persistent shoulder tenderness/feeling of weakness

hi, i came across this website while doing research on how bicep tendons heal, and i was struck by the thoughtfulness of people's responses so i thought i'd try posting my current conditions and see what you guys think. i apologize for the long post. this injury's been pretty frustrating, and like you guys i'm trying to find out exactly what's wrong and the best possible treatment for it.


i broke my left humerus in January while climbing rope in army basic training (i didn't fall off the rope, my arm literally popped while i was still climbing). as a consequence of the fracture, i suffered nerve damage to my radial nerve resulting in severe nerve palsy in my forearm and hand. what made this injury frustrating and mysterious was that it occurred toward the end of basic training, and by then we were all used to climbing ropes (which we did once or twice a week throughout basic).

since then, i've been attending physical therapy, and through the care of my wonderful PT i've regained full range of motion in elbow and shoulder, as well as near full strength in muscle and nerve. however, a feeling of weakness and mild pain persists in my shoulder whenever i try to conduct motions involving pushing (like pushups or bench press). an MRI revealed a longitudinal tear in the long head of my bicep tendon (my orthopedic ruled out a labral tear through a very brief physical exam in which he had me extend my arm and pushed on it every which way, asking if i felt pain...basically told me to come back in a month or two if the situation doesn't improve).

through my PT regime, i have a strong rotator cuff and am continuing with shoulder strengthening exercises. i'm wondering how slowly/quickly tendons heal? is there anything else i can do to facilitate the recovery process?

Normally I would say that a tendon will heal in about 6 weeks, which I presume is what the orthopaedic specialist is thinking by leaving it a couple of months before re-assessment.

The long head of biceps has 2 functions. The first is obviously normally bicep contraction, but it also holds the humeral head up into the shoulder joint.

When you look in a mirror without a t-shirt on do your shoulders look symmetrical or can you describe the differences.

Also, how have you been training your rotator cuff? With what exercises?

hi karen, thanks for your response. my PT has had me doing everyday 3-4 sets of 15-20 reps, using a resistance band, of:

internal rotation
external rotation
arm rows
frontal pulldowns
lateral pulldowns

those are the core exercises, i've also been doing some wall pushups and human coffeetable on and off

the orthopedic doc i saw claims that my left shoulder is slightly higher than my right due to muscles compensating for its weakness (i couldn't really tell the difference looking at myself in the mirror).

i get some clicking/popping noises in my shoulder when i rotate my arm, but it's not as much as it used to be. i read somewhere that it could be the tendon sliding over a bony protrusion?

in the gym, my PT recommended lat pulldowns and bicep curls. i've even been able to do assisted pullups with no pain. it seems like my shoulder only hurts when i push/pull something heavy with my left arm toward or across my body (like pushups or pulling something from my right side with my left hand).

what mystifies me about this bicep tendon tear is that i've been in rehab for 8 months now. if it was just a tear, shouldn't it have already healed?

The clicking/popping noises are probably the tendon being tight that is flicking over a bone.

The core exercises are all well and good initially, but then you need to make them more specific. Your problems are push-ups and pulling accross the body, so strengthen up these two actions. Start with push-ups against the wall like you are doing but progress towards the floor then on knees and full length. Use the thereband to mimic the other exercise.

I would also work on some proprioception, ask your PT for some exercises.

I would have thought that a tear would have healed, but without seeing you I wouldn't want to say for definate.

Karen

hi
first of all doing strenthening training shoul be

4-8 reps with gradual loading,4-8 sets long breaks
or 4 sets with gradual loading 8-12reps short breaks,next 4 eccentrics long breaks.
u can in 1 month improve up to 100%.
but as karen said control and coordination are more important.
re healing proccess
physical therapy cold,hot laser etc can accelerate healing.
thanks

Hi
about tendon healing found in
"principles of neuromuskuloskeletal treatment and management"
in general
1-7 days inflammation phase
7-21 regeneration.
thanks
21-to 1 year maturation phase

thanks for everyone who's made suggestions! i've definitely seen significant improvements in my shoulder. the discomfort level has definitely declined, and i have been able to do more pushups pain free, as well as moving heavy boxes around the house in general. the cracking noises in my shoulder, however, have appeared to increase , not sure what to make of that.

have had a couple sessions with a professional rolfer who does cold laser therapy as well, which i think have helped in the recovery process. also started seeing an acupuncturist for the first time, im still kind of skeptical but im willing to try anything to get my arm/shoulder better