Im a little confused about Rotator Cuff injuries and TMS:

Yes, it's hard to find a PT or orthopedic surgeon open to the idea that shoulder pain might have a psychogenic origin. The structural bias is just too pervasive. Interesting what you have to say about constructing tests that would be designed to include both physical and psychological causation. Wonder if Howard Schubiner or Alan Gordon have ever done anything like that? You might want to ask them on the TMS Wiki.

 

Hi Bruce

I'm really glad I found your (and others') posts in this thread. I've been having some kind of issue with the my shoulder the last week or so after a gym session and I'm a little bit worried about it. I'm really hoping its TMS. I think I may have overdone it in the gym and about 24 hours later my shoulders and biceps felt sore. The shoulder soreness disappeared after a couple days but my biceps remained sore. At the weekend I (stupidly) posted a question on a fitness forum about whether its safe to train through muscle soreness in my biceps or if I need to rest. Someone responded that bicep soreness is often a consequence of rotator cuff injuries. As soon as I read that, boom, my shoulders started hurting again and the soreness in my biceps changed to a more sharp/stabbing pain and also extended to the elbow.

This is all classic TMS stuff but still a little scary because it was definitely connected to lifting in the gym so am currently not able to fully accept TMS. I'm scared to go to a doctor about it. I live in Germany and German orthopaedists are sharks. They just want to scan everything and try and operate. I'm even scared to bring it to a PT or Osteopath.

If you have any words of encouragement I'd be really grateful. I have a decent range of motion in the shoulder, although I'm too scared to test it fully. The main pain seems to occur when I bring my arm back down after raising it. Maybe I just need to wait a few weeks to let it settle down as you did. It's only been a week.

Man, I hate TMS

 

"I live in Germany and German orthopaedists are sharks. They just want to scan everything and try and operate."

Boy, Shakermaker, that sounds all too familiar and conforms to my own experience. Of course, I'm not an MD and cannot diagnose and treat etc etc etc blah blah blah. But what my old sawbones family doctor of 40 years said seems highly applicable in your case: Leave off all activity on the affected parts for 5-6 weeks and see if the pain subsides and/or goes away. Then, gradually resume activity in small increments. Also, one thing my old MD did that all the fancy pants orthopedic people did not was to administer a full range of motion study of the affected limb. For instance, if you can hold your arm out straight in front of you at a 90 degree angle, you don't have a full rotator cuff tear, no matter how they interpret your MRI in their favor to indicate the necessity of an operation. Try it yourself or get a traditional MD or PT who will. An MRI is subject to interpretation, a range of motion study tells the objective truth. In any event, take a very conservative approach before going down the path of surgery, which is an invasive procedure fraught with all the attendant dangers of such. It's been 7 or 8 years since Kaiser-Permanente said I absolutely needed a rotator cuff operation and my left arm is doing just fine today, thank you! In fact, I've been curling, bench pressing, doing pull ups and dips with no problem whatsoever ever since then. A 5 or 6 week rest and a gradual return to full activity was all it took.

 

Thanks a lot for your encouraging message Bruce. When you say lay off activity for 5-6 weeks, what kind of activity do you mean? Do you mean don't move the arm/shoulder at all for 6 weeks? Or do you just mean not doing strenuous things like lifting? I am able to move it fairly well already. I can get clothes on ok, get things out of fridges, cupboards etc. Last night I ran (very carefully) after a train and a bus and that didn't cause a problem. I just held the arm out in front of me at 90 degrees and could do it with a bit of discomfort. And I think if it was a full tear it would be excruciating pain. I think I'm letting anxiety get the better of me. I could probably find a PT who is trustworthy to test the motion. And I've got an appointment with a neurologist for my other TMS problem on Friday, she's also qualified in sports medicine so maybe I'll ask her.

 

Well, again I'm not an MD or a PT and cannot diagnose or treat your condition, but what I mean about laying off is avoiding any movement that enters into the pain threshold. In other words, keep your movements within the range dictated by the ouch pain parameter. Sounds like if you're getting your shirt on and off you're already enlarging the parameters of movement you feel comfortable within. Just keep doing what you're doing and don't push too far at any one time. Your body will tell you when it doesn't hurt any more. That's all I did: instead of exercising my upper body, I went running and let my arms move naturally without causing pain. Of course, if it suddenly gets worse, consult a physician or PT. Just have to add on that caveat. While you're out running, try not to fall on the affected area either. Just common sense.

 

Hi all. So I’ve been dealing with TMS for years. I’ve noted in past posts about groin pain after Hernia surgery. I have a new issue. Shoulder pain! It started 15 years ago and got an MRI That showed a torn rotator. I stopped lifting weights and for the next bunch of years was fine. Around five years ago the pain started again. Went to the dr and he said to have surgery. I didn’t. I started working out two years ago. I got pretty heavy into it. About three months ago while doing pull ups something happened and the pain started again. I didn’t even think TMS until a few days ago(duh!). I had a massage last night and now the pain is worse.
My question is should I lay off working out and playing golf or should I start again immediately?
Thanks for any advice!

 

A rotator cuff tear can heal after some weeks, if it's a very serious tear it will be very visible on the ultrasound plus the pain will be constant and will come with the same movement. If it's tms, the pain is more likely to spread to other areas in the shoulder, plus it is more likely to change in intensity at different times of the day. I was told I had a Rotator Cuff tear and it ended up being TMS. Even if it were a real injury, it should heal within 6 weeks max, if it's been much longer it is most probably TMS. Plus, I also have a tear under the socket of the shoulder which I found out via MRI, and they blamed it for my pain and told me to have surgery. Guess what? I didn't have surgery and I don't even feel it. And, I'm a rock climber!
Deal with your fear, look at the pain objectively, follow a TMS pain program, and you'll be just fine!

 

Kaiser had already scheduled me for surgery and I omitted the procedure. Within 6 weeks the pain disappeared. They prey on your doubts and fears when the pain is at its most intense and when you're most suggestive. I would say this hold true for 90% of the injuries classified as rotator cuff tears. In any case, though it out for 6 weeks before crying uncle. One excuse they use is saying that the operation must be done immediately, and I say ballocks! And I'm a rock climber too.

 

I knew a woman who had what was diagnosed by the M.D.s as a "partial rotator cuff tear" that didn't disappear after 6 weeks but continued on for a year, at the end of which she decided to have surgery to repair it. However, this same woman, a bio-scientist with Ph.D., has also had constant lower back pain (LBP) ever since her late 20s when she first began working on her dissertation in grad school. Constantly having back adjustments and going to chiros and acupuncturists. Although this is of course only incidental, I would suggest that the underlying reason her shoulder pain persisted was she also had a ongoing case of TMS that amplified whatever symptoms she was experiencing.