Shoulder impingement

[Punkrocker]

So I've had problems in my left shoulder for probably 8 years now. I don't bench press anymore I do dumbbell presses instead although I have to say I do bench every once in a blue moon and it aches every time I do it. Same goes for certain overhead pressing depending on what machine I use and how my arms and elbows are angled. My training has been going pretty good lately and I've been lifting with a lot of intensity and I have definitely flared up my left shoulder. Yesterday at work I noticed that the movement in my left arm was beginning to get limited and I was starting to get pain like I used to get from back in the day but I kind of ignored it. I go back to the gym to do chest and I'm having a great chest workout but my shoulder is aching during the workout and what do I do? I pushed through the pain and train anyway. At the end of the workout my shoulder hurt a little bit but it wasn't too bad. I wake up the next morning and my shoulder is wasted. Tons of pain, limited range of motion. Can't lift my arm up to do a front raise or side raise (I mean I could if I really wanted to but boy it hurts). It's been 3 days now and it's very very slowly starting to get better. I can now move my arm a little bit more without pain but it still hurts a lot on my shoulder still feels stiff as hell. I don't want to be out of the gym for numerous weeks. Is there anything I can do to speed up the recovery? Is ibuprofen and ice a good idea or should I just allow it to remain swollen as that is the body's natural immune response? What's the quickest way I can get back in the gym?

 

[PolishHamm3r77]

Ideally ice for 20 then heat for 20 lather rinse repeat. Motrin call is up to you and your stomach lining. I used it sparingly during my torn tricep rehab. But for 1st 2 weeks if I was able I was icing and applying heat RELIGIOUSLY.

 

[PolishHamm3r77]

And obviously taking time off and coming back and more going through the motions than trying to set PR’s

 

[Smont]

If yiu want I have a decent routine I did for a while that took my shoulders from a weak point to a strong point while rehabbing the injury.

You have to eliminate basically every single gle exercise that hurts for a while and just kinds do bare minimum maintenance on your chest in the meantime or your just gonna keep aggravating it.

It's a lot of rotator cuff work and light weight high rep stuff 15-30reps a set.

And I'm being dead serious, it's what made my shoulders pop for the first time too.

Bpc 157 was used but looking back I should have used the combo of the 2 healing peps and I did high frequency light weight shoulders 2-3x week every week, sometimes every other day.

Start off with a couple standing sets of rotator cuff rehab exercises for 20 rep sets.

Light side laterals, start with a weight you can do for 30 reps and run up the rack till you hit failure at 15 reps

The next part will ruffle some feathers but light behind the neck presses getting as much stretch as possible without pain. I usually don't go above 120lbs even with good shoulders. Rehab weights were 30,40,50,60 and I started adding more reps at 60

Finished off with a superset of rear delt fly snd front raises.

Your really only hitting failure on 1 set of side laterals and that's it.

 

[Resolve10]

Honestly first off you need to just not be stupid and push through pain and keep going and then wonder why it isn't getting better.

If it is something you have been dealing with for years you will probably need to get help from an actual professional (a physical therapist experienced with lifters) to figure out the actual issue and a plan. Asking random people on the internet with something that has been an issue that long is just going to get pretty general and bad advice regurgitated. An actual professional who knows what they are doing will be able to get you a program that keeps you lifting, but obviously the specifics will depend on the actual issue based on an accurate diagnosis.

It is also better to take a step back and get actually fixed then keep burying your head in the sand and hoping it gets better because you are too afraid to take some time off from it (which again you won't have to avoid the gym in most cases you just need a specific targeted approach that may mean certain things are limited for a bit).

 

[Punkrocker]

Honestly first off you need to just not be stupid and push through pain and keep going and then wonder why it isn't getting better.

If it is something you have been dealing with for years you will probably need to get help from an actual professional (a physical therapist experienced with lifters) to figure out the actual issue and a plan. Asking random people on the internet with something that has been an issue that long is just going to get pretty general and bad advice regurgitated. An actual professional who knows what they are doing will be able to get you a program that keeps you lifting, but obviously the specifics will depend on the actual issue based on an accurate diagnosis.

It is also better to take a step back and get actually fixed then keep burying your head in the sand and hoping it gets better because you are too afraid to take some time off from it (which again you won't have to avoid the gym in most cases you just need a specific targeted approach that may mean certain things are limited for a bit).

I've already gone to a professional and I've had MRIs done. The main issue seems to be arthritis in the AC joint which when irritated causes inflammation. I've also had issues with bursitis and I have a minor tear on the superspinatus but according to the orthopedic doctor he said it was similar to fraying at the bottom of your jeans from wear and tear type stuff. Very minor and nothing to be concerned about considering what I was doing for work and what I do in the gym. There are certain exercises that I need to avoid which I was being stupid and did not avoid and now I'm in this predicament again

 

[Punkrocker]

If yiu want I have a decent routine I did for a while that took my shoulders from a weak point to a strong point while rehabbing the injury.

You have to eliminate basically every single gle exercise that hurts for a while and just kinds do bare minimum maintenance on your chest in the meantime or your just gonna keep aggravating it.

It's a lot of rotator cuff work and light weight high rep stuff 15-30reps a set.

And I'm being dead serious, it's what made my shoulders pop for the first time too.

Bpc 157 was used but looking back I should have used the combo of the 2 healing peps and I did high frequency light weight shoulders 2-3x week every week, sometimes every other day.

Start off with a couple standing sets of rotator cuff rehab exercises for 20 rep sets.

Light side laterals, start with a weight you can do for 30 reps and run up the rack till you hit failure at 15 reps

The next part will ruffle some feathers but light behind the neck presses getting as much stretch as possible without pain. I usually don't go above 120lbs even with good shoulders. Rehab weights were 30,40,50,60 and I started adding more reps at 60

Finished off with a superset of rear delt fly snd front raises.

Your really only hitting failure on 1 set of side laterals and that's it.

That routine sounds amazing and I'm going to start it once I'm able to actually lift my arm over my head lol. Currently if I'm doing a front raise with me left arm (no weight) I can only get my arm up to just about my face without horrible pain. It seems to be improving ever so slightly day to day as I have not been going to the gym these days

 

[Smont]

That routine sounds amazing and I'm going to start it once I'm able to actually lift my arm over my head lol. Currently if I'm doing a front raise with me left arm (no weight) I can only get my arm up to just about my face without horrible pain. It seems to be improving ever so slightly day to day as I have not been going to the gym these days

What's the actual diagnosis, have you ever been to the doc? Cus resolve has so.e good points. That routine was kinda influenced by the Dr. Reccomendations I had got but the injuries could be very different

 

[Punkrocker]

What's the actual diagnosis, have you ever been to the doc? Cus resolve has so.e good points. That routine was kinda influenced by the Dr. Reccomendations I had got but the injuries could be very different

I've got arthritis in my AC joint and when I irritate it it rubs on the tendon causing inflammation and bursitis, I also have a slight tear in the supraspinatus but it's more of like a wear and tear type of deal not something that is required surgery or anything like that. When this original flare up happened I was a garbage man and I was flinging heavy barrels all day so it was next to impossible for the inflammation to go down I ended up having to take two weeks off of work which was my only vacation time. I went to a physical therapist who had me do a variety of different exercises I got different massages done like deep tissue type stuff around my shoulder and eventually I got mobility again and I avoided certain exercises and everything has been good for years since then but I've gotten more serious into lifting the past couple years and I've been using higher doses of tests with other anabolics and now growth hormone and I'm just feeling stronger than I usually have been and I've been taking it a little too far in the gym I guess and now I'm paying the price. I think the main thing that caused this was possibly doing overhead press kind of heavy like 4 to 6 reps and I did some incline bench press a week ago and it didn't feel quite right and I think that's what started everything. I think when I did the incline bench press that's what started the inflammation and then ever since that everything else that I did that was intense just made it worse and worse and worse.

 

[Resolve10]

It’s good you got a diagnosis but you should then bring that to a sports physical therapist who can help you fix your deficiencies and make an adequate program. I don’t want to paint with too broad a brush but not all orthopedists will understand with the nuance needed for what to actually do in a gym and exercise selection setting.

If it was really just random wear and tear you wouldn’t be completely immobile from just doing some exercises.

 

[Resolve10]

Ok so you did see a PT. You should be continually revisiting those exercises then and progressing those things you have to continually be proactive if you have deterioration in any area to keep things strong and pain free (I’m being super generalized for brevity).

 

[Punkrocker]

It’s good you got a diagnosis but you should then bring that to a sports physical therapist who can help you fix your deficiencies and make an adequate program. I don’t want to paint with too broad a brush but not all orthopedists will understand with the nuance needed for what to actually do in a gym and exercise selection setting.

If it was really just random wear and tear you wouldn’t be completely immobile from just doing some exercises.

I'm pretty sure that the issue I'm having though is not related to the slight tear. I remember when I was with the physical therapist he explained to me how bench press and other certain workouts can affect the AC joint and when you really mess with the AC joint it really screws everything else up with inflammation and tendonitis and bursitis etc and what happens is the inflammation starts and it only hurts a little bit and you keep pushing and it just gets worse and worse and now we're at a point where the bursa and the tendon are too big to fit in the confines of the shoulder area or whatever it's called and I'm at a point where I can barely move lol now I should have discontinued what I was doing a week ago when I initially felt the first onset of this pain and inflammation but of course I kept going cuz I'm mentally retarded. And in terms of the slight tear the orthopedic doc did not even want to call it a tear he thought it was a bogus claim on the report and told me it's technically a "tear" but in the same way the bottoms of your jeans fray from dragging on the ground at your feet and it's no big deal. So from everything I've learned and in terms of the MRI results I'm pretty sure that I've flared everything up really bad and I'm just trying to bring things down ASAP

 

[botk1161]

If you really like to lift, you will take this opportunity to turn this around. I am 56 and really starting taking care of my shoulders 10 years ago and I have zero problems or pain. And I enjoy pressing
barbells/ dumbells a couple of times a week.
I do lots of shoulder band work, ropes, face pulls etc. Too much heavy or taxing Bicep work and heavy pulling are often the culprit that pulls the shoulder out of orbit and keeps it there putting strain on everything else.

 

[AwakeningAlpha]

I train back and chest on the same days to ensure I get a solid stretch and engagement for shoulder support/pressing. I also got relief from using a bow tie accessory on warm ups and the day after shoulders or push. Expensive but gave me a lot of relief and great pumps. https://www.roguefitness.com/donnie-thompson-formal-bow-tie
"The Bowtie attacks this issue by applying firm compression to the pectoral tendons and reducing strain on the muscles behind the shoulders. When worn during warm-ups or as you move through your squats, bench, deadlifts, etc., the Formal Bowtie not only helps limit some of these aches and pains, but also trains more consistent form. Along the way, your muscle memory is rewired, as the brain encourages better posture in your day-to-day life."

 

[Rad83]

If you really like to lift, you will take this opportunity to turn this around. I am 56 and really starting taking care of my shoulders 10 years ago and I have zero problems or pain. And I enjoy pressing
barbells/ dumbells a couple of times a week.
I do lots of shoulder band work, ropes, face pulls etc. Too much heavy or taxing Bicep work and heavy pulling are often the culprit that pulls the shoulder out of orbit and keeps it there putting strain on everything else.

Interesting that you’ve found it’s back and bicep work….Something for me to look at, as been having some shoulder/upper pec issues

 

[PolishHamm3r77]

Interesting that you’ve found it’s back and bicep work….Something for me to look at, as been having some shoulder/upper pec issues

When I was seeing my orthopedic and physical therapist they both said I can do any movement or lift I want. But the part I loved hearing the most as I looked at all his plaques and degrees on the wall was “if it hurts, don’t do it.” 2 cents of simple advice. As much as I wanted to bust his balls, this made/makes so much sense. I have never been a fan of instinctual training. I felt that was a way people talked their way out of leg day. But if legs is Thursday and it’s Thursday then we r doing legs. I always felt planning went a long way. I would design a routine, have a weight and a rep count in mind for each exercise for 6-8 wks at a time. Take a week off and design my next routine. But I was in 20’s and 30’s then. Now on the wrong side of 45 and have to listen to my body especially while rehabbing from an injury. Perfect example, I hit back and bi’s sat, had plans after working out and was pressed for time. I normally do 4 exercises, 5 sets, 15 reps 45 sec rest between sets for each body part. I decided to super-set the first 2 and second 2 exercises to eliminate rest period between sets. Time saver! Barbell curl w incline dumbbell and cable curl w dumbbell hammer. I only dropped the weight 10lb on barbell and 5lbs on the db movements. Pump was insane. Loved it. Got some cramping in the shower when shaving my head. All signs of a good workout. Lol. Then, Saturday my right elbow hurt(rehabbing torn right tri). That’s fine, it’s an “off” day. Figured I’d be g2g for chest and tri Sunday. WRONG. elbow still hurt. Now this is throwing my schedule off for rest of week. But I’d rather deviate from plan and listen to my body and exercise some common sense.
Long rant, hopefully someone takes something from it other than me being old n beat up

 

[BEAST73]

Rest and Stretching.

 

[GreenMachineX]

Haven't read everything but after several years of shoulder issues, multiple failed physical therapy rounds, doctors who wanted to do exploratory surgery and MRIs only showing tendinosis (but was actually impingement causing that), it took months off and seeing a chiropractor who specialized in sports medicine to get me lifting my arm overhead pain free again.

Edit: I should also say that being a butthead and trying to work through it resulted in getting significantly weaker and smaller...Bench went from 315 for 5 to 225 for 5 over that time.

 

[PolishHamm3r77]

Haven't read everything but after several years of shoulder issues, multiple failed physical therapy rounds, doctors who wanted to do exploratory surgery and MRIs only showing tendinosis (but was actually impingement causing that), it took months off and seeing a chiropractor who specialized in sports medicine to get me lifting my arm overhead pain free again.

Edit: I should also say that being a butthead and trying to work through it resulted in getting significantly weaker and smaller...Bench went from 315 for 5 to 225 for 5 over that time.

Dude I’m w you. Been pussy-footing around weight wise as to not re-injur my tricep as I rehab it. I just did chest and tri’s and am embarrassed by my working weights. It’s like showing up to a 1/4 mile in an 84 civic 4 door against a Hellcat. I know ego lifting won’t do me any good at this point in my life but man, light weights r just no fun

 

[Resolve10]

Haven't read everything but after several years of shoulder issues, multiple failed physical therapy rounds, doctors who wanted to do exploratory surgery and MRIs only showing tendinosis (but was actually impingement causing that), it took months off and seeing a chiropractor who specialized in sports medicine to get me lifting my arm overhead pain free again.

Edit: I should also say that being a butthead and trying to work through it resulted in getting significantly weaker and smaller...Bench went from 315 for 5 to 225 for 5 over that time.

Man it is pretty disheartening. I don't want to get too far on a tangent, but the way most insurances are set up it really doesn't incentivize PTs from doing a great job for some of these more sport oriented things (and I mean this not from a conspiratorial place but from getting authorizations and how they get paid for their work).

Going cash based tends to be a must for some of those places, but then it can be pricey if you are looking for help from someone good.

I can't tell you how many "second hand" or already been through some crappy PT people we've seen that would never have been cleared if people knew what they were doing. The system makes it tough, but still think people should find proper ways to do things regardless.

/rant.

 

[PolishHamm3r77]

Man it is pretty disheartening. I don't want to get too far on a tangent, but the way most insurances are set up it really doesn't incentivize PTs from doing a great job for some of these more sport oriented things (and I mean this not from a conspiratorial place but from getting authorizations and how they get paid for their work).

Going cash based tends to be a must for some of those places, but then it can be pricey if you are looking for help from someone good.

I can't tell you how many "second hand" or already been through some crappy PT people we've seen that would never have been cleared if people knew what they were doing. The system makes it tough, but still think people should find proper ways to do things regardless.

/rant.

I concur with your rant. I have a sub-par insurance plan. It did not cover any PT. I’d pay $60 at check-in, use the arm bike for 10 min, do some band movements, then ice and tends unit. Took about an hour. And then get billed for another 120 or so per visit.

 

[Resolve10]

I concur with your rant. I have a sub-par insurance plan. It did not cover any PT. I’d pay $60 at check-in, use the arm bike for 10 min, do some band movements, then ice and tends unit. Took about an hour. And then get billed for another 120 or so per visit.

See that is what I mean, you really shouldn't be getting billed for that and the amount insurance is covering is kind of stupid AND no offense that is a pretty crappy PT regiment.

I've seen that kind of stuff too much then it leaves a competent PT with so much extra to do in the future.

 

[PolishHamm3r77]

See that is what I mean, you really shouldn't be getting billed for that and the amount insurance is covering is kind of stupid AND no offense that is a pretty crappy PT regiment.

I've seen that kind of stuff too much then it leaves a competent PT with so much extra to do in the future.

Ortho wanted 4 visits of PT. PT felt I should keep coming. Of course they did. Why sign off on me when I can keep handing you my money? I stopped going because there was nothing I couldn’t replicate at home aside from the arm bike. 1st 3 visits I did get an arm massage and she used what looked like a big butter knife and some lube to drag across the tricep. U could hear the different tones as it ran across good tissue and or scarred tissue. I believe this is a very old practice. It was done in the Roman Bathhouses at the dawn of the Roman Empire. There were no eunuchs at my PT just to clarify

 

[AwakeningAlpha]

Ortho wanted 4 visits of PT. PT felt I should keep coming. Of course they did. Why sign off on me when I can keep handing you my money? I stopped going because there was nothing I couldn’t replicate at home aside from the arm bike. 1st 3 visits I did get an arm massage and she used what looked like a big butter knife and some lube to drag across the tricep. U could hear the different tones as it ran across good tissue and or scarred tissue. I believe this is a very old practice. It was done in the Roman Bathhouses at the dawn of the Roman Empire. There were no eunuchs at my PT just to clarify

Yeah! The butter knife treatment is called "Gua Sha" I think. Great but painful.

 

[Resolve10]

Ortho wanted 4 visits of PT. PT felt I should keep coming. Of course they did. Why sign off on me when I can keep handing you my money? I stopped going because there was nothing I couldn’t replicate at home aside from the arm bike. 1st 3 visits I did get an arm massage and she used what looked like a big butter knife and some lube to drag across the tricep. U could hear the different tones as it ran across good tissue and or scarred tissue. I believe this is a very old practice. It was done in the Roman Bathhouses at the dawn of the Roman Empire. There were no eunuchs at my PT just to clarify

Ugh that sucks to only get approved for 4 sessions. You can't really blame a PT for wanting more sessions though, they provide a service and want/need compensation obviously. Also, if it is too short (like 4 sessions) it just ends up potentially making them look bad as it isn't enough time to get any change or resolve the issue.

They do look bad though if they aren't up to date and doing poor practices like just some basic bands and tens unit.

There is definitely a disconnect in some places between the doctors and the therapists though. I've seen fresh off ACL patients only approved for 10 sessions, which is not going to get you anywhere near where you need to be. Which then leaves both the therapist and the patient in a poor place. It almost seems the insurances aren't caught up to current medical practices enough to encourage proper codes being used and hanging therapy clinics out to dry for finances, leading to these places turn and churn through people (clients and therapists).

Yea

Yeah! The butter knife treatment is called "Gua Sha" I think. Great but painful.

There are lots of techniques with scraping like that, Graston, etc. Can hurt and can be quite helpful in the right situation.

 

[Resolve10]

Also, sorry OP didn't mean to derail your thread.

This is just I guess a passion area for me. I feel there is a lot of misinformation that gets parroted online (I guess that could go for many things though) that is pretty out of date.

I had very crappy treatment after a shoulder surgery nearly 20 years ago and I really wish I had known better. It is tough though since the field is moving very fast and recommendations from even 10 years ago feel ancient. Makes it tough because by the time someone finishes their doctorate the thing they learn may not be what are even being used in the top places in the world anymore, so it requires active work to stay on top of things.

I wish I could be able to recommend top clinics and clinicians in every state/area/country/etc., but I am sure there really are places that don't even have any good options yet.

 

[PolishHamm3r77]

Yea

Yeah! The butter knife treatment is called "Gua Sha" I think. Great but painful.

I felt this did the most good. I liked it. Felt odd as hell and the sounds…oh the sounds.

 

[Rad83]

Too much heavy or taxing Bicep work and heavy pulling are often the culprit that pulls the shoulder out of orbit and keeps it there putting strain on everything else.

Anything in particular you’ve eliminated from your training?

 

[botk1161]

Anything in particular you’ve eliminated from your training?

Chest flys, Dips, heavy lateral and front raises, heavy bicep work and pull ups (at 230lbs, pulls ups shredded one of my bicep tendons over time requiring surgery, so I rarely do pull ups now). When I do they are a close grip or V bar and only perfect reps.

I like to use straps for heavy rowing, but don't use them for conventional deadlifts. I train more for powerlifting so my heavy work is 1-4 reps most often. I do specific grip work instead of frying forearms and lower bicep attachments with rows and bicep work etc..

I use bands most often for lateral and front raises (constant tension with thumb up more often than not) , Front raises with with palm up with a cable machine, I like a banded standing rear delt. Various grips and implements for face pulls. I like higher rep (at least 10) for biceps with zero cheating and never past 90% or so. I find I am just working biceps to keep the tendons happy and stretched out / and they keep growing a bit. I do heavy tricep work still. Most importantly, I can press without issues. And shoulders, elbows, forearms don't ache anymore.

 

[Rad83]

@botk1161 thanks man, that’s very helpful. I have a reoccurring pain, in the ‘pec-delt tie in’ area that sometimes travels down to the bicep. (It’s happened on both sides) Dips were one of the first thing I got rid of years ago.

 

[botk1161]

@botk1161 thanks man, that’s very helpful. I have a reoccurring pain, in the ‘pec-delt tie in’ area that sometimes travels down to the bicep. (It’s happened on both sides) Dips were one of the first thing I got rid of years ago.

I think a single arm palm up front cable raise would help break that up and open it up. In the stretch position, you can really open up the pec right up to the neck. There is a bunch of crucial nerves along that channel that get freed up using this exercise. Along with a face pull to keep that nerve channel open and ready for your next pull and or press session. I like to do these clean up routines either after pressing and or pulling or the next day.

 

[botk1161]

......I find sets 20-50 reps with these exercises is what is needed to get things moving again.

 

[Rad83]

......I find sets 20-50 reps with these exercises is what is needed to get things moving again.

Trained lower body tonite…but gonna start with that palm up asap at home with 5lb dumbbells and my bands with handles..in addition to the band work I do and rotator cuff etc.

 

[botk1161]

Sleeping on my side is something I had to change. It caused impingment and all kinds of misalignment and discomfort. I had to train myself to sleep on my back and stay on my back.

 

[Dustin07]

I've rehabbed dudes older than you with the same issue doing a lot of KB work, especially KB Armbars. Basically everything Smont recommended above. it can be a slow process but one fella couldn't push a barbell past his nose on an OHP, and after 6 months had full lock out.

 

[Resolve10]

Ya dealt with a decent number of people who have pain side sleeping. Fixing up the scalenes and the supraspinatus seems to help in those situations.

 

[PolishHamm3r77]

Beginning of the year I had a similar issue. I work outside in New England year round. February was real cold for us. One of those “can’t get the chill out of me” situations even once in warm house and had a hot shower. If I slept on right side left hand would go numb middle finger to pinky. Sleep on left side, same issue w right hand. Sleep on back no issue other than me snoring and the misses waking me up.

 

[SharonCosta]

Pushing through the pain during workouts, while admirable, might not be the best approach in the long run. It's essential to prioritize rest and recovery to allow your shoulder to heal properly. Rest, ice, and ibuprofen can definitely help with inflammation, but it's also worth considering seeking professional medical advice from a shoulder specialist.
A specialist can provide personalized recommendations and treatment options tailored to your specific condition. Visiting a shoulder specialist, like the one at https://www.kevinkrusemd.com/garland-tx-shoulder-specialist/, could be a valuable step toward understanding your injury better and finding the best course of action for recovery.