Long-term shoulder impingement and pain

[adoringhummus]

I’m a 33 y/o male with a shoulder problem that has kept me out of the gym for 6 years. It seems to be a chronic problem that doesn’t go away with rest time and lack of activity.


The pain was not originally brought on by anything sudden, it was a slow onset as I was lifting weights previously and has evolved over the years since I’ve stopped.


I feel a strong pinching sensation in my left shoulder at the back (area pictured with awful selfie angle) when I raise my arm up in the scapula plane. The pain kicks in when my arm is around 50 - 60° raised and continues until around 140°.


I don’t have any loss of range of motion and can still generally perform daily tasks. I can get my arms above my head easily and feel like I have plenty (maybe too much) flexibility through the joint.


Rotator cuff exercises always make my pain worse — not whilst doing the exercise — but after. Because of this, I’ve never stuck to these exercises for more than a couple of weeks at best. Equally, any gym exercises involving the shoulder also aggravate the pain.


The sleeper stretch does temporarily remove the pain. Also massaging right into the teres minor / insfraspinatus area temporarily removes the pain.


I do also seem to have some achy pain in my SC joint on the same side. I have no idea if this is related.


I have had MRIs on both my SC joint and shoulder and neither shown anything to note.


The pain definitely does feel like impingement. From what I understand, it’s more likely to be internal impingement. But every corrective exercise seems to make the pain worse. Should I just push through this?


I’m frustrated, confused and lost with it.

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[physiobob]

Hi adoringhummus and thanks for your post. In general almost all shoulder issues (non traumatic) are impingement issues. And as in your case most take years to develop to the state which causes pain. The interesting thing for your issue is that you mention pain begins rather early in the range. A true subacromial impingement of the supraspinatus tendon, especially in respect of a negative MRI, would not normally be painful that early in the range. It does not mean no other structure could be involved though. With a sleep stretch giving temporary relief I wonder if your issue might be somewhat neural i.e. the brachial plexus (nerves) are implicated here. As a therapist I would take an approach to test you face up on the table before and after some cervical mobilisation to see if that area is involved. Also to take a look at the movement at your SC joint as you abduct the arm as sometimes if that joint is not tracking correctly it can cause symptoms that minic impingement.

My advice would be to see a good manual therapist with a view to rule out or in the neck and SC joints involvement. Once we get some more information on that let us know and I'd be happy to provide some further comment.

regards

PB

[adoringhummus]

Hi adoringhummus and thanks for your post. In general almost all shoulder issues (non traumatic) are impingement issues. And as in your case most take years to develop to the state which causes pain. The interesting thing for your issue is that you mention pain begins rather early in the range. A true subacromial impingement of the supraspinatus tendon, especially in respect of a negative MRI, would not normally be painful that early in the range. It does not mean no other structure could be involved though. With a sleep stretch giving temporary relief I wonder if your issue might be somewhat neural i.e. the brachial plexus (nerves) are implicated here. As a therapist I would take an approach to test you face up on the table before and after some cervical mobilisation to see if that area is involved. Also to take a look at the movement at your SC joint as you abduct the arm as sometimes if that joint is not tracking correctly it can cause symptoms that minic impingement.

My advice would be to see a good manual therapist with a view to rule out or in the neck and SC joints involvement. Once we get some more information on that let us know and I'd be happy to provide some further comment.

regards

PB

Many thanks for your reply, and apologies for the delayed response.

As you're based in London, would you be willing to send me details so I can book privately?

Feel free to DM me if you don't want details posted publicly.

I really am quite desperate at this stage and am looking to try anything I can.