Shoulder injury/damage advice...
Discussion
In short, I felt something ‘ping’ in my shoulder 4 weeks ago, and 14 months after shoulder surgery on the rotator cuff and to reattach tendons damaged in a 10 year old skiing accident.
I’m guessing/hoping/praying that it is muscular rather than tendon damage again, but after 4 weeks it still hurts. I left it a week before doing any press exercises (which are the ones that hurt), but it hurt through the workout. I left another week and ditto.
So the question, should I leave it several weeks before pressing exercises (shoulders, chest, inclines) again (is it 6 weeks for soft tissue to heal?) and continue to do pulling exercises (pull downs, low pulley, upright rowing etc)? Or should I avoid all exercise?
Or should I bother to go to the physio? I’m an advocate of physiotherapy but if it is only a twanged muscle is there any point?
I’m torn between a physio session and just doing pull exercises for the next 3 – 6 weeks.....
I’m guessing/hoping/praying that it is muscular rather than tendon damage again, but after 4 weeks it still hurts. I left it a week before doing any press exercises (which are the ones that hurt), but it hurt through the workout. I left another week and ditto.
So the question, should I leave it several weeks before pressing exercises (shoulders, chest, inclines) again (is it 6 weeks for soft tissue to heal?) and continue to do pulling exercises (pull downs, low pulley, upright rowing etc)? Or should I avoid all exercise?
Or should I bother to go to the physio? I’m an advocate of physiotherapy but if it is only a twanged muscle is there any point?
I’m torn between a physio session and just doing pull exercises for the next 3 – 6 weeks.....
I'll show you my 3" scar if you show me yours! Badly damaged tendons in both shoulders, through impact damage (both skiing). So the shoulder in question has been repaired tendon-wise - this one key-hole, but the right shoulder was cut open last December.
As for the GP - Leesa, I'm a bloke! PH first, physio second then tail between legs to GP last of all
You're probably right about no weight training at all, rather than sticking to pulling type exercises. Maybe I had best go see the physio first. Sigh.... Another £45.
As for the GP - Leesa, I'm a bloke! PH first, physio second then tail between legs to GP last of all
You're probably right about no weight training at all, rather than sticking to pulling type exercises. Maybe I had best go see the physio first. Sigh.... Another £45.
Loopyleesa said:
Paying for pain
OK, so it was a poor attempt at irony.However, and this is a very sad indictment of men, even if it hurts there is something very attractive about getting the undivided attention of and the laying on of hands from a fine looking woman - which my physio is.
There. I've admitted to part of the pathetic nature of being a man.
OK Aunty Loopy and Uncle Bill.
I've visited Janine, my physiotherapist (I've spend so much money with her over the last few years that I feel she has now become a friend, albeit one for whose friendship I pay, so can call her by her first name).
She thinks that it is my supraspinatis muscle and connectors that I have damaged; she also thinks that it's a case of 'as good as it gets' in that I will be prone to injury. Both shoulders have had significant repair in that area so I need to start cutting my cloth accordingly.
So I need any suggestions of shoulder conditioning exercises please...
Also, suggestions of scapula setting exercises. My right shoulder, most recently cut open and stitched back together, clonks and knocks horribly (I wnet under the knife last December) but seems to quiet down when I set the bottom of the shoulder blade. The ironic thing is that it started giving me real grief just recently when I'd been doing some proper lat pull down exercises (behind the neck, 'old school' style) as these seem to help develop the muscles at the bottom of the scapula. But I think that I might have pushed the weight up a bit because I'm getting a bit of grief now - exacerbated by a Sunday of hedge trimming I guess.
Any suggestions (apart from never use my arms and shoulders again) gratefully received....
I've visited Janine, my physiotherapist (I've spend so much money with her over the last few years that I feel she has now become a friend, albeit one for whose friendship I pay, so can call her by her first name).
She thinks that it is my supraspinatis muscle and connectors that I have damaged; she also thinks that it's a case of 'as good as it gets' in that I will be prone to injury. Both shoulders have had significant repair in that area so I need to start cutting my cloth accordingly.
So I need any suggestions of shoulder conditioning exercises please...
Also, suggestions of scapula setting exercises. My right shoulder, most recently cut open and stitched back together, clonks and knocks horribly (I wnet under the knife last December) but seems to quiet down when I set the bottom of the shoulder blade. The ironic thing is that it started giving me real grief just recently when I'd been doing some proper lat pull down exercises (behind the neck, 'old school' style) as these seem to help develop the muscles at the bottom of the scapula. But I think that I might have pushed the weight up a bit because I'm getting a bit of grief now - exacerbated by a Sunday of hedge trimming I guess.
Any suggestions (apart from never use my arms and shoulders again) gratefully received....
Bill said:
TBH the girl on the ground (ie Janine) is best placed to give advice as she's actually assessed you.
That said there's a couple of things you've mentioned that I'll comment on.
First off the problem you have is a control issue, and if you push it on the weights you're likely to come unstuck so it's important that you increase gradually and work on reps rather than power. Since you mention them, lat pull downs work your lat dorsi and lower pecs (amongst others) and these both attach at the front of the shoulder which will tend to pull your shoulders forwards and down. This will increase the likelihood of impingement, or the pinching of your supraspinatus on the underside of the acromion. It also will tend to pull the ball of the joint forwards which won't help it move smoothly on the joint.
Scapular control is important because there's only one bony attachment between the scapula and the rest of your body, at the clavicle. Look at your arm like a cherry picker van. If the van doesn't use stabilising feet it'll fall over as the arm extends, and that's exactly what happens at the shoulder if you have poor scapula control.
Impingement will tend to happen when your arm is out to the side at about 90 degrees (generally 80-140), which is why the pain often subsides as your arm gets up to the end of range. This means that repetitive action in this range is likely to aggravate your symptoms as you're effectively rubbing the tendon back and forth through a pinch point, particularly if you're carrying anything. Hence the hedge trimming issue.
Thanks Bill; the control and pushing slow, high rep, exercises rather than pumping heavier weight is a message that I was 'reminded' about (read slapped wrist) yesterday.That said there's a couple of things you've mentioned that I'll comment on.
First off the problem you have is a control issue, and if you push it on the weights you're likely to come unstuck so it's important that you increase gradually and work on reps rather than power. Since you mention them, lat pull downs work your lat dorsi and lower pecs (amongst others) and these both attach at the front of the shoulder which will tend to pull your shoulders forwards and down. This will increase the likelihood of impingement, or the pinching of your supraspinatus on the underside of the acromion. It also will tend to pull the ball of the joint forwards which won't help it move smoothly on the joint.
Scapular control is important because there's only one bony attachment between the scapula and the rest of your body, at the clavicle. Look at your arm like a cherry picker van. If the van doesn't use stabilising feet it'll fall over as the arm extends, and that's exactly what happens at the shoulder if you have poor scapula control.
Impingement will tend to happen when your arm is out to the side at about 90 degrees (generally 80-140), which is why the pain often subsides as your arm gets up to the end of range. This means that repetitive action in this range is likely to aggravate your symptoms as you're effectively rubbing the tendon back and forth through a pinch point, particularly if you're carrying anything. Hence the hedge trimming issue.
What exercises would you suggest for scapular control? I though old-school lat pulls behind neck pulled the scapular down and in. Janine has suggested exercises such as sitting on a swiss ball and using a theraband to rotate outwards (don't know how to describe it) slowly and under control.
Any suggestions for helping with the impingement?
Bill said:
Lat pull downs bring the scapula down as a byproduct of the movement, rather than emphasising the control element.
What you're describing from Janine is pretty much what I'd get you doing, with you trying to control your scapula against the pull of the band. I'm not going to try explaining anything else because it's hard enough getting people to do what you want with them sat in front of you
Your best bet is to invest in some time with your physio so you understand what you're trying to achieve. I think my wife and I are keeping her in business this year....I'll keep on with her exercises (which include incline press ups keeping the scapula tight and under control) and book another appointment to check how I'm progressing. I'll give the lat pull downs a miss for a while until I'm happier with the control element.
It's blody weird, because until you have a problem with your shoulders you don't realise how all over the place your shoulder blade can get. Then when you try to bring it back under control it's damned hard..... Probably a lesson in life there.
Bill said:
I'm not going to try explaining anything else because it's hard enough getting people to do what you want with them sat in front of you
A quick one Bill; there are loads of scapula setting things and supraspinitus rehab exercises on YouTube. I'm cautious about taking stuff off there, especially when it relates to rehab and repair of injury, but as I'm also 'under' a physio would you suggest using some of these exercises as a supplement? Or would you suggest steering clear?Gassing Station | Health Matters | Top of Page | What's New | My Stuff