Low Grade Tendonitis

RE: Low Grade Tendonitis

Former Member — Mon, 20 Dec 2004 16:00:08 GMT

Originally posted by Rnovitske I was diagnosed with tendonitis (after an MRI) in October after several months of increasing shoulder pain. (Probably swimming with pain and old age.) My doctor never mentioned shots, but referred me to a physical therapist. I first had an evaluation (tests to determine range of motion, type of motion that brought on the pain.) I had 3 weeks of physical therapy with exercises designed for me, twice a week at the PT gym, and exercises at home. The main goals were to reduce the inflamation and irrataiton, improve range of motion, strengthen everything that holds the joint together, and "stretch those things out in there" to prevent the tendons from rubbing against whatever they were hitting. (I do not have a medical vocabulary.) At first it didn't seem to work at all. But, after 3 weeks back in the pool, the shoulder is much much better, (although my "tired" butterfly and backstroke at the end of a workout can bring on the fireworks.) Popping and clicking?...My shoulders both sound like an old vinyl record. The therapist mentioned surgery if the PT did not work and I could not live with the results, but no shots. I too am surprised that shots were the first recommendation, but I do not know the severity of your problem. Sounds pretty bad. I think that I have updated my condition on another thread but I'll recap it anyhow since this thread is up top. My condition was tendinopathy of the supraspinatus tendon/low grade chronic. My ortho suggested that I continue doing what I was already doing which was slowly getting back in the pool after two weeks of rest. After 2 trips back to the pool my shoulder felt pretty good but then I caught a cold so I am sidelined again!! I plan on heading back again tomorrow and with an ounce of luck I will be on my way to breaking the 30 minute mile mark once again. After nearly three weeks out of the water I am scared to find out just how much stamina and strength I have lost. In any case, one of the things I like most about swimming is the ability to push myself to improve and to actually see results. I've got plenty of improvement to make/regain now.

RE: Low Grade Tendonitis

Rnovitske — Mon, 20 Dec 2004 10:34:08 GMT

I was diagnosed with tendonitis (after an MRI) in October after several months of increasing shoulder pain. (Probably swimming with pain and old age.) My doctor never mentioned shots, but referred me to a physical therapist. I first had an evaluation (tests to determine range of motion, type of motion that brought on the pain.) I had 3 weeks of physical therapy with exercises designed for me, twice a week at the PT gym, and exercises at home. The main goals were to reduce the inflamation and irrataiton, improve range of motion, strengthen everything that holds the joint together, and "stretch those things out in there" to prevent the tendons from rubbing against whatever they were hitting. (I do not have a medical vocabulary.) At first it didn't seem to work at all. But, after 3 weeks back in the pool, the shoulder is much much better, (although my "tired" butterfly and backstroke at the end of a workout can bring on the fireworks.) Popping and clicking?...My shoulders both sound like an old vinyl record. The therapist mentioned surgery if the PT did not work and I could not live with the results, but no shots. I too am surprised that shots were the first recommendation, but I do not know the severity of your problem. Sounds pretty bad.

RE: Low Grade Tendonitis

Former Member — Mon, 13 Dec 2004 14:10:42 GMT

I am a firm believer in physical therapy. You have to look for the underlying cause of the tendinitis and try to correct it. It seems to me that rest alone is too simplistic an approach, particularly if the individual is very active physically and participating in sports.

RE: Low Grade Tendonitis

Former Member — Mon, 13 Dec 2004 13:57:36 GMT

I have tendinitis in my wrist. When I was first diagnose with it I was told it was from overuse and there really isn't anything I could do about it but rest. I could take pain medicine but that was about it. It will come back if I overuse my wrist. It is something that I will have to deal with all my life and not something that will heal and go away permittly. At least this is what I was told.

RE: Low Grade Tendonitis

Former Member — Sun, 12 Dec 2004 09:44:00 GMT

Hi 330man - thanks for keeping us informed of your condition. I am pleased that it looks like you wont have to have surgery and that there are alternative approaches which you can try to heal the tendonitis. When you have time I would be interested to learn which alternatives work best for you. Regards - Johnathon.

RE: Low Grade Tendonitis

Former Member — Fri, 10 Dec 2004 11:37:40 GMT

You mentioned the possibility of "loose cartilage" in another thread ("Not shoulder instability after all"). Antiinflammatory agents reduce the inflammation of tendinitis, in addition to relieving pain (and most doctors would try oral agents before a steroid injection). Many swimmers develop some weakening of the rotator cuff as they age because they don't do exercises that target these small muscles--apparently that doesn't apply to you. However, these are the same exercises that pitchers use, since throwing a baseball, like swimming, is an overhead type activity. It's seems a little odd that a single violent stretch would cause tendinitis in an otherwise healthy joint; perhaps it was just a freak occurence and you'll have no further problems after it heals. I've yet to meet a radiologist that can "diagnose" tendinitis from an MRI (although it sounds like that's what it is); usually the diagnosis is made by a doctor who has actually examined you and reviewed the MRI results. You can't actually see tendinitis on an MRI--it's more a diagnosis of exclusion. Anyway, good luck with your recovery.

RE: Low Grade Tendonitis

Former Member — Fri, 10 Dec 2004 09:26:40 GMT

Originally posted by gull80 I disagree with your doctor. First of all, doing nothing is nonsense since the tendinitis will recur if you don't address the underlying cause (impingement). Rest alone won't fix the problem. Second, most orthopedists don't use steroid injections as first-line therapy. The treatment consists of physical therapy (to strengthen the rotator cuff and stabilize the shoulder blade), ice, and antiinflammatory agents. This has been discussed in other threads. Isn't this the same doctor who said you had "loose cartilage"? This doctor thought that I might have a torn labrum after he felt the popping and clicking in my shoulder joint. The MRI ruled that out and the radiologist diagnosed me with low grade chronic tendinitis of the supraspinatus tendon. The injury was caused by a one time "violent" type of stretch in which I was swinging my arms in a circle. Provided that I don't stretch in that manner again I should be able to avoid further shoulder injuries for some time. Strengthening of the cuff muscles is not needed because they are not weak. Anti-inflamatory agents will help to soothe the pain which is virtually non-existent at this point. I don't recall anything about any loose cartilage BTW.

RE: Low Grade Tendonitis

Former Member — Fri, 10 Dec 2004 07:38:19 GMT

I disagree with your doctor. First of all, doing nothing is nonsense since the tendinitis will recur if you don't address the underlying cause (impingement). Rest alone won't fix the problem. Second, most orthopedists don't use steroid injections as first-line therapy. The treatment consists of physical therapy (to strengthen the rotator cuff and stabilize the shoulder blade), ice, and antiinflammatory agents. This has been discussed in other threads. Isn't this the same doctor who said you had "loose cartilage"?

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 15:47:48 GMT

Originally posted by USMSarah 330- ... once you are back to new... you won't take that for granted! S.:p Truer words have never been spoken. I am going to be so acutely aware of my joints and muscles I will be like a swimming MRI machine!!

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 15:06:19 GMT

330- glad to hear that you don't have to get surgery. just be patient and let your shoulder heal... once you are back to new... you won't take that for granted! S.:p

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 13:42:06 GMT

I was once run over by a car when I was jogging in college. I used to get steroids in my shoulder & knee every 5-6 months form then on. The I graduated form college & moved to DC. When it was time for my next shot, I told my doctor. She sent me to the head of Orthopedics at Howard. That doctor was the team doctor for Howard's football & basketball team & gave opinions to the Redskins. He was very much against steriods & suggested that I had probably never healed form the accident. He sent me to a physical therapist. The therapist had me do several differnet exercises that were very strange at the time. We used a large ball!! After about 6 sessions the pain was almost always gone. RICE was also used. I take steroids for amy asthma. I have gotten serveal shots of solumedral(sp) in ER's through out the contry. But I will never get a steroid shot for an orthopedic or any other (besides asthma) reason ever again. I must say that I'm not a doctor. For three years I was in constant pain. In one month there was NO PAIN. I've had some doctors suggest that the prednisone I have taken for asthma helps relieve the pain in my shoulder & knee. I've also had doctors say that's nonsense.

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 13:39:00 GMT

aren't bad. They have a local anesthestic in them (partially so they know they placed the injection correctly--you get immediate relief) along with the steroid. It takes a few days for it to work and they DON"T encourage you to swim for a couple of days to allow the injection to work it's magic. It's better than taking a week's worth of oral steroids that blasts the entire body. The shot targets JUST where it is needed and is a more concentrated dose. You usually don't have to be peeled off the ceiling. I've had one (from an orthopedic surgeon who deals with NFL players) and he's really good. Just be aware--most docs allow only THREE (3!!!) injections into a tendon or ligament---any more than that and "shredding" of the tendon or ligament can occur. So you don't want to have to do this all the time---follow the doc's instructions to the letter and it may be the only injection you'll have to have.

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 13:29:30 GMT

Originally posted by Seagurl51 That's good that is nothing more than tendionitis (well not good, but it could have been a lot worse). I have never personally had the shots (coritzone injections?), but I know someone who has. He said that they hurt like hell, but after when they heal up it is well worth it. Hope that you feel better soon!!! ~Kyra p.s. Congrats on being able to swim again! Thanks Kyra, I am stoked that nothing is "wrong" with my shoulder. I am going to wait another few days before I get back in the water though, just to be on the safe side.

RE: Low Grade Tendonitis

Former Member — Thu, 09 Dec 2004 13:15:09 GMT

That's good that is nothing more than tendionitis (well not good, but it could have been a lot worse). I have never personally had the shots (coritzone injections?), but I know someone who has. He said that they hurt like hell, but after when they heal up it is well worth it. Hope that you feel better soon!!! ~Kyra p.s. Congrats on being able to swim again!