Shoulder pain management

As the saying goes “once bitten twice shy” or in Greek “once you burn your mouth from hot soup, you even blow on yogurt”.

Maybe a genetic predisposition, maybe playing tennis since junior high, maybe years of heavy weight lifting, I’ve been dealing here in there with my right shoulder.

Usually nothing a little rest and some external rotations wouldn’t take care of.

Ffwd late 2018 and I injure my shoulder again doing dips. Bad. This time around things were not that easy. Would lay off and do the usual treatment for a while, but as soon as I got back to training immediately I would be in pain again.

See, the shoulder is a very vulnerable and mobile joint. You have a large humerous barely fitting in a glenoid fossa.

Because it’s so highly mobile we tend to put it wrong positions. Even in everyday posture.

Shoulder pain is not always linked to the shoulder. It could be a stiff neck radiating in the shoulder.
We think we have a shoulder problem but what we have is really a posture problem. It could be overuse injuries.

The culprit? Usually rotator cuff and/or biceps tendons.

The easiest way to protect your shoulder joint think of the risk to reward ratio.
There are many things I won’t do anymore that many people love doing. Over time and with progressive resistance that strain on those soft tissue structures is gonna increase and potentially hurt you.

I’m not telling you not to do certain exercises. I am telling you to think. Exercise should protect you not hurt you.

People (and mostly older folks) usually have some problems from overstretch under loading and overusing with that load. They overstretch the bicep tendon. Exercise that you perform a horizontal abduction (think bench press, peck fly etc) will do that. Don’t overstretch your front shoulder (Don’t let the elbow fall way back past your body).

Shoulder injury management

1. Address the problem immediately
3. Exercise is imperative
4. Access your do’s and don’ts

You’d be surprised but the most common shoulder injury is a re-injury. People who have been hurt and try to get back too soon or too aggressive.

Tendons heal slower cause of their poor blood circulation. Don’t rush things.

Things to avoid:

If you have tendinitis lifting your elbow above shoulder level is not the greatest idea.
So things like lateral raises that end up too high or military raises, shoulder presses and upright rows are a no-no.

Things to do:

Strengthen external rotators, lats and low traps. That way you Create shoulder stability AND scapula function.

Many people tend to forget that poor scapula movement can predispose to injury. It must be mobile enough to allow positions needed to allow the arm to move without impingement.

How:

1. Perform horizontal abduction exercises (that send your arms backwards) like rear delt flys, face pulls etc. That way you’ll strengthen your supraspinatus and rear delt to pull your numeral head back and up in the glenoid fossa so it’s not pinching anymore.

2. External rotation. Put your shoulder into scaption (55 degrees abduction and 30 flexion).
That’s where the joint is most open. Ideally you want to be antigravity. Preacher bench works excellent for that! External rotators stabilise the arm. Don’t forget internal rotation also!

3. Exercises that send the arm down from overhead (granted you don’t hurt by raising your arm). Try the one-arm lat pull down You’ll activate your lats that pull the arm inferiorly. As a result compression is reduced and sub-acromial space is increased.
You will also work your low traps (they help in upward rotation, posterior tilt of the scapula) assuring better scapula kinematics as you perform overhead movements.

Don’t do anything unless pain free!!

The pain is gonna go away when the inflammation goes away. Don’t forget to ICE!

That’s when you SLOWLY re-introduce your favourite pressing exercises.

Cut all intensity by 50% and do about 17 reps or so. Then increase by 20%.