Templates, Injections, PT and still in pain

[Jonblood]

Background: 33 years old 210lbs. Weight lifting seriously for 15 years BJJ for 6 years.
No acute injury but a year or so ago my left shoulder started hurting chronically. Never stopped lifting or BJJ through this mostly tried to train around it.


Trained with the shoulder templates while doing BJJ and pain did not improve.
PT 1. 3 months, lots of band work, reverse flyes, scapular retractions etc and pain did not improve.
PT 2. Found on clinical athlete. Worked together for 3 months.
Lots of barbell stuff, similar to what I hear on these forums. Pain did not subside.
PT 3. Prescribed 3x/week 3 sets of 30 side raises, front raises and external rotations. Told me to stop doing BJJ for a few months. Said that during my sparring my shoulder are incredibly tense with all the pulling and pushing and tension even if they aren’t being cranked on (which doesn’t happpen I tell my training partners i have a bad shoulder) F*** THAT!

I went ahead and got a cortisone shot which helped for a few weeks but pain is coming back. X/ray prior to the shot showed arthritis.

Sadly, i think the more I train BJJ the more it hurts. Do I need to stop? Do I need to take a break?

[Derek Miles]

This likely warrants a consult as it sounds like there are a few topics here that are worth discussion. That being said, this scenario is fairly typical so I will offer some general advice.

If we look at how your laid out your approach to the issue there is a lot of and. So continued with BJJ and did the shoulder template, continued doing BJJ and did some silly band work, continued doing BJJ and did barbell work.......

If this is a training injury that would fall in the overuse camp (no mechanism of injury tends to slant that way) then continuing to add training volume/intensity/movements is rarely the answer. That does not mean that I am advocating for you to stop BJJ but likely some modifications are in order. If your primary goal is to get your shoulder feeling better, then continuing at the same level of participating likely isn't the best approach. The issue being (and why a consult can be more beneficial) is no two dojos are the same and what constitutes BJJ is highly variable. If you are spending the vast majority of your sessions rolling or drilling at high intensity, that would likely be the first modification I would seek to make. Or, if you are reporting (honestly) that you sessions are typically RPE 9, I would likely work to dial that back. The same principles that apply to lifting work here in that it ultimately comes down to managing load/intensity/frustrations with progress. If adding exercises has not worked, I would look to see what we can subtract from the equation to help manage symptoms.

Once again, I am not saying to stop participation but any time I see a F*** THAT! while I respect that position, the combination of profanity and all caps tends to slant that intensity may be on the high side. The questions then become what can you do at practice that does not bother your shoulder. That may mean you are drilling for a few weeks and that is it, but drilling with symptoms improving is typically better than to keep grinding with an injury that has been present over a year. As you get back into higher intensity, it may mean trying to roll with the higher belts as they can typically control the environment a little better than white belts. If you find there are certain position that aggravate your shoulder more, it's scaling drills and rolling to where you can practice said positions. There may be some accessory work that would help keep your shoulder stronger while symptoms are calming down but if we're adding volume there, we likely need to balance that with subtracting volume from somewhere else.