Shoulder problems..Impingement syndrome??

naughtoj

naughtoj

Cathlete
Ok. I think I got a problem. I think I have some kind of overuse/chronic injuries of my shoulders. Back in high school I injured my right shoulder (don't remember how, but in weightlifting class). I remember only lying awake at night crying because the pain was so bad. Like a dull ache, a headache of sorts in the shoulder.

Well, every now and then this problem seems to come back to a lesser degree. Now, it also seems to happen every now and then in my left shoulder as well! I can't say exactly what part hurts because many times it doesn't start hurting until evening. When I try to determine what action exacerbates it it still seems unlcear, because the pain isn't super intense..just radiating. It seems to "catch" at certain points where I sortof flinch and don't want to move it, but I can't pinpoint it. And I don't know if it is the same on both sides because both shoulders have yet to hurt at the same time.

Currently, it is my left shoulder. All I did was few FIRM upper body exercises on MON and was up with the "ache" lastnight.

I did some research on the net and have somewhat concluded that it must be impingement or rotator cuff tendinitis?? It is somewhat early stages I guess since it doesn't hurt all the time.

Does anyone have this as a recurring problem? I don't get why it is happening in my shoulders since I think I use good form, but my question is, do I continue to lift heavy weights or not? Of course not while there is acute pain, but there really is no acute pain. Do I have to modify how I lift or should I just look into some rotator cuff strengthening and rehab exercises?

Even if I went to the doc I don't think I could describe it and it is likely to be not hurting me then. Does anyone have advice??? Please...

Janice
 
Janice,

I was wondering if what you're experiencing might be similar to what has been happening to me. I'm going to my Physical Therapist tomorrow, and I'm going to ask him.

Sometimes it seems, after working out or riding my horse, that one shoulder or the other just "aches". It feels like not all the puzzle pieces are in the right place, and if someone were to just give my arm a good yank or stretch it just the right way, all the bits and pieces that make up my shoulder would snap back into place and the dull achiness would go away.


When I was doing PUB tonight, my right shoulder moved smoothly and easily but the left one seemed to keep "catching" on something and there was a noticible lack of fluidity in my movement through the left shoulder. The popping and snapping isn't really audible, and there's no pain, but I certainly could feel it happening.

Anyway, any insight you can offer would be helpful, and I'll be sure to share what the PT says, if you are interested.


Best,

Susan G.
 
I have had pain off and on in my shoulder area for a while, but here are some things that have helped me. One, I really try not to sleep on my shoulders by sticking my arm under the pillow and basically sleeping on the joint. I have an extra pillow I hug, or I just cuddle with DH. Two, I switched to a backpack style purse. I found that the shoulder I carry my purse on had much more soreness than my other shoulder. Also, I really try to remember to stretch out my shoulder girdle after EVERY workout, even cardio. I hope these suggestions help. :)
 
Hi Janice! I think you should see your doctor & either get an x-ray done or an MRI to really know what's going on. This way your doctor can give you a plan of treatment to follow so that the problem will go away. If not, the problem will only persist. HTH, Kathy
 
Janice,
Get thee to a doctor, who can better diagnose what the problem is and send you to a PT if necessary. You've described the pain to us, so it shouldn't be hard to describe it to the doctor.

Once you've gone through PT, there are certain things that can help prevent shoulder problems in the future:

Muscle imbalance self test: stand up and raise your arms to a "cross" position. Now drop them to the sides. (DO this before reading on.......) Which way are your palms facing? If they are facing backwards, your shoulders are rounding forward, which can mean the chest and front delt are disproportionately stronger than the rear delt. If they are facing each other (facing your body), then the musculature is more balanced.

Exercises to avoid: upright rows (may be done in a modified version with dumbbells); Arnold presses; flye moves done with the pinky raised.

Exercises to modify: You may find that overhead presses done with dumbbells are easier on the shoulders. You can change the position of your hands (palms forward or facing each other, or somewhere in between) to better fit your individual anatomy.

Exercises to include: rear shoulder raises are important to balance chest and front shoulder work. Lying L flyes and lying 60-degree raises are good for the rear rotator cuff. L flyes are done on your side, with the top arm bent at a 90 degree angle. Cathe does them in Slow and HEavy (though I wouldn't recommend doing them "slow and heavy" but rather working up to 15 reps at a 2/2 count and using light weights. Start with 1# even. If you are really strong, then mahybe 2 or 4 pounds to start. Never go above 5# on these). 60-degree raises are also done on the side. Straighten your upper arm and lift it as in a lat raise, but only about 60 degrees. If you do one set of each of these two exercises after every weight workout, you will go a long way to helping balance the musculature of the shoulder girdle and preventing further injury.

When doing any upper body weight work, keep your scapula retracted (pulled back and down). This puts the shoulders in a more protected position.

Again, this advice is NOT to be used in lieu of seeing professional help, but the PT can discuss some of these things with you and show you how to do them correctly.
 
Thank you everyone. I did upper body today and was fine, so I guess it is gone for now.

Susan, it does sound somewhat similar. I never feel pain when I am doing an exercise, just during the night and if I position my shoulder "just right" when doing something. As I said, I don't know what that "just right" position is and I think if my injury was severe I probably could tell you. So I think I can be thankful for that.But I must say, all through shoulder work my delts just click away...especially in those Arnold Presses. Overheads don't seem to bother me, but the clicking is almost audible to others in the room even!!

I know I have a muscular imbalance. My pectorals and front delts are much stronger than the rear. I somewhat have rounded shoulders as well, so I am sure it is from this imbalance that this chronic injury originates. I have been trying to do more "pulling" exercises than "pushing" for this reason.
I have pretty crappy insurance so I don't know if I will see a PT. While I respect all your advice, I am somewhat anti-doctor. I feel that with a little research I can find all the strengthening exercises I need and just do them. I went to a PT once and that is basically all they did.....give me a list of exercises and watch me do them. I don't need to pay for that. They did very little to explain to me anything specific about me. It is almost like they have a book. They look up under "rotator cuff tendinitis" and give you the xerox copies of exercises. Maybe I have just been going to the wrong place, but it was HealthSouth. I can imagine them sending me for an MRI and finding nothing..with tendinitis I know that is often the case.

I will exercise caution and try some of the exercises you gave me Kathryn. Thanks so much for taking the time to type that for me!!
Thanks everyone!

JANICE
 
I also have problems with my right shoulder.It is a dull pain and only hurts sometimes.I just work thru the pain.But that is me.What I mean by working thru it is yoga and stretching.If I don't do at least 10 min of yoga a day I get this pain.So I just do my yoga.I did not go to the doctor but recommend that you do if you feel it is nessasery {I just don't go to the doctor haven't been for 11 years ,just for my yearly pap is all).But you might want to try yoga and stretching real good.Hope it feels better.
 
Janice, How do you hold your arms when you sleep? I read in a book by Douglas Brooks that a lot of shoulder impingement problems are made worse by people sleeping with their arms over their heads (which is how I like to sleep normally, but since I've read this, I've tried to keep my arm down and it seems to help with avoiding a.m. shoulder stiffness and/or pain.

I understand being anti-doctor, especially if you've had a bad experience with them in the past. I went to a PT once who actually made my knee feel worse by putting me on some diagnostic machine that forced me to push hard against in to full or almost full extension. Snap...crack...pain... and the next few sessions (before I asked my doctor to send me to another PT office) were basically rehabbing from that injury!! The second PT was good in that he showed me a lot of exercises that I could do at home. I only saw him a couple of times, but got much more out of it than with the first (who basically did the "exercise while I watch you for $20 every 15 minutes!" thing).

Still, I would consider going to a PT at least once (and ask everything you can). They can at least do the diagnostic tests (maybe there are some that diagnose for free, as there are some chiroprators who offer free initial visits, even with xrays. Probably just wishful thinking, huh?)
 
Janice,

I went to my PT yesterday morning and he told me that my shoulders round forward. He said although I generally have very good posture, he would like to see me do some weight lifting exercises that works the LOWER portion of my lats (more pulling exercises like dead rows) in order to bring my scapular region back and down.

My PT lifts weights himself, so he was able to give me some good exercises to do. He is also a sacro-cranial PT, which is different than you regular PT in that he focuses more on the interaction of systems (muscles, fascia, bones, etc.) in the body and manipulates you in such a way as to release tension between the systems and bring your body back into alignment. It sounds very hokey, but it does work, and it's not about watching you do the same exercises for 20 minutes!

My insurance does not pay for my PT sessions and they run me about $100 each. I try to see him every six months just to "shake things loose" or whenever I fall off my horse, whichever comes first - LOL!

Good luck!

Susan G.
 
Wow..I really appreciate all the advice you guys have given me!!!

As far as the shoulders rounding forward...THAT'S ME!! As far as the sleeping position...its ALWAYS arms over my head (actually tucked under my pillow). Usually I cannot fall asleep unless I am in this position. My pain is not that chronic though in the sense that it is occurring daily. I only get pain for typically 24 hours maybe every 2-3 months. But I know what you all are saying as far as it being an imbalance.

Susan, thank you for sharing. I am sure you have the same problem as I from the way it sounds. I would go to a PT, but you are not supposed to see a PT unless you have already seen an MD that diagnosed you right?? I can't just walk in and say "Hey Doc..I think I have shoulder impingement..fix me up". You know what I mean. I am going to do more "pulling" exercises than pushing, which reminds me of a question I want to post here..

Maybe I will add myself to my hubby's insurance so that I have a secondary carrier. This would be the way to go...

Gracias, everyone..
Janice
 
Actually, I did go to my PT without consulting a doctor first. Since my PT is not a regular type of PT, what he does is not typical PT stuff. He mostly does manipulation, stretching, adjusting, etc., and no exercises.

I also purchased one of those band thingies you hang from the door to practice more pulling exercises for my lower lats.

Susan G.

P.S Sometimes when I lay in bed, I also like to lie on my back with my arms over my head - go figure. I also like this position - which can't be good for me:

I lie on my side, say the right side. I tuck my right arm behind me so my right hand is almost touching my lower back. My right leg is straight and my left knee is bent, pointing towards the headboard. I'm almost lying on my stomach but not quite. My pillow is tucked between my face and my right shoulder. My left arm is in front of me.

From above, I probably look like I'm running.

I do the same on the left side.

Makes you sore just thinking about it, right? But I swear it's so comfortable. But it can't be good for my alignment.
 
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