Reply With QuoteCan you post his actual medical report so we can see what is actually going on?
Member
Bony Shoulder Impingement
I have searched the forums but can't find anyone with a similar case. 10 years ago, my husband wrecked on his dirt bike from the top of a table top jump. He fell directly on his left shoulder which caused extreme nerve damage and a mess of other issues. Because of this, he cannot lift his left shoulder above about 60 degrees and does not have full rotation. The only way he can get that arm above his head is if he uses his other arm to get it up there and then prop it up on something to support it. He cannot raise it on it's own. He has seen a specialist at UW who said surgery would be a waste of time. Because of the extent of the damage, "it is what it is." He has also seen a PT and a men's health/sports doctor who reported the same. I have him doing safety bar squats because he doesn't have the ability to rotate his shoulder to do a low bar squat. My main concern is missing out on the OHP. What is there that can substitute for the OHP that doesn't require lifting overhead? I have him doing landmine presses but not sure if they're super effective. He is doing some mobility stuff around his pecs and lats to maybe help gain a little flexibility in the shoulder, but he'll never be able to lift it above his head unassisted. Unless someone knows how to make bones mobile LOL
TMPHBITEU
Can you post his actual medical report so we can see what is actually going on?
Member
I know he had the hospital forward the records to his men’s health doc. I’ll see if I can get my hands on them. I’ll also check and see if the doc has provided a write up from his visit on Friday.Originally Posted by Mark Rippetoe
I don't see a way to attach a PDF. How do I go about sending the records?
TMPHBITEU
Just type it in. Take your time.
Member
Ok, I copied and pasted. This is just one page of many. This was back in May of 2014
SUBJECTIVE: Gary follows up for MRI results ofhis affected left shoulder. Please refer to prior clinic notes, but briefly, he is a pleasant 36-year-old gentleman who was involved in a motorcycle accident 9 months ago, I perfonned an arthroscopy in December of2013 where I found significant and considerable bone embedded within the posterior rotator cuff tendons. He has had considerable stiffness and dysfunction ofhis left shoulder with upper extremity activity, At any rate, he has gone for a repeat MRI for re-evaluation ofhis rotator cuff He still has considerable pain and dysfunction, mostly with overhead activity,
PHYSICAL EXAMINATION: Examination ofhis left shoulder is unchanged. He has limitations to about 90 degrees with forward elevation and abduction ofhis shoulder and he has notable and considerable exiernal rotation stiffness to about 25 degrees,
DIAGNOSTIC DATA: MRI results ofhis left shoulder confirms that he has considerable heterotopic ossification embedded within the infraspinatus and teres minor rotator cuff tendons, consistent with his trauma to his shoulder. The rotator cuff itselfis grossly intact without any evidence ofa full-thickness rotator cuff tear. There is a considerable impaction type injury on the lateral tuberosity ofhis humeral head. There is no evidence ofany degenerative arthritis. There is no fat atrophy ofthe supraspinatus or infraspinatus rotator cuff muscle bellies, There is a split within the long head ofthe biceps tendon suggestive ofa biceps tear.
ASSESSMENT AND PLAN: I had a thorough discussion with Gary. I think most ofhis pain, stiffness, and dysfunction is stemming from the heterotopic bone embedded within the teres minor and infraspinatus rotator cuff tendons, I was frank with him that I have really never seen this before from this s01i oftrauma, I think this is the root cause ofmost ofthe pain and dysfunction and lack ofmotion, I do suggest that he follow up with an 01ihopedist in Seattle, Dr. Matsen, regarding his shoulder. I think he may have something further to offer him surgically and I would like him to discuss those surgical options with this patient in particular. I did instruct Gary that he will certainly need his MRis as well as his arthroscopic pictures and the clinic notes here in anticipation ofa referral to Dr, Matsen, He was clear on the plan. He understands I am closing my practice and at this time there is no need for further followup.
TMPHBITEU
I think this is pretty clear. He needs to schedule with Dr. Matsen.
Member
He did. They just didn't give us those records. Dr. Matsen said that he COULD do surgery but the likelihood of it working was basically 0 so he felt no need to go in and do basically what would be exploratory surgery.
Here's what Dr. Dawson said when referring to Dr. Matsen:
I am hoping you could see Gary Wilson in regards to his left shoulder I have attached a clinic note from today1s visit, but briefly, Gary was involved in a motorcycle accident in September of 2013. I subsequently perfom1ed a left shoulder arthroscopy in which 1 found considerable bone embedded with his infraspinatus tendon. He has developed considerable heterotopic ossification within that tendon with notable limitations with his external rotation and any sort of forward elevation. He is wondering if anything can be done at this point. Frankly, this is outside of my area of expertise and competence. I did discuss possibility of excision of this heterotopic bone. However, with the notable defect this would leave, I am not comfortable with that treatment I am hoping that you have seen enough of this in your career that you might have something to offer Gary regarding his shoulder function and pain. I appreciate you seeing him and will get a referral in process shortly. He will be coming with all of his imaging, as well as arthroscopic photos from December of 2013.
TMPHBITEU
Then Matsen is not the right guy. How determined is he to have this revision procedure done?
Member
That's an excellent question. Trying to "fix" his shoulder was basically abandoned after the UW specialist said nothing could really be done. And he's lived with it for so long, I'm not sure he'd even consider having what would probably be experimental surgery. I guess that's a conversation we'll have to have along with "what do you want for dinner?"
Thanks a bunch, Rip. Appreciate all you guys do and yes....we all love "Comments from the Haters" but mostly because of your reactions/responses to
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