Shoulder issue (request for treatment advice)

So I'm 20 year old guy, been doing gymnastics since September last year, however with the unfortunate exception of the past ~2 1/2 months, where I've been experiencing pain in my left shoulder.

As written, I started gymnastics about a year ago now. This was from a completely untrained and not particularly strong starting point, and for the first few months I'd do mostly supervised technical training along with my seniors (recreational) team. The strength training during this period was not particularly structured, and I would do mostly exercises I had picked up from this website, looking at other gymnasts, etc. (My point is I didn't do any specific joint-prehab exercises for this extended period of time).

Occasionally (this started after five months or so), pain would flare up in my left shoulder, especially on mornings after training sessions. Lateral-raise type movements were the most painful and occasionally unbearable (couldn't get my hand up past my shoulder). However, it would usually disappear in a days time of little to no movement, after which I felt pretty much good to go (no pain, at all).

Then one day, just over two months ago, it did not go away. The first few days I couldn't move my arm up past my shoulder at all, and keeping it relaxed was thus pretty easy. I started doing Ido Portals shoulder routine/dislocates once the pain died down (not structured, typically did dislocates morning and evening, and the routine every other day when I got around to it). This helped, and I happily jumped straight on back into training, after which I just ended up right where I began. After this I readjusted my expectations, as to how fast I was going to come back from this. This general theme continued for a while, after which I did not go to the gym at all, tried to rehab it and then manage to aggravate it again, once it got better.

The past five days I've been doing the stretches described in

video every other day, while treating it with Voltaren 3-4 times every day. I have also been doing the shoulder routine mentioned earlier (smooth sailing, except for lateral raises, which I can't go very far with, without feeling pain), as well as some light pain-free strength training (FSPs) with no overhead movements.

This is where I am today:

- Lateral-raises with just my arm feel pretty good, no real pain at all. My shoulder does feel like its marginally swollen somehow (?), and definitely different from my right shoulder (could be just me). Doing it with an elastic band does not feel particularly good, and I don't really know how to work this section safely at all.

- Push-ups/dips are still slightly painful. Not ouch but more like woah if you know what I mean. It gets worse as I do more.

- Holding my arms out in front of me, I experience a slight, sharp pain that gets worse as I hold the position.

These are some questions for which I would like assistance:

- Is what I'm doing fine, or should I back off? Should I introduce more elements with the elastic bands?

- Should I strive to keep the shoulder at rest, when not working out? (I like to occasionally 'test' it, while I go about my business)

- What could have been different this time, compared to all those other times I've had this type of pain, and it disappeared in a day?

There's probably more, but it's getting late, and this post is dragging on :wink: . If anyone has some general constructive advice/words of wisdom, I'd happily take them. Obviously, if someone needs more information I will also answer. Thanks in advance!

That sounds like shoulder impingement/bursitis symptoms.

There are a number of posts on the topic that you can search, and then get back with further questions.

Whenever its so bad you can't lift your arm you should see a professional.

More than likely the repeated irritations have caused the area to become sensitive. The 'injury' itself may be due to structural issues, but is more likely do to a fault in shoulder movement. Its important to keep the head of the humerus pulled down in the socket while lifting, this keeps is from rubbing against the bursa that is now most likely irritated.

Notice i do say most likely, a proper diagnosis can't be made on an internet forum.

Mr Brady said:

That sounds like shoulder impingement/bursitis symptoms.

There are a number of posts on the topic that you can search, and then get back with further questions.

Whenever its so bad you can't lift your arm you should see a professional.

More than likely the repeated irritations have caused the area to become sensitive. The 'injury' itself may be due to structural issues, but is more likely do to a fault in shoulder movement. Its important to keep the head of the humerus pulled down in the socket while lifting, this keeps is from rubbing against the bursa that is now most likely irritated.

Notice i do say most likely, a proper diagnosis can't be made on an internet forum.

Pardon my ignorance (being new and all) but could you elaborate a bit on "Its important to keep the head of the humerus pulled down"

How can I make sure I'm doing this correctly? Having had my fair share on injuries over the years in other sports, I'm trying to absorb as much info as I can on injury prevention

Thanks!

Agreed. Once the tissue is swollen it will take a few weeks to subside completely. This condition came from improper movement so you will want to strengthen the posterior muscles responsible for proper shoulder position (traps, rhomboids, rear delts, external rotators, long head of the triceps), stretch the anterior as shown in the video, and in a month or two when your daily rehab work has finally led you to where you THINK you can start training again you should work on push ups and weighted push ups with a focus on using your serratus anterior to keep the shoulder blades tight against the ribs.

You should see a professional and completely refuse all NSAID treatment. That is for pain only and will actually inhibit the inflammatory response that you NEED for healing to occur. Only take these drugs if you want your body to heal slowly or if pain is unbearable/making you miserable. They should be avoided. Cold immediately after exercise and long duration moderate heat (115-120 degrees for at least an hour) all over the deltoid and upper shoulder region at LEAST once a day will make a noticeable difference in how quickly you heal.

slizzardman said:

long duration moderate heat (115-120 degrees for at least an hour) all over the deltoid and upper shoulder region at LEAST once a day will make a noticeable difference in how quickly you heal.

Will this work for a partially torn anterior deltoid? Been icing alot but have never had anyone tell me to heat it.

Thanks for the help. Lots of stuff for me to work on here.

I've been wondering if plank/inv. plank are ok to do with this particular type of issue? Planche leans are pretty close to those positions and they definitely hurt. In fact, simply plank with fingers toward my feet are quite painful. I'm worried I might be hurting my shoulder doing those, despite there being no pain.

Keep in mind this is NOT medical advice. This is merely my opinion, which is thus:

In my opinion you should not be loading the shoulder at all. You need to just give it a rest with tons and tons of heat, because heat will increase the circulation as well as the rate of healing. That will actually help the swelling go down faster, and while it may be slightly less comfortable for the first 3-5 days it works much better in the long term. Comfort does not always = progress.

After at LEAST a week of total rest with tons of heat application and whatever medicinal herbs or creams you want to use in conjunction with that, you will eventually be ok to start working on band or cable external rotations. You may also be ok working scapular retraction, but that has to be monitered by someone who knows what they are doing. Possibilities for this are bent over rows or seated cable rows, always using a shoulder width grip. Under or over is up to you, but eventually you'll want to use both equally. In addition to this you need to be doing daily stretching for your chest and shoulder, and you will probably require a good bit of soft tissue work for everything that connects to the scapula, particularly in the arm and chest areas. A lot of this can be done with trigger point therapy, self myofascial release, and self-administered gua sha. You will have to find or buy your educational materials for that stuff, but it's well worth it and not very expensive.

Eddie: YES! Long term heat application speeds up healing, period. It doesn't matter whether it's infrared bulbs or heating pads, bet some heat on there as much as possible! If you're really clever you'll combine that with sipping whey all the time, but especially 30 minutes before and all the way through the treatment time. That way you get fresh nutrients to the area while circulation is highest and healing rate is fastest.

Thanks alot! It sound like myself and OP are having similar issues. I have been seeing a PT guy and he has narrowed it down to a partial tear in the anterior deltoid. But, he has never prescribed heat. I have been wondering why though because he always ultra sounds it before working some rehab band work. I can't wait to try this out! Thanks for getting back to me. So ice immediately after the rehab work and heat the rest of the day, got it. As for the protein sippy idea, how much protein do you take? Do you have like a target amount to hit for the day or for the hour, or is it just get as much in as you can at a slow absorbable rate?

I m taking in 5-7g per hour. That's why I take a scoop and put it into an average of 2 quarts of water! It takes me about 4 hours to sip that down which makes for an average of 6g per hour. Between that and regular food I'm good to go all the time. It feels great.

Awesome thanks! One other quick question, the soft tissue work you referred to, should that be on the torn muscle or inflammed area or on the surrounding muscles? I thank you immensly for your help, I am so lost right now, I have never had an injury like this.

Both. Just take your time working into the injured area. It's pretty hard to make things worse, but I suppose it's possible if you're too overzealous! The gua sha AKA graston type work will probably benefit you the most right now. You can use just about anything that has a rounded edge. Watch gua sha or graston videos, get ideas, and then find or make something that will do what you need it to! You can also order cheap gua sha tools online for like 10 bucks. They are very general shaped and can be used a number of places, and last for a while. They're mostly made of animal horn so they will break down eventually, but hey... for 10 bucks it's a goood deal.

Gotcha. Thanks alot! The PT guy I am working with has never worked with a torn anterior deltoid. He said that he has only seen it with gymnasts, and we don't have very many in Charleston! So, all of this advice is outstanding, I will let you know how it works. Thanks again!