Injury question

[UrbanCityCowboy]

So, 2019 hasn't been the best year for me. I'm not sure if this is related to a previous bike accident I had years back but I am currently suffering what seems to be bursitis. When I was 16 I had a really nasty accident when I was pedalling away minding my own business and when I went to go round a steep corner one of my tires blew and I got thrown off my bike. Had a serious case of road rash and I tweaked my shoulder. 2 months after that I came off my bike again and this time my shoulder went again. However, this time I couldn't move my head for about 3 weeks. Over the years I have had the odd twinge on the shoulder but nothing as bad as previous. Then, this year, I started having excruciating pain in the same shoulder again. I tried ignoring it for a while (I'm terrible for going to the doctors) but in the end I went to the docs and he arranged for an ultrasound. Except the waiting list was so long and by time I got an appointment I was starting to feel better so I (foolishly) cancelled it. Around about October the pain started coming back again and this time it was pretty bad. I was at the dentist one day and I could feel her messing with my teeth even with all the extra numbing agent because of the referred pain from my shoulder. A few days later I had a day when I had what I can only explain as the worlds worst headache followed the next day by a seizure (not sure if this is related to my shoulder or not). Since the seizure I continue to have pain going from my shoulder, up my neck and round my head constantly. So far I've had an EEG which proved I have a brain and it's working (thankfully) and an ultrasound on the shoulder which proves I have bursitis. Just waiting on some heart monitor thing and a head CT which I'm having done next week. Not sure if anybody has had what I've had but if there is anybody out there that has any advice on managing shoulder pain it would be much appreciated because I've been out of action for 3 months. I've been referred to physiotherapy but the waiting list is stupid. Anything I can do in the meantime can only help.

 

[Mikerb]

pretty common complaint especially if you have previously injured a shoulder and is usually due to the muscles around the shoulder becoming inflexible.....which again is not unusual in the winter due to cold/damp and a decrease in physical activity compared to spring and summer.
I sometimes suffer shoulder pain more especially in my left shoulder which I injured years a go.....and yes the pain can extend down my arm and also upwards around my neck and across the back of my head. I use inflammation gels plus a neoprene shoulder strap and some arm flexing/stretching exercises and can usually get back to normal in a couple of weeks. It does not stop me riding in fact it seems to help! Your physio will probably recommend a series of flexing and stretching exercises to loosen the muscles around the shoulder and hot/cold treatment to reduce the inflammation. You can of course do these yourself but try to avoid anything that causes pain, build slowly.

 

[steve_sordy]

Physios are cheaper than you think. Well, they were certainly a lot cheaper than I thought! If I waited 2-3 weeks until I could get to see my GP and then waited another 6-8 weeks to see a physio, and then another 6-8 weeks for the second appointment, I might be in as much pain and distress as you are now.

When I first went to see a physio about a banged up shoulder, about 5 months after the accident, the first thing she did was bollock me for waiting so long. She told me if I wait until the body has started to heal itself, it always takes the easiest route and often gets it wrong. You may be in less pain, but your movement is restricted and other stuff may not work well.

She fixed me. Now I go straight away, I don't bother waiting for the free GP and waiting some more for the free physio. I just pay and grin because I'll be well and riding my bike a lot faster. It is your health we are talking about here isn't it? It's worth making a few sacrifices for.

PS: Half the time of the first appointment will be spent on diagnosis. Your physio may discover that a ligament under your shoulder blade was trapped and you are getting referred pain elsewhere. Or it may be something completely different. YOU have no way to tell!

 

[Zimmerframe]

I've broken more bones in my first year of mtb(emtb) than I have in the rest of my life .. and I like to think I've lived it to the full .. So it's been a painful (smashing ???) .. but fun filled year .

For shoulder pain, or arm pain, I find much of it can be caused by other injuries causing contraction in various muscles, especially the pecs (chest), which then create pressure in the shoulder and the associated nerve bundles.

A good starting point is just lying on your back on the floor for 10 minutes and see how that goes. Then try to focus on the chest area with a tennis ball resting in a door frame and lean against it with various points in your chest, if you find a sore point, stick at it until the pain goes. This should, in theory, free things up. Then do what everyone else has said.

I might be wrong but @Jeff McD might have suggestions ?

 

[Pdoz]

You've injured your upper neck in the original accident - then when dentist had your neck tilted back / to the side and all the muscles in your upper neck / below your scalp are NOT happy .

Find a good physio who recognises this is a neck not a shoulder problem , plus fiddle around with different height pillows ( folded up towel underneath the usual one, decide each day if you go up / down etc ) . Be patient - it might get worse before getting better, but if you work with the physio it helps. I was surprised to get some relief from acupuncture , and know a couple of people who eventually needed botox +/- nerve stimulators but that's getting into pain specialist territory.

The bursitis is real but partly because you're holding that shoulder high / forward - because your neck us so tight. All the cortisone injections and physio will be a waste if you don't fix the neck.

On the bike, try a shorter stem / higher bar / possibly lower seat - little changes make a big difference. You're trying to avoid reaching forward +/- having to tilt your neck back.

good luck

NB if you start getting spinning +/- visual or swallowing changes ask your doc about vertebrobasilar insufficiency - you can test for this by tilting your neck back / to the side of the headache and seeing if you start feeling like chucking / dizzy etc - if you do, then it might be worth asking your doc about a contrast ct / mri to get a better look at the circulation where those vertebral arteries kink around c2.

 

[kafkastan]

What @steve_sordy said.

Obviously the NHS is generally amazing, but in my personal experience, when and how they opt for physiotherapy can be questionable. Get yourself ASAP to a private physio, and/or a decent sports massage therapist. In London and Brighton, I've generally paid £35-60 for 30-60 minute sessions. Obviously I know nothing about your finances, but if you're hanging around these parts, I reckon the cost of the private physio may be less your unused eMTB is depreciating!

My thing like yours #1:
- Neck pain causing brutal, occasionally utterly debilitating, headaches.
- GP suggested solution: painkillers, and more painkillers. Later suggested tests, but never did.
- Actual solution: Sports massge from small Korean chap called Kil-ho with thumb strength of a gorilla. Released tension in traps that was pressing on nerve. After months of headaches, and feeling increasingly miserable, I felt better after one session.
- Cost = maybe £35.

My thing like yours #2:
- Shoulder freezing up so badly that I couldn't raise my elbow more than a few inches from my side; probably bursitis.
- It was obviously really bad, so I went to a private physio within days. First physio did big bug eyes of horror when he saw my problem and referred me to a shoulder specialist - in the next-door office, the next day. She actually got it moving a little during the first session, but I did see her for maybe five sessions overall. However I was back cycling around two weeks after the injury.
- Cost = c£200.

Genetics, rather than any hard work, made me muscular - but I tend to stiffen up badly. These days, in my forties, I require a fair bit of maintenance to avoid muscular pain. I do yoga once or twice a week, and have a sports massage once a fortnight. I sense it may be time for your good self to start doing similar!

Best of luck with sorting yourself out!

 

[UrbanCityCowboy]

First of all thanks to everybody for getting in touch and sorry for taking so long to reply. It's been a tough time.
I ended up taking peoples advice and started seeing an osteopath. I've done a few sessions now. Turns out I have one leg longer than the other. Because of this it has caused a curvature in my spine at L5, L2 and C2. To the chap who mentioned C2 you were spot on. I've been to see 3 doctors. They all refuse to send me for a scan and all refuse to acknowledge its a neck problem. I'm now considering prolozone injections. Has anybody tried this before?

 

[steve_sordy]

@kafkastan suggested that you should consider Yoga or something similar. I was having lots of problems with back pain and followed the advice given in one of the MTB magazines where three specialists replied to a sports injury question. All three included Pilates in their answer as an ongoing regime to reduce/avoid similar problems. I signed up there and then and I have been going to a weekly session ever since Jan'09. One of the best things I ever did!

Pilates is good for balance, flexibility, and core strength. All of which are very beneficial to mtb. For something that doesn't get you all sweaty and with a girly reputation, it can be surprisingly difficult.

Apart from the obvious physical benefits, you will learn to control your farting! Firstly, it's no good slipping out a silent one, the ladies will always know it's you! I have lain there with my face turning purple trying to keep one in, but I'm much better at it now!

 

[GrahamPaul]

 

[steve_sordy]

The ladies always seemed much better at withholding than I ever was. Must have taken years of practice, probably since they became 16.