By Joshua Tucker

Left Shoulder Surgery And Pain After Car Accident, Trying To Stay Active

by Michael
(Richmond, KY USA)


I need some help. May 2007, I was struck head-on by another vehicle while being on-duty at 90 mph (mine was 12 mph, his was 78 mph. I have a tremendously high tolerance for pain and was forced to go to the ER.

I was released to go back to work 1 week later.

After 1 year, I was forced by my employer to seek an advanced medical evaluation. Followiwng that eval, I had left shoulder surgery (torn labrum-removal w/debrisment) and after another 9 months, had a tendon re-attached in my left elbow, diagnosed w/lateral epicondilitis.

Another year went by, I had another left shoulder surgery on 09-2009(torn labrum-repair w/debrisment & 2-3 anchors, along w/ about 10-15 bone spurs removed. I have been off work since Sept. 22 and in addition to my continued shoulder pain, burning, & weakness, my left forearm continues to KILL me. I have taken two different anti-inflammatory meds, Percocet 10mg (Lord knows I hate them so I weaned myself from them) & am currently on Tramadol 50 mg, Mobic, & Skelaxin.

I am wearing a generic tennis elbow strap that seems to work 25%-35% of the time.

I don't know how much longer I can stand being off work, in addition to the meds seem to just Band-Aid the problem but don't seem to help.

I was in the EMS field prior to my 13 year police career & my wife is a Nurse Practitioner so I have SOME medical knowledge. I had a Cortisone shot in left shoulder and left elbow over a year ago & had no noticed improvement/relief.

My doctor wants to do another elbow cortisone shot & I'm reluctant. Any words to help me out in what to do to fix it all (shoulder, elbow, therapy, devices, surgery, plasma injections)or am I done from my police career & extra hard work.

I am a very active man, ran the drug K9 Unit for 9 years, am a natural country boy so I get rough, work hard, & always go 125%.

Now, just 75% hurts & as I get older. My pain tolerance is weakening from dealing with this so long plus being 35, my body is not 25 again so my strength is going.

I love to do heavy weight lifting & that, along w/my career just seem like they're leaving me & are to painful to continue to pursue.

Please give me some guidance & share your opinion of the situation, as well as any options I can speak to my doctor about.


----



Joshua Answers:


Hi Michael.

I hear ya. And I can relate a bit, to an extent that I'm 37 now with a collection of various injuries.

I'm sure you're at the point where you are starting to get the truth of 'Youth is WASTED on the young'.

Anyhoo.

So here's the predictable future if it continues to go like this. More pain, less activity, older, more pain, less activity, repeat.

Which includes doctors wanting to do more surgery and prescribe you more drugs under the pretense of 'this will work'.

I think you know that it won't, and you see the trend.

You're a high activity kind of guy. Your body got smashed. You tried to tough it out, but the body can only do so much. This is a case where the mind is NOT stronger than the flesh.



The question becomes not 'how to get back to 100%', but 'How do I lower my pain, and keep it low'.

Maybe you can get to zero pain, we'll see. I don't know enough yet to predict.

I suspect that with the right work, you can drop your pain levels significantly, up your activity levels significantly, and then learn how to do self care to keep yourself with minimal pain.

I suspect that it will take a certain amount of ongoing maintenance, but you'll get efficient at it.

From a Tendonitis perspective, let's consider that you have a Tendonitis dynamic ALL OVER. Upper body at least, as everything tightens up and gets dry and crunchy

I'm going to ask you a bunch of questions at some point here, but let me talk for a minute first.


The following sounds like orders/directions, however, these are only suggestions.

1. Drop the tennis elbow splint/sling. I might hear something from my questions that has me change that suggestion, but in general, immobility is bad.

2. Painkillers only as needed. Short term only starting now.

3. Anti-inflammatories won't help you heal. If they reduce pain some, fine.

4. Muscle relaxants. If you notice benefit, ok. I rarely hear someone they say they helped. They certainly haven't helped me (I almost drowned in the hot tub once though, and got into a fight with a physical therapist that I totally don't remember:)

5. Corticosteroid Injections.
They don't deal with the source of the problem. Personally, I don't like them, I think they are more dangerous than they are worth, and I wouldn't bother because they just don't seem to be effective.

6. Long story short: big strong guy --> major injury to shoulder and whiplash etc --> Severe Process of Inflammation --> big time Pain Causing Dynamic --> more pain, more tightness, more pain, etc --> body tries to compensate but loses, surgery --> more pain, more tightness, more pain, etc.



Questions:

1. Describe the accident in detail. It sounds bad. Did you go through a windshield, have an air bag, smack your head or shoulder on something, etc.

2. Where all did you hurt for the next 6-12 months? Neck? Shoulder? Back? Etc. (pretend you're not a tough guy. Where did it hurt)

3. What hurts now other than the shoulder?

4. What is tight now other than shoulder?

5. What exactly can you do/can't do with your shoulder?

6. Full range of motion with your neck?

7. Can you go for a jog? If so, does it irritate pain levels?

8. Describe normal daily pain levels. Up and down? Constant? Hurts at night? Worse in am or pm, etc.

9. Can you actually lift heavy weights now?

10. What's your diet look like?

11. Anything else interesting for me to know?





Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Dec 30, 2009
PART 2 - Reply back to questions - Left Shoulder Surgery And Pain After Car Accident, Trying To Stay Active
by: Michael

I am 6'11" in height, 245 pounds, eat a fairly good diet and was on a pretty good exercise routine when the collision occurred.

Daily I ran 2.5 miles & went to the gym for heavy weights 2-3 times a week.

Now, to answer your questions in order. 1)HMay 12. 2007 a head-on collision at 78 mph, I held steering wheel & bent it doubled on both sides, both vehicles erupted in flames.

I had dual front air bag deployment, no windshield contact, was wearing seat belt, and had body armor on. I was pinned in by steering wheen on my legs (no injury there).

Freed by mechanical means, & after my K9 partner was moved, went to ER. Initial diagnosis, sprained left ankle (was never hurt, no injury, not sore since).

Left shoulder burned & had a bad burning ache/hurt pretty much 24-7 and was about a 5 or 6 on a 1-10 scale w/10 being the most painfufl.

2)Within 1 week, pain was down through entire left arm w/lots of pain in left lateral epicondilitis area. Numbness was moderate, neck got to hurting a few months later on full time basis, headaches 2-3 times a week which meds didn't phase.

3)Left shoulder front, back, sides, upper & middle of left side of back,neck from shoulder to earlobe, outside of bicep area just below point of shoulder muscle, left elbow top & bottom, numbness in left pinky & ring finger that I would call slight to moderate.

4)Shoulder, shoulder blade, neck, left chest(pec). bicep, tricep, & forearm.

5)No moderate or heavy lifting, can't lift my younger children, can't lift arm over shoulder level, the closer I hold an object the more of a chance I have to lift it

6)Pretty much, just really tight when I go to extreme right

7)I have tried to jog & treadmill so many times , both HURT. Bouncing hurts the shoulder BAD.

8)For last several months, pain levels up & down. For last several weeks pain constant, worse in am. If I sleep on it 20-30 minutes, I hurt all night & half of next day worse than usual.


(CONTINUED IN PART 3)

Dec 31, 2009
PART 3 - Left Shoulder Surgery And Pain After Car Accident, Trying To Stay Active
by: Michael

(CONTINUED FROM PART 2)


9)Weights off limits per doctors orders. PT has started light bands but not over 5 pounds.

10)2-3 cups of coffee for bkfst, average lunch, healthy dinner w/lots of veggies. I consume no less than 15 one litre bottles of water daily, I love water. 1 sometimes 2 pops a day.

11) Tried to support myself in upright push-up position, HURTS./INTOLERABLE Lay on left side supported by left elbow, HURTS BAD/VERY INTOLERABLE. Placing arm around wife while on couch, painful/tolerable.

Much like your opinion on meds, here is mine. Cortisone is a waste, Skelaxin doesn't help, Mobic doesn'thelp, Tramadol in am (50mgx2) and in pm (50mgx2) seems to slightly ease edge off pain to be tolerable.

If it's real bad, I still have the old reliable Percocet 10's which I hate but keep for a rainy day. Ambien, 1 works to relax me as long as I am in average pain, doesn't touch me if I am really hurting. Pain averages a 7 to 8 daily now.

I appreciate your quick initial response, please continue your responses.

Thank you.

Anything helps.


Dec 31, 2009
PART 4 - Left Shoulder Surgery And Pain After Car Accident, Trying To Stay Active
by: The Tendonitis Expert

Hi Michael. Lots of info, thanks that saves a lot of back and forth.

1. Holy crap. Sounds like you're lucky to be alive. Dare I ask about the dog?

2. All of that, and they diagnosed you with a sprained left ankle? WTF?? That's kind of funny.

3. Ok, so.

3a. You have a serious case of whiplash. This doesn't just go away on it's own.

3b. Other muscles connected to neck/collar bone/shoulder structures are involved in the whiplash - tight, spastic, panicked.

3c. I would need to hear more about the actual shoulder injury/surgery. The left got burnt, and impacted? Or did the bending the steering wheel push/injure the shoulder out backwards?

You have major shoulder injury, so that's playing a role (obviously) in the nervous system clamping everything down.

3d. I need to know more about the tendon re-attachment in the elbow. Ultimately I'm not to worried about the forearm/elbow, because that's easy to get to, so easy to deal with.

Unless the tendon at the elbow was seriously ripped/torn, I wish you hadn't gotten the reattachment.


SO.

1. Tell me more about the elbow/elbow surgery. Who what how why when?

I think I'm good on the shoulder surgery.


2. Do you have a cold body of water around? unheated pool, unheated hot tub sized thing, lake, etc?

3. I'm just going to mention this and then say more later.

EAT BREAKFAST. I won't tell you to drop the coffee (nervous system stimulant) but add in some calories and protein. You aren't eating enough protein.


Sorry, this response wasn't very well organized, so work with me here...




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