Shoulder Tendonosis Help

I have been lurking on this site for about 5-6 yrs. Taking in all the things it has to offer. I have been working out for the past 5yrs on and off. Finally I have a need to post. Here is my problem. I’m 30 and have been diagnosed with shoulder tendonosis. Since this condition has surfaced I have dropped 25lbs. I have done evrything I could think of to help speed up the healing process from acupuncture, ART, and I now just completed my first month of Physical therapy.(still going) All to no avail. I have not been able to go to the gym due to problems I’m having with my lower back (spondylitis/herniated disc L4/L5).

So here is my question: Does anyone know of any other alternative medicine or exercise I can do speed up the process or to keep from wasting away any further. Thanks in advance.

First, keep up with the physical therapy. It may be hell but this stuff takes time. I hate to say it but being 30+ doesn’t help your rehab times.

Keep the diet healthy and talk to your PT/ATC about at home modalities.

As far as other supplements you might try going with your general support but nothing hardcare. Hit every micronutrient and go from there.

What does your diet look like?

Supplements (including fish oil/flax oil)?

TriGWU, thanks for the response. My diet is fairly clean. Morning snack is usually 2 scoops Grow!. Breakfast consists of 6 eggs, & cups oatmeal. Mid-morning snack 1/4 cup almonds & a yogurt. Lunch 8-10oz grilled chicken, 1 cup of broccoli or spinach, 1 cup of brown rice. Afternoon snack couple pieces of beef jerky & usually another yogurt or a piece of fruit. Maybe hand full of almonds as well. Dinner varies but usually consists of some sort of meat & veggie combo. Bedtime snack 1 container of cottage cheese. As far as supplements go, I take about 2000 mg of fish oils per day. A b-complex. I just started taking a joint support formula with MSM/Glucosamin/Chondroitin. Taking 6 caps a day of Alpha Male as well…trying to hold to some muscle.

[quote]Fletch wrote:
TriGWU, thanks for the response. My diet is fairly clean. Morning snack is usually 2 scoops Grow!. Breakfast consists of 6 eggs, & cups oatmeal. Mid-morning snack 1/4 cup almonds & a yogurt. Lunch 8-10oz grilled chicken, 1 cup of broccoli or spinach, 1 cup of brown rice. Afternoon snack couple pieces of beef jerky & usually another yogurt or a piece of fruit. Maybe hand full of almonds as well. Dinner varies but usually consists of some sort of meat & veggie combo. Bedtime snack 1 container of cottage cheese. As far as supplements go, I take about 2000 mg of fish oils per day. A b-complex. I just started taking a joint support formula with MSM/Glucosamin/Chondroitin. Taking 6 caps a day of Alpha Male as well…trying to hold to some muscle.[/quote]

It sounds clean, I am not sure how the calories rank up recovery. I’ve always been a proponent of epsom salt baths for muscle health, but I would suggest you talk to the PT because, while I cannot see any detrimental effect, they have a more thorough education in modalities.

In the area of supplementation I would push you more toward nutritional supplements then strength supplements (if you can see what I am defining as the difference). I would almost push something like ZMA as it is more on a mineral level and making sure you have covered everything your body needs to repair. The Alpha Male is great, but (in my semi-educated perspective) I don’t think the body could utilize its components for muscle tissue repair over that of “natural” micronutrients.

Aside from that, be wary of too many overhead motions. Abduction, external rotation (the typical overhead motion) puts the entire shoulder in a vulnerable position. You name most shoulder injuries and the common MOI occurs in that position.

You seem to have a good foundation in lifting technique… If not, you might have someone look at your form… Even the slightest slack in form can but those structures in jeopardy. I am not sure if your PT suggested this, but it couldn’t hurt to cut back on the overhead motions. If you want to work your shoulders go for stuff that keeps the joint in a more “happy” position. Do horizontal and vertical abductions and scaions but keep your thumb pointed up as this is usually agreed to be the safest position for shoulder structures.

While keeping strength now may be a goal, there will likely be some sacrifice so you can eventually get full health. 2 steps forward 1 step back type of approach. If you stay greedy with your strength now you might end up 2 steps forward 2 steps back for a very long time.

Hey bud, sorry to hear about the problems, I know how shitty it feels not to be able to train.
the first thing I thought of when I read this post was this guy has to have some pretty unidivdualized program design.
I don’t know the cause of your back injury, so please don’t think I am judging you here-cause I am not.

But whenever I see shoulder tendonitis in guys in the gym or back issues, I find that guys are not following programs that jive very well with their individual needs and biomechanics.
For me, I haven’t deadlifted, snatched, cleaned, or squatted below or close to parallel in a year. I used to have terrible hip and low back pain when I did, but since I have stopped, no problems since.

Over the last year I have worked on learning more about joint mobility and soft tissue extensibility, and that has helped me drop a few inches lower on all these lifts. However, I still haven’t worked myself down to the floor or a parallel box.
And you know what-who cares! I am not a competitive powerlifter to where this really matters, I get good results from the exercises, and most importantly, I don’t get injured. I will continue to work on my mobility, but I won’t go balls deep if or when, my body tells me I can.

I also used to have real problems with core stability, shoulder/scapular stabilization and glute medius/maximus firing. So I researched a lot on that and now incorporate drills and exercises to work on those areas.

Like I said, I don’t know enough about your specific situation to really help, but this may be an area you would want to look into.

Hey Mike,

Thanks for the insight. I too have some problems with core stability, and glute medius/maximus region. I will definitly do some research in that area. If you have any links to help jump start my searching, I would appreciate you sending them my way.

Thanks again guys for your responses.

[quote]Fletch wrote:
I have been lurking on this site for about 5-6 yrs. Taking in all the things it has to offer. I have been working out for the past 5yrs on and off. Finally I have a need to post. Here is my problem. [/quote]
Sounds like your receive to give ratio is hovering around infinity.

Fletch,

Were you diagnosed based on symptoms or an MRI?

Also, saying you have a tendinosis is pretty vague in that it doesn’t give any information as to what functional deficit you have. What motions, positions or exercises hurt and where the pain in located etc.

What are you doing in phys. therapy?

Eric Cressey and Mike Robertson did an article series Neanderthal No More that addresses some factors that can predispose you to developing shoulder problems. Also, Eric’s Debunking the Myths part two has some info on shoulders and a link to a rotator cuff article he did. Check those out as well.

Fletch,

In addition to what the good doctor noted, I’d be interested in hearing what you’re doing outside of physical therapy. Specifically, are you still training in the gym? Also, what do you do for a living?

Often, people will do everything right while they’re at PT, but once they leave the office, they “accidentally go out of their way” to screw it up!

Dr. Ryan,

My diagnosis was based on an MRI Arthrogram. The results are tendinosis along the supraspniatus tendon distally, w/no evidence of rotator cuff tear. I have lost very little range of motion and strength is not affected greatly either. All positions are comfortable. Any motion involving my shoulder + pressure bother it. As well as simple motions like brushing my teeth can set it off. (even with my elbow by side)

As far as exercises it seems as though all chest/shoulder exercises are affected.(bench/shoulder press/dips/etc.) Pull-ups and rows seem to aggravate it as well. The pain is mainly about half way down the anterior deltoid. When aggravated it seems to travel along the biceps tendon about half way down my bicep. In P.T. they have me doing stabilization exercises for my shoulder and low back. (low back stabilization for spondylitis)

Eric,
I have not been to the gym in a month or two. I sit at a computer all day. Nothing strenuous. I try to maintain proper posture, but as the day wears on I catch myself slipping.

Fletch,

Was there any mention of the long head of the biceps tendon on the MRI report? How long ago was the test done and how long have you been having this problem?

Regarding sitting at work all day, click on the Cool Tips archive and read the ‘Get on a Roll’ tip. It will make a difference with your low back and upper back/shoulder. Make sure to stand up at least every 30 minutes to help decompress the spine. Prolonged sitting increases disc compression and will aggravate disc injuries.

Without knowing what exercises you are doing in therapy it is hard to give you more specific advice. However, I would suggest that you work on not only rotator cuff exercises, but also the muscles effecting scapular motion. Often it is an imbalance between tightness/strength, etc of the rotator cuff and parascapular muscles that causes the problems which leads to tendinosis.

Take care,

Ryan

Fletch,

I forgot to ask, does your shoulder bother you at work, during your normal activities?

The towel roll will help you sit up straight, but make an effort to keep your arm from reaching forward the whole time. That prolonged postural strain can keep it aggravated. Try to adjust your work station so that you can sit with your arms hanging at your side, bent about 90 deg, resting on the arm rest. The arm rest should not push up on the arm, as that upward pressure can stress the injured area.

Take care,

Ryan

You should check out the Target Tendonitis website blog. The guy talks about a lot of aspects of tendonitis/tendonosis, and knows his stuff. Everything he says is backed up by science.

I don’t know if the OP is still around to read this, man… This thread is from 2005…

he is 35 now… prolly dead :stuck_out_tongue:

I realize this is an old post but I’ve had my share of tendinitis. It can out a really big dent in your training and I literally tried everything before I found the answer that worked for me - eccentrics for the injured body part.

I first read about it here on T-Mag a few years ago but I couldn’t re-find the article.

Here’s another link to an article at talks about how to use it of you ever experience the problem. You’ll need to modify it for your body part but it works FAST - usually in less than a week:

http://blog.questproteinbar.com/the-secret-to-eliminating-tendinitis/

Seems to be superbump month