shoulder impingement?

[cooGy]

I think I might have a possible shoulder impingement, and looking for help.

History: About 2 months ago I started doing single arm snatches with dumbells, after 1 or 2 training sessions I started to get some pain with movement (reach across the front of my body and reach around back, and overhead movements) in the general area of my acromion (i think, the little point that sticks up just before delts). I went to a physical therapist and he gave me 2 exercises to do, which I remember him saying they were Bill Hartman's exercises, one was lying down on my side with one knee up and using a 2lb dumbell and bringing it from the floor to just below my knees and letting it down on a 6 count. The second one is also lying down with the 2lb db, and with my arm bent 90 degrees externally rotating it up, then extending it up, then internally rotating my whole arm and bringing it down to the floor on a 6 count across my body. This helped get rid of the pain almost completely.

But lately (past 2 weeks) the pain came back on my right shoulder. It is only when I bring my arm across my front and also reaching around back that I feel it. It is not exactly pain, but more of a discomfort and feels like something is "getting caught". That is the best way I can describe it. I have been going to an Active Release Technique practitioner for a few sessions, and it helps but the discomfort just keeps coming back.

I do a lot of overhead presses, snatches, and I don't know if it makes a difference but my pulling is a lot stronger than my pushing.

If anyone has any help, it is GREATLY appreciated. I just hate not being able to perform at full capacity.

Thanks, and sorry for being such a long post!

[UConnJulie]

Are you still doing those exercises? Or any other mobility/pre-hab exercises?

Do you do any stretching?
What does your ART guy say about your pain/injury?

What does your warm up look like?

[NeilC]

Did you do the classic thing of doing the rehab exercises until the pain went away and then not doing them anymore?

[cooGy]

Originally Posted by UConnJulie

Are you still doing those exercises? Or any other mobility/pre-hab exercises?

Do you do any stretching?
What does your ART guy say about your pain/injury?

What does your warm up look like?

I am still doing the 2 exercises, hopefully I explained them good enough for you to understand what they are. One question I have is for the first one what is the correct hand placement? Palms facing down or to the side with pinky down?

At first when it started about 2 months ago it was mainly my left side and had pain when I reach across the front of my body, behind, and also overhead. But that went away after doing those exercises.

Then about a week ago this started with my right shoulder. The best way I can explain the symptoms is that if I try to bring my right arm back to scratch my middle back, my ROM is limited, more than left side, and a little pain when I get to that point. But after that point I can either use my other hand to bring it up or use the same arm to inch my hand up with no pain. Doing over head exercises also causes no pain or discomfort.

I stretch a lot, after each workout and also almost every night before bed. For shoulder ROM specific stretches I do the lying down arm out at 90 degrees and then rotate it towards the ground, tricep overhead, arm behind back and pulling up with a rope. I hold each stretch for about 30 seconds.

The ART guy did the the art techniques, and then told me to do push-up pluses and another exercise that I will try to explain. Lying on my stomach, arms along side my body with palms facing down. Rotate shoulders back and down, hold it like that throughout, try to externally rotate palms as much as possible, then curl arm up, then back down to start.

My warm-up consists of dynamic rom exercises, mostly from a book "magnificent mobility" and I also just purchased "Inside-Out" and will be incorporating some of those into my warm-up too. After the rom exercises I then do a circuit of 10-15 reps each exercise with a 10lb dumbell of shoulder presses, shoulder scaptions, bent-over rows, full squats, lunges, reverse wood-chops, then push-ups, and then plank on a swiss ball for 60 seconds.

Also, on a different subject, while doing standing cable row (knees bent to balance) am I supposed to let my shoulder blades pull forward to get a full ROM, and on the concentric movement at the end pull the shoulder blades back and down? Or am I supposed to be locking my shoulder blades back and down for proper posture and keeping it that way throughout the exercise?

I'm just trying to get more opinions on the subject matter to hopefully find the thing that helps it the most. I'm on a never-ending quest to have the most injury-proof and conditioned body that I can achieve to do my job (firefighter) as efficiently as possible.

Thanks!

[cooGy]

Originally Posted by NeilC

Did you do the classic thing of doing the rehab exercises until the pain went away and then not doing them anymore?

I'll admit it, I didn't do them as frequently as maybe I should have after the pain went away.

[UConnJulie]

Did you have any x-rays done of the shoulder?

[cooGy]

No I haven't. Should I request that I get x-rays? I have absolutely zero pain while training, it's only the one movement when I get a little bit of pain, kinda feels like a muscle is tight and just not letting it have full rom and is pulling therefore causing the pain.