Is there a doctor in the house?

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    Zero Tolerance's Avatar
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    Is there a doctor in the house?


    May I suggest an "Injury Talk" forum?

    Anyway. I had an MRI of my left shoulder and here's what I was told (an X-Ray came up normal):

    Findings:
    There is mildly diffusely increased signal, thickening of the distal supraspinatus tendon consistent with tendinitis with no evidence of rotator cuff tear. There is no visible labral tear. The glenohumeral joint is normal, there is no significant joint effusion. There is slight increased fluid in the bicipital tendon sheath consistent with tenosynovitis.

    The acromioclavicular joint is normal. The undersurface of the acromion is flat. There is an acromial spur. The acromion is severely laterally downsloping. There is no significant marrow signal abnormalities and the visualized muscles are normal.

    Impression:
    1. Mild supraspinatus tendinitis
    2. Mild bicipital tenosynovitis
    3. Severely laterally downsloping acromion contributes to impingement

    -- End of report --

    So, I knew about #3. I was told about that during my boxing days. It can be fixed with surgery - they shave the bone down - but I'm not fighting Mike Tyson any time soon. Also, I'm not a competitive body builder, so it's not detrimental that I can be a full-fledged muscle-head, although I'd like to be...

    Anyway. For #1 and #2, can anyone out there recommend exercises? They want to send me through physical therapy but I'd rather spend my money on supplements.

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    I'm not much help, and I don't really know my rotator cuff physiology very well at all, but here's my 2 cents anyways:

    I'd be willing to bet that doing higher-rep external rotation work + light stretching while simultaneously avoiding movements that cause inflamation for 6-8 weeks will help significantly. I'm pretty confident that is what the physical therapy is going to be.

    And I have no clue what problem number 3 is. If it 'requires' surgery, then maybe using the therapist is a good idea, because I have no idea how that effects the tendinitis/tenosynovitis.

    My thought on the matter is this: Rotator cuff work, aka physical therapy, works well, but isn't complicated or difficult for someone who is accustomed and familiar with weight training.

    I have rotator cuff problems similar to your problems 1 & 2. This means it's difficult to continuously make strength increases on presses. What I do is this:

    1) Do rotator cuff work 2-4 times per week, as a warmup for presses and on it's own.
    2) Focus on strength work with strict form for 2-3 weeks only, at which point I switch back to high rep work or GVT or similar, always with form in mind. I cannot try to increase weight in the 6-8 rep range for more than 2-3 weeks before I get inflamation that persists after each workout.
    3) If I reach a point where I experience rotator cuff inflamation after workouts because my form was sloppy or I pushed the strength portion too far, then I must give up the culprit exercise temporarily and continue rotator cuff work.

    Having messed up shoulders sucks. Being easy on them and smart about it is the only way to go.
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    Bro,
    I had a really, really bad AC joint impingement in my left shoulder.

    In the end, it sorta just went away on it's own after doing no weightlifiting for like a year or something. (I posted a story on it in my picture thread.)

    I also did PT with like 3 or 4 different guys. That seemed to help.

    I guess I really don't have good advice if you'd still like to stay muscular.
    If you want it to heal, you are going to have to leave the shoulder alone (I had to start sleeping on my right shoulder and carry my backpack over only it).

    I was so bad I couldn't even do concentration curls without it bothering me.
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    Quote Originally Posted by Zero Tolerance
    May I suggest an "Injury Talk" forum?
    Quote Originally Posted by Zero Tolerance

    Anyway. I had an MRI of my left shoulder and here's what I was told (an X-Ray came up normal):

    Findings:
    There is mildly diffusely increased signal, thickening of the distal supraspinatus tendon consistent with tendinitis with no evidence of rotator cuff tear. There is no visible labral tear. The glenohumeral joint is normal, there is no significant joint effusion. There is slight increased fluid in the bicipital tendon sheath consistent with tenosynovitis.

    The acromioclavicular joint is normal. The undersurface of the acromion is flat. There is an acromial spur. The acromion is severely laterally downsloping. There is no significant marrow signal abnormalities and the visualized muscles are normal.

    Impression:
    1. Mild supraspinatus tendinitis
    2. Mild bicipital tenosynovitis
    3. Severely laterally downsloping acromion contributes to impingement

    -- End of report --

    So, I knew about #3. I was told about that during my boxing days. It can be fixed with surgery - they shave the bone down - but I'm not fighting Mike Tyson any time soon. Also, I'm not a competitive body builder, so it's not detrimental that I can be a full-fledged muscle-head, although I'd like to be...

    Anyway. For #1 and #2, can anyone out there recommend exercises? They want to send me through physical therapy but I'd rather spend my money on supplements.
    Hey Zero, i am not a doctor however, I have my BS degree in Exercise Physiology and am working towards my Physical Therapy degree. Now for answers.
    #1: I am sorry to tell you but this problem is caused by your impingement. The common belief is that the impingement of the supraspinatus tendon leads to supraspinatus tendonitis. PT can help but may not clear the problem (maybe surgery). Don't worry the surgery is not as invasive as you think. Certain exercises can help a lot.
    #2: With Mild bicipital tenosynovitis PT can definitely help but there are certain stretches as well as exercises that can help.
    If you want some of the exercises and stretches just say the word and i will email them to you. Hope i helped out a little.
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    Sad, there was some stuff my PT's gave me to try to increase the distance between the acromium and clavicle to help stop the irritation of the ligament between the two.
    I attributed doing those exercises (plus some weird stretches) and the time off to the huge positive improvement.

    I'd advocate him trying if, if his insurance will cover most of it.

    He is only 33. The surgery might not be invasive, but it's surgey nonetheless. I'd look to any and all options to help it get better before surgery - but that's just me.
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    Quote Originally Posted by Zero Tolerance
    May I suggest an "Injury Talk" forum?

    Anyway. I had an MRI of my left shoulder and here's what I was told (an X-Ray came up normal):

    Findings:
    There is mildly diffusely increased signal, thickening of the distal supraspinatus tendon consistent with tendinitis with no evidence of rotator cuff tear. There is no visible labral tear. The glenohumeral joint is normal, there is no significant joint effusion. There is slight increased fluid in the bicipital tendon sheath consistent with tenosynovitis.

    The acromioclavicular joint is normal. The undersurface of the acromion is flat. There is an acromial spur. The acromion is severely laterally downsloping. There is no significant marrow signal abnormalities and the visualized muscles are normal.

    Impression:
    1. Mild supraspinatus tendinitis
    2. Mild bicipital tenosynovitis
    3. Severely laterally downsloping acromion contributes to impingement

    -- End of report --

    So, I knew about #3. I was told about that during my boxing days. It can be fixed with surgery - they shave the bone down - but I'm not fighting Mike Tyson any time soon. Also, I'm not a competitive body builder, so it's not detrimental that I can be a full-fledged muscle-head, although I'd like to be...

    Anyway. For #1 and #2, can anyone out there recommend exercises? They want to send me through physical therapy but I'd rather spend my money on supplements.

    Hello, first of all a tendinitis is an inflammation of the distal supraspinatus tendon that goes from the scapula all the way to the shoulder joint. The only way to remedy that problem is basically taking some time off and taking anti-inflamatories for it, or the other option you have is basically taking it slow with that left shoulder. As someone said above the problem originates in the laterally downslopping acromion, as it goes down the joint suffers a lot.
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    Since I have this severely laterally downsloping acromion, aren't I just SOL? I mean, I think all I can really do is stay away from what's causing me pain. I'm not doing any barbell presses for chest or shoulders anymore.. I'm doing dips on a machine that you sit at. I'm using a Hammer Strength and going light for shoulder presses. Even upright rows are no good. I'm doing "sort of" dumbell upright rows. I tried some light dumbell lateral raises last night and that seemed okay. I do dumbell flat bench and slightly inclined bench presses.. No more pullups - I do pulldowns to the front and that seems okay so far.

    I don't have a lot of options but I'm going to hang in there for as long as I can..
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    I tried that Zero. Doing what I could without it hurting badly.
    Eventually, the pain got really bad.
    LIke I said, all I could do was take a lot of time completely off.
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    Yeah, that's what I've been doing.. 6 months off and 5 months off in the last 14 months.. So far, nothing is hurting with what I'm doing. I'm being very careful and lifting slowly - no more "explosiveness". It's depressing but I'm happy to be back in the gym...
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