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Ex-Hasbeen

Shoulder Bursitis - Cortisone

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I've just got the results back from the US I had last week, and no tears or calcification visible. Just subacromial bursitis under the deltoid. I'm already seeing a physio (recommended by the doctor) and he suggested the US. Now that it has confirmed bursitis, they are recommending an US guided Cortisone injection.

I've tried rest & therapy in the past, and the pain has gradually come back. I'm seriously tempted to try the cortisone, as for the past 3 years I haven't been able to really work hard with my swimming due to knowing that anything like paddles or multiple high intensity sessions on successive days would see me in pain.

Has anybody had this injection before, and if so, what was the success. I have full intention of continuing therapy to strengthen the shoulder after it, rather than just relying on a quick fix.

TIA

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Not had the injection but have had ongoing pain in the area you describe for a couple of years. I have some incredibly tender areas around/under the deltoids. By shrugging my shoulder I can make the sore areas 'stand up' so they can be attacked...

Saw Parkside a couple of years ago and got it sorted but it gradually came back. I've been seeing him again for the past couple of months and it's pretty much sorted now (I have some neck issues as well but they're getting there too.)

I think it's the sort of thing which can take a while to settle and needs consistent and continued maintenance when resolved. Not much help with regards the cortisone but just putting forward that it may take time to get it right and continued effort to keep it right.

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Research shows cortisone and surgery no better than rehab for this sort of problem.

Having said that, non-responders to intelligent training changes, rehab exercises over 4-6 weeks can sometimes benefit from an injection, quietens things down so the rehab can do its job and get the shoulder stronger. Injections can be hit and miss, fixes some permanently, some no effect, some get a steroid flare and can't use their arm for a week. 

Trinube is right about the long term stuff, some people just need to avoid particularly provocative exercises/activities, smaller paddles, less pull bouy, no fly etc for a swimmer may be part of that

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Thanks Parky, & Trinube. Wish I was in Sydney to stop by. I've tried 1 physio that just made things worse (almost instantly). I persevered but nothing changed. New guy has helped a bit, but we still can't seem to shake it. I'm giving it a bit longer with the therapy but unless something changes in the next month I'll probably get the injection. 

1 hour ago, Parkside said:

Having said that, non-responders to intelligent training changes, rehab exercises over 4-6 weeks can sometimes benefit from an injection, quietens things down so the rehab can do its job and get the shoulder stronger.

That's what the doctor & the current physio both suggest, that if they can settle things down we can get on with the rehab to try to strengthen around it. 

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I had shoulder bursitis late 2013 and into 2014.  Took up Triathlon early 2013 and jumped straight into a 70.3 so I think the increased load in training caused it.  Did rehab for a few months with little success, so got a US assisted cortisone injection early 2014 which seemed to help.  Had another one later that year as I was going overseas for 12 months so the specialist said it can't hurt to throw another one in to help while I was away.  I didn't swim for 6 months while away anyway and it seemed to help as I haven't had any problems since, although my swimming load from then was fairly light as I didn't do any major training til late 2016 when I decided to do IM OZ 2017.  Also did IM Oz this year, still no problems.

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I had this and the ONLY thing that made it better after trying everything the physio could throw at it including months of rest was the cortisone shot.

it worked like a charm for me! Have had both shoulders done and both are now great touch wood...

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14 minutes ago, more said:

I had this and the ONLY thing that made it better after trying everything the physio could throw at it including months of rest was the cortisone shot.

it worked like a charm for me! Have had both shoulders done and both are now great touch wood...

How long ago? Are you still getting benefit of the shot, or is it long ago, but settled the issue so you could get on with therapy & strengthening it?

 

Thanks More.

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Do you know what's causing/exacerbating it? There have been people that have had cortisone shots and their issue has never returned, but if the problem is never resolved e.g poor swim technique, it's logical that the problem will continue to reappear, which it did with me. I had 3 cortisone shots, 2 in left shoulder, 1 in right, various degrees of success, best was 6 months pain free swimming. Did all the rehab excercies, some made it worse, went to some great physios, tried rest, none worked until I spent a good amount of time time researching the injury and modifying/fixing my catch which was overloading the shoulder. Until I fixed that, the problem was always going to reappear. You could get lucky with the cortisone shot and never have pain again, but you problem need to get to the root cause of the problem.

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1 hour ago, Ex-Hasbeen said:

How long ago? Are you still getting benefit of the shot, or is it long ago, but settled the issue so you could get on with therapy & strengthening it?

 

Thanks More.

They were probably around 5 years ago. By memory the major problem with the shoulder and this type of issue is that its such a tight joint that once it becomes inflamed it becomes a perpetual motion type problem were the inflamtion causes the inflamation which causes the inflamation.

The cortisone helps to reduce the swelling and heal the joint. If you do do it though make sure you rest and dont rush recovery even if it feels better. Just take your time, get it better and be done with it once.

As others have said I also cut any any exercise that would/could inflame it, no more bench press, no more shoulder press but I started doing rotator cuff exercises and stretching etc. All seemed to do the trick.

 

 

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Quote

Trinube is right about the long term stuff, some people just need to avoid particularly provocative exercises/activities, smaller paddles, less pull bouy, no fly etc for a swimmer may be part of that

Usually the answer is so simple "stop doing what caused it" - you're getting to old to do too much hard stuff - be kind to your body - it's the only one you're going to get 😉

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4 hours ago, AP said:

Usually the answer is so simple "stop doing what caused it" - you're getting to old to do too much hard stuff - be kind to your body - it's the only one you're going to get 😉

At this point in time Al, swimming, driving, sleeping, using a mouse, and sometimes eating hurt it. 

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37 minutes ago, Ex-Hasbeen said:

At this point in time Al, swimming, driving, sleeping, using a mouse, and sometimes eating hurt it. 

Yep, sounds familiar. FWIW Id def recomend getting the shot, nothing to loose.

 

BUT take your time with recovery-2 month at least let it heal, and then if ANYTHING starts to make a twinge in there stop it, doing push through it.

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I've had them in each shoulder at different times years ago. Each time the pain settled within about 3days and I was able to move on to strengthening etc. Mine was probably a result of increasing swimming load too quickly and without appropriate overall shoulder strength. Anecdotally, some general strength maintenance (push-ups etc) and managing swim load and technique has kept mine at Bay. I don't ever swim that much though, so you might have a different experience based on the amount of swimming you do.

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2 hours ago, Ex-Hasbeen said:

At this point in time Al, swimming, driving, sleeping, using a mouse, and sometimes eating hurt it.

Well there ya go

Stop sleeping under and then eating the mouse.

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watch the whole video, but 4.20 is important, watch what she does with her shoulder joint, internally rotating it, elbow is up, you can't drop elbow in this position and will have a much better catch, plus there will be significantly less load on the rotator cuff and shoulder joint. Seems to be a critical part of a an EVF, but something that never really gets mentioned.

 

 

Edited by zed
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