Chiropractic / Musculoskeletal / Joint pain Q & A...

ScottyDoc

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Hey guys, I have introduced myself before, but I will do so again. My name is Dr. Albert Scott and I am a licensed, board certified Chiropractor in Atlanta, GA. I am currently REPing for REDEFINE NUTRITION on this Forum, but that is not the point of this thread.

I have created this thread in an effort to offer my services in the form of advise on any sports related injuries, specifically musculoskeletal &/or joint pains. So please feel free, if you have any questions I promise to give my professional opinion and do my best to guide you in the proper direction of recovery.
 
ken22

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I have a question. I have elbow pain. right on the tip of the Funny Bone. Hurts when I do overhead tris but not pushdowns. hurt about 3 to 4 weeks ago. I think I actually hurt it by bumping it on something at the gym. what do u think. I also have typical tendonitize in that elbow also.
 
waynaferd

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just to the right side of my spine, above the butt bone....I do P90X stretches and one where I roll my ass around on a small ball, and that helps, but I still get the pain on the side....

Any ideas?
 
ScottyDoc

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I have a question. I have elbow pain. right on the tip of the Funny Bone. Hurts when I do overhead tris but not pushdowns. hurt about 3 to 4 weeks ago. I think I actually hurt it by bumping it on something at the gym. what do u think. I also have typical tendonitize in that elbow also.
Does it hurt now, or are you saying you injured it 3-4 wks ago?

Hard to explain why it would hurt with overhead tri's and not press downs, my only assumption there is... and also you say it occurred from bumping the funny bone region, sounds like a deep tendon bruise and considering their are 3 heads to the tricep, the one you bruised is not as actively used when doing tricep press downs vs. overhead tricep exercises. OK, so your tricep attaches to the olecranon process of the ulna bone (elbow). The funny-bone location is on the lateral aspect of your elbow, where the lateral head of the tricep attaches.

Again, just sounds like a bruise, I would contrast between heat and ice, also stretch while heating and massage while icing. Do 15mins of one, then 15mins of the other and you can continue that cycle for as long as you want, I would just always recommend you end with ice, unless it is just prior to a workout, in that case, end with heat so your muscle and tendon are warm and more elastic.

I hope this helps, unless you suffered a worse blow to your elbow (funny-bone) than you are letting on, I would not assume anything is broken or torn.
 
ScottyDoc

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just to the right side of my spine, above the butt bone....I do P90X stretches and one where I roll my ass around on a small ball, and that helps, but I still get the pain on the side....

Any ideas?
Ok, so from what you are telling me it sounds like you are having pain over your PSIS (posterior superior iliac spine). The PSIS is where your right hip connects with your sacrum, what I am assuming you are calling your butt bone. It is a very common articulation (joining of two bones) to become misaligned and put pressure on a nerve and for a lack of better words, hurt like a Fother Mucker.

How did you injure it, how long has it been hurting and is it getting better or worse as time goes on?

It honestly sounds like you need a chiropractic adjustment my friend, unfortunately it does not sound like something you can just heat, ice and stretch away, not that those will not help the healing process and decrease pain and inflammation once the bone is adjusted into it correct position, but a good adjustment sounds like what you need my friend.

Do you know of a good Chiro in your area?
 
MAxximal

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Dr Scott what do you recommend for muscle sores apart of (Glutamine,BCAA and REST)
 
celc5

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waynaferd,
it could also be an instability issue with your SI joint. In which case, stretching would be counter productive. But it'd be tough to diagnose over the interweb in your case :think: You'll probably need to be evaluated as Scott suggested
 
bluehealer

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Quite nice of you to put up this tread Dr. Scott!

I was just questioning another member about a pain I get in my spin/pelvis joint when squating. It doesn't happen every time but it's is pretty often. It's like dead center of the tailbone area. At the bottom of the squat, more so when pushing up.
 
ScottyDoc

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Dr Scott what do you recommend for muscle sores apart of (Glutamine,BCAA and REST)
Heat is always good pre-workout... whether you spend a few mins in the sauna, or get on the treadmill some other type of cardio. No matter which route you choose... approx. 15mins. You can also do it after you work out, but later I would definitely look to ice the area stressed that day/workout in the gym.

Ice is good for post workout never pre, do not wanna try and workout when cold. Also, it is always good for any type of injury or soreness. Also, contrasting the two, heat/ice 15mins each, always end with ice, doesn't necessarily matter which you start with, as long as you end with ice, helps to reduce the inflammation process.

Just something to remember, soreness is similar to an injury in the sense that it is caused by wanted micro-trauma to the muscle fibers (normal occurrence with a good workout), which must heal and when they do heal they heal bigger and stronger and over time, this is how we get muscle & strength gains. Anyway, I explained all this so it is understood that muscle soreness can be treated the same way as an actual injury (macro-trauma)

As far as supplements are concerned, absolutely the ones you mentioned above, some others that are good with both micro & macro-trauma is MSM, Glucosamine, Chondroitin, & EFA's (Omega 3-6-9).

I hope these simple yet effective methods help.
 
ScottyDoc

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Quite nice of you to put up this tread Dr. Scott!

I was just questioning another member about a pain I get in my spin/pelvis joint when squating. It doesn't happen every time but it's is pretty often. It's like dead center of the tailbone area. At the bottom of the squat, more so when pushing up.
Happy to help my friend. OK, so when you say your tailbone, do you mean the very small of your back? (put your hands on your hips at the level of your waist/pant line with your thumbs pointing towards your back, slide thumbs back until they touch, this is the approximation of the small of your back give or take 1/2 inch above/below) Or, is it lower? What I consider my tailbone to truly be is my coccyx, which is the very lower tip of my spine, about 1/2 inch above my rectum, then right above that is your sacrum which connects to your pelvis on either side and your last moveable vertebrae, L5 above it. Try to describe exactly where your pain is on this picture I am posting below, will help me!

 
vidapreta

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ScottyDoc a few years ago i had a buldging disc in my neck that was pinching a nerve which was causing this pins and needle feeling running from my neck down my arm to my thumb and back up again throughout the day. I did the physical therapy thing for awhile and it eventually went away for the most part. My neck is always sore and feels cracky/crunchy. I always have the urge to crack it but my chiropractor only wants to put me on that machine that pulls my chin back to open the space between the discs. Should i go to another chiropractor to get a neck adjustment?
 
bluehealer

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From your description, I would say the sacrum area. About where the butt cheeks start, where the lowest set of nerves are in the picture.
 
ScottyDoc

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From your description, I would say the sacrum area. About where the butt cheeks start, where the lowest set of nerves are in the picture.
OK, next Q... Does it hurt dead center or on one side or the other? If it is dead center (most common) it could be a number of different issues between your lumbosacral joint (joint between L5 & Sacrum). If it is on either side then it could be a number of different issues between your right or left sacroilliac joint (joint between sacrum and pelvis).

All this is just helping me diagnose the problem the same way I would do if you were coming into my clinic, which would only take a few minutes of talking to you and a little palpation of the area. Either way, from what you are telling me, it is involving one of the two described joints, I would say that is a chiropractic issue and you should go see a chiropractor. Yes, ice, heat, stretching, & massage would all help with the pain and inflammation as well as the healing process, but would not resolve the original issue, which I believe is a subluxation (misalignment of the joint putting pressure on the nerve).

I just wish I could give cyber adjustments for an extremely discounted price, I would be racking up the $$$, LOL

One thing I will do my best to explain because it is a commonly asked question is, why does it always seem to come back and happen in the same place. My best explanation for this is... it is a pre-disposed area of injury, as in it is a weaker joint/articulation due to previous injury and if all the other surround joints are stronger and you are lifting a lot of weight or exerting yourself, it is going to give before the others. So even after correction, it should always be focused on as an area that always needs proper warming pre-workout, proper icing-post workout, and always listen to your body when trying to push the envelope in order to prevent future injuries. Also, additional strengthening exercises should be incorporated in order to strengthen this weakened area of the body the same way pitchers always warm up their arms/shoulder pre-pitching, ice their arm/shoulder post-pitching and strengthen all the muscles in and around their shoulder (glenohumeral joint).

I hope all this makes sense to you and helps you, low back pain (LBP) can be a bitch, the best way I can describe it to people who have never experienced it, "it makes you feel like an old man" like as if you instantly put 20yrs on yourself. When in severe LBP you will look, act and walk like you are 20yrs older than you are!
 
bluehealer

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It's dead center. It's an unusual pain, nothing like I've ever felt before but not unbearable. I can push through and when I'm done with that exercise I'm fine. I do have the occasional pinched nerve in my left hip but I've been doing stretches and hadn't had one of those in over a year.
 
JohnRock

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OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?

 
bluehealer

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OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?
My unprofessional opinion, pinched nevre in the neck. Get an adjustment.

How'd I do Scottydoc?
 
ScottyDoc

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OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?

Ahhh, you are in luck, I have personally had this issue happen to me. It sounds like a problem with you SCM (sternocleidomastoid muscle) named so because it attaches to your stermum, clavicle, & mastoid bones. It is almost impossible to do any kind of shoulder or trapezius movement without flexing this muscle, it is a very strong muscle, one of the primary muscles used to rotate your head from side to side. It could be one of a few things to be honest, do you ever notice when doing your shoulder presses the posture of your head and neck? I have come to realize that mine will occur when my head is not looking exactly straight forward &/or my neck is slightly flexed laterally to the right, mine always happens on the right as well, probably because I am right handed, which considering you are pointing to your right side and also because 80% of the population is right handed that you are as well.

OK, now that we are pretty sure of what is going on and why, let's talk about ways to correct and prevent this situation. Just like every other injury, I suggest heat pre-workout and ice post-workout. More importantly, you need to start doing some neck flexion & extension exercises, lateral neck flexion exercises, and head/neck rotational exercises to strengthen this pre-disposed area of weakness and prevent this from happening in the future.

Unfortunately, the saying that "You are only as strong as your weakest link" applies here and that is your weak link, so if it is not hurting now, maybe take like two weeks off of shoulder and trap exercises and in while you are refraining, do neck strengthening exercises every 3rd day, starting very light for high reps and slowly, I mean slowly increase the weight never doing too heavy of a weight where you can't complete 15 reps.

So exercises: with mild resistance... (4 sets of 15 reps each exercise every 3rd day)
- head flexion (head forward)
- head extension (head back)
- lateral head flexion (ear to shoulder R & L)
- head rotation (rotating head to look R & L)

* not a bad idea to use heating pad to warm up neck before doing this, or sit in hot tub or sauna and stretch your neck out while warming it just prior to neck exercises, if possible!
 
JohnRock

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Thanks man! Today was the day I normally do military press/clean & press and I stuck to dumbbell movements for high reps and it's feeling good. I think I'll stick with low weight/high rep for several weeks and start doing the exercises you mentioned. I appreciate the advice!
 
ScottyDoc

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My unprofessional opinion, pinched nevre in the neck. Get an adjustment.

How'd I do Scottydoc?
Masta say....Ahhh.... nooo complete-delly coorrect yung grass-hoppa... butt-uhh you-ah thinking.... goood!!!

Aa-hem, excuse me, now to be professional again. You are correct, but it is a little different only because I believe the nerve is getting pinched due to a weak muscle, so always if possible go after the source. From their (correcting the source of your problem) your body will heal itself, for it is an incredible machine designed to do so when the interference is removed.

It boils down to semantics, what came first the chicken or the egg. Did the weakened muscle cause a strain which in turned cause the vertebra to misalign and put pressure on a nerve. or Did the misaligned/pinched nerve cause the muscle spasm and pain? The evidence in my mind would be that it always follows certain exercises, which cause the activation of certain muscles... But, as always, the human body is an incredible and diverse machine that can only be truly mastered when you realize that anything is possible and different things affect different people in different ways.
 
ScottyDoc

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Thanks man! Today was the day I normally do military press/clean & press and I stuck to dumbbell movements for high reps and it's feeling good. I think I'll stick with low weight/high rep for several weeks and start doing the exercises you mentioned. I appreciate the advice!
Also, that is you in the picture right... so it looks like you are working out in your basement or something. You can do those exercises one of two ways cheap and easy. If you have someone to help you, have them resist your exercises with a towel or their hand. If you do not have the assistance of someone, then purchase some resistance bands that you can rig up to your wall, can be found for next to nothing on just about any rehab or weight equipment supply store online or even locally if you know of one, they even have them at most sporting good stores here in ATL.
 
JohnRock

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Yep, that's me in the basement. I have some bands I'll probably use for this.
 
ryansm

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Hey DR. Scott what is your opinion on the benefits of implanting a TENS unit? Also what do you suggest for severe arthritis?
 
BigKrabbe

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Scotty Doc,
First, I think it's awesome you are doing a thread like this. My question is about my right shoulder. When I was 18 I had small tears in my infraspinatus, never had surgery but went through physical therapy twice. Since then it has been a constant up-hill battle to keep my right shoulder healthy, and it almost never feels 100%. I have been doing rotator cuff exercises (variety of external rotation variations), as well as lots of rear delt work for the last 4 years. I don't do flyes, or anything that aggrivates it extensively but I just feel like nothing I do gets it back to 100%. Self Myofascial Release has helped TREMENDOUSLY, but I really just wish I could beat the **** out of my chest more without risking having shoulder pain for a few days after. Whenever it's feeling tempermental I do ice/heat, I take 10 grams give or take of Cissus a day, stretch, properly warm up, bench and military press properly, but nothing makes it feel 100%! Any suggestions or reasons you can think of my shoulder being tempermental? The weird thing is I pass all of the rotator cuff tests that a physical therapist do...
 
ScottyDoc

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Hey DR. Scott what is your opinion on the benefits of implanting a TENS unit? Also what do you suggest for severe arthritis?
OK, sooo sorry it took me this long to get back to you. When you say implanted TENS unit do you really mean an implanted neurostimulator? They are similar, but the implanted ones, vs. the ones I sell in my office are really way different.

Severe Arthritis.... Hmmm I see your age, kind of young! What type of Arthritis? You seem too young for anything other than Osteoarthritis, playing football, contact sports, past injuries, etc??? or do you actually have Rheumatoid or Psoriatic arthritis?

With answers to my above questions, I can give much better answers to your questions, please, just remember this is more of a professional/online advise thread, all I can promise is to give you my honest/professional opinion and advice. The same advice I would give to the most dearest loved one of mine, as in this is what I would do if my mom/dad asked me this question!
 
ScottyDoc

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Scotty Doc,
First, I think it's awesome you are doing a thread like this. My question is about my right shoulder. When I was 18 I had small tears in my infraspinatus, never had surgery but went through physical therapy twice. Since then it has been a constant up-hill battle to keep my right shoulder healthy, and it almost never feels 100%. I have been doing rotator cuff exercises (variety of external rotation variations), as well as lots of rear delt work for the last 4 years. I don't do flyes, or anything that aggrivates it extensively but I just feel like nothing I do gets it back to 100%. Self Myofascial Release has helped TREMENDOUSLY, but I really just wish I could beat the **** out of my chest more without risking having shoulder pain for a few days after. Whenever it's feeling tempermental I do ice/heat, I take 10 grams give or take of Cissus a day, stretch, properly warm up, bench and military press properly, but nothing makes it feel 100%! Any suggestions or reasons you can think of my shoulder being tempermental? The weird thing is I pass all of the rotator cuff tests that a physical therapist do...
First off, Thank you! Second, Dude... I am sooo sorry! I have a similar issue from a torn pec muscle (left). Unfortunately, like I have mentioned above, it will always be a predisposed area of injury, I'm sorry bro, but it is your weakest link, it is gonna give out before the other muscles and ligaments in your body do. Wait, I'm not saying give up, I'm saying keep doing what you are doing, fight, fight, fight some more! Minus trying to win the next strongest man contest, or the Mr. Olympia, there is no reason why you cannot still accomplish your goals in the gym. Personally, I have found that by lightening up my weights and increasing my reps, I have achieved a better, healthier body than I ever dreamed of. Today, even on my fattest days, I am still wayyy leaner and stronger than I ever was before my chest injury and my change/shift in my workouts!

In short, I don't really have much advice for you as in a magical cure, or something new to try, it really sounds like you are doing everything right, just have to continue doing what you are doing and listen closely and carefully to what your body is telling you (ie. your limits). I am sorry because I wish I could have been more help, but as mentioned before, all I can do is give my honest/professional opinion (based on the information you have told me of course).
 
ScottyDoc

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BigKrabbe,

How old are you now if you don't mind me asking? You said your injury happened when you were 18, how many years of recovery and rehab are we talking about? Also, because I know exactly how you feel, I have thought of one possible thing... if you can find the right orthopedist, because remember as a Chiro, I believe surgery to be the last resort, but I am a medically/scientifically based Chiro, so my modo is if it works it works and science/physiology works. OK with that being said, if you can find the right orthopedist who is just eager as hell to cut you open and make an extra buck, but actually examine your glenohumeral joint and all the surrounding muscles, not just the infraspinatous, there might be some scar tissue in there that if removed might.. key word might make your recovery closer to 100% than you are now. Also, there are 4 muscles that make up your rotator cuff, I like to use the acronym SITS S=supraspinatous, I=infraspinatous, T=teres minor, & S=subscapularis. Any one of the other 3 muscles of the rotator cuff could have been injured in the compensation process while the infraspinatous was injured and recovering.

Here is a good question for you, you said you pass all the tests performed on your rotator cuff muscles by the physical therapist, do you pass them when it is actually inflamed and really hurting? or do you just pass them in general when it is not hurting?
 
ryansm

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OK, sooo sorry it took me this long to get back to you. When you say implanted TENS unit do you really mean an implanted neurostimulator? They are similar, but the implanted ones, vs. the ones I sell in my office are really way different.

Severe Arthritis.... Hmmm I see your age, kind of young! What type of Arthritis? You seem too young for anything other than Osteoarthritis, playing football, contact sports, past injuries, etc??? or do you actually have Rheumatoid or Psoriatic arthritis?

With answers to my above questions, I can give much better answers to your questions, please, just remember this is more of a professional/online advise thread, all I can promise is to give you my honest/professional opinion and advice. The same advice I would give to the most dearest loved one of mine, as in this is what I would do if my mom/dad asked me this question!
lol, sorry for not articulating that correctly, but yes an implanted neurostimulator. Which I have been told uses electrical impulses similar to a TENS unit to help with pain and inflammation? And yes I have severe Osteoarthritis (DJD) from being an athlete all my life, specifically olympic weightlifting. I have been told that I need a knee replacement but can't get insurance to cover it because of my age. It has also presented in other major joint areas including my lower back where I ruptured two discs. Which is why I am interested in the implant.

Thanks
 
ScottyDoc

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lol, sorry for not articulating that correctly, but yes an implanted neurostimulator. Which I have been told uses electrical impulses similar to a TENS unit to help with pain and inflammation? And yes I have severe Osteoarthritis (DJD) from being an athlete all my life, specifically olympic weightlifting. I have been told that I need a knee replacement but can't get insurance to cover it because of my age. It has also presented in other major joint areas including my lower back where I ruptured two discs. Which is why I am interested in the implant.

Thanks
Alright, now with a clearer picture of what is going on... Neurostimulators are pretty good from what I am told and my own personal research. I actually have a friend who is a pharmaceutical device sales rep who sells that exact thing, obviously he swears by them, LOL, but seriously I have heard from others that they are pretty good, just don't expect a miracle and you won't be displeased.

As far as the Osteoarthritis, that is wear and tear on the joints and other than constant physical therapy exercises, which once learned, you can perform on your own, there is not much I can offer you in the form of advice other than what your orthopedist is telling you. I can tell you I have had friends with similar knee injuries ( I played football at LSU back in the day when Men were Men and Sheep were nervous!) and they got great results with injected artificial cartilage (chicken beak) and were very pleased with their results, not perfect, but sure beat surgery / knee replacement. That is about as much as I can offer in advice, hope I have been of assistance to you my friend!
 
ryansm

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Thank you sir. Ya you pretty much said what my ortho did, the injections are expensive so I am hoping for some new, more permanent options become available. I think at this point I am going to pursue the Neurostimulator as opposed to any back surgeries. I currently visit my chiro on a weekly bases, and have good relief for a few days. My problem is I still lift heavy, and my ortho wants me to quit lifting period, but there is no way that is happening lol. I appreciate the feedback!
 
BigKrabbe

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BigKrabbe,

How old are you now if you don't mind me asking? You said your injury happened when you were 18, how many years of recovery and rehab are we talking about? Also, because I know exactly how you feel, I have thought of one possible thing... if you can find the right orthopedist, because remember as a Chiro, I believe surgery to be the last resort, but I am a medically/scientifically based Chiro, so my modo is if it works it works and science/physiology works. OK with that being said, if you can find the right orthopedist who is just eager as hell to cut you open and make an extra buck, but actually examine your glenohumeral joint and all the surrounding muscles, not just the infraspinatous, there might be some scar tissue in there that if removed might.. key word might make your recovery closer to 100% than you are now. Also, there are 4 muscles that make up your rotator cuff, I like to use the acronym SITS S=supraspinatous, I=infraspinatous, T=teres minor, & S=subscapularis. Any one of the other 3 muscles of the rotator cuff could have been injured in the compensation process while the infraspinatous was injured and recovering.

Here is a good question for you, you said you pass all the tests performed on your rotator cuff muscles by the physical therapist, do you pass them when it is actually inflamed and really hurting? or do you just pass them in general when it is not hurting?
Thanks for the fast reply! It doesn't bother me all the time, but sometimes I would say at least a few days a month it feels irritated. The pain comes from the right teres minor. It was bothering me a little bit tonight, but after doing SMR on a pvc pipe it feels pretty damn good! One thing I thought of that might help is doing self ART using a tennis ball on the teres minor. It's kind of weird but I think that my right humerus fits differently than my lift humerus into my shoulder socket. I can tell when I stand in the anatomical position. I realize my shoulder will probably NEVER be 100%, and I'm ok with that..but I am always looking for new and different options for recovery. I would say my shoulder is 90%. One thing I am gonna start doing is on all of my work sets never going below a 1 board (of course except when I start competing in meets again). To answer your question about the tests, No when it is irritated I do not pass all the test. However, whenever my shoulder is acting up I get ALMOST immediate relief from SMR using a pvc pipe and icing..surgery would only be an option in my book if I could no longer do pressing motions without pain, but alas that is not the case. Thanks for the replies. Reps.
 
celc5

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Thank you sir. Ya you pretty much said what my ortho did, the injections are expensive so I am hoping for some new, more permanent options become available. I think at this point I am going to pursue the Neurostimulator as opposed to any back surgeries. I currently visit my chiro on a weekly bases, and have good relief for a few days. My problem is I still lift heavy, and my ortho wants me to quit lifting period, but there is no way that is happening lol. I appreciate the feedback!
IMO the implanted neurostimulater is not your best option unless you've exhausted all other options first. It's a last ditch resort when ALL other options have failed.

In my experience, I've never seen a stimulator completely alleviate pain. Just making a rough guess, I'd say it can cut pain by 20-40% to allow for function. Again with a rough guess, I'd say most patients say that it does help most of the time though. Keep in mind that the stimulator can reduce pain, but it will not solve your structural problems whatsoever... in which case, you're heading for surgery anyway.

It is my opinion that over the past 5-10 years, back surgeons have improved their methods and technology (including diagnostics) has improved. Simply "avoiding" back surgery is an old wives tale that comes from people who got hacked up 10-15 years ago.

Finally, you mentioned that you can't get surgeries covered. That being said, I'm confused as to how you can get the stimulator implant covered?

I understand that you feel handcuffed by your situation. At the same time, your posts give me the impression that you aren't headed toward a solution yet.
 
ryansm

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Thanks for the post
I am covered for surgery by insurance certainly, I was referring to the cost of the knee injections with synvisc are costly. I have been told by my insurance that they will not cover a knee replacement at this time due to my age and the average knee replacement lasting 10-20 years based on activity level. I haven't even pursued the implanted stimulator yet, so I don't know if insurance will cover it or not.
 
ScottyDoc

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IMO the implanted neurostimulater is not your best option unless you've exhausted all other options first. It's a last ditch resort when ALL other options have failed.

In my experience, I've never seen a stimulator completely alleviate pain. Just making a rough guess, I'd say it can cut pain by 20-40% to allow for function. Again with a rough guess, I'd say most patients say that it does help most of the time though. Keep in mind that the stimulator can reduce pain, but it will not solve your structural problems whatsoever... in which case, you're heading for surgery anyway.

It is my opinion that over the past 5-10 years, back surgeons have improved their methods and technology (including diagnostics) has improved. Simply "avoiding" back surgery is an old wives tale that comes from people who got hacked up 10-15 years ago.

Finally, you mentioned that you can't get surgeries covered. That being said, I'm confused as to how you can get the stimulator implant covered?

I understand that you feel handcuffed by your situation. At the same time, your posts give me the impression that you aren't headed toward a solution yet.
Celc5 poses a very good point, how is that you can get the stimulator covered by insurance, but not the surgery? I'm not the biggest advocate of surgery by any means, but they have advanced the technology and it is way better now than it was 10-15yrs ago, completely agree on that, just it is not always the answer. Not sure with the statistics of 20-40% relief of pain with a stim, but, it is definitely not fixing the problem either, only masking the symptom, or blocking the pain at best. So you say your seeing a Chiro, what is his/her opinion on your condition? As in they should be able to make a better diagnosis of your problem than me since they get the luxury of seeing your x-rays and and performing the various, necessary orthopedic tests to get the big picture. Last, but not least, I kinda have to agree with your orthopedist somewhat. I'm not saying give up lifting all together, that would be nonsense, it is a use it or loose it game when it comes to osteoarthritis, but if you are still powerlifting, you are only going to make it worse on your joints (low back & knee). Ultimately, you will have to make the decision and realize that if you continue to power lift, things will only get worse and celc5 is right you are not ready to resolve your problem yet, or you could start to lighten up the weights and change directions. I noticed your weight/height ratio, that is huge. I used to lift heavy as well, not quite power lifting, but followed my old College football regiment and all it did was get me injured years down the road. I tore my left Pec muscle about 5yrs ago and since I have shifted gears, lost about 50lbs of unnecessary fat, I lift in the 10-15 rep range, still extremely strong for my size/weight, but no longer lift crazy heavy and I look and feel way better than I ever have. Believe me, I know how hard it is to change your mind set on this, I always knew I was lifting too heavy, but it took the injury to actually make me change and I not saying I am glad I got injured, but I am glad I made the change. It truly was the best thing for my overall health!

Please don't take this post/reply the wrong way, I'm just offering my opinion with your health and injury being my number one concern, not in any way trying to rip on you.
 
vidapreta

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ScottyDoc a few years ago i had a buldging disc in my neck that was pinching a nerve which was causing this pins and needle feeling running from my neck down my arm to my thumb and back up again throughout the day. I did the physical therapy thing for awhile and it eventually went away for the most part. My neck is always sore and feels cracky/crunchy. I always have the urge to crack it but my chiropractor only wants to put me on that machine that pulls my chin back to open the space between the discs. Should i go to another chiropractor to get a neck adjustment?
ScottyDoc, sir did you not like my post??:crying::sad2:
 
ScottyDoc

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ScottyDoc, sir did you not like my post??:crying::sad2:
Holy $hit, I'm sorry, I honestly totally missed your post... I even had to go back and look for it to see, LOL. My bad, thank you for bringing this back to my attention.

Now for your question, there is nothing wrong with going to another Chiropractor for a 2nd opinion. What your chiropractor is doing is great, he is opening up the disc spaces, I personally adjust everyone in my clinic unless there is a contraindication to do so (rare). So to tell you what I would do with your case is hard without seeing your x-rays, doing a little palpation and checking your ROM (range of motion).

So the only answer/advice I can really give you is to seek a 2nd opinion. Because your symptoms are a classic case of nerve impingement. I can even tell you the nerve that is impinged, it is your C6 nerve, it exits the spine between your C6 & C7 vertebra. That is the nerve responsible for your thumb & index finger.

Hope that helps a little, again sorry for missing your original post,:spank: definitely was not intentional.
 
ScottyDoc

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Thanks for the post
I am covered for surgery by insurance certainly, I was referring to the cost of the knee injections with synvisc are costly. I have been told by my insurance that they will not cover a knee replacement at this time due to my age and the average knee replacement lasting 10-20 years based on activity level. I haven't even pursued the implanted stimulator yet, so I don't know if insurance will cover it or not.
On a non-professional note, I got a buddy who I play racquetball with and he gets those injections in his knee like 2 x's a yr and he says they hurt and cont. to hurt for like a day or so, but after that he says he's good to go, he swears by them. So costly or not, if I had knee troubles, that is definitely the route I would continue on until I was left with no other options, but surgery or knee replacement. It is funny the way he described how much it helps, he compared it to having a rusty hinge in his body grinding, squeaking, and hurting, and the injections being the oil and lubrication on that hinge needed to lubricate it and then it doesn't grind, squeak or hurt.
 
ryansm

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Ya my chiro is inline with the ortho about seeking some type of surgery, I basically just get adjustments and TENS work. As far as training I have already stopped squatting and doing heavy pulls, and have also lowered the weight I'm using. Thing is I still lift more than most but it's not necessarily heavy to me. I'm in the process of dropping the unnecessary mass I am carrying, but I am still a large guy even if I was sitting at 8-10% bf. Basically I am still in denial over the whole situation, and I recognize this. At some point I am going to have to come to the realization that things need to change. When I sit down and recollect on my issue it really defines the word insanity, lol.
 
vidapreta

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Holy $hit, I'm sorry, I honestly totally missed your post... I even had to go back and look for it to see, LOL. My bad, thank you for bringing this back to my attention.

Now for your question, there is nothing wrong with going to another Chiropractor for a 2nd opinion. What your chiropractor is doing is great, he is opening up the disc spaces, I personally adjust everyone in my clinic unless there is a contraindication to do so (rare). So to tell you what I would do with your case is hard without seeing your x-rays, doing a little palpation and checking your ROM (range of motion).

So the only answer/advice I can really give you is to seek a 2nd opinion. Because your symptoms are a classic case of nerve impingement. I can even tell you the nerve that is impinged, it is your C6 nerve, it exits the spine between your C6 & C7 vertebra. That is the nerve responsible for your thumb & index finger.

Hope that helps a little, again sorry for missing your original post,:spank: definitely was not intentional.
No problem at all, and I appreciate your responce i think what your doinv here is great. I assume he's afraid that a neck adjustment could possibly make the disc buldge out again. I'm not sure what to think the pinched nerve went away with physical therapy 3 years ago and never came back. I am left with a pretty regular urge to crack my neck, sometimes it feels tight and sore and when i self crack by turning mg neck left to right i can feel and hear that it's a little cracky and crunchy if that makes any sense. Thank you again
 
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No problem at all, and I appreciate your responce i think what your doinv here is great. I assume he's afraid that a neck adjustment could possibly make the disc buldge out again. I'm not sure what to think the pinched nerve went away with physical therapy 3 years ago and never came back. I am left with a pretty regular urge to crack my neck, sometimes it feels tight and sore and when i self crack by turning mg neck left to right i can feel and hear that it's a little cracky and crunchy if that makes any sense. Thank you again
I wish I could help you more, but without being there to personally examine you and see your x-rays I can only tell you that it is very rare that I won't perform an adjustment on someone. If a past bulging disc is the only reason why he is reluctant to adjust you, I think he is being a little over cautious. But, again, remember he may have seen something on your x-ray or something that I obviously cannot see. So again, I would go see another Chiro for a second opinion. Well my friend, I'm signing off to get ready for a New Years Eve party with the Wifey, have a safe and Happy New Years Eve. I'll talk to you more next year! LOL, I love saying silly $hit like that!
 
celc5

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Ryan,
the synvisc would be a reasonable option. I see mixed results with those injections as well. Some respond like Scotty's racquetball partner, others don't really get any lasting relief. At the same time, your insurance is one of many that doesn't cover it because of those mixed results.

Cortisone, chiropractic, physical therapy, anti inflammatories are more reasonable options for your knee. Then it's time to at least try to get it/them scoped. With your aggressive history, maybe cleaning up some scar tissue and arthritis can get you some relief.

Finally, have you had an MRI on your back?

Scotty,
you're right about relief percentage for the stim implant. I was totally guessing based on subjective reports that I've heard (I'd guess somewhere between 5-10 reports over the past few years).
 
ryansm

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Ryan,
the synvisc would be a reasonable option. I see mixed results with those injections as well. Some respond like Scotty's racquetball partner, others don't really get any lasting relief. At the same time, your insurance is one of many that doesn't cover it because of those mixed results.

Cortisone, chiropractic, physical therapy, anti inflammatories are more reasonable options for your knee. Then it's time to at least try to get it/them scoped. With your aggressive history, maybe cleaning up some scar tissue and arthritis can get you some relief.

Finally, have you had an MRI on your back?

Scotty,
you're right about relief percentage for the stim implant. I was totally guessing based on subjective reports that I've heard (I'd guess somewhere between 5-10 reports over the past few years).
Ya cortisone, chiro, pt, and anti-inflammatories have been my life over the last couple of years, lol. They all provide transient relief, which is great while it lasts. The whole process gets old, and the longer this goes on the more pain I tend to feel from just doing even the simplest of things. Part of my problem is I have a high pain threshold, and if I am feeling decent one day I will go out and flip tires, or push a sled, or something else that is simply not a smart idea and usually lands me in bed. It's very hard for an athlete to realize they are no longer at their prime, but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
I had my knee scoped last year and cleaned out a lot of crap which definitely helped, problem is the condition is constantly degrading, and the pain again is becoming more prominent. It doesn't help that I continue with strenuous activity. As far as my back I have had an MRI, but it was right after my injury, have only had x-rays since. The x-rays show degradation of the spine as far as arthritis, from what I understand osteoarthritis will present in previously injured areas, especially if the area is consistently stressed.
 
ScottyDoc

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Ya cortisone, chiro, pt, and anti-inflammatories have been my life over the last couple of years, lol. They all provide transient relief, which is great while it lasts. The whole process gets old, and the longer this goes on the more pain I tend to feel from just doing even the simplest of things. Part of my problem is I have a high pain threshold, and if I am feeling decent one day I will go out and flip tires, or push a sled, or something else that is simply not a smart idea and usually lands me in bed. It's very hard for an athlete to realize they are no longer at their prime, but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
I had my knee scoped last year and cleaned out a lot of crap which definitely helped, problem is the condition is constantly degrading, and the pain again is becoming more prominent. It doesn't help that I continue with strenuous activity. As far as my back I have had an MRI, but it was right after my injury, have only had x-rays since. The x-rays show degradation of the spine as far as arthritis, from what I understand osteoarthritis will present in previously injured areas, especially if the area is consistently stressed.
You kind of answered your question, in order to make a real recovery where you can even think about doing the things you want to do that you say someone in their 60's can do is if you actually do all those therapies while also giving your body the necessary time to heal. Not going to heal if you go flipping tires or relive the power-lifting glory days just because you are having a good day and not feeling pain. Think of pain like this... when an injury occurs over time it is the last thing to happen, as in it just gets a little worse and a little worse and all the while your tolerance for this pain builds as the pain progresses. Therefore, you get all these treatments & therapies and you get some relief, that does not mean the problem is gone, just means it is getting better/healing.

I'm not saying this is you, but I will tell you I have a great many patients, both weight lifters and non-weight lifters alike who will come into my clinic get some treatment, go home take a pain pill, wake up the next morning feeling great and then go continue doing whatever it was that caused their injury in the first place and come back into my office complaining that it felt better, but now suddenly and for some unknown reason the pain is back and even worse??? I look at them and say "Really... Honestly... You don't know why the pain is back?" That is a problem of mine though, because as you know (psychologically) when we feel good, we feel healthy and when we feel healthy it is only in our nature to push our boundaries.
 
ryansm

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Oh you are absolutely right, and I'm not pushing myself to the point I was when competing. I guess what I have been doing is thinking that if I only lift x amount of weight, or flip a tire x amount of times then that will be enough. Basically downgrading the output, however I am coming to the realization that this is not working, and I need to make a serious change. But it's like you state "Psychologically" it is much easier said than done.
 
vidapreta

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but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
.
Unfortunately as bodybuilders/powerlifters there's a constant wear and tear from pushing our bodies to the limit everyday. The passion that we love is making our joints,cartilage,discs and tendons age alot quicker than your regular guy walking the streets. Our joints ect..ect.. are probably older than our actual age. IMO.
 
ScottyDoc

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But it's like you state "Psychologically" it is much easier said than done.
I am not saying that just about you, I am saying we are all like that no matter what the sport and no matter who we are. If you are an athlete, which is about 99.99% of the people on this site, then pushing it to the limit is a mind-set (psychological) issue that is not easily broken. I will be the first to admit that I am personally 100% guilty of this!

No worries bro, you'll figure this out, I can tell from our conversations you are a very intelligent guy, no need for me to beat a dead horse on this issue, LOL
 
ryansm

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I completely understand doc, and appreciate the help.;)
 
ScottyDoc

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Unfortunately as bodybuilders/powerlifters there's a constant wear and tear from pushing our bodies to the limit everyday. The passion that we love is making our joints,cartilage,discs and tendons age alot quicker than your regular guy walking the streets. Our joints ect..ect.. are probably older than our actual age. IMO.
I agree with what you are saying for the most part, I mean you are right, just wanna make sure that people know that just because we rode our bodies harder when we were younger with extreme sports/lifting doesn't mean we need to quit all together. It just means we need to listen to our bodies and switch gears in the way we lift and/or exercise. As I have stated before in my case it was to lose excess weight and start lifting lighter and for higher reps.
 
vidapreta

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I agree with what you are saying for the most part, I mean you are right, just wanna make sure that people know that just because we rode our bodies harder when we were younger with extreme sports/lifting doesn't mean we need to quit all together. It just means we need to listen to our bodies and switch gears in the way we lift and/or exercise. As I have stated before in my case it was to lose excess weight and start lifting lighter and for higher reps.
I'll never quit, but i do hate the idea of going lighter,it goes against everything that i started lifting weights for.
 
ScottyDoc

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I completely understand doc, and appreciate the help.;)
Anytime bro, anytime! On a different note, when you were competing what exactly were you competing in? I ask because you originally stated you power lifted then mentioned flipping tires, were you entering strong man contests? I love watching that $hit on TV, my big head tells me.. "I can do that," but my logic knows I cannot, LOL. I remember from some of the older ones, the way they man handled.. and I mean MAN-HANDLED those full kegs... and I helped a buddy set up for a Christmas party and felt like a total weakling struggling to carry a full keg up a flight of stairs all alone. With that kind of stuff... the word cumbersome is the best way to describe it, because it wasn't all about the actual weight, but the size/weight that was the issue. I find the same thing is true whenever I have the joy of helping a friend move furniture, which unfortunately I am the first one they all call, this happen to you?
 
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Diversity in life is a blessing, there is a reason moderation is advised in more than just the simple things. Athletes, especially professional, have or develop a perfectionist mindset. The key is to define yourself by many different things, and not hold your eggs in one basket. ^^^I'm trying to follow this outlook, lol.
 

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