Hi Nick,
My advice would be to go see a good shoulder physio FIRST UP. Will PM you the name of the person I generally recommend. She works closely with Greg Hoy (mentioned above) and will be in a very good position to assess and advice re what's gonna work and whether you'll need to see a surgeon.
Your other alternative would be to see one of the sports docs at Olympic Park, or similar, they see sporting shoulders day-in, day-out and will be in a good position to assess and order tests, if needed. Will email you the name of someone who's been recommended to me recently for shoulders by one of my colleagues.
The comment about surgeons recommending surgery is very true, although it's not universally true. Again, as with all things, choose carefully, know what questions you want answered and be sure to ask them in the consult.
On some of the other suggestions ...
Scans -
If needed, first point of call is generally an ultrasound in muscle/tendon damage is suspected, or an MRI if the findings point more towards joint-related pathology. Sometimes an xray is appropriate also, depending on the symptoms you're experiencing and how the injury happened. Let the physio/sports doc assess and decide whether it's required. Not all scans are equal so preferably let someone who sees lots of shoulder injuries tell you what imaging you need and where to get it from.
Same goes for MRI, the local imaging place won't necessarily give you the same results as the orthopaedic imaging centres where the sports docs and orthopaedic surgeons send their patients too. Also, if you need an MRI, best to get it via a specialist (ie sports doc/surgeon). Many of the imaging houses have special rates for imaging ordered by affiliated specialists/clinics. Last time I checked, the price differences were far from insignificant - ie $50-$100+. The risk you run, if you organise an MRI yourself, is that the surgeon you end up seeing may want you to get it repeated anyway ... yet more money.
Surgeons -
Melbourne Orthopaedic Group are well regarded. That said, my advice would be to get the name of a specific shoulder surgeon, assuming you need to go down that path. The person I recommend, and who I've trusted re advice about my own shoulder, is part of that group. Will PM you his details. The shoulder physio I've used previously (for shoulder problems) works closely with him.
Exercises -
Correcting muscle imbalances (often part of the underlying cause of rotator cuff problems) and returning damaged tissues to normal function post-injury are specialised tasks. If there's no pre-existing pathology (ie injury) then doing your stuff with a theraband to prevent a problem *may* be ok, perhaps - but not if think you've got a rotator cuff problem of some sort.
If you have pain, injury or weakness, then get professional advice before starting a 'do-it-yourself' program. This means getting a diagnosis first (physio, osteo, myotherapist, sports doc etc) and then being given some appropriate exercises which take into account whatever it is that you've damaged etc, and plus other factors you've got going on, eg past injuries, muscle imbalances you weren't aware of etc etc.
Shoulders can be really tricky and, as you already know, they're particularly important to climbers so get it fixed properly by someone (a) who understands shoulders really well and (b) who understands and appreciates how you use your body - ie as a climber.
Hope that helps.
Check your mailbox for specific names and contact details.
Cheers!
Elaine. |