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View Full Version : Input/Opinions on dx of Bursitis, L Shoulder


Mike Kesthely
12-13-2009, 10:21 PM
History:
36 y/o male, actively CF'ing since Nov 2007
Developed L shoulder pain, AC and anterior delt area, on OH movements Jan 2009---no previous pain on OH movements prior to this.
Potential previous subluxation of L shoulder during a takedown during a martial arts class Oct 2007.
shoulder joint DOES have slight laxity, but only when I'm extremely relaxed i.e half asleep, rolling over in bed.
XRays show osteolysis of distal clavicle.
Ultrasound of rotator cuff L bicep tendon clear
Contrast MRI done Nov 2009 clear
Have had continual chiro/massage/ART/physio with no relief since March 2009Apt. with the orthopedic surgeon, Dec 8/2009, ended with a dx of "bursitis"; he recommended I "strengthen my rotator cuff" to "tighten up the joint". Next tx option cortisone, then next tx option arthroscope.

This pain has been persistent for almost a year---the only thing that has quelled it is removing overhead/pushing movements from my WODs. Does bursitis last this long? Could the MRI be incorrect in not identifying a torn labrum/tendon?

Steven Low
12-14-2009, 12:46 PM
It's unlikely they missed a labral tear with contrast MRI.

Bursitis is an overuse injury (one that manifest usually closer to the surface of the skin rather than deep).

With overuse injuries you basically need to NOT AGGRAVATE them, rest, massage, anti-inflams, etc.

Basically, you can follow this tendonitis protocol wfs:
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

EXCEPT remove the stretching and strengthening exercises and add specific rotator cuff work.

You're chronic so the rest will help some but not cure it. You need to massage a lot, and get some RC work going (not painful) to help with the laxity.


I'm not quite sure why you want a torn labrum/tendon instead of bursitis though... that would be surgery.

Mike Kesthely
12-14-2009, 03:44 PM
I'm not quite sure why you want a torn labrum/tendon instead of bursitis though... that would be surgery.

Thanks for your input, Steven.

Trust me, I don't want a torn anything, nor do I want surgery. Due to the length of the injury, though, I was surprised at the dx of bursitis; it seems like more of a diagnosis of exclusion versus definitive.

Damon Stewart
12-15-2009, 10:54 PM
I went down the same path with subacromial bursitis. After nearly a year of little improvement I upped my fish oil intake to 12,000 mg/day and experienced total relief in 5 days. Not saying it will work for you but is worth a try.

Mike Kesthely
12-16-2009, 08:50 AM
I went down the same path with subacromial bursitis. After nearly a year of little improvement I upped my fish oil intake to 12,000 mg/day and experienced total relief in 5 days. Not saying it will work for you but is worth a try.

Thanks Damon,

I've been taking 0.5g EPA/DHA per 10lbs BW(8g) as of June 2009, as per Robb Wolf; prior to that, I was around 4g EPA/DHA for a few years. I dabbled with a tumeric/bromelain combo, which seemed to have no perceivable benefit. I may go there again, and I may up my fish oil to perhaps 1g EPA/DHA-10lbsBW.

I think a combo of high dose fish oil, tumeric, and NSAIDs in the form of naproxen dumped my immune system in the summer---ended up with flu-like symptoms 3 times in one month. Pure speculation, though.

Did you end up getting cortisone? Was it for obvious overuse, and did you have joint laxity prior? I appreciate your input.