Shoulder Pain Help

[juvefc]

Hi

I really hope someone can help me before i actually go visit a Physio. About 20 years ago i partially dislocated my left shoulder. I never did anything to rehab it. Over the years i always had mobility issues with the shoulder but not really any pain. It was still as strong as my right shoulder. I am an athlete who now mostly trains in Olympic Weight Lifting, 38 years old, diet on point and cardiovascularly in great shape (5'9'', 180 lbs, 8% bodyfat).

Last week i went to see my massage therapist just to get rid of some overall tightness in my hips, shoulders and upper back (deep tissue). She realized from the start that the only issue i really had was that my left shoulder was really knotted up so she pretty much worked on that for about an hour. Everything felt great, took the next day off from training and went back the day after. I did some push presses and chin ups and went home without any issues. The next day i had some major tightness and mild pain in the shoulder. The pain and tightness only occurs when i raise my arm over my head or when i try to do a pressing movement. I have no pain or loss of ROM in any other movement. I can still bench press heavy, i can still do lateral raises with weight, squat, deadlift etc etc but anything that has me raising my arm over my head you can forget about. I feel slight pain when trying to grab the chin up bar and i'm afraid to do any type of overhead pressing. I also do hear some popping or cracking when doing some other movements even without any weight. No pain with the cracking/popping.

For the last few days i have been taking an OTC NSAID 400mg ibuprofen three times daily, i've been icing it 3 times daily and i've also been sitting in a hot epsom salt bath twice daily. I also foam roll my upper back / shoulders / lats / triceps NUMEROUS times daily. While it is getting better i still feel slight pain when lifting my arm. My right i can reach over 180 degrees + without issues but my left i can get around 160 degrees before i feel some soreness. I also feel some pain when getting into the shoulder with my fingers. The pain is mostly in the posterior deltoid. I am also wondering if i could try to stretch my arm overhead or should i refrain from that?

I have also been doing a ton of stretches that i've seen from reputable physios based on rotator cuff issues.

Does anybody know what this could be? Is it tendinitis, impingement etc? I just find it strange that i can lift a lot of weight when it comes to anything at or below shoulder level but i can't even raise my arm 180 degree over my head.

Thanks

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[fisiofisio]

To get accurate result for your shoulder, please check to orthopaedic, but i predict that there's a problem from your "Labrum" due to your serious injury a few years ago.

Labrum is a cartilage disc attached to the socket of the shoulder that doesn't have a lot of sensoric nerve so pain will not be felt too strong though the damage occured there.

that's different if you have rotator cuff tendinitis, pain will be felt too strong.

Or ff there is an impingement syndrom of bursa subacromialis, will not appear cracking/poppoing sounds. just cant raise your arm until 70-120 degree because pain will be happened.

Limitation of range of motion must be felt if there is a labrum's damage without appearing too strong pain.

[finchr]

If there is no painful arc and you don't have symptoms until at the very end of elevation, you probably want to look into stabilizing your AC joint. That is the main time this will produce pain and make noises. Popping can come from multiple sources such as tendons sliding against bones, a tight posterior capsule or pec minor allowing the humeral head to lip on the anterior labrum or against the coracoid process causing anterior impingement , AC joint during elevation, and there is a phenomenon that I have called snapping scapula. If you can physically stop the problem, which is what I do n the clinic, then you he your answer. Try some strong tape over your AC joint and repeat" the "offending" movement to see if there is any change and if so does it remain so repetitively.
Try mid-range push ups or push up position only on your arm. Rule it out or in 1 a time. There are very good sensitive and specific tests and a lot that have no evidence to support them. I can give you an excellent reference if ever interested

[toddchaney]

You really need to see an orthopedic doctor. You dislocated your shoulder and yet did nothing about it. Get it checked thoroughly, only your doctor will be able to ascertain the cause behind the pain. X-rays or MRI will help him find out any broken ligaments or tendons in your shoulder and start the treatment.

[finchr]

Partial dislocations 20 years ago without repeat to me does not necessitate immediate MD visit. As a patient, I try to gather more info on if, what, when, how 1st if I can. Many,many times the patient will tell you what you need to know because they have observed the behavior of their problem. You are an active part of your diagnosis and healing. Surgeons are necessary when they are necessary but they also only operate on about 25-30 % of their caseload.
I don't know how the health system works in Canada. A visit to an ortho here would involve some physical tests and an x-ray which will only show joint spaces and bone spurs. If that is you problem then they would give you the option of a steroid injection and send you to therapy. In light of no results they would then send you for an MRI.
A good seasoned orthopaedic therapist will be able to discriminate and rule in or out shoulder pain based on various pathologies. There are valid and very sensitive and specific tests that are available ( see Chad Cook - ortho physical exam tests an evidence based approach). A good experienced orthopaedic therapist is not only trained to do exactly that but also prescribe a plan of care. If you can directly access a good shoulder therapist I would go that route 1st. You will be there anyway. There is nothing wrong with finding out what affects your problem if you choose to do so. As an orthopaedic specialist I ask my patients to do so in the clinic and for homework. Cause and effect is very powerful