dc
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Post by dc on Jun 21, 2014 11:06:26 GMT -7
Hi, I was wondering if anyone had experience rehabbing a chronic shoulder impingement? The shoulder doesn't hurt at rest anymore but I've got about 3/4 full range of movement. I've had 3 weeks off and wondering when to start gentle climbing again?
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Post by Chris W on Jun 21, 2014 20:34:06 GMT -7
DC, have you seen a doctor or PT for this condition? How did you arrive at the diagnosis of impingement?
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dc
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Post by dc on Jun 22, 2014 0:09:04 GMT -7
DC, have you seen a doctor or PT for this condition? How did you arrive at the diagnosis of impingement? Hi Chris, thanks for the reply, I've seen doc and pt and had a scan. Some tendinitis and bursitis and underlying SLAP type 1 (not unusual in active population over 35-40) and impingement tests positive. It's just got a bit chronic and I was wondering if others had a similar experience and how they progressed back to climbing. Pretty frustrating injury which I should have rested 6 months ago. |
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Post by Jack Ziegler on Jun 22, 2014 5:15:26 GMT -7
I've been working hard at increasing shoulder flexiblity and reducing shoulder popping in my right when I reach over head. I was doing gymnastic excercises before I started the rock prodigy method and got more flexiblity but also more pain and gave my self pinched nerves in my arms and a stiff neck (thoracic outlet syndrome).
I've been seeing a massage therapist and a physical therapist and a functional manual physical therapist.
Through the massage therapist I've learned more about which muscles in my body are tight and have almost completely gotten rid of my pain ( still working on the stiff neck though). For me, my shoulder impingment that has been reducing range of motion was/is caused by multiple factors. One, inflammed and tight biceps where the long head of the bicep connects to the shoulder. Also, tight and inflamed supraspinatus muscles, which were restricting my flexibility from reaching across my chest. Also, my pec minors were very tight. This affects your ability to lock off close and pull your shoulders back and puff you chest and also how far back you can reach. Also, my rhomboids were so tight that my scapula could not move freely, you need lots of unrestricted movement of your scapula to have shoulder flexibility and no impingment. Also, lately what I have been working on is giving my self better posture. From climbing and working at a computer my upper spine has become curved forward to much, so I have been using a foam roller and double lacrosse balls tapped together to loosen up the upper spine. Having your ribs and upper chest f lexible is also importantant.
I've made the most progress by figuring out what muscles are tight and targeting those muscles with self massage using a lacrosse ball, most notabley the pec minor and the muscles attracted to the scapula. To massage the long head tendon of the bicep, I lay on the ground and roll a large 45 lb barbell over my shoulder very carefully. If your muscles are Inflammed or have scar tissue, these self massages will hurt like hell but you will feel great and have reduced pain and range of motion afterwards. Takes a few days. The popping/impingment has been reduced. A test of your progress is this exercise called the wall slide where you put your back against the wall and reach up and down with your arms in contact with the wall as much as you can. You make it harder by also flexing your abs and putting your lower back close to the wall.
For self massage with lacrosse balls and foam rollers and dumbbells, check out the supple leopard book. Yoga/stretching helps, but if you have impingment /extreme tightness like me, you will need other methods make progress. Yoga classes don't help my shoulders too much. I often grab doorways and squat racks to get high leverage to stretch.
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Post by Jack Ziegler on Jun 22, 2014 5:28:43 GMT -7
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dc
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Post by dc on Jun 22, 2014 12:36:01 GMT -7
Thanks for all the great ideas, I've not read move like a supple leopard but I know friends who rate it. I'll definitely try some trigger point massage and scapula wall slides. It drives me nuts not being able to climb as I'd been going my best in years!
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Post by Chris W on Jun 22, 2014 20:48:13 GMT -7
DC, it sounds like you've had a pretty extensive evaluation. Typically, physical therapy is a great way to go, but the road to recovery is almost always long and frustrating. Once you do get better, you have to be religious about performing the exercises that helped to keep the problem at bay. In rare cases, surgery can be helpful if boney abnormalities are contributing. Be sure to avoid any exercises that can contribute to the problem (such as the popular upright rows). If doing pushups, military presses, bench press, dips, etc, do not move past a 90 degree bend in your arm at the elbow joint. Doing so puts your shoulder joint at risk, which far outweighs any rewards gained from increasing the ROM in those exercises.
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dc
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Posts: 14
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Post by dc on Jun 22, 2014 23:08:11 GMT -7
Thanks for the reply Chris. I'm definitely avoiding any risky shoulder exercises and will begin the PT exercises once it settles down a bit more. I may try a sub acromial injection to see if it will kick start the rehab.
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Post by Chris W on Jun 23, 2014 5:43:43 GMT -7
DC, good luck with the therapy. Don't forget that a corticosteroid injection may cause some temporary weakness in surrounding tendons. Make sure your physician knows the forces applied to your shoulder during climbing. Bring in a picture from a climbing magazine of someone pulling some crazy mono dyno in a limestone roof and tell him/her "See!!! That's what I do!! When can I do that again?"
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dc
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Post by dc on Jun 23, 2014 13:04:50 GMT -7
Thanks, that's a good idea. I was planning to have a couple of weeks rest after the injection then begin gentle rehab exercises and easy trad with a view to being proper fit for October. I'll hopefully integrate some of the exercises posted above. One of the reasons I posted here was I don't think most doc's or PT's really know what you put your joints through, even if they have done a bit of climbing.
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Post by Jack Ziegler on Jun 27, 2014 8:57:07 GMT -7
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dc
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Post by dc on Jul 3, 2014 23:41:15 GMT -7
That hurts just looking at the pictures! |
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