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sampleinajar
Apr 3, 2009, 4:28 PM
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I am hoping someone can give me some insight on what I may have done to my shoulder. I have had some minor discomfort for the last 2 weeks , so I decided to take some time off from climbing. Over the last week the pain seems to have gotten worse. It seems to hurt the most when I raise my arm all the until it’s straight up, or If I put my elbow at my hip with my arm bent 90 degrees and move my arm out, like when shifting gears while driving. Sometimes it will hurt when I put my arm behind me, when putting on a jacket or reaching to chalk my hands. I have no pain while climbing or putting weight on the shoulder. Reaching up to grab a hold may hurt but when I put weight on it and pull I don’t really feel anymore pain. Hanging with arms straight, pull ups, pushups nothing causes any kind of pain. However, if I reach behind me to chalk up or when I shift gears driving home it hurts. Has anyone had anything similar to this happen to them? I have an appointment next week with a sports medicine doctor next week, is there anything I should be doing the meantime?
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memoman
Apr 3, 2009, 4:44 PM
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You might have secondary impingement of your shoulder, it is sometimes called internal impingement. It is usually seen in baseball players. However you might have a minor tear. You might want to see a orthopedist or at least a physical therapist.
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sampleinajar
Oct 6, 2009, 1:59 PM
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It’s been a little over 6th months of PT and I still have pain in the front of my shoulder only after climbing. There is no pain when I climb. I have no issues with the shoulder ever feeling unstable. Every now and again when making small movements it may make a slight click or pop and cause a little pain. I have a lot of pain if I cross my arms and relax my shoulder, but that pain seems to be around the biceps tendon in the front of the shoulder. I have not been to the PT since the MRI. I have been doing mostly the following exercises:
Internal Rotation using Dumbbells
External Rotation using Resistance Band
Lateral Raise using Dumbbell
Biceps Curls
The orthopedic doctor recommended standing rows and shrugs in addition to the exercises listed above, but I have not started those yet.
Are there any additional exercises that might help?What could be causing the pain in the front of the shoulder? It been a while since I took anatomy but the Partial tears of the supra and infraspinatus tendons are in the back of the shoulder correct?
MRI Shoulder w/ Contrast
Final report
1.Partial tears of the supra and infraspinatus tendons with mild tendinosis of the subscapularis tendon.
2.AC joint hypertrophy
There is increased signal and thickening of the supra and infraspinatus tendon near the insertion of the humeral head most likely representing partial tears. There is mild increased signal within the subscapularis tendon near its insertion as well likely representing tendinosis. The bicepts tendon and teres minor tendon appear normal.
There is AC joint hypertrophy. Otherwise the joint spaces and cartilage appear normal. The labrum is intact. Marrow signal is normal.
Note:
The original reading stated normal appearance of the labrum and should read the following:
There is irregularity of the posterior/superior labrum most likely representing a labral tear. In addition, there is a thickened irregular inferior glenohumeral ligament. The anterior/inferior labrum is ill-defined and difficult to separate from the inferior glenohumeral ligament possibly representing an anterior/inferior labral tear.
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onceahardman
Oct 6, 2009, 11:00 PM
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sampleinajar wrote: It’s been a little over 6th months of PT and I still have pain in the front of my shoulder only after climbing. There is no pain when I climb. I have no issues with the shoulder ever feeling unstable. Every now and again when making small movements it may make a slight click or pop and cause a little pain. I have a lot of pain if I cross my arms and relax my shoulder, but that pain seems to be around the biceps tendon in the front of the shoulder. I have not been to the PT since the MRI. I have been doing mostly the following exercises: Internal Rotation using Dumbbells External Rotation using Resistance Band Lateral Raise using Dumbbell Biceps Curls The orthopedic doctor recommended standing rows and shrugs in addition to the exercises listed above, but I have not started those yet. Are there any additional exercises that might help?What could be causing the pain in the front of the shoulder? It been a while since I took anatomy but the Partial tears of the supra and infraspinatus tendons are in the back of the shoulder correct? MRI Shoulder w/ Contrast
Final report
1.Partial tears of the supra and infraspinatus tendons with mild tendinosis of the subscapularis tendon.
2.AC joint hypertrophy
There is increased signal and thickening of the supra and infraspinatus tendon near the insertion of the humeral head most likely representing partial tears. There is mild increased signal within the subscapularis tendon near its insertion as well likely representing tendinosis. The bicepts tendon and teres minor tendon appear normal.
There is AC joint hypertrophy. Otherwise the joint spaces and cartilage appear normal. The labrum is intact. Marrow signal is normal.
Note:
The original reading stated normal appearance of the labrum and should read the following:
There is irregularity of the posterior/superior labrum most likely representing a labral tear. In addition, there is a thickened irregular inferior glenohumeral ligament. The anterior/inferior labrum is ill-defined and difficult to separate from the inferior glenohumeral ligament possibly representing an anterior/inferior labral tear.
Sample, this is a shoulder that has some problems. You have quite a bit of damage to several structures. This is not the shoulder of a virgin 18 year old. Nor will it ever be.
You could have a surgeon cut on it, and do a subacromial decompression. It will then be very painful for 3-6 months...then probably get somewaht better, but it will never feel the way it did when you were a teenager.
If you were in my clinic, I'd try to do some manual things that can help reduce an impingement that has resisted pure RC strengthening. A very skilled manual PT may well be able to help. But, it still will never be 18 again. Keep your cuff very strong, and avoid full-reach dynos. If you continue exactly as you have, a full thickness RC tear is in your future. Perhaps biceps tendon first. Then you can have them repaired, but it will still never be the same.
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paulcblais
Oct 17, 2009, 4:35 AM
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Registered: Jun 25, 2009
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just had my RT AC joint impingement repaired in april '09. the pain after surgery was minimal, it just felt tight. i was back climbing in may and was released by the doctor by june. if you have AC joint degeneration GET IT FIXED! it is SO worth it.
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saponga
Oct 21, 2009, 12:11 PM
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Registered: Oct 21, 2009
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http://www.ncbi.nlm.nih.gov/pubmed/16766370?dopt=AbstractPlus
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sampleinajar
Oct 21, 2009, 5:22 PM
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Registered: Sep 21, 2007
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The last thing I want is to have to have surgery on it. What surprised me was to see how much was wrong in the MRI. The pain is usually pretty mild most of the time. There are no issues with stability. My main concern was how bad is this going to get over time if I keep climbing. I really don’t want this to prevent me from climbing in the future. I have not been back to the PT since the MRI, but I am religiously keeping up with all the exercises that I was doing before. The shoulder seems like it’s doing ok. Most the pain is in the front of the shoulder. I’m just hoping that if I keep the shoulder as strong as I can and avoid any unusual moves that involve that shoulder it will be ok.
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puckeatr31
Nov 23, 2009, 5:56 PM
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Registered: May 12, 2007
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I just got back from orthopedic surgeon. After 9 months of pain in my left shoulder and doing everything the family doctor asked (rest, ibuprofen, ice, etc) I got a referal to the orthopedics guy. diagnosis is impingement syndrome. He is recommending physical therapy. My symptoms are pain when pushing (push ups, bench press, shoulder press, mantling etc). Doctor believes that the PT will solve my issue and surgery will not be needed. Draw back is he says will take another 3-6 months before PT really helps.
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paulcblais
Nov 23, 2009, 6:26 PM
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Registered: Jun 25, 2009
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my recommendation is Get The Surgery Done! i had it done april 15 and was climbing lightly by may 15. PT will not fix the bone problems only the muscles around the area. by the day after the surgery my shoulder felt like the impingment was gone and the area just healing. it felt much better.
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summerprophet
Nov 23, 2009, 6:37 PM
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Registered: Jan 17, 2004
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Suffered with impingement for a few years.
The key is slow recovery..... trying too much to fast just re-damages the shoulder.
I do low weight / high rep exercises, and once it starts acting up, remember to slowly work excercises into the problem area (over a few weeks).
In my case..... tightness when arm above shoulder height, so I start with low weight/high rep, and over the course of a few weeks, expand the lifts to cover the full range.
The stretchy bungees work great for this.
That and take up trad climbing, and give up dynos.
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