Need quick advice! rotater cuff injury!

Wai Jia: The Kung Fu Forum Kung Fu Training and Health
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It’s kind of freaky, maybe 2-3 yrs ago i was putting on some lotion and out of no where i dislocate my rotater and end up putting it back in place myself. So i go to this Doc (a quack you could say) and he sees absolutely nothing wrong with it and tells me to just continue doing all the excercise im doing now. This happened before i seriously started doing martial arts. So i do martial arts and everything and had no problems and infact it felt alot better.

Now just yesterday i sneezed (how should i explain this?) on my left side of the same shoulder and it ends up sliding out of location again (3rd time its happend now) so here i am trying to put it back in place and my arm is moving in different a different motion and shacking and i figure it out and…POP! back in place. I talked to sifu over the phone about it and he gives me these excercises and says wait till 2wks to do them. Can’t go to a professional unless the (quacks) see anything wrong with it. I’m looking for some professional adivce, anything that you guys could tell me I would really appreciate alot.. :frowning:

2

Ok, I’m not a doctor so you won’t be getting any professional advice but I have a rotator cuff injury so I can speak from experience.

The first thing I would do is go back to the doctor. Not just a regular doctor but an orthepedic surgeon. If he can’t do anything try to get him to prescribe some physical therapy at least. In physical therapy you’ll learn all the exercises that you need.

Again, I’m not a doctor but it doesn’t sound like you have an injury. Maybe just a joint that is prone to dislocation. You should be able to fix this by strengthening the muscles of the rotator cuff.

Rotator cuff exercises are not heavy weight exercises. They are done with light weights (10 to 20lbs).

I did a search on google for “rotator cuff exercises” and got many results back. Here is one of them. http://www.bodyresults.com/E2RotatorCuff.asp

In addition to the rotator cuff exercises I would do some standard exercises that will strengthen the other muscles of the shoulder like: Pushups, military press and lateral raises.

For my shoulder I use some homemade clubbells (plastic bats from WalMart filled with sand). I intend to eventually buy a real clubbell but they do the job for now.

Hope this helps. Good luck.

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Go see a doctor. It may not be a rotator cuff problem. The shoulder is extremely complicated, and all kinds of things could be causing your instability.

If one of those things is a labrum tear, then the LAST thing you want to be doing is overhead movements to strengthen your RC’s

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yep, see a doctor. I’ll add that you probably want to find one that specializes in sports med versus a general ortho as they’ll have a better insight to what your goals are.

interesting that a sneeze caused a dislocation. I can get tremendous pain in both my shoulders if I sneeze hard (and I have some bad allergies so it happens often) and I thought I was just wierd.

good luck

5

The Rotater Cuff is a very thin muscle, if something is poping out of place, it’s not a rotater cuff problem. You need to get with a doctor and get a MRI done.
I had a slight tear of the rotater cuff some years back, getting a MRI done is the only way to see it.

I hope this helps

6

Sorry to be thread digging, but I just got back from seeing a sports medicine doctor and I have a rotator cuff injury (tear?). If anyone else can expand on what’s already here, maybe talk about exercises and how you dealt with it, I’d greatly appreciate it. The doctor kinda ticked me off because he just gave me a shot and told me to come back in two weeks. No meds, no other advice, nothing.

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ok, for the record, and pay attention to this:

rotator cuff injuries / tears have almost nothing to do per se with things “popping out”; when the shoulder subluxes/dislocates, almost always it’s in an anterior direction, which has to do with lack of anterior support: tears of the anterior ligaments / glenoid labrum or both; of course, you can have issues with RTC at the same time, but etiologically it’s not the cause of the anterior dislocation - that’s usually trauma based

it sounds like the poster is a chronic anterior dislocator (but I can’t be sure because I haven’t examined him): to treat this, there are typically two options: train the rotator cuff to help keep from dislocating or get a surgical repair of the torn anterior structures (guess which one chronic dislocators typically end up getting? you guessed it…#2); regardless,

again, you can have a rotator cuff tear and be at no risk for dislocating; RTC tearing is typically due to imbalance of the anterior mnuscles (pecs, biceps), being chronically hypertonic (a typical postural issue in general), and also the RTC also can be stressed over time due to rapid decelleration demands (such as a baseball pitcher) requiring the RTC to eccentrically contract way harder than it ought to;

regardless, the poster should go see a qualified doc ASAP as this probably will not get better on its own (the more it happens, the worse it tends to get)

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[QUOTE=chud;715257]Sorry to be thread digging, but I just got back from seeing a sports medicine doctor and I have a rotator cuff injury (tear?). If anyone else can expand on what’s already here, maybe talk about exercises and how you dealt with it, I’d greatly appreciate it. The doctor kinda ticked me off because he just gave me a shot and told me to come back in two weeks. No meds, no other advice, nothing.[/QUOTE]

go see a good physio / PT - that will solve your problem usually; if the shot is what I think it was, cortisone (or some similar steroidal anti-inflammatory), it will help with the immediate acute issue, but in the long term won’t do much to deal with the cause - as far as dealing with it, typically (and this may not be the case with you), I personally spend time doing several things: mobilizing the rib cage / thoracic spine primarilly, secondarilly the cervicals, them lumbars if needed, occasionally the pelvis; I spend time working on rebalancing the balance of the RTC to the pecs / bicpes / upper traps, and more specifically the external rotators (supraspinatus, infraspinatus, teres minor) to the internal rotators (subscapularis and latissimus), the latter of which are typically hypertonic; again, this is a general approach, so it may not apply in your case - a good PT will know what to do

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ok: version 2 (hopefully the non-argumentative one)

  1. the exercises linked above are in the post by Chief Fox, are as he stated, one example of and are pretty typical for RTC rehab and there is nothing wrong with them per se; they will be helpful to many people, as was the case with CF above;

  2. there is, however, a not insignificant percentage of patients with RTC issues for whom these will be less successful, or not at all, depending on the specifics; therefore, if someone were to use them and not get the results they were hoping for, it would not be out of the realm of possibility, and it doesn’t mean that their injury was beyond help - it wold just mean that the typical approach was not appropriate for them

  3. some of the potential shortcommings of the standard methods are as follows:
    a) doing open chain free weight training of the external rotators does not address their functional in-context roll either posturally or activity wise;
    b) the door frame stretch is VERY non-specific and can actually put strain on the anterior sholder ligaments as opposed to doing anything to work on lengthening pecs;
    c) the one in standing is not a great idea for some people because of what it can do to the low back, and to acurately isolate lats, requires a more specific position of both the arms and lumbar spine: lats go from the upper arm and attach contractile fibers from T6 down to like about L1 or L2 (and non-contractile down the whole lumbar spine, sacral spine and cocyx), so you have to do simultaneous etension of thoracics and flexion of lumbars, al the while maintaining your arms in external rotation with scapulae roatated upwards, flat on the rib cage - bottom line, you really need someone to show you in a specific step by step sequence to get the full benefit

  4. in light of this, developments in the field have come up with alternate methods that are a) more structure specific and b) take into account the in-context functional relationships of the RTC to surrounding structures; decribing them is difficult and lengthy, because they are detailed and more complex, and need to be taught in person for reasons of specificity and safety (although I have describe the one for pectorals later on for illustrative purposes only)

  5. my overall point is that if someone were to employ those medthods and didn’t have success, they still have options available to them, but would have to seek out someone trained on a more advanced level;

I hope this is a more palatable restatment of my point

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[QUOTE=cjurakpt;715386]I don’t mean to be a PITA, but, honestly, in terms of what is considered state of the art approach to exercise for rehabing an injured RTC, are pretty out of date, largely because they lack the degree of specificity to what you are trying to do; for example, doing open chain free weight training of the external rotators does not address their functional in-context roll either posturally or activity wise; the door frame stretch is VERY non-specific and can actually put strain on the anterior sholder ligaments as opposed to doing anything to work on lengthening pecs; the one in standing is not a great idea because of what it can do to the low back, and to acurately isolate lats, requires a more specific position of the arms and lumbar spine: lats go from the upper arm and attach contractile fibers from T6 down to like about L1 or L2 (and non-contractile down the whole lumbar spine, sacral spine and cocyx), so you have to do simultaneous etension of thoracics and flexion of lumbars, al the while maintaining your arms in external rotation with scapulae roatated upwards, flat on the rib cage - bottom line, you really need someone to show you in a specific step by step sequence to get the full benefit

not to say that these won’t work for some people, just that if they don’t there are plenty of reasons why not…[/QUOTE]
Dude, if you’re going to quote me at least make sure you do it in the correct context.

This is what I wrote “I did a search on google for “rotator cuff exercises” and got many results back. Here is one of them. http://www.bodyresults.com/E2RotatorCuff.asp”

The point of the sentence was not that the exercises in the link where state of the art. The point of the sentence was that there’s tons of information about rotator cuff injuries on the web.

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[QUOTE=Chief Fox;715635]Dude, if you’re going to quote me at least make sure you do it in the correct context.

This is what I wrote “I did a search on google for “rotator cuff exercises” and got many results back. Here is one of them. http://www.bodyresults.com/E2RotatorCuff.asp”

The point of the sentence was not that the exercises in the link where state of the art. The point of the sentence was that there’s tons of information about rotator cuff injuries on the web.[/QUOTE]

ok, I hope that my repost has satisfied your concerns

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[QUOTE=cjurakpt;715673]what do you mean out of context? I just posted the link by itself as a reference to your post, which was only a few posts away, so I didn’t feel the need to re-quote the whole thing: obviously, anyone reading this thread would not take it out of context - it was quite clear what your intention was - to show an example of some standard RTC exercises you found: in no way does my post contradict what you said, nor does it criticise you for posting it - obviously, anyone who did a google search would come up with the same results; and I didn’t say that anyone shoulddn’t do them, nor did I suggest you were even recommending that someone try them

however, some people might be inclined to try them; that is why, in my post, I stated that a) while these were typical, they were not optimal and that b) while some people might benefit from them, that if someone didn’t, it would not be surpising - that way, if someone tried them, and had no results, they wouldn’t think “oh no, I’m screwed, these don’t work”; I was also pointing out some of the potential shortcommings of them in case someone tried them, so as to give them a guide to avoiding unecessary secondary complications

yes, there is tons of info out there: I was trying to give some sense to people about how to differentiate between standard and optimal approaches: this would apply to any links that they found not just your

I really don’t see why this is problematic…[/QUOTE]

At it again I see…

This A hole thinks he is the only one that should be allowed to give advice on this board!:smiley:

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[QUOTE=cjurakpt;715673]what do you mean out of context? I just posted the link by itself as a reference to your post, which was only a few posts away, so I didn’t feel the need to re-quote the whole thing: obviously, anyone reading this thread would not take it out of context - it was quite clear what your intention was - to show an example of some standard RTC exercises you found: in no way does my post contradict what you said, nor does it criticise you for posting it - obviously, anyone who did a google search would come up with the same results; and I didn’t say that anyone shoulddn’t do them, nor did I suggest you were even recommending that someone try them

however, some people might be inclined to try them; that is why, in my post, I stated that a) while these were typical, they were not optimal and that b) while some people might benefit from them, that if someone didn’t, it would not be surpising - that way, if someone tried them, and had no results, they wouldn’t think “oh no, I’m screwed, these don’t work”; I was also pointing out some of the potential shortcommings of them in case someone tried them, so as to give them a guide to avoiding unecessary secondary complications

yes, there is tons of info out there: I was trying to give some sense to people about how to differentiate between standard and optimal approaches: this would apply to any links that they found not just your

I really don’t see why this is problematic…[/QUOTE]
I don’t have a problem with it. I gave advice on an injury that I myself have experienced. I did a google search and picked a link at random that had some of the exercises that I was instructed to do by a physical therapist and had worked for me.

You went to the link, stated how the exercises were dated and not “state of the art” and proceeded to pick apart each exercise. At the same time you offered up no alternatives.

I don’t find this problematic, just strangely argumentative.

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[QUOTE=cjurakpt;715386]I don’t mean to be a PITA, but, honestly, in terms of what is considered state of the art approach to exercise for rehabing an injured RTC, are pretty out of date, largely because they lack the degree of specificity to what you are trying to do; for example, doing open chain free weight training of the external rotators does not address their functional in-context roll either posturally or activity wise[/QUOTE]cool. trying to engage in constructive dialog:

so i’ve been given similar exercises by physiotherapists, variants with therabands plus some extra shoulder exercises (eg pulling the shoulder back) but im not concinved there optimal either. so moving on, what is state of the art?

thanks in advance.

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[QUOTE=Chief Fox;715723]I don’t have a problem with it. I gave advice on an injury that I myself have experienced. I did a google search and picked a link at random that had some of the exercises that I was instructed to do by a physical therapist and had worked for me.[/QUOTE]

and you stated that clearly, and I have no issue with that (even if I did, that’s not your problem, obviously); I didn’t say that they wouldn’t work for someone - just that, if they didn’t, there was a reason for it;

[QUOTE=Chief Fox;715723]You went to the link, stated how the exercises were dated and not “state of the art” and proceeded to pick apart each exercise. At the same time you offered up no alternatives. I don’t find this problematic, just strangely argumentative.[/QUOTE]

I picked them apart to explain why they weren’t state of the art; I offered no alternatives because the alternative cannot be adequately described on an internet forum: they need to be shown in person because in order to be structure specific, the level of detail necessary and ongoing feedback from the client requires a one-on-one interraction: the more general the exercise, the less you need personal instruction

it’s simply pointing out that there are different levels of approach out there, and those exercises do not represent the best level; I didn’t say they were bad, just not the best: why is that argumentative to point it out?

I don’t get it - you seem to be responding as if I am attacking you personally: please point out where I said anything negative about you or criticised you for posting what you did? I am happy to reword whatever you find offensive;

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[QUOTE=Chief Fox;715723]I don’t have a problem with it. I gave advice on an injury that I myself have experienced. I did a google search and picked a link at random that had some of the exercises that I was instructed to do by a physical therapist and had worked for me.
You went to the link, stated how the exercises were dated and not “state of the art” and proceeded to pick apart each exercise. At the same time you offered up no alternatives. I don’t find this problematic, just strangely argumentative.[/QUOTE]

again, I hope my repost has addressed this

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[QUOTE=BoulderDawg;715681]At it again I see…

This A hole thinks he is the only one that should be allowed to give advice on this board!:D[/QUOTE]

ah, the Armchair Physician: I wondering what happened to you after our last “exchange” - I figured you were off somewhere figuring out basic definitions of kinesiology (and, BTW, you never did respond to my comments on the thread in question)

as for your assertion, lets point some things out:

a) I have never given anyone direct advice on this forum: I challenge you to find a single example of where I told someone what they should do specifically for their complaint, beyond generalities, and I have never made promises about results; if I do discuss treatment options, it is always in generalities, stating what is typical for what someone seems to be describing; I always preface everything with the caveat that I can’t specifically tell what is the deal with them because I haven’t examined them, and that they shouldgo see a trained professional for an accurate assessment of their situation

b) i have never told anyone not to give advice: people can do whatever they want; but if someone with no qualifications gives some “advice” to someone that is dead wrong (as was the case with your comments), i will explain why I think this is the case, because someone might follow that advice and go make themselves worse - the kicker is that, because YOU are an unlicensed individual, they have no recourse if your advice causes them harm; on the other hand, if I post something deleterious, I can get sued for malpractice, and even loose my license

c) it strike me as pretty funny that you think me an A-hole: you are the one promising a specific outcome to someone’s medical condition without having any qualifications and without properly examining them…sounds like you are engaging in a little transference…

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[QUOTE=stricker;715724]cool. trying to engage in constructive dialog:

so i’ve been given similar exercises by physiotherapists, variants with therabands plus some extra shoulder exercises (eg pulling the shoulder back) but im not concinved there optimal either. so moving on, what is state of the art?

thanks in advance.[/QUOTE]

well, there are a couple of basic considerations in regards to the issue; first off, it requires an understanding of the concept of force couples and agonist / antagonist balance of muscles in general and specific to patterns of postural dysfunction and injury; rather than get into too much detail, I’d just say go read up on anything by Shirley Sahrman,PT (US) or Vladimir Janda, MD (Czech Rep.) - they are generally the agreed upon authorities in the field;

that said, in regards to the options that I (and, of course, those who taught them to me) find to be the most efficacious, I will describe the pectoral stretch that I use with clients (bear in mind that I am not giving this out prescriptively - it is meant for general infomation, and I DO NOT advocate anyone try it for their own use, rehab or otherwise - it is illustrative only, so that you can have a frame of reference if you want to go find someone who uses it):

Pec Stretch: to repeat, the door fram stretch is non-specific: you can’t isolate pecs enough, you can get too much movement through the upper quarter in other associated structures (kindds the same thing) and you can stress anterior glenohumeral ligaments unecessarilly; so, what really nails pecs is this: stand with your feet together, toes pointing at the wall and get as close to the wall as you can (nose almost touching); to stretch the left pecs, place your left palm against the wall at shoulder level, so that your upper arm and forearm make a an approximately 135 deg angle “v” (elbow is the bottom of the “v”, and the elbow will prbably not actually be touching the wall); turn your head to the right; then do 2 things with your elbow: move it towards the wall and at the same time try to pull it down to the floor by “settting” your inferior scapular angle (that is, try to approximate it to the underlying rib cage) it’s almost like you want to think as if you are putting your elbow into your back pocket; if you do this corectly, you will feel a super stretch to the pecs, because a) you are isolating them and b) you are stretching them directly along the line of pull of the contractile fibers (because you are horizontally abducting and externally rotating the shoulder right at the glenohumeral joint); oh, if you want to increase the stretch, a) stand with the feet at a 90 deg angle to the wall, toes pointing to the right, and b) slide the left palm ****her away from the left shoulder (make the elbow angle more obtuse); if you are actually motivated enough to try this based on my very crude description, then for God’s sakes, PLEASE be careful - it’s very easy to overdo it because it’s so isolated (this is why you need to do constant feedback with a client while teaching it)

if this was interesting / of use, I’ll consider posting the lats stretch I use (although given the degree of negative feedback I seem to be generating of late, I am seriously considering discontinuing my posting activity in a “professional” capacity)

oh, and BTW, the guy who taught me these is Mark Bookhout, PT - he is affiliated with Michigan State Univ., and teaches this stretch as part of a course entitled “Exercise Prescription as a Complement to Manual Medicine”

http://www.com.msu.edu/cme/courses.html#e1

[INDENT]Description: This four-day program was developed in 1992 by Mark Bookhout, P.T. based upon the work of Vladimir Janda. This unique course is designed to complement the muscle energy biomechanical model. The exercises taught assist the participant in developing an individualized exercise program based upon the patient’s biomechanical findings and help to maintain the changes made with manual therapy treatment.

Objectives: 1) to understand the functional anatomical connections of the upper and lower quarter musculature to the proximal trunk and pelvis; 2) to introduce the concept of neuromuscular imbalance as a contributor to chronic musculoskeletal dysfunction; 3) to be able to identify local versus centrally mediated causes of neuromuscular imbalance; 4) to understand the role of adverse neural tension as a contributor to neuromuscular imbalance especially in chronic pain patients; 5) to learn specific exercises to refine neuromotor control in both the upper and lower quarter; 6) to learn exercises to address specific somatic dysfunctions found in the vertebral column and pelvis; and 7) to be able to develop a treatment program and rational to address musculoskeletal dysfunction related to the vicious overload cycle.[/INDENT]

notice the term “prescription” and “adjunct” to manual therapy - again, I do not recommend trying this on your own…it is purely for illustrative and discussion purposes

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Strangely argumentative. :rolleyes:

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[QUOTE=Chief Fox;715804]Strangely argumentative. :rolleyes:[/QUOTE]

I don’t know about that but I think “Strange” is a good word for this guy playing doctor :rolleyes:

I know if I’m ever hurt I’m coming here to the board to ask advice from the great Dr CJ. Then I’m going to do the exact opposite of what he said!:smiley: