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View Full Version : yet another shoulder injury.. pic included (WFS)


Neil Duncan
12-04-2009, 01:52 PM
Well after getting some improvement already on my wrist (thanks steven!) - I think I may have injured my shoulder.. I'm not sure exactly what caused it but most likely the lifting in cold whether without warming up. Stupid stupid stupid.

http://www.atlanticsoftware.nl/otto/health/model_1-shoulder.JPG (WFS)

In the above pic its around the AC joint area where if I move my arm backwards (imagine a chest fly movement backover) I feel a pinching pain around that area and almost if something is going 'tight', not constantly and I wouldnt say a severe pain, but it hurts. Ive taken to icing it in the evenings, I've rested since. Have done light shoulder rotations and band dislocations.. but not sure what to do from there.

Tom Nguyen
12-04-2009, 04:24 PM
Do you have pain with the cross body abduction test?

http://www.youtube.com/watch?v=Gj7kjFr8ETA WFS

That would be indicative of AC joint injury/separation. AC joint injuries are fairly common in BJJ. I injured my AC joint a few weeks back as did a few of my other classmates over the years.

Steven Low
12-04-2009, 04:26 PM
Well, it could be AC joint problems if you feel the clavicle moving against the acromial part of the scapula (aka AC joint -- acromioclavicular joint).

Otherwise, I'd suspect something like impingement.

What shoulder articulations hurt?

Rest, ice, massage the area and work on mobility (band dislocates is good.. add in wall slides) is always a good conservative estimate for now.

Stretch chest and lats and biceps.

Neil Duncan
12-04-2009, 04:33 PM
Tom - Nope, thats doesnt hurt

Steven - best way I can describe it is if I stuck my arm straight out thumb up, like I was hitchiking then moved the arm backover it gets tight right over that area

Steven Low
12-04-2009, 04:36 PM
Tom - Nope, thats doesnt hurt

Steven - best way I can describe it is if I stuck my arm straight out thumb up, like I was hitchiking then moved the arm backover it gets tight right over that area

I ask for shoulder articulations because you guys aren't descriptive enough..

wfs
http://www.exrx.net/Articulations/Shoulder.html

Neil Duncan
12-04-2009, 04:42 PM
sorry fella, Transverse Abduction causes the tightness/nipping

Steven Low
12-05-2009, 11:17 AM
sorry fella, Transverse Abduction causes the tightness/nipping

Check your internal rotation with the sleeper stretch.. how far do you get?

Neil Duncan
12-05-2009, 11:40 AM
my arm goes so far as getting my wrist 5 - 5 1/4" off the ground

Steven Low
12-06-2009, 01:02 PM
There is some deficit there.

I'd make a guess to either internal impingement or some anterior instability or both.

Do arm across the chest stetch, keep doing sleeper stretch, strengthen the muscles on the back of your shoulder with external rotations, rowing, ITYs, etc.

Neil Duncan
12-06-2009, 02:01 PM
There is some deficit there.

I'd make a guess to either internal impingement or some anterior instability or both.

Do arm across the chest stetch, keep doing sleeper stretch, strengthen the muscles on the back of your shoulder with external rotations, rowing, ITYs, etc.

Thanks for the advice Steven, but.. ITY's? Don't know them :)

Steven Low
12-06-2009, 08:27 PM
Thanks for the advice Steven, but.. ITY's? Don't know them :)
Prone:

Shoulder extension (body/arm makes a I)
Transverse abduction (body/arm makes a T)
Shoulder flexion (body/arm makes a Y)

Alternatively you can add Ws as well with arms bent.

Neil Duncan
12-07-2009, 09:25 AM
ah cool, thanks Steven I really appreciate you taking the time to help me out :)

Steven Low
12-07-2009, 10:46 AM
Prone:

Shoulder extension (body/arm makes a I)
Transverse abduction (body/arm makes a T)
Shoulder flexion (body/arm makes a Y)

Alternatively you can add Ws as well with arms bent.

Scratch that. Do this instead wfs
http://davedraper.com/blog/2009/07/22/shoulder-ytwls-become-lytps/

Neil Duncan
12-09-2009, 11:56 AM
Very interesting stuff that, thanks Steven :)

Based on how you've helped me on the 2 previous posts, wrist and shoulder injuries would you recommend I lay off upper body work for a while and rest up? (apart from the rehab stuff) - It feels like my body is telling me to, and lay off the BJJ too.

I suppose I can still run/pistol lol..

Steven Low
12-09-2009, 07:02 PM
Yes... rest.

Michael Holmes
12-12-2009, 02:32 PM
I'm another in the separated AC joint boat as of last Monday and have been advised to rest it, take some ibuprofen to take out inflamation and then this weekend start moving it around doing internal and external rotator cuff work

A related question though is, I know I can cycle, run, pistol, air squat, walking lunge amongst other movements, but how advisable is back and front squatting?

Sorry for the thread hijack

Steven Low
12-12-2009, 11:27 PM
As long as it doesn't hurt it's generally fine.

If there's any doubt avoid like the plague.

Neil Duncan
12-13-2009, 02:07 PM
Steven I meant to ask, although your probably sick of me, how often should I be doing the rehab work? - dislocates, mobility work (a-la Ido), YTWL stuff? I mean obviously I'm going light with it, that YTWL circuit is actually quite good fun feels like it's working muscles I never have before.

Steven Low
12-13-2009, 02:12 PM
3-4 times a week is generally fine for strengthening the muscles.

Mobility work you can do everyday.

Neil Duncan
12-17-2009, 03:50 PM
Hey Steven, one thing I've noticed now the pain is lessening somewhat (still not gone..) is that I get a click/crunch that feels like something is almost popping (no pain at all) when I'm doing the Transverse Adduction movement at the furthest back point, would that be related to the same problem possibly?

Steven Low
12-17-2009, 07:36 PM
Likely a misarticulation with the tightness of the posterior capsule and lack of IR ROM.

Keep up the sleeper stretch, and posterior capsule stretch. Multiple times a day if possible.

Got any postural or strength/mass imbalances?

Neil Duncan
12-18-2009, 11:14 AM
ah I see, will keep up the stretches more often didn't realise I could stretch that often :) - Already getting a better ROM in the sleeper stretch.

Postural probably got problems, have to consciously make the effort to have good posture while at work.. strength and mass wise it is slightly unbalanced, the injured shoulder side is slightly bigger than the other side, but slightly weaker too

Neil Duncan
12-18-2009, 12:23 PM
One thing that I will add.. not sure if it's relevant is that doing shoulder circles (just rolling them - sometimes dislocates) it pops and cracks in both shoulders with no pain, moreso the uninjured shoulder. I think I'm genuinely falling apart... quite depressing.

Steven Low
12-19-2009, 09:23 AM
ah I see, will keep up the stretches more often didn't realise I could stretch that often :) - Already getting a better ROM in the sleeper stretch.

Postural probably got problems, have to consciously make the effort to have good posture while at work.. strength and mass wise it is slightly unbalanced, the injured shoulder side is slightly bigger than the other side, but slightly weaker too

Stretch as often as possible without it getting too sore.

Yep, that contributes to the problem.

One thing that I will add.. not sure if it's relevant is that doing shoulder circles (just rolling them - sometimes dislocates) it pops and cracks in both shoulders with no pain, moreso the uninjured shoulder. I think I'm genuinely falling apart... quite depressing.

Popping/cracking generally tends to be due to some misarticulation in the joint usually due to postural or muscle imbalances and tightness. Basically, anything that is going to be limiting proper mobility and range of motion as well as things that imbalance the shoulder joint specifically.

Proper strengthening to rebalance the shoulder as well as improving mobility should help decrease this.

Without pain it's generally nothing to worry about though. Some people have it regardless of whether their mobility et al. are good.

Neil Duncan
12-22-2009, 02:37 PM
Just thought I'd let you know Steven seen as you've helped me out so much... had a physio over last night (big bodybuilder monster!) he found a muscle that runs from my shoulder almost in my armpit and lat that was tight as a metal cable, said it was pulling my shoulder out of alignment (sound familiar?) spent ages giving me a painful deep tissue massage after which almost instantly I had better mobility, can already get further on the sleeper stretch on the first 'rep' and next to no clicking.

I have to thank you Steven, you've absolutely helped speed up my recovery so much and gave me so much to consider which has changed my outlook on training.

Steven Low
12-22-2009, 03:11 PM
Probably subscap or teres major or something like that... yeah.

Glad to hear that you're helping.

Soft tissue work and proper mobility and strengthening work is the key to staying healthy.

Neil Duncan
12-27-2009, 10:14 AM
Just a quick question Steven if you don't mind, I'm pretty much back to normal with the shoulder already (havent worked out on yet - being sensible and making sure I take it easy) should I keep up the work with the YTWL circuit even after my shoulder feels 100%?

Steven Low
12-27-2009, 10:43 AM
Just a quick question Steven if you don't mind, I'm pretty much back to normal with the shoulder already (havent worked out on yet - being sensible and making sure I take it easy) should I keep up the work with the YTWL circuit even after my shoulder feels 100%?

Yeah, add it in after your workouts.

Start off very slow man. Don't want to reaggravate..

Neil Duncan
12-29-2009, 11:16 AM
Oh don't worry I absolutely will not, it's certainly not ready to come back yet.. still goes tight and feels like its pulling right over my AC joint so thats a signal to me to be very sensible..

Neil Duncan
01-15-2010, 04:06 AM
Hey Steven, just thought I'd update you on this.. I finally bit the bullet and went to see a physio in person, he performed a few tests and says its not an actual injury of the joint.. I have a winging of the scapula (like noted in the other thread) and have got to concentrate on pulling the shoulder down and back into place (he held it in place manually himself and got me to move my arm - much freer movement) without engaging the upper trapezius and my lat, so I've got to concentrate on that when I can.. sets of ten when lying on belly and sitting.

He also noted a thickening of the biceps tendon into the shoulder on that side? - Come away feeling a lot more positive, he says I'll be back quicker than I think - but basically what you said and be sensible lol

Steven Low
01-15-2010, 08:54 AM
Yeah.. if you have one issue then you probably have some systemic issues that may pop up.

Unfortunately, I didn't put two and two together because I just glance through these posts now so good thing you went there.

Makes it even more serious tha tyou should get that winging fixed though.

Neil Duncan
01-15-2010, 09:49 AM
Oh absolutely Steven, going to make sure this works.. going to fix myself :) - You always recommend going to see someone in person anyway despite your advice, suppose they can do so much more than even your best efforts online! - Thing is your advice has most definatly helped though thats for sure