Nagging Shoulder Issues

I'm an old pro with TMS. I won't recount my whole history (lots of it already here), but I've never had shoulder issues before (aside from a torn labrum injury/repair back in '09, where I felt it rip). I am very adept at detecting tightness in my back & distinguishing between TMS-type pain & the Crohn's Disease-related inflammatory arthritis I've suffered from since adolescence. I can ease the tension & pain when it's muscular..but this shoulder thing has me confused.

I played some pickle ball back in early August. The next day my shoulders were killing me. BOTH of them, even though I'm right-handed. Anyway, both of my shoulders still hurt whenever I use them for anything, all these months later. A couple of cortisone shots helped quite a lot, but the relief lasted about 4 weeks each. I'm rehabbing them slowly, but I can't figure out the relationship to that pickleball game, the pressure I put on them while sleeping, or additional stress I've been under. It's not like back or neck pain, as I don't feel tight muscles; but I don't want to go down the MRI rabbit hole because no doubt someone will want to operate. PT tests show a rotator cuff injury, of course, but I'm not convinced of that. Either way, I'm not getting surgery. The weather definitely has an impact, and sure, there's been plenty of stress & tension, but I feel pretty confident about how/where stress gets me - in my gut & back, maybe neck once in a while... The shoulder thing though ... Anyone want to share any details about how their TMS-related shoulder pain presents? Thanks.

 

You're looking at the physical: sleep, pickleball, weather...but you do mention "stress I've been under"
It's more stress you generate - and the anger it creates that you don't recognize is happening. It doesn't matter if it's shoulders, gut, neck, back...it's all the brain, the mind. Your fixation with the pickleball game is simply a distraction from what the real, deep issue is.
Think psychological.
What is pissing you off that you can't get angry at, or what is pissing you off that you are holding on to the anger..or what often happens, what is pissing you off that you are avoiding thinking about. It may have absolutely 0 to do with pickleball.

 

Thanks. It's just hard to separate because of the timing, and how dearly I pay for random, inconsistent exercise. It's also a different sort of pain than other TMS issues I've experienced. Cortisone/steroids generally don't work on those... and that it acts up with the weather, and I'm recently off of Prednisone ... and have had systemic inflammation/joint pain since I'm 6 years old so it's taken a lot of years to identify which is which and when/why, but I like to think I've gotten pretty good at it. There's no doubt I'm under a ton of self-induced stress, but it's really acting like an injury. Arg. So it goes. I'll keep strengthening and stretching, and I suppose the improvement path will indicate... if it is totally inconsistent despite a consistent rehab program, then I suppose I'll know.

 

Pretty much everyone who reports symptoms talks about "TIMING" TMS is a sneaky devil. You may have honestly hurt yourself and it was healing in a few days, weeks but it's the TMS that keeps the pain sticking in your mind.
The type of pain doesn't matter. Use your common sense (that's not to be mean, it's just at times like these that seems to fly out the door with TMS) - some folks get a head ache, some stomach upset, others dizziness, others fullness in the ear. It is ALL TMS no matter what the pain is, no matter the symptom (it may not be pain).
Dr. Hanscom has suggested things like systemic inflammation are part of the chemical response to anxiety and a heightened nervous system. This is also being proven by TMSers with CFS ME and other diagnosed "dis-eases" that totally heal. Their TMS acts like an incurable, diagnosable disease...but it's TMS.
The mindset Dr. Sarno suggests is that we most certainly should move and be active. It's part of being healthy, but do so with the mind to just move. Not to heal or treat. That is focusing on the physical.
Instead of using your rehab program to judge progress, why not flip the switch and use your psychological state to judge your progress. and help you doubt by creating an evidence sheet that deals only with the mental/emotional and do not put anything physical on this list.
Honestly this last message sounds like you have just given up, when you really can take your power change your life. It's in your hands.
A in favorite talk I saw recently - a scientist pointed out that thoughts like it must be physical come from the brain. The brain is simply an organ like the liver, or kidneys - he asks: do you let your liver or kidneys tell you what to do and how to think?
NO!
So take charge. Exert your power. Decide how and what you are going to think and lay down some personal boundaries.
Review pain science.
Understand injury and physical healing times.
Make a choice to either give up and let your TMS take over, or take a hold of your power and recognize how you can respond to your inner stress instead of reacting in pain.
You can do this you have done it before.
I suggest you read this post, and recognize how you can apply TMS principals for LIFE, not just as a bandaid approach to every symptom. That was not Sarno's approach.

https://www.tmswiki.org/forum/threads/my-truly-crazy-healing-journey-adventure-with-john-sarno.27809/ (My truly crazy healing journey adventure with John Sarno)

 

The whole systemic inflammation/Crohn's Disease being a TMS equivalent was one area Dr. Sarno & I disagreed. I was lucky enough to have been a patient of his, and he affected my life forever. Having been diagnosed at 6 with a chronic illness certainly created a whole lot of repressed stress...but I can't get on board with having enough of that stress already at age 6 to make me sick. There is definitely going to be a significant increase in pain when cutting off pain killers & steroids, and maybe overdoing it with the exercise (I was a mess the last few days after pushing it too far). The other big difference is not feeling any tightness in my shoulders; doing my breathing, mindfullness, etc. In other words, it is presenting more like my torn labrum than my TMS. Then again, finding the exact connection really doesn't matter. Thinking psychologically does. Taking care of both is also something Dr. Sarno was a little uncertain of; and is different for everyone. PT can reinforce the focus on the physical, but also is good for you & can improve symptoms. As long as you're treating the cause at the same time. Thanks for the pep talk. The other thing though - the incredible efficacy of the cortisone - that kind of treatment never worked at all for my TMS back pain.

 

The first symptom that tricked me right after recovering full from back pain was the shoulder. I blamed it on the long batting practices I was throwing....500-600 pitch afternoons.
I, like you went and got the cortisone shot..and I 'rested it' which only made it worse. It was absolutely TMS.
I was going to a wedding I did NOT want to go to, because it was in Vegas and I had two young sons to watch...my family said they would help and did not (as I expected)...The whole thing was lame and I was also probably in a rage that I used to be a "fear and loathing in Las Vegas" kind of partier and now I was a boring little league dad. I also resented coaching baseball instead of playing baseball.

When that 'aha' moment came, I went and threw the longest batting practice of my life....all the while focusing on those resntments and probably cussing under my breath like a person with tourettes. The symptoms left immediately.

Don't know anything about Chrohns , but I blame TMS first for all musculo-skeletal stuff and about 90% of the rest..in 20+ years that's never harmed me...

so what was going on inside when the pickleball happened?

 

Hello @eightball776 ,

Pain that doesn't make any sense is (partly) what caused Dr. Sarno to develop his theories and eventually his TMS practice. As you've read and know, he was initially baffled and frustrated when healthy people did not recover from relatively minor issues, and when the pain could not be connected with any injury or illness (what you describe above with the pain in your left shoulder, and the fact that the pain stuck around for months). What you describe here reminds me of a couple of the example stories Dr. Sarno used in Healing Back Pain. He often discussed folks who were pulled away (because of TMS) from exercise and athletic pursuits (tennis, running, etc.) that brought immense joy to their lives. Dr. Sarno wrote extensively about situations just like what you're dealing with now.

This older thread discusses stopping physical therapy. There are quite a few perspectives that may be helpful:
https://www.tmswiki.org/forum/threads/do-i-really-have-to-stop-physical-therapy.4215/ (do I really HAVE to stop Physical Therapy ?)

I suggest keeping it simple and returning/expanding upon the techniques you learned from Dr. Sarno when he was your doctor.
You're so fortunate to have had that experience! Build on that.

 

Interesting... my labrum tear back in '09 was from throwing a ball. THe cortisone shot's efficacy definitely has to be considered. My TMS has always been a bigger challenge because of the various symptoms Crohn's can cause. I had my 1st brush with TMS when I saw Dr. Sarno back when I was about to graduate from college. I also started having back and knee pain at around age 11 or so, and my childhood was just too good to consider that much stress at that age. My illness didn't start messing with my brain for real until I was 30. What I'm experiencing now will vanish with steroids, which I've recently stopped taking, and when I was on more, it wasn't a problem. When the 'injury' first happened, I was working at my old summer camp during the most stress-free summer I can remember having since being a kid. While it's true that right now I'm under a ton of stress, these physical symptoms are much more consistent with my disease & steroid dependency than TMS.. but again, I have to remember that making the exact connection doesn't really matter. The stress will make it worse regardless of its origin, so working on that should help, and I am... but it's motion & exercise that activates it as opposed to noticing it on an especially difficult day or mindset. I haven't actively participated in sports in years, and my favorite hobby, motocross, has been impossible because of my poor physical fitness that comes from sickness. I got laid off a few months back and can't find work, so there's that too.

 

OK... I'm gonna give you a big NO on that. I had what some people might call a terrible upbringing but I had little TMS because I responded to the rage inducers, neglect and alienation with violence and drama..It was when that STOPPED being a dick that the TMS showed up. I Imagine you had all sorts of rage inducers but because you're from a 'nice' family, you were trained early to suppress them. If someone told me I was 'ill' at 6? That would be a huge one right there! Mad at the world
Then right at graduation...that's scary for everyone so it's obvious. You're lucky you got to see Sarno. Curious what his outlook on Chrohn's was... I just read about it and some of your older threads....

That is EXACTLY when my extinction event happened... the TMS that no longer responded to placebos and 'treatment' and ultimately failed surgeries and stuff. Most people and cultures agree that age 30 is when men begin to go 'WTF is my life about and what am I doing in it?" That's when Jesus and Buddah both started their ministries

Most of my TMS episodes have shown up when I have little 'perceived' stress...
The big issues were always existential fear, personal relationships , family and responsibility...what I was doing occupation wise was only a small factor when I look back over 58 years. In fact, a lot of times, when stuff really sucked I had NO symptoms because I had plenty of stuff to focus my anger on.

That would make me REALLY angry consciously and unconsciously... hell, I am scared now just cause work is a little slow.. I just know that I'm scared and pray about it a lot....and talk to people about it. The reason I do isn't to 'feel better'...I am always vigilant about TMS. Sarno said in 'mindbody prescription'; the best way to fight TMS is to prevent it.

Ya know what's weird too? I have abused prednisone before....one of the side effects is it literally makes me want to fight people and destroy the world...not on day one...takes about 4-5 days of it. I get really shitty and have started a lot of fights with GF's and co-workers. I can't imagine what taking it regularly would do, but that anger's gotta go somewhere.
If this shoulder issue started any time near your layoff, I would be reeeeally suspicious
peace

 

There's no doubt I have tons of reasons why the TMS monster could reappear. I am very, very familiar with the "type" of stress that's usually the culprit, but I thank you all for the reminders. You can never reinforce this stuff enough. There are reasons to be suspicious it's TMS, and reasons to think I was more susceptible to injury & am feeling pain just about everywhere because I'm off of corticosteroids & pain killers for the first time in years, so that's just expected. If it was just my right shoulder, I'd say yep, pickle ball did it. And yet TMS, for me anyway, is the nagging spasms & soreness that varies wildly in severity & I can tell when I'm tightening the affected areas. This is constant, in the exact same spots & has stayed consistent, worsening with the gentle exercise & stretching. Of course an MRI will show something nefarious. My thumb, which I bent back about 4 weeks ago & had an "ouchie" still hurts, like a lot. My blood inflammatory markers are off the charts, along with my WBC, as is par for the course when the disease is angry. That's the thing with CD; not only is it exacerbated by stress, it sets off a cycle of symptoms that are different for everyone. It's like I know my back hurt for years because of TMS. It was on both sides, alternated, and did not behave like an injury. Then years later I started having the sciatica & very deep sharp pain that ran down my leg L5/Si, and then the MRI showed the "pinched nerve" in that exact spot, and my bone density came back with significant bone loss / osteoperosis in the lumbar spin from the years of steroids. So I've spent my whole life mastering the ability to distinguish between TMS pain & inflammatory/CD pain, which can sometimes be related, but not the same thing when the stress kickstarts the autoimmune process. When I am unconsciously tightening muscles, and notice it, and do my breathing, progressive relaxation, mindfullness, etc., it goes away. The inflammatory arthritis from the CD makes every joint in my body creak & hurt in the morning, when it rains, etc. Soooo - this bilateral shoulder pain is throwing me for a loop. TMS never affected my shoulders before at all, and it doesn't feel like there are any muscles to tighten up there; when I get issues up there, it's in the traps. Steroids never helped "TMS pain" - but it definitely helps this. Imaging is dumb because I'm not getting surgery - I mean, unless this is going on another 6 months & it's exactly the same...

 

Well, one thing is for certain, if it IS really TMS, but you continue to waffle between maybe it's physical maybe it's not, your symptoms will not go away. That kind of waffling is what TMS thrives on

 

Agreed. I do feel like I'm advanced enough to be able to separate them pretty effectively. The fact that it's 90% gone now that I'm back on the Prednisone leads me back to no injury & inflammatory arthritis. Now the autoimmune process is most definitely kicked off & worsened by stress... so whether the pain is actually caused by oxygen deprivation in the muscles or inflammation in the joints doesn't really matter a whole lot... well, main difference is that once it's this aggressive, and coming in tandem with monthly bowel obstructions, no amount of journaling & TMS reminders is going to help; high dose steroids is the only remedy.