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Stubborn impingement syndrome. What else can I do?
Hello, all. I have filled out the questionnaire below. I've been dealing with shoulder impingement since November 14th, 2008. It started as just a dull, aching pain in my right shoulder. I simply thought I slept on it wrong. The pain never went away, and to exacerbate the problem I kept training Brazilian Jiu Jitsu 3-4 times a week until February 14th, 2009, at which time, after some research, I decided that I needed some time off.
I had very limited range of motion and constant twinges when reaching overhead, to the side, behind my back, straight out, etc. Other than a trip or two to the Chiro, NSAIDs, and rest I didn't do much to help my situation.
The beginning of May I finally broke down and consulted an Orthopedic Specialist. He took X-Rays and performed an orthopedic exam and diagnosed me with Shoulder Impingement. I performed 3 weeks of physical therapy that consisted of external rotator strengthening mostly. The PT also recommended that I perform door-way stretches to lengthen my tight chest muscles.
Since then I admit I have been pretty lax on my PT. I have nearly full range of motion and hardly any pain, though. I would say I've made a full recovery, except I still can't do one movement and it's driving me insane.
My left, good shoulder, is very flexible. I can put it pretty far behind and up my back. My right shoulder is almost there, but there is still some pain right around the back of my shoulder joint when I try to put my forearm far across my lower back. This is the only movement that is not 100%. I'm at a loss. I've tried everything. Cortisone shot, physical therapy, The "Ming Method" (this is actually very effective, but that's for a different thread), rest NSAIDs, etc, etc. I've been out of full-time BJJ/MMA training for about 10 months and I'm going crazy. I'm 25 years old, for Christ's sake. Where has my resiliency gone?
Anyway, to the questionnaire:
1. When did the pain begin?
About 10 months ago.
2. What were you doing at the time? Or did the pain come on gradually over time?
It came on gradually. I'm assuming it's an overuse injury from BJJ. We do lots of overhead "warm-up" exercises before class, like bear crawls.
3. Where, anatomically, is the pain?
Currently I do not have any pain unless I put my forearm really far behind my lower back. By really far, I mean far enough for my right hand to touch my left hip. My left shoulder can handle this and is really flexible.
4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting?
Sharpish, I guess. On a scale of 1-10, with 10 being the worst pain, I receive about a 1.5.
5. Is the pain constant, or intermittent, or only on certain motions?
Only during one stretch.
6. What motions make your pain worse?
Putting my right forearm far behind my lower back.
7. What, if anything, makes your pain better?
I don't have pain most of the time, really. Just a few twinges here and there maybe once or twice a month.
8. Does your pain radiate to any other part of your body?
No.
9. What things could you do before, that you cannot do now because of your injury?
I shoulders are extremely flexible. My right shoulder isn't as flexible. Also, for some reason, BJJ seems to aggravate my shoulder. I've made a few attempts at returning when I've felt "100%". I only do the technique with some light rolling at the end. I'm not sure why, but this seems to really inflame my one shoulder, whereas it does not affect my other.
10. What is your main concern regarding the pain and its consequences?
I'm 25 and want to get back into competition. I feel I've been out long enough, but every time I've tried to come back I've had to take a few weeks off due to inflammation.
11. Have you ever injured that part of your body before? If so, how?
No.
12. Is your pain getting worse over time? And if so, how much worse over what time period?
It is a lot better. I would say it's about 99%. There's some flexibility and maybe some small strength gains to be made.
I'm at work, but when I get home I will try to include pictures.
Did I not fill something out correctly? Not include enough information? I saw that Mon replied, but someone deleted her post. I'd really like some additional help. The next step is MRIs and surgery and I'd hate to go that route if there is another way.
Did I not fill something out correctly? Not include enough information? I saw that Mon replied, but someone deleted her post. I'd really like some additional help. The next step is MRIs and surgery and I'd hate to go that route if there is another way.
I'm going to add a plea for assistance to goatmeal's. His situation mirrors mine in many ways, so I'd be very interested to read what some of our resident experts have to say here. I'm sure there are others who could benefit from it as well, so if anyone would be so inclined as to help us out, I'd be much obliged (so would some of those who have to live with me not being able to compete in my chosen sports ).
I'm going to add a plea for assistance to goatmeal's. His situation mirrors mine in many ways, so I'd be very interested to read what some of our resident experts have to say here. I'm sure there are others who could benefit from it as well, so if anyone would be so inclined as to help us out, I'd be much obliged (so would some of those who have to live with me not being able to compete in my chosen sports ).
I'm sooooo close to being 100%. I just want my right arm to do everything that my left can so I know I won't be jumping into training too early. That may sound silly, but after re-continuing training and then stopping due to flare ups a handful of times, I don't know of any other way.
Just thought I'd link you to a couple of good articles on stuff to do AFTER you are cleared to do them without pain. These articles might give you a better understanding about whats going on especially with your scapular/thoracic joint. Many times impingement is the result of postural issues. I know I developed an issue form years of punches and reaching out/up with my arms.
All three of these exercises have become full time (one each per training day) prehab/dynamic warm ups for me.
This should give you something to think about while you wait for the pros to come along.
P.S. This came to me as an after thought. Might you have so much flexibility that you have created a stability issue? The shoulders are fickle. They require stability yet they need mobility. A tight rope walk!!!
Just thought I'd link you to a couple of good articles on stuff to do AFTER you are cleared to do them without pain. These articles might give you a better understanding about whats going on especially with your scapular/thoracic joint. Many times impingement is the result of postural issues. I know I developed an issue form years of punches and reaching out/up with my arms.
Thanks for the reply! I've actually skimmed these already, but I'll give them a look again. I'm sure I missed a lot of stuff.
All three of these exercises have become full time (one each per training day) prehab/dynamic warm ups for me.
This should give you something to think about while you wait for the pros to come along.
P.S. This came to me as an after thought. Might you have so much flexibility that you have created a stability issue? The shoulders are fickle. They require stability yet they need mobility. A tight rope walk!!!
I actually do the Spiderman Crawls already, but in Brazilian Jiu Jitsu class. We call them Gator Crawls, though. They're tough!
Anyway, thanks again for providing some reading material. Until the pros can get here I've been doing YWLT work on a stability ball, using a foam roller for thoracic mobility, tennis ball for massage (I'm not sure how to use it), and just generally trying to stay positive and tell myself that I'll be 100% soon.
I had/have left shoulder impingement. It took over a year to go away with PT, shots, and anti-inflammatories. I can still feel effects of it at times and have to continue to do PT/rehab/prehab/etc to make sure it doesn't get worse.
I don't know what your PT has you doing, but what depends on the issue. I wasn't strong enough in the end range of motion, which left me open to injury in those positions. I was not only bound up (a non-technical term), but tight and short in many muscles surrounding the area (pecs, for one).
All I'm saying is that is that it takes time and it may take a different doctor/PT to diagnose the issue and give you different exercises to help you.
I had/have left shoulder impingement. It took over a year to go away with PT, shots, and anti-inflammatories. I can still feel effects of it at times and have to continue to do PT/rehab/prehab/etc to make sure it doesn't get worse.
I don't know what your PT has you doing, but what depends on the issue. I wasn't strong enough in the end range of motion, which left me open to injury in those positions. I was not only bound up (a non-technical term), but tight and short in many muscles surrounding the area (pecs, for one).
All I'm saying is that is that it takes time and it may take a different doctor/PT to diagnose the issue and give you different exercises to help you.
Dang. It sounds like impingement is just as bad as a rotator cuff tear.
When I first began researching, I was reading recovery times of 2 weeks to 2 months. I'm going on 7 months of recovery myself and when I first started I expected to be fully healed by June at the latest.
I've been researching all day at work, like the terrible employee that I am, and have now come to the conclusion that I no longer have bursitis, but something to do with the posterior shoulder capsule.
I can do overhead lifts, push-ups, and pull-ups with zero pain which is not common with shoulder impingement.
I cannot reach behind my back to the opposite shoulder blade, which is an indicator of a tight posterior shoulder capsule. Since that's the only thing I'm really concerned with, I think I've found some stretches to perform. Unfortunately the recovery could take from anywhere from 1 month to 3.
goatmeal, do you have the inside out dvd by mike roberton and bill hartman? http://www.inside-out-warm-up.com/ a lot of us on this forum have it and it helps a bunch with mobility and keeping the shoulders healthy.
goatmeal, do you have the inside out dvd by mike roberton and bill hartman? http://www.inside-out-warm-up.com/ a lot of us on this forum have it and it helps a bunch with mobility and keeping the shoulders healthy.
Hmm, thinks. I'll definitely check it out. The warm-ups will help me when I continue my BJJ training.
Can you post static photos ... left, right, front, rear views?
Also the behind the back reach on each side?
Thanks.
Hi, Julie. Thanks for posting.
My shoulder definitely feels better since starting the posterior capsule stretches. I can get my arm farther behind my back without nearly as much pain and if I try right after I stretch I get no pain at all.
Stubborn impingement syndrome. What else can I do?
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