cortisone injection c5/6

Dear physio in (cyberspace),

I injured my shoulder 4 years ago and as a personal trainer and injured dancer I would be interested in your perspectives on how to 1) improve scapula mobility and 2) thoracic mobility 3) literature or advice based on your clinical experience on the benefits of cortisone injections near the nerve root (specificaly C5/6 if possible) vs conservative treatment.

History of injury
I sustained a rotator cuff injury on my right arm about 5 years ago and 12 months later I partially disclocated my shoulder. I have a suttle anterior instability which my physio believes that it is not the capsule itself but the muscles which are weak and unstable.

Initially with my injury, my sports doctor noted some scapula dumping which was corrected through scap stabilising exercises. My thoracic also does not move very well either and I am addressing this through pilates exercies.

In January 2010 I compressed the ulnar nerve which has affected my ability to use the computer for long periods of time and to type.

Strength program
I have been working on scapula stability for about 4 years now and have good strength (mainly compound based exercises, and theraband) . I am still quite weak with above the head movements and my strength it is taking longer than expected to progress with weights.

Constant flare ups
The Levator / infraspin constantly flares up or becomes irritable. My physio discovered that because I have poor scap mobility as in it doesn't glide very well with elevation, the neck muscles are strained and this causes the irritation
These issues are in part postural and think that I need to focus on core strength, and shoulder and neck positioning.


Because of the constant flare ups in levator and infraspinatus along with the nerve compression, my physio is recommending CT scan guided cortisone injection around the nerve root C5/6. I am hesitant because 1) it is invasive, 2) there is a possibility that it may not work and 3) his diagnosis may not be correct. Can anyone shed light on some potential options or considerations other than a cortisone?

Many thanks in advance.