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I follow a pretty strict, some would say very strict, Paleo diet. I am also very leery of drugs. I'm not asking for medical advice; I'm just hoping some of you may have some insight or previous experience with my dilema.

I was recently injured at work, nothing life-threating, a sprain or strain in my shoulder that may be connected to the rotator cuff. The prescribed treatments have included generic versions of Vicodin, an anti-imflamatory, and Prilosec to protect my stomach from the first two. I haven't taken any of them, so now the doctor is suggesting steroids shot directly into my shoulder. I guess I asked too many (or just enough) questions because he's sending me to physical therapy for now and putting off the drug treatments. I'm hoping someone has other suggestions for reducing inflamation in the shoulder. My doctor is suggesting it's necessary. I absolutely will not consider any responses medical advice.

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I would consider all of the above options before a steroid shot. Steroid shots are notoriously overused in the shoulder area. Having had a few into each rotator cuff, and having used most of the below treatments as well, I would make sure to be very particular with your physical therapy above all else. Shoulder stabilization, in addition to strengthening the rear delts and assuming a neutral position posture, can do more than any anti-inflammatory. Good luck! – Kamal May 2 2012 at 0:56
Thanks, that's good to know. I've been afraid the steroid shots would take away the pain enough for me to injure it agian without knowing it. – aseafish May 2 2012 at 18:24

15 Answers

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I'm a weight-lifter/athlete and have been dealing with chronic injuries/pain on and off since I was 16 (am 35 now). Over the years I've discovered two ways to counter injury and inflammation.

  1. Build muscle around the affected area. For rotator cuff that means rotator cuff exercises 3X a week. It means doing shoulder presses (I'd use dumbbells) and lateral raises (side and front) two to three times a week. Start very, very light. Slowly but surely, week by week, add a little weight.

  2. Intermittent Fasting - I was startled how this has lowered my inflammation. It's really incredible. I follow the 16/8 methodology prescribed by leangains.com

But overall building muscle is the key. I'm convinced that the root cause of most injuries is muscle weakness/imbalances. This is definitely true for rotator cuffs, which I've personally been through.

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your right muscular weaknesses/imbalances but caused by over active and tight upper trapezius and pectoral minor and weak lengthened lower trapezius and serratus anterior creating an unstable platform (scapula) for the rotator cuff to fire from. therefore your exercises would actually be causing an imbalance and not helping the problem. to keep my shoulders healthy I incorporate exercises that activate the lower trapezius and serratus into my training such as the Y, T, W and I exercise and also the push up plus and variations - ul be able to find these on you tube. – Whirl May 9 2012 at 18:29
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a healthy shoulder starts with a stable scapula for which the rotator cuff muscles can work from. I'm a BSc sports therapist by the way not an opinionated quack, all the best. – Whirl May 9 2012 at 18:31
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Check out arnica, there are both topical and oral forms.

I don't know how paleo they are! but I use the penetrex brand from Amazon. If it's just the pain you want relief from check out Sombra or other capsaicin creams ~ that stuff is amazing!

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Curcumin has been the only saving grace for my injured ankle. I take the Jarrow brand, two in the evening and one or two in the morning if I'm noticeably swollen - right now I'm down to just one in the evenings and maintaining just fine.

Fasting has a significant positive affect on the inflammation and overall pain, as well.

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I've found acupuncture to be great for not pain reduction and in reduction of inflammation with my shoulder injuries.

Eating ginger/drinking ginger tea is also a good systemic anti-inflammatory and works about as well as over the counter NSAIDs.

Arnica is a great topical homeopathic option, but I find works best immediately after injury as opposed to over the long term.

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Heat before physical therapy exercises, then ice after helps significantly (I had a shoulder injury followed by months of shoulder impingement and 6 months of physical therapy). I agree with the other poster re: fasting helps inflammation in general. My blood pressure readings always drop 10-15 points on my fasting days. Crazy, but true. Accupuncture works for a couple of days, but honestly, I think the best thing would be to take the cortisone injection if it's offered and do the strengthening/stretching offered by the physical therapy and let it work its way out. You might have increased blood sugar readings/cravings while you have the cortisone (I was very strict Paleo when I had my cortisone injection) so it isn't ideal, but man it works on shoulders - and quickly. It allowed me to do the physical therapy strengthening and stretching exercises and heal more quickly.

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Omega 3's, krill oil, broth with lots of gelatin and connective tissue.

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Eat only grass-fed beef and wild caught bottom feeders.

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That one's easy enough. I do it already. Thanks. – aseafish May 1 2012 at 19:34
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Never tried it, but just read that peppermint soap can treat tendonitis. http://coolinginflammation.blogspot.com/2012/05/dr-oz-pain-hotcold-receptors.html

Apparently the peppermint can "stimulate hot/cold receptors that have nothing to do with changing the temperature of deeper tissues, but these treatments are very effective in stimulating general endorphin production that reduces troublesome inflammation and pain."

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From this same very pertinent blog entry: "The essential observation is that triggering hot and cold sensing nerves is more important than changing the temperature of the damaged tissues." – tdgor May 10 2012 at 5:23
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I've not read this book, but it's highly rated on Amazon:

Treat Your Own Rotator Cuff

"Based entirely on research from peer-reviewed journals and randomized controlled trials, Treat Your Own Rotator Cuff is a complete program to prevent and rehabilitate rotator cuff injuries for athletes and non-athletes alike. In less than 100 pages, readers will learn precisely how the rotator cuff works, what can go wrong with it, and then are guided step-by-step through an evidence-based program that takes just minutes a week to complete. Drawing from the latest rotator cuff research, Treat Your Own Rotator Cuff will be especially useful for those who have been diagnosed with either a partial or full-thickness rotator cuff tear, experience shoulder pain, do upper body weight lifting, play a sport or have a job that involves repeated arm motions above shoulder level, have been diagnosed with "impingement syndrome," or for anyone simply wanting a healthy and properly functioning rotator cuff."
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Can't see how to reply directly, but I second the "Treat Your Own Rotator Cuff" suggestion. See the physio and get the book would be my advice. I have his knee book and the rotator cuff one, my knees are pretty good now after a few months strengthening up my legs and making sure I get some exercise. The rotator cuff is a longer term thing (I injured it years ago) but after years of rest and slow recovery I'm now trying to rebuild some strength - the book seems to give good advice.

PaleoRocks.

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Ouch! Good for you for asking just enough questions! Are homeopathics paleo? Traumeel is pretty good. Epsom salts bath (apparently an even better way to absorb magnesium than taking it orally), saunas, lots of sunshine, acupuncture(?). It seemed to help when I slept on a magnetic pad when I tore my supraspinatus tendon. 1g/day vitamin c. Pectin fruit (eg apples).

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Go to a Chinese herb shop and ask for "701" plasters or patches. You want to get the big roll in a can. It is sticky patches infused with chinese herbs to heal soft tissue and relieve pain. Also Yunnan Baiyao(or Paiyaio) patches will help you. These are inexpensive and the modern equivalent to herbal poultices and they work. Just put them on the area. Also do corrective/strengthening exercises for the area. But get some 701s and you will feel better. Lay off the ice too, except for ice baths.

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Ive actually also heard great things about deer antler for its unique healing properties on soft tissue injuries.

heres a good video about it http://www.youtube.com/watch?v=9Qt9qJ5BCik

all the best.

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Zyflamend is a well know herbal anti-inflammatory product.

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Physical therapy can be VERY effective.

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