Joe A Shaw PA-C - 2/24/2011

Question
Hi,

I am a 25 year old caucasian male, weight 160 lbs, height 6 feet even.  I am an active mountaineer, trail runner, and climber.  I lift around 2-3 days a week and run about the same.

I have chronic left shoulder impingement.  I have full ROM and very flexible shoulder joints.  I have been to 2 physical therpaists, and am currently seeing a message therapist and chiropractor.  My shoulder pain never goes beyond 2-3 on a scale of 1-10 expect when I do something stupid and strain it.  When this happens I have a hard time with abduction, horizontal abduction, and internal rotation.  I usually have to sleep on my right side to keep from waking myself up.

It has been 5 years of this, and nothing seems to make it better.  It happened when I was rock climbing, I had my left arm high overhead, I was straining hard for a hold and suddenly I got a stinger.  My whole arm burned and siezed up.  It eventually relaxed and I didn't think much about it.  Over the years I have continually re-injured the shoulder by doing only mild things.  Just when I think I am being careful I will tweak it just slightly, but sure enough the next day it hurts and my mobility is lessened.  I am at the point now where I can't do any lifting overhead, I can't even do chest press.  My climbing is also seriosly effects.  9 months ago I could do push ups and pull ups, but I can't even do that.  The joint feels increasingly unstable.

I had an MRI about 6 months ago that came back with no major findings.  Also, it seems weird to have so many issues with no major effect on my active ROM.  While the pain isn't bad, its always there, and frankly I'm sick of it.  Is it time for me to see an orthopedic specialist and talk about surgery?  I have been putting it off for a while becuase I see it only as a last resort.  But my sports performance is being serisously effected.  Please advise!

Your help is much appreciated
-Jordan

Answer
Yes I would see a shoulder ortho..could try cortisone injection 1-2 x..probably need shoulder scoped for SAD subacromial Decompression procedure... very common cause of chronic impingement is build up of excessive bone from overuse etc.. encroaching on that space