Shoulder/bicep tendonitis problem advice

[100Rev]

For the last couple of years my left shoulder has occasionally been giving me slight soreness when doing shoulder press. Recently it got worse to a degree it hurts if I lift a barbell behind my neck to do squats. The further back my hand is the more it hurts - somewhere inside the shoulder at the back side, with an ezy bar it took off some of the stress. The only movement that mainly hurts is if I put my hand up with elbow bent, and the pain increases the further I move my hand back (like putting out you arm out of the car window to signal you are stopping)

To avoid further damage I stopped weights that affected my shoulder and went to a physio here in Ecuador. He said it was tendonitis. I said it hurt somewhere inside the shoulder area at the back of the shoulder when I moved my hand back with actions such as putting a barbell behind my head. Also if I pushed my finger in the front of my shoulder I felt some small pain there too. He said it was bicep tendonitis and maybe something else (In south america and my medical spanish isnt that great).

He has got me going for two weeks for some sort of electro pulse therapy for 25minutes a day. Trouble is after just three sessions the front of the shoulder hurts worse than before which feels like muscle pain (like someone has punched me in the front of the shoulder) but its maybe just the bicep tendon.

Is this normal? should I continue this treatment or have I started it too soon? (ie should I ice and rest for a week or so and then start the treatment? I have only been resting the shoulder area and doing no exercises for it. I have done alot of searching and plan to do rotator cuff strengthening exercises but not sure when to start (actually I wished I started it before I found out about how common these types of injuries are!)

note I have never felt pain when doing bicep exercises which I thought is unusual if it is the bicep tendon.

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[100Rev]

I have tried a few tests watched online and had negative results from such as Hawkins and Neers.
I did feel some pain in the "bicipital groove" area with the Speeds test. When I got someone to do the apprehension-relocation test I suprisingly didnt feel any pain. But if I lift my arm in that position unassisted it hurts but I dont know exactly where, somewhere deep in the shoulder joint it seems.

[100Rev]

Are there actually any Physios here on the PHYSIO forum??? ....

[pudding_bowl]

By apprehension relocation what do you mean you felt no pain. You should feel apprehensive and then when the glide is applied you should feel fine, it's not really supposed to be painful - When I read your description I felt it was a likely anterior instability, but that doesnt mean it can't be a RC injury or something else.

[100Rev]

Thanks for the reply!
I meant I didnt have any look of aprehension or pain. It only hurts when I voluntary lift my hand up and back, somewhere deep in the back of the shoulder.

[pudding_bowl]

This isn't a very normal movement to do and is usually associated with a anterior dislocation... so anterior instability was my leading thought - but if no problems with aprehension then I guess your ok with that. It's very hard to make any assumptions without seeing you. Given a positive speeds test biceps tendinitis is a possibility... The treatment your receiving isn't my first choice given there is little to no evidence supporting it. I'd say if it makes you feel worse then you should be stopping it and asking the physio what exercises you can do - assess for any muscular imbalance in the shoulder and also assess the effect of mobilisations of the thoracic spine. I'd suggest you look into some scapular stabilisation exercises and see the effect of those as well. Like I say hard to know without an assessment.

[100Rev]

Thanks again for the info. I would see a professional if I was back in Australia but the reason I ask here is because I am in Ecuador and the comm. difficulty. I stopped the electro muscle stimulation and have just rested it and iced for a few days. The bicep tendonitis has subsided and much better, I still feel the ache when I bring my hand up but not as bad. I will rest it a bit longer and then start the exercises. I do regular weight training and am keen to get back into it but am only training the right side of the upper body and legs/core at the moment. But it is getting better anyway. will see.

[pudding_bowl]

Sounds perfect. Rest and Ice till it settles then start super slowly and super light weight strengthening and slowly build it all back up till your back to normal at the gym.

[100Rev]

Thanks for the reply pudding bowl. The bicep tendonitis has healed but still feel the pain in the back of the shoulder, I have started light dumbell exercises that are prescribed for rotator cuff strengthening, started stretching as well. Will report back in a couple of weeks.