Shoulder bursitis? Doctor suggested PRP as alternative therapy Shoulder bursitis? Doctor suggested PRP as alternative therapy

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Thread: Shoulder bursitis? Doctor suggested PRP as alternative therapy

  1. #1
    Join Date
    Feb 2019
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    Default Shoulder bursitis? Doctor suggested PRP as alternative therapy

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    Hi Rip,

    I am a 31 year old male, and I have been struggling with a shoulder issue for the last 6 weeks. I have tried to power through it, but ultimately, that strategy failed. I took 2 weeks off, but that didn't help either.

    A bit of history - I had a subluxation (shoulder popped out of its socket briefly and went back in) in the same shoulder almost 3 years ago, but haven't had an episode since. I had an MRI shortly after the subluxation, and luckily enough, my labrum is intact.

    Fast forward until now, over the last 6 weeks, I have gotten two surgeon's opinions - one who wants to do surgery or a cortisone inject, and the other who has recommended physical therapy and PRP.

    I have full range of motion, but I have a sharp pain in the front of my shoulder whenever I press overhead - this is most prominent when I am lowering the bar, and getting ready to press again.

    I had an MRI (3T without contrast) a few days ago and here are the findings:
    • Acromion is of type 3 hooked, the most anterior portion of the acromion has a hooked shape.
    • Mild lateral sloping of the acromion
    • No significant A-C osteoarthritis
    • There is minimal increased signal intensity of the distal supraspinatous tendon with no tendon tear, keeping with tendinosis
    • Localised cystic collection measuring 8.6 x 8.1 x 8.8 mm, located in the subacromial bursa, indenting the proximal supraspinatous tendon
    • Minimal fluid in the subscapularis bursa
    • Normal glenohumeral synovial recesses
    • Normal infraspinatus and subscapularis tendons and muscles
    • Normal long head of biceps tendon with no evidence of tendinitis
    • Glenoid labrum is normal in signal and appears intact
    • Normal marrow signal intensity

    Impression
    • Lateral stopping of the acromion
    • Minimal tendinosis of the supraspinatous tendon
    • Loculated cyst in the subacromial bursa, indenting the proximal supraspinatous tendon
    • Minimal fluid in the subscapularis bursa

    My questions are:

    1. What rehab approach do you recommend?
    2. Should I ramp up the NSAIDs? I have been taking them sporadically (when I'm in pain) until now
    3. Is PRP worth a try?

    Thanks Rip.

  2. #2
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    What surgery does he want to perform? A simple Mumford procedure?

  3. #3
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    Quote Originally Posted by Mark Rippetoe View Post
    What surgery does he want to perform? A simple Mumford procedure?
    A subacromial decompression, also known as an acromioplasty.

  4. #4
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    An osteophyte will eventually chop a hole in your cuff tendon, but the surgery is not much fun. I'd wait as long as possible, and make sure your form is correct on your presses. Post a press video. Change to a close-grip bench too.

  5. #5
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    Iím curious to hear your opinion on PRP, Rip. Specifically, if you believe it is effective in speeding up reabsorbtion, or if it can help heal a herniated disc by some other mechanism?

  6. #6
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    I really haven't looked into it, but I don't know anybody who says it helped them.

  7. #7
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    I know two guys who had success with it for long term chronic shoulder pain. Not sure on the specifics of their injuries, but they swear it worked.

    I havenít met anyone who has had it done for a disc herniation.

  8. #8
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    At any rate, NEVER get a cortisone shot in your shoulder.

  9. #9
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    Feb 2019
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    Will do, Rip. I'll post a video of my pressing forum when I'm in the gym next.

    The cortisone shot is one thing I'm not considering at all.

    I live in Dubai and doctors here are generally very quick to recommend surgery because of how easy insurance approves it.

    For now, my plan is to press light everyday for 3 sets of high reps, gradually increasing the weight / reps, and supplementing with 3 sets of chin ups on the lat machine.

    I will bench 3 times a week.

    Hot / cold therapy on the shoulder after each workout.

    Does that work, Rip?

  10. #10
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    starting strength coach development program
    Seems like Rip moved this thread.

    Chris, if you don't mind, does this approach look okay to you?

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