Strained rotator cuff: options and perspectives
August 16, 2024 6:25 AM Subscribe
Strained my rotator cuff. I have been doing PT diligently, but it's not getting better. I really don't want to have surgery. I'm also not sure if there might be something about my PT exercises / my desk setup / my life that is making the issue continue. Hoping to get a perspective on next steps from others who have been there. Snowflake details inside!
In April I strained my rotator cuff by...keeping my hand on my cross-body handbag strap for too long in a day. The pain got so bad that I couldn't sleep through the night, and I struggled to work (I'm an editor and my work is on the computer). I got a cortisone shot in June, did not start PT until July because it is very hard to get in.
PT has been...mediocre. He doesn't seem to pay attention when I do my exercises in office; for example, this week he corrected the way I do an exercise. Not a minor "Oh, you need to make a slight adjustment," but "wait, what are you doing, that's all wrong!" But I'd been doing the exercise the wrong way for my previous four visits. It's definitely a difference between me and the other patients I see; their PTs massage the afflicted area (mine does not) and seem focused on them when they do their exercises (mine mostly looks at the TV or flirts with the PT assistant). I would like to switch but I'm concerned I won't get any better or that switching will mean I don't get PT for another two months.
I do not know if there is something about my desk setup that is triggering the issue. When I ask about life adjustments I should make (desk or otherwise), the PT just shrugs. My amazing partner has added a keyboard tray to lower my keyboard. I am also going to try to leave my phone alone as much as possible because it is heavy.
I'm in too much pain to sleep more than 4-5 hours a night at this point, even with prescription pain meds. It seems like something about the way I sleep makes my shoulder worse. The pain makes me slow at my work, which means I spend more hours at the computer trying to get my work done. I have no doubt that working 7 days a week is part of the problem, but the more pain I'm in the more I have to work to keep up. (I am a freelancer so "take a few sick days" is not an option.) I have been warned that more steroid injections in my shoulder can lead to a terrible cycle. I saw my mom trapped in a similar cycle and I don't want that to happen to me.
I got a massage a few months ago, which helped, but massage is very expensive and my insurance will not cover it. But if people with this issue have had success with massage, I'll find someplace to cut corners in order to make it work.
My insurance will cover PT and surgery. I am really scared that the only option I am going to have is surgery. I am hoping that someone else has been there and might be able to point me in the right direction.
In April I strained my rotator cuff by...keeping my hand on my cross-body handbag strap for too long in a day. The pain got so bad that I couldn't sleep through the night, and I struggled to work (I'm an editor and my work is on the computer). I got a cortisone shot in June, did not start PT until July because it is very hard to get in.
PT has been...mediocre. He doesn't seem to pay attention when I do my exercises in office; for example, this week he corrected the way I do an exercise. Not a minor "Oh, you need to make a slight adjustment," but "wait, what are you doing, that's all wrong!" But I'd been doing the exercise the wrong way for my previous four visits. It's definitely a difference between me and the other patients I see; their PTs massage the afflicted area (mine does not) and seem focused on them when they do their exercises (mine mostly looks at the TV or flirts with the PT assistant). I would like to switch but I'm concerned I won't get any better or that switching will mean I don't get PT for another two months.
I do not know if there is something about my desk setup that is triggering the issue. When I ask about life adjustments I should make (desk or otherwise), the PT just shrugs. My amazing partner has added a keyboard tray to lower my keyboard. I am also going to try to leave my phone alone as much as possible because it is heavy.
I'm in too much pain to sleep more than 4-5 hours a night at this point, even with prescription pain meds. It seems like something about the way I sleep makes my shoulder worse. The pain makes me slow at my work, which means I spend more hours at the computer trying to get my work done. I have no doubt that working 7 days a week is part of the problem, but the more pain I'm in the more I have to work to keep up. (I am a freelancer so "take a few sick days" is not an option.) I have been warned that more steroid injections in my shoulder can lead to a terrible cycle. I saw my mom trapped in a similar cycle and I don't want that to happen to me.
I got a massage a few months ago, which helped, but massage is very expensive and my insurance will not cover it. But if people with this issue have had success with massage, I'll find someplace to cut corners in order to make it work.
My insurance will cover PT and surgery. I am really scared that the only option I am going to have is surgery. I am hoping that someone else has been there and might be able to point me in the right direction.
I'm kind of surprised they haven't done any imaging yet. Though, many times doctors will put someone through a round of PT because they know the insurance company will insist of PT before they authorize any imaging being done.
Your work setup might need looked at. I work at home and my setup was definitely not perfectly ergonomic, with my desktop sitting higher than it should be, making my mousing work such that it severely agitated my already-damaged rotator cuff.
I went a couple of years in severe pain before I decided something had to be done and got my rotator cuff repaired. I'm sooooo glad I did it.
posted by Thorzdad at 6:58 AM on August 16
Your work setup might need looked at. I work at home and my setup was definitely not perfectly ergonomic, with my desktop sitting higher than it should be, making my mousing work such that it severely agitated my already-damaged rotator cuff.
I went a couple of years in severe pain before I decided something had to be done and got my rotator cuff repaired. I'm sooooo glad I did it.
posted by Thorzdad at 6:58 AM on August 16
I've had lots of rotator cuff problems over the years from sports, but few cortisone shots and never prescription pain medicine. Mostly, I was helped by PT. I'd say it took a couple of months or more each time to see a big difference from that, so it might take longer than you think, but it also sounds like you need a new physical therapist. I also had trouble sleeping during those periods. I don't know if you already do this, but I found egg crate foam (not memory foam) on top of my mattress really helped with sleep. I also had luck with Aleve and ice for short term relief. I never tried massage.
posted by pangolin party at 7:00 AM on August 16
posted by pangolin party at 7:00 AM on August 16
My shoulder and neck problems are not the same as your shoulder problem, but: if there's any possibility that reaching forward (for the keyboard or mouse) or any other aspect of your posture at the desk is exacerbating the problem, and the keyboard tray doesn't help, then a standing desk might.
[I would recommend the Ikea BEKANT desk, which goes low enough for 5'4" me to sit ergonomically with my feet on the floor as well as high enough for me to stand, but it looks as if they've discontinued it, at least in the UK - "last chance to buy" - so that may not be a helpful recommendation.]
posted by ManyLeggedCreature at 7:08 AM on August 16
[I would recommend the Ikea BEKANT desk, which goes low enough for 5'4" me to sit ergonomically with my feet on the floor as well as high enough for me to stand, but it looks as if they've discontinued it, at least in the UK - "last chance to buy" - so that may not be a helpful recommendation.]
posted by ManyLeggedCreature at 7:08 AM on August 16
My wife at a previous workplace was able to get an "ergonomic assessment" that resulted in changes that made a fairly big difference to her shoulder issues. Obviously getting something like this as a freelancer will be different and probably cost (and cost more to deal with whatever they tell you is the problem). But, some quick googling suggests it isn't impossible, so this might be worth looking into. Also, maybe look into TTS options for whatever work can be done this way?
I have no doubt that working 7 days a week is part of the problem
yes, it's pretty hard to imagine that this isn't drastically compounding things. I understand this can't be easy but it seems from the outside like it would be worth doing whatever it takes (incl dropping clients) to get this at least to 6 days a week.
posted by advil at 7:26 AM on August 16 [1 favorite]
I have no doubt that working 7 days a week is part of the problem
yes, it's pretty hard to imagine that this isn't drastically compounding things. I understand this can't be easy but it seems from the outside like it would be worth doing whatever it takes (incl dropping clients) to get this at least to 6 days a week.
posted by advil at 7:26 AM on August 16 [1 favorite]
Best answer: I also have a pissed off rotator cuff and a rotator cuff impingement from basically nothing. It could be postural, it could be wear and tear, or if you're a person in/around menopause, I've read that shoulder problems are basically a rite of passage for us.
My doctor did Xray and ultrasound imaging on the spot, because I grabbed an appointment with a shoulder specialist who operates out of a large building owned/operated by the large local healthcare company. He referred me to PT, and I chose a PT who is associated with the same large local healthcare company over an independent PT office. Because of this, my doc and PT can message each other.
I'm about to finish up my first 6-week round of PT with very little improvement and my therapist is requesting another round of 6 weeks.
However, she is GOOD. She has been showing me how to sit better at my desk. She recommended a lumbar pillow which keeps me more upright. She also recommended I set an alarm for once an hour where I stop, lift my shoulders to my ears, push them backward so they are where they *should* be, and pull my neck/head back in line with my shoulders. She gave me an elastic band to work with at home. But it took four of my six weeks to figure out what is working for me. In this case, it's some strength building exercises along with my PT manually stretching my shoulder. I'm seeing some improvement, but it's very very slow.
I have a prescription NSAID that I use the day after PT (like today, I feel like I ran into a wall shoulder first), and I liberally ice my shoulder. But it stinks to hurt at such a major high-use spot for so long. It wears on you, and I'm sorry.
All of that anecdata to say: finish this course of PT while trying to get a second round set up with a new office. Get this PT to print out your exercises for you so you can continue them while waiting for the new office to get you started, and bring them to your new PT.
Here's hoping we both feel better at the beginning of October.
posted by kimberussell at 8:32 AM on August 16 [1 favorite]
My doctor did Xray and ultrasound imaging on the spot, because I grabbed an appointment with a shoulder specialist who operates out of a large building owned/operated by the large local healthcare company. He referred me to PT, and I chose a PT who is associated with the same large local healthcare company over an independent PT office. Because of this, my doc and PT can message each other.
I'm about to finish up my first 6-week round of PT with very little improvement and my therapist is requesting another round of 6 weeks.
However, she is GOOD. She has been showing me how to sit better at my desk. She recommended a lumbar pillow which keeps me more upright. She also recommended I set an alarm for once an hour where I stop, lift my shoulders to my ears, push them backward so they are where they *should* be, and pull my neck/head back in line with my shoulders. She gave me an elastic band to work with at home. But it took four of my six weeks to figure out what is working for me. In this case, it's some strength building exercises along with my PT manually stretching my shoulder. I'm seeing some improvement, but it's very very slow.
I have a prescription NSAID that I use the day after PT (like today, I feel like I ran into a wall shoulder first), and I liberally ice my shoulder. But it stinks to hurt at such a major high-use spot for so long. It wears on you, and I'm sorry.
All of that anecdata to say: finish this course of PT while trying to get a second round set up with a new office. Get this PT to print out your exercises for you so you can continue them while waiting for the new office to get you started, and bring them to your new PT.
Here's hoping we both feel better at the beginning of October.
posted by kimberussell at 8:32 AM on August 16 [1 favorite]
Best answer: I recently tore my rotator cuff and have started PT for it too. I love my PT—I saw her for a while for back pain and it helped and although I was hoping not to have to be in PT again I’m glad it’s with her. With the shoulder, here’s how it’s gone so far, if this helps you compare experiences:
- She did massage it a couple of times, first in front and then in back—to me she explained this as trying to make a bit of space for the inflamed tendon to fit in: there’s a limited amount of room for those muscles and tendons in the bony cage between the humerus, collarbone, shoulder blade and certain positions cause more pinching of the tissue and hence more pain (my arm hurts most when raised between about chest and chin and she said this is called “the painful arc”).
- She did some strength tests such as having me push against her arm from different directions
- She had me try some exercises and tell her how difficult they were and where they hurt, and did mention if I needed to adjust the way I was doing it
- She gave me printouts with the exercise routine to take home
- The first time, she taped my shoulder to see if it would help support it
- She gave guidelines on the amount and type of activity I could be doing—basically an all clear unless something makes my shoulder obviously much worse, and it was a relief hearing I wouldn’t damage it further if I tried doing some of the motions that cause pain
- She also said that tendons are very slow to heal so it made sense that my shoulder might take a while to rehab
My doctor said insurance wouldn’t pay for imaging without a round of PT and my PT said she didn’t think my shoulder was hurt badly enough for them to approve it.
In your shoes, I would look for a new PT, but keep going to the current one or at least doing the prescribed exercises in the meantime. I’d also be a lot more vocal about concerns and questions in the moment—asking explicitly for feedback on form, calling back his attention with questions if I felt like he wasn’t looking at me, asking for advice about how to sleep better, about workstation setup, medication (my PT recommended NSAIDs only for symptom management as she felt the inflammation ultimately helps it heal), mentioning massage helped and asking if he could try that, asking him to describe which muscles are damaged so you can visualize what’s going on, etc.
But it does sound like it just takes a long time. Best of luck, I’ve been so frustrated with mine as well but at least I can sleep (on my back—sleeping on either side hurts it)
posted by music for skeletons at 8:37 AM on August 16
- She did massage it a couple of times, first in front and then in back—to me she explained this as trying to make a bit of space for the inflamed tendon to fit in: there’s a limited amount of room for those muscles and tendons in the bony cage between the humerus, collarbone, shoulder blade and certain positions cause more pinching of the tissue and hence more pain (my arm hurts most when raised between about chest and chin and she said this is called “the painful arc”).
- She did some strength tests such as having me push against her arm from different directions
- She had me try some exercises and tell her how difficult they were and where they hurt, and did mention if I needed to adjust the way I was doing it
- She gave me printouts with the exercise routine to take home
- The first time, she taped my shoulder to see if it would help support it
- She gave guidelines on the amount and type of activity I could be doing—basically an all clear unless something makes my shoulder obviously much worse, and it was a relief hearing I wouldn’t damage it further if I tried doing some of the motions that cause pain
- She also said that tendons are very slow to heal so it made sense that my shoulder might take a while to rehab
My doctor said insurance wouldn’t pay for imaging without a round of PT and my PT said she didn’t think my shoulder was hurt badly enough for them to approve it.
In your shoes, I would look for a new PT, but keep going to the current one or at least doing the prescribed exercises in the meantime. I’d also be a lot more vocal about concerns and questions in the moment—asking explicitly for feedback on form, calling back his attention with questions if I felt like he wasn’t looking at me, asking for advice about how to sleep better, about workstation setup, medication (my PT recommended NSAIDs only for symptom management as she felt the inflammation ultimately helps it heal), mentioning massage helped and asking if he could try that, asking him to describe which muscles are damaged so you can visualize what’s going on, etc.
But it does sound like it just takes a long time. Best of luck, I’ve been so frustrated with mine as well but at least I can sleep (on my back—sleeping on either side hurts it)
posted by music for skeletons at 8:37 AM on August 16
Best answer: Speaking from personal experience, I really really wish I had bailed on a PT I suspected was bad (for many of the same reasons you shared). Instead I stuck with her on the principle that doing something was better than nothing, and I ended up with a totally new injury that is taking months to heal. So now I am stuck waiting for my fun new tendon strain to heal until I can go back to addressing my original problem. I know many people who have had life-changing experiences with good PTs, but a bad PT can do a lot of damage. I think finding someone new is going to be your best move.
I also don’t have any experience with rotator cuff injuries specifically, but my severe tendon strain (knee and foot) has been a wild education for me on the importance of rest for healing. It is taking much more reduced activity, and for much longer, than I expected. Can you spend a couple of weeks radically reducing your use of your shoulder to see if it helps? I’m talking never pick up your phone or bag or anything heavy on that side, switch mouse hands, experiment with voice-to-type, take whole days off work where you don’t use your computer at all, enlist a friend or partner to dictate work to for a bit, etc.
It has been a hard lesson for me to internalize, because I always want to be working on the problem, but you might also be in a situation where rest actually is the work.
Oh, and while my injury is not your injury, etc, anti-inflammatories and elevation have also helped a surprising amount. Not really with pain in the moment, but I notice the change the next day. (Maybe being propped up while sleeping might help?) Ice, on the other hand, has helped alleviate pain in the moment, but seems to have less impact on long-term improvement. Again, my injury is not your injury, but this is what has been helping me.
posted by CtrlAltDelete at 8:43 AM on August 16 [2 favorites]
I also don’t have any experience with rotator cuff injuries specifically, but my severe tendon strain (knee and foot) has been a wild education for me on the importance of rest for healing. It is taking much more reduced activity, and for much longer, than I expected. Can you spend a couple of weeks radically reducing your use of your shoulder to see if it helps? I’m talking never pick up your phone or bag or anything heavy on that side, switch mouse hands, experiment with voice-to-type, take whole days off work where you don’t use your computer at all, enlist a friend or partner to dictate work to for a bit, etc.
It has been a hard lesson for me to internalize, because I always want to be working on the problem, but you might also be in a situation where rest actually is the work.
Oh, and while my injury is not your injury, etc, anti-inflammatories and elevation have also helped a surprising amount. Not really with pain in the moment, but I notice the change the next day. (Maybe being propped up while sleeping might help?) Ice, on the other hand, has helped alleviate pain in the moment, but seems to have less impact on long-term improvement. Again, my injury is not your injury, but this is what has been helping me.
posted by CtrlAltDelete at 8:43 AM on August 16 [2 favorites]
Best answer: From my experience, shoulder/rotator injuries do take quite a long time to heal; that being said, you're in a lot of pain and your PT doesn't seem to be very interested in actually helping you manage it, so it's definitely worth trying someone else. Can't be worse, right?
In the meantime, you should definitely make changes in your day to day to try to get the shoulder some relief: think stuff like moving your mugs down to the counter so you're not reaching up into cabinets, or switching your mouse to the uninjured side. You will probably want to adjust your sleeping position as well, which can be difficult, but it's important to not let the shoulder get squashed or over-extended during the night. A U-shaped pillow might help--they're recommended a lot for pregnancy to support lax joints.
Your best chance to avoid surgery is to make rest and recovery your number one priority. Which, yes, may mean doing less work for a bit. Think of it this way--you can reduce your workload and find ergonomic workarounds now for chance to heal, or you can push it and get a guaranteed 3 weeks (or more ) prohibition from work after surgery.
posted by radiogreentea at 8:46 AM on August 16 [1 favorite]
In the meantime, you should definitely make changes in your day to day to try to get the shoulder some relief: think stuff like moving your mugs down to the counter so you're not reaching up into cabinets, or switching your mouse to the uninjured side. You will probably want to adjust your sleeping position as well, which can be difficult, but it's important to not let the shoulder get squashed or over-extended during the night. A U-shaped pillow might help--they're recommended a lot for pregnancy to support lax joints.
Your best chance to avoid surgery is to make rest and recovery your number one priority. Which, yes, may mean doing less work for a bit. Think of it this way--you can reduce your workload and find ergonomic workarounds now for chance to heal, or you can push it and get a guaranteed 3 weeks (or more ) prohibition from work after surgery.
posted by radiogreentea at 8:46 AM on August 16 [1 favorite]
Best answer: I'm in too much pain to sleep more than 4-5 hours a night at this point, even with prescription pain meds.
When I had this and couldn't sleep for more than one hour at a time, taping with kinesiology/kt tape helped me get to 3-4 hours (and also helped make the daytime pain a little more manageable). In my case leaning back at all brought on sharp pain, so I also had to sleep nearly sitting up for a while.
Massage did help, though I could only afford it a few times and the first massage therapists I tried did not help at all. But I felt like the good massages I eventually got helped me turn the corner.
Have you tried topical pain relievers like Salonpas patches, tiger balm, and so on? Sometimes they can distract your brain from the pain to some extent. (That might sound like a mild endorsement but it's not, distraction can be very helpful.)
I would like to switch but I'm concerned I won't get any better or that switching will mean I don't get PT for another two months.
Do you have much to lose? It sounds like your current PT is not much better than just doing exercises on your own. I would switch, the sooner the better. If you truly can't, try talking with your PT (again?) and tell them what you need from them. Since it sounds like you're at a multiple-therapist practice, you can also try talking with management and seeing if they'd be willing to just reassign you. Tell them you want someone who is willing to try massage with you too.
I am a freelancer so "take a few sick days" is not an option
That may be true in terms of income, but if missing deadlines is the issue it sounds like it's worth bringing it up with clients and seeing what they have to say. I've had clients be fairly understanding about stuff like this, and deadlines that seemed fixed suddenly became more flexible. Also surgery (which, like cortisone, doesn't always solve the problem) could end up forcing you to take some time off regardless. Sometimes "not an option" isn't really an option either.
posted by trig at 9:31 AM on August 16
When I had this and couldn't sleep for more than one hour at a time, taping with kinesiology/kt tape helped me get to 3-4 hours (and also helped make the daytime pain a little more manageable). In my case leaning back at all brought on sharp pain, so I also had to sleep nearly sitting up for a while.
Massage did help, though I could only afford it a few times and the first massage therapists I tried did not help at all. But I felt like the good massages I eventually got helped me turn the corner.
Have you tried topical pain relievers like Salonpas patches, tiger balm, and so on? Sometimes they can distract your brain from the pain to some extent. (That might sound like a mild endorsement but it's not, distraction can be very helpful.)
I would like to switch but I'm concerned I won't get any better or that switching will mean I don't get PT for another two months.
Do you have much to lose? It sounds like your current PT is not much better than just doing exercises on your own. I would switch, the sooner the better. If you truly can't, try talking with your PT (again?) and tell them what you need from them. Since it sounds like you're at a multiple-therapist practice, you can also try talking with management and seeing if they'd be willing to just reassign you. Tell them you want someone who is willing to try massage with you too.
I am a freelancer so "take a few sick days" is not an option
That may be true in terms of income, but if missing deadlines is the issue it sounds like it's worth bringing it up with clients and seeing what they have to say. I've had clients be fairly understanding about stuff like this, and deadlines that seemed fixed suddenly became more flexible. Also surgery (which, like cortisone, doesn't always solve the problem) could end up forcing you to take some time off regardless. Sometimes "not an option" isn't really an option either.
posted by trig at 9:31 AM on August 16
Best answer: I went down a similar road and ended up with surgery and I should have done it 6 months earlier. If your efforts with PT don’t pan out, surgery isn’t as bad as I was expecting. I was back at work in two weeks (wfh, desk job) out of pain completely at about 6 weeks and completely back to normal, full range, no pain at a year. I had built up surgery in my head and was terrified but it wasn’t bad. Good luck! Shoulder pain is miserable.
posted by pearlybob at 9:56 AM on August 16
posted by pearlybob at 9:56 AM on August 16
Best answer: New PT for sure*. Do a bit of research on which shoulder surgeon you would use; then call that office to ask who (PT) they send their patients to. That's the person you want. I just did this whole thing, and I wish I'd had that PT to start with. He does nothing but shoulders. He is the shoulder Guru.
Re: sleeping, I had some success with sleeping on my side and using various pillows under my hurt- side forearm (and next to my back) to get comfortable enough. Keeping the wrist pointing out straight instead of folded across me was key.
One bit of advice, I've had more problems post surgery (mine turned out to be full thickness tear) with my neck then with my shoulder, which is doing very well now. Keep working on keeping the neck loose.
*the definition of insanity is ...
posted by Dashy at 12:11 PM on August 16
Re: sleeping, I had some success with sleeping on my side and using various pillows under my hurt- side forearm (and next to my back) to get comfortable enough. Keeping the wrist pointing out straight instead of folded across me was key.
One bit of advice, I've had more problems post surgery (mine turned out to be full thickness tear) with my neck then with my shoulder, which is doing very well now. Keep working on keeping the neck loose.
*the definition of insanity is ...
posted by Dashy at 12:11 PM on August 16
Best answer: I didn't see you mention ice. Ice daily. Or more.
posted by Dashy at 12:14 PM on August 16 [1 favorite]
posted by Dashy at 12:14 PM on August 16 [1 favorite]
I'm sorry you're going through this. I had a similar injury and a PT friend told me what exercises to do, and after a bunch of months it got better. You've only been doing the PT for a month, so you're going to need to give it a lot more time if you want to try and fix it without surgery. It's excruciating, and it's awful to not know if you're making any progress. I found that changing my sleep position helped the overnight pain, and lots of ibuprofen was enough to get by, but if you're having a lot more pain than that, surgery might be the better option.
posted by rikschell at 7:54 PM on August 16
posted by rikschell at 7:54 PM on August 16
Best answer: First of all welcome to aging. :(
A research group in Australia is conducting a randomised controlled trial of rotator cuff repair surgery versus placebo surgery. The reason they are able to conduct this study i.e., get approval from an ethics committee to subject participants to one of either real rotator cuff surgery or placebo surgery is that, to date, there is really no evidence that rotator cuff repair surgery works. It might work, and also it might not -- and we have absolutely no idea which.
I'm not sure if you have a tear, but regardless the trial information might be helpful for you.
This includes a video about the trial and why they are doing it.
And here's the participant information sheet.
A note on imaging, which has been recommended above. I work in an orthopaedic research group and while traumatic injuries need imaging to see what happened (fall from a height, motor vehicle accident, high force injury, etc), in cases of age-related wear and tear, it's often not helpful as there is often little association between what a scan or image shows and what you feel. For example, as the video linked above states, many people have a rotator cuff tear and are fine, with no pain, whereas others have shoulder pain but no obvious source of this pain. So if someone sends you for an MRI and sees a rotator cuff tear they will identify it as the source of your pain. But this is not necessarily true. Same with backs - there is very little association between what shows up on an MRI or CT or xray and what the person is experiencing. This is why, over the past several decades, we have moved toward patient-reported outcome measures (pain, function, activities of daily living) rather than relying on imaging.
On a personal note, I hurt my shoulder a few years ago in a similar manner as you - by sitting, or looking to the left once ie almost nothing. It took several months, and one physio told me that because the shoulder joint is so small and constrained by various body structures, bones, etc, if something gets just a little bit inflamed it can set off a series of problems and it all takes a while to settle down. This was helpful for me as it seemed reasonable and also reminded me that this state was not permanent.
Finally, you mention not being able to take down time, time off etc. Surgery comes with at least 4 weeks of immobilisation and months of rehab afterward, so regardless of how you approach this you are going to require time off.
posted by lulu68 at 3:16 AM on August 17 [1 favorite]
A research group in Australia is conducting a randomised controlled trial of rotator cuff repair surgery versus placebo surgery. The reason they are able to conduct this study i.e., get approval from an ethics committee to subject participants to one of either real rotator cuff surgery or placebo surgery is that, to date, there is really no evidence that rotator cuff repair surgery works. It might work, and also it might not -- and we have absolutely no idea which.
I'm not sure if you have a tear, but regardless the trial information might be helpful for you.
This includes a video about the trial and why they are doing it.
And here's the participant information sheet.
A note on imaging, which has been recommended above. I work in an orthopaedic research group and while traumatic injuries need imaging to see what happened (fall from a height, motor vehicle accident, high force injury, etc), in cases of age-related wear and tear, it's often not helpful as there is often little association between what a scan or image shows and what you feel. For example, as the video linked above states, many people have a rotator cuff tear and are fine, with no pain, whereas others have shoulder pain but no obvious source of this pain. So if someone sends you for an MRI and sees a rotator cuff tear they will identify it as the source of your pain. But this is not necessarily true. Same with backs - there is very little association between what shows up on an MRI or CT or xray and what the person is experiencing. This is why, over the past several decades, we have moved toward patient-reported outcome measures (pain, function, activities of daily living) rather than relying on imaging.
On a personal note, I hurt my shoulder a few years ago in a similar manner as you - by sitting, or looking to the left once ie almost nothing. It took several months, and one physio told me that because the shoulder joint is so small and constrained by various body structures, bones, etc, if something gets just a little bit inflamed it can set off a series of problems and it all takes a while to settle down. This was helpful for me as it seemed reasonable and also reminded me that this state was not permanent.
Finally, you mention not being able to take down time, time off etc. Surgery comes with at least 4 weeks of immobilisation and months of rehab afterward, so regardless of how you approach this you are going to require time off.
posted by lulu68 at 3:16 AM on August 17 [1 favorite]
I strained my rotator cuff very badly by insisting on carrying my shoulder bag, shopping bags, etc. on my right side. I switched sides, and the pain has gone away. This is not the first time in a very long life that I have done something similar.
posted by Peach at 1:10 PM on August 17
posted by Peach at 1:10 PM on August 17
I do not know if there is something about my desk setup that is triggering the issue.
Over the fifteen years I worked as a school IT guy, I learned how close the correlation was between staff who'd shifted their screen aside from where I'd set it up for them in order to fit more tchotchkes on their desks, and staff who complained of neck and shoulder pain.
Screens should be centred, not off to one side. Sitting for lengthy periods with your neck turned one way, even slightly, will hurt you.
Screen height is important too. When you're sitting comfortably to work, the top edge of the active screen area should be at your eye height. Lots of people get this wrong, putting the centre of the screen at their eye height, and then their necks hurt from having their heads tipped slightly backwards all day.
If your computer is a laptop, its ergonomics are horrible by design. Screen and keyboard being fixed to each other means you get to choose between putting the screen too low or the keyboard too high. Cheapest fix is an external USB keyboard and mouse and jack the laptop up, perhaps on top of a keyboard garage. Best fix is external keyboard and mouse plus a properly positioned external monitor.
posted by flabdablet at 2:31 PM on August 17
Over the fifteen years I worked as a school IT guy, I learned how close the correlation was between staff who'd shifted their screen aside from where I'd set it up for them in order to fit more tchotchkes on their desks, and staff who complained of neck and shoulder pain.
Screens should be centred, not off to one side. Sitting for lengthy periods with your neck turned one way, even slightly, will hurt you.
Screen height is important too. When you're sitting comfortably to work, the top edge of the active screen area should be at your eye height. Lots of people get this wrong, putting the centre of the screen at their eye height, and then their necks hurt from having their heads tipped slightly backwards all day.
If your computer is a laptop, its ergonomics are horrible by design. Screen and keyboard being fixed to each other means you get to choose between putting the screen too low or the keyboard too high. Cheapest fix is an external USB keyboard and mouse and jack the laptop up, perhaps on top of a keyboard garage. Best fix is external keyboard and mouse plus a properly positioned external monitor.
posted by flabdablet at 2:31 PM on August 17
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posted by HearHere at 6:43 AM on August 16 [2 favorites]