Shoulder impingement.

Hi all,
a bit pissed off because of a shoulder injury,that's made me decide i need to take a week out.
I've had a niggling problem for a few years now,and i've had therapy/physio,that's never really cured it.
x rays have shown nothing,and i get the usual rest and ice advice from doc,but nothing more.I've tried it,even for extended periods,but
it hasn't been a success.Been offered cortisone shots,but i steer well clear of them,as i believe they do more harm than good.
In the gym,i seem to manage ok once i'm warmed up,and the symptoms are less bothersome,but for whatever reason,one exercise
i've had to stop,due to the severity of the pain,is dumbell curls.Once i'm home,and the adrenalin drops,the pain returns,and now
it's affecting my sleeping.
I don't think i've torn my rotator cuff,as i'm able to lift my arm above head height etc,but when i search the net and you tube in particular
looking for answers and advice,there are so many 'experts' giving conflicting advice,i get lost in it all.
If there is anyone on the likes of you tube,who anyone has followed,and found out there advice is good i'd sure like to know their name.
Thanks.

Do you retract your shoulder blades when you lift?

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Originally Posted by Nogbad the bad

Hi all,
a bit pissed off because of a shoulder injury,that's made me decide i need to take a week out.
I've had a niggling problem for a few years now,and i've had therapy/physio,that's never really cured it.
x rays have shown nothing,and i get the usual rest and ice advice from doc,but nothing more.I've tried it,even for extended periods,but
it hasn't been a success.Been offered cortisone shots,but i steer well clear of them,as i believe they do more harm than good.
In the gym,i seem to manage ok once i'm warmed up,and the symptoms are less bothersome,but for whatever reason,one exercise
i've had to stop,due to the severity of the pain,is dumbell curls.Once i'm home,and the adrenalin drops,the pain returns,and now
it's affecting my sleeping.
I don't think i've torn my rotator cuff,as i'm able to lift my arm above head height etc,but when i search the net and you tube in particular
looking for answers and advice,there are so many 'experts' giving conflicting advice,i get lost in it all.
If there is anyone on the likes of you tube,who anyone has followed,and found out there advice is good i'd sure like to know their name.
Thanks.

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I have issues with both of my shoulders...left one is the worst and it hurts 24-7. Sleep is affected and I get shots in both shoulders several times a year. Arthritis in left shoulder from old wrestling injury the size of a golf ball..
The point of my sharing is that a week off will do nothing but make you weaker and stiffer.
The pain is something I just have to deal with and be cautious of my movements.
But I can tell you from experience that keeping active and lifting is far less painful than when I don't.
Even a few days off and my shoulders and knees start to ache twice as bad as they do after a workout.
Especially at my age. I just keep it pushin... Tylenol and Gabapentin brother!!!

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Originally Posted by The Deadlifting Dog

Do you retract your shoulder blades when you lift?

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Well,if you mean barbell work,i do very little,as i've already said due to lower back injuries.The only two movements i'm still doing,are bench press
and close grip bench for triceps.
If by retracting shoulder blades,you're referring to good form,yes i do and always put form first.There are fellas in the gym throwing twice the weight
i use around,yet my physique is infinitely better than theirs,because their form is shit,and their ego rules.

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Originally Posted by Sicko

I have issues with both of my shoulders...left one is the worst and it hurts 24-7. Sleep is affected and I get shots in both shoulders several times a year. Arthritis in left shoulder from old wrestling injury the size of a golf ball..
The point of my sharing is that a week off will do nothing but make you weaker and stiffer.
The pain is something I just have to deal with and be cautious of my movements.
But I can tell you from experience that keeping active and lifting is far less painful than when I don't.
Even a few days off and my shoulders and knees start to ache twice as bad as they do after a workout.
Especially at my age. I just keep it pushin... Tylenol and Gabapentin brother!!!

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Appreciate your input mate,but i know that continuing is making it worse.
The pain is getting worse week by week,and i fear a major trauma if i keep pushing.I've had it before,so i didn't train for around a year,until it
eventually disappeared.It reappeared around a month ago,while i think i was on a pec dec at full extension.That seems to be where my problem
is.Some machines,are poorly designed,in my opinion,as when you're seated ,and your arms are fully extended,you still have to reach back for
the grips.This leaves your shoulders in an extremely vulnerable position,especially when you're capable of moving a good weight.
I have seen some equipment,where you can move the weight to a more joint friendly position,by using a foot press,but there's nothing
like that in my gym.
To be honest,i'm still going to go and train legs because there's no excuse not to.I'm also not keen on taking painkillers,as they only mask the
pain.Not sure what folks think about anti inflammatorys,as i've heard some say it stops muscle growth while on gear.Then again,i've only
one pin left on cycle,so i may try them before my pct.

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Originally Posted by Nogbad the bad

Appreciate your input mate,but i know that continuing is making it worse.
The pain is getting worse week by week,and i fear a major trauma if i keep pushing.I've had it before,so i didn't train for around a year,until it
eventually disappeared.It reappeared around a month ago,while i think i was on a pec dec at full extension.That seems to be where my problem
is.Some machines,are poorly designed,in my opinion,as when you're seated ,and your arms are fully extended,you still have to reach back for
the grips.This leaves your shoulders in an extremely vulnerable position,especially when you're capable of moving a good weight.
I have seen some equipment,where you can move the weight to a more joint friendly position,by using a foot press,but there's nothing
like that in my gym.
To be honest,i'm still going to go and train legs because there's no excuse not to.I'm also not keen on taking painkillers,as they only mask the
pain.Not sure what folks think about anti inflammatorys,as i've heard some say it stops muscle growth while on gear.Then again,i've only
one pin left on cycle,so i may try them before my pct.

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No worries...I guess my point was a week off is not going to do anything IMO.
Either get medical treatment or manage your movements to limit risk and deal with the pain.
1 week off will just slow you down. Your not going to heal from this kind of injury in a week.

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Originally Posted by Sicko

No worries...I guess my point was a week off is not going to do anything IMO.
Either get medical treatment or manage your movements to limit risk and deal with the pain.
1 week off will just slow you down. Your not going to heal from this kind of injury in a week.

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Appreciate your response bud,and yeah
i know a week off won't cure an injury,it's just i'm not worsening it,and it gives me time to think about how to continue.As far as medical treatment
is concerned,i just get a bit of physio/massage,then a list of rehab exercises to do,so it's pretty pointless me bothering my doc.
The best advice i can think of where pain is concerned is if it hurts,don't do it lol!
I'll see how things go this week,then decide what to do. Thanks again.

Nogbad I posted this in another thread but have you tried acupuncture? I had significant impingement with chronic pain for about 6 months from heavy benching. Acupuncture gave me relief in 2 visits. It may work for you too and most insurance will cover it. I refuse to have cortisone shots because all they do is mask the injury and you just do more damage because the injury is still there but the pain isn't. Just my opinion on the cortisone shots. I'm sure they have their place and are effective for some.

Not sure why you think an intraarticular joint injection can/will do more harm than good. Sometimes it calms down the inflammation and you're good to go, sometimes it is limited, and sometimes does nothing.
For me it's worth a shot (no pun intended). Earlier this year I damaged the TFCC in my L wrist, didn't mess with rehab, rest, etc., went right to an ortho buddy and asked him to inject under ultrasound guidance. He made me take a week off after injection and it hasn't bothered me since. Injection is a relief to a lot of people with impingement. You can have a bursitis, a partial tear of the RC which is painful but allows full ROM, a tendinosis, etc. I'm a fan of injection and have experience with it in my line of work.

For me personally I simply have to avoid certain lifts to keep my shoulder from hurting - BB bench, military press or upright rows guarantee acute onset pain and difficulty from there out. DB shoulder press, isolated DB raises and cable raises all seem to do fine, as do DB presses and Hammer Strength machines.

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Originally Posted by TrailRunAZ

Not sure why you think an intraarticular joint injection can/will do more harm than good. Sometimes it calms down the inflammation and you're good to go, sometimes it is limited, and sometimes does nothing.

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The cortisone shot can and will work. The problem comes when you start feeling better and begin to use the joint again. I've worked with and worked out with numerous guys over the last 35 years that have had cortisone injections. The vast majority felt better initially then began to do the same things that caused the problem. I'd say that less than 10% actually got permanent pain relief. Most lasted a few weeks to a few months and when the cortisone wore off they were as bad or worse than they were before. If you can control youself and let the cortisone work then you'll probably be ok. Just because you feel better doesn't mean the injury is healed.

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Originally Posted by 600@50

The cortisone shot can and will work. The problem comes when you start feeling better and begin to use the joint again. I've worked with and worked out with numerous guys over the last 35 years that have had cortisone injections. The vast majority felt better initially then began to do the same things that caused the problem. I'd say that less than 10% actually got permanent pain relief. Most lasted a few weeks to a few months and when the cortisone wore off they were as bad or worse than they were before. If you can control youself and let the cortisone work then you'll probably be ok. Just because you feel better doesn't mean the injury is healed.

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Great point. I guess I assumed after the injection he would identify the movement(s) that caused the flare up and avoid, but you're absolutely correct. And in that context it may be much worse the second time around if you're still incurring damage as opposed to simply inflammation. I just like some instant relief and have dialed in what affects my shoulders. Excellent cautionary information, thanks

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Originally Posted by 600@50

Nogbad I posted this in another thread but have you tried acupuncture? I had significant impingement with chronic pain for about 6 months from heavy benching. Acupuncture gave me relief in 2 visits. It may work for you too and most insurance will cover it. I refuse to have cortisone shots because all they do is mask the injury and you just do more damage because the injury is still there but the pain isn't. Just my opinion on the cortisone shots. I'm sure they have their place and are effective for some.

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I haven't tried it bud,but i have given it a bit of thought.I may just give it a go sometime this year,if i'm no better.
At present,i'm doing stretching exercises with those elastic ropes,with the handles on the ends,and i'm actually
feeling a bit of improvement.I have also incorporated a lot more stretching/warming up,before exercising.
I'm in complete agreement,regarding cortisone.It may be ok for those who just want pain relief,but not for anyone
wishing to continue with strenuous activity.
I was going to try deep tissue massage,at a Thai massage parlour near me,because they advertise such,but i've
seen a lot of older fellas going in,and i'd put money on it the only massage they're having,is the type with a 'happy ending'.
Best not be seen frequenting that place lol!

Quote:

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Originally Posted by Nogbad the bad

I haven't tried it bud,but i have given it a bit of thought.I may just give it a go sometime this year,if i'm no better.
At present,i'm doing stretching exercises with those elastic ropes,with the handles on the ends,and i'm actually
feeling a bit of improvement.I have also incorporated a lot more stretching/warming up,before exercising.
I'm in complete agreement,regarding cortisone.It may be ok for those who just want pain relief,but not for anyone
wishing to continue with strenuous activity.
I was going to try deep tissue massage,at a Thai massage parlour near me,because they advertise such,but i've
seen a lot of older fellas going in,and i'd put money on it the only massage they're having,is the type with a 'happy ending'.
Best not be seen frequenting that place lol!

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While I agree intraarticular injection is not a cure-all, and for the reasons cited in my earlier comments, I do think it has utility and can be curative, depending upon the issue. If you have acute/chronic inflammation (tendinitis, bursitis, etc.) it can eliminate the inflammation which IS the issue. If you have impingement due to acromion type, or partial rotator cuff tear, etc., then yes, an injection may simply mask the pain. But again it depends upon the diagnosis.
I get it if someone doesn't want an injection, but I think it's incorrect to make the blanket statement that a steroid simply masks the pain and allows for further injury. The inflammation may be the issue and the steroid eliminates that.
Regardless, I think the routines need to be evaluated and exercises that cause pain need to be modified or eliminated.

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Originally Posted by TrailRunAZ

While I agree intraarticular injection is not a cure-all, and for the reasons cited in my earlier comments, I do think it has utility and can be curative, depending upon the issue. If you have acute/chronic inflammation (tendinitis, bursitis, etc.) it can eliminate the inflammation which IS the issue. If you have impingement due to acromion type, or partial rotator cuff tear, etc., then yes, an injection may simply mask the pain. But again it depends upon the diagnosis.
I get it if someone doesn't want an injection, but I think it's incorrect to make the blanket statement that a steroid simply masks the pain and allows for further injury. The inflammation may be the issue and the steroid eliminates that.
Regardless, I think the routines need to be evaluated and exercises that cause pain need to be modified or eliminated.

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Don't disagree with your points
bud.If you only have a minimal amount of shots,it can do good,but numerous shots can soften catilage,and weaken tendons.A couple of fellas i know,have
had numerous injections,and their arms (on the shoulder that's damaged) have virtually withered away.They've had an injection,then went back to the
heavy industry work that caused it.Shortly after,they need another shot,then another and so on.
A doctor offered me the same,without mentioning side effects,and when i explained them to him,he was surprised i had any knowledge of such things.
Maybe they just assume we're all dumb!

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Originally Posted by Nogbad the bad

I haven't tried it bud,but i have given it a bit of thought.I may just give it a go sometime this year,if i'm no better.
At present,i'm doing stretching exercises with those elastic ropes,with the handles on the ends,and i'm actually
feeling a bit of improvement.I have also incorporated a lot more stretching/warming up,before exercising.
I'm in complete agreement,regarding cortisone.It may be ok for those who just want pain relief,but not for anyone
wishing to continue with strenuous activity.
I was going to try deep tissue massage,at a Thai massage parlour near me,because they advertise such,but i've
seen a lot of older fellas going in,and i'd put money on it the only massage they're having,is the type with a 'happy ending'.
Best not be seen frequenting that place lol!

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There is also a modality used in the US by physical therapists (those who are certified to do it) referred to as dry needling. I had a knee surgery in Jan of this year and am still fighting to rehab. I had a huge effusion (probably more than 100ml) and after two sessions of dry needling (with electric current) the effusion was reduced 50%, by the end of the week and until now (three weeks later) I have been able to avoid another painful knee tap to draw off fluid. Pretty impressive. I would definitely give it a shot for a shoulder issue.

Something else i forgot to add.
Tried sitting with an ice pack,for varying lengths of time;no improvement
Take a hot shower;no pain at all,and complete freedom of movement,for up to half an hour or so...go figure.

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Originally Posted by Nogbad the bad

Something else i forgot to add.
Tried sitting with an ice pack,for varying lengths of time;no improvement
Take a hot shower;no pain at all,and complete freedom of movement,for up to half an hour or so...go figure.

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This can be typical for degenerative issues/arthritis. Other signs would be "gelling," where joint is stiff from immobility but gradually improves in ROM and decreased (slight to moderate) with movement (normal movement and use, not lifting).

I am going through the same thing the therapist gave me exercises to do.Was feeling good for a couple days then I twisted it while sleeping.Well that was the end of my sleep at 2:30AM.

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Originally Posted by songdog

I am going through the same thing the therapist gave me exercises to do.Was feeling good for a couple days then I twisted it while sleeping.Well that was the end of my sleep at 2:30AM.

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Yeah,it's a bitch when it wakes you from a nice deep sleep...grrrrrrr!

Forgot to mention that PRP (platelet rich plasma) is an option which might help immensely. Below is a link to an article comparing dry needling to PRP in rotator cuff pain. A step up from that might be stem cell therapy. Neither PRP or stem cell are covered by insurance, but if you find a good doc (I would see a Physiatrist) they will give you an idea of what the likelihood of curative effects it might have. Just wanted to throw that out there since it hasn't been mentioned.

SAGE Journals: Your gateway to world-class journal research

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Originally Posted by TrailRunAZ

Forgot to mention that PRP (platelet rich plasma) is an option which might help immensely. Below is a link to an article comparing dry needling to PRP in rotator cuff pain. A step up from that might be stem cell therapy. Neither PRP or stem cell are covered by insurance, but if you find a good doc (I would see a Physiatrist) they will give you an idea of what the likelihood of curative effects it might have. Just wanted to throw that out there since it hasn't been mentioned.

SAGE Journals: Your gateway to world-class journal research

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Sounds interesting bud,but i imagine the cost of this treatment would be extremely prohibitive....at least in my case!

Update; last few sessions,i've found cable work,causes a lot less pain/stress on my shoulders,particularly curling movements,
so i'm doing more of that at present.

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Originally Posted by Nogbad the bad

Update; last few sessions,i've found cable work,causes a lot less pain/stress on my shoulders,particularly curling movements,
so i'm doing more of that at present.

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Glad you're doing better Nogbad. Just remember "If it hurts don't do it ". Find another movement because your body is trying to tell you something with the pain. You can attempt to work through pain but it's only going to take longer to heal.

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Originally Posted by 600@50

Glad you're doing better Nogbad. Just remember "If it hurts don't do it ". Find another movement because your body is trying to tell you something with the pain. You can attempt to work through pain but it's only going to take longer to heal.

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Cheers bud,
yeah i've been struggling a bit with curls,particularly dumbells,and have just tried to soldier through,but the pain was just getting worse.
Funny thing is,i seem to be able to get through my shoulder/back/triceps routines,fairly comfortably,but biceps YIKES! pain.
Did some strict ez bar curls on the bench last night-ok only slight twinge.Did cable curls with bar-no problem.Tried dumbell hammer
curls,AAAAARGGGHHH! felt like a knife being pushed into the top of my arm.Went back on cables,and did rope curls,which kinda
imitate hammers-no problems again.
Struggled to sleep last night because of the aching,so it's just gonna have to be cables for the time being.
Wish i wasn't such a stubborn bastard,then maybe i would just leave the dumbells alone!

If it's truly an impingement, from a few people whom i've known (baseball pitchers) who have had this problem, the problem is easily remedied arthroscopically. Down time is extremely minimal after surgery. You might be back lifting in a few days.... Get checked out by a surgeon. Don't try to fix this through Dr. Google.