Help with shoulder / arm injury (with VIDEO!)

[sepandee]

This is taken from a previous post I made just yesterday. The difference is that i don't have a set of instructions for the exercises that cause pain in my shoulder. Instead, I've provided a link to a video I've made that explain those exercises.

Back in June 2007, so approx. 9 months ago, I was playing tennis. Nothing serious, and after 20 minutes into the game i felt a pain in my shoulder after a regular forehand. I didn't do anything special, it was just a normal forehand. I kept playing for another 10-20 minutes, then stopped. I've carried the pain ever since. I did physio in Oct. for 2 months (around 15-20 sessions?). The physio said it was my rotator cuff, though the pain i felt was more in my arm as opposed to my shoulder. And the problem was that I couldn't, and still can't, pinpoint the pain. it's just somewhere in my arm/shoulder, i don't know where.

Needless to say, I still have the pain, and I wanted to know if anyone's experienced a similar problem. I give instructions for 3 exercises that bring back my injury pain in the following video, so if anyone's an expert and can try these exercises/stretches and figure out what my problem is, then it would be greatly appreciated:

http://ca.youtube.com/watch?v=3gwXGXchbHY

I should also say that a standing military press brings the pain as well.

 

[SystemicAnomaly]

For the most part, all 3 exercises appear to be shoulder stretches. Even tho' the triceps are stretched in #1 and the biceps group is contracted in all 3, these are basically shoulder stretches. In fact, these look like they may the sort of stretches used to determine the nature of a shoulder injury.

I actually do have an old rotator cuff issue that has come back to haunt me for the past 7 months. I found stretch #1 to be a bit painful. However, #2 and #3 only produced a mild discomfort for me. When I modified #3 so that my hand/arm rotated upward instead of downward, I felt intense pain.

The #3 variation makes sense (for me), since my primary rotator issue is external rotation. I also have a secondary problem with shoulder flexion. It appears that your problem may very well be internal (medial) rotation. You may also have a problem with shoulder abduction.

Note that the rotator cuff actually consists of 4 different muscle groups and associated tendons. It appears that the muscles & tendons that bother me are different than the ones that cause you pain. It is not uncommon for rotator cuff damage to be felt in other parts of the upper arm -- this is sometimes referred to as referred pain.

Rotator cuff or shoulder pain can be due to various issues -- impingement, inflammation of 1 or more of the rotator group tendons (tendinitis), inflammation of the shoulder bursa (bursitis), or a rotator cuff tear. For more on this, check the following:

Yahoo Health: Rotator Cuff
Wikipedia: Shoulder issues
Wiki: Rotator Cuff muscles & injuries

Internal Rotator exercise
Shoulder Abduction (easy)
Shoulder Abduction (advanced)

More shoulder exercises
Upper body exercises

 

[sepandee]

Wow, thanks for the links. THere are so many exercises that I don't know how to start or which ones to do!

That can indicate a problem with shoulder abduction. You may also have an issue with internal rotation (judging from the pain felt with the 3 stretches you've described. Try another movement -- instead of lifting your (straight) arm to the side, lift it up in the forward direction -- this is shoulder flexion. I only feel slight pain with this movement. However, when trying to lift something relatively light, even a partially-filled milk carton, I feel an intense pain.

No pain when i lift something forward. However, the same container of tomato juice (a bit more exotic than milk!) causes pain when i lift it up to the side and bring it to a level with my shoulder.

 

[Teyko]

Wow, thanks for the links. THere are so many exercises that I don't know how to start or which ones to do!



No pain when i lift something forward. However, the same container of tomato juice (a bit more exotic than milk!) causes pain when i lift it up to the side and bring it to a level with my shoulder.

Your rotator cuff can be felt from your shoulder to about an inch or two from your elbow. I had this issue as well for a while and it went away once I routinely start doing rotator cuff exercises.

 

[sepandee]

Your rotator cuff can be felt from your shoulder to about an inch or two from your elbow. I had this issue as well for a while and it went away once I routinely start doing rotator cuff exercises.

which exercises did you do? And describe 'routinely'. Did you do them 3 times a week? twice a week?

 

[SystemicAnomaly]

Wow, thanks for the links. THere are so many exercises that I don't know how to start or which ones to do!

...

No pain when i lift something forward. However, the same container of tomato juice (a bit more exotic than milk!) causes pain when i lift it up to the side and bring it to a level with my shoulder.

The pain that you feel with that lateral (tomato juice container) raise, is probably another indication that you have difficulties with shoulder abduction. I think that exercise #1 in your video may also be an indication of this. Video exercise #3 probably indicates that internal rotation of the shoulder is another issue.

I'm not really certain what the pain that you are feeling in exercise #2 indicates. Perhaps further reading or feedback from your physio could shed some light on this.

Focus on the exercises that deal with internal rotation and with shoulder abduction as well as any exercises recommended to you by your therapist. If you are doing lateral raises with dumbells or on an exercise machine, it might be best to follow the 30 degree recommendation shown on the simple arm raise (Yahoo Health) rather than lifting directly to the side.

If you are still playing tennis, save the static stretches for after your tennis session. As soon as you get home apply ice to the shoulder (and upper arm). Ice or ice massage several times per day is also a goof idea.

Prior to play, I would suggest using heat to warm up the shoulder. Also include some dynamic shoulder stretches as part of your warmup. This can include arm circles and arm swings. Include some easy practice swings for the forehand and service motion as part of this warmup. Gradually increase the speed of these practice swings.

 

[sepandee]

thanks again.
These exercises, should I do them everyday? Or should I do them 3-4 times a week?

 

[SystemicAnomaly]

thanks again.
These exercises, should I do them everyday? Or should I do them 3-4 times a week?

Not sure. What did your physio say? I would think that 3x to 4x per week is a minimum.

 

[danix]

sepandee,

Funny, but I have the exact same problem. I woke up one morning and my arm/shoulder hurt. Wasn't from tennis or exercise, I just woke up that way.

So, I stopped playing tennis, and I started conservative, opting to try acupuncture for the first time ever. It did nothing except drain my wallet.
Then I went for PT. Did that for 3 weeks, got a little better.
Finally went to see a top orthopedist. He diagnosed bursitis, gave me a cortisone shot. Hurt more for a day, then by day 3 it was better. Day 4 I was pain free for the first time in months. Day 6 it came back gradually and today it's back at around 50%. I haven't played in about 2-3 months now (except left handed). I'm returning to PT tomorrow as the dr said we have to give it more time and that another cortisone shot won't help.

Don't know if this helps you any, but there it is.