Sternoclavicular issue/arm pain

[daabrowns]

Hey everyone,

Earlier this year I began having severe shoulder/arm pain. I am a weight lifter and do amateur strongman competitions. I have never had any problems with my shoulders or arms before. After noticing this pain (not really located, just throughout my left arm, but not down into my hand) I stopped pressing for about 2 months. I then began with pushups, then DB floor press, etc and have now worked up to regular floor press (after about 6 months). After an ultrasound in March, the physio thought I might have a small tear in my labrum. This was never confirmed with an MRI as I moved out of the country. A labral tear doesn't make much sense, as I had no acute incident to cause it.

Over the past few months, I've noticed a sternoclavicular problem as well. If I do arm circles, I can hear and feel the joint popping and moving around quite a bit. It does not cause severe pain while doing this, but at times (namely doing chest-supported row) if I fully extend my arms out in front and then try to pull a heavy row, the joint will crack and it will hurt like hell for a few seconds, but then the pain is gone.

I am beginning to think that the arm pain may be related to the sternoclavicular injury- although for this, I also have no acute cause. I am very frustrated at this point because after doing floor press recently, I began to feel the arm pain again. This is a very dull pain throughout the arm, and when the pain leaves, my arm simply feels tired and dead. The pain is most common when lifting my arm up and back.

This is clearly a very complicated case and it could be 2 seperate issues. I felt like posting it here to see if anyone has any ideas as to what may be going on.

I think my first step is to arrange an MRI to get my Sternoclavicular joint and shoulder looked at. This will hopefully be able to get me some answers.

Thanks in advance to anyone who might have some insight.

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[pudding_bowl]

Go for the MRI, if it tells you whats wrong then it's much easier to treat.
My tutor had a problem with stiffness in his SC joint so he showed me how to make it pop - your joint is popping which is a sign of instability in the joint. That joint has very limited ROM and shouldn't be unstable. I am unable to give u much advice on getting that joint to stop clicking. You should try and see an experienced physio that can assess if there is a muscle imbalance that needs working on to resolve the issue.
Not sure about your arm pain - but with body builders and a pain that comes on slowly we often think of thoracic outlet syndrome - where the increased muscle size occludes the blood flow to the arm. If you haven't been checked for that then make sure you get that. Otherwise given the floor press pain it's possible you have an overuse injury of one of the rotator cuff - although ultrasound should have highlighted this.

Go with further investigations and an assessment from a experienced musculoskeletal physio for now. Let us know the results. Good luck

[Quickstart]

Labral tears don't have to be from a single acute incident. They can arise from repetitive strain and wear, particularly if you've been lifting very heavy weights. The downward drag on the humeral head can cause a small lesion on the labrum quite easily.

The SC joint is a very difficult joint to manage, and there is a similar thread in the Sports Physiotherapy section about the SC joint. Found here. .

MRI would be great, for excluding labral tear, but it is unlikely to show you an unstable SC joint (unless it shows ligament trauma) your best bet to exclude SC joint is to get it injected with a corticosteroid under radiographic imaging and then see if the pain disappears. It will not stop the clunking, but it will tell you 100% if the SC is the cause of the pain.

Advice: Find a good sports physio. Tell them your suspicions. Get them to assess, and see if you can get an MRI, and if the physio thinks it's indicated a cortico shot. If the cortico works organise a referral to agood orthopod who specialises in shoulders.