Chris has pain in his right shoulder

March 1, 2016

Hi Guru,

I am having an issue with my right shoulder which has been going on for quite a long time.

I injured it in a bike crash but I also use to do weight-lifting and this might have aggravated it. However, I am now taking time off to recover.

As a test, I have tried reaching my opposite scapula with my arm behind the back for both sides. I am able to do that on both sides, however when you are looking from a lateral angle, you can see that on the injured side the shoulder is sort of rolled forward when the arm is touching the scapula.

I cannot say I get pain on specific movements, the pain is rather diffuse in the shoulder, perhaps a bit on the anterior side, more like discomfort rather than aching or sharp pain. There is no pain when reaching overhead, however doing overhead presses at the gym will almost 100% lead to pain next day so I have stopped doing them a long time ago.

I was wondering if you could advise me what the best course of treatment would be in order to get back to lifting as soon as possible. I am doing rotator cuff exercises along with lat, chest and traps stretches but I am not sure I am targeting this particular issue.

Thank you!

March 1, 2016

Hi Chris

It’s sometimes tricky to know what is wrong, when you don’t really know what right is – you very rarely try to reach your other shoulder blade, and so the comparison is negligible.

We want to blame something for something and don’t like the idea of coincidences….

Saying that your overhead head stuff maybe telling.

Your bit of rehab sounds good, but you need to make sure you’re doing the right stuff in the right/optimal body position.

Your arm hangs in the right position, in the shoulder joint when the shoulder blade is in the right position.

Shoulder blades “sit” in the right position when your thoracic spine is held in a neutral position – not too slouched forward or not too pulled back.

What’s really common, due to postural affects, is allowing your chest to slump forwards – which pulls your shoulder blades into the wrong orientation. Any overhead stuff is really effected by this – hence a day later pain.

Do what ever you can do and get your thoracic spine moving and then try doing your rehab with your thoracic spine in a neutral posture. It’s tricky, but it’s also key to full recovery.

The Guru

Chris has a couple of follow-up queries for the Guru:

Hi Guru,

Regarding your suggestion, is this something that we could be working on with the sports physiotherapy sessions? I would like to know your honest opinion as I am a student and the service is expensive for me – I do not want to invest money into something that does not fix this for me.

Looking forward to your answer. Thank you very much for your input!

The Guru responded:

Hi Chris

Fair question – you need to be given the ability to move better through your thoracic spine (a la Physio) and given the right rehab to do (also from a Physio)

You can however do things to get you moving better and carry out a progressive, controlled rehab program without any Physio intervention.

The (major, hopefully!) difference between the is speed & control of progress – seeing a Physio will be able get you moving quicker, with less pain and progress your rehab as and went needed.

Going solo you have very little idea of its the right or wrong thing to do (pain doesn’t always mean is not good) and speed of recovery (is a week normal or is 3 months acceptable)

If a Physio doesn’t “fix” you (if that’s possible) or at least manage your expectation then I think it’s reasonable to get a little stroppy…

The Guru

Guru Responded

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