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Old 12-08-2008, 10:33 AM   #1
Daniel Watts
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Stuck at OCS (Injured)...Help Please

Hey everybody,

I'm currently at Navy OCS, in the holding class, diagnosed with a posterior rotator cuff strain. They said I have a sprained shoulder. Basically, my shoulder does not work worth a damn for pressing movements, and it is a lot less effective with pulling movements than before. Lack of pressing strength is the worst part though. My pushups fell from about 65 to 25 on the in-pfa. That number is probably even smaller now. After about 5 or 10 pushups, my body begins to torque because my left arm has to do all of the work. There is no pain at all, just a huge loss of strength. It feels like the back of my shoulder and my lat just aren't working. I also couldn't fully raise my arm over my head, but that has since improved.

Initially, there was a huge knot in my right lat and one of the muscles on the back of my shoulder (right above the armpit) felt inflammed. No pain when using the shoulder, but foam rolling was very painful. I've since foam rolled the knot in my lat out. I've also been able to really loosen up the back of the shoulder. Oddly enough, as I was doing this, the side of my shoulder started feeling a little inflammed. As I worked on this, I noticed that the part of my rotator cuff that is between my tricep and biced now feels swollen compared to the other side. No pain still, but everytime I seem to "fix" an area, the problem seems to move.

On top of all that, the strength gains are extremely tedious. I'm barely stronger than I was 5 weeks ago. I've been doing physical therapy for 4 weeks here, which includes resistance work, electric stimulation, and icing. I do additional icing and foam rolling in my room during the day. I was doing extra physical therapy in my room as well as swim therapy 3 times a week. I've taken a week and a half off of both of those to see if complete rest would work to heal it. I'm restarting swim therapy today, but am going to be mostly kicking (just to stay in shape). I'm also taking about 2400 mg of ibueprofen throughout the day.

My questions are:

a) What is wrong?

b) Should I keep completely resting it, or really ramp up the physical therapy and swimming?

I'm hopefully getting an MRI sometime this week. I won't be able to class up until Jan. 4 at the earliest and with how slow my progress has been, even that doesn't seem feasable. I did crossfit for about 4 months at CrossFitNC before showing up. I still try to sneak in some bodyweight crossfit workouts in the evenings with a jump rope, lower body exercises, and core work.

If anyone has any routines fitting that criteria, feel free to share.

Thanks for the help!

Dan
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Old 12-08-2008, 12:11 PM   #2
Bryan Gates
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Re: Stuck at OCS (Injured)...Help Please

It sounds like at least the teres minor was/is giving you issues.

http://en.wikipedia.org/wiki/Teres_minor_muscle (Safe unless a wiki troll is causing mischief)

Good tools for that area are a tennis ball, back nobber, or theracane. A foam roller just doesnt get into the nooks and crannies well enough.

It might be a good idea to check all of the muscles in the rotator cuff.

Check the subscapularis by bringing the arm with the affected shoulder across your body such that your shoulder blade moves out and sticks out a bit. Stick your thumb/fingers on the underside of your scapula and check for sore spots.

Check your supraspinatus by placing your opposite arms fingers on the spine of the scapula (the horizontal line of bone near the top of the scapula) and dig in with your fingers just above and along the spine of the scapula. Its a small area maybe a couple of inches wide and its pretty thin too. If you are an inch above the spine of the scapula you may have went too far already. A tennis ball may be too big to effectively hit this area.

Check the infraspinatus by placing a tennis ball between your scapula, below the spine, and a wall. Roll the entire area of the scapula below the spine searching for sore spots.

Check the teres minor by rolling the tennis ball off of the outside of the scapula near the armpit. A tennis ball is really too big for this area but it should let you know pretty quick if anything in the area is sore. You could be hitting the teres minor/major, long head of the triceps brachii, or latissimus dorsi

I would suggest trigger point massage, but any massage should provide benefits as long as you dont over do it. Follow with stretching. This might allow you to continue what you are doing without any changes.

The problem could have stemmed from a winged scapula or a protracted shoulder girdle. You would have to work on those to truely fix your shoulder issue.
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Old 12-08-2008, 03:07 PM   #3
Andrew Wilson
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Re: Stuck at OCS (Injured)...Help Please

Stay In Physical Therapy

Doing nothing will make the recovery process worse
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Old 12-09-2008, 01:28 PM   #4
Daniel Watts
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Re: Stuck at OCS (Injured)...Help Please

Thanks for the replies guys.

I'll check all those areas. I think you're right about the teres minor. I'll give the tennis ball a go. I get Christmas leave in a couple weeks, should I see a professional trigger point massager? I've also had some issues with shoulder blade winging, but that was mostly on the other side after I dislocated that side. I guess I still have some more work to do. I'm starting physical therapy up again on thursday and I guess I'll full throttle it if you guys don't think the rest is helping. Hopefully the MRI will happen this week.

Thanks again,

Dan
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Old 12-09-2008, 02:59 PM   #5
Pete Nadeau
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Re: Stuck at OCS (Injured)...Help Please

I know military Doctors are slow, but maybe you should let Ortho and the PT treat your injury. Have patients you may regret decisions made today years from now, I speak from experience
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Old 12-09-2008, 03:26 PM   #6
Bryan Gates
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Re: Stuck at OCS (Injured)...Help Please

Getting enough TP massage from a professional will be expensive. I would suggest this:

http://www.amazon.com/Trigger-Point-.../dp/1572243759

You could have some scar tissue from the shoudler dislocation. An ART therapist might be a good idea there.
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Old 12-10-2008, 08:04 AM   #7
Daniel Watts
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Re: Stuck at OCS (Injured)...Help Please

Quote:
Originally Posted by Pete Nadeau View Post
I know military Doctors are slow, but maybe you should let Ortho and the PT treat your injury. Have patients you may regret decisions made today years from now, I speak from experience
Oh I definitely am. I figure that they have seen tons of shoulder problems in their day. I just know that you guys usually have some great input with some more unconventional healing methods.

Thanks again,

Dan
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Old 12-10-2008, 08:53 AM   #8
Robert Peck Fletcher
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Re: Stuck at OCS (Injured)...Help Please

When you are on leave, seek a second opinion from a civilian doctor.
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Old 12-10-2008, 07:09 PM   #9
Chad Cilli
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Re: Stuck at OCS (Injured)...Help Please

The weakness is alarming and the recurrent swelling, as well as the temporary loss of range of motion. The knot on the trap I have seen before. Have you had problems with this shoulder in the past? Have you ever felt any popping? How much do you weigh? Sounds like a bankart lesion to me. You might want to have an MRI arthrogram specifically to see if the dye escapes the shoulder capsule.
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Old 12-11-2008, 12:48 PM   #10
Daniel Watts
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Re: Stuck at OCS (Injured)...Help Please

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Originally Posted by Chad Cilli View Post
The weakness is alarming and the recurrent swelling, as well as the temporary loss of range of motion. The knot on the trap I have seen before. Have you had problems with this shoulder in the past? Have you ever felt any popping? How much do you weigh? Sounds like a bankart lesion to me. You might want to have an MRI arthrogram specifically to see if the dye escapes the shoulder capsule.
The knot was actually in the lat. I dislocated the other shoulder before arriving here but am fully recovered. No trouble with this shoulder other than a few instances of tightness. My shoulders do pop ocassionally, but I think it's in the normal range. I weighed 172 lbs when this happened but now I'm probably below 165 lbs. Everything I'm reading says that a bankart lesion is accompanied with pain, and I haven't had any. I'm getting an MRI soon, I'll ask about the dye.

Thanks,

Dan
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