Torn Shoulder Tendon

[itstimeforme]

So after many months of gradually increasing pain in my shoulder and finding sleeping, brushing my hair and doing up my bra extremely painful I've been for a scan and have completely torn a tendon in my shoulder. Lots of inflammation and fluid too. At the moment I have been recommended physiotherapy exercises and painkillers as and when needed. Possibility of surgery if the pain isn't any better within a few months, any suggestions from anyone who has been through this? Would rather avoid surgery if possible, but want my life back! Thanks 🙏

Thank you @PlopSofa, very interesting as I already suffer from low iron.

Gosh thanks @MsMartini. Your post really gives me hope, I'm so glad for you.

Did you bust through the pain?

It sounds like your physio was excellent. That said, if you were already doing pull ups you were very strong already so I’m not sure I have that base musculature to rely on sadly. Too many years at a keyboard for me plus perimenopause.

I should have trained harder earlier, but not always easy when low iron etc.

There’s a good Facebook group called the Iron Protocol.

i now take 2 x solgar gentle iron with 500mg of asorbic acid on an empty stomach one hour before food. Raised my ferritin like nothing else.

b12 was low also though (should be 450 or above, 600 ideally) and vitamin D.

i do recommend blood tests to check for nutrient deficiencies.

im coming to the conclusion i may be deficient in copper which is needed to convert t4 to t3 and also to make collagen… for tendons!

anyway, enough! I feel like menopause set me a ‘fun’ conundrum of how to get my body back without hormones. Thanks Mother Nature!!

I should add @MsMartini my nhs physio just gave me 3 exercises and that’s it. I’ve done them religiously for months but my pain comes and goes and I don’t feel particularly strong, no way I could do a pull up.

i can probably do one full press up, probably around 15 from the knee press ups. But they hurt these days, hurt my shoulders to do these, in that rotator cuff area. Impingement is what they call it I think.

Tendoforte https://osavi.com/en/collagen-tendons-and-ligaments-150-g.html

and another with Fortigel and Tendoforte.

https://puracollagen.co.uk/collections/powders/products/flex?variant=46279843807523

decisions decisions…

@PlopSofa no I never busted through pain. Gradual progession. I paid for private sports physio and did a lot of Pilates as well (couldn’t do shoulder circles at all at first, gradually gradually increased). I was lucky to have the time and resources to do this.

Not sure how relevant my prior strength was although knowing how to train strength helped. Mainly tho it was sticking to the physio regime properly and inching forwards. Both nhs and private physios said sometimes conservative management works and sometimes it doesn’t - obviously you increase the chances if you can get good advice and can put the effort in but no guarantees.

if you do have surgery you will still need to do lots of physio and get good advice to make a good recovery.

some RC FT tears go unnoticed as I say. The joint is complex with lots of structures supporting each other.

In general you need to create space. Shoulder blades back and down, elbows close to body and not pulled back. External
rotation. I could do bicep curls throughout which helped as the top of the biceps can pitch in to compensate. There is lots of info online but you need to let inflammation die down while retaining as much mobility as possible (but not through acute pain) and then try to rebuild strength (whether having surgery or not you will need to do this). I cracked on with the pylhysio and Pilates and gradually realised surgery wouldn’t be needed. The only thing I’ve not gone back to is racquet sports and I do avoid doing the sort of low weight high rep strength classes that involve waving weights around overhead. All my strength work is slow, controlled, low reps, high load.

good luck to everyone. It is horribly painful and frustrating.

@MsMartini Thank you.

Im trying to create space, as you say it stops the pinching.

I also don’t lift any more above my head which I miss. I also don’t play tennis anymore. I think serving was probably what got me to this place sadly. I really miss it so badly. 😢

But you get on with it.

Can I ask what sort of Pilates? Would you know a good YouTube channel to follow? I’d like to try some strengthening through that modality but I don’t know where to start.

I’m not good with group exercise and commitments or else I’d go to a class. I prefer to do what I can at home and specific shoulder stuff if possible.

I found a great strength training channel so I feel good for that but I can’t do the arms days because they all set my tendons off. Sleeping is a challenge too.

how do you sleep?

I’ve been having problems since about March this year. I didn’t seek help till about June though as I’ve been diagnosed with osteoarthritis in my knees so I tried using the gym as it worked for my knees. First physio didn’t think it was frozen shoulder because I can reach behind my back (but can’t take my bra off) so wouldn’t refer me for steroid injection in case my knees flared up and I needed it there. I couldn’t do the exercises she gave me but carried on at the gym.
I went back to the physio last month and she referred me to the musculoskeletal person for a steroid injection. Again because of being able to reach behind my back he wouldn’t do the injection and suggested it could be tendonitis, osteoarthritis, frozen shoulder or all three!
So he’s referred me for an ultrasound scan and an X-ray. He hasn’t ruled out an injection but wants a proper diagnosis first.
I struggle to wash and dry my hair, can’t reach wall cupboard properly or lift heavy saucepans etc but I can mow the lawn and lift pots around in the garden. I do use my other arm to support my bad arm when I need to raise it in the air such as hair washing. I no longer use a shoulder bag - just a handheld bag with as little as possible in. Sleep is a problem and I often wake up in pain so I use ibuprofen gel which usually dulls the pain enough to allow me to fall back asleep. I just take a couple of paracetamol doses a day.

The pain has been so bad at times I just cry. I can’t wait for it to be sorted out. I can’t remember what being pain free is like

@PlopSofa I did in-person Pilates which I would recommend. I treated it as part of my rehab. Good teacher, knew my issue. You need to keep the rest of your body strong and active as well and learn to move in a way that doesn't aggravate it, so I wouldn't recommend shoulder specific anyway. And

When it was bad I slept with a bolster pillow at my side, and put my sore shoulder and the corresponding knee on that so it took the weight and I wasn't twisted. I struggled with hair washing and bra etc at first and avoided anything that hurt and took ibuprofen. Then once the inflammation had died down, I gradually started rebuilding. I said below I didn't push through pain and that is true. But sometimes I went into the 1-3 level (out of ten). You learn to calibrate - sometimes it hurts just because you haven't moved that way for a long time and you are sensitised. Again, having a good physio can help you distinguish.

I do now lift overhead (probably one of the last things to come back) and do whatever I want in the gym. Physio said I could go back to badminton and tennis but they are higher risk and not what I love. I've done stints of boxing and other classes and no problems. I never think about it, now.

Here is the NICE guidance
https://cks.nice.org.uk/topics/shoulder-pain/management/rotator-cuff-disorders/

Here is one of many NHS leaflets with exercises and advice (including how to calibrate the pain).
https://www.ruh.nhs.uk/patients/patient_information/PHY049_Rotator_Cuff_related_pain.pdf

The pp who had private medical insurance through work - get private physio! It is much better to have a specific programme and regular checks. My ds has a different injury atm and is getting some NHS physio that is helpful too, tho has been a battle.

Thank you MsMartini. As I have imbalanced muscle patterning they can’t seem to find out which ones are causing my tendons to rub. I have tendonosis of my supraspinatus but apparently not tear but a thickening of the tendon.

If it was torn I’d have more to go on but instead I have a scapula that wings out on the right and the whole joint clicks and clunks a lot. It seems they can’t fix it sadly.

I get periods of relief and then it starts again. My jumping scapula never goes away though. No one seems to be able to stabilise it. When I lift my arm above my head it jumps out, and bringing it down it’s like it had to jump to slot back in again.

looking in the mirror it’s like my right shoulder falls forward more than my left. It’s like the ligaments don’t hold it in place. I’m not hypermobile though so everyone is scratching their heads.

strenthening the infraspinatus muscle hasn’t led to tye improvements every physio hopes for. I must have seen over 20 by now.

ah well, good luck to everyone with their shoulders. May I wish you a pain free existence soon!

@PlopSofa menopause really doesn't help at all. Your info about iron is very useful.

@Happyher good luck with the scan, hopefully it will give you an accurate diagnosis. I can relate to so much of what you have written.

@MsMartini so much advice, thank you, really gives me hope

@PlopSofa can I ask broadly what food you have cut out in the anti inflammatory diet? I think I eat too much sugar! And drink too much wine!

I did the Zoe nutrition course about 18 months ago. I’ve not drunk much in years as I have a squiffy bladder and alcohol sets it off.

I’d say I follow now the DASH diet but I eat good quality red meat once or twice a week as well for the iron. I’ve also introduced duck liver (it’s the least offensive I’ve found) once per week as my hair started falling out. I need b vitamins. I eat 2 eggs most days at lunch, two servings of dairy a day for the calcium, quite a lot of seeds and nuts, prunes for osteoporosis (check PubMed for the prune studies!), lots of veggies, beans, pulses, salads, fruits, whole grains like oats and seeded bread, rice and potatoes. Zoe said limit/no to that last lot but I feel better even though I get blood sugar spikes. It’s not out of range so I don’t worry. Sockeye salmon once per week. I also eat soup at lunch and add collagen to it most days. I eat a serving of beans/pulses/lentils every day. It’s a high protein quite high fat diet with lots of fibre. This is needed to maintain bone and stop loss, along with the lifting.

i also get the ginger shot bottle every other week or so and dilute with water. With sparking water it’s even better - I like a special Polish brand my cleaning lady occasionally finds for me very high in calcium which is now like my champagne 😆

I try to add in spices, herbs garlic, olive oil, a variety of vinegars to at least one meal a day. All of these are anti-inflammatory. I try to have a mix of raw veg and cooked veg also but not at the same meal.

Only dark chocolate most of the time. Christmas is difficult 😆

my snacks are dark chocolate, nuts, bananas, apples, Yeo valley plain yogurt with honey and cinnamon, prunes, dates, apricots. Dried fruit is great and much less expensive than fresh. It can spike blood sugar though.

When I did the Zoe diet I analysed the microbiome data and I had the signature microbiome for potentially developing bowel cancer. Unfortunately they don’t provide the breakdown anymore. I’ve tested with other companies that use 16s sequencing but I prefer shotgun sequencing. As you can see I’ve gone pretty deep into the whole thing. I just want to feel better. I’ve been fortunate to have the time and money to do this. I thought I was healthy before doing Zoe but it highlighted areas I could do more with. I’ve personalised it for my own needs now.

In all the plant food you find lots of polyphenols, flavonoids which are all anti-inflammatory.

It seems though that estrogen, which acts like an anti oxidant is the main reason for tendon failure. But adding in extra antioxidants through your diet may go some way to mitigating this loss.

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04778-5

if I could take HRT I’d do it in a heart beat. But I can’t. Unfortunately that estrogen beta receptor is something related to my squiffy bladder also and anything estrogen (like HRT) sets it off no end so it’s impossible for me - but for you? Maybe?

@PlopSofa This is all so interesting and useful, I am working all day today but will have a proper read when I get back. I feel like I eat very healthily but also unhealthyily at the same time if that makes sense ! Could certainly do some tweaking. Willing to try anything at this point!

Hi, to anyone still struggling a quick update. My physio has given me some exercises to do daily, they are quite tough and take about half an hour in total but I can already see a difference after just over two weeks. I have more mobility and less pain. I'm going to keep doing this until after Christmas and see where I'm at. They said if pain levels are still bad a steroid injection could be the next step, failing that considering surgery. Hope everyone else is doing ok.

Really pleased the exercises are helping you.

just over a week ago my hip was suddenly agony - minor injuries diagnosed a bursitis on my hip and to rest. A Google suggests it could be the same thing on my shoulder (still a rota cuff issue). Thinking I need to get seen properly but that’s half the battle these days!

I referred myself for physio via my GP surgery website and was seen within two weeks. He an NHS physio and he speaks to the specialist on my behalf to ask for advice. I see him every two weeks. @Tillow4ever if you have a similar service I thoroughly recommend it.

I suffered for nearly a year with something similar frozen shoulder/torn rotator cuff tried all the none invasive treatments, physio hydro therapy acupuncture none of it really helped eventually had the surgery my only regret is that I didn't have the surgery sooner.

@HappyNannie I've been told that my tear is quite bad and won't repair itself so all I can do is strengthen everything around it. How was your recovery from surgery, was it a long process?

Thank you @itstimeforme - I’ve actually started a post in general health asking for advice because there’s a few things going on and I’m wintering if they are all connected. Sadly I’ve had no replies though!

An update for the thread. I’ve found taking magnesium malate has helped with the pain.

maybe any magnesium would do. It’s helped so much. I tried mag glycinate and I didn’t feel right so tried another and this one makes me calm but had the other side effect of helping with the pain. Quite something.

im not taking a high dose. Very sensitive to it and if I have to much it makes me go 💩 so if you want to try, my advice is go low and slow!

I open my capsules and put the powder on a teaspoon of yogurt, then fold into another bit of yogurt and swallow.

i was fine on the first capsule but after three (recommended daily dose) I was rushing to toilet with cramps.

Hope you are all doing ok. I’ve found too doing my exercises every day and using a heated beanie on the microwave helps also.

I have a torn tendon in my shoulder, albeit not as bad as yours sounds and I'm currently having physio which is going well. I don't have pain anymore. One thing that was recommended to me that seems to get good results is PRP injections in the shoulder - I haven't tried them as I've responded well to physio but it could be something you can ask about. Sorry if it's already been mentioned. I did skim the replies quickly.

Recovery was tough first few days, but can honestly say it was worth going through for the long term relief, would I do it again yes in a heartbeat