What's up guys,
Well I'm 3 months out from a sub-acromial decompression surgery on my left shoulder. I started PT the week after my surgery and I'm still going and while I'm making good progress, I still have this nagging bicep issue that I really want to resolve and can't seem to pin-point how to make it better.
I might be slightly confused since I've been reading a lot of Cressey's stuff lately, but I believe I had an External Impingement since I had a huge bone spur on my acromion and a type 2 hooked process. The surgery got rid of the spur and shaved down my acromion to a type 1 flat process.
Prior to the surgery the only time I felt pain in my shoulder itself was during any over-head pressing, shrugging movement. From reading Cressey's stuff this leads me to believe I had an AC Impingement. Range of motion was always excellent and I definitely could hear an audible "crack" when abducting the shoulder past 90 degrees.
I've learned a lot about correcting posture, foam rolling, stretching tight pecs, thoracic extension, prone y, t, ws etc.
However as I mentioned I still have a nagging dull ache on the inner part of my elbow, just below my bicep and just above my forearm on the effected side.
Here are some of the symptoms I notice in that bicep area:
-as mentioned dull ache, usually gets better once I do my stretching (sleeper stretch)
-pain (throbbing) in one of my rotator cuff tendons. feels like its right on top of my left shoulder blade, and just inside my left lat. I know referred pain down the arm is common with some of the cuff muscles (supraspinatus) so this might be connected, since doing the sleeper stretch for my posterior capsule tends to alleviate both the posterior throbbing and the ache below the bicep.
-lack of blood flow in the left arm and obvious weakness
-when doing direct bicep work with very light weight for high reps (in therapy) the muscle gets tight sometimes and fatigues very quickly in relation to my good side
Now I've been through the ringer with this situation. Prior to my surgery I was in PT, but had a terrible therapist so I didn't make much progress. I saw a guy who does Graston, but was only able to see him a couple times. He did Graston on the bicep and said there was a lot of scar tissue in that area.
I went back for my one month post op appt with my Ortho who is a shoulder specialist. I kept telling him about the ache just below my bicep and he kept telling me he was puzzled by it since bicep pain and the impingement I had are totally unrelated??? Everything I read in literature says the LHB tendon is often impinged when the shoulder is injured.
My ortho even had me get a nerve test where I got hooked up to this machine and everything came back normal?
To make matters more confusing my therapist thinks it could be one of two things:
a) she says it is likely nerve irritation. She said often times nerves can get compressed especially when there is a shoulder injury. This makes sense, but I still have no clue how to make it better?
b) she said there is a possibility that you might have a partial tear.
My MRI prior to the surgery said the following:
-Left Supraspinatus rotator cuff tendinopathy with a partial thickness tear of the superior fibers. Left AC Joint hypertrophy with a downward sloping acromion process
Now obviously the spur was removed and the acromion was shaved down. When I asked my doc about the partial tear, he said there was no tear, all the cuff muscles were in excellent condition. I'm imaging perhaps there was only some fraying?
I apologize for the length of this, but really want to get to the bottom of this...
Lastly I will say, that perhaps in time this issue will resolve itself, considering i'm only 10 weeks out from a pretty big surgery?? However I feel like that's wishful thinking.
Any help would be greatly appreciated!