Persistent right shoulder/deltoid issue after injury: rest or active rehabilitation?

Pain & Rehab Forum [Moderated]
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Hi everyone! I’d like to get some opinions about an ongoing issue with my right shoulder/deltoid. I’ll try to keep this as concise as possible, although the problem has been going on for several months.

A little background: I’m 28 years old and have been weight training for over 10 years, without ever having any significant shoulder problems. Shortly before the symptoms started, I had begun a new training program that involved a particularly slow and controlled eccentric phase (around 3 seconds) on the main compound exercises, something I had never emphasized to this extent before. I don’t know whether this may have contributed to the problem, but I’m mentioning it as a possible contextual factor.

It all started after a minor fall between late December 2025 and early January 2026, when I experienced a sharp pain in my right deltoid area. The more intense pain gradually subsided, but I was left with intermittent tightness, stiffness, and a feeling of “heaviness” in the deltoid area, with several flare-ups during weight training, especially when training chest, shoulders, and doing biceps curls. When training my biceps, I would sometimes also feel the area becoming very tight and “inflamed.”

In mid-January, I stopped going to the gym for about a month. I then gradually resumed activity, first with resistance-band exercises (external rotations, face pulls, isometrics) and later with reduced weights and training loads. However, in April I experienced another flare-up during a chest/shoulder superset. Since then, things have improved, but the symptoms have never completely disappeared.

On July 10, 2026, I had a non-contrast MRI, which was subsequently reviewed by an orthopedist and showed no significant joint-related problems according to the evaluation I received. I was prescribed Gladio (aceclofenac) for 10 days, Lucen (esomeprazole), 10 Tecar therapy sessions, and one month off from the gym. Initially, the only recommendation I followed was taking time off from the gym, as explained below.

I have been completely off weight training since July 21 (although I use my arm normally in everyday life). With rest, I am genuinely improving: I feel much less stiff and tight, although a mild sensation of “heaviness” is still present.

Last week I had another physiotherapy assessment. The physiotherapist found some joint stiffness, but said that overall my shoulder is functioning well. I was advised to continue taking time off from the gym and, to potentially speed up recovery, to have 5 Tecar therapy sessions and take Gladio as previously prescribed.

CURRENT MANAGEMENT: At the moment, I’m not doing any weight training, applying ice for 20–30 minutes per day, using arnica cream once a day after icing, and taking Flogomu (a natural anti-inflammatory supplement, 2 capsules per day).

My main concern is this: I understand that recovery generally shouldn’t rely exclusively on rest, but should also involve a gradual return to movement and loading. However, when I previously tried to return gradually, I experienced new flare-ups, which is why this time I decided to stop weight training completely (although it’s possible that I progressed the loads too aggressively — I’m not sure).

My questions are:

  1. Am I managing this phase appropriately, considering that I’m progressively improving while taking time off from weight training?

  2. Would it be better to continue resting from weight training for now, or should I start a specific physiotherapy/therapeutic exercise program? What type of professional would be best to guide me through this?

  3. What criteria should I meet before returning to weight training, and how should a gradual return be structured, particularly for chest, shoulder, and biceps exercises?

  4. What could explain the residual mild feeling of “heaviness” and stiffness despite the improvement, an MRI without significant findings according to the assessments I received, and a shoulder that appears to function well on physical examination?

  5. Can Tecar therapy and Gladio actually promote recovery, or are they mainly useful for symptom management? Could I reasonably avoid them?

Obviously, I’m not looking for an online diagnosis and I’m already being followed by healthcare professionals. I’d particularly appreciate input from physiotherapists, sports medicine professionals, strength coaches, or anyone who has dealt with something similar, especially regarding how to transition safely from rest to active rehabilitation and eventually back to weight training without triggering another flare-up.

Thanks to anyone who takes the time to read this and reply!

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Howdy,

Welcome to the forum. You’re not leaving any stone unturned and admire your tenacity for combatting this. However, I do think there are some changes I’d make.

The pattern seems to go irritated shoulder, rest until calm, return, flare, rest again. Each round of complete rest calms symptoms but also lowers the shoulder’s tolerance for load, so you come back to a lower ceiling and re-flare more easily, especially if the programming is not modified to fit where you’re now at. I think the programming has been incorrect each time, unfortunately.

Your workup (MRI and physio) is reassuring, but I’m wondering what the PT recommended? I don’t think rest is the correct treatment, so I’d be interesting to know if they recommended that.

For the treatments you mention, I don’t think they’re particularly useful, but if you like them, that’s cool with me.

What you need is a graded return: start clearly below your flare threshold with tolerable loading and movements for your upper body. Reintroducing load is the treatment, and the right professional is one who rehabs lifters back to lifting that way, rather than defaulting to more rest and passive modalities. Your specific questions, what criteria to return on and how to structure it per movement, are exactly what an individualized rehab consult is for. This is past the point where a forum thread can give you the useful back-and-forth, so I’d point you there rather than have you guess at the dosing again and risk another flare.

Where to go from here

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Thank you very much for taking the time to reply and for your kindness. I truly appreciate your help.

If I understood you correctly, you are suggesting that instead of continuing with complete rest, I should begin a properly graded rehabilitation program, progressively reintroducing exercises and load while staying below the threshold that causes a flare-up, ideally under the guidance of a physiotherapist who has experience rehabbing lifters back to lifting. Is that correct?

There is one thing I still don’t fully understand. I continue to experience an intermittent feeling of heaviness/tension around the deltoid/shoulder area, even though the more acute pain has improved considerably with rest.

Could this sensation of heaviness simply be related to the shoulder still having a reduced tolerance to load and not having gone through an appropriate progressive rehabilitation process yet? Or would you consider that symptom something that should be evaluated separately?

For some additional context, the diagnosis I was given was subacromial-subdeltoid bursitis associated with supraspinatus tendinitis/tendinopathy. My right shoulder MRI did not show any tears or significant lesions of the rotator cuff; the main finding was only a small amount of fluid in the subacromial-subdeltoid bursa, consistent with bursitis.

Again, thank you sincerely for taking the time to help me. Your explanation has been extremely useful, and I really appreciate your patience and kindness.

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Yea, we generally do not advise complete rest and prefer tolerated movements in a structured, gradually progressed program. This sometimes takes a trained professional to implement, because we (the lifter) can have trouble getting out of our own way. Ask me how I know.

The symptoms you describe would not be particularly worrisome to me if I were in this situation, but I’m unable to comment on your case specifically through the forum. I would want more information and follow up, which is not something I can do through this medium.