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View Full Version : Rotator cuff issues, anyone?


leehayes
12-20-2007, 09:09 AM
Hey everyone. I have a question regarding anyone with rotator cuff injuries and how it affects their play. I have two torn rotator cuffs, one in each arm of course. My bridge hand is the better of the two but when I play alot my shoulder gets very sore. My other arm does not get affected by the play but the bending over does seem to make my shoulder sore. My stroke is very good, very smooth and recently it seems that I'm having trouble with accuracy. I'm wondering if the rotator cuff would affect this. Also, wondering if anyone else has had this issue and what they've done about it.
A friend of mine was watching me shoot the other night and he said that it made no sense why I was missing because everything in my stroke looked perfect. Any thoughts at all?

Jaden
12-20-2007, 09:18 AM
I was born without a bicep tendon and over time it developed some real problems. My shoulder has been known to dislocate from time to time. It is my bridge arm and it has never really been a problem at playing pool....

mosconiac
12-20-2007, 09:20 AM
When I was deeply obsessed with pool, I often would have shoulder pain towards the end of the day. Playing 8-10 hours a day was tearing my bridge arm shoulder apart. I started using more bend in my bridge arm and I noticed the pain started to fade. I didn't bend the arm to reduce the pain, I thought it would improve my game.

bsmutz
12-20-2007, 09:39 AM
I had a rotator cuff injury in my left shoulder (bridge hand for me). I do get pain now, but it's not too bad. It's kind of like a sore muscle after working out type of pain, but is always there if I move my arm in the right way. If I'm playing by myself, it's worse than if I play someone else where I'm not shooting all the time. There are ways to make it less painful, but when I experimented with it, I found that it decreased my accuracy. I am most accurate when I have my eyes close to the cue stick. If I take some of the weight off my left shoulder to ease the stress on it, I have to stand more upright.
It may be that once you get to a certain level of proficiency, you can take a more upright stance and still be able to dazzle. I do see older players that have been doing this awhile play pretty darn good standing pretty much straight up. I also see that they miss some of the longer shots that take a more precise aim, though, so I think it might be beneficial for someone such as yourself to differentiate between shots that require precise aiming and those that require less precise aiming and adjust your stance accordingly. Just be aware that this may cause problems with your consistency. Personally, I figure I'll keep putting up with the pain until it gets too annoying, then look for a way to alleviate it. Using the word alleviate reminded me to suggest that a mild pain reliever may help also. I've tried taking a few days off, but that didn't work for me. The pain was still there when I started playing again.
You may also want to experiment with letting your bridge arm go limp. Just flop it onto the table and let it lie there while you shoot. This will probably put more stress on your back and feel uncomfortable, but once you allow those muscles to build up, it might work to ease the shoulder stress. I've also seen some pretty good shooting from people using a sand/bean bag as a bridge.

cubswin
12-20-2007, 09:43 AM
I have problems with my right shoulder. After I play for 3 or 4 hours it starts getting sore. Couple of advil in the middle usually help out.

Wake up the next morning lots of times though and can't move my arm. Same problem when I spend a day fishing. Sooner or later it will be surgery time I'm sure. Probably next winter if it continues to worsen.

Drew
12-20-2007, 10:06 AM
Have you tried exercise? Use 1 lb weights and extend your arms. Any more weight and the movement will transfer to your back muscles.

ceebee
12-20-2007, 10:22 AM
When I retired from BOEING in 1998, I thought I had shoulder problems. Then I started playing POOL again & sometimes I could NOT pick up my arm (rotate it up from the shoulder joint). My Ortho-Pedic Doc said I had Rotor-Cuff problems & will probably face surgery.

7 years later, I have not had surgery & the pain has gone away (for the most part). I hope that my problem was slowly exercised away.

Hierovision
12-20-2007, 10:27 AM
I'm 6 weeks out of surgery and I'm playing better than I ever have. No pain except when I jack up for certain shots. I definitely won't be jumping for another few months.

I'm also 23, so that might have something to do with it.

Also using a heat-pack on your shoulders should help quite a lot before a session.

leehayes
12-20-2007, 10:30 AM
Hi guys...thanks for the input so far. I have been dealing with the pain and sometimes it's better than others. My left arm is really bad...I can't lift it over my head without MAJOR pain....but that is the stroke arm and it doesn't really hurt too much when I play. What I was wondering was if the stroke arm having a range of motion issue(even though my elbow going back and forth doesnt' hurt) would affect my accuracy. And, if so, did anyone else have the problem and what did you do about it. Once I"m in my shooting stance my shoulder does not move...only from the elbow down....and I rarely shoot hard.

Paul Mon
12-20-2007, 12:00 PM
Try a google search using rotator cuff and RSB. I've answered this a few times.

Rip
12-20-2007, 09:15 PM
Many doctors mistake rotor/rotator cuff issues with a relatively new problem identified as Thoracic Outflow Syndrome (TOS). Symptoms include a very painful shoulder that feels like rotor cuff pain and quickly turns to numbness from the lower shoulder radiating down one side of the arm and thumb.
The syndrome is aggravated and possibly caused by the upward tilt of the head and neck that occurs for most people when viewing a computer monitor, large screen tv and certainly when playing pool. I've been treated for the past month by one of the finest Orthopedic guys in the country for TOS and the pain has subsided and now we're working to eliminate the numbness issue. At least I can play without the pain. :o I also switched from a PC to a laptop so it's easier to avoid cocking by head & neck upward during the way too many hours spent on AZB!
Seriously though, if you're experiencing any of these symptoms, you might question your doc about TOS.

mantis99
12-20-2007, 09:19 PM
Drew,
I am not sure what exercise you are referring to, more explanation may be required, such as what position you are doing them in, and what body part you are extending. Extending your shoulder in standing would be to move your arm back behind you, which would generally cause more pain with a rotator cuff injury.

Hierovision,
I am assuming you did not have a rotator cuff repair, and had something more simple like an acromioplasty. I would not allow any of my patients to play pool after 6 wks post op RTC repair if it was their bridge arm. An acromioplasty or something similar could be a different story.

Leehayes,
I would think the trouble you are having with your accuracy would be stemming more from your bridge arm than your back arm (not that it could not be your back arm), especially if the back arm does not hurt during your stroke. When you put your arm into the bridge position, it can impinge the rotator cuff between the humeral head (your upper arm bone) and a bone from your shoulder blade called the acromion. The supraspinatus muscle, the most commonly torn RTC muscle runs in between them. This is a fairly common problem in pool players. My first suggestion would be to bend your elbow. This will decrease the angle at your shoulder. You really want it be under 90 degrees of elevation if possible, with under 60 being the best. 60 would be almost impossible to shoot pool with though. The less angle at you shouilder though, the less change for the impingement. The other things that may help are icing the shoulder (or heating) to decrease inflammation, and possibly strengthening the 3 other muscles of the RTC to help them perform their function. You may have to be careful with these though depending on how much you other muscle is torn. In general, getting a decent ex program from a physical therapist will be your best initial treatment, with surgery possibly being your only permanent solution depending on the size of your tears. PM with anymore questions, or if you would like more detailed info. I work with these types of injuries all the time.

mantis99
12-20-2007, 09:19 PM
Drew,
I am not sure what exercise you are referring to, more explanation may be required, such as what position you are doing them in, and what body part you are extending. Extending your shoulder in standing would be to move your arm back behind you, which would generally cause more pain with a rotator cuff injury.

Hierovision,
I am assuming you did not have a rotator cuff repair, and had something more simple like an acromioplasty. I would not allow any of my patients to play pool after 6 wks post op RTC repair if it was their bridge arm. An acromioplasty or something similar could be a different story.

Leehayes,
I would think the trouble you are having with your accuracy would be stemming more from your bridge arm than your back arm (not that it could not be your back arm), especially if the back arm does not hurt during your stroke. When you put your arm into the bridge position, it can impinge the rotator cuff between the humeral head (your upper arm bone) and a bone from your shoulder blade called the acromion. The supraspinatus muscle, the most commonly torn RTC muscle runs in between them. This is a fairly common problem in pool players. My first suggestion would be to bend your elbow. This will decrease the angle at your shoulder. You really want it be under 90 degrees of elevation if possible, with under 60 being the best. 60 would be almost impossible to shoot pool with though. The less angle at you shouilder though, the less change for the impingement. The other things that may help are icing the shoulder (or heating) to decrease inflammation, and possibly strengthening the 3 other muscles of the RTC to help them perform their function. You may have to be careful with these though depending on how much you other muscle is torn. In general, getting a decent ex program from a physical therapist will be your best initial treatment, with surgery possibly being your only permanent solution depending on the size of your tears. PM with anymore questions, or if you would like more detailed info. I work with these types of injuries all the time.

hejests
12-20-2007, 09:43 PM
Not a rotator cuff issue here, but I popped my clavicle on my stroking arm right out with a really bad fall on the ice a couple of yrs ago. Long and short of it is they can't reset it without surgery, and they only typically to the surgery for athletes (apparently pool players don't count). It's still half out but doesn't bother me too much. It did change my game a little bit though. I'd always played with ~19oz cues but I found myself struggling a lot with my stroke after the accident. It was just choppy. I went down to a 17.8oz cue and my stroke is totally back to normal and fluid. The lighter cue also doesn't tire my shoulder nearly as much. Aside from weight though, I've also noticed that I'm a lot more sensitive to balance points now. A balance point over 19.5-20 inches just doesn't feel good on the shoulder at all (like something's rubbing in there), no idea why.
And of course I went to a much lighter case as well....

hejests
12-20-2007, 09:43 PM
double post... argggg database issues.

DoomCue
12-20-2007, 10:04 PM
I broke my right collarbone, tore my right labrum, and tore my left rotator cuff in a softball accident summer before last. My collarbone has healed somewhat, at least to the point where it doesn't hurt much, and the labrum only hurts when I pick up something heavy. The rotator cuff, on the other hand, hurts like hell. I've been doing PT (aka Physical Torture) for the last month, and my therapist finally gave up and told me to have surgery. I have an appointment tomorrow to meet my orthopedic surgeon, go over all of my MRIs, and finally schedule surgery. Frankly, I'm ready. I've tried everything I could do to avoid it, but I haven't played pool for a month and before that, I hadn't played pain free in almost a year and a half. While I've still been able to play at a fairly high level, it's not the level it was before I got hurt. I'll be sure to keep the OP posted, as rotator cuff injuries are fairly common - many go undiagnosed. I'm sure this is going to mean another stroke overhaul for me. I had to realign my body differently after the collarbone healed up to where I could play, and I will probably have to do the same for the rotator cuff. Who knows what's going to happen if I get the labrum repaired, too? I'll have done so many adjustments by then, my stroke isn't going to look anything at all like what it looked like 2 years ago.

-djb <-- praying for a light at the end of this tunnel....

-djb

leehayes
12-20-2007, 11:02 PM
Drew,
I am not sure what exercise you are referring to, more explanation may be required, such as what position you are doing them in, and what body part you are extending. Extending your shoulder in standing would be to move your arm back behind you, which would generally cause more pain with a rotator cuff injury.

Hierovision,
I am assuming you did not have a rotator cuff repair, and had something more simple like an acromioplasty. I would not allow any of my patients to play pool after 6 wks post op RTC repair if it was their bridge arm. An acromioplasty or something similar could be a different story.

Leehayes,
I would think the trouble you are having with your accuracy would be stemming more from your bridge arm than your back arm (not that it could not be your back arm), especially if the back arm does not hurt during your stroke. When you put your arm into the bridge position, it can impinge the rotator cuff between the humeral head (your upper arm bone) and a bone from your shoulder blade called the acromion. The supraspinatus muscle, the most commonly torn RTC muscle runs in between them. This is a fairly common problem in pool players. My first suggestion would be to bend your elbow. This will decrease the angle at your shoulder. You really want it be under 90 degrees of elevation if possible, with under 60 being the best. 60 would be almost impossible to shoot pool with though. The less angle at you shouilder though, the less change for the impingement. The other things that may help are icing the shoulder (or heating) to decrease inflammation, and possibly strengthening the 3 other muscles of the RTC to help them perform their function. You may have to be careful with these though depending on how much you other muscle is torn. In general, getting a decent ex program from a physical therapist will be your best initial treatment, with surgery possibly being your only permanent solution depending on the size of your tears. PM with anymore questions, or if you would like more detailed info. I work with these types of injuries all the time.

Hey, I really appreciate the input. It is definitely a rotator cuff issue. I know exactly how they happened in both arms. The recent aggravation is actually increased from sleeping because I sleep on my side.
Believe it or not...I had instinctively done what you suggested about bending my bridge elbow tonight and won two matches against higher ranked players. One match I won 6 3 and the other 4 1. Played great but less shoulder pain. I do think you hit the nail on the head and that it was the bridge hand. Of course...I've gone from shooting once a week to shooting 6 days a week and 5 to 7 matches a week. So I'm sure the elevated play has only increased the problem. Now, I just need to remember to bend my elbow every time...yay.

jimmyg
12-20-2007, 11:35 PM
Ripped my rotator cuff whiffing a hard tennis serve about 15 years ago. Could not lift my arm above my shoulder without screaming.

I wanted to avoid surgery so I began using physical physical therapy. Started with little or no weight, lifting my arm in several directions as much as i was able to. As it got ever so slightly better, I increased the weight and the range of motion accordingly.

When I was able to, I started using the workout machines known as the Fly, and the one that uses fully extended arms over your head (can't think of the name), very little weight, and very slow, limited motion. Eventually, I worked out most of the pain and about 90% - 95% of the range of motion returned.

I now stretch in three directions everyday, alternate pushups and dumbells every day. Still can't serve worth a shit, or play hard without a day's rest from playing in between, without it reagravating the injury.
Pool doesn't bother me at all, although I don't try to break like Godzilla anymore.

I also massage the shoulder and arm, and use a TENS machine occasionally.

But I can play both tennis and pool, and it beats only watching.

Jim

leehayes
12-21-2007, 06:53 AM
Ripped my rotator cuff whiffing a hard tennis serve about 15 years ago. Could not lift my arm above my shoulder without screaming.

I wanted to avoid surgery so I began using physical physical therapy. Started with little or no weight, lifting my arm in several directions as much as i was able to. As it got ever so slightly better, I increased the weight and the range of motion accordingly.

When I was able to, I started using the workout machines known as the Fly, and the one that uses fully extended arms over your head (can't think of the name), very little weight, and very slow, limited motion. Eventually, I worked out most of the pain and about 90% - 95% of the range of motion returned.

I now stretch in three directions everyday, alternate pushups and dumbells every day. Still can't serve worth a shit, or play hard without a day's rest from playing in between, without it reagravating the injury.
Pool doesn't bother me at all, although I don't try to break like Godzilla anymore.

I also massage the shoulder and arm, and use a TENS machine occasionally.

But I can play both tennis and pool, and it beats only watching.

Jim
Hey Jimmy, thanks for that, I really appreciate knowing what you did. It's what i'd prefer...I"m not a doctor, surgery type of guy and hate drugs even more. Therapy and stuff are the things I choose to try first.

Blackjack
12-21-2007, 07:12 AM
I broke my right collarbone, tore my right labrum, and tore my left rotator cuff in a softball accident summer before last. My collarbone has healed somewhat, at least to the point where it doesn't hurt much, and the labrum only hurts when I pick up something heavy. The rotator cuff, on the other hand, hurts like hell. I've been doing PT (aka Physical Torture) for the last month, and my therapist finally gave up and told me to have surgery. I have an appointment tomorrow to meet my orthopedic surgeon, go over all of my MRIs, and finally schedule surgery. Frankly, I'm ready. I've tried everything I could do to avoid it, but I haven't played pool for a month and before that, I hadn't played pain free in almost a year and a half. While I've still been able to play at a fairly high level, it's not the level it was before I got hurt. I'll be sure to keep the OP posted, as rotator cuff injuries are fairly common - many go undiagnosed. I'm sure this is going to mean another stroke overhaul for me. I had to realign my body differently after the collarbone healed up to where I could play, and I will probably have to do the same for the rotator cuff. Who knows what's going to happen if I get the labrum repaired, too? I'll have done so many adjustments by then, my stroke isn't going to look anything at all like what it looked like 2 years ago.

-djb <-- praying for a light at the end of this tunnel....

-djb

David

If I knew how my body would feel in my 40's - I would have never been a part of the world of professional wrestling when I was young and stupid. I have bulging discs (L2 L3 L4) as well as massive damage to my neck (C4 C5) let's not even talk about my hips, knees and shoulders - combined with Young Onset Parkinson's, its a wonder how I am still able to play this game as much as I do and as well as I do.

One of the things I learned is to approach the table and get into my stance "softly". To learn how to do this, I watched tapes of The Miz - and watched how smoothly he seemed to glide into his shooting stance - it was a thing of beauty. This has really helped - and I have completely stopped leaning all of my weight on my bridge hand - something I was doing to compensate for my hip issues.

Like you, I have been putting off surgery (hip replacement) for a while now - stubbornly - I've needed the assistance of a cane to get up and down for quite some time. At this point I am more scared of the recovery period than I am of the degeneration. The recovery of that surgery combined with the Parkinson's is not something I am looking forward to at all. I just can't see me going 8 months without hitting a ball - and rolling around in a wheelchair. At my age, that type of layoff would completely reverse whatever momentum I have built up recently.

My recommendation is to go through with any surgery that is recommended immediately - avoid the avoidance - by this I am talking about the cortisone injections, putting it off, etc. When you put it off, you just keep damaging the injury. Do as I say, not as I do... lol... eventually, I will have that hip surgery when I run out of excuses - so basically I am just avoiding the inevitable. :rolleyes:

mantis99
12-21-2007, 11:06 PM
RIP,
TOS really isn't relatively new, but certainly is over looked fairly often.

Leehayes,
In this case, if you are going to try conservative measures first (which may be worth a try), make sure the program you do is given to you by a knowledgeable professional. A physical therapist should be your best option for this. There are exercises that will definately irritate and/or make the injury worse. Avoid any exercises that require you to push or raise your arm against weight over your head. That will only further impinge the tissues, and should be saved for much later in your rehab.

Blackjack,
While it is really difficult to advise someone with your diagnosis without physically observing and evaluation that person, just remember that any advancement in you Parkinsons will make your recovery harder and may also limit where your final level of function may be as compared to doing something now if it really warrants it.

If it were my shoulders, I would look at it like this: If the tears were fullt thickness tears, I would not mess around with conservative treatments, I would just have them fixed. If they were anything less, I would try PT first. If it does not work, it will still give you an improved ROM and improved strength that will aid in the post rehab recovery. After the PT I would decide if the shoulders were functional enough for my daily activities, and would decide if I needed surgery based off of that. I have seen many people with small tears avoid surgery. Medium level tears often do require surgery, but it can depend on the persons activity level and age. Remember that the RTC will likely get worse from the impingent that is occurring, becuase it is just rubbing the tendon between the 2 bones.

Tom M
12-22-2007, 12:18 AM
Also using a heat-pack on your shoulders should help quite a lot before a session.

Heat can help with flexibility, but if one suspects an injury, heat is bad.

If a shoulder is sore AFTER use, ice or a cold pack is the correct treatment.

Also, if you can take Ibuprofen (Advil), you need to take 800 mg per dose, which will give you a real anti-imflammatory benefit. The regular 400 mg dosage, or even 600 mg will help the pain, but without the anti-inflammatory benefit. Or, if you don't like taking that much medicine, plain old aspirin helps the pain AND inflammation with a regular dose.

I've been living with a rotator cuff injury for 20 years and manage it as above but mostly with flexibility and strength training. Take a look at my avatar. The shoulder holding the rope is the injured one. No problem as long as I take care of it.

It's very likely that even if you do have an injury, surgery could be avoided by simple conditioning. It's definitely worth a try before going under the knife.

Good luck,
Tom

Terry Erdman
12-22-2007, 07:52 AM
I am a chiropractor and I am getting great results using Graston Technique which is an instrument assisted soft tissue mobilization. It uses stainless steel instuments and an emolient so the instument glides over the tissue. This technique was developed by a physical therapist and is used by many PT's, and DC's that get certified in it. Bottom line; unless the tear is too great it will heal with conservative treatment and usually 1-3 Graston treatments will improve even a chronic shoulder problem. It is amazing how well it works in most cases. Google Graston and go to a PT or DC in your area and give it a try. You will be impressed by the results as I have been the last 3 years of using it. It is like a deep tissue massage but much more specific and beneficial. Give it a try and post your results! I was sceptical so I brought a friend of mine with chronic plantar fascitis( foot pain) to a seminar and they treated him. He went from 6 on a pain scale of 0-10 to 1 in about 5 minutes of treatment and he has not needed surgery. Check it out, I think you will be impressed.

acedotcom
12-22-2007, 08:49 AM
My rotator cuff has been partially torn for years. I can pee farther than I can throw a ball (that's saying something since I have prostate problems), but it doesn't effect my pool playing at all. Thank goodness for small blessings.