Sclerotogenous Pain? New "Hot Topic"?

Donna: Thanks for being concerned. It probably isn't a tear and just recurrent tendonitis and muscle strain. I had 2 bouts of rotator cuff tendonitis last year that I mostly swam though. (I have a high pain tolerance and really wanted to go see my friends in CA last August.) ART finally got rid of it for awhile, but the trap is bothering me again (although my shoulder is OK). We're doing the MRI as a precaution because it's gone on so long. Hopefully, it will rule out a tear. Apparently, sclerotogenous pain is a "hot topic" among doctors now, and they want to make sure they don't miss something. I just had never heard of it before, and wondered if any one else had. Unless it's some nasty tear, which doesn't seem too likely as I just went to practice and swam some fly last night, I'm going to try prolotherapy first. I want to try every single thing I can before surgery. I got me a busy schedule here. I gotta go be an overbearing swim parent at some big meets. Quicksilver: I do not touch those awful paddles! I do take Glucosamine and try to do my rotator cuff exercises and lift weights. One of my teammates told me that Chondroitin is not good for you? I have also had people tell me that it may take awhile for my shoulders to fully adjust to intense swimming again. I can reach back over my shoulder fine. But I can feel a little muscle or nerve spasming back there sometimes. I'm always clicking. Isn't that scar tissue? I think I'll just be doing more backstroke with fins and a lot of kicking. I'll be thinking of your 10 x 100 back set. Maybe I'll make that my "external challenge" set/goal. Tomorrow, however, I am doing the annual family turkey trot. And I don't even have to cook dinner!

I have never had the kind of pain you are referring to, but I want you to know I am sorry it has been bothering you for so long. It's a shame that you were told a long time ago by your orthopedic doc that it couldn't possibly be a tear and went without an MRI at that time. An MRI film should indicate almost anything that is wrong, unless it is 1/zillionith of a centimeter and then I am told, even if a tear does not show up, everything around it will show signs of not being "quite right" thus leading to a diagnosis. A tear, any tear, affects everything surrounding it. I had a lot of downtime with two shoulder surgeries about 2-3 years apart, but without fixing what was wrong, I wouldn't be swimming and setting goals today. It is better to fix it and then rebuild your water stamina later. And, I was still able to get in the water several weeks afterwards but I could only kick and I was grateful for that. If it's broke, please fix it. Donna

This may have nothing to do with your problem...but I can relate to a similar ailment about five years ago when I first started swimming again. The shoulder pain was so bad that I could barely reach over to scratch my back without wincing (both arms...but mostly the left). I attribute this to overuse of paddles at the time. There was even a distinct clicking sound which was not a good sign at all. Anyway...it took about a year to subside. ...(I found out what glucosamine with chondroitin is.) And fortunately the pain never stopped me from swimming altogether. A combination of strength training (dryland)...and a break from the paddles proved to be a good remedy. Not too much fly swimming either. Hope you are able to recover.

I should probably know this, but an you tell me what an arthrogram is? I asked my daughter (a RN) and she said It was a study of a joint and to look it up so I did. Try this link: www.webmd.com/.../hw198411.asp

Hi Leslie! Happy Turkey Day! If you are having a MRI you really need to have an arthrogram with it for it to be accurate. I had one on my right shoulder and it clearly diagnosed my problem. They inject contrast medium into your shoulder "capsule" and can see the anatomy of the joint and if it has been compromised. My doc insisted that I made sure they did the arthrogram with the MRI or else it would be a "waste of time". It is not painless...but it's not too bad either. You just feel a lot of pressure when they inject the dye. My shoulder already hurt so bad that the procedure really didn't make it much worse! It was worth it to find out what the problem was. I had surgery and I'm feeling better....as long as I do my exercises!

I believe an MRI can miss small tears of the labrum unless an arthrogram is performed at the same time. As for glucosamine, a recent NIH-funded trial demonstrated no significant benefit; I've quit taking it and haven't noticed a difference. Gull: I saw that study too. My recollection may be off, but wasn't it limited to osteoarthritis? I should probably know this, but an you tell me what an arthrogram is?

Quicksilver: I do take Glucosamine and try to do my rotator cuff exercises and lift weights. One of my teammates told me that Chondroitin is not good for you? I have also had people tell me that it may take awhile for my shoulders to fully adjust to intense swimming again. I can reach back over my shoulder fine. But I can feel a little muscle or nerve spasming back there sometimes. I'm always clicking. Isn't that scar tissue? I think I'll just be doing more backstroke with fins and a lot of kicking. I'll be thinking of your 10 x 100 back set. Maybe I'll make that my "external challenge" set/goal. Tomorrow, however, I am doing the annual family turkey trot. And I don't even have to cook dinner! You're right about the chondroitin...which is used as a vehicle to deliver the glucosamine faster to the joints. A study has shown that too much of this is bad for the liver. As far as the healing process...I'm not a doctor...but the shoulder troubles can get better without surgery in some cases ...assuming there's no major breakdown. Backstroke (the other long axis stroke) will help your freestyle. Even double arm back on recovery swims (from a long freestyle set) has a soothing action on the lats and shoulders. The muscles are going in reverse. Happy Day of turkey, family, and college football.

I believe an MRI can miss small tears of the labrum unless an arthrogram is performed at the same time. As for glucosamine, a recent NIH-funded trial demonstrated no significant benefit; I've quit taking it and haven't noticed a difference.

Arthrogram---not too bad. had one 3 weeks ago for a knee problem. can be used if previous surgery to distinguish scar tissue (from surgery) vs new problem. Have had them for the shoulders too. Back in 1989 had them but without the MRI (not yet popular for diagnostic work while in an MRI) and just plain x-rays used. They can see if any of the contrast material "leaks" out of the joint capsule. My shoulder injection was done from the rear and wasn't too bad on a pain scale. I had had 4 surgeries on the the left shoulder and we wanted to see if there was a new problem due to a new pain. A slight "leak" was detected but we weren't sure if it was there from a previous injury or was new. We left well enough alone. Most of the time a local injection is used prior to the actual injection of the contrast (gadolinium or something like that) or the local is "front loaded" on the needle. Sometimes they use a contrast material that shows up on a fluro machine as the injection are usually fluo guided and then when the location is confirmed--the MRI contrast material is injected (using the same needle--just a different barrel is placed on it)

The glucosamine study enrolled patients with osteoarthritis of the knee, which is the condition the supplement was purported to help. There was a trend toward a benefit in those patients with more severe arthritis, but it did not reach statistical significance.