Shoulder pain and rehab

Hi there,

I've been dealing with shoulder pain for awhile now.  I injured my right shoulder roughly 3 years ago and it got better but now the pain is back.  I can perform pushups without loss of strength but by the end of the day and the next morning, there is an achy pain which I assume is the joint being inflamed.  I actually just came back from a sports medicine physician that I've been waiting to see for weeks and the ultrasound showed that there is mild tendinitis in the shoulder. I know they mentioned a couple of rotator joints (the subscapularis and suprasptinatus) but I can't remember if the inflammation is coming from there or in the shoulder capsule. They want me to go for an MRI to rule out any tearing in the capsule but I perosnally don't think that is my issue. We then discussed remedies and started to get into cortisone shots which is something I would like to avoid altogether.

This all being said, I have had days where my shoulder feels great with no pain I just wish I knew what I did to get that state again.  I've rested it for weeks at a time with no pushups or any movement that could irritate it but then as soon as I do a movement, the pain comes back.  

My question is, are there shoulder exercises that the coaches could recommend to help strengthen the shoulder joint?  I've tried handstand holds and feels good when I perform them with no pain.  I've seen weighted dislocates demonstrated but wonder if that would be too advanced for me to do yet.

Any help would be very much appreciated as i would like to avoid any injections/surgery if I can.

Thank you,

Rich 

(I'm not your doctor, etc.)

How did you injure the shoulder?

Tendonitis usually responds to gradually increased loading, not rest: this is something a good physiotherapist should advise you on. The physio should also evaluate the shoulder and from an exercise function point of view, determine what hurts, in what range of motion it hurts and how much it hurts.

Imaging - MRI, ultrasound, etc - are useful if they guide the type of treatment you get, in this case, depending on how you injured the joint,because that also influences how you treat it, the MRI is probably a good idea, so you know which structures are involved and which to treat.

While everyone doesn't want cortisone, it has its place: a small dose can make it easier to begin performing your rehab without it hurting too much.

None of this answers your question, I know, but it sounds as if the shoulder needs a little more evaluation.

Is the achy pain you feel next day after push ups in the front of the shoulder? If so, I was in the same situation than you. You story sounds very very familiar to me.

Thoracic Bridge course adresses shoulder deficits and also Handstand 1. Apart from that to take the pressure out of your shoulder you can do table, table rock, a, t, y, cactus up, cactus down, deadhang, hpb mobility, etc. Always only if it feels good, that means 0 pain.

Thanks for the responses @Nick Murray and @Antonio Alías Montoya.  I believe I was doing a heavy set of squats.  Nothing hurt that day but the next I could barely move my arms.  So was it the squeezing the bar in that externally rotated position that did me in - I'm not too sure but I have had other related injuries to that shoulder in the past - CrossFit related - going to heavy, etc.  (I don't do CF any longer just this program)

So the achy pain is in the front yes but it feels really deep like it could be in the capsule area.  The physician that assessed me did all of the arm positions asking me if it hurt and about 3 positions bothered it.  Arms straight out with thumbs down pushing up on his hand as he pushed down, extending my arm straight up over my head (felt like pinching), and then arm straight out palm up and crossing in front of my chest pushing down as I  push up.  Apparently these must be the subscap and supraspanatus muscles of the rotator.  No movements were given to me as I think they want to check the MRI first to make sure there are no tears in the actual capsule - which I don't believe there will be.

I might give some of these exercises a go and see how I fair.  Yes, only going with 0 pain of course.

Thanks again

@Richard Robichaud it s a good idea to wait for mri and to make sure there is no damage. In case there is not, you probably have, like in my case, very inflexible, inmobile and infunctional shoulders. They might be simply not able to hold that kind of stress. TB is a must.

Why in particular not have the cortisone shot?

I had a similar shoulder problem along with bursitis which I tried to manage with rest and physio with no improvement for 4-5mo before I succumbed to the shot (ultrasound guided). Unsurprisingly I immediately saw an improvement in pain but it then enabled me to make much better progress with the physio. I had one flare up in the shoulder about 3mo after the shot as I was transitioning back into Crossfit but rest and physio were enough to manage that and since then it has been fine.

If it was to flare up again I would try the rest and physio approach first but would not avoid a cortisone shot if I was not seeing progress. Just my lay opinion.