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Old 02-28-2012, 03:31 PM   #1
Josh Brehm
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Yet Another Shoulder Injury - Possible SLAP?

TL;DR: currently have 3-5/10 dull + sharp shoulder pain with external rotation, and especially while in lateral extension. Pain localized over what feels like short head of bicep, directly over shoulder joint. Injury occurred via OH pressing. Same injury occurred nearly 2 months ago, thought it had mostly healed, went through 3 weeks of benching w/o any problems, tried OH press yesterday, found out it's still injured. Also been experiencing gradual onset of painless clicking and popping the last year-ish. Feels like short head of bicep is noticeably swollen. SLAP or something else?



I've been having shoulder pain for ... maybe a year? It's been a gradual onset. Though I did hurt one of my shoulders trying to lift my girlfriend overhead probably about a year ago, but I can't remember if it was this shoulder or the other. Anyway, that healed just fine it seemed, and I was back to working out in around a month I think. I got into a mainpage WOD kick around September or October of last year and noticed that there was some strange popping and clicking going on, especially when I did shoulder dislocates and whenever I put my arm into external rotation with my elbow at a 90 degree angle, especially if my humerus was placed at a 90 degree angle to my torso laterally. It didn't hurt, and I don't think it felt weak at all, but it made me somewhat worried, especially after reading Gravel's Slap Journey thread.

Then last month, January, I did a 3x5 LBBS then OH Press workout followed by 10-9-...-2-1 KB swing & strict chin up WOD. I noticed during the squats that as I rotated my arm externally to get the bar into a LBBS position that the click/pop, that it normally makes, actually hurt this time. Of course, I was stupid enough to finish the workout versus stop and make sure I wasn't damaging my shoulder. It gradually got worse through the night and the next morning I had 4/10 pain. I had full range of motion, but it hurt to go into much external rotation at all. I also noticed that one of the biceps tendons was quite swollen. That day I decided to give my shoulder a break and begin therapy with therabands, doing internal rotation, external rotation, lateral and front raises (with dumbells), taking plenty motrin and upping my fish oil, and icing multiple times a day (ice until the skin is pretty much numb, remove and let the area return to normal body temp, then repeat). I got my shoulder checked out by an ortho early this month. At that point my shoulder was feeling a good bit better and while some of the positions he put my arm into didn't feel as strong or perhaps comfortable as my other shoulder, they didn't actually hurt. Because of this, he said it sounds like what I was doing was working, so just keep at it. He didn't give me a diagnosis as to what he thought it was.

About a week later I started back up with weightlifting, doing a westside split focusing for three weeks on bench and deadlift. My shoulder still didn't feel perfect, but felt strong and I set plenty of personal records on bench, incline bench, weighted and BW ring dips, pull ups and weighted pull ups, all without any pain from my shoulder. All the while though I couldn't help but remember someone's post on here saying how they were doing full mainpage WODs without any difficulty but had some popping and occasionally some very mild pain and it turns out he had a SLAP tear that required surgery.

Fast forward to yesterday. I switched up my westside routine to emphasize OH presses and squats for three weeks. I did a few sets of press up to my max and noticed that my shoulder was feeling a little sore. I went to massage it between sets and found that the biceps tendon (which had remained slightly swollen compared to my right shoulder since first injuring it early this year, though it could also have been swollen before that and I just never noticed it) was much more swollen than normal and was slightly tender to touch. I decided to stop lifting and resume the therapy I started last time.

As of right now, it feels just like it did when I first injured it in early January, though perhaps not AS bad. I used to think I first hurt it trying to get into position for LBBSs, but I think it was actually the OH pressing that did me in, since that's all I did during my w/o yesterday. It feels somewhat like a mix between a sharp and a dull pain right now, 3-5 out of 10. It feels like it's right over the short head of my biceps tendon. I can't tell if it feels deep, or more superficial like a tendon. FWIW, I have very inflexible shoulders. My internal rotation sucks, my overhead extension sucks (I have to hyperextend my lower back to allow the bar to travel directly over my feet in an OH press), and my external rotation is only ok (I can hold a wide front rack all day). And, as any normal crossfitter, I used to do plenty of kipping pull ups (will NOT be making that mistake again), and I'm sure that kipping, mixed with severely inflexible shoulders didn't do any favors for me.

I apologize for the length of this post, I'm very long winded. Does this sound like a SLAP tear or like something else? I'll perform some of the therapy tests and report back. Below is a link to a picture showing what I feel is swollen. What he has drawn as the biceps tendon, directly next to where it intersects with the subscapularis, is where I feel the swollen tissue. I'm pretty certain it's the biceps tendon.

http://www.athletestreatingathletes....shldmusc11.jpg
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Old 02-28-2012, 08:38 PM   #2
Sean Rockett
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Re: Yet Another Shoulder Injury - Possible SLAP?

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Originally Posted by Josh Brehm View Post
TL;DR: currently have 3-5/10 dull + sharp shoulder pain with external rotation, and especially while in lateral extension. Pain localized over what feels like short head of bicep, directly over shoulder joint. Injury occurred via OH pressing. Same injury occurred nearly 2 months ago, thought it had mostly healed, went through 3 weeks of benching w/o any problems, tried OH press yesterday, found out it's still injured. Also been experiencing gradual onset of painless clicking and popping the last year-ish. Feels like short head of bicep is noticeably swollen. SLAP or something else?



I've been having shoulder pain for ... maybe a year? It's been a gradual onset. Though I did hurt one of my shoulders trying to lift my girlfriend overhead probably about a year ago, but I can't remember if it was this shoulder or the other. Anyway, that healed just fine it seemed, and I was back to working out in around a month I think. I got into a mainpage WOD kick around September or October of last year and noticed that there was some strange popping and clicking going on, especially when I did shoulder dislocates and whenever I put my arm into external rotation with my elbow at a 90 degree angle, especially if my humerus was placed at a 90 degree angle to my torso laterally. It didn't hurt, and I don't think it felt weak at all, but it made me somewhat worried, especially after reading Gravel's Slap Journey thread.

Then last month, January, I did a 3x5 LBBS then OH Press workout followed by 10-9-...-2-1 KB swing & strict chin up WOD. I noticed during the squats that as I rotated my arm externally to get the bar into a LBBS position that the click/pop, that it normally makes, actually hurt this time. Of course, I was stupid enough to finish the workout versus stop and make sure I wasn't damaging my shoulder. It gradually got worse through the night and the next morning I had 4/10 pain. I had full range of motion, but it hurt to go into much external rotation at all. I also noticed that one of the biceps tendons was quite swollen. That day I decided to give my shoulder a break and begin therapy with therabands, doing internal rotation, external rotation, lateral and front raises (with dumbells), taking plenty motrin and upping my fish oil, and icing multiple times a day (ice until the skin is pretty much numb, remove and let the area return to normal body temp, then repeat). I got my shoulder checked out by an ortho early this month. At that point my shoulder was feeling a good bit better and while some of the positions he put my arm into didn't feel as strong or perhaps comfortable as my other shoulder, they didn't actually hurt. Because of this, he said it sounds like what I was doing was working, so just keep at it. He didn't give me a diagnosis as to what he thought it was.

About a week later I started back up with weightlifting, doing a westside split focusing for three weeks on bench and deadlift. My shoulder still didn't feel perfect, but felt strong and I set plenty of personal records on bench, incline bench, weighted and BW ring dips, pull ups and weighted pull ups, all without any pain from my shoulder. All the while though I couldn't help but remember someone's post on here saying how they were doing full mainpage WODs without any difficulty but had some popping and occasionally some very mild pain and it turns out he had a SLAP tear that required surgery.

Fast forward to yesterday. I switched up my westside routine to emphasize OH presses and squats for three weeks. I did a few sets of press up to my max and noticed that my shoulder was feeling a little sore. I went to massage it between sets and found that the biceps tendon (which had remained slightly swollen compared to my right shoulder since first injuring it early this year, though it could also have been swollen before that and I just never noticed it) was much more swollen than normal and was slightly tender to touch. I decided to stop lifting and resume the therapy I started last time.

As of right now, it feels just like it did when I first injured it in early January, though perhaps not AS bad. I used to think I first hurt it trying to get into position for LBBSs, but I think it was actually the OH pressing that did me in, since that's all I did during my w/o yesterday. It feels somewhat like a mix between a sharp and a dull pain right now, 3-5 out of 10. It feels like it's right over the short head of my biceps tendon. I can't tell if it feels deep, or more superficial like a tendon. FWIW, I have very inflexible shoulders. My internal rotation sucks, my overhead extension sucks (I have to hyperextend my lower back to allow the bar to travel directly over my feet in an OH press), and my external rotation is only ok (I can hold a wide front rack all day). And, as any normal crossfitter, I used to do plenty of kipping pull ups (will NOT be making that mistake again), and I'm sure that kipping, mixed with severely inflexible shoulders didn't do any favors for me.

I apologize for the length of this post, I'm very long winded. Does this sound like a SLAP tear or like something else? I'll perform some of the therapy tests and report back. Below is a link to a picture showing what I feel is swollen. What he has drawn as the biceps tendon, directly next to where it intersects with the subscapularis, is where I feel the swollen tissue. I'm pretty certain it's the biceps tendon.

http://www.athletestreatingathletes....shldmusc11.jpg
some of it sounds like a SLAP and some of it sounds like a anterior labral tear or Bankart tear. Would get rechecked good physical exam should be able to pick up on this. You can go my my website to see the difference

www.orthopedicsne.com
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