Lat Pain...not shoulder!

[Blackjack]

So I met with my doctor about another issue and took the opportunity to discuss my shoulder pain with him and he did some assessment. It turns out it's not actually my shoulder but where my lat attaches to the back/lower portion of my shoulder.

He said it is most likely an issue of bad form on my bench press where I'm stretching that muscle too much by coming down too far. I recognize the fact that he is not a PT and sports med isn't his specialty. But I do think he has pinpointed the pain.

It's hurts when I do bench and somewhat when I do shoulder presses, but not to the extent that it does with the bench. Which supports the idea that it's not a shoulder issue.

Where it really becomes an issue is on my golf swing, follow through. It is my right arm so when I follow through it seems to pull on that spot.

My concern is that it isn't getting any better - should I push for some actual PT? Any exercises or things I can do on my own that would help? I mentioned the weak point workout from MF that addresses shoulder roll, he said that may help, but I'm not so sure.

Appreciate any helpful feedback. Thanks in advance.

Ted

[John Izzo]

Well...it can be classified as shoulder dysfunction. The muscles of the back (teres major, rhomboids, infraspinatus, supraspinatus, and latissimus) all attach or help move the scapula (shoulder blades). It sounds like when your scapula abducts there is pain. Can be bursistis as there are many bursea sacs located in and under the shoulder blades.

My advice to you is seek out a PT or ATC that is good with upper extremity injuries and begin some prehab/rehab exercises.

Don't wait to "hope it goes away".

[Bill Hartman]

Tell your doc to pick up an anatomy book. The lats don't attach on the back of the shoulder (there is a slip on the inferior angle of the scapula, but it doesn't sound like that's your issue). They attach on the front of your shoulder.

Pain on the posterior shoulder in follow through is often a posterior rotator cuff issue (internal impingement). Your symptoms in the bench press where shoulder extension is greater would be indicative of that as well.

Reach behind your back and try to touch the opposite shoulder blade. Compare sides. Most likely your painful side will be tighter. Move your arms as if you do a maximal lat pulldown behind the neck. If you have pain, it's possibly a posterior impingement. Put your arm in a high five position and have someone push against your hand. If there's pain, it could be a posterior impingement.

You also need to test your single leg squat and compare sides. If the side opposite the painful shoulder is more difficult, requires forward bending, the knee drops down and in, or you twist, it's a shoulder problem.

It's usually a combination of hip weakness, ab/lower back weakness, limited thoracic spine mobility, limited scapular mobility, and weaknesses in the scapular muscles

Don't try to fix it yourself. See a PT.

Bill

[Blackjack]

Bill, looks like you were right on. Met with a PT today and she said it appears as though I have some tendenitis in the posterior rotator cuff. She is concerned with some pretty sharp pain I experienced during her assessment. She thinks it may be an inflammation of my labrum (sp?).

I'm going in for a full PT evaluation on Friday and will try physical therapy for a couple weeks then decide whether or not I should see an ortho.

Thought you might be curious. Thanks for your help!

Ted