UKC

I've injured my right shoulder about 6 months ago gradually whilst training indoors over the winter. The front part (roughly the region where where the biceps heads connect to the rotator cuff) hurts when stretching my arm to the extreme end straight to the top (like when you stretch for a pull up or hang straight off your arm) and also when angling it backwards at 90 degrees (like you would hold it when playing pool). 

I've rested it, used ice, have taken NSAIDs (naproxen) for over 3 months, and had 2 steroid injections - and it's only gotten worse. I had two ultrasounds: the first resulting in the physio saying he can't see anything and I'm probably just a bit too flexible; the second where a different physio said he sees a slightly inflamed bursa (hence another steroid injection, ultrasound-guided this time). I've rested the shoulder and not climbed, and have done physio exercises as instructed by each different physio I've seen. I'm on an NHS waiting list to see an NHS physio, but that won't be for another 6 months (I'm probably quite far down any priority list as an office worker).

Does anyone know a good surgeon/shoulder specialist (using visual scanning techniques for diagnosis, auch as ultrasound or MRI) who could help? I'm getting a bit desperate as nothing seems to be working despite following treatment plans religiously and I'd really appreciate suggestions from the community for good physios/surgeons or people saying what they've done if they had similar problems.

Thanks in advance!

I have a similar problem with my left shoulder, and I'm wondering whether a CT scan may be more useful than US. I know that ultrasounding canine shoulders is difficult, and I suspect that a number of less experienced ultrasonographers are not truly familiar with the shoulder, and consequently cannot glean much from the exercise.

Possibly it is involving enthesiophytes (mineralised soft tissue around the joint. Like osteophytes only not directly conjoined to the bone), and hopefully they would show up on a CT scan. If they are present, I believe that surgery can excise them, but am not certain of circumstances.

You could try getting a referral to Tim Cresswell at the Pulvertaft Hand Centre at Royal Derby. He’s a climber and also specialises in shoulder operations. 

First of all, don't bother with an NHS physio. You won't get anything out of it. Private physios don't cost that much.

Ultrasound is only useful if it's someone familiar with the structures they are inspecting.

If you are anywhere near Sheffield, and do want to go the physio route, I'd suggest you pay James Walker a Sheffield Climbing Clinic a visit. He's a top tier physio and does diagnostic ultrasound.

I don't think you've said where you are based, but if you want shoulder specialist suggestions around Manchester let me know.

On your specific symptoms, the pain with your arm 90deg behind you is similar to one of the symptoms I had (e.g. I couldn't reach behind my back to tuck a shirt in) due to a SLAP tear (type 4) that extended down into the long head bicep tendon.  This was picked up via the consultant requesting an MRI after some private physio sessions had failed to alleviate the symptoms and pain.

Currently 10wks post op following a biceps tenodesis.

If you are based anywhere near Manchester I’d suggest going to The Arm Clinic at The Wilmslow Hospital as they specialise in shoulders and have a number of excellent surgeons. 

Where are you based?  I had similar issues, NSAIDs, lots of physios, rest, acupuncture, trying to get seen on the NHS was a nightmare... the list goes on.  It took me a couple of years chasing until I got to get a good diagnosis; I went private and had a few rounds of injections into the bursa and AC joint area before getting surgery.  

Seeing a shoulder surgeon was the best thing I did (Bristol, Mr Packham), he knew shoulders better than any physio I'd seen, it wasn't rotator cuff for me in the end, it was muscle rubbing on bone causing inflammation, which then became more inflamed and the cycle continued. 

I had an MRI, which showed it wasn't rotator cuff, then subacromial decompression surgery (shaving a bit of bone off). I was climbing easy climbs within 8 weeks, and leading my normal grade (albeit a little slower and carefully still) in 12 weeks or so.   

Luckily for me I had health insurance, however if I hadn't had health insurance and if I had known the cost (approx £3.5k) for the surgery I would have probably paid it myself as 2 or 3 years of pain and waiting on the NHS isn't worth it (obviously circumstances for other are different but the pain and mental health suffering as a result of my injury took its toll). 

Feel free to DM me if you want to chat any more. 
​​​

According to a number of climbers who've had shoulder surgery (some I know personally and some anecdotally) Lennard Funk is the man if you're Manchester way and going down the surgery route.

https://www.shoulderdoc.co.uk/article/240

I've heard he also does NHS work but I can't be certian of that...

Val Jones is a renowned Shoulder physio based in Sheffield and if you can get to see her it might be an idea - she's an advocate for non-surgical measures for things like SLAP tears and I saw her privately when I did mine (complex SLAP tear - possibly 360degrees - diagnosed via MRI Arthrogram - on the NHS I add).

https://oryon.co.uk/develop/speaker/val-jones/

I tore my labrum dropping onto an extended arm in 2020 and opted for non-surgical measures (on Val and other's advice - and against my surgeon's wishes) as I still had full ROM (had climbed 7b a week or so before diagnosis!) and while there's a definite weakness in that shoulder I am religious with doing my theraband and scapula strengthning work before any climbing session , on the whole I'd say I can pretty much climb as normal (I tend to favour not too steep, fingery routes anyways)... The caveat here is that it could all go belly up one day, but if it does then I can always go for the surgery. 

Guys, I can't tell you how helpful it has been hearing all your suggestions!! Thanks so much for all your great advice and help. It has been really helpful hearing the personal stories and how you've all got/are getting better! Fingers crossed for speedy recoveries all round.

I indeed forgot to mention I'm based in the South West, but am willing to travel for good medical advice (totally agree with the mental health aspect here ...). 

It seems like the best thing to do is get an MRI to actually get to the root of what's going on. I'll get on touch with Mr Peckham in Bristol, but I'll keep the great suggestions for Manchester and Sheffield in the back pocket, as there's an office I can work from if needed! 

Massive thanks again, this all really lifted my spirits ❤️

Gareth Crankshaw at Bristol Physiotherapy (https://www.bristolphysiotherapyclinic.co.uk/) sorted out my completely knackered shoulder a few years ago; Richard Bricknell at the same clinic was also highly recommended.

Edit: Gareth was also able to sort out an MRI, which confirmed his diagnosis.

I have a very different, long running shoulder issue (won’t bore you with the details) but am based in Cambridge, so if anyone knows a specialist shoulder physio in the South East I’d be keen to hear recommendations.

Sorry if this is a slight thread hijack but it is in keeping with the title

Professor Lennard Funk at shoulderdoc.co.uk he is the one based at Wilmslow - UK top shoulder expert - couldn’t recommend him and his team enough- informative website as well.