Shoulder Bursitis

Bigger Stronger Leaner Injuries and Rehab
1

Results of a painful MRI showed swelling and Bursitis (not a torn rotator cuf as thought). I was surprised to hear that since the outside of my shoulder and shoulder blade have been killing me for months.

On Friday I got a Cortisone shot…Doc said give it till Sunday, well…today it took everything I had to not lift hard and heavy!!! I felt like superman! I LOVE the results of the shot!! I have to admit when my Doc gave me the shot in the shoulder I didn’t think it was going to help!

Just thought I would share…exited to lift again!

2

I am glad I posted this when I did (there is a date on it). Turns out the great feeling I had was short lived. The outside of the shoulder is starting to give me pain again. My shoulder blade (so far) only hurts after I lift. I will tough it out a few more weeks, but may soon be begging for another shot. I really do not want to see an orthopedic surgeon.

I will post again if/when I get another shot. I have read a handful of different rules for cortisone shots. Some say 4 months before shots, some say its ok for continuous shots, etc. Not sure if the Doc will hook me up again.

3

There are multiple reasons for having bursitis. You may have an anatomic abnormality causing narrowing of your subacromial space, in which case surgical intervention may be necessary. Alternatively, likely something you are doing in your workout is causing mechanical narrowing of the space. The hard part is figuring out what it is you are doing to irritate it and correct the technique.

I had my shoulder injected years ago. I competed in a bench contest 3 weeks afterwards. Then I went to PT and strengthened my rotator cuff. I also changed my bench technique with keeping my scapula retracted. This allowed my scapula to tilt, to open up the subacromial space so that the bursitis would be relieved. I have not needed another injection since then.

In short, getting repeated steroid injections is not the solution to your problem.

beef

4


Beef,

You make a good point. When you talked about the subacromial space it reminds me of something my doc said. Something about some bones in that area that are not connected, they are not broke or anything just the way they grew. He did mention that I can’t have multiple Cortisone shots and that surgery may be an option. I really don’t want surgery and had high hope for the cortisone shot but the fact that it only lasted 4 weeks, does not leave a warm fuzzy feeling.

As I said before, I will grunt and bare it for a few more weeks, then hopefully get a shot.

5

My physio reckons I have this. It appeared suddenly 2 months ago - couldn’t sleep at night, pulsating pain down the arm, poor and painful ROM, etc. I got ultrasound and took NSAIDs and it settled quite quickly, although it was always in the background and I could do zero pressing movements including a simple push-up.

I was working on rehab and got to the point I could do vertical pressing without issues. I did a bodyweight session at the weekend using pull-ups and bench push-ups, and the shoulder flared up dramatically 12 hours later. Had to take NSAIDS last night as I couldn’t sleep. Can’t get to see the physio until next Monday so need to rely on NSAIDs until then (and take it easy, of course). I suggested cortisone to the physio previously. But the physio, who is a qualified ART practioner, said the clinic prefer injecting sugar and even my own blood into the area. I assume this is prolotherapy? Will be interesting to see where the treatment goes next. Really pissed though as just making progress.

6

JB007

I will need to meet with my Doc to get clarification on what he was saying, but I believe that in my case my Acromion and clavicle do not connect. That said, one of them is causing my Bursa to be inflamed, I assume by pressing on it. The Cortisone shot cut down the inflammation.

My first question to him will be “why is this just now causing problems after so many years?”

I must say however that I would not know any of this had I not had my MRI (horrible experience). Glad I did it but will try to avoid it again in the future!

7

You might have had subtle changes in your technique over time that finally led to this or even consistent technique over time that finally led to this. I had been powerlifting for 8 years before my shoulder bursitis finally came to be. Bursitis and tendonitis tend to be accumulation injuries, that require time to become a problem.

beef

8

[quote]normet wrote:
My first question to him will be “why is this just now causing problems after so many years?”

I must say however that I would not know any of this had I not had my MRI (horrible experience). Glad I did it but will try to avoid it again in the future![/quote]

The physio suggested may be calcium deposits building up on the bone and then causing friction/inflammation. They way it was explained to me was:
option 1 - standard anti-inflammation treatment, e.g. ultrasound, NSAIDs
option 2 - prolotherapy
option 3 - surgery

Hopefully I will not need to go beyond no 2!

I had an MRI on my lower back last year. I guess if you’re claustraphobic it’s an issue! Physio actually said the shoulder problem could diagnosd via hand-held ultrasound, although I appreciate MRI is much more competent way.

9

Be wary, ultrasound as a diagnostic tool is user dependent. Prolotherapy is still a very controversial topic. The science is limited.

beef

10

Give some more info.

What hurts your shoulder? What exercises? What movements?

DId your pain slowly set on or did it all of a sudden become bad one day?

etc. The more the better.

11

[quote]BReddy wrote:
Give some more info.

What hurts your shoulder? What exercises? What movements?

DId your pain slowly set on or did it all of a sudden become bad one day?

etc. The more the better. [/quote]

Cheers mate. Epic tale below:

I have had a history of shoulder trauma, mainly left shoulder, since I was fairly young.

That said, I’ve managed sustained periods (months/years) of heavy lifting as well as high volume conditioning work with no issues.

My shoulders were a bit ‘clicky’ in the run up to injury 2 months ago. I was doing almost daily push-ups (100 - 150 reps), as well as pull-ups.

I woke up with a very slight strain (amost stiffness) across the top of the left bicep and front of the delt one morning. Foolishly I did a heavy push session later that day and felt no ill effects.

The following morning it felt like it had the previous morning. As the day wore on it got worse. By morning 3 it was really becoming painful with poor ROM. By day 4 and 5 (which were hampered by being away on business) it was agony driving, in the shower, dressing, etc, and in bed it kept me awake with pulsating pains going down into my forearm. There was visible swelling around the top of the shoulder joint area. The epicentre felt like about an inch down towards top of my bicep.

Day 6 and my Chinese girlfriend got me to see a Chinese ‘doctor’. Big mistake. After lulling me into a false sense of security with acupuncture, gentle music and lights, I was subjected to a session the most kinky masochist would have complained about! The manipulation leaving me in agony. Later that day I got NSAIDs and the affect was almost immediate.

Two ultrasound sessions later in the week together with another 2-3 days of NSAIDs and the pain, swelling dropped dramatically. I also started some remedial work with bands. as well as foam rolling, and ROM drills.

Fast forward a month and I felt strong enough to vertically press my 20kg KBs. However ROM was still not perfect and horizontal pushing felt so bad I didn’t really do any as my shoulder was clicking and feeling vulnerable). As stated though, I felt pretty normal for vertical pressing with the KBs.

Then last Saturday I did some bodyweight circuits in the park. I did controlled bench push-ups, i.e. hands on bench making it easier, about 4 sets of 12 reps, as well as semi-supinated pull-ups. 12 hours later I started to feel similar pain. By the following evening I couldn’t sleep due to same pain as before. I took 2 NSAIDS through the night (x2 50mg dicoflex sodium) and by morning pain had almost vanished and decent ROM resumed. I haven’t done any training since and have a physio appointment tomorrow (Monday).

I’ll see what is said then and make a decision from there. I hope to fuck it’s not too serious as I’m getting seriously soft and totally pissed off. On the plus side, there is nothing to stop me doing lower body work to get my condtioning levels up - especially using my KBs outdoors. I don’t believe moves like the renegade row irritate the shoulder, so paring that with lunges, etc, should keep me ticking over. I hope!

12

Great insight guys!

My story has a much shorter time frame then JB007. Thankfully this has not been a problem for years. I personally thought that I did this in the gym and if I think back hard enough, I think I loaded to much weight on a shoulder press. That being said, it would not lead to Bursitis. Whatever, I can’t explain.

All I know is that the cortisone shot I got was amazing. NSAID’s make a difference but since it hurts pulling a gallon of milk out of the fridge means I have to live on them for everyday tasks. The shot lasted almost 4 weeks.

I have tried shoulder exercises (light weight), warm ups, stretches, etc. Any upper body exercise hurts, whether chest or back. Oh, and I tried sitting on a incline bench (set about 80 degrees) and doing arm curls. After about 2 reps I think I almost had a tear from the pain!! That is far and above the worst. It’s the everyday tasks that piss me off, playing with my 5 year old son, reaching for anything all hurt.

Any day soon, I will be calling the Doc again. Maybe next week.

13

Had my physio session yesterday. Got some ART soft tissue work and ultrasound. Physio believes my postural issues in relation to scapulae is the underlying problem. I have thought I had visible scapulae ‘flare’. She got me doing slow bicep curls with just 2kg DBs and focussing on the scapulae mind muscle connection. I have to say I was surprised that I could actually feel the scapulae working. Also given other exercises, e.g. scap push-up, to work on.

I have been advised that if it doesn’t clear in another 2-3 weeks (with one physio session a week) it’s ultrasound diagnostic with the orthopaedic doc, then possibly injections or worse case scenario surgery. I’m paying for this privately and can’t really afford the financial hit so I’m hoping to fuck a lay-off period until the New Year may calm everything down. Otherwise Santa is going to be one mother of a scrooge this year!

This morning, and while I have improved ROM, the joint area that received the ART is sensitive to touch and a slight ache starting to radiate has prompted me to pop a NSAID. The physio doesn’t want me to use them unless necessary, a feeling I share, so I hope this is all I will require and by tomorrow morning it will have calmed down.

14

[quote]JamesBrawn007 wrote:
Had my physio session yesterday. Got some ART soft tissue work and ultrasound. Physio believes my postural issues in relation to scapulae is the underlying problem. I have thought I had visible scapulae ‘flare’. She got me doing slow bicep curls with just 2kg DBs and focussing on the scapulae mind muscle connection. I have to say I was surprised that I could actually feel the scapulae working. Also given other exercises, e.g. scap push-up, to work on.

I have been advised that if it doesn’t clear in another 2-3 weeks (with one physio session a week) it’s ultrasound diagnostic with the orthopaedic doc, then possibly injections or worse case scenario surgery. I’m paying for this privately and can’t really afford the financial hit so I’m hoping to fuck a lay-off period until the New Year may calm everything down. Otherwise Santa is going to be one mother of a scrooge this year!

This morning, and while I have improved ROM, the joint area that received the ART is sensitive to touch and a slight ache starting to radiate has prompted me to pop a NSAID. The physio doesn’t want me to use them unless necessary, a feeling I share, so I hope this is all I will require and by tomorrow morning it will have calmed down.[/quote]

Do you or can you get any videos of your shoulder moving?

Ultrasound normally sucks for this kind of stuff. I doubt it’ll do much.

You gotta improve how that shoulder is moving.

15

[quote]BReddy wrote:
Do you or can you get any videos of your shoulder moving?

Ultrasound normally sucks for this kind of stuff. I doubt it’ll do much.

You gotta improve how that shoulder is moving. [/quote]

No videos mate.

The ROM is not great but not bad either. Actually the joint is feeling pretty good at the moment (don’t want to speak too soon). So the soft tissue therapy and ultrasound appears to have had a positive impact so far.

I realise that improved mobility is crucial to long term shoulder health. I want to get that inflammation right down (assuming there is no tear at the route of the problem) and then increase mobility and strength in the RC and scapulae areas.

Next physio session is Monday so will take it from there.

16

ART is supposed to take a while to work. If your shoulder has been damaged it’s possible there can be a lot of inflammation. I’m surprised they have you doing exercises so quickly, you possibly can have too much inflammation for any exercise to really be helpful. If NSAIDs work likely ice would’ve been good to put on the first few days.

I’ve found push ups to be worse then a heavy pressing session. I think the shear volume pushups require hurts it more than what heavy weights require. That said, it sounds like solid rest followed by weights and no overheard work for a few months is your best option. Good luck with the therapy.

17

[quote]Airtruth wrote:
ART is supposed to take a while to work. If your shoulder has been damaged it’s possible there can be a lot of inflammation. I’m surprised they have you doing exercises so quickly, you possibly can have too much inflammation for any exercise to really be helpful. If NSAIDs work likely ice would’ve been good to put on the first few days.

I’ve found push ups to be worse then a heavy pressing session. I think the shear volume pushups require hurts it more than what heavy weights require. That said, it sounds like solid rest followed by weights and no overheard work for a few months is your best option. Good luck with the therapy.[/quote]

Cheers mate, I agree with quite a bit of that. I find as much rest as possible is preferred than rather forcing rehab work.
Regarding push-ups, you’re correct. You are soon found out if you have any shoulder issues. When I’ve suffered impingement issues in the past, I have been able to press DBs with no problems yet push-ups were a different story.
I may see my GP in between times for a cortisone shot but, as I said before, it has calmed down a lot over the last few days. I feel sometimes it comes on in the evening prompting an NSAID before bed. Hate taking them but only medication that addresses it. High strength over the counter anti-inflammatories, pills and gels, had zero impact.

18

Dec 30, 2011 – Update

Working out over the past few weeks as been nothing short of a joke. The pain has been off the charts. The breaking point was that my sister bought my family a Wii and it kills me to play with my son. So today I went in and saw my same doc as before. He thought the Wii story I told him was funny. He said that he would give me a another Cortisone shot (I was cheering inside my mind) only this time he would increase the dose!!!

Right now my right should is killing me. But I am hoping for the same result as in my initial post. I will post again in two days on the results.

Note: He did say the next time I go in he will highly suggest I go and have a scope done (forgot what its called) ie: surgery.

19

I followed this same pattern for almost four years. Cortisone shots are only a temporary fix. In fact I found that the Cortisone injections were setting me back. Cortisone masks the pain well and yes you do feel like Superman after the injections. Because of this I found that I started training with the shoulder when it was still inflamed and I compounded my problem. I also found that the more Cortisone that I got the more quickly it would wear off. What used to give me two months of relief in the beginning only gave me a week towards the end.

Bottom line is that you need to find out what the underlying reason is that you are getting inflammation in the shoulder. Whether it is genetic where you were born with limited joint space, postural imbalances, lifting with improper form, or a combination of issues, you need to figure it out or you will continue down this path to chronic shoulder problems.

I would start off by cutting out any pressing movements that aggravate your shoulder. At least until you have been pain free for a good while. Concentrate on strengthening your scapular muscles and upper back. Lots of rows, face-pulls, pullups with a neutral grip, etc…This will help correct any postural issues and scapular instability that may be contributing to your impingement. I found that this helped me a lot. Also ice is your friend. Make sure that you are icing your shoulder two or three times a day.

Like I said, I followed the pattern you have started for almost four years. In the end I ended up electing to have my shoulder surgically fixed. I had a distal clavicle resection and a subacromial decompression. In lamens terms, they cut bone out of my shoulder in order to make more joint space. I was initially against any type of surgery, but when my day to day life was affected I relented. I got to the point that I was only sleeping two to three hours a night and it hurt to even pick up a coffee cup off of a table with my arm outstretched in front of me.

A year after the surgery (2010) I was back to where I was before I injured it and making gains. I will say that I am pressing pain free but I am cautious. If I feel any discomfort in either shoulder I immediately concentrate on my upper back and scapular muscles.

Good luck. Shoulder problems suck.

20

Thanks for that insight. I fully understand what you are saying. I have to say that after the first shot, I immediately started training hard as soon as I felt better (like superman). Needless to say I thought once the first shot wore off I was in more pain then before I got the shot. Hence my previous post where I cried about the pain. So based on your post, it sounds like I am following down your same path.

As for the problem, Doc said the Bursa is/was inflamed and my Clavicle and Acromion aren?t lined up properly. That be said, I suppose I need to work on technique now and see if that is what is causing the Bursa to become swollen. From this point forward, while I am free of pain, I will learn to strengthen my scapular muscles and upper back. Certainly can?t hurt!!

As for the surgery, I am really not hyped on it, I don?t like the idea of sticking a scope in my shoulder to see what the actual problem is and potentially removing the Bursa. However, I do like the fact that you claimed your surgery was a success. That really helps in the decision.

Shoulder problems do suck!