Shoulder Impingment

[DPS]

Last winter I hurt my shoulder lifting weights. I stayed off of it and it seemed to heal. Recently I re-injured it hanging and finishing drywall. The doctor diagnosed a shoulder impingment and prescribed naproxen (Alleve) and suggested I see a physcial therapist for exericises I can do. Being too lazy to see a PT, do you have any recommendations for shoulder exercises to help heal my shoulder? Thanks a bunch!

[Peter_Puget]

Was it an Ortho Physician or a GP? Was an imagining study performed?

[DPS]

Just my family doc. No imaging done.

[Al_Pine]

Peter_Puget said:

Was an imagining study performed?

 

I went to a doc and then PT for shoulder impingement. They gave me exercises to rebalance the muscles in there to reduce the tendons getting pinched between bones. I would think that which muscles need to be strengthened differ by person and the PT person can figure that out for you. However, there does seem to be a pretty good chance you have the same thing going on as me if it is because of climbing, ...so...I can relate what exercises seemed to help me. But if you got insurance, I'd suggest going to the PT since they are relatively cheap (well except at the UW they call them "MD" on the billing, probably to sock the insurance company more ) and you get a massage and shit .

 

Anyway, here's an exercise chart I found on the web that might help my explanation. What seemed to help was external and internal rotations but using a theraband (stretchy thing), keeping your elbow propped away from your body with a pillow. Also I think maybe the shoulder flexion but without weight, basically try to work the back muscles pulling down between your shoulder blads. Good posture was also emphasized, and stretching the shoulder, especially the one where you put your arm behind your back and try to reach the fist as far upward as you can. That stretch seemed to be an important benchmark for my doc.

[Dr_Flash_Amazing]

Ditto the advice for the ext/int rotation exercises (lay on your side and use a relatively light weight if you don't have Therabands or the like). Pushups are good, too. And stretches. Stretching out your lats is important for helping your shoulders move how they were meant to before your back muscles got all huge and apish from climbing.

 

A great thing you can do posture-wise is try to straighten up your upper back. If you're like most climbers, you're all hunched forward, which rolls your shoulders forward. If you stand sideways to a mirror, you can see this. If you look in the mirror as you slowly straighten up, you'll see a point at which your shoulders kind of roll back. Thissiz a much healthier position for them to be in, and keeps the blood flowing to the rotator cuff better. Speaking of that, you should also watch how you position yoru arms in bed. Having the injured arm lifted up over your head (or resting your head on your arm in a similar position) will really aggravate the impingement AND reduce the blood flow to that area.

 

Be patient, too. Shoulders are slow to heal and easy to bugger up, so don't blow it by pushing too hard too soon, eh?

 

Good luck!

[lummox]

Dr_Flash_Amazing said:

A great thing you can do posture-wise is try to straighten up your upper back. If you're like most climbers, you're all hunched forward, which rolls your shoulders forward. If you stand sideways to a mirror, you can see this.

hand position reveals this more easily. your palms shouldnt face backwards when standing while relaxed unless your way simian. humans stand with palms facing their legs.

[j_b]

all that was said plus deep tissue massage (across the fiber). i have found the following sequence works well for me: massage, stretch, exercise, ice. see a masseur to understand how much and what kind of massage induced pain is reasonable.

 

as for exercises. start with very low weights (1-2 lbs) exercising once the pain is gone then increase weight every ~week as long as you remain pain free. push ups are probably too much initially. as suggested using very light dumbells in rotational exercises as you lie on your side (on a bench or something), front and side dumbell raises, triceps extension, shrugs, flys, etc .... since you have to do the exrecises twice a day, you should consider picking up a used set somewhere. finally you'll probably have to make shoulder and back strengthening part of your out of season routine for the rest of your climbing career.

 

as for the arm overhead sleeping habit, force yourself to sleep lying on your back. wearing a t-shirt without pulling the arms through the sleeves will insure that you do so.

 

it works as long as you are methodical.

[lummox]

"I hate to advocate drugs . . . but they've always worked for me." ~ Hunter S. Thompson

[j_b]

drugs can mess you up (esp. stomach) and are often quite expensive (esp. if easier on stomach) and they often don't work.

[glassgowkiss]

danielpatricksmith said:

Last winter I hurt my shoulder lifting weights. I stayed off of it and it seemed to heal. Recently I re-injured it hanging and finishing drywall. The doctor diagnosed a shoulder impingment and prescribed naproxen (Alleve) and suggested I see a physcial therapist for exericises I can do. Being too lazy to see a PT, do you have any recommendations for shoulder exercises to help heal my shoulder? Thanks a bunch!

as far as treatment you have to loosen up your lattissimus dorsi. the reason you have this problem is you scapula doesn't release early enough and your own scapula cuts into superspinal tendon causing inflammation. is your pain with horizontal abduction between 70 and 120 degrees? pm me and i can send you to a couple of good massage therapists or pt's in seattle area. ciao- r

ps do you have any neck pain?

[lummox]

j_b said:

drugs can mess you up (esp. stomach) and are often quite expensive (esp. if easier on stomach) and they often don't work.

oh sure. orally consumed drugs can mess up your stomach.

[Peter_Puget]

Try the rest and rehab that others have recommended and if you find yourself in a constant cycle of rehabing don’t spend too much time screwing around go see an ortho guy and have an imaging study performed. Remember that most of the terms used such as “impingement syndrome” are very general. For some problems with the AC rehab will not work.

 

Link

 

PP

[Courtenay]

Don't forget horizontal rows for the rhomboids. Most climbers have lats that are far overdeveloped and rhomboids (the postural muscles in the middle of the back that help draw the shoulder blades together) that don't fire properly. Seated rows or 1-arm 90 degree dumbbell rows (drawing the weight to you as though your upper body is a cross) are examples. Yes, rotator cuff exercises MAY help with certain shoulder conditions; basically, whatever the PT says is your "weak link" is where you need to start. But if you're in a position where you're trying to stay in balance and prevent impingement and other shoulder problems from developing, ALL CLIMBERS should do some form of PUSHING and HORIZONTAL ROWING in which they get those shoulder blades to squeeze together. See our off-season strength routines at BodyResults.com if you need ideas.

[glassgowkiss]

hey don't forget ice and getting the inflamation down first before any excercise. if your acromion process keeps grinding on the superspinal tendon it will snap it. good luck.

 

[Dr_Flash_Amazing]

glassgowkiss said:

hey don't forget ice and getting the inflamation down first before any excercise. if your acromion process keeps grinding on the superspinal tendon it will snap it. good luck.

 

Ditto the ice/general inflammation control recommendation. According to the nifty home health guide book that Legacy Hospitals just sent the Amazing household, ice is far more promoting of healing than heat, despite heat's temporary soothing properties. On a related note, they do recommend ice with the caveat that you only use it as long as it seems to be helping with pain/inflammation (and they're talkin' about like 4x/day for 10 min. ea. time, FYI), otherwise it's not that useful.

[layton]

don't rule out massaging/stretching you scanlenes muscles (esp the anterior which can impinge your brachail plexus of nerves and your axillary a.)

 

Get a new pillow -memory cell or a chiro-pillow and be mindfull of keeping that area "opened up" while you sleep.