Advice on Shoulder

Hello,

I am a 33 yo male lifter of ~20 years. I have purchased the shoulder rehab template and was hoping to get some advice specific to my situation. I started experiencing left shoulder pain back in February of this year the next day after a heavy workout that could be best described as a pain in the superior/posterior portion of the shoulder . There was no specific moment of acute pain or indicator of injury during the workout so at the time, I thought it was a small tweak or strain that would go away in a couple of days.

I proceeded with my next upper body session which made the pain worse and I took a break from training for 2-3 weeks because of a trip and the hope that some rest might let the shoulder calm down. It did not and during the trip I started experiencing sharp pain in the area of what I believe to be the infraspinatus but also going into the anterior shoulder as well when doing things such as putting on a jacket or lifting my arm to the front and some positions felt lacking in strength but I think this was limited by pain. I went to the doctor who performed some minimal special tests on the shoulder and an X-ray. He said the joint space looked good, it was likely subacromial impingement, and to go to physical therapy for 6 weeks and if not better follow up with him.

I went to a PT for several weeks who agreed with the diagnosis after some minimal testing. They had me perform stretching, rotator cuff strengthening, and told me I should continue to incorporate lifting to tolerance (some of which we would do during PT sessions) but avoid above 80% effort or so. I was seeing limited progress at first using light weights until I purchased and started incorporating the progression in the shoulder template for the lifting. Upon progressing the weights, albeit gradually, it seemed there was a period of improvement and close to complete symptom resolution despite the development of some clicking and grinding I could feel in the shoulder every time I move through certain ranges of motion.

After progressing in this manner for a few months, I had a recurrence of symptoms the day after a heavy barbell bench workout where I accidentally overshot my RPE 8 target a bit on a set of 6 with 265 and had to grind out my last rep. This was made worse by a decision to go fishing and golfing the days after it happened. I took a few days off and saw the doctor again who spent maybe 3 minutes in the room and told me to get an MRI.

I have tried incorporating some of the same things again like increasing the rep range, lowering the weight, and using 3 second negatives but perhaps not quite resetting the weights as low as I should out of frustration this time around. Mostly, I have mild pain during lifting and day to day activity that comes and goes and I can usually ignore but find the popping/grindining I feel every time when putting the shoulder through certain positions (think combing hair, putting on a shirt, etc) to be concerning as it does not seem to be resolving and seems to be in the same location as the pain.

My questions are:

  1. What do you think is going on, should I get the MRI?

  2. Is the popping and grinding something to be concerned about considering I feel consistently almost every time I put my shoulder through certain ranges of motion and it seems to be associated with pain?

  3. What next steps would you recommend? I can do a consultation, but was unsure if this situation would be appropriate for working with the BBM team remotely.

Thanks!

Hi there,

Sorry to hear about this. This is a pretty common scenario, and unfortunately one that we often have to learn the hard way – specifically, the problems with not pulling back as far as we really need to in order to get control of symptoms. To your questions -

  1. We have not evaluated or consulted with you, and unfortunately a forum post is insufficient for us to make a confident recommendation here.

  2. This is not necessarily indicative of any specific pathology.

  3. Yes, I would strongly recommend a consultation with our team for further individualized guidance through this process. It will likely save you a lot of time and frustration in the long run, compared with continuing to attempt to self-manage as you have so far.