Fixing a (medical) guitar-playing issue

[Tom]

I've had some physical issues with a full-size guitar, causing me to buy a 3/4 size guitar. I came to realize they were related to some long-standing shoulder issues (limited movement and lots of pain). I'd previously tried getting relief from two different chiropractors, one of whom diagnosed a torn rotator cuff, and the other guessed arthritis.

Concerned that this would affect both my instrument playing and my ability to cast flies during the upcoming trout fishing season in WY, today I had X-rays at a local orthopaedic clinic, which revealed:

• Narrowing of the joint space and slight tearing of the rotator cuff in one shoulder.
• Some arthritis in a tendon in the other shoulder.

If one (the 'worst') shoulder doesn't improve, the next step will be an MRI and possible surgery.

I was given cortisone shots in both shoulders, and hope there will be improvement in time for our upcoming stay in WY, in addition to being able to play a full-size guitar.

[prfcdoc]

If you have a partially torn rotator cuff then physical therapy is often the best approach . It's impossible to accurately diagnose that with an X-ray though. X-rays only see bone. MRIs see soft tissue and can usually accurately diagnose a torn rotator cuff. They can also tell the degree to which it's torn which is imperative in order to make an informed decision on whether or not surgery might be necessary. Cortisone shots will sometimes settle the issue down but you have to be careful to not overdo it because the pain is better. I'm a family doc and have seen dozens, if not hundreds, of them in my 40 years of practice. Additionally, I had one, myself, in my right shoulder. Mine was partially torn and completely resolved over about a 2 year time frame.  I did the physical therapy myself. Mostly stretching without putting undue weight on the joint. It's always good, though, to go to one or two PT appointments to learn what is good and what might cause harm.
Bob

[Tom]

Thanks for posting that Doc. Bob, much appreciated. As a non-medic, I'm having a tough time understand how physical therapy would not irritate or exacerbate the partially-torn rotator cuff. (Sorry, I have zero medical knowledge.)

MRIs see soft tissue and can usually accurately diagnose a torn rotator cuff.

The last time I had an MRI was the 80's, for a back issue; It took 90 minutes. Just curious if MRI technology has advanced and if the MRI scan takes less time.

[prfcdoc]

When you have not used a joint to it's fullest capacity for a period of time you start developing what's called a frozen shoulder. Adhesions build up to prevent it's full range of motion. Those adhesions need to be worked/stretched out or you'll have a permanent issue. The physical therapy, in good hands, will work the joint passively without aggravating the rotator cuff itself. It takes time for the cuff to heal, but if it heals with too much "scar tissue " then you get the frozen shoulder syndrome. The cuff itself is made up of several tendons and, again, knowing which tendon has the tear (thus the MRI) the orthopedic specialist can help guide the physical therapist. I can diagnose a torn cuff accurately up to 90% of the time but can't say how severe or which tendon is involved. I usually refer to a specialist who concentrates on sports medicine because that's where a large percentage of these injuries come from. Sometimes, though, unless you are an athlete, it's better to avoid sports physical therapy places because they tend to be too aggressive on those of us who don't make their living by sports.
Bob

[prfcdoc]

The last time I had an MRI was the 80's, for a back issue; It took 90 minutes. Just curious if MRI technology has advanced and if the MRI scan takes less time.

They still take some time--usually not that long--but have also advanced a lot in their accuracy.
Bob

[UTTransplant]

I am definitely not a propfessional like prfcdoc, but I will second the recommendation to stay away from sports rehab PT groups. I have had bad experiences with them too. I also had a rotator cuff issue that resolved itself with a single steroid shot and PT. Mine was just stretched, not really torn. It got bad so gradually it took me a few months to really identify something was wrong.

[Tom]

Doc, thanks again for the great explanation. Our local physio/chiro practitioners focus on sport injuries, so I need to find alternatives. Hopefully, the ortho folks can recommend appropriate choices.

[Lou Schneider]

I had an MRI of my neck after my truck accident last year.

It took me 90 minutes waiting to get into the MRI machine.

Once I was in place the scan only took a couple of minutes.

The length of time you're in the machine depends on how much of an area they have to image.  X-rays expose the entire field of view at once, MRIs work on a slice by slice basis, each coil rotation makes the equivalent of a scanning line in a TV picture.

[Tom]

Thanks Lou.

[schrederman]

My old guitar is 50 years old and I've owned it for 49 of those years. I feel bad for you having those problems. I worked with my hands all my life in telecommunications and earlier as an aircraft mechanic, and my problem is now arthritis in my left hand. It's really hard to make bar chords for me but since I retired, I've been doing a lot of heating and stretching of my hands. It is working... slowly but surely...  Best of luck with the shoulder.