I'm also supposed to stretch everyday and apply ice and NSAIDs as often as I feel soreness. I'm also going to physical therapy once a week.

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By slim
Administrator
May 4, 2011
tomato, tomotto, kill mike amato.
welcome to the club nick, your membership card is in the mail :) i have been pretty consistent doing my exercises and stretching over the last 6 months and overall i think it has been pretty helpful. keep us posted on how things are going.

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By MeganLM
From Golden, CO
Jun 22, 2012
Hey Nick, I've been looking around on here and came across your post. I'm pretty sure I have a mild case of rotator cuff tendinitis as well. Right now I'm in Chile, so I can't really go to my normal doctor or a physical therapist that I know. I was just wondering if you could maybe tell me what types of physical therapy activities you did and how much time you took off before you started climbing again. I managed to find a theraband and have been doing basic activities with that and trying to ice a lot. Thanks!

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