Solving Shoulder Pain

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Solving Shoulder Pain:

A Corrective Exercise Strategy

[/split_line_heading][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”padding-3-percent” column_padding_position=”left-right” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”2/3″ tablet_text_alignment=”default” phone_text_alignment=”default”][vc_column_text]Hi Paul,

I hope you’re all doing well, I miss my workouts with you guys 🙂 When you have time, I would like to get your input about an issue I’ve been having for the past few months, since I know you have lots of knowledge about the body.

[pullquote class =”left”]In the fall, I started getting stiffness, soreness, and pain after workouts (mostly bootcamp classes, burpees, pushups, using heavier weights). This was on the left side of my neck, around my collarbone and into my pecs, aching, pulling and twinging sensations. [/pullquote]I thought that it was just muscle soreness, or maybe I had tendonitis, and I would use heat or cold and massage to treat, but it gradually got worse and was an issue when I was working as well. I never felt a one time injury, but it could be from so many things (working out, trying to do chin-ups and pull-ups with full body weight, working, carrying heavy groceries upstairs, headstands, etc.) I had some tingling in my left arm for a few days but that went away.

 

About a month ago I was having a lot of pain and stopped doing any workouts other than yoga and running. I did some more massage and acupuncture/cupping and Advil which helped alleviate my symptoms. I went to the doctor, they said I had a pinched nerve and to get physical therapy. Thinking I may have something else going on, I went back to get an xray which showed I have a very straight neck, and slight misalignments in cervical spine. No pinched nerve from tests they did. They also told me to do PT which I can’t get to for another week. I went to a chiropractor to get their opinion, they said my muscles were tight and that I should correct my cervical spine to get the curve back or I may have issues in the future. I did get an adjustment and muscle stim which helped, but since I do not have insurance coverage for chiropractic and I’m not a huge fan of going indefinitely, I’m hoping it’s something I can correct on my own. Is this something that you’re familiar with and what are your thoughts? I know there are exercises you can do to help get the curve back, and use special pillows or  devices, but moving forward, I’m also anxious about getting back to regular workout routine.

Thanks for any help with this!  -Nicky[/vc_column_text][divider line_type=”No Line” custom_height=”30″][vc_row_inner text_align=”left”][vc_column_inner background_image=”57382″ column_padding=”padding-3-percent” column_padding_position=”left-right” background_color=”#ffffff” background_color_opacity=”0.9″ width=”1/1″][vc_column_text]

Can we identify the movement pattern that is causing you pain in your neck/shoulder?

Probably, we would need to observe your technique on several key exercises.  Generally with injuries, the pain comes from the muscle group that is compensating for the weakeness.  So the weakened muscle doesn’t hurt, it’s the muscles that are firing and getting overtaxed which hurt.  E.g. if your neck is sore, some of the muscles in your shoulder or neck may be doing extra work because some other muscles aren’t doing their job (often these are different muscles in your neck and shoulder).

Initial thoughts:

Some of the symptoms you describe and your interpretation of your X-ray are consistent with an impingement of your brachial plexus or median nerves.  However you are also suggesting symptoms that are consistent with a deep muscle sprain which has an entirely different treatment protocol.

Xrays and MRIs

An X-ray can show bone misalignment, but an MRI is much better for that (plus it can show soft tissue.)  If your bones are misaligned, we need to strengthen the correct muscles so that your move your bones back into the correct position.

How we would determine the source of your pain:

Our process for helping people in your situation is as follows:

  1. Identify the movement pattern(s) that cause the inflammation by looking at problems with form in functional movement patterns;
  2. Teaching how to correct those movements patterns,
  3. Improving your muscle control of the muscle(s) that are not firing, and
  4. Improving mobility of the joints in that area that causing the mobility restriction.

Advil and other pain relievers

Advil dampens your ability to sense pain.  Pain is a warning to your brain, please don’t do this exercise anymore.  Anti-inflammatories (Advil is not a strong anti-inflammatory, it is more like a pain blocker) can help, but they won’t prevent you from engaging in the exercise patterns that cause the pain.  The pain will just get worse as you do more and more damage to the joint of muscle.  One must identify the biomechanical source of the instable movement pattern to prevent it from doing damage to the part of your body that is hurting.

Corrective Exercise Strategy

Once we know where the weaknesses are, we can design a corrective exercise strategy to help you strength the muscles that aren’t functioning properly.  We would teach you those corrective exercises and you would be able to do them on your own.

Shoulder Function

In attempting to diagnose the root cause, I’d start with a shoulder impingement analysis and probably recommend an MRI.  Sand & Steel has a shoulder functionality benchmark that we use to test for impingement.  It includes several of the better known tests like Hawkins test and the Neer test, plus several tests I designed that give me information about grip, shoulder ROM, and strength.

Exercising with a shoulder injury

  1. For most injuries, Yoga is a good exercise routine. It won’t correct muscle activation problems, but it is good for improving mobility and Range of Motion.  If it hasn’t helped your problem in a month or so, it probably won’t with more classes.
  2. Running is not a good idea with a shoulder impingement (or the symptoms you describe.) The Gait (which is one of the seven classic movement patterns) requires the entire body to move across the sagittal plane in complete symmetry.  A shoulder injury is going to necessarily cause a shift in the way your arms move while you are running.  It’s very common that there will be a mobility restriction near the area you are having pain.  While this may not hurt initially, the mobility restriction will cause an imbalance in the way you run.  Another joint (e.g. your hip or maybe your knee) will take on rotational forces that it is designed to leading to another injury down the road.
  3. Bootcamp classes are notoriously bad for causing shoulder pain. In my youth I did some damage to my shoulder in a bootcamp class as well.  20 students to one instructor doesn’t work.  All bootcamp instructors know that they cannot deliver any where near the same level of supervision that they could with one-on-one coaching.  They do it to increase their revenue per session.  Clients like it because it’s cheaper per session, until they get injured.

Chiropractic care:

Chiropractic adjustments will mobilize a stuck joint, but unless you have good muscle health surrounding those joints, you bones will more or less just float back into the unhealthy position.  They are part of the solution, but they do not strengthen weakened muscles.  That is what your personal trainer and/or physical therapist do.

Bottomline can you fix the shoulder/neck problem on your own?

I would say it’s unlikely, because it sounds like you have already exhausted the solutions that were initially obvious to you.  If your main goal is exercising without pain, then we need to determine biomechanical patterns that cause the pain.  Once we know what those are, we can begin to determine a corrective exercise strategy to start reducing the pain in those patterns.

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Corrective Exercise and Mobility Services

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