Sub Acromial Bursitis (Secondary Tendonitis) Shoulder

[newyorker]

Hi,

I had some shoulder pain and (foolishly) played golf with it for a couple of weeks. One day after some range practice and 18 holes it was too sore to carry on and I got to the stage when even lifting my arm was a struggle.

I made a docs appointment and was diagnosed with shoulder tendonitis, with the advice to rest for a couple of weeks and take Diclofenac. I rested for 3 weeks with little improvement and saw a physio who diagnosed Acute Subacromial Bursitis (Secondary Tendonitis) in my left shoulder.

I have been having physio every 2 weeks, using the bands to strengthen and stretching exercises and the improvement has been gradual but unbelievably slow. I hit 50 balls about 6 weeks ago but the day after I was sore again, it probably set me back about a month regarding rehabilitation. This was the wrong thing to do, and I’d obviously returned too early but we were on a golfing weekend away and thought I’d give it a go.

The question is, how long normally should tendonitis last? It’s 21 weeks this weekend since I first injured it and my physio reckons I’m at least 3 weeks away still!!!

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[elinwee]

Hi,

There is no definitive answer as to how long tendonitis should last. It depends on what the contributing factors to the shoulder pain/ problem (in your case, it seems to be both the bursa and the tendon).

It sounds that you are on the right track with the shoulder rehab, with your theraband and stretching exercises. As a clinician, I usually go by the very rough time frame of a 3-month trial of conservative treatment. If there is no response, or the response is slow, then I start looking for other causes of the problem (ie, my initial thinking was not correct and hence the treatment wasnt effective), or if I was sure of my original diagnosis, then perhaps that the patient wasnt going to respond to conservative treatment.

The questions I may raise in regards to what you have written above are:

1. In your rehab so far, how much improvement and progress do you think you have made? Have specific answers such as "I couldnt lift my arm past 90 deg 3 months ago but now I can lift it to 120 deg" and an overall percentage score for improvement for eg, "I think I am 70% better now than first injury", then think about what the 30% lacking is. This gives you an idea if you think you are heading the right direction with your conservative treatment.

2. What other information can I get about my injury. Have you had XRays, ultrasound scans done to determine the extent of your injury? This may help to shed light on why you havent responded to rehab the way you would have liked to.

I have to stress - do think about the above 2 points in consultation with your physio or health care provider. Since they know your history, they would be the best people to assist you in your decision-making and information-gathering.

Gotta run - late for work! Hope this helps.

[alophysio]

I agree with elin wee... what examinations have been done on your shoulder.

For example, if you have a tear in there, it might aggravate the pain whenever you use it and not really get much better.

21 weeks is way too long.

I think 3 months is long - i am a fan of seeing improvement (not necessarily complete recovery) in 6 weeks. Otherwise my patients get sent to the orthopod.

Find someone who is more proactive. I think you know in yourself what you need, perhaps you are looking for permission to go look for answers? I get the feeling you feel more should be done about your shoulder. I agree - i would start at an U/S scan or MRI.

Cheers

[newyorker]

Firstly, thanks for your replies and advice, it's really appreciated.

I also think that 21 weeks seems too long for tendonitis, as I have completely rested (as regards the initial cause of the injury) and undertaken exactly what my physio has told me.

I am going to return to my doctor/GP and ask if I can be sent for an MRI scan as the injury is obviously not clearing up as quickly as it should be

I'll post back my findings from the scan.

Thanks again

[alophysio]

good luck newyorker. Let us know what happens!

[elinwee]

Good luck! Keep us posted.