Shoulder Pain - Inflamed Supraspinatus?

Hi everyone! I'm afraid I'm yet another internet hypochondriac looking for some advice!

Quick background is that I regularly weight train (mainly powerlifting / olympic lifting), play hockey and go climbing, so normally I would say that I don't have issues with muscle imbalance / weakness.

However, I had a few weeks without any training recently (trying to save my hands for a piano exam), and one morning woke up with really terrible pain in my right shoulder, which has persisted on and off for a few weeks now. It got better with rest, but I probably went back to training too soon and now it's bad again.

The pain comes on when I try to adduct the upper arm, especially with the elbow bent to 90deg. It never flares up before I raise my arm to 30deg, but it does vary as to whether I can get it no further without pain, or sometimes right up to above my head before the pain hits.

If I keep my elbow directly in front of me, I can raise my hand above my head with no pain whatsoever, and I have no pain or loss of strength when lifting myself using my arms (e.g. climbing, chin-ups etc.). There's no pain from shrugging motions when I let my arms hang down, and I can pull my elbow back behind me without pain, so it just appears to be lateral motion that sets it off. That said, if I'm making more complex / general overhead movements (e.g. forgetting about the injury and reaching for something off a shelf), it gives me the odd stab to remind me it's still there.

I'm keen to get back training as I'm starting to fatten up (also nursing a torn hamstring :( ), but I'm concerned about making things worse.

Anyway, to cut a long waffling story short:

• Am I right in thinking that this is probably an inflammed supraspinatus tendon?
• What's the best plan of action to get it back to normal?
• How long before I can start fully loading it again in the gym?

Thanks in advance!

Hey mate,

Sounds like we share alot of the same interests! I'm a climber and a pianist also. Though I found the best thing was for me to climb before my piano exams (guess it's finger memory and I play better once they relax post workout).
I think you meant Abduction not adduction?
The mechanism of injury doesn't make much sense because you just woke up with it... but yea your symptoms do sounds like a bursitis or supraspinatus tendonitis, though there are some things in there that would make me consider other pathologies and I'd need to examine it to differentiate.

With the inflammation of bursa or rotator cuff you'll find that the scapula-humeral rhythm is affected... this means you don't co-ordinate the movement correctly and everytime you feel that pain it's because you are pinching the tendon or bursa against the acromion - which will only inflamme it further. Hense you need to avoid aggrivating factors, utilise ice and NSAID's to reduce the swelling and then undertake a gentle and graded strengthening program to strengthen the Rotator cuff and correct any co-ordination issues.

What this means is that you really aught to visit a physio... I say this because although you may be right... shoulders are tricky - and in black and white they can give symptoms for one condition when really it's actually something else. You need a physical examination of the shoulder to get a correct diagnosis and appropriate exercises.

Have a good one.
Pudding

Hi There,
If you've just woken up with this one day with no prior issues and fit and healthy i would also suggest you get your lower neck checked out on the same side as the sore arm. What you describe could be a result of a facet joint irritation (wry neck - from sleeping in an awkward position, stress etc) and could be irritating the nerve path from neck to elbow (hence why doing the movement with 90 degrees elbow flexion is more painful even though lever-arm is shorter and therefore should require less shoulder muscle effort than straight arm).

Gist of this is...get your lower cervical facet joints assessed and see if that's a limitation to your shoulder movements and referred pain as i find this is quite common with many physios and medicos forgetting to clear the neck as a source of symptoms in the arm and shoulder.

Let us know how you go.

Cheers,
msk101 :)

Quote:

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Originally Posted by pudding_bowl

Hey mate,

Sounds like we share alot of the same interests! I'm a climber and a pianist also. Though I found the best thing was for me to climb before my piano exams (guess it's finger memory and I play better once they relax post workout).
I think you meant Abduction not adduction?
The mechanism of injury doesn't make much sense because you just woke up with it... but yea your symptoms do sounds like a bursitis or supraspinatus tendonitis, though there are some things in there that would make me consider other pathologies and I'd need to examine it to differentiate.

With the inflammation of bursa or rotator cuff you'll find that the scapula-humeral rhythm is affected... this means you don't co-ordinate the movement correctly and everytime you feel that pain it's because you are pinching the tendon or bursa against the acromion - which will only inflamme it further. Hense you need to avoid aggrivating factors, utilise ice and NSAID's to reduce the swelling and then undertake a gentle and graded strengthening program to strengthen the Rotator cuff and correct any co-ordination issues.

What this means is that you really aught to visit a physio... I say this because although you may be right... shoulders are tricky - and in black and white they can give symptoms for one condition when really it's actually something else. You need a physical examination of the shoulder to get a correct diagnosis and appropriate exercises.

Have a good one.
Pudding

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Hi there, thanks for the advice! Yes, I should have said abduction, that'll teach me to try and use the right words :D Shoulder is feeling quite a bit better today, but I'm going to try and sort out a physio referral from my doctor today (time willing :rolleyes: ).

I'm currently on 150mg/day of diclofenac for knee bursitis (yes, I know, I'm a wreck), so hopefully that will meet my anti-inflammatory needs for the shoulder as well.

I've got a good set of rotator cuff exercises, that until this year, I had been doing quite regularly. Probably serves me right for stopping, but I plan on bringing them back in, without weights in the next few weeks before trying to build up the strength.

The shoulder does feel a lot better today, and I'm now able to abduct to horizontal without any weakness, just with slight pain in the joint. I've no plans to jump into the gym and start maxing out on shoulder press yet though!

Quote:

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Originally Posted by msk101

Hi There,
If you've just woken up with this one day with no prior issues and fit and healthy i would also suggest you get your lower neck checked out on the same side as the sore arm. What you describe could be a result of a facet joint irritation (wry neck - from sleeping in an awkward position, stress etc) and could be irritating the nerve path from neck to elbow (hence why doing the movement with 90 degrees elbow flexion is more painful even though lever-arm is shorter and therefore should require less shoulder muscle effort than straight arm).

Gist of this is...get your lower cervical facet joints assessed and see if that's a limitation to your shoulder movements and referred pain as i find this is quite common with many physios and medicos forgetting to clear the neck as a source of symptoms in the arm and shoulder.

Let us know how you go.

Cheers,
msk101 :)

---

Thanks for the extra info! I'll mention this to the doc when I go. I think you may have hit the nail on the head, as I was totally confused as to how this could happen in my sleep when I hadn't stressed my muscles / joints properly in weeks!

HI again,

Pop along to a good musculoskeletal physio and they should be able to thoroughly assess your neck and shoulder and treat as necessary.

good luck
msk101 :)

Furthermore, to help heal and reduce that inflammation in addition to rehad and NSAIDS, you should try ultrasound. You'd be best to treat frequently with a home use device such as Sonic Relief - you can treat frequently (up to 3 times per day) for up to 3 weeks to see a faster response.

I supose this tread is old, but I trye post a question here.

Many years ago, at age 15-22 I realy enjoyd climbing.
I am to day a musician, playing piano.

I just wondred if I took up climbing again, would that reduce my ability playing the piano? would the fingers get thick, and stiff? or something

Youmay find you develop callouses (thickening of skin) on the palm and palm side of fingers and this may reduce sensitivity a bit - not really sure if this would have any detrimental effect on playing. It would also be reversable by stopping climbing at any time. A protectve measure you can do is wear apprpriate high grip gloves for climbing. A good sports store should be able to help you. The change in muscle development as you strengthen up houldn't be detrimental. So why not do it!

On thing you should consider however, and this has nothing to do ith piano playing, given your age and gap in training you may be more prone to injury and overuse problems. Muscles may be prone to tears and also tendons- particularly iaround the shoulder joint but also arms, back and neck. I would suggest tou consider dong some training that would include a geeral weights program.

hi, thanks ...

I dont know why, but I dont think I ever had any injury, even tho I have been treining with weights and doing sports on and off all my life. But - sure, Im not 22 now, and climbing I supose is very stressfull on arms and back, hands and fingers, and most of the body.

Better to be sure but if you are currently doing weights and keepinf fit - nothing to worry about!

I have climbed for 12 years and played the piano all that time with no problem at all. You can play the piano with callouses ;) however I haven't had callouses for a long time which is because I work with waxes and creams when massaging since becomming a physio. Prior to that when I did have callouses I found no problem playing. And personally I'v always found climbing beneficial for my playing because the exercise always helped me to relax the finger muscles allowing them to move quickly... this may not be the same for everyone however.