Shoulder Injury

Pain & Rehab Forum [Moderated]
1

I dont know if yall can help me out but I figured I would ask. Going to give some back story first.

I commute an hour to work, I work in a paint and body shop, so the gym I go to is in the same city I work in, so I can train on my lunch break. I live in a rural area and this is the only gym around here that has a decent barbell section.

About 6-7 weeks ago I picked up a side job painting a 40 ft RV Camper. Worked 6 days a week 11-12 hour days, between my regular work and working on the Camper, for 2 weeks. As with anything that big I was working above my head a lot, holding my sander, or my spray gun when painting.

During this time I was not training, and I have not really since then because I have developed some pretty bad shoulder pain. Extremely painful for me to get into the low bar position, painful but doable to get into the high bar position. I can bench and over head press ok, the press feels better than bench. Raising my arms above my head, and holding weight anove my head doesnt hurt, but I experience pain when lowering the weight down, also reaching behind me, say in my car, trying to scratch my upper back, washing my hair.

I have friend in sports medicine and athletic prosthetics. He gave me instructions for some at home tests with my wife and thinks I have injured infraspinatus, to what extent he is unsure, obviously. His suggestion was your typical rotator cuff exercises with bands and suggested some sort of neoprene type brace that covers my whole shoulder and goes down to my elbow for support.

My main concern is recovery because of my job. I can’t not work for many weeks, and movements in my job, such as sanding with an outstretched arm in a circular motion, dont seem to be helping. I has been nearly 8 weeks at this point with moderate,at best, improvement.

I am asking here for second opinions and a barbell oriented prescription if possible.

Sorry for the long-winded post.

Thanks guys.
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2

Hey, sorry to hear you are dealing with a shoulder issue. How old are you? Have you had any recent traumas to the area? How’s your unloaded range of motion (reaching overhead, to the side, behind your back, etc)? This sounds like an acute overload to the shoulder which would make me lean towards a tendinopathy issue.

3

I am 29 years old, no previous trauma to the area. Range of motion is normal, but painful in certain movements. For example, using my right hand to touch my left shoulder blade, and vise versa, Reaching into the back seat of my car. Another painful motion would be like washing the middle of the hood on a truck, so reached out,pressing with slight force/circular motion

4

Gotcha. Given the timeline of when shoulder symptoms began in correlation to starting the side job, and no acute traumas to the area; I’d lean towards an overuse issue such as a tendinopathy. Which means you need to manage daily loading of the shoulder. Movements that have to be completed for work obviously take priority but you need to have a plan in place to mitigate symptoms. For instance, if you can work 1/2 hour before you notice symptoms then try to work just sub-threshold and take a break. Switch arms, do some air overhead reaches, something that is different from the same movement you have been doing. Without knowing your prior training regiment, it is difficult to give specific advice. With that said, I’d encourage training to tolerance to aid with the process of recovering from this and getting back to doing the things you want to do. The easiest heuristic with this, adjust loading (weight being utilized and/or sets/reps) of sensitized movements first, if that helps with symptom resolution then slowly progress forward. If altering loading doesn’t work then it’s time to alter range of motion, if that doesn’t work then it’s selecting different regressed exercises to load the area and then progress back to desired movements. In regards to shoulder tests, overall the majority of these actually are not valid tests. They may tell us someone has shoulder pain but that’s about it. Drawing conclusions from these tests are not great and I typically don’t utilize them in clinic for diagnostic purposes. Rather than getting too caught up with a “tissue cause” I’d say focus on the things you can do right now and will help you progress towards future goals. Does this make sense?

5

I am not sure i understand what you mean by work 1/2 hour before I notice symptoms. I would say half the movements I do at work give some sort of discomfort, but cant really stop them since its my work, and both shoulders giving me issues. My right shoulder is my dominate side, and has more pain than my left, I am guessing just because I use it more.

Before all this started and I was training regularly I was on novice LP, towards the end, was looking at “the bridge” planning for that in the future. Obviously with all the time off I have had in conjunction with this injury Im back at square 1.

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6

I understand. Sounds like certain movements begin bothering you instantaneously? Going back to your original post, training would likely be beneficial for you to aid with the recovery process and progress towards your goals. A consult would allow more individualized and specific information but that’d be the initial approach. Pain is a complex multifactorial issue and not so straight forward as there is something tissue wise wrong with your shoulder necessitating fixing. To reiterate, this sounds like an overload to your shoulders acutely with the side job. If it has been ongoing for 8 weeks and you’ve noticed moderate improvement at best, then this is a BIG step in the right direction and sounds like you need more time. Given the lapse in training, I’d suggest slowly reintroducing movements and loading to tolerance. Happy to discuss more. Hang in there.

7

Ok looks like its back to gym. My main concern was training on top of daily work was going to be too much, but sounds like Ive nocebo’d myself.

Thank you Michael for your time, and input.

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