posted
Dammit, dammit, DAMMIT. I got the MRI results today...inconclusive.
*bangs head on desk*
Let me back up. I fence. I fence a lot. I fence three days a week for two and a half hours, plus 6+ hour tourneys on weekends. Since my health has improved from whatever-virus-I-had-for-months, I've been back at fencing that regularly. A month and a half ago, I started having serious trouble with my right arm, a different pain than the normal tendonitis. Twinges, sharp pains, weakness, the arm giving out when pressure is put on it, hurting all the time. Now, this pain is very different from my normal "tendonitis" pain.
Back to today.
Basically, the orthopedist told me that there wasn't anything big wrong showing on the MRI, (which makes me wonder what small things are wrong and what constitutes "big"). They did see plenty of tendonitis (duh). I have tendonitis. ALL THE TIME. This isn't the same pain and it occurs with certain movements. There's popping and things that happen that shouldn't be happening (which my coach has commented on).
I said this to the doc, he said that it could be a tendon slipping and catching and arthroscopy could fix it. So I said, fine, cool, let's fix this shoulder so I can keep fencing long-term.
He says they have to try other things first, because a surgeon won't want to go in on inconclusive results without more conventional methods being tried (I can see that point). He also said he doesn't think the three weeks of PT he's referring me to will help much and is scheduling me to see the surgeon once that time is up.
I really don't think the doctor is quite getting how serious I am about fencing. This isn't just some random inconvenience. Fencing is a large part of my life and part of what keeps me sane. My coach got to listen to my end of the conversation today since the doc called while I was helping out finishing putting polyurethane on the new floor downstairs and said the same--the doc isn't getting how intensely we train for fencing.
Anyway, the doc asked if I've been fencing this whole time. "Yes, aside from the cortisone shot."
(Which, by the way, he offered to do again. I immediately said, "NO!" I mean, it didn't help before, it can break down tissue, why the hell would I want to do it AGAIN. He then said that the shot wasn't mandatory.)
Mmmph. He says that fencing must be causing most of the current problem and can't be good for it and asked for me to stop fencing while I'm doing the PT.
Honestly, can this really all just be tendonitis? I mean, the popping and catching and the sudden pain? And I know what sort of pain the fencing causes and I've taken steps to alleviate that (loose fitting plastron and jacket, being careful about my extensions and making sure they're proper, etc).
I'm not emotionally ready to give up my sport for some undetermined length of time. At least if they said "This is what's wrong, here's what we're doing to fix it, this is your recovery," I'd know a ballpark of how long I couldn't fence.
Right now it's like being grounded indefinitely.
Posts: 14745 | Registered: Dec 1999
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posted
Don't forget, the PT can be an advocate for you. His additional documentation and assessments are valuable. He can also contact the doctor personally if he has a significant opinion to bring to his attention. So think of this as a second opinion of sorts. Sometimes therapists do therapeutic ultrasound and other techniques that can be more helpful than injections, btw.
Posts: 1014 | Registered: Jul 2005
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Seriously though, I've had similar problems and giving that particular muscle group a rest helped alot. If I were you, I try working on your left arm skills and give your right arm a rest.
Posts: 2425 | Registered: Jan 2002
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posted
What you describe sounds neurogenic in origin. Like, a nerve being squooshed or damaged. So, perhaps a referral to a neurologist?
Posts: 10397 | Registered: Jun 2005
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I've had PT on my shoulders before. They're always in pain, that's the thing. The last PT I had was over a year ago and it was finishing up fixing my posture problem--most of the pain was caused by poor posture. Posture had been fixed and I kept up with the exercises and stretches. I was anal about making sure my shoulder was properly warmed up, loose, and non constricted. Also about watching my shoulder posture. The pain was dulled enough that I didn't think twice about it unless it got to where I had to an an anti inflammatory. But then that meant icing it and resting it for a day and I'd wake up and it would feel fine. I could also figure out a trigger--I'd twisted my arm wrong during a lunge, I'd worn a plastron that didn't allow for enough range of movement, etc.
I think what bothers me most is that this is an entirely different sort of pain. The tendonitis pain is like a ball of discomfort located in my entire shoulder joint. If I do something like not warm up, not stretch it, constrict it or anything, the ball gets bigger and warmer and more prickly. I stop what I'm doing, take celebrex, ice it, rest it for a day, and it's fine.
This pain is different. It's a catching. The shoulder could feel fine, then if I move it quickly, or in certain movements (behind the back, over my head, catching anything, throwing anything), it hurts like a mother. And the pain that settles in afterwards is entirely different. It just...hurts and it's a hurt I can't identify as one I've felt before. And it stays with me. It doesn't go away, the pain will keep me up at night.
Also, the ortho said nothing really bad was found. There's stuff there but it's small. He suspected a labrum tear (before the MRI) and labrum tears are hard to see even on MRIs, especially without contrast dye. That's the part I wonder about, what constitutes "really bad" when it comes to an athlete vs. a non athlete. Stopping fencing isn't an option (in the long term).
My range of movement is...painful. I think part of what bothers me about going to PT is that I know it's going to hurt. Why? Because I still have and do the exercises that my physical therapist had me doing when I "graduated" from PT and was left to my own devices. The stretches with the resistance bands, the decceleration with the ball, the position stretches, etc. They hurt, even at the lightest amounts, the least resistance. And that's what PT is going to be, these strengthening/stretching exercises. If doing stuff that hurts it is only going to make it worse, then...*sigh*
posted
Another thing to mention is this: the doctor works for you. If you don't agree with the prognosis, go get another orthopedist to look at it.
The orthopedist I saw for my shoulders insisted on doing an MRI. I insisted we did not do an MRI. He was shocked, as I don't think a patient disagreeing with him was a common occurance. But ultimately, your treatment is always your own decision.
Posts: 5462 | Registered: Apr 2005
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posted
She IS seeing a new doctor in three weeks. And don't forget PT can push that date up if they are concerned with what they see in therapy. Their opinion on all this can be very helpful.
Posts: 1014 | Registered: Jul 2005
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posted
I think the first one is probably more of a general orthopedic surgeon. Orthopedic surgeons do everything from back surgery, knee surgery to finger surgery. The new surgeon is probably an orthopedist who specializes in shoulders. Just a guess.
Or maybe the first surgeon prefers to simply do office work, including joint injections and other office procedures, and no longer does OR surgeries. Or maybe he only works part time, or has a bad back or something. Or maybe he was actually a chiropracter or nurse practioner who works with the actual surgeons.
Posts: 1014 | Registered: Jul 2005
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