Shoulder injury/damage advice...

Shoulder injury/damage advice...

Author
Discussion

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
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.....

Loopyleesa

2,894 posts

168 months

Thursday 16th June 2011
quotequote all
Have you been to your GP?

Maybe a steroid injection would help. If it hurts then I wouldn't do any exercise with it!

I had Tendinitis and Bursitis a couple of years ago and I can still remember the pain it caused!

£10,000 (private health insurance) later and a 3 inch scar all fixed smile

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
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 smile

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

2,894 posts

168 months

Thursday 16th June 2011
quotequote all
After I had the ops, the surgeon recommended physio at Nuffield, which I attended, but it was too painful, so the very nice man gave me Acupuncture, which helped with pain more than anything.

I've never had it before and was a bit cautious, but it was definitely worth it.


Maybe that's an option for you.


And yes I'll show you mine if you show me yours wink

And GET to your GP! smash

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
Loopyleesa said:
And GET to your GP! smash
Yes Mum!

Loopyleesa

2,894 posts

168 months

Thursday 16th June 2011
quotequote all
T40ORA said:
Loopyleesa said:
And GET to your GP! smash
Yes Mum!
hehe

Bill

52,920 posts

256 months

Thursday 16th June 2011
quotequote all
Tbh (and I know I'm a physio so I'm bound to say this) I don't see any downside to going to the physio... You get a diagnosis and an idea of what you should be doing rather than ignoring it and hoping it'll go away.

mattikake

5,058 posts

200 months

Thursday 16th June 2011
quotequote all
GP visit before you do anything else!

Pain could be as simple as scar tissue on your tendond or liagment and that is for a physio to fix. OTOH it could be a more serious injury that is still trying to recover.

If muscular and you only get it on press exercises it could be just your subscapularis rotator. Google rotator cuff exercises and use some light weights to see which of the 3 exercises cause pain, then you will have a good idea which muscle/tendon it is.

Most light-moderate damage will heal quite quickly - a week or so - and the pain is something interfering with movement. The recovery involves strengthening the weakened areas. You're looking at high rep, 25-ish, exercises for muscular endurance work.

Do none of that until a GP has checked you out though!

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
OK. Question though; who will have a better handle on the muscular/skeleto things? The GP or the physio? Will the GP be able to tell me anything more than that I should go to the physio?

BTW I'll look up those exercise though.

Bill

52,920 posts

256 months

Thursday 16th June 2011
quotequote all
The physio.

mattikake

5,058 posts

200 months

Thursday 16th June 2011
quotequote all
Yep. Sounds like Bill is your man on this, at least initially. Worry about getting Personal Training advice from me when you have the damage diagnosed and treated, and THEN want to get onto the road to long-term recovery.

Bill's quals will out-rank mine basically! tongue out

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
So, back to square one. The physio is the best option, but will probably only tell me what I already sort of know.

But then it's worth the £35 - £45 for the piece of mind that I'm not further damaging myself.

mattikake

5,058 posts

200 months

Thursday 16th June 2011
quotequote all
Yeah but if you have a build-up of scar tissue the physio will be able to loosen this so your body can get rid of it. Only then can you start exercising properly and effectively.

Btw if the physio is any good it will hurt! wink

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
I shall look forward to paying for the pain!

T40ORA

Original Poster:

5,177 posts

220 months

Thursday 16th June 2011
quotequote all
I shall look forward to paying for the pain!

Loopyleesa

2,894 posts

168 months

Thursday 16th June 2011
quotequote all
Paying for pain

scratchchin

T40ORA

Original Poster:

5,177 posts

220 months

Friday 17th June 2011
quotequote all
Loopyleesa said:
Paying for pain

scratchchin
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.

T40ORA

Original Poster:

5,177 posts

220 months

Tuesday 21st June 2011
quotequote all
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....


Bill

52,920 posts

256 months

Tuesday 21st June 2011
quotequote all
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.

T40ORA

Original Poster:

5,177 posts

220 months

Tuesday 21st June 2011
quotequote all
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.

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?