# Conflicted



## killclimbz (Aug 10, 2007)

If you tore your rotator cuff, it is going to stay that way until you have surgery. I've got a slight tear in my left rotator cuff. It is not going to get better unless I choose to go under the knife. So basically it's up to you if you can deal with the pain or not. Of course you could make it worse too, but that will probably just motivate you to go see the doc sooner.


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## Snow Hound (Jul 21, 2012)

I hurt mine on the early trip last year, think it was just damaged. Was considering riding in a sling on the second trip but it had pretty much healed. You don't want to make it worse, I passed out one night from the pain after a hard day at work fitting ceiling speakers.


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## jml22 (Apr 10, 2012)

How do you know it's your rotator cuff that's torn?


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## poutanen (Dec 22, 2011)

Yeah it's more likely a pulled muscle in the rotator cuff than a full on tear.

I've had several of these injuries and they hurt like hell. I remember going to grab a burger out of a bag a month later and I just about keeled over when my shoulder popped...

I now ride with upper body armour to help prevent some of the injuries. Oh and I would say go enjoy it. Good snow days in Ontarible are few and far between, so take advantage of them! :yahoo:


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## jml22 (Apr 10, 2012)

Any popping or clicking?
Pain at night?
Do you sleep on your side? Does it hurt when you sleep on it? Does it hurt if you dont sleep on it?


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## jjz (Feb 14, 2012)

i went to a chiro/doctor what ever they called.
He said i had a minor tear, most likely in the supraspinatus (part of rotator cuff).
This was 2 weeks ago and 3 days, the last time i felt bad pain was yesterday petting my dog i just felt it really sharp. Its weird how you can carry stuff, no pain, do a lot of stuff but one wrong movement and holy shit.

However its looking good as today i havent felt pain once, so if we get the full 10 cm im goin tmrw.

BTW: Sorry to the mods, i totally forgot about the slam section.


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## jml22 (Apr 10, 2012)

What i'm getting at is approach to shoulders changes everyday cause they're figuring out new stuff, actually with the whole body it changes everyday.
It could even be sub acromial impingment or something, thus all the questions


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## TorpedoVegas (Dec 25, 2011)

Suck it up buttercup....get some advil in you and giver! 10cm is calling your name!


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## jml22 (Apr 10, 2012)

So if they didnt ask you similiar questions to the ones i posted, i'd keep looking for an answer and possibly a rehab program


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## Ocho (Mar 13, 2011)

jjz said:


> i went to a chiro/doctor what ever they called.
> He said i had a minor tear, most likely in the *supraspinatus* (part of rotator cuff).
> This was 2 weeks ago and 3 days, the last time i felt bad pain was yesterday petting my dog i just felt it really sharp. *Its weird how you can carry stuff, no pain, do a lot of stuff but one wrong movement and holy shit.*
> 
> ...


Supraspinatus is a muscle. It's deep to the deltoid and has the action of raising your arm away from your body - which is why you felt a sharp pain when petting your dog. Don't attempt any jumping jacks. 

A minor tear in (non-weight bearing) muscle is FAR better than a tear in other soft tissues like ligaments or tendons. Unless the chiro/doc was referring to the tendon of the supraspinatus?

Either way, rest it by avoiding its action. If it's a muscle tear, it'll heal faster. If tendon, take it easy and don't push it. 

Topicals like BioFreeze and Arnica will help it along. Ice and heat, also, especially since it's been over 2 wks.

Edit: What I mean by take it easy and don't push it if it's the tendon - not saying you can't get out tomorrow. Just be cautious about it and careful not to push its action (like in a fall).

Oh. And I'm not a doctor but I do know a bit about this stuff.


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## Efilnikufesin (Oct 8, 2011)

killclimbz said:


> If you tore your rotator cuff, it is going to stay that way until you have surgery. I've got a slight tear in my left rotator cuff. It is not going to get better unless I choose to go under the knife. So basically it's up to you if you can deal with the pain or not. Of course you could make it worse too, but that will probably just motivate you to go see the doc sooner.


Well it does depend on if you have a type I, II, or III tear. A type I (minor tear) can heal on it's own by reducing swelling and limited use. Type II or above will not heal on their own and will require surgery to repair, though there are always different cases.

Edit: Ice the shit out of it, take aleve (naproxin is the OTC name), then ice it more and take more naproxin. When it feels better, continue to ice the shit out of and take naproxin, after that repeat again. Ice for 15 min at a clip and 20-30 min off and repeat several times each night. If you still feel some pain after a couple weeks, you probably need surgery. Best bet, see a doctor to check it out. Do all of the above though either way.


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## jjz (Feb 14, 2012)

He asked me the popping and clicking question, i wouldnt call it a click but there was a scrunching noise when i moved it. 

I went at the end of the day (i continued snowboarding after fall) but went at around 5 oclock to the doctor.
He couldnt of asked about sleeping on it.

He did the external/ internal rotation strength test. Arm raising to front and above head. Pain was only felt raising arms above head.

Your right that the science is not yet definitive, and their are still some things that doctors just dont know what to do about.

I know a bodybuilder (IM a dedicated lifter), whose right shoulder gives out just outta the blue, Its not a joint but a nerve problem. Literally his brain just stops sending messages to his shoulder, and the doctors dont have any solution.


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## Efilnikufesin (Oct 8, 2011)

EatRideSleep said:


> Supraspinatus is a muscle. It's deep to the deltoid and has the action of raising your arm away from your body - which is why you felt a sharp pain when petting your dog. Don't attempt any jumping jacks.
> 
> A minor tear in (non-weight bearing) muscle is FAR better than a tear in other soft tissues like ligaments or tendons. Unless the chiro/doc was referring to the tendon of the supraspinatus?
> 
> ...


Biofreeze and things like that are crap(sorry Eatridesleep, not trying to undermine!) Never put heat on it till the swelling is down. Heat will increase blood flow, but also increase swelling. Only heat to promote healing when swelling and pain has subsided.


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## Sudden_Death (Mar 23, 2011)

This 10cm at Blue or Moonstone most likely right? So 10 in the middle of Christmas break and after they run the groomers over it. I don't think the risk of hurting it more is worth the 1cm of compacted "machine groomed packed powder" you'll be riding. On the hand it is a chance to ride a snowboard so nut up and do it. Just keep it mellow and you should be fine.


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## jml22 (Apr 10, 2012)

Ok first of all cuff tear is a very very very very general term as there are 4 cuff muscles. 
The supraspinatus is not deep to the deltoid... I guess saying the tendon is deep might be better but its' not realyl something anyone ever says cause of where it goes.

Second, topicals only reduce pain, they do not change physiology by any means, and when they do it's very superficial. Also, the body needs inflammation for the area to heal. Anti-inflammatories longer term will impede this process from happening, they should only used for pain and acute situations.

Was there any pain in any of the muscle tests and did he do a bunch of them?
When you lift your arm your arm out to the side all the way up does it hurt?
Does it hurt lifting it forward? and where
Try this one, lift your arm up point your thumb down and then move it across your body, does that hurt and where?

My main point is that, pain in the shoulder can be caused by the neck, impingement, labrum, cuff, muscle strains ligament strains, scapula... ETC..... 
Most docs are very terrible at differentiating one from the other, because they've never learned or haven't kept up to date on it. Saying cuff tear is a real half ass answer.


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## Ocho (Mar 13, 2011)

Efilnikufesin said:


> Biofreeze and things like that are crap(sorry mixie, not trying to undermine!) Never put heat on it till the swelling is down. Heat will increase blood flow, but also increase swelling. Only heat to promote healing when swelling and pain has subsided.


BioFreeze and Arnica actually _treat_ the tissue and promote healing. NSAIDs do have anti-inflammatory action, but the risk there is that some can block the pain receptors. That's when additional injury can happen.

Correct; you don't want to apply heat with active inflammation. But the OP said it's been over 2 weeks so heat would be okay at this point. He didn't mention anything about swelling.

Ice stimulates circulation while not increasing inflammation. Which is why ice is preferred as the initial application to an injury.

Edit: Oh haha saw your edit re: mixie


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## Ocho (Mar 13, 2011)

jml22 said:


> Ok first of all cuff tear is a very very very very general term as there are 4 cuff muscles.
> The supraspinatus is not deep to the deltoid... I guess saying the tendon is deep might be better but its' not realyl something anyone ever says cause of where it goes.
> 
> Second, topicals only reduce pain, they do not change physiology by any means, and when they do it's very superficial. Also, the body needs inflammation for the area to heal. Anti-inflammatories longer term will impede this process from happening, they should only used for pain and acute situations.
> ...


Sorry, deep to the deltoid in action, meaning supportive. It's palpable so not deep in terms of depth.

I have to disagree about topicals not having physiological benefit. What about transdermals? The skin absorbs.

I agree with you about shoulder pain being secondary to other things like the cervical issues, impingements, issues of the scapula, etc.

And you are SO right about most MDs not being good at musculoskeletal injuries and the reasons for that.


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## Efilnikufesin (Oct 8, 2011)

EatRideSleep said:


> BioFreeze and Arnica actually _treat_ the tissue and promote healing. NSAIDs do have anti-inflammatory action, but the risk there is that some can block the pain receptors. That's when additional injury can happen.
> 
> Correct; you don't want to apply heat with active inflammation. But the OP said it's been over 2 weeks so heat would be okay at this point. He didn't mention anything about swelling.
> 
> ...


Lol, was looking at two threads, mixie was in the other. But to add there is always swelling in that type of injury after two weeks, especially if it hasn't been attended to. Used to be a minor league pitcher and powerlifter as well and have seen and had more shoulder injuries than probably this whole site combined, well maybe. 

Topical packs and rubs only provide temporary relief without actually doing anything to help the injury, real ice (with no buffer, just throw a bag of ice on) and anti inflammatories work much better.


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## Ocho (Mar 13, 2011)

Efilnikufesin said:


> Lol, was looking at two threads, mixie was in the other. But to add there is always swelling in that type of injury after two weeks, especially if it hasn't been attended to. Used to be a minor league pitcher and powerlifter as well and have seen and had more shoulder injuries than probably this whole site combined, well maybe.
> 
> Topical packs and rubs only provide temporary relief without actually doing anything to help the injury, real ice (with no buffer, just throw a bag of ice on) and anti inflammatories work much better.


Haha I thought maybe it was because all chick riders appear alike on the internet.

Good point about the presence of inflammation if not attended to in two weeks time. It also depends upon the degree. This is a minor tear according to the info. I was under the impression the OP did something, like rest it, considering he went to the doctor day-of. So, heat should be okay at this point. You don't want inflammation stagnating; heat and ice can help get it flushed. Heat at the initial stages can do damage so ice then is best.

With your background of pitching and powerlifting, I'm sure you've seen a lot of issues in the shoulders! 

Yeah, I agree that _most well known topicals_ like icy hot (which is crap imo) don't do anything. But the topicals I've tried and mentioned do work for me and others. But they're only one facet of the approach.

I love ice. Straight ice, like you said no buffer. I personally stay away from traditional NSAIDs and pain blockers, however. Pain is the body's version of a warning signal not to overuse/over injure.


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## jjz (Feb 14, 2012)

just to clarify the doctor i went to wasnt a regular MD, he was a some sort of specialist. I was able to get this without an appt cus hes a friend of my dads friend (IM 15).

Thanks for all the recommendation, i remember him saying something before a test saying he was testing for impingment and he really seemed pretty knowleagable, did a bunch of tests.

7 cm has fallen already but the snow stopped, If it gets groomed over (likely) ill wait till the weeekend to go up.

Thanks for all the help guys, i apreciate it.


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## Efilnikufesin (Oct 8, 2011)

jjz said:


> just to clarify the doctor i went to wasnt a regular MD, he was a some sort of specialist. I was able to get this without an appt cus hes a friend of my dads friend (IM 15).
> 
> Thanks for all the recommendation, i remember him saying something before a test saying he was testing for impingment and he really seemed pretty knowleagable, did a bunch of tests.
> 
> ...


Good luck if you are going to go for it, keep the ice up. Check out some rotator exercises while your at it, can do a great deal to minimize the pain (though it may hurt more initially it will go away) but will also help to prevent something like this from happening again. Inner rotation and outer rotations are a great way to start.

Good luck man, and if the pain remains, go see the doc again, or another doc. Some are morons though they made it through med school .

Edit: Did he recommend any PT?


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## jml22 (Apr 10, 2012)

Orthopedic surgeon missed my AC sprain and he was the shoulder guy to goto in the country.
He cut me up without trying any type of conservative care and completely missed my AC sprain. Pretty f'ing easy thing to mix.
Trust no one, get second opinions when possible, but do not tell them what the previous person says til after. Previous opinions will always skew the new person's opinion, best not to chance it.

Ice is always good for acute things, Out with the bad in with the good.

Yeah but when i mean physiological changes i mean an increase/decrease in blood flow and how the cells are working. Most transdermals are for pain.


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## Ocho (Mar 13, 2011)

jjz said:


> just to clarify the doctor i went to wasnt a regular MD, he was a some sort of specialist. I was able to get this without an appt cus hes a friend of my dads friend (IM 15).
> 
> Thanks for all the recommendation, i remember him saying something before a test saying he was testing for impingment and he really seemed pretty knowleagable, did a bunch of tests.
> 
> ...


Ah good to know you are being smart about it at your age. 
I was the type to "walk things off" and push through it as a teenager and still have shit that haunts me from then. I don't advise it.



jml22 said:


> Orthopedic surgeon missed my AC sprain and he was the shoulder guy to goto in the country.
> He cut me up without trying any type of conservative care and completely missed my AC sprain. Pretty f'ing easy thing to mix.
> Trust no one, get second opinions when possible, but do not tell them what the previous person says til after. Previous opinions will always skew the new person's opinion, best not to chance it.
> 
> ...


That sucks; sorry to hear it. Whenever I hear some specialist is the "go-to" person, red flags go up. 

And you'll most often never get conservative or alternative methods from a surgeon. They are trained to cut. That's what they know, that's what they do. 

Very good advice to get second (or more) opinions. 

Not to belabor the point about transdermals, but just to clarify: I was referencing them in general: patches for nicotine, birth control, hormones, pain management, etc, etc. The skin absorbs such things, they enter the bloodstream and have affects on physiological function that way. It's why bathing in bleach is a bad idea. It goes beyond the skin.

Topicals like even crappy icy hot _do_ actually affect an increase in circulation, which is why the warming/cooling sensation happens - dilation of the skin's capillaries in response to a substance such as menthol or camphor oil.


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## jjz (Feb 14, 2012)

I went to dagmar, left this morning as its only 45 minutes away so my mom didnt mind driving me and my brother. 

Had a good time, conditions were nice, no pow, it seems as if whereas in toronto we got 15 cm, they only got 5 (their website claimed 10), but it was good conditions anyway. 

Didnt fall on my shoulder or arm once, had one semi hard fall on my tailbone off an awkward box but thats just the usual soreness.

Overall i was very happy with my shoulders response, as it only bothered me once but not too bad.


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