Shoulder issues and Foundation 1

I'm very exited to start progressing on Foundation 1. I have done some pre testing… just recovering flu, so no any serious testing yet.

Anyway i have this shoulder issue, i had it now couple months and finally decided to go see specialist to find out what is the problem. So I was in doctor(and x-ray + ultrasound) and i have two issues in my left shoulder:

1. Mild osteoarthritis in AC joint (don't know is this the right translation), that was probably caused some old injury what i don't remember.

2. Supraspinatus Tendonitis (rotator cuff inflammation, rotator cuff Tendonitis)  (It may have change that issue number 1. can cause this issue number 2.)

For i treatment i got shot of cortisone in my shoulder. 

Doctor says that cortisone should help and after couple days i can start exercising. Of course i should not start by doing ton's of work what affect shoulder.

Here is what i found before doctor and cortisone...

When i do moves below, i really feel sharp pain top on my shoulder: 

HBP/PE

RC/PE

sPL1 and MN/PE1 Mobility… i don't feel pain, but i don't know is it good for my shoulder…

So how do you suggest that i continue? I had plan's to start Foundation on Monday(4 times per week). Should i test and the progression all the moves, where the shoulder is not used so much. And maybe just at level 1 those those moves above(if i don't feel any pain)?  Or just do some rehab work for shoulder when i feel that everything is all right?

This shoulder has been pain in my ass a long time, and now i want to be smart and get that fixed. I really want to get rid all of my shoulder pains and start injury free training...

Thanks!

Hummm...... the Cortisone shot was likely to cool down the inflammation in the A/C joint but won't do much for the supraspinatus tendonitis...

You'll need to address that and maybe remove the cause which may be impingement due to improper movement of the shoulder.

There is a difference between tendonitis and tendonosis, not sure if you got exact description.

It is easier to recover from tendonosis, with tendonitis you are looking at more time off starting with removing inflammation.

In general what to do, get inflammation away (as Fred says cortison shot is not whole remedy for your problem if it is really tendonitis, just help at this very moment), you may also help yourself with cold/hot compress/showers, get blood flowing there and start rehab. It may be good to visit good physio, get him to check and advice on excersises. Anyway you will find some good rehab routines from Kit Laughin, just remember to take it slowly, don't get to much resistance, only no pain/very mild pain can be aceptable while excercising. If there is really tendonitis (or even tendonis), some time off would be adviced/required to get inflammation under control and then rehab work, still do your core/legs/etc .

For osteoarthritis, I can tell you what is helping me to go along with my joint issues, UC-II collagen (and if you add glucosamine+MSM+chond to that it may be even better).

Thanks! 

I try to translate my doctor's writing with my not so good medical english.. But it's supraspinitus joint inflammation (i'm pretty sure). The ultrasound - image shows that my left shoulder's supraspinitus joint is 2millimetres thicker than right one...

This time i definitely take slowly. And i hope that i have change to see good physio soon.

I agree with everything said above.

It's a tough combo AC Arthritis and Suprasipinitus tenodonitis/osus.

I've also had good results with UCII collagen for a pretty serious case of elbow osteoarthritis.

That cortisone shot will make you feel better, but don't let that fool you into overdoing it. Go slow, clinical evidence suggests that cortisone does nothing for the long term prognosis of your issue. It is likely to reoccur if you don't take care of it.

If you have a therapist you can work with in your area in could be very helpful.

For the Foundations program, you may have to confine yourself to the PE1 on RC and HBP for a while. Don't do anything that hurts. The sPL PE's should be fine as they don't hurt.

If even those hurt, then do your rehab, and test every couple of weeks.

Do not exercise for 2-4 weeks after the cortisone shot. If you do, you will degenerate tissues. If your doctor tells you this is not the case, disregard his advice in this area, and anyone else's that says anything similar.

This shot can help with the inflammation, but it does so by completely, and I mean completely, shutting off your healing mechanism in that local area.

This can be useful, but you need to know that any exercise at all in this area, other than unweighted range of motion work that does not hurt, is a bad idea.

It will absolutely help the supraspinatus as well as the AC joint, but may need to be injected right next to the tendon to take full effect. Your doctor should know best on this kind of thing.

Once you have that taken care of, you'll need to find a good occupational therapist or physical therapist, and start working on correcting your scapular dysfunctions. They are there, and they are why you have this problem.

They may be secondary to any number of things, from uneven anterior tilt (pelvic tilt) to scoliosis (which itself can be secondary to quite a number of things).

Please get evaluated by a professional after the cortisone wears off in 2-4 weeks (I suggest 3-4 weeks), and start working on your dysfunctions.

Once you get that started, and begin learning how to move correctly, Foundation 1 will actually HELP the rehab process, but not until you have basic movement re-patterning. You will need to limit yourself to those movements that can be performed properly, but you'll get to where you can just go with the regular template flow after a few months at the most (assuming proper rehab is being done).

Disregard this post at your own risk.

Thank you all! 

Joshua N. Do you mean that i should drop all my exercise for 2-4 weeks or just everything what's affect on the shoulder? Or i can i do core/legs normally + walking etc... and start doing other foundation stuff when i got my shoulder fixed?

I'm sitting front of the computer all my days... so i have a feeling that maybe can affect on my shoulder and definitely my posture... 

You can do anything that doesn't use the shoulder right away.

I'm surprised your MD didn't tell you to rest the shoulder for at least two weeks. Three weeks is better after the cortisone. You can still do light mobility work however.

Mikko Oikarinen said:

Thank you all! 

 

Joshua N. Do you mean that i should drop all my exercise for 2-4 weeks or just everything what's affect on the shoulder? Or i can i do core/legs normally + walking etc... and start doing other foundation stuff when i got my shoulder fixed?

 

I'm sitting front of the computer all my days... so i have a feeling that maybe can affect on my shoulder and definitely my posture... 

Anything that involves the shoulder that gets injected, other than pain-free range of motion work. No hard stretching, just use the ROM that you currently have.

That includes deadlifts and squats, unless they are bodyweight only. Walking is fine, and moderate running is fine too, but I wouldn't sprint. No high-power arm movements at all. To be safe, I'd just walk and bike for cardio for those two weeks.

Ab work (obviously no roll-outs), SLS, NLC, are all appropriate. So are bodyweight only arch ups, curl ups, etc.

No pull ups, biceps curls (or anything that does elbow flexion), basically no holding weights in the hands, and don't go crazy. No rapid movements, but make sure to use 100% of your available pain-free range of motion every day.

Basic arm lifts and slow arm circles are fine, but don't go crazy on the reps and don't do anything that makes you feel any pressure in the joint itself.

Mikko,

Let me give you some advice most people don't know about.

What you describe as shoulder pain may simply be a symptom of the real problem which may be an imbalance and weakness in another part of the body...

Most people think 'shoulder hurts... shoulder must be the problem'. But this is rarely ever the case. Perhaps the pectoral minor is to tight and weak. Or the muscles supporting the lumbar spine are weak. It could be your bicep, tricep, deltoid, latissumis dorsi, even your foot!

It's a little outrageous of a thought that something so little in one part of your body is the cause of all these other symptoms.

I would tell you to go see my deep tissue specialist (not some massage) but he's in California.

So that is my $.02

Somalie said:

Mikko,

Let me give you some advice most people don't know about.

What you describe as shoulder pain may simply be a symptom of the real problem which may be an imbalance and weakness in another part of the body...

Most people think 'shoulder hurts... shoulder must be the problem'. But this is rarely ever the case. Perhaps the pectoral minor is to tight and weak. Or the muscles supporting the lumbar spine are weak. It could be your bicep, tricep, deltoid, latissumis dorsi, even your foot!

It's a little outrageous of a thought that something so little in one part of your body is the cause of all these other symptoms.

I would tell you to go see my deep tissue specialist (not some massage) but he's in California.

So that is my $.02

You do, of course, realize that every muscle you listed except for the lower back musculature is actually a part of the shoulder girdle, right? And that, as such, any decent therapist (which can absolutely include chiropractors and soft tissue people, but no guarantees on any of them, including PTs) is going to do manual muscle testing of all of these in various parts of the shoulder ROM?

A postural analysis is always a good idea, and, while ideally is part of any exam, is all too often neglected. This is a good thing to ask about.

Allright. So i think i will go light walking for next weeks and some parts of Foundation 1.  And try to find good physio as well...

I'm also bit surprised that MD didn't say nothing about shoulder rest...  Glad i asked here, i have to say that excellent support!

I'm not surprised, they aren't trained in musculoskeletal medicine unless they are a physiatrist.

That's one of the reasons that physiatry is growing so quickly here: They are finally starting to realize that sports doctors should know a lot more than just orthopedic testing procedures and invasive or surgical options. There are quite a few in the Emory sports medicine clinic these days.