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Old 05-06-2010, 02:56 AM   #1
Jared Paiva
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Shoulder Pain - Lifesaving Injury

Hey Guys and Gals

In about September 2009, I was doing lifesaving training on the beach. We were doing an event called beach flags, to cut a long story short, Two guys dived on my arm and I felt a clicking feeling. I immediatly felt a sharp pain in my shoulder, but I carried on training.

The next day my right shoulder was very sore, so I decided to rest it for a few days. After resting and thinking the pain had subsided, I went back to gym, I immediatly felt a lagging pain, but decided to push through it. I proceeded to gym for the next few days, but eventually decided to head to my chiropractor. After feeling around and doing a test, he identified the pain as tendonitis of the bicep tendon that leads into the shoulder.

I went for quite a few sessions, which comprised of acupuncture, massaging and then manipulation of my back. These sessions did help and I felt i was able to have a greater range of motion. I was also icing and heating my shoulder for about ten minutes, three times a day.

Eventually my Chiro said I can do light weights again as long as there is no pain. I went back and there was no pain, but pain started once again after doing certain movements. I was extremely frustrated, but decided to carry on gyming as I had to go National champs, which was a few months away. Bearing in mind the pain was definately less after going to chiropractor and even through gyming again. My shoulder would have its on an off days, whereby sometimes the pain was dull and other times, I woild not have pain for hours, then all of a sudden I'd feel something.

Now that lifesaving season has ended and socccer has begun, I have now taken off 4 weeks from doing ALL weights. I have Searched different stretches and implimented them such as wall stretches, two kinds of broom stick stretches and towel stretches. My shoulder has definately improved since resting it. Yet it seems that it is just stuck in a sort of limbo period, where it is nether improving or getting worse. I continue to stretch and even take anti inflammitory's. I have pain when I do the wall strecthes and a pain on the one towel stretch, where the my right arm( The injured one) is behind my back. Also when I sit in a chair, put my arms over my head and lean back, it is sore then. It is a pinching feeling. I have no pain during the broom stick stretches

Should I go to a doctor? In which case what type of doctor? I dont want to be hurlded back and fourth between doctors and referred al over the place. Or should I just rest it and carry on strecthing. Here in South Africa doctors are very expensive, especially specialists!

Please guys, any advice would be greatly appreciated, As I want to start doing the Crossfit WOD's. It looks so exciting, but this injury is not allowing me to go further.

Thanks

Jared Paiva - Cape Town, South Africa
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Old 05-07-2010, 06:03 PM   #2
Steven Low
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Re: Shoulder Pain - Lifesaving Injury

Well, if there's no trauma and the musles are just tight then all you need to do is stretch back out the range of motion.

Internal rotation (sleeper stretch or behind the back one), external rotation,

Flexion and abduction with stuff like wall slides, corner stretching, etc.

Sounds like its just tight and you may have a bit of impingement or residual swelling overhead. Especially with internal ROM (hand behind back).

Probably don't need to see a doc unless you don't need improving with the mobility work. Start rotator cuff strengthening definitely. If anything, avoid the doc and get toa physical therapist.
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Old 05-09-2010, 02:10 PM   #3
Jared Paiva
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Re: Shoulder Pain - Lifesaving Injury

Hey Steve,

I am so pleased you replied, as I have seen your replies on other threads and they are so informative. Thank you for your advice.

By trauma do you mean tears or something like that? If that is the case then no, the chiro identified no tears, he said I would have been in agonising pain if that was the case.

Maybe I should give you a little more info regarding the symptoms:

* When I lift my right hand up above my shoulder and then lean back, I feel a pinching feeling in my shoulder.

* I have been doing the diesel crew rehab program and when I did circuit 3, the pull up retractions and over head shrug, and the push up plus, I felt the pinching feeling

* Walking finger wall stretches hurt my shoulder ( I think thats what its called)

* If I feel around my front shoulder, it has a tensed feeling to it, it aslo feels a little puffy compared to my uninjured left shoulder.

* When I swing my arm in a sprinting motion, then I feel a pinch.

* The sleeper stretch seems to relieve the pinching for a while.

* After doing the broom stick stretches, when I bend over, arms out and palms facing the ceiling, when I squeeze my upper back, the back of my right shoulder makes a click noise, like the feeling when you click your knuckles. My left, uninjured shoulder does the same, but not as loud or frequent.

I hope the above helps.

Should I continue with the Diesel program?, I noticed immediatly after circuit 1, there was an improvement. After circuit 3, there was a little pain. I am going to do circuit 4 today.

With massaging, how many times a day? and must I do it with something like Arnica?

Lastly, should I not go to a specialist to get a second opinion? Will a physio give me an immediate diagnosis?

Thanks one again Steve, also for taking the time to reply and provide with us all with the knowlege you have gathered over the years.

Jared Paiva
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Old 05-09-2010, 10:57 PM   #4
Steven Low
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Re: Shoulder Pain - Lifesaving Injury

It sounds like you have some impingement... possibly internal impingement, and tight posterior capsule. Maybe some biceps tendinopathy as well.

Don't do anything that hurts it obviously.

HIt up the sleeper stretch more, and do posterior capsule stretching often as well. Do some corner/door stretches, lats, pec and pec minor stretches too.

Start working overhead shoulder mobility with wall slides, and strengthen your external rotator cuff muscles only. Probably don't need to hit up the internal unless it's weak too.


If you have access to a physical therapist you may want to go. However, if they don't deal with sports people then it's probably not worth it. PT will likely have more experience rehabbing soft tissue problems of the shoulder than ortho. Ortho would either tell you to rest or ship you off to PT... both of which you already know.
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Old 05-10-2010, 12:47 AM   #5
Jared Paiva
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Re: Shoulder Pain - Lifesaving Injury

Hey Steven,

Thanks once again

I will do those stretches. With the wall stretch, must I just walking my fingers up the wall and thats it, or must I walk them up and lean into it. That is when it hurts (when I lean into it).

Just a note, the chiro manipulated my AC joint a little too.

Must I continue with the Diesel Crew rehab program? Should I leave out the ones that hurt?

On average how long does impingement last? What was the clicking sound when they fell on my shoulder?

lastly what is the difference between impinegement and tendonitis?

Keep well.

Jared Paiva
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Old 05-10-2010, 08:31 AM   #6
Steven Low
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Re: Shoulder Pain - Lifesaving Injury

You're thinking of the wrong wall stretches. Don't do that one if it hurts.

Corner stretch is better. It's a chest stretch. wfs
http://backandneck.about.com/od/desk...rstretchwa.htm

Dig in with your hands or roll your pec minor with a basketball or any other type of ball. Loosen that sucker up.

You can continue with DC but avoid the ones that hurt.

Impingement depends on severity. Can be anywhere from weeks to months... more likely the latter since you'd had the problem a while and it's become chronic.

Re clicking wfs
http://www.eatmoveimprove.com/2010/0...licking-oh-my/


Sigh. If you have simple questions like impingement or tendonitis you can google these. You don't need me to answer everything for you... you can do it for yourself. I'm not going to next time.

Impingement is when the soft tissue structures are being compressed to the point of painfulness/damage... hence getting impinged.

Tendonitis/tendonosis tends to be a stress and/or overuse issue with the tendons. Usually manifests itself in poor eccentric control, and hypertonic muscles.

Also, if you can get massages or massage yourself loosen up everything around your scapula, chest and upper arm as well. Biceps in particular... dig in.
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Old 05-11-2010, 12:12 AM   #7
Jared Paiva
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Re: Shoulder Pain - Lifesaving Injury

Hey Steven,

Sorry about that, I apologise.

Once again thank you for your help, guidance and advice. It is appreciated.

Keep well.

Jared
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Old 05-21-2010, 01:25 AM   #8
Jared Paiva
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Re: Shoulder Pain - Lifesaving Injury

Hey Steven,

Been a while, I hope that you are well.

Just an update, since we last spoke, which I think was about 3 weeks ago, I have been to see a Pysiotherapist. I told her what happened, she identified it as shoulder impingement. She felt around and identified swelling of the bicep tendon in the shoulder.

So far she has been massaging the tendon, using a heat type of machine on the area, a laser machine and then the best one is this machine that sends a frequency or something to the muscles, it has pads and it causes the area to contract etc. Sorry for the vague explanations.

I have had three sessions and have seen a huge improvement already. My range of motion without pain has increased and I can do certain stretches with only a tiny hint of discomfort, It wouldn't even be classed as pain. I have also been taking salmon oil, I hope that is correct.

She has encouraged me to do external and internal rotations, which I have been doing with resistance bands. I have also been doing shoulder retractions and protractions.

One thing I have noticed is that when i lie on my back, affected arm straight overhead, the muscle in my afected shoulder feel soft, compared to my uninjured left shoulder, the muscles there feel contracted. What does this mean? Must I do strengthing exercises for that? If I must, then what can I do ?

I will ask my PT about that at my session today, just wanted your opinion.

Thanks again,

Keep safe.

Jared Paiva
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Old 05-21-2010, 10:59 AM   #9
Steven Low
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Re: Shoulder Pain - Lifesaving Injury

Uhhh salmon oil... not sure about that. Fish oil is what you want -- specifically teh contents you want high amounts of omega 3 fatty acids aka EPA and DHA.


Anyway, muscles feeling soft is actually normal. Muscle, when at rest, should feel pliable and basicalyl feel like a slab of meat you get from the butcher.

If your muscles are contracted that means you either have high tone or your muscles have a lot of scar tissue and other things making them more rigid. You can use massage to help loosen them up as well.

Sounds like your PT is pretty good though... keep it up.
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Old 05-21-2010, 04:11 PM   #10
Jared Paiva
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Re: Shoulder Pain - Lifesaving Injury

Hey Steve,

Yeah she is really good and pretty experienced, been a PT for like 40 years!

I went to a health shop and asked for fish oil, the lady looked confused and said they only have salmon oil. I know my mom takes cod liver oil. The salmon oil does contain omega 3's.

What other names does fish oil go by, remember I'm from South Africa, so maybe fish oil is called something different here in South Africa.

Another question, she said I can hit the weights again, but take it easy obviously, which I will do. In the past, before I got injured, I did alot of cleans and other forms of olympic lifts and compound exercises. My goal is to start crossfit and also get back to my normal routine. So my question is, what type of exercises do you recommend I start with? What would be the safest?

So I will continue with the internal and external rotations, what other shoulder exercises do you recommend? I'm assuming I must strengthen my scapula as well? What do you think of the WYTL's?

Thanks again Steve.

Jared.
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