So far, I've heard nothing I like. Let's start at the top: how did you aggravate the shoulder (we don't actually know it's bursitis)?
Member
Shoulder Bursitis
Mark,
It has been a while...
I've been back into jiu jitsu here for the past nine months... lost about 40 pounds, training down for tournaments, but I've managed to stay relatively strong.
So, I've got bursitis in my right shoulder. It took 3 weeks and 2 packs of prednisone to get it under control, and I'm back training again. It's possible that it will require either a cortisone shot or surgery, but I'm holding out until the new year when my deductible renews to start spending money on MRIs, etc...
Pressing is out of the question, at least with a bar and/or to full overhead extension. Push-ups and dips are also off the list.
Do you have any thoughts on things that I can do for my shoulders? The recommendations that my ortho' gave me were limited and mostly about the rotator cuff. To his credit, he did suggest getting the area as strong as possible, and he acknowledged that he is not the guy to give too much advice on that.
So far I've got... well, nothing. Maybe dumbell raises... they seem to not hurt it if I keep my arms out at about 45d as opposed to straight out from the shoulder or straight ahead.
Zach
TMPHBITEU
So far, I've heard nothing I like. Let's start at the top: how did you aggravate the shoulder (we don't actually know it's bursitis)?
✓ Member
This sounds a little like something that used to give me the miseries, although less so recently. Does it hurt in the front around the collarbone? If so, it could be the acromion joint. What brought it on, an arm bar or hammerlock? If you can pinpoint when and from what it might have begun.
Member
Land badly on your shoulder during a fall/takedown? That happened to me awhile back from a nasty tai-otoshi, and it took about 3 months to finally calm down. I couldn't even bench press the bar from the pain at the time...just took a long-ass time to heal.
Member
The injury appears to stem from overuse. Likely from doing too many push-ups... I doubt you remember, but I have a screw in my left wrist. The combined 12 months that I spent casted from injuries to my scaphoid left me unable to fully extend that wrist. So, push-ups (even with handles) tend to be rough on my shoulders. My right shoulder is always jammed up pretty tight.
I have also for years slept on that side and had occasional periods where I would have aching around the top of the deltoid that only switching sides could fix.
There was one odd event that may have contributed to the injury, but I can't clear in my head whether I was hurting before or after it... I seem to remember it just coming on over time. Anyway the event was in the beginning of a round in training. I was standing with a guy that has 20 pounds and 10 years on me, working for a takedown. I arm-dragged him and slipped to take his back, but he spun away very hard. I was facing his back with my arm fully extended. My forearm was trapped inside the bend of his elbow, and my thumb was pointed down. My elbow was locked out.... the force of his spin pulled me off of my feet for a split second.
The pain (after knocking out most of the inflammation) is centered at the top of my deltoid. Depending on where I place/rotate my arm, I can cause the pain to radiate through the AC joint or down my deltoid.
The doctor I have been seeing seems legit as far as I can tell. He has been willing to examine a number of times without an MRI, being sympathetic of my situation. However, he won't go with a cortisone shot unless he sees an MRI. Assuming that the problem is still there in January (a safe assumption it seems), I will go ahead and get an MRI. It just doesn't make sense for me to spend that money now, when I'm nowhere near spending my deductible, and the year is almost up. So, a lot of time spent in the doc's office doing physical examination and watching my progress on the prednisone brought on the opinion.
TMPHBITEU
First, prednisone is reserved (everywhere but North Texas) for serious shit like brain swelling. It is stupid to use it for orthopedic inflammation when an NSAID will work because it is so systemically catabolic. Second, why so damn many pushups? I thought you were a lifter, training for strength. Were you pressing at the time? Third, if you let this guy give you a cortisone shot in the subacromial compartment, I don't want to hear about that shoulder ever again. I'm telling you, DON'T DO THAT. There is a weight you can press, and there is a lat machine you can simulate a chin on. Start light and go up with presses and chins for sets of 20. If it still feels like shit in January, get the MRI, because if it does you will need a definitive diagnosis.
Member
Hmmm... I see so much prednisone thrown around here that it's surprising to hear that opinion. You know I value it, so I'm going to dig into that some more. We've had to run our 3-year-old through at least 4 or 5 courses when he was having severe allergic reactions. Of course, we're talking throat swelling shut or emergency-room asthma attacks.
The doctor seemed as leery as you are of the cortisone shot. I was at one point sorely tempted to go to a doc-n-a-box that is famous for giving them out, but I decided against it.
I was pressing once a week before it got really bad. Pressing, of course, made it feel better immediately but worse the next day... is that dopamine response or something else? I can't remember. Anyway, I haven't consistently lifted with progress for about 6 months. My lifting has been sporadic, though none of my lifts has suffered dramatically, with the exception of my deadlift... though, that had been a primary focus before I started back into jiu jitsu and had a lot to do with the weight I was carrying.
I've been training jiu jitsu 5 days a week and focusing much of my remaining time (after kids, wife, work) on my studies. I've come close to canceling my membership at MetroFlex a few times, but I just can't bring myself to do it.
I'm coming up on the last semester of my AAS and a belt promotion, and I plan to work a little less (busy season = more money for less time). So, I shouldn't have a problem putting in 2 solid workouts at the gym. I also have 3, 30 to 45-minute slots where I'm watching my 5-year-old train jiu jitsu, and we've been putting together some rudimentary equipment at the academy.
The push-ups are my own stupid fault. Doing 100 after every class is like a religion in most martial arts, and I had to keep up... now I have a good reason to just not dot it.
Member
Mark, can you elucidate on the dangers of cortisone. I've noticed that you have vehemently disuaded several posters from using cortisone for shoulder injuries. I'm assuming your advice holds true for the body's other joints: knees, back, etc. I understand that it is a catabolic substance and can cause tissue wasting, but there seems to be a lot of conflicting information about it's usefullness. In what circumstances would it be useful?Originally Posted by Mark Rippetoe
Starting Strength Coach
For the life of me, I don't understand why orthopods still do this shit. The literature demonstrating that it's a waste of a needle is at least ten years old.
TMPHBITEU
Because they can charge for it. I know that's horribly cynical, but like Sully says, it doesn't work, and it fucks up more good tissue than it wastes bad tissue. Shotgun for a fly, perhaps. I'll ask Stef to post about the prednisone, but she's obviously very busy.
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