T Nation

Shoulder Pain


#1

Hey guys,

For the past two weeks I've had a pain in my left shoulder. I've noticed it when I'm doing lifts that use my shoulder (bench press, overhead press) but also sometimes I'll have a slight pain when I lift my elbow up to parallel with the shoulder blade.

I changed two things in my training recently that could have had something to do with the cause of the pain: (1) switched from high bar squat to low bar squat (2) changed my bench press form to arch back and squeeze shoulder blades together after watching some videos from Dave Tate.

I have a couple of questions

  1. What sort of doctor / specialist would you recommend seeing if I were to see one about this issue?

  2. What sort of stretches / shoulder mobility exercises can I do in the future?

  3. Are there any good trainers in the Atlanta area that are recommended? I wouldn't mind hiring a respected trainer for a little while to make sure I'm not doing something stupid with my form.

  4. Would you recommend backing off the weight training for a while until I figure out what I'm doing wrong?


#2

Sounds like a rotator cuff impingement issue. I'll try my best to answer your questions based on my experience with a similar problem:

A doctor will tell you to stop lifting altogether and take pain meds. For now, you can try to manage this yourself with some intelligent training.

Do a search for "rotator cuff exercises". Start off light, and don't try to push things if you experience pain.

Don't know about Atlanta, but this is a good idea.

Yes - don't do any exercises that cause you pain. Probably no overhead pressing or dips for now. Once you have taken some time to heal, start strengthening the rotator cuff and slowly work back into exercises that you can do pain-free. DB presses are usually easier on your shoulders than BB presses for example.


#3

Hello.
I second that this sounds like a rotator cuff injury. I've had a similar injury to this recently (also characterized by that pain you feel, when lifting parralel to shoulder level, arm stretched in front).

You may also notice that when doing bench press, the pain really seems to kick in, when you bring the bar down low to your chest.
Google around to confirm more shared symptoms of this problem, but I suspect you will reaffirm that it is indeed your rotator cuff.

The gent above me, from my knowledge/experience, just gave really good advice - right on the ball, esp about what a doctor would tell you / how to approach your injury.

My cuff injury was REALLY REALLY bad (volleyball). I was in excruciating pain - It would wake me out of my sleep and have me yelling.
But I've slowly, nursed this arm back to health. I could write a book :wink:

Your first aim, is to get rid of whatever swelling/inflammation is there. Thats one of the primary causes of pain. Lay off ANY excercise with weights, that cause pain. Your rehabilitation, CANNOT take place with swelling.

Icing works well, but what works even BETTER, is whats called the Hot and Cold method (read up about that).

After you've reduced the swelling as best as you can, you need to do the strengthening excercises that you were told to look for above. I'll come and post any links that I find, but for the sake of example,one such exercise involves just raising your arm out in front of you (right about to that position that you say hurts you).
Also - stretching it to the side in much the same manner, and above head level.

Do a couple reps of these, (the aim is to strengthen ALL the muscles involved in these motions,)
then REST IT the next day or 2. When you can do these with very very very little pain, or NO pain, you can move unto doing those same exercises with light weights. If you can already do this with no pain, move unto using the light weights.

These exercises really strengthen the network of small muscles that make up the rotator cuff. There is ONE exercise in particular that is great for this injury, but I cant remember its name! - and it would be a bug to describe, so, I'll find out its name from a friend, and let you know.

-All the best.


#4

Thanks a lot for the responses! I do also get this pain while bench pressing. It's not terrible pain like you described so I think I am catching it relatively early. It's definitely a bugger though because I'm in the middle of a mesocycle with 5/3/1 and the last thing I want to do is back off, but I suppose taking time off to prevent an injury from getting worse is well worth the minor set back in the long run.

I think I definitely need to strengthen the "small network" of muscle in my shoulder, because I've basically only been doing overhead presses and bench press with 5/3/1 and have been ignoring a lot of other shoulder exercises.

How do I know when I have reduced the swelling? What I'm gathering is this: (1) First, lay off exercises that aggrivate the shoulder and get the swelling and inflamation reduced. (2) Slowly start to strengthen the rotator cuff. Makes perfect sense, but how do I know when swelling is reduced? Is pain usually an indication of that?

Thanks again for all the help!


#5

THere's more than a small network of muscles in the shoulder. The shoulder connects to an awful lot of back, an awful lot of arm and an awful lot of stabilizers.

Often injuries to the tendons in the cuff have about zip to do with their strength. That's a false premise. sorry. Often the injuries happen from poor movement, weak traps, high reps etc.

here's a bit of an overview on how the shoulder works

Really do see your doctor - if you have swelling - and it's not clear you do and that's what's up, then your doc has strategies on how (a) to test what kind of issue you may have - which muscle injured and (b) how to get the swelling down.

Yes pain reduction can be an indication of swelling going down. But pain going down can also be a result of improved movement.

Here's some other work on the role of different therapies including eccentrics to help rehab a tendon.

but it's not clear from what you've described that you've got a tendon injury.

Ask your doc for a referral to a sports-med osteo, and see a movement specialist to help reform your action - someone who can do additional assessments to find what will help get you out of pain and back to function.

Remember, the site of pain is not always the source of pain.
I've been amazed by how often working vision actually helps shoulder performance, just as an example

best
mc

ps
never move into pain
reduce ROM, speed, load in any motion till out of pain with it.


#6

Some good Points MC.

Different strokes for different folks I guess. I promise,I suffered with my shoulder for MONTHS UPON MONTHS. And the ONLY Time I began to get real improvement, was when I worked my limb through ROM,GRADUALLY (slowly) working against the pain.
A reflexologist (yeah, not quite her feild but) told me, that the only way to restore ROM, and get rid of pain, was to gently work through the pain, and then let the limb/muscles REST.

Thats the ONLY thing that helped THIS guy...

EDIT
Sup with BB code??


#7

@ ethanwest

Yeah I feel your pain brother. I have been battling what has been diagnosed as a rotator cuff impingement/ severe tendonitis. It can be described as a constant dull pain, and after being agitated it flares up and gives sharp pain.

Me and a few of my fellow lifters along with my doctor concluded it is most likely the result of constant lifting at work (2x12x16 PT boards, 80-100 lbs bags of concrete all day) and then going home and lifting with great intensity. I was seeing huge gains in strength and size and then my shoulders went to hell. In the end lesson learned as has been said before it may have been sloppy form and jerky movements and high reps (counting work as over use potential) that did me in.

So now I control my movements very well which actually I feel helps gain greater results and keep the reps on the lower end of the spectrum. I am 22, lesson learned (I have knowledge in sports medicine and injuries, I played 4 years of varsity sports for football, baseball, and wrestling).

Also, just as a side note, I still deal with the dull pain, and sometimes strong pain in my shoulders and that's part of getting older and being a lifter. Best thing you can do is work around it and work with it.


#8

I've gotten some real good advice from this thread, so thanks to everyone who has commented. I think the big takeaway for me right now is that I need to see a doctor, who can hopefully give me a recommendation for a physical therapist. I've located a sports rehab center with physical therapists that I think would be very helpful in identifying exactly what the issue is. In the meantime, I'm going to back off of the exercises that are causing pain and try to relax my shoulders for a couple of weeks and focus on some stretching and rotator cuff exercises.


#9

All the best Ethan.