Rotator cuff problems
General Topic
Was lifting my daughter up the other day (weighs 12 pounds) and ended up having bad shoulder pain shortly after. 2 doctor visits and an orthopedic visit I've been diagnosed with a slight rotator cuff injury. The orthopedic doc gave me a cortisone injection into the bursis in my right shoulder. Go back in 4 weeks for a follow up and another cortisone shot if needed.
So, what is the likelihood that this will affect me shooting my bow long term? I'm 29 and up until now have been using a 76# draw Hoyt. I guess one good thing is that there is no pain moving my arm in a drawing motion, only raising my arm upward from my side towards the sky.
Josh
Same prob I had, but I'm a couple decades older. Had a MRI done and visited my ortho Dr. The shot lasted two weeks and back to pain.
Cause was a 8-9 mm bone spur that he removed on 9 Jan. Back to nearly 100% and have been shooting normal 70# wt for the past month.
The MRI was key to the proper diagnosis in my case.
Good luck with yours.
They did a sonogram, and x-rays and said they didn't see any bone spurs. Said if it's not getting better they'll set up an MRI next visit but didn't see a reason to do one now. Not sure why you'd wait, I have insurance. Meanwhile I'm on light duty at work indefinitely.
Had my right rotator cuff done 10 years ago. Scheduled for an MRI on the left next week. Hope I can put it off till this winter. Full recovery is about 3 months or so.
I had the MRI 2 tears had a cortisone injection after about 3 months of therapy ,shot lasted 6 weeks.it has been almost a year and I can only pull my bow back 3 or 4 times ,hunted with xbow last season hoping to shoot this year I am 64 dont heal as fast as you younger guys .
Cortisone shot is code for MD CYA !!
If there is a tear the shot is only a band aide. The MRI will give the dr. a better idea of the problem. Drs really don't know for sure the extent of the injury till laser is inserted for surgery.
I have had L(2003) & R(2001) shoulder rotator cuff surgeries.
First move when you allow to draw a bow is immediate reduction of bow poundage.
Best of luck-
I have never heard of a diagnosed tear via MRI being treated with therapy and injectioins. I have ben told tears will never heal on their own. Maybe not always true?
My story....I went thru all of the shots and therapy crap 20 years ago only to finally see a specialist who after 10 seconds said you need an MRI as I am sure you have a tear. Big bad one that is now fine. Last fall I battled with my other shoulder and was shooting at only 50 lbs by end of season. Cost me a nice buck as I could not draw at 56 lbs after sitting all day. Got a bad stabbing pain. Now insurance lets you go right to an Ortho doctor as it sounds like you guys did. Go see one and he will get you the MRI. I had surgery on my left on 2/6 after first seeing the Ortho doc in early Jan. I had a bad tear, plus they removed the cause which was a big bone spur and also re-attached a partially torn biceps tendon. I am working hard on rehab to be able to shoot a bow this summer. No turkeys with a bow this spring.
If you have an MRI insist on a contrast MRI where dye is injected into the area. The tear if there will show up much better. I had my rotator cuff re-attached two years ago this August. I shot my bow (70lbs) golfed and played hockey while it was detached. After surgery, and rehab I was able to draw my bow albeit turned down some by mid November. I was 57 at the time of the surgery.
I will never have another cortisone shot. I was warned going in that it wil make u feel better etc. etc . Exactly ! It allows you too do things that you shouldn't be doing. The pain is telling u something, listen to it. My tendon/muscle tore complete through a week after the shot. Surgery on March 6th, therapy is going well. Cortisone is a bandaid !!!!!
You are getting some good advice. MRI with contrast. Be aware, a very large percentage of the population lives fine with torn rotator cuffs. The question is will it effect your lifestyle. The extent of the damage won't be fully known until they go in during surgery. I have had both shoulders done. The latest I had the MRI w/ contrast. When the surgeon got in there the tear was bigger than expected. They had to put a patch on the tear for it to hold. My recovery has been far worse than the first go around. I am 6 months out. I have full range of motion back. But I still wake up about once a week from shoulder pain. The bottom line is. Can you live a normal life without surgery? There was no way for me. I couldn't even use a ATM from my car.
I need my right shoulder done bad. I was saving it for this summer, but I drew an AZ archery bull tag for this September so have decided to put it off until after the hunt. I can still draw my bow back but I can't shoot for more than 20-30 mintutes a day before I'm hurting pretty bad. I need to see about getting a shot or two between now and my hunt to hopefuly help out. How long do the shots last for and how well do they work? Thanks guys.
My shot lasted about 10 days. That was last Aug. Sept - Nov I shot alot. By Dec, I could only shoot three arrows. My shoulder went downhill fast.
Had shots, didn't work. Have MRI on both shoulders this morning. Will have to wait until I find out more.
What rooster is talking about is an arthrogram. I needed one to finally determine that an attempted repair of a bicep tendon tear was failing. Even then the doc missed it and the radiologist saw it. Four months later I was shooting my 63# longbow.
Here's the results.
I am a medical doctor and I have shoulder problems. My family Dr. Have me several cortisone shots and they helped for a few weeks then wore off. I then went to a Pain Specialist. Not someone that just hands out pain pills, but Anestiologists that have also completed a pain control fellowship . My MRI showed small tear and tendinitis. He did 2 cortisone shots into the shoulder with fluoroscopy. That is like watching live X-rays. That way they are 99% sure they get the cortisone where it is needed. If a physician, family doc, ortho, whatever just does an injection it may or may not get where it is supposed to. With flouro it is much more specific.
Before, I couldn't pull my bow at 62 pounds back. I have been pain free for months. Can pull my bow without difficulty, great range of motion. Feels like 20 years ago . Even though I have a small tear, it looks like my main problem was tendinitis. Anyway, it's worth a try before you jump to surgery or it may help buy you several months before your surgery.
I am in the same boat I hurt my shoulder years ago in Iraq. After a few years of dealing with the pain and having done physical therapy and X-rays taken they never knew why it still hurt me. Finally yesterday I had a MRI done and they found a tear in my rotator cuff and in some other tendon I forgot what they said. Now I have an appointment with a orthopedic surgeon yikes not looking forwards to this one bit.
My advice from a complete layman who has dealt with a rotator cuff injury that happened 24 years ago:
1) If you lift heavy weights, reconsider.
2) If you don't want to reconsider, at the very least rethink what lifts you are doing and how you are doing them.
3) Reduce the poundage on your bow and focus on immaculate draw form, fully utilizing your back muscles and not allowing your shoulder muscles to take over when your form goes to hell.
4) Get a list of exercises to strengthen the muscles around your shoulder joint.
5) Immediately get ice on it if it hurts.
6) Plan on doing your shoulder exercises for the rest of your life. Weak muscles = recurring injury/inflammation
I have a large calcium deposit on the top of my shoulder that will likely need to be removed someday. However, the last 8 years have been more pain free than ever and gave me great hope that I can continue bowhunting for many years without needing reconstructive surgery.
LKH you are correct about the arthrogram, I mis-spoke about the contrast MRI. Great buck by the way!
Just finished reading an article about proper form while drawing your bow. Mentioned to start with back tension with your shoulder blades trying to touch and then pushing your bow and pulling bowstring while maintaining back tension.
I soon realized that I had poor form while drawing my bow.
Time to start practicing perfect form and I believe my shoulder pains will reduce. I still have a little bit of burning on top of my shoulder and it's probably from poor form.
I guess being a residency trained and Board Certified Emergergy Physician with 30 years of ER experience only qualifies me as an armchair doctor? I was only trying to help based on my experience as a physician and as a patient.
If you have any other questions or concerns you can refer them to Dave. It sounds like he knows everything.
In my case it was a waste of money to do physical therapy for a month and a half. And to visit my family doctor two or three times and get an x-ray and to be told everything is fine. Then I convinced my doctor to request an MRI and the radiologist and my doctor said it was only a small little tear you'll be fine.
Once I convinced them to send me to a specialist an orthopedic surgeon that said I have a large bone spur and it was very common with archers.
Lots of good insight on here from different people with different experiences and levels of injury. I start PT soon and hopefully will be healed up and comfortable enough with the shoulder to shoot my bow sooner than later.
Thanks for sharing the experiences guys, will have to update as I recover.
In the mean time I'll have to hold her with my left arm ;)
Josh
That's priceless Josh.
Cherish them when they're young because they grow up really fast.
I think the problem with rotator injuries is that because you are using that joint all the time, they don't ever heal good unless you totally let them rest for a long time. If you keep using it, it may not heal good. Good luck and she's precious bro!
Solid advise doc. I appreciate as other do, your contribution to this thread.
Come on Dr. Dave! I'm a fisheries biologist and I get people telling me how to manage fish all the time. And since I am in the biology field, I think that qualifies me as a expert in orthopedic medicine. LOL! Listen OP, listen to Dave!
Yes Dave I think that is good advice. I still think Flouro guided shoulder injections is preferable to blind sticks unless they are done by somebody that does it daily. Even then, I believe flouro has a higher degree of accuracy. The other thing is I don't think it can hurt to have an injection or two before surgery to see if it can help resolve the problem. Like I said, they saw a small tear(yes I understand it may actually be larger), but my pain and limited R.O.M was being caused by a badly inflamed supraspinatus tendinitis that did not respond to rest, NSAIDs,ice,heat,blind injections and 9 months of conservative therapy. After 2 flouro-guided steroid joint injections my pain was totally gone and my R.O.M. Is 100% with no pain, and it's been that way for several months now . Maybe if the future it may come back or it may not.
My point is even if there is a tear(of some degree) it may or may not be causing the pain. They should see an inflammed tendon on MRI, but sometimes people focus on "torn", and not so much on "inflammed". While I'm not suggesting anything about you whatsoever, because I don't know you, some orthopods might use the words torn or tear as a reason for surgery when that might not even be what is causing the pain.
That is why unless there is some contraindication to a cortisone injection it should be considered before going straight to surgery.
Ok, I can agree with that. I was talking about an initial trial of 2 or 3 injections. Obviously if that dosen't relieve the problem, or if it comes right back in a few weeks or a month or two them something other is causing the pain. I think them using flouro is the "expected standard of care" in our region.
I think we're both getting to the same place, just traveling a slightly different path. Like they say, there's more than one way to skin a cat.
I just basically wanted him to know that shoulder pain dosen't automatically mean surgery, and that if he is on a schedule to elk hunt a cortisone injection or 2 may give him enough relief to get through the hunt, then have surgery after the hunt and rehab through the winter.
A sonogram-guided needle cortisone injection into my bow shoulder allowed me to shoot last summer, got me through elk season, and even through the late archery season in January. There were some days in the cold, late season that I wondered if I'd be able to draw my bow. I'm currently five weeks past surgery to repair a torn labrum, a cartilage defect in the glenoid, trim frayed tendons, and general debridement. The doc also did a microfracture procedure into the glenoid. The diagnosis was a GLAD lesion, only revealed by an arthrogram. An X-ray last year showed only arthritis, and the cortisone shot saved my hunting season. I only wish that I had some cool picture of an elk to attach to this post!
I talked to my family doctor this morning and he said that he saw the results of my two shoulder MRIs. He said to contact the surgeon right away. That doesn't sound very good. He said that I had a lot of impingements in my shoulders.
Other Dr.'s can laugh. Gobbler we now know why Dave chose surgery.
This is an interesting thread. I too am a board certified, fellowship trained orthopedic surgeon ( for almost 30 years )who focuses on shoulder and knee and treats a lot of archers. Have also had three shoulder surgeries, the last one a year ago for a large, chronic rotator cuff tear and associated pathology. In other words a lot of experience from both sides of the knife. Had planned some extensive comments but Dave pretty much sums it up in his post. Solid commentary. We all want to help but need to be careful regarding specific advice in areas we are not trained. Except for fishery management of course , we all think we are experts!
Also, good suggestions from JLS post above. Many of the archery related issues are simply due to too much poundage and not using common sense and also poor technique. You can get away with it for a while but it will eventually come to haunt many. Most quit doing their exercises when it feels better. Need a well rounded shoulder girdle strengthening program that includes all the muscles ( especially those that control the shoulder blade) and not just the rotator cuff. Boring but necessary.
Appriciate the input for a real surgeon. Sorry we tried to tell what we know from our experiences. Having 2 shoulders done and spending a lot of time getting info from my surgeons sure doesn't make me the dolt you prefer to paint us all as being.
I am going to the doc tomorrow for shoulder pain, I've had 2 cortisone shots in the past not for the shoulder but one in the elbow and one in my heel both results have been excellent. I'm hoping the shoulder is tendinitis. The foot was about 5 yrs ago and the elbow was last summer.
I'm headed under the knife June 4. Luckily it's only spurs and a thickened clavical causing impingment. The X-ray didn't catch the spurs, but the MRI did. I have been dealing with it for about 3 years, finally got tired of it aching all the time and not being able to toss a ball around, but my shooting wasn't affected.
J.E., I've had both shoulders done for bone spurs. Wish I hadn't waited so long. Recovery was quick.
Waiting only caused more damage to the tendons.
Listen to Dave! And lower your poundage, if you like the speed and your shooting a 7" brace height bow, go to a 6" brace height bow, the new 6"ers shoot just as well as a 7" and you can shoot 10 pound less and achieve the same speeds with the same arrow!
Thanks LKH. Being ths typical male I just thought I'd deal with it. It isn't debilitating, just irritating. Finally I realized that was ridiculous. I am blessed to be able to accumulate leave and have plenty (4000+ combined)... time to use a little.
My shoulder doc will only inject if there is no tear. He says the injection will damage the tissues and make the tear worse. I am in therapy. I'm surprised you are not. Icing my shoulder right now.
Did my first PT session. Took me a bit to get into a place.. Several never called me back. Only issue now is its $40 a visit but the PT place was pretty good in understanding I may only come a few times and explained what exercises I should be doing. I go back to the orthopedic 5/12 so hopefully things are better by then. I have a lot of tightness/soreness down into my bicep and forearm, any idea what that's from? Is it related to the rotator cuff or something seperate?
Josh
Ace I feel your pain man. You will get through it but do not get very many of those injections.
Doc said that I do not have any tears which is great news. I started PT this morning and will go back three times a week for 6 weeks. Hope it helps.
Of course, having three fused disks in my lower back and three in my neck doesn't help the situation. Middle back is very tight I was told. I could have told them that.
BIGHORN,
Hey man I had a fusion of L5-S1 and it made me twice as bad as before it. I am surprised you can even walk bro?
Hammer,
I injured my back in 1966 and I have taken more pain killers, muscle relaxers and anti-inflammatory pills than I care to remember. They about chewed my stomach up until I learned to control the pain mentally. I taught myself to ignore pain. It's just like hitting your finger with a hammer. You can jump around yelling but what good does it do? I didn't learn to do this in a short time period. It took years to acquire the ability.
Also, back in 66 I slipped off of a wrench and rammed my wrist into the metal frame of a truck tractor. My had when numb for about a week and I didn't go to the base hospital because I felt it would just go away. I had problems with the wrist for 44 years and, finally while getting a MRI on my knuckle, I asked the doctor to take a look at my wrist too. After he saw the film, he wanted to know when I broke my wrist. There were several large bone chips that he had to staple back in place. He was amazed that I could put up with the pain for so many years.
Anyway, enough about all of this
Update- pt is helping, a lot of the tightness in my ulnar nerve has gone away allowing me to use the arm more. Stretching and light weights have helped to get the shoulder range of motion better. There is still pain in the shoulder but I'd say its 20% of what it was. I was able to draw my bow once last week and may try shooting it some with a dramatic poundage decrease (76 down to 65 or so?). Just going to take things slow though. Headed back to full duty at work Monday, just can't take missing out on all of the overtime as police work gets busier this time of year.
Ordered a Hoyt Ignite Vicxen for the wife for mothers day, hope we will get out shooting some 3d together this summer. :)
Josh
For the guys with shoulder problems,switch to a bow with a high brace height such as a Mathews monster 8 it will relieve a lot of shoulder strain while drawing.
