Shoulder pain Chronic Biceps Tendinitis

[zoda1121]

Its a little lengthy so bare with me.

First off, I am a very active person. Before the injury I weight lifted on a regular basis, played lacrosse throughout high school (i just finished my freshman year in college), and I frequently took trips to the rock gym and various outdoor rocks for climbing. In January I started the Crossfit fitness program (www.crossfit.com). This program combined strength training, agility work, running, gymnastic, olympic lifting, balance, mobility, and flexibility. Its basically consist's of intense circuit training where exercises are completed in succession and timed. Its a solid program with a great community and i LOVE doing it. Its definitely not something I want to give up. On to the injury. In January I felt a deep shoulder pain performing power cleans. It wasn't that bad so for a week or so after the initial injury i continued to work through the pain (stupidly). Later in the month I saw my pediatrician who gave my a cortisone shot and prescribed physical therapy for a month, which did not help. A month later March rolls around and I visit an orthopedic doctor. He prescribed 800mg ibuprofen and rest for a month. I rested the shoulder, but still performed lower body exercises and continued to run regularly with the doctors permission. A month later the pain is still there. After that I was frustrated and did some research on message therapy. Saw a therapist who performed ART (Active Release Technique) which is a deep tissue message used to break up scar tissue. This helped minimally. After that I kind of rehabbed it on my own. Progressing from eccentric shoulder movements, to isolation movements, then slow compound movements. This seemed to do the trick but I was only pain free for three weeks before I messed it up again carrying boxes at work (same motion as before, pulling the box up to my shoulder). This time around I went to a brand new doctor, prescribed me to a second therapist. This time around the therapist gave me a cortisone patch. This seemed to do the trick this time, the pain was gone. After the patch was removed, i rested the shoulder for about three weeks and returned to exercise. Everything went fine for a month and there it goes again. The pain is back. I cannot seem to get rid of it! It is the most frustrating injury I have ever had. Im at the point if there is a surgery out there that can fix this I will do it and go through the rehab just to rid of the problem!!!

A few other side notes:
-Most of the time its not as much a pain in my shoulder as a deep discomfort that is mainly aggravated with pulling motions.
- My upper shoulder/trap/side of my neck is also extremely tight, I cannot seem to loosen it up.
- Throughout the past 7 months I have not remained inactive. I HAVE been running and I HAVE been doing lower body and core exercises because i cannot stand being inactive.
- Two weeks ago I picked up the book "The Trigger Point Therapy Workbook: Your Self Treatment Guide to Pain Relief" by Clair Davis, and so far after everything i have been through THIS has given me the most pain relief. It has gotten rid of all the tenderness in and around the long head of the bicep and the front of the shoulder but it has yet to rid me of that deep discomfort in my shoulder that is keeping me from returning to normal activity. Although if trigger points is the problem, im not sure im addressing all of the trigger points involved.
- My first orthopedic doctor did prescribe an MRI which diagnosed me with Tendonosis of the biceps tendon. I did research on tendonosis and my doctor told me that I am to young to have degenerate tendons and that that is just how the MRI reading classifies my tendonopathy.

Where do I go? Do I continue with the trigger point therapy?!?! I was considering calling up some local sports teams to talk to a sports doctor? I am so lost!

[Tuckamore]

Hello Zoda,

Welcome to the Pain Mangement Forum. You have given an excellent description of your injury and history. I bet you are doing well in college.

As Designgyrll stated there are not any physicians on this site. However there are ppl with a lot of experience with pain and injuries. Some of us have some medical backgrounds but none of us are experts or physicians. With that clarification I think you are on the right track. A Sports Medicine Physician may be the right physician to treat your injury. They are everywhere and not just associated with sports teams. Indeed I have even seen one.

I see you are only 19 and I agree that you are very young to have degenerative tendons. But nothing is impossible. The radiologist saw something that indicated  at least to him that you have something major going on with that tendon. Has another radiologist read the MRI? If not I would request that it be re-read by another set of eyes. A Sports Medicine Physician may even be able to evaluate your MRI.

I had a rotator cuff tear that occurred when I swung a bat in a softball game, (great 3 hitter by the way). Because I was a 28 year old female and a non-professional athletic surgery was not performed. It took two years to heal the injury or at least two years to heal the pain from the injury. Follow PT I continued rehab at home. The shoulder is a joint that is difficult to rest. You cannot help but use it. Healing can be a time consuming, slow and painful process.

Acupuncture as suggested above may be beneficial. It does work for some ppl. However it may just take time and patience. I am guessing that just about the time it has begun to heal you are re-injuring the already weakened and sensitive tissues of the tendon and surrounding structures.  

I wish I could be of more help. There are exercises that I could suggest but they may not be right for your specific injury or at the level of that you should be. You have most likely been given a series of exercise by your first PT. Consider returning to the basics of the exercise regime, back down your training until you can be seen by a good Sports Medicine Physician. Don't risk over extending or another injury.

Please let us know how you are doing. I will look forward to your updates with interest. I am sorry that you are dealing with this painful condition. I wish you a speedy recovery.

Take Care,
~Tuck

[designgyrl]

I know this may sound a little strange to you, but do you know of anyone that does accupuncture?  The reason why I'm asking is that I hurt my ribs wrestling around with my boyfriend at the time and I pulled my ribs.  I tried everything, and nothing helped.  I ended up going to a chiropractor and she tried accupuncture on the site, and it worked.  It released the pain, I could lift up  my arm and move my body around.  I did a couple of visits of that and I was done.  We are not doctors here, just people that have chronic pain, and we offer advice to what we've been through before.

Welcome to the forum and I hope it gets better soon!  Let us know how it's going, and I'm glad your staying active even though your shoulder is injured.