rotator cuff injury.

[Richie1988]

During November 2007 I did my normal benching exercises for my chest at the gym. I had taken 2 weeks off for studying and had come back to the gym and continued lifting what I had been lifting 2 weeks earlier. I was pushing myself on the last 2 reps, and as I was doing it i felt something in my left shoulder pop out/in (thats what it felt like). I continued working out a bit more than said no more.

I believe that I had injured my rotator cuff. I stopped going to the gym since and read that the pain would subside shortly. The majority of the pain is gone (without any treatment) however i still have slight pain. When i put my arms straight infront of my body, I can lift them up to the sky and down to my sides without any pain. However when i bend my left arm and just stretch at the back on my head, i can feel a slight soreness/pain(it is only a slight pain and I don't feel it at all unless i bring my arm behind my head and just bend my arm in a 50 degree angle). None of this pain affects my everyday activities whatsoever however I have a few questions for you professionals.
(a) Do you think this pain in the deltoid area will go away or is this permanent damage(do u think it is a serious injury or just a minor one that wil heal with more time)? The reason I ask is because it has been 4 and a half months since I injured it and I still have this slight pain. It really concerns me this slight pain because i dont want to start working out again and then permanently stuffing it up, unless I already have!
(b) Should I start strengthening my rotator cuff even though i have this slight pain?(I have been taught the exercises i need to do to strengthen it)?
(c) And the main question. How long after the injury can I start working out again. Can i continue to work out now, 4.5 months since the injury or should i rest it for longer as i still have slight pain?

Thank you for your time in reading my problem. Much appreciated

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[Canuck Physio]

During November 2007 I did my normal benching exercises for my chest at the gym. I had taken 2 weeks off for studying and had come back to the gym and continued lifting what I had been lifting 2 weeks earlier. I was pushing myself on the last 2 reps, and as I was doing it i felt something in my left shoulder pop out/in (thats what it felt like). I continued working out a bit more than said no more.
I am a fellow weight-lifter, I think I can understand what's happened.
I believe that I had injured my rotator cuff. I stopped going to the gym since and read that the pain would subside shortly. The majority of the pain is gone (without any treatment) however i still have slight pain. When i put my arms straight infront of my body, I can lift them up to the sky and down to my sides without any pain. However when i bend my left arm and just stretch at the back on my head, i can feel a slight soreness/pain(it is only a slight pain and I don't feel it at all unless i bring my arm behind my head and just bend my arm in a 50 degree angle). None of this pain affects my everyday activities whatsoever however I have a few questions for you professionals.
(a) Do you think this pain in the deltoid area will go away or is this permanent damage(do u think it is a serious injury or just a minor one that wil heal with more time)? The reason I ask is because it has been 4 and a half months since I injured it and I still have this slight pain. It really concerns me this slight pain because i dont want to start working out again and then permanently stuffing it up, unless I already have!
Did you see a Physio when this happened? Acute Ultrasound treatment may have helped microscopic soft tissue repair and alignment, as well for both Ligamentous and Muscle/tendinous tissue. At least some evidence suggests this would be helpful in acute injury.
Weightlifting injuries take specific rehabilitation for full recovery. Just letting it rest and atrophy (become weak) will not help you recover any quicker. I would be very cautious of working out on the injured shoulder without appropriate adaptation, intervention and consideration of the structure at fault. It will just end up being a longer delay
(b) Should I start strengthening my rotator cuff even though i have this slight pain?(I have been taught the exercises i need to do to strengthen it)?
From where have you got the exercises, have you had an assessment done. It could be that you are not getting pain from the rotator cuff itself. Other tissues underly and cross over this joint.
(c) And the main question. How long after the injury can I start working out again. Can i continue to work out now, 4.5 months since the injury or should i rest it for longer as i still have slight pain?
There is no reason you can not work out, but I would be very cautious of going back to doing what you are doing. Any movements that cause pain or discomfort should be avoided. You could for example3 work out legs with no issues in the rotator cuff region. I have had similar issues in the past, and have discovered the only way to get back to full fitness is to properly implement and treatment and management program.
Thank you for your time in reading my problem. Much appreciated

As above, regards

[Richie1988]

First and foremost, thank you for your reply.
(a) Do you think this pain in the deltoid area will go away or is this permanent damage(do u think it is a serious injury or just a minor one that wil heal with more time)? The reason I ask is because it has been 4 and a half months since I injured it and I still have this slight pain. It really concerns me this slight pain because i dont want to start working out again and then permanently stuffing it up, unless I already have!
Did you see a Physio when this happened? Acute Ultrasound treatment may have helped microscopic soft tissue repair and alignment, as well for both Ligamentous and Muscle/tendinous tissue. At least some evidence suggests this would be helpful in acute injury.
Weightlifting injuries take specific rehabilitation for full recovery. Just letting it rest and atrophy (become weak) will not help you recover any quicker. I would be very cautious of working out on the injured shoulder without appropriate adaptation, intervention and consideration of the structure at fault. It will just end up being a longer delay
No, I didn't see a physio at all. I made the mistake of reading over the internet that the pain will subside and also taking advice from friends who said that time will heal the pain. While the majority of the pain is gone like i said there is only slight pain coming when i bend my arm at the back of my head. I am sure that this is from that rotator cuff injury. Is it too late for that Acute Ultrasound treatment?

(b) Should I start strengthening my rotator cuff even though i have this slight pain?(I have been taught the exercises i need to do to strengthen it)?
From where have you got the exercises, have you had an assessment done. It could be that you are not getting pain from the rotator cuff itself. Other tissues underly and cross over this joint.
My mates have shown me exercises that I need to do to strengthen the rotator cuff and i have found some over the net. The exercises involve using dumbells and are used to strengthen the rotator cuff. Apart from that, no assessment is done.
(c) And the main question. How long after the injury can I start working out again. Can i continue to work out now, 4.5 months since the injury or should i rest it for longer as i still have slight pain?
There is no reason you can not work out, but I would be very cautious of going back to doing what you are doing. Any movements that cause pain or discomfort should be avoided. You could for example3 work out legs with no issues in the rotator cuff region. I have had similar issues in the past, and have discovered the only way to get back to full fitness is to properly implement and treatment and management program.
Yes, I did that for a while. I did cardio and some lower body work but my mainfocus was on upper part of my body and since i got injured and figured i shouldnt work out i stopped working out altogether.

I know I will need to go see a physio soon and stuff to get this scanned but from what I have described what sort of injury do you think i have? Is it just a minor problem or a really serious one that will require surgery? And the main question, i know you don't know the answer to this because you dont know what is wrogn my shoulder but can these rotator cuff injuries be 100% healed. I mean it felt like a pop out/in and i still have a bit of discomfort(it looks as though its coming back from the back deltoid area) so is this something i will have for the rest of my lift and wont allow me to work out ever again? Thank you again for your time.

[Canuck Physio]

No, I didn't see a physio at all. I made the mistake of reading over the internet that the pain will subside and also taking advice from friends who said that time will heal the pain. While the majority of the pain is gone like i said there is only slight pain coming when i bend my arm at the back of my head. I am sure that this is from that rotator cuff injury. Is it too late for that Acute Ultrasound treatment?
That's fine, lesson learned I guess. Seriously there is so much mumbo jumbo on the web I could spend days describing all the false information out there. Not just about Physio, but about exercise science, strength training, nutrition and the lot. You seriously don't have a clue how much false information floats about. I like to think here at Physiobob thing's are done differently, most if not all the information is backed up with evidence, or straight up common sense, and intelligent years of experience. Coming back to your q: according to a recent study ( R. Ainsworth , K. Dziedzic , L. Hiller , J. Daniels , A. Bruton , and J. Broadfield A prospective double blind placebo-controlled randomized trial of ultrasound in the physiotherapy treatment of shoulder pain Rheumatology Advance Access published on May 1, 2007, DOI 10.1093/rheumatology/kel423. Rheumatology 46: 815-820.) US would not appear to prove beneficial for any of the parameters measured. If the changes are there, we have yet to measure them.

My mates have shown me exercises that I need to do to strengthen the rotator cuff and i have found some over the net. The exercises involve using dumbells and are used to strengthen the rotator cuff. Apart from that, no assessment is done.
I wouldn't suggest rehab'ing that shoulder immediately with DB's, simply because as you stated you don't know if the problem is specifically the rotator cuff. What may happen is that with improper technique, and targeting of the incorrect muscle groups you may in fact increase muscular imbalance, or recruit the incorrect patterns of movement, and may not see the benefit you are looking for.

Yes, I did that for a while. I did cardio and some lower body work but my mainfocus was on upper part of my body and since i got injured and figured i shouldnt work out i stopped working out altogether.
Common mistake is to completely stop exercising. I don't believe this helps with recovery of injuries, as you probably become less active, and begin to use the muscle groups less and less, leading to reduced speed of recovery. In "THE LONG-TERM OUTCOME OF ROTATOR CUFF TENDINITIS — A REVIEW STUDY M. D. CHARD, L. M. SATTELLE and B. L. HAZLEMAN" researchers found active tendinitis in 35/137 individuals at a mean of 19 months after presentation. So it may take some time to resolve.

I know I will need to go see a physio soon and stuff to get this scanned but from what I have described what sort of injury do you think i have? Is it just a minor problem or a really serious one that will require surgery?
My 'belief' is that you won't need surgery. It just needs specific treatment.

And the main question, i know you don't know the answer to this because you dont know what is wrogn my shoulder but can these rotator cuff injuries be 100% healed.
Perhaps not 100%, because ultimately microscopic changes take place that alter the biomechanics, neuromuscular recruitment, and rhythm of normal movement. But experience with my own injuries has taught me that it is possible to get back to 95%, and modify things to get around that 5% that can still re-aggravate it.

I mean it felt like a pop out/in and i still have a bit of discomfort(it looks as though its coming back from the back deltoid area) so is this something i will have for the rest of my lift and wont allow me to work out ever again?
Of course you will be able to work out again.
Thank you again for your time.

Regards, as above.

[Richie1988]

Hi, thank you for your reply once again.

The only thing I am scared is that this pain will stay with me forever and if i go back to working out, I am scared and have a feeling that it will get re injured straight away.

I'll most likely have to go see a doctor/physio some time soon but as I am a uni student I am stranded with many assingments and work and will find it hard to go within the next week. I will definitely keep you updated on what is happening.

Do you think i will need to take an MRI or something like that?