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Old 01-30-2013, 09:10 AM   #1
Hunter Dale
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Shoulder pain has me stumped

Hey guys,

I've been doing CrossFit for about 8 months now, and within the past month have developed some form of shoulder injury. I have absolutely no medical experience at all though, and am stumped as to what part of my shoulder I have injured.

With that said, I will do my best to describe what's going in hope that someone could give me advice.

Injury History
About four years ago I injured my shoulder in college playing rugby, and determined that I had strained my anterior deltoid muscle. After a few weeks of rest, ice and compression the pain went away and the only time I noticed any discomfort was if I ever held out anything to my side (lat raises) over say, 20-30 lbs.

Recently however, the pain has returned and I'm starting to think that either my injury either never fully healed, or that some of the smaller muscles in my shoulder are very angry with me and not quite as strong as the others.

It all started after christmas break. I spent a lot of the holiday break working on overhead squats and squat snatch. I didn't use heavy weight at all, and just focused on technique and form - but I still think I might have overdone it.

I ignored the pain at first, and just didn't do anything overhead for a day or so and then went right back at it - however, eveventually it transformed into a dull pain in my shoulder that would keep me up at night.

That was the last straw, and I have since taken two weeks off from Crossfit completely (Absolutely terrible experience) and am now starting to make workouts with no overhead work.

What I have done to try and repair it

Over my little two week break I iced my shoulder twice a day, and massaged it with a foam roller and lacrosse ball. I also worked around with a stretch band and pvc pipe and tried to stretch out in the positions that made me sore.

I also couldn't mentally keep myself from training - so I did do a few rowing metcons.

Current Status of the Injury

Right now I have no pain, but my shoulder has started popping when I make any type of press movement.

I experimented yesterday with various movements with very light weight (squat snatch, shoulder press, handstand pushups, kipping pullups, etc.) and nothing seemed to hurt during excercise. However this morning, I could tell that my shoulder was not a fan, and it has been slightly sore. I decided to grab my pvc pipe and test it out, and just as I guessed, some of the pain had returned, but only minor (during the high pull of a snatch).

What next?

I apologize if this post has been long winded, but I am just getting very frustrated with this injury and trying to figure out what to do next. The pain is going away, but I'm not convinced that the problem is fixed. I don't know how to explain it, but my shoulder just doesn't feel like it is working correctly.

I've talked to some of the guys at my Crossfit gym about it and I've gotten a recommendation for a chiropracter (who is actually a level 1 trainer) and a sports massage therapist but I am ignorant about either. I just dont want to waste my time with one (massage therapist) or get sucked into going once a week at the other (chiropracter).

Anyways, I guess I'm just hoping that someone can atleast point me in the right direction. Not being able to train normally is absolutely killing me and I'm just ready to get over this little bump in the road and move forward.
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Old 01-30-2013, 10:49 AM   #2
Brian Strump
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Re: Shoulder pain has me stumped

I find it funny when people say "I don't want to get sucked in to blah, blah, blah". You're an adult, I assume? You know how to use the "no"?
You will unlikely find a PT that would not want to "suck" you in once, twice a week for treatment. It's called a plan. It's unlike Western medicine, where you get a pill for pain, and your done. That way of thinking has cause chronic pain syndromes and addictions for years, and will continue to.

We attempt to diagnose, and treat you. We see how your respond in a few days, and from that we develop a further course of action. Or would you prefer a doctor give you a set of "one size fits all" shoulder exercises for you to do with total disregard to if those are even correcting the problem, or in some cases making them worse?

Alot of rhetorical questions, I know. But it's to get you to think about how you currently view the treatment model.

I find it funny that you talk about your ignorance of MT and chiropractors, yet asking for help via the internet where anyone can chime in with or without any medical background can chime in; and you'd take their advice.

I see it as 2 options;
Be ignorant. Find some exercises, and hope it helps. Or at least hope your body compensates enough for you to forget about the shoulder pain for a few weeks, or months' only to have something else go wrong as a result of the compensations for the current situation.

Or,

Ask around for a good DC or PT that works with injuries and rehab. Whether or not they have their Lv 1 cert should not matter to you. Sure he may understand what you do in CrossFit, but that doesn't mean they are any better suited to get you better. And lets face it; if a doctor tells you to stop CrossFit, you're not going to listen anyway.

IF you feel comfortable with the doctors treatment options, go for a trial of care. I tell my patients, that can "talk with their wallet". If you don't think I can, or am helping you....Leave, or ask me for a referral. I'm not the one with the pain, or problem. No one is forced to come here.
Be weary of treatment plans that are for a year, or ONLY give options to pay for everything upfront.

Don't expect miracles, although they do happen in the offices everyday. We tell patients that we expect to see improvements in less than 4 visits. Depending on the injuries this can mean no more pain, or 20% improvement. It may not mean our job is done if there are still mobility, stability, etc. issues, but we expect to see changes in less than 4 visits or we'll re-evaluate how we are treating the patient.
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Last edited by Brian Strump; 01-30-2013 at 10:53 AM..
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Old 01-30-2013, 12:18 PM   #3
Hunter Dale
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Re: Shoulder pain has me stumped

Brian,

Thanks for your response bud, I really appreciate what you had to say. It helps put this in an entirely new perspective.

I guess I just need to do some more research and figure out what type of doctor I should be looking for, and truthfully that's what i'm most ignorant about. I am completely unfamiliar with where to get properly treated for an injury like this and need to figure out what my options are.

With that said, thanks again.
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Old 01-30-2013, 02:54 PM   #4
Brian Strump
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Re: Shoulder pain has me stumped

I would ask around for a referral. Perhaps a DC or PT that works closely with a HS or local college. Actually works on them, not just sponsors the team.

Many more PT's will be familiar with a shoulder injury than a chiropractor, however you will certainly find some in both fields very familiar with shoulder pathology.

Good luck



Quote:
Originally Posted by Hunter Dale View Post
Brian,

Thanks for your response bud, I really appreciate what you had to say. It helps put this in an entirely new perspective.

I guess I just need to do some more research and figure out what type of doctor I should be looking for, and truthfully that's what i'm most ignorant about. I am completely unfamiliar with where to get properly treated for an injury like this and need to figure out what my options are.

With that said, thanks again.
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Old 01-30-2013, 09:30 PM   #5
Michael Henry
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Re: Shoulder pain has me stumped

Medical help would be the best thing, and an MD would probably do some tests, call it impingement, and send you to a PT. You can look up how to palpate the superspinatus (probably this one), infraspinatus, subscapularis, and biceps tendon, and see which one is the most painful. You can RICE it and cross-friction massage it, but you probably have some movement fault that is causing the impingement that someone would have to look at to identify in order to correct it.
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Old 01-30-2013, 09:49 PM   #6
Brian Strump
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Re: Shoulder pain has me stumped

Quote:
Originally Posted by Michael Henry View Post
Medical help would be the best thing, and an MD would probably do some tests, call it impingement, and send you to a PT. You can look up how to palpate the superspinatus (probably this one), infraspinatus, subscapularis, and biceps tendon, and see which one is the most painful. You can RICE it and cross-friction massage it, but you probably have some movement fault that is causing the impingement that someone would have to look at to identify in order to correct it.
FWIW, just because something hurts to touch rarely means that's the sight of the problem. That would be like continuously changing a tire that wears abnormally, and not looking at the alignment of all four of the tires.
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Old 01-31-2013, 05:10 AM   #7
Michael Henry
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Re: Shoulder pain has me stumped

Quote:
Originally Posted by Michael Henry View Post
but you probably have some movement fault that is causing the impingement that someone would have to look at to identify in order to correct it.
Quote:
Originally Posted by Brian Strump View Post
FWIW, just because something hurts to touch rarely means that's the sight of the problem. That would be like continuously changing a tire that wears abnormally, and not looking at the alignment of all four of the tires.
Yes, we said the exact same thing.
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Old 01-31-2013, 09:19 PM   #8
Sean Rockett
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Re: Shoulder pain has me stumped

is it still clicking, does it bother you with overhead motions anymore?, does it feel loose or like it is not sitting in the right place compared to your opposite side? If so do what the gang said and get checked out, hold off on painful things
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