Rotator Cuff???

[aahepp]

Well just left the ER a few minutes ago. Went there because while doing heavy squats then bar rolled off my shoulders and my arms didn't release in time, thus sending my arms straight down behind my back. Felt something in my right shoulder give out, pain immediately shot from my shoulder all the way down to my elbow. After trying to let the pain wear off, I found that I could still raise my arm forward, but I can not get any lateral movement at all or rotation. Palm up I can move it lateral but palm down no lateral movement at all. ER said it was just a muscle sprain, but a muscle sprain shoulder allow lateral movement no matter what. When I go to try raising it laterally, my tricep starts burning.

X-rays showed negative on any breaks or blood pooling, and my MRI isn't scheduled till next week. Anyone have a clue what this could be? They kept saying rotator cuff, but don't think thats the injury.

Anyone have any insight? I guess my show in November is going to be out now.:confused:

[Killer]

Hey AAHEP,

The good news is that the weekend is almost here.

The bad news is that you moslty likely (at least) ruptured your supraspinatus. That initiates lateral movement and no lateral movement (sometimes you can have trap subsitution) means a rupture.

Did you see an ortho? See one ASAP!!! You should not have to wait till next week for MRI. Hell, go so a good ortho and he will not even bother with an MRI if he can evaulate certain signs and symptoms.

I am sorry bro.

[aahepp]

Hey AAHEP,

The good news is that the weekend is almost here.

The bad news is that you moslty likely (at least) ruptured your supraspinatus. That initiates lateral movement and no lateral movement (sometimes you can have trap subsitution) means a rupture.

Did you see an ortho? See one ASAP!!! You should not have to wait till next week for MRI. Hell, go so a good ortho and he will not even bother with an MRI if he can evaulate certain signs and symptoms.

I am sorry bro.

No on the ortho yet. I had an ortho that did my bicep tendon repair last year, but he moved his practice out of state, and now in the process of trying to find another good one that deals with sports medicine and also specializes in shoulders.

As I stated lateral movement is a nil from a starting position, but if I have some one manually raise me arm and release it, I can maintain it in that position. If that helps with anything.

The ER doctor gave me percocets and flexirile. I wanted some anti-inflammatory but with the 3 erosions in my stomach he suggested against it. So all I have in me is items to numb my mind of the pain, but nothing to heal it.

But Killer thank you for the info. Hopefully this doesn't keep me out too long.

[Killer]

That pretty much means you have a ruptured supraspinatus (rotator cuff). That is the basic test for a rupture. Try to get to an ortho ASAP my man.

You can hold it up cuz you are using other muscles at that point, but the supraspinatus initiates the movement.

You will need a repair. They make a boney trough in the humeal head and re-attach the supra. You will be imobilzed in a pillow for 4 weeks or so. It will be a long road back.

I have worked with several people who had this performed. Getting the ROM back (external rotation) is painful but you will be fine in the end.

[aahepp]

Well got an appointment with an ortho today at 1. He is going to want to do an MRI but my past experience with them is that they never show correctly. My bicep tendon which they said was just tendinitis ended up being 94% tore. My right shoulder showed negative on a tear but the scapular tendon was tore. So when he says that I am just going to suggest he scope my shoulder. Might as well not beat around the bush on it and get it done first off.

Will he be able to see the tears if he does a scope or would only an MRI show them?

[aahepp]

Well I went to the ortho today and he sent me straight down to get an MRI done. Of course as I am sure it goes with most of you all, I don't fit in the damn machine. Well the pushed and squeezed but I got in there. Took about 25 minutes and they was done. Won't know the results till Wednesday when he does the follow up.

From his observation I have a torn rotator cuff and a possible detached lateral deltoid. When trying to raise my arm up he said the pain I am feeling in my tricep is from the lateral deltoid not being attached to the bone so it is pulling from the tricep. I didn't know them two muscles even connect to each other but he said the lateral delt runs down the length of your arm some and interconnects with your tricep. Learned something new today.

I asked him about my show I have in November and he said I can almost count on missing that. Thats the one thing that pissed me off the most. I can deal with lifting with pain, but when all the hard work you put in toward a goal is lost, that just destroys you. He gave me some good pain meds to get me through the pain, and to help take my mind off of other things. I guess I will let you all know Wednesday what the MRI reveals if anything. I normally don't have good results with them.

[Killer]

You mean you are not the size of your avator? haha

Keep your chin up my man. There can be much things worse in life to have than a torn up shoulder.

Yeah, they can scope you to take a look around. It is usually called an exploratory scope. I have even know a couple orthos who would do a quickie in their offices.

Regardless of the results, it seems that they are going to have to go in and fix you up. Sounds like you did a number on yourself!

Keep us informed!

[aahepp]

Got back from the ortho today. From the imaging it revealed a 40% tear of the rotator cuff and showed fluid inside the rear deltoid itself. He talked about doing surgery but made the statement that if he was to remove the tear and reattach it to the bone that it would only be 50% as strong as what it was originally. He said this was directly out of the text book and the subjects was not body builders and such.

So his plan is he did a cortisone injection today and gave me PT. The PT instructions are massage, ultra sound with cortisone, and electrical stimulation. He is hoping the cortisone will clear up the fluid and bursitis that was seen on the scan. He is going to see me back in 3 weeks for a follow up. He don't want to do surgery because of the year lay off that I would be looking at. 6 weeks in a sling, 3 month no lifting, 6 months light lifting, 12 months before I could return to my normal lifting routine.
i guess in 3 weeks I will figure out if the PT and cortisone is working, if not I guess I go under the knife.

[Nate]

it would be a good idea to start taking some copper (sebacate) @ 2mg, two times per day, for 14 days and then reduce to 2mg per day after this two week period. don't exceed 4mg per day of copper for longer than 2 weeks as it can actually be counterproductive.

here is why:

lysyl oxidase is highly dependent upon an adequate supply of copper.

from pubmed:
"Lysyl oxidase (LO) is a copper-dependent amine oxidase that plays a critical role in the biogenesis of connective tissue matrices by crosslinking the extracellular matrix proteins, collagen and elastin. Levels of LO increase in many fibrotic diseases, while expression of the enzyme is decreased in certain diseases involving impaired copper metabolism."

or in other words: lysyl oxidase is the enzyme that helps to strengthen all of the connective tissue, ligaments, and tendons in the body.

[kook]

aahepp, I don't know that much about what is going on, but in general have had lots of training partners go through surgeries.

Everyone of them found a guy that told them that they will be stronger after the surgery is done, and had to go through guys that said you won't be able to lift, etc,etc.

So him saying 50% of strength after the surgery sounds fishy to me. May have to find someone that deals with athletes. Tell them what you do, and what you want to do after the surgery, just something to think about, if you got the surgery route.

[aahepp]

As I stated. He said the 50% was straight out of the text book for people in my age class. He said the studies was never based on a physical athlete, but a normal person. He also said that the 50% is just studies. No one has ever allowed them to after a repair is completely healed to go back into the shoulder and see how much pressure it would take to re-detach the repair. So he was quoting test book information. The surgeon that repaired my bicep tendon said it would be stronger after the surgery because of the way it gets repaired. The tendon is pushed into the bone and the bone grows around the tendon instead of the tendon just being attached to the bone.

I'm going to give it the 3 weeks of healing and PT to see what the results are. If after that I don't feel that it is going to work then I will opt for the surgery.

[Killer]

Hmmm...

That is a toughy at 40%. It would have been better if you just ruptured (avulsed) the whole thing!

I would talk to the PT and at the same time go see an ortho who specializes in athletes.

Did the guy that you saw have any exp with your injury? If not, is he part of an ortho group (groups have specialists in different areas)?

[aahepp]

Did the guy that you saw have any exp with your injury? If not, is he part of an ortho group (groups have specialists in different areas)?


Yes he is a shoulder specialist that deals in sports medicine. I checked when I was calling around for one to make sure I got a shoulder specialist that worked in sports meds. There was only a few in the city.

The PT I ended up getting is the one that rehabs the U of L football, basketball, and baseball team, so he should be able to set something up right.

[solidspine]

The shoulder is such a complicated joint, almost impossible to diagnosis over the computer.

I hurt mine in January and it is just starting to feel better, so 4 months recovery