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Northerner
62 Posts |
 Posted - 08/15/2009 : 16:48:09
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How can I tell if shoulder pain is caused by a physical problem, such as a tendon or ligament tear, or TMS?
I'm 50 and very physically active.
I am a whitewater kayaker, and kayakers frequently injure their shoulders. We frequently push off rocks with our paddles, sometimes when we're upside down and trying to roll rightside up. A number of my friends have had shoulder and rotator cuff surgery, including surgery after dislocations when they have virtually ripped everything in their shoulders apart.
I first noticed pain in my right shoulder about two years ago (the right shoulder is by far the most vulnerable when kayaking for a right-handed kayaker). I really can't remember the exact cause, but I think it first appeared when I rolled and pushed off a rock on the bottom of a river. It was relatively minor for over a year, although I did notice some pain when doing an overhead weight lifting press.
A physical therapist 18 months ago found some mild tendonitis in both shoulders, saying that my shoulder capsule showed some tightness, and gave me some exercises for these - this was actually when we were trying to fix my back pain. He could find no reason for my back pain, but did find this on an examination.
Starting in March or April of this year, I noticed significantly more right shoulder pain when I raised my arm above my shoulder(left shoulder is pain free); it may have come from trying to roll in a shallow, cold river in March - it was an ugly kayaking exhibition. It hurt to throw a baseball with my son, and I had to throw sidearm. It also hurt when trying to block a shot when playing basketball, early in the game. The pain would go away when I warmed up (increased blood flow?) later in the basketball game.
I've also experienced minor pain when I do an eskimo roll (this is a complex, corkscrew motion, which would make a contortionist wince, and your arm needs to stick up above the water while you're upside down).
Today, however, after a few practice rolls in calm water and feeling only minor pain if any, I went upside down in some pretty stiff rapids, rolled up quickly and beautifully, and felt a sharp pain in my shoulder while doing so that didn't go away right away. I checked with a nurse in our paddling group, who asked me to show her which motions hurt, and she said to take two Advil, ice it tonight, and to try to take the easier routes on the rest of our journey (she didn't tell me to stop right then and there, which I could have). She said she wasn't worried that I would hurt something if I rolled again.
I took two Advil, and felt modest, occasional pain when paddling (unusual, by the way - I normally feel pain in the shoulder only if I roll or push off the bottom with my paddle). Surprisingly, I felt no real pain when I had to do an eskimo roll in a stiff rapid two hours later.
For me, kayaking is a way to relieve all my tension (can't think of much else but staying upright when you're trying to stay upright in heavy whitewater). It can also be scary, for the obvious reasons, even though I avoid the life threatening stuff.
I have a TMS personality, and am pretty sure that my upper back and nerve pain (attributed to a bone spur in the neck) and my lower back pain had TMS as its root cause. These have mostly subsided since I started working the TMS program and reading the books, starting in January. The only symptoms to speak of are minor numbness in the fingers now. When I started the program nine months ago, I had numbies, left arm weakness, elbow pain and scapular pain that was significant. I have a prior history of TMS-type pain, such as back pain followed by excruciating knee pain (diagnosed as a torn meniscus, and that disappeared without treatment after 6 months). The back pain disappeared for about 10 years, and then reappeared 1.5 years ago, out of the blue, when I woke up one morning.
Psychologically, this recession has had me terrified. I'm a consultant, work has been spotty, and I'm very concerned about my finances, as have many other people.
The big question, however, is how can I determine if this is an injury that poses a legitimate risk, or TMS? I'm pretty certain that if we do an MRI of my shoulder, they'll find something in there by my age (perhaps they will in the other shoulder as well, which is pain free). At the same time, just as baseball players do serious damage to their rotator cuffs and shoulders, kayakers do, too. The pain wouldn't stop me from kayaking, but I don't want to keep going until I rip something apart in there.
By the way, I read on the internet that rotator cuff pain can also be caused by a pinched nerve in the neck. If so, the same bone spur in my neck that supposedly caused my neck pain could be used to explain the shoulder pain. If that is the case, I would feel certain that this is TMS.
If anyone can offer any comments or wisdom, you will earn my undying gratitude.
I am an old man and have known a great many troubles, but most of them never happened.
- Mark Twain |
Edited by - Northerner on 08/15/2009 22:01:10 |
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Wavy Soul
USA
779 Posts |
Posted - 08/19/2009 : 05:57:21
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I can offer that I had a pretty debilitating shoulder thing a year or so ago. I tried everything like physical therapy, even cortisone shots, because I was practically disabled. Nothing made any difference (including my TMS work). Eventually it went away when the physio taped my shoulder back with athletic tape. This meant that I couldn't round my shoulders when I was doing something with arms forward. It felt very opening in terms of breathing and heart, and after the tape came off, I had slightly different habits.
I can now feel that my habitual tendency, especially when stressed, to have my shoulders round forward causes a certain compression, and when I feel it coming, I have someone tape my shoulder back into better posture. After a few hours or days the painful spots get relief.
This is not a "true believer" post, because although I absolutely believe in TMS, it hasn't been true for me that relief is completely a non-physical process. I've found that some of my chronic emotional patterns have somatized into unhealthy ways of "holding" in my body and that unraveling these has been a big part of my feeling better.
xx
So I'm not sure if it was "really TMS" or not. I definitely do have, or rather I do "do" TMS. And I also have some old postural habits from early emotional stuff that I think contribute to pain syndromes now.
Love is the answer, whatever the question |
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Northerner
62 Posts |
Posted - 08/24/2009 : 13:32:28
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To follow up on this, I saw a physical therapist about my shoulder today. He said that it appears that my shoulder capsule on the right side is tight, and there appears to be inflammation of the supraspinatus tendon.
He also said that my strength was normal, and that although my range of motion is not full, I can do my normal activities, including kayak rolling. He said that this will probably go away in 4 to 6 weeks, with some exercises.
My best guess is that this is a minor injury, not TMS, but I can’t be sure for certain that TMS is not the culprit. If it is TMS, it’s different than my back pain, because this pain gets reduced by anti-inflammatories.
I’m going to treat this as an acute, but minor, injury. If it doesn’t go away with normal treatment in a short time, I’ll assume it is TMS.
One thing I can say is that I’m a lot less worried about this now – shoulder injuries are common in whitewater kayaking, including ripping the shoulder out of the socket, and I was worried this could be the first step towards that. The lack of fear that this is a serious injury seems to make me feel better physically – I worry too much, and I think TMS people worry too much about little pains doing them damage.
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I am an old man and have known a great many troubles, but most of them never happened.
- Mark Twain |
Edited by - Northerner on 08/24/2009 14:58:23 |
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Argh! Is it a shoulder injury, or TMS?
