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dvarner
January 31st, 2006, 08:28 PM
Can the physiology experts please help explain a shoulder "impingement"?

My frustruated interpretation is that it's not torn, not arthritis, but something ain't quite lined up correctly. I think I jammed it on a sprint finish and a few weeks off have not lessened the pain (arm raised 90 degrees laterally = ouch). Friend therapist says don't start anything remedial until the pain stops. Slowly going postal and gaining weight being out of the water.....

I have an appointment with an orthopedist who has a sports leaning but am interested in other's experiences, too.

Thanks,

DV

msgrupp
January 31st, 2006, 10:27 PM
Impingement is when the acromion (arch) keeps getting banged by the tendons (?ligaments?) in the upper part of the shoulder. Causes inflammation.

The usual surgical procedure is to go in arthroscopically and shave down the UNDERSIDE of the acromion to allow more room for the tendons.

There is a recent thread (the past week or so) about another person with the same problem and his surgery.

Surgery generally isn't too bad. Had it done twice--once on each shoulder.

sanwin
February 1st, 2006, 11:07 PM
I had a left shoulder scope 2 yrs ago, I had more pain pre op. I am having the Right shoulder done in 2 weeks. I am just so glad to see other swimmers with both sides done. I tend to overdo and not let my shoulders heal when tender. It is hard to get older. Thanks, and to all the swimmers with sore shoulder GOODLUCK.

dvarner
February 2nd, 2006, 05:07 PM
Thanks,

I am hoping for the elusive non-surgical solution, but I appreciate your sharing of experiences. Will look up the other threads.

DV

scyfreestyler
February 2nd, 2006, 05:22 PM
I suppose you are still waiting on an appointment. Be sure to let us know how it goes. I am always interested to hear how various physicians treat shoulder injuries. I had some impingement along with a few other issues and I took the non surgical route. Not sure if I made the right decision or not, but I am back in the pool and I have no scars on my shoulders.

msgrupp
February 2nd, 2006, 08:10 PM
surgeries I had (all arthroscopic), only the 2nd surgery of the bunch left noticeable scars on my left shoulder (and I'm female). I think the scars were because staples were used in 1989 to close the incisions (3 little ones) and the staples were left in almost 2 weeks. The worst scars were on the shoulder near my smallpox scar.

The next 4 surgeries were all closed with sub-cuticular stitches and steri-strips.

Last surgery was in 1998---I have to look for the scars--they are thin white lines now and flat except for the raised ones (which I've had injected) on my left shoulder.

BruceGianniny
February 3rd, 2006, 07:57 PM
DV

You hit the motherload....I had the impingement diagnosis and tried every conceivable remedy for nearly a year till succumbing to the scope two weeks ago....

first off...the people who posted on my own inquiring thread ("shoulder surgery") several weeks ago were very opinionated, concerned, knowledgable and helpful....now I know why there are support groups for every malady or affliction..'cause they help...

Since the surgery I've been in the water once just kicking with fins mostly lazily for a few thousand yards and started PT which is more rudimentary than I'd anticipated...I hesitate to call what I'm doing "exercises" cause they're so simple, and after initially wanting to set the world on fire with a brilliantly speedy recovery, I had a few sore and depressing days and I've resolved to take it easy and let myself heal rather than make it happen which everyone was telling me from the outset I should do anyway...(thanks Nancy...maybe I WILL be the first)

Anyway the surgery widened the path through which the supraspinatis (one of the rotator cuffs) muscle and tendon and
Biceps tendon pass through...The Doc shaved some bone and snipped some soft tisssue to make more room and eliminate rubbing/friction which was causing inflammation and pain...


Obviously the jury is still out but I'm generally pleased with my progress although I fear the horizon for a complete recovery and return to pre impingement swim condition is a ways off...

I'd be happy to help answer any questions you might have and keep you abreast of my return if it helps with your decision making prcoess...I talk about this thing alot 'cause it's always on my freakin' mind and it helps me come to grips with it a bit...not to be too patronizing but the forum people really were helpful.



Bruce

sanwin
February 4th, 2006, 09:40 AM
Bruce, You will be so so happy with your results once everything is healed. I thought my MD was crazy when he told me it would take 6 to 9 mon. to be totally rehab. Well he was right, take your time listen to MD /pt don't rush it. I was back in the pool in about 6weeks doing laps, very slowly. I had to learn not to OVERDO. Today my shoulder is great. Goodluck. It does seem like swimmers have very strong ideas regarding shoulder injuries, cause many of us have them. Take care Sandy

gull
February 4th, 2006, 12:59 PM
David, it certainly could be acute tendinitis (supraspinatus) in the setting of chronic impingement. In the short term, ice and antiinflammatory agents (I prefer Aleve) reduce the inflammation. Long term, I believe (as did my orthopedist) that a trial of physical therapy may be warranted before opting for surgery (he recommended a minimum of six months). However, I had an MRI which did not show any tears. I think the key is being evaluated and treated by an orthopedist and a physical therapist who specialize in sports medicine. I had tried rest alone, staying out of the pool for several weeks, but the problem resurfaced (pardon the pun) as soon as I got back in the water.

craiglll@yahoo.com
February 4th, 2006, 03:31 PM
Over Thanksgiving weekend I hurt my rt shoulder. I ws taking norflex and a pain pill. the tight pain went away but I ws having other weird pains throughout my shoulder. My doc suggested I go to the orht to see what he thought. He said shots & then if not okay by yesterday, surgery.

Yesterday, I went to a chiropractor for the first time in my life. I was really amazed at how good I felt when I went swimming yeaterday afternoon. I also feel like I'm standing much taller.

dvarner
February 10th, 2006, 05:37 PM
Finally met with the orthopedist.

Verdict is 4 weeks of rehab (stretching plus rubber band) with Aleve twice a day then another checkout. At that point it could be something like cortisone or closer examination to search for a tear. Many warnings to go slow and not overdo things.

Not too bad but a shame to have to "start over" after so long out of the water. This summer is now about recovery and not advancement.

Be careful out there, gang. Watch out for the perfect roll-on-your-side-to-make-yourself-10-feet-long-reach-for-the-wall trick, in my case it backfired on impact with an immovable touchpad. The pressure transmitted up my outstreached arm into an internal hammering of the shoulder joint. The 12.03 25yd time isn't quite worth it, maybe that's why I prefer open water, although I did swim headfirst into a boat hull in the choppy, murky water of the Bay Swim - yet another embarassing story for the humor thread!

Happy laps to you,

DV

scyfreestyler
February 10th, 2006, 05:54 PM
Best of luck with your recovery. I hated the time I spent in physical therapy because I was afraid I would wind up needing surgery anyhow, making all of the PT time a waste. The PT along with a few months of taking it easy worked for me though.

geochuck
June 23rd, 2006, 09:36 AM
Found this interesing site on shoulder impingment
http://www.donalfagan.com/html/shoulder.html
http://www.donalfagan.com/html/spitz.html

scyfreestyler
June 23rd, 2006, 10:09 AM
Originally posted by geochuck
Found this interesing site on shoulder impingment
http://www.donalfagan.com/html/spitz.html

For a moment I thought you were going to connect us to a Steely Dan website.

dvarner
June 23rd, 2006, 11:18 AM
Hitting the weightroom and starting back relatively slowly seems to have done the trick following the cortisone shot. Gotta love those awkward rotator cuff exercises when everyone around you is truly pumping iron. I'm back up to three workouts a week, though struggling to get through the last half of the last hour and a half workout long course. I enjoy long course so much more than short course, too much like NASCAR. The only time I ever feel anything "funny" is at the end of the workout, but it's not necessarily pain, just a sensation where the pain used to be.

DV

Gil
June 23rd, 2006, 05:40 PM
I have been told based on an MRI that my sprispinatus is torn and has pulled away from the bone. I am 78 years of age. The combination of major tear and age has led two orthopedists to suggest that I not get surgery. Both say that I will get limited function back but that freesyle is out of the question. I am now in physical therapy and have noticed good improvement in strength and range of motion. Finally, to my question. Has anyone returned to swimming freestyle with a permanent not fixable tear?

geochuck
June 23rd, 2006, 05:48 PM
My sister Margaret had the tendon flipover the shoulder and everything was torn away, they told her she would never swim again. That was before she became a marathon swimmer. They operated but told her to never swim freestyle. I worked with her on her stroke so we could eliminate her pain walla she became one of the top marathon swimmers in the proffessional circuit.

Gil
June 24th, 2006, 03:36 PM
Geochuck, Hope springs eternal!! How did you change the motion of Margaret's freestyle motion so that she could avoid pain and swim marathons?

geochuck
June 24th, 2006, 03:53 PM
We worked on getting the hands closer to her body almost touching her body as she stroked. We also had her rolling more and instead of reaching to enlongate the vessel we had her going directly to the catch and a changed her finish to a roll out finish. She did have to increase her turnover rate.

Margaret's shoulders no longer give her problems she has changed back to her original style. But much older now she does not swim the marathons anymore, she is 8 years younger than me.