Shoulder Pain

[Doro]

A couple of months ago (about 3 now) I went diving after a particularly strenuous workout in the morning. Several hours had passed when I suited up for a cold water dive in San Diego. I remember my shoulder being a little sore prior to the dives but didn't think much of it. After the dives (first to 90 feet or so well within the no-deco limits, second to 60 feet, aslo withing no-deco limits) my shoulder starting aching more and more. I didn't recognize any obvious signs of decompression sickness at the time (it never occured to me actually so I didn't really pay much attention :11: ). My shoulder kept getting worse and worse as the day passed on. The pain evened out and stayed constant for a couple of weeks. I figured I had strained a muscle or something during the workout and hoped the problem would resolve itself. It didn't.

A couple weeks later I went to the doctor and was diagnosed with a torn rotator cuff (I didn't mention anything about the dive). No MRI was taken. I'm still having problems with it despite PT and have started to wonder if the dive or any form of mild decompression sickness could have contributed/aggrivated the injury. I have not yet consulted a doctor. Any ideas? Is this a wild goose chase?? please :help: thx!

 

[pmarc68]

A couple of months ago (about 3 now) I went
diving after a particularly strenuous workout in the morning. Several hours had passed when I suited up for a cold water dive in San Diego. I remember my shoulder being a little sore prior to the dives but didn't think much of it. After the dives (first to 90 feet or so well within the no-deco limits, second to 60 feet, aslo withing no-deco limits) my shoulder starting aching more and more. I didn't recognize any obvious signs of decompression sickness at the time (it never occured to me actually so I didn't really pay much attention :11: ). My shoulder kept getting worse and worse as the day passed on. The pain evened out and stayed constant for a couple of weeks. I figured I had strained a muscle or something during the workout and hoped the problem would resolve itself. It didn't.

A couple weeks later I went to the doctor and was diagnosed with a torn rotator cuff (I didn't mention anything about the dive). No MRI was taken. I'm still having problems with it despite PT and have started to wonder if the dive or any form of mild decompression sickness could have contributed/aggrivated the injury. I have not yet consulted a doctor. Any ideas? Is this a wild goose chase?? please :help: thx!

First of all, I am sorry that you are having so much difficulty. Although I am not a physician, I doubt that your injury is due to or exacerbated by DCS. A torn rotator cuff takes a very long time to heal on its own, and sometimes never does. Some people end up requiring surgery for the repair.

I have just a few suggestions for you: 1. I would make another appointment with your physician, and mention to him exactly what happend the day that the pain increased. He/she cannot make a proper diagnosis without a full picture. 2. I would ask for an MRI so that the full amount of damage can be assessed. 3. Ask for a referall to a orthopedic surgeon that specializes in should injury. 4. Continue with physical therapy.

Hope this helps, and I hope you are better soon.

Pam

 

[Mrs Mares]

I myself have had a torn rotator cuff, and it is very painful so I can sympathise with you.
It's taken 9 months for it to start feeling better, although sometimes I still get a little discomfort from it.
The consultant at the hospital offered steroid injections which I have as yet refused, or the alternative is surgery but I think i'll pass on that as well. Hopefully yours will get better with time on it's own. Good luck

 

[Doro]

Thanks for the well wishes on my shoulder!! I was hoping to have to avoid and MRI since my insurance sucks and I'll have to pay for most of it out of pocket... However, I probably need to know exactly how bad the tear is so I can decide if this one will need surgery or if PT will get this one resolved on its own.

Next time I go into the Ortho I'll mention the diving scenario to him to see what he has to say. This is the arm I use to grab lobster so lets hope it gets better for the California season starts!!

 

[CameronMartz]

Doro,

I have also torn a rotator cuff, and to echo the others, it can ache for months even when you're doing everything right. It took me two years to forget about my injury, though even now, 12 years later, it gets angry from hard swim sets.

Living with the damage is often more attractive than surgical repair, mainly because you have to cut through a lot of good stuff to get to the bad stuff. Since you usually only damage one or two connections in a rotator cuff injury, you can have a very usable shoulder by strengthening everything else to help compensate.

I must say, though, that MRIs are not necessarily better at determining the degree and type of damage than an experienced ortho or PT. One of the reasons is that an MRI is a static picture with the joint relaxed and generally asymptomatic. While you *might* be able to see ruptures, inflammation, etc., there are no guarantees that what you see is going to be a fair representation of the injury in a practical sense.

The second reason is that there are only so many things in a shoulder (or knee or hip, etc.) to get injured, and this makes diagnosis using manipulations to elicit discomfort very robust. Stick your arm straight out in front of you, pronate your arm until your thumb points to the ground, then raise your arm against resistance. If this hurts, this means something very specific. Turn your thumb up towards the ceiling and do the same thing. If this hurts, it means something else.

By doing these types of tests, an ortho or PT can "outdiagnose" an MRI with some regularity. There are certainly very important uses of MRI. However, it is only one arrow in a quiver of diagnostics that can often get you exactly the same answer.

Now, what's left is the question, "can you see the effects of DCS on an MRI 3 months later, and if so, will it result in any different treatment?" That answer can come from DAN's medical hotline or from one of the docs on this board.

Cameron

 

[pasley]

Evidently you dod not read the DAN articles about avoiding strenious exercise immediatly before and after a dive.

Sorry you are haveing a problem wiht your shoulder. You could have a torn rotator cup, or DCI or both. You need to give the doctor all the informaiton so he can make a decision. But at this stage, the DCI is most likely in the oh, well, if we had seen him at the time we might have been able to do something catagory. So if it was DCI you could have nerve damage.

Not a doctor or other qualified expert. Just a diver who has had DCI.