Shoulder pain

[idmd]

About a month ago I was benching and I felt a moderate sharp pain in my right shoulder. I stopped immediately but for the next week my shoulder was very sore to the point where it made work difficult. No pain lifting my arm laterally but I did have pain holding my arm out in front of me (same motion as benching). Also pain when doing biceps curls. Pain feels like anterior deltoid. Things got slowly better until I was benching yesterday and the same thing happened only after I stopped the pain was much worse and was much worse last night.

Here's the weird thing...I took a single dose of Motrin 800 before bed and woke up with my shoulder feeling 100%? No pain at work today although I have not lifted. Nothing adds up here...I was convinced yesterday when it happened I tore something and this was serious.....


Any ideas what it could be? Go easy for the next week?

 

[Demondosage]

I'm no Dr. so take what I say with a grain of salt here, but if the pain subsides and then returns under a heavy workload this sounds like definitely a joint issue, not a muscle issue. I had an issue with my A/C joint in my shoulder some years back, and it came from doing extremely heavy military presses with dumbbells. It was what is termed "impingement injury" which means basically the cushion in my joint was wearing thin due to heavy weights causing the joint to rub against itself. It really bothered me sleeping on it more than anything. I cut out military presses for about 4-6 months, and took glucosamine and fish oil, I think I trained with alot of machines during this period as well, keeping my elbows in and doing 3/4 reps. The common cure for this is a shoulder scope, where they go in and clean the joint out giving it room to move freely once again.Mine felt like something was clicking or pinching inside my shoulder and limiting my range of motion. I would recommend going to an orthopedic Dr. and having it X-rayed so you know what your dealing with, if its a joint you'll see it on the xray, a muscle will obviously need an MRI. The best advice I can give you is to #1- stay away from whatever exercise gave you this pain, in your case bench pressing. Stick to more incline or decline movements and see if it the pain subsides. Also, machines are great while working through an injury. #2- Any pressing movements go 3/4 motion on, stop the push about 3-4" from lockout, and stop the descent about 2-3" above your chest. This will keep the shoulders out of play and keep it on the chest. Start taking some glucosamine w/ chondroitin and also fish oil daily. It wouldnt hurt you to get a cortisone shot in the joint either, just use the shot to help with the pain, NOT TO TRAIN THROUGH IT. You can cause more damage with cortisone if you simply use it as a crutch to continue training the same way you were. In my case the pain came on all of a sudden, the 130 lb dumbbells was just enough weight to push that joint over the edge and cause pain. It eventually subsided without any surgery, but I had to change things up a bit and train smart. I cant be sure this is your issue, but if the pain is more during a front delt raise then I'm guessing its your A/C joint, the most common joint injury in lifters actually

 

[idmd]

Thanks DD...did you also have pain with biceps curls? Also just trying to figure out why a single dose of Motrin took care of this problem this time but a month ago the pain lingered for a week....

 

[509iron]

Idmd......Ive had an A/C impingement and it did require surgery. I hurt my left shoulder benching. The pain was immediate the next day was severely worse and stayed that way. When I went to see the doc he made me go through 6 weeks of PT . After six weeks with no improvement the doc wanted me to go through 6 more weeks of PT. After a couple more appoimtments. My physical therapists discharged me saying there has been no progress at all......after all that the Dr. finally ordered the MRI. I had an impingement of the A/C joint with several bone spurs. Surgery was scheduled and was success. After surgery I basically had to learn how to bench again.....start all over. It took about 2 and a half years since surgery.....with smart lifting techniques.....and now I can lift more than before the surgery. One thing I do now is that if something feels a little off ....pain wise.....I will STOP that movement immediately . And then next time I train that body part I go with a lighter weight more reps until if feels right. One thing I can tell you is that when I injured my shoulder ....there was no amount of Motrin or Naproxen or any NSAID that would alleviate the pain. The pain was constant. Basically if I raised my left arm straight out in front of me and tried to move it across my chest.....it was the the most severe pain. Now afted the surgery.....everything is all good. Hope this helps.

 

[idmd]

Yeah...this isn't anywhere near constant pain ATM. I'm going to layoff anything that puts pressure on my shoulder for the next few weeks and if it feels 100% SLOWLY get back to benching. In the mean time I'm going to read and watch about proper technique.

I'm a dentist by profession and need full non-painful movement of my right arm....

 

[idmd]

So I was "trying" to be good....did legs yesterday and thought pushing the Prowler would be a perfect end to the work out. Loaded up some weight and the moment I started pushing my right shoulder gave out with A LOT of pain. Couldn't lift my arm laterally past 90 and even worse lifting my arm in front or across me.

Went to the orthopod yesterday - specializes in sport injuries/upper extremities. Had some x-rays and a physical exam done. Dx as shoulder impingement with maybe a touch of bicep tendinitis. X-rays show I have a "low slung" acromion with minimal space for my rotator cuff tendons and he said to be careful because I'm more prone to this injury. No other pathology noted.

Treatment is anti-inflammatories and rest the joint for the next two weeks. Feels much better today.....

 

[smt71]

So I was "trying" to be good....did legs yesterday and thought pushing the Prowler would be a perfect end to the work out. Loaded up some weight and the moment I started pushing my right shoulder gave out with A LOT of pain. Couldn't lift my arm laterally past 90 and even worse lifting my arm in front or across me.

Went to the orthopod yesterday - specializes in sport injuries/upper extremities. Had some x-rays and a physical exam done. Dx as shoulder impingement with maybe a touch of bicep tendinitis. X-rays show I have a "low slung" acromion with minimal space for my rotator cuff tendons and he said to be careful because I'm more prone to this injury. No other pathology noted.

Treatment is anti-inflammatories and rest the joint for the next two weeks. Feels much better today.....

Interesting, I'm sure he probably did but do you know for certain if he tested you for a slap tear?

 

[idmd]

So I did 2 weeks of ibuprofen and went for a followup two weeks after the injury. Doctor did all sorts of physical test and shoulder was feeling 100%. Said to back off on heavy lifting for a while and slowly build up weight again. No problem...I did just that. I've moved to dumbbell presses for chest and they seem to put less pressure on my shoulder - probably because I'm using a much lighter weight.

So I'm weeks out from the followup and now my shoulder never hurts at the gym but if I do a chest day the day after I have times through out the day were I get pain doing seemingly simple things like raising my hands above my head to stretch or extending my hands out to type on a slightly elevated keyboard.

I feel the pinch, pain can be substantial limiting movement for 1-3 mins and then it subsides and my shoulder feels fine. If I try and recreate the same movement nothing happens. It literally feels like something is getting pinched between two bones - impingement.

Doctor said next step was cortisone injection if it didn't behave...what do you guys think?

 

[heel hook]

If you go back to Benching hopefully you lift with the elbows tucked as comfortable as possible for you saves a lot of wear and tear or db's with palms facing, I rarely grind reps atleast not to the end of a cycle if that even, rolling works great for me and acupressure and stretching nothing new but just what keeps me injury free.

 

[raysugar1234]

I always do rotator cuff exercises and hit the speed bag for a few minutes before benching. My shoulder used to click but now that I've strengthened the muscle it doesn't anymore. This has always been a concern for me because if you blow your shoulder out you can't train.

 

[idmd]

Thanks fellas....yeah this is definitely an anatomical defect exacerbated by lifting. I have never been able to throw a ball overhand in a fluid motion....when my hand got to 12 o'clock I could feel something "bind" and as I passes 12 o'clock it was fine. Never pain. Throwing sidearm was fine. Luckily growing up I played lacrosse and football and seldom had to make this movement.

When I went to see the doc he said the space between the humoral head and acromion was narrow and asked if I ever had problems throwing a ball.

Just wondering if cortisone is my next step....

 

[raysugar1234]

Definitely be carefull with it, This is something I hope I never have to deal with. Good luck.

 

[Bucky]

Hey IDMD, you wouldn't happen to have a slight hunch or posture problem with your upper back? I had/have the same problem and worked it alright with some PT. The problem is my scapulae roll forward enough to tighten the gap in my shoulder, resulting in impingement. Raysugar is right about RC exercises. They suck because there is no visual payoff, but very important non-the-less. Also, to strengthen the muscles on the scapula, put your chest on an incline bench, pull your shoulders back, and concentrate on tightening the muscles on your mid-back. While doing this raise light DB's straight out in front of you like superman when he's flying. It works on a flat table better, but most gyms wont have that. It feels real awkward, but it helps. Hitting the rear delts hard and going easy on presses for some time wouldn't be a bad idea either.Hope it works out for you. I see you're a dentist so you are working in a bent/leaning over position most of the day. In between patients or on down time, try to concentrate on pulling shoulders back and squeezing scapulae in/down.

 

[idmd]

Thanks Bucky! I work very hard on my posture both at work and outside work since dentists have so many back, shoulder and neck problems. I'd say outside work my posture is great. At work my posture is as good as it gets but with the nature of my work it's never going to be 100% so I think your suggests are right on target!

Thanks!

 

[idmd]

So first episode I was pushing on something and that caused immediate intense shoulder pain that got better with time. Things were going well with the occasional pang of very mild pain during certain movements and then about 3 weeks ago I started noticing my shoulder felt weird when I woke up (pressure) every morning and as the day went on it evolved into legit pain - maybe a 4 on the scale of 1-10. Next morning it would be better.

Went to the orthopod today and when he tested my rotators my right side was significantly weaker (arm was shaking too) even though that did not cause any pain or any abnormal feeling. I've been able to workout normally with no pain....any pain until 3 weeks ago was always caused by doing something outside the gym like extending my arm straight-out in front of me.

Sent me for an MRI.....so we'l see.

 

[radcon]

For as long as this has been going on it's good that you're getting an MRI to see the extent of the damage. These things can range from partial fraying of the supraspinatus tendon to full rupture. Lots of people walk around with full on supraspinatus ruptures and don't even know it but I would assume that if they started using their shoulder a lot such as with weightlifting, it would likely become symptomatic. The shoulder complex is fascinating in how things can pick up slack and stabilize when one part doesn't do it's job.

Small rant, not at all directed at you IDMD but towards weightlifters in general. You all move like shit (obviously a generalization)! The crowd thinks it knows about the body because they think they know about little subtle angle changes to hit the vastus medialis vs lateralis or emphasizing their post delt over their medial delt. The brain doesn't care about individual muscles - it cares about movement patterns. The whole bodybuilding mindset is to build yourself into a statue - statues don't move very well. Nothing wrong with wanting to look good but why not move well in the process.

Regarding shoulder impingement - The Body is a System of Systems and the site of pain is usually not the site of dysfunction. The glenohumeral joint is intimately connected with the scapula which is intimately connected with the thoracic rib cage which is intimately connected to the thoracic spine. And there's all the muscles in between as well as possible glenohumeral capsular tightness issues. If a couple rotator cuff exercises work for you, great!, but it's also a pretty myopic solution.

There is some genetic variation in the size of the acromion process so some people are more prone to impingement issues and this structure can undergo some degenerative changes and bone spurs will narrow the space for the supraspinatus.

External rotation of the humerus will create more space for the suparaspinatus, this is why neutral grip pressing is better tolerated by symptomatic shoulders (it has to due with the greater tubercle of the humerus). If your thoracic spine is stiff and tight and lacks extension range of motion - your scapula will sit rolled forward on the rib cage and this will reduce the subacromial space. If you lack glenohumeral internal rotation - your scapula will have to pick up the slack and compensate by abducting and rolling forward which will narrow the space. There's other elements that can play a role but I won't go into those.

Wouldn't it be nice if things didn't have to progress to the point of having to have cortisone shots and surgery. Too bad we don't have professionals that can intervene before this - or maybe we do???

 

[radcon]

Hopefully that didn't come across overly cocky, I wasn't really trying to be a dick but could see it interpreted that way. I'm just passionate and trying to draw awareness to people taking care of their issues before they become a problem that needs drug and surgical intervention because those options are by no means 100% effective.

 

[idmd]

Hopefully that didn't come across overly cocky, I wasn't really trying to be a dick but could see it interpreted that way. I'm just passionate and trying to draw awareness to people taking care of their issues before they become a problem that needs drug and surgical intervention because those options are by no means 100% effective.

FWIW I was told based on my radiographs the space between my acromion and humeral head is "narrow". He asked me if I had a hard time throwing a ball and guess what? This jives with the fact that I have always had trouble throwing a ball. At the 12 o'clock position my shoulder seems to "bind" and side arm was always much easier. Actually I just played lacrosse and football and it was a non-issue. Actually I NEVER had shoulder pain prior to the inciting incident. Just not sure what will be found. Unlike the first time where putting my arm across my body caused the most pain this time wiping my ass from a standing position causes the most pain. When it's painful I'm also tender to palpation of the most superior point on my shoulder.

Thanks for the input! Not cocky at all....passionate!

 

[radcon]

FWIW I was told based on my radiographs the space between my acromion and humeral head is "narrow". He asked me if I had a hard time throwing a ball and guess what? This jives with the fact that I have always had trouble throwing a ball. At the 12 o'clock position my shoulder seems to "bind" and side arm was always much easier. Actually I just played lacrosse and football and it was a non-issue. Actually I NEVER had shoulder pain prior to the inciting incident. Just not sure what will be found. Unlike the first time where putting my arm across my body caused the most pain this time wiping my ass from a standing position causes the most pain. When it's painful I'm also tender to palpation of the most superior point on my shoulder.

Thanks for the input! Not cocky at all....passionate!

You might see if your acromion is genetically more "hooked" or "beaked" creating narrowing or if it's narrowed from spurring/degeneration. If you google "types of acromion" that might make more sense if it doesn't already.

 

[Bucky]

I hope it works out for you bro. Lax and football FTW!