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Old 05-16-2009, 08:11 PM   #1
Nick Cruz
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Need a shoulder therapist recommendation (SoCal)

My shoulder has been in pain since November. I have no idea what I did but I woke up one morning in pain. At first it was impossible to do pullups up hang with my palms facing out. I could not even dead hang. Since then I have found that I can do pullups (even kipping) if I do palms facing in. Jerks also hurt it. I can clean the weight but there is a point in the upward drive that I pass through that hurts a lot during the jerk. I can hold the weight overhead ok, its just getting through that point that is painful. Shoulder presses, interestingly, do not hurt like a jerk. I have been taking glucosamine and fish oil for the past 3 weeks but it has not really done any good.

The pain used to be pretty bad and I missed a lot of workouts, now I can get through the workouts, especially if I do pullups with palms out and if I go through some rotation warm ups (big arm circles with light weight in my hand). Its now a dull constant pain that flares up when I do certain movements.

Its obviously very frustrating and time is not helping the problem. Im thinking that the next step would be to visit some sort of physio or therapist or deep tissue person. Would that be correct? If so, I am looking for a XX person in SoCal (I am in Anaheim) that can set me up. I will be paying cash so proper insurance acceptance is not necessary and hopefully will help with the cost.

Thanks,

Nick
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Old 05-16-2009, 10:26 PM   #2
Steven Low
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Re: Need a shoulder therapist recommendation (SoCal)

Quote:
Originally Posted by Nick Cruz View Post
My shoulder has been in pain since November. I have no idea what I did but I woke up one morning in pain. At first it was impossible to do pullups up hang with my palms facing out. I could not even dead hang. Since then I have found that I can do pullups (even kipping) if I do palms facing in. Jerks also hurt it. I can clean the weight but there is a point in the upward drive that I pass through that hurts a lot during the jerk. I can hold the weight overhead ok, its just getting through that point that is painful. Shoulder presses, interestingly, do not hurt like a jerk. I have been taking glucosamine and fish oil for the past 3 weeks but it has not really done any good.
The fact that it's CHRONIC now because you let it sit for months...... means the supplements may help, but you can't tell because the problem is going to be very stubborn.

It SOUNDS like impingement though.

1. What shoulder articulations hurt?
http://www.exrx.net/Articulations/Shoulder.html
2. where does it hurt (google a pic and mark it)?

Quote:
The pain used to be pretty bad and I missed a lot of workouts, now I can get through the workouts, especially if I do pullups with palms out and if I go through some rotation warm ups (big arm circles with light weight in my hand). Its now a dull constant pain that flares up when I do certain movements.

Its obviously very frustrating and time is not helping the problem. Im thinking that the next step would be to visit some sort of physio or therapist or deep tissue person. Would that be correct? If so, I am looking for a XX person in SoCal (I am in Anaheim) that can set me up. I will be paying cash so proper insurance acceptance is not necessary and hopefully will help with the cost.

Thanks,

Nick
Aggravating it by insisting on working out through pain only makes it worse and longer to recover from.

In my opinion, RIGHT when you got the pain you should've rested for a week or two + ice + massage (or whatever modalities depending on the problem) and then if it doesn't improve see a doctor/physical therapist.

This is very problematic since you let it sit for months and continue to aggravate it with your workouts. Therefore, see a doc immediately to get it diagnosed, and then probably see a PT for rehab.

And again I say.... STOP working out and aggravating it. Seriously. If you plan on having a long training career ahead of you then permanently injuring yourself by constantly working through pain is stupid. That's like the dumbest thing you can do... trust me.

Pain means your body is trying to tell you something is wrong.
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Old 05-18-2009, 10:39 AM   #3
Nick Cruz
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Re: Need a shoulder therapist recommendation (SoCal)

In my attempt to hastily post a question to get an answer I neglected to put in my due diligence in explaining my situation.

1. There is discomfort during abduction, and medial rotation at the outer limits of the movements.
2. In the muscle picture I have shaded an area on the shoulder where I can press with my fingers and can feel the pain. It does not seem more anterior or posterior but right between (if the coronal plane split me in half). I have also pointed to the ligament area that seems to hurt when I put pressure there. If I relax the shoulder I can dig my fingers between the muscle and get to it. I cannot get to it with muscles under tension. If I had to guess where the top of my humerous was I would say that the pain is evident at the top area (not cresting over the ball area to about 2Ē below that point-see shaded area)

I did see my sports medicine Dr about 2-3 weeks after I first noticed the problem. The pain was quite sharp and most of the articulations hurt. I went in when I realized that the pain was not going away at all. I thought I just slept on it wrong and it would subside on its own. He had me go through some ROM to find which articulations hurt. He discussed with me that he would not be able to see anything with Xray and that he didnít think it was necessary yet to go for an MRI. He prescribed me PT. I didnít go (yes, I deserve all the flames for this one). From what I had seen of this PTís work, I thought I could do the same job on my own. After about a week off, I started working out again, butI did NOT go right back in to the WODís at all. In defense of myself, I really tried to listen to my body and did WODís that did not require me to use my shoulder in any of the articulations that caused discomfort. In addition to my WODís I worked on very slight ROM exercises. I did ice it but probably not as often as I needed to. I found that the ROM work I was doing seemed to help but again, in a couple of weeks I decided to take another week off of all WODís which turned in to nearly 2 weeks. The rest did help quite a bit and when I returned to the gym I found that some of the articulations that hurt before no longer hurt. So, I added those slowly back into my routine.
So now I am at where I am now. The two articulations listed above are the ones that still cause me discomfort. In all cases the pain is present at the outer edges of the movement, meaning that the pain is not there for the entire movement, only when it nears the end of the movement, If that makes any sense.

I know I made mistakes, and dumb ones at that. So, my situation is this. I am on a high deductible insurance plan with Kaiser Perm. I have no problems, personally, going to see a Dr, PT or MT outside of Kaiser seeing as I will be paying for the entire visit no matter which way I go. But if I go with KP I will have to start the whole process over and see a primary. If proper diagnosis requires something like an MRI I can tell you right now, that with my current financial and medical plan situation, that will be out of the question. Therefore, what kind of doc should I be making an appt with? Whatís the next appropriate move?

On a side note, Steven, I really appreciate your opinions and advice, even if they may be a bit tough to hear and to swallow.

Nick
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Old 05-18-2009, 09:18 PM   #4
Steven Low
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Re: Need a shoulder therapist recommendation (SoCal)

Well, to me it sounds like something in the range of

impingement, tight/knotted up supraspinatus or partially torn supraspinatus. Might also be some infraspinatus involvement as well from where you indicated on the pictures.

I would strongly suggest finding a good PT to go to. MRI might not hurt as well if the tendons are actually torn... would rule that out.


Right now you can be cross friction massage (pull blood from the infraspinatus area into your acromial area) + ice + anti-inflams/fish oil. That should help out somewhat for now until you can be seen by someone.
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Last edited by Steven Low : 05-18-2009 at 09:21 PM.
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