Cortisone Shoulder Injection Advice

Hi everyone

To try and put a long story briefly, I've had a long lasting shoulder pain in the front of my shoulder for 2 years which occurred in the gym and I have
had various diagnoses:

-One physio said it was infraspinatus issues and to self massage
-Another said bicep tendon injury
-Another said scapula winging

All diagnoses and subsequent rehab programmes failed to help, apart from the first one (more later), in fact the subscapularis work from the third
physio hurt me more than helped me!
I saw a doctor at uni and he thinks I have an impingement of the supraspinatus, so wants to give me the cortisone injection.
Now this sounds good but I have a few questions that are playing on my mind and my appointment is a few days away.

When I laterally raise my arm, I do get the classic pain of impingement. However if I then self massage the infraspinatus with a hard ball against a wall
and then repeat the arm raise, it seems that the pain is pretty much gone and strangely returns later on. This being said, will the cortisone still help?
Is the issue with the infraspinatus? I do get pain on both left and right sides around the infraspinatus region, and both hurt the front of my shoulder
when pressed on - but only the right shoulder is noticeable after doing upper body exercises.

Hoping for advice here, because all my doctor said about the infraspinatus pain was that it was some sort of "strain pattern". I only found the above out
tonight, after my appointment so I couldn't ask. Even if I did ask, despite him being very good, I imagine he'd shrug it off.

I'm not sure if it would help to know but I also have right wrist, both hips and right knee pain.

Many thanks, I appreciate any input!

Matthew

Just to further this, it specifically hurts my shoulder when doing things like lat pulldowns, seated back rows and chest exercises.
With the back rows, it hurts when I pull back beyond the plane of my body - would this suggest infraspinatus?

shoulders are difficult when seeing them so appreciate this is to stimulate discussion. first with the history of wrist pain, did it come on around same time, or was it there before shoulder injury - eihter way though you need to have your neck assessed and also the neural tension in the upper limb to see if this is compromised. with the pain being there so long it is likely to be contributing.

also you may have an anterior subluxing shoulder, or some such instability, and/or you may have an inflammed rotator cuff tendon, without examining you impossible to tell. have you had an ultrasound scan? i would strongly recommend if they are considering cortisone (which is in my opinion good option if for the right reasons) they do one and also inject under its guidance so they insure 1) there is inflammation and/or small that they are targetting and 2) that they hit it when injecting and not miss which they may do if they inject 'blindly'. sort of also acts as good differential diagnosis tool, as they can confidently tick it off it it doesnt work. make sense? talk it over with your physio

also rehab still paramount to strengthen and stabilise the scapular and shoulder especially rotator cuff and serratus ex.

good luck

Quote:

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Originally Posted by GrantP

shoulders are difficult when seeing them so appreciate this is to stimulate discussion. first with the history of wrist pain, did it come on around same time, or was it there before shoulder injury - eihter way though you need to have your neck assessed and also the neural tension in the upper limb to see if this is compromised. with the pain being there so long it is likely to be contributing.

also you may have an anterior subluxing shoulder, or some such instability, and/or you may have an inflammed rotator cuff tendon, without examining you impossible to tell. have you had an ultrasound scan? i would strongly recommend if they are considering cortisone (which is in my opinion good option if for the right reasons) they do one and also inject under its guidance so they insure 1) there is inflammation and/or small that they are targetting and 2) that they hit it when injecting and not miss which they may do if they inject 'blindly'. sort of also acts as good differential diagnosis tool, as they can confidently tick it off it it doesnt work. make sense? talk it over with your physio

also rehab still paramount to strengthen and stabilise the scapular and shoulder especially rotator cuff and serratus ex.

good luck

---

Hey, many thanks for your input.
The wrist had been sore for years prior to the shoulder. I once dived for a ball at a penalty, the taker hit it very hard and it bent my wrist far back. This is the single wrist trauma that I can remember, could it have caused pain years later aswell as at the present?
The doctor did check my shoulder stability by pulling it in various directions - I assume he would of found anterior subluxation?
I have not had a scan, I had a 20 minute appointment with the doctor where I told him my history and he assessed physically.
From the sounds of it, I think he may be injected blindly. He simply said it will be a quick thing over and done with in 5 minutes.

Currently I do not have a physio, would it be advisable to ask the doctor to refer me?

Once again many thanks.

wrist, has it been continually sore for years or just worse now since this shoulder injury?
good thatdr checked for obvious instability - it may be acive instability, ie when you are using your arm at extremes, such as rows that cause problem rather than just when at rest in the drs office.
my opinion, US scan and inject under guidance into what they see at time and not do blind.
yes definetly see a physio!
good luck

Quote:

---

Originally Posted by GrantP

wrist, has it been continually sore for years or just worse now since this shoulder injury?
good thatdr checked for obvious instability - it may be acive instability, ie when you are using your arm at extremes, such as rows that cause problem rather than just when at rest in the drs office.
my opinion, US scan and inject under guidance into what they see at time and not do blind.
yes definetly see a physio!
good luck

---

The wrist comes on every now and then, with pain on my pinky side on the top of my arm.
Certain random actions bring pain on such as squeezing a bottle of ketchup, holding a pan by the handle and then general computer use can hurt it.
Thanks for your advice, it's much appreciated.
I'd like to ask one more thing: when exercising upper body I squeeze my shoulder blades together during the exercise, is this wrong? I don't know why I do it, I must of been told to a long time ago.

I just noticed that if I sit at a table, with my elbows about 20 cm from my body, then my right shoulder feels like it is partially dislocating. It clunks forward and I can clunk it back.

Is this out of the ordinary? Can I do any exercises to prevent it? I'm tempted to go and see the university physio again with some questions.
Just making a few connections, I had clunking when exercising upper body, could this of led to the inflammation and hence the pain?

Just to confirm: I feel no clunking/partial dislocation in the left shoulder when I place it in the same position.