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Dave Hardy
06-27-2010, 04:26 PM
Hi all

Have been having some shoulder issues for around six weeks or so, and though I'd run it by the forum. As best I can describe it, I have some pain in my shoulder, which feels kind of 'within' the joint, if that makes any sense. ROM is normal in most directions, however a couple of movements bring on pain.

Mainly, these involve moving my arm behind my back. If I position my arm straight down my side, and try and rotate it behind me, it starts to hurt very quickly. The pain seems to extend down my upper arm sometimes as well. Pressing overheard is mostly ok, but benching has seemed to result in a dull ache afterward, as do pulling exercises such as rowing or pull ups. During the night, if I roll onto the shoulder that can cause it pain, and its usually worse in the mornings.

I can't pinpoint a specific cause for this problem, I trained one day and it was fine, the next day I woke up and it hurt. I realise there is no substitute for consulting a doctor or PT, but I've usually not had much help from the first in the past (for sports related issues), and seeing the second is not something I can afford right now. I've started the Diesel Crew rehab program today, and thought I'd see if that helped, in the meantime if anyone has had similar symptoms I'd be interested to hear your experiences.

Thanks

Steven Low
06-27-2010, 07:16 PM
If you want a real diagnosis, see an orthopedic doc.

If you want a guess by myself, we can do that..

1. Google a pic and mark where it hurts.

2. What exercises hurt? Which shoulder articulations hurt?
http://www.exrx.net/Articulations/Shoulder.html wfs

3. What type of pain is it? Burning? Ache? Tingling? Sharp?

4. Acute or chronic? What date was onset?

5. Any previous injury history?

6. How's your posture?

7. What is your current workout routine for that bodypart? Do you play any sports?

8. Have you been training through pain? If so, how long?

9. Check the tissue quality of the surrounding muscles. Which ones are tight? Which ones are tender? Is there any swelling?

10. What have you been doing for recovery purposes?

11. Any other information I should be aware of or that comes to mind that may help?


Initial impressions -- Hmmm... so far you presented some info to go on though not a lot...

If I were to guess at this point it could be some internal impingement given your symtoms especially internal rotation stretching hurting. Bench and pulling exercises only compound a bit on this thought. Severe internal impingement can lead to posterior labrum tearing which I hope it's not.... but given the pain inside the joint it doesn't sound promising.

Personally, I think you should see a doc abotu this.

Only do Diesel program IF it doesn't aggravate your symptoms. While most people think rotator cuff strengthening helps everything shoulder-wise this is not always the case and sometimes can be harmful especially if it's a labral tear that's healing. So use pain level as your guide there...

Dave Hardy
06-29-2010, 03:14 PM
Steven

Thanks for weighing in, I appreciate you taking the time to reply. As to the points you raised

1) Pic attached.

2) Performed all the exercises in this link. A few caused some pain.
- Extension; pain at the 'rear' of the movement, as arm goes behind the head, felt around the clavicle
- Adduction; BTN pull ups were ok, during normal ones experienced some pain whilst lowering in the upper arm
- Transverse Flexion; some pain in the upper arm whilst lowering the weight
- Transverse extension; minor pain, felt around the clavicle

3) Ache, other than when performing particular movements, which can bring on sharper pain.

4) Acute. Woke up with pain on the 28th May, presumably from the workout on the 27th. It's not been consistent since then, some days it been barely noticeable, or has faded over the course of the day. This last week its been more persistent.

5) No previous injury history

6) Posture, probably not great. Do spend a lot of time sitting at a desk, and although I try not to slouch, I catch myself doing it fairly regulary.

7) Workout routine. Benching and Shoulder pressing usually once a week each, occasionaly will fit in another session for one of the two. Also regular squats, dead lifts, pull ups, some other bodyweight exercises like press ups. Also I row, since this occured almost entirely indoor on the ergs. The last workout I did before I started to experience pain in the shoulder was squatting, bench, pull ups (mostly dead hang), and sculling later that day.

8) Yes have trained through pain, although I have avoided movements which hurt it during the workout. Benching went first, but carried on pressing. Then when it persisted, I dropped that out, then pull ups and rowing went too. ATM, just squatting, dead lifting and running.

9) No noticed any swelling, the persistent ache is centered around the clavicle (I think, my anatomy is poor. The protruding bone around the top of the shoulder) and the surrounding tissue. The pain running down the upper arm is only really there during exercise/movements.

10) painkillers (ibuprofen), which does seem to reduce the pain somewhat.

11) N/A

I think you're right, a doctor might be in order. I really don't know much about injuries, but thinking possibly Rotator Cuff tendonitis, or possibly a tear? From what I've read on shoulder problems, SLAP lesions usually are accompanied by weakness in overhead movements, which has not been the case for me.

Thanks

Dave

Steven Low
06-29-2010, 04:13 PM
OK, well it's good that you dropped painful exercises becaues that's always a generally good idea.

It actually sounds like, given the info you told me, that you just may have an issue with some impinging on the brachial plexus. In most cases, that can easily by corrected by some soft tissue, postural work and possibly some stretching as well.


Check out a couple of these:

1. Posterior capsule stretch, sleeper stretch, external rotation stretch

2. Lats stretch, pec stretch, pec minor massage. Can use basketball or other ball and lie on top of it for pec rolling.

3. Deep tissue massage all around the scapula; anterior, lateral and posterior shoulder; coracobrachialis, biceps brachii, and brachialis.

4. Nerve glides (google first link)

5. Foam roll thoracic spine (put 45s on your chest for deeper stretch). Also, roll side to side as you are rolling and try to arch your back wfs
http://www.marksdailyapple.com/how-to-improve-thoracic-spine-mobility/

If some of them hurt, don't do them.

What I really want to know out of these is if rolling out your chest (specifically pectoralis minor) or using your hand to loosen it up helps out significantly with either pain or discomfort with any of these exercises (and if it's tender there as well).

Also, do some neck stretchign to the opposite side of the injury as well. To hit up the scalenes just in case you're getting some of the problems from there too.

Dave Hardy
07-01-2010, 05:11 AM
Thanks, I'll give all of these a go. For the stretching & mobility work, do you think twice daily, for 2-3 weeks initially sounds about right?

Steven Low
07-03-2010, 10:46 AM
Thanks, I'll give all of these a go. For the stretching & mobility work, do you think twice daily, for 2-3 weeks initially sounds about right?

Play it by ear. If you're too sore for a couple days then feel free to take a rest.

It's easy to overdo rehab work too you know.

I usually recommend 2-3x per day 3-5 days a week or thereabouts.

Keep us updated.