# soft tissue damage- shoulder



## rivers (22 Feb 2017)

I came off my motorbike today on my way to work, trying to avoid a collision with a car who pulled out in front of me. I collided with the tarmac instead. Went to A& E who have said I have a concussion and some soft tissue damage in my shoulder. They were afraid it was broken, but thankfully not I guess. Obviously, I'm not allowed to lift anything for a bit, and that's diving out for a few weeks. But how long should I stay off my cycle for? Motorbike needs repairing, so wife will have the car. Which means my cycle is my main mode of transport for a bit again, not that I mind. However, I'm not sure how long I should, or if I should, stay off it for. Any ideas or should I talk to my GP?


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## vickster (22 Feb 2017)

Talk to your GP
Also, get them to refer you to a physio, you want to stop that shoulder stiffening as much as possible. If you can't get NHS, pay for some private sessions

I had 11 weeks off the bike after a labral repair last year (and 8 weeks off driving). I've just got back on my bike after a second more minor op on the 21 December (8/9 weeks) (could drive after 3 weeks)

I'd not do anything until you've seen a physio. Keep it moving as much as possible,. Ice and heat

GWS


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## Hugh Manatee (22 Feb 2017)

What Vickster said. Shoulders are complex joints. Both mine are FUBARed after a spectacular mountain bike crash just before the Millennium! I am in constant pain and if I dare do something they don't like such as go for a swim, we are talking sleepless nights.


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## kingrollo (22 Feb 2017)

Keep mobile would be my advice. you don't want that joint stiffening. - Very short term hammer it with pain killers - 
could you ride a turbo or an exercise bike ?


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## ColinJ (22 Feb 2017)

Soft tissue damage can be worse than broken bones!

I have damaged soft tissue in both shoulders and have still not regained full strength after many years. I think that shoulder exercises might help but I have to be careful not to strain the shoulders or I wouldn't be able to ride my bike for a week or more each time and that puts me off trying.

Take vickster's advice about seeing a physio!


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## mrandmrspoves (22 Feb 2017)

Good sense written above. Did A&E not give you any advice? 
If in doubt see your GP - but if things are not too bad, keep the shoulder moving using its full range.
If it starts to get too stiff - physio will help.
The best long term solution is get a recumbent trike!


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## rivers (22 Feb 2017)

A&E put me in a sling for the next 3 days and gave me a load of exercises to do over the next few weeks. As well as told me not to do any heavy lifting. I've started the exercises they gave me, and it hurts. At the moment it's just things like lifting and moving my arm in various ways to keep movement. I'm buggered if I lose my range of motion...


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## fossyant (22 Feb 2017)

If it's not broken, get advice from a physio and use it. Worse thing you can do is totally immobilise any joint.

I banged up my shoulder badly recently at Llandegla. I struggled to get the bike back in the car, and get 2nd or 4th gear in the car for a few weeks. I saw a private physio and got a rollocking, but it wasn't an A&E visit and I wasn't about to go. Do the mobilisation and carry on. Take the pain killers. Strapping up a limb that's not broken is a very bad idea. 

Do not follow A&E's advice for a non-broken joint - go see a private physio that deals with sports injury. I was given the worst advice possible from NHS physio's after my fractured spine - I went private and got the correct treatment that enabled me to get back to work.

Unfortunately, NHS physio does not have time to treat people properly.


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## PK99 (22 Feb 2017)

lots of good advice.

Key point - see a sports physio ASAP. Tomorrow if you can. You need guidance on what exercises you should and which you should not to.

This site is very good for guidance on how to do rehab exercises, but only do the ones your physio recommends

http://www.physiorehab.com/videos-rehab-exercises-shoulder-rotator-cuff

I've been following the ACL rehab program and it is outstandingly good, my sports physio has been very happy for me to follow it with periodic check-ins


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## ColinJ (22 Feb 2017)

PK99 said:


> http://www.physiorehab.com/videos-rehab-exercises-shoulder-rotator-cuff
> 
> I've been following the ACL rehab program and it is outstandingly good, my sports physio has been very happy for me to follow it with periodic check-ins


I think I will give those a try - thanks for posting the link!

Incidentally, to show how delicate soft tissues can be - one of my shoulders was buggered by me being too lazy to roll over to turn off my morning alarm. I reached back behind me, couldn't quite reach the clock, and put the shoulder out trying. Years later it _still_ hurts!


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## MarkF (23 Feb 2017)

ColinJ said:


> Soft tissue damage can be worse than broken bones!



Too right, there have been time when I dearly wish I'd broken bones than suffered tissue/tendon damage.



rivers said:


> A&E put me in a sling for the next 3 days and gave me a load of exercises to do over the next few weeks. As well as told me not to do any heavy lifting. I've started the exercises they gave me, and it hurts. At the moment it's just things like lifting and moving my arm in various ways to keep movement. I'm buggered if I lose my range of motion...



You had an x-ray?


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## rivers (23 Feb 2017)

MarkF said:


> Too right, there have been time when I dearly wish I'd broken bones than suffered tissue/tendon damage.
> 
> 
> 
> You had an x-ray?


 Yes, they originally thought I may have broken something in my shoulder. But, no breaks.


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## MarkF (23 Feb 2017)

rivers said:


> Yes, they originally thought I may have broken something in my shoulder. But, no breaks.



Hopefully it is just bruising then, but if it doesn't heal normally/quickly and you don't have full range of movement, push for an MRI scan.


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## vickster (23 Feb 2017)

MarkF said:


> Hopefully it is just bruising then, but if it doesn't heal normally/quickly and you don't have full range of movement, push for an MRI scan.


Indeed. I tried 9 months of Physio before I had an MRI and the suspected labral tear was confirmed. Luckily having private healthcare, I didn't have to wait for the MRI (once referred by Consultant)
Not helped by having an unusual injury for my demographic!


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## rivers (23 Feb 2017)

MarkF said:


> Hopefully it is just bruising then, but if it doesn't heal normally/quickly and you don't have full range of movement, push for an MRI scan.



At the moment, every time I move my arm, I feel sick and I have a fairly high pain threshold. GP is getting a phone first thing in the morning, and hopefully I can get an appointment that doesn't clash with my other appointment tomorrow.


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## vickster (23 Feb 2017)

Doesn't sound good. Did the hospital give you some beefy pain pills? You could also try a bag of peas wrapped in s teatiwek to help with the pain  is the arm in a sling to give it a rest?


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## MarkF (23 Feb 2017)

rivers said:


> At the moment, every time I move my arm, I feel sick and I have a fairly high pain threshold. GP is getting a phone first thing in the morning, and hopefully I can get an appointment that doesn't clash with my other appointment tomorrow.



Still early days yet, hope you manage to see the GP.

I had an accident and an xray and was sent home despite my protests, I knew something was wrong as my bicep was in completely different place to pre-accident. I had an MRI about a week later, then an operation 2 days after that, just before a cadaver would have been needed as my distal tendon was dying off!


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## rivers (23 Feb 2017)

vickster said:


> Doesn't sound good. Did the hospital give you some beefy pain pills? You could also try a bag of peas wrapped in s teatiwek to help with the pain  is the arm in a sling to give it a rest?



Yeah, the sling is just to take the pressure off. if I'm lounging about on the sofa or in bed, I'm to have it propped up on pillows. Just finished my round of icing and am holding off on the painkillers until I'm ready for bed.


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## fossyant (23 Feb 2017)

An MRI would show the extent of soft tissue damage.


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## rivers (3 Mar 2017)

Update: back to the GP yesterday as the pain hasn't really subsided, and range of movement hasn't improved. Finally got a referral for physio. The GP I saw on Friday didn't even look at me, and just wrote a prescription for stronger meds (which didn't do anything), and gave me an amended duties sick note. I saw my actual GP yesterday, who listened, looked and had a chat. Her immediate response was physio and to go private as I can't really wait. But the bad news is, no diving for 2 months at least, and cycling can resume once I can keep my arm out in front of me without pain. If physio doesn't help, I need to go and see a shoulder specialist as I might need surgery. So who knows if I will be able to cycle the tour de bristol next month...


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## PK99 (3 Mar 2017)

the aussie physio I mentioned has now published an on line shoulder program, I used the ACL program and found it excellent

the link is:
http://www.physiorehab.com/rehab-programs-shoulder-injury-surgery-rehab


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## vickster (3 Mar 2017)

What does the GP think you've actually damaged? Lots of structures in the shoulder, they need different management, so wait until you've seen the physio


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## rivers (3 Mar 2017)

vickster said:


> What does the GP think you've actually damaged? Lots of structures in the shoulder, they need different management, so wait until you've seen the physio



Rotator cuff


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## vickster (3 Mar 2017)

rivers said:


> Rotator cuff


Definitely wait until the physio has given appropriate exercises  Have you made an appointment? Find someone with an interest / expertise in shoulders


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## rivers (3 Mar 2017)

vickster said:


> Definitely wait until the physio has given appropriate exercises  Have you made an appointment? Find someone with an interest / expertise in shoulders


 consult and assessment at 17:30 this evening


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## vickster (3 Mar 2017)

Good luck


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## Drago (4 Mar 2017)

You have my sympathy Rivers. I'm currently enduring a shoulder impingement, and when it twangs it hurts enough to make me feel faint. Shoulder pain is blummen miserable.


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## rivers (25 Apr 2017)

About 70% of my range of motion has returned, yay! But my physio isn't happy with the amount of pain I still have and a fun, loud, painful clunk that my shoulder makes when moved in a certain direction/way. So she has sent my GP a letter so I can get a referral for a scan. She wants an ultrasound for my rotator cuff and an MRI or CT scan to check for a SLAP/labral tear and an avulsion fracture. I'm going to push for a CT scan as I have a few piercings I would rather not remove.


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## vickster (25 Apr 2017)

rivers said:


> About 70% of my range of motion has returned, yay! But my physio isn't happy with the amount of pain I still have and a fun, loud, painful clunk that my shoulder makes when moved in a certain direction/way. So she has sent my GP a letter so I can get a referral for a scan. She wants an ultrasound for my rotator cuff and an MRI or CT scan to check for a SLAP/labral tear and an avulsion fracture. I'm going to push for a CT scan as I have a few piercings I would rather not remove.


Hope it can be resolved without surgery - recovery from a labral tear repair isn't any fun at all 

I think you'll need to remove the piercings for a CT scan too. Best to go for whichever scan is best suited to the job (I've had U/S and MRI on my shoulder, think CT is better for bony stuff rather than soft tissue)

@Cunobelin might be able to advise


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## rivers (30 May 2017)

I had my MRI last week. The results are in, but doctor won't discuss over the phone. Appointment is classed as non-urgent, so the earliest I can get in to see my GP is the 15th of June


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## Drago (30 May 2017)

Good luck. I'm at the consultant on Tuesday for mine, but every GP and physio I've had have said I'm looking at an op, or possibly manipulation under general anaesthetic. 

Either way, yoiks!


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## rivers (8 Jun 2017)

Got my appointment moved up to tomorrow morning! And an offer of compensation from the other side, which, if I understood the letter from my solicitor correctly, I shouldn't accept and we should wait for all of the medical reports to come back (including from the medico-legal expert). Anyways, I shall be phoning her tomorrow to talk through my options and give the results of the MRI.


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## vickster (8 Jun 2017)

Your solicitor is right. Do not settle until everything is 100% better (or the expert has said it's as good as it'll get). Thus you need to be sure no surgery needed or you are recovered fully from said surgery. Once you settle, that's it

If you still have issues, it's likely the expert will want to see you again in 6 months anyhow (or 6 months after surgery if he has suggested that as a prognosis)


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## rivers (9 Jun 2017)

Results are in: subacrominial impingment and supraspinatus tendinosis. So no tear. Just a steroid injection, physio, and time. I spoke to the solicitor, and the report from the medico-legal expert is in as well. Based on both the MRI results and the medico-legal report, my solicitor says the offer is quite good, so I will most likely accept it (new bike time!). It was never about the money to me, just recovering costs.


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## Drago (9 Jun 2017)

Good luck. I'm being chopped open for my subacromial impingement, because physio did nothing more than hurt me a lot, so I would be inclined to wait until you recover to ensure you don't need the same.


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