Friday, October 24, 2008

Coming out

Went to the dojo and had our sensei holding his right shoulder. Told himn I was a sportsmedicine doc and eventually got to the point of telling him it was a small entrapment of the rotator cuff. Told him a few things to do and eventually he told me of a student who was very competitive and suffering from a right shoulder issue. MRI showed a bucket handle tear to the labrum. Not a good thing to have. In most sportsmedicine circles....this injury is the reason many orthopedic surgeons scope shoulders. I am also in eastern medicine and believe the body can heal anything(as long as there is time). On eval, the shoulder was loose and there was "apprehension sign" with me attempting to push it out of socket. This was the recreation of her pain. It may not be the tear of the cartilage but more the looseness to the shoulder htat gives her the problem. She has good insurance but doesn't want to be laid up with the post op surgery right now. She never went back to the doc and has just been handling the issue/ pain. Sensei says she is and up and coming judo practitioner and very competitive on the national level. I told her about and antiinflammatory diet, ice, strengthening exercises and acupuncture. I believe there is a great chance to improve....told her it can be up to 6 months with a shoulder trained physical therapist but we are on our way. Worst case would be if she can't wait.....I send her to my surgical friends and we cut.

The reason I speak of this is many people will trust their doctor, who refers straight to ortho. In western medicine, specialist base treatment plans on study outcomes. They do what they do best and cut. Sometimes its worth it for patient and doctor to think outside the normal western medicine box and formulate plans that range from conservative to ultra aggressive and dive 100% into either by diet rest restriction therapy or surgery.

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