my first rotator cuff injury

[IronFist]

A few weeks ago I hurt my left shoulder doing a human flag, which is something I'd been working on for a few months.

It didn't go away for a few weeks, so I got an eval from a physical therapist who said I have microtears in my rotator cuff and an inflamed biceps tendon.

So no upper body work for a few weeks (months?) for me. Pressing actually hurts. I can't do biceps work because of the tendon, and she didn't specifically say no triceps work but I would imagine that the rotator cuffs act as stabilizers in things like skull crushers, and they certainly come into play in things like triceps pushdowns.

I can't even squat because holding the bar hurts my shoulder :(

All I can do is deadlift and ab exercises. I guess that's better than nothing.

I start shoulder physical therapy soon.

Anyone here had a rotator cuff injury before? Discuss.

[JamesC]

I've had problems with both of my rotator cuffs.

Like you, I got to a point where I was unable to even do dumbbell curls because of it. I ended up taking off about a year(only movements that involved the shoulder) before it healed, but I didn't do any rehab. Also, even when doing exercises that didn't seemingly involve the shoulder, I would sometimes tweak it just right and it would floor me.

Now, for some strange reason, if I don't work my shoulders regularly the pain seems to come back.

The important thing is to think of it as an oppurtunity. What can you work on during rehab that is lacking? Running? Flexibility? Footwork? Technique? You get the idea.

Anyhow, good luck with recovery. I also recommend you rehab the other shoulder in the process. My left shoulder never had any problems until months after my right was injured. There was no catalyst, they just started to hurt one day.

Probably from years of front-delt pushing on bench, years of grappling, and lots of rock climbing.

[taai gihk yahn]

RTC stuff comes from direct trauma to the area, which is straightforward, in a way, because u know the cause, or because of compensatory damage from another area, which is for many people the case, and also a bit trickier to treat successfuly; for example, a lot of people have extension restriction at mid thoracic level, meaning that the vertebrae of ~T4-6 are stuck in a relatively flexed position; this can result in local hypomobility that can impact the way the scapula sits on the thoracic cage, usually biasing it into a relatively forward tipped position; as a result, u can get relative inhibition of lower trapezius, which is an important scapuar stabilizer, especially during deceleratory movements, such as when throwing a ball or thowing a punch (especialy hooks / overheads); as such, RTC, specifricaly supraspinatus and infraspinatus, which are shoulder external rotators, end up doing the job of develerating the arm, without the benefit of lower traps to stabilize scapula or optimal biomechanics of thoracic spine; as such, u can start to get overuse injury of supra/infraspinatus which are sitting in a relatively elongated position, given that the shoulder, because of the forward tipped scapula and relative flexion bias of the trunk, biases into internal rotation; on top of that, u can have relative faciitation of latissimus and pecs, which r shoulder internal rotators; lats especialy r influenced by flexed thoracic, as they attach from T6 on down, so dysfunction there can create aberrant firing patterns in lats;

take home message is that the shoulder / RTC is the terminus onto which a lot of stress is dumped due to hypomobiity / dysfunction elsewhere (I can even make an argument for how a chronic sprained ankle can create RTC tears, if anyone realy wants to suffer through that);

my suggestion: find a therapist who thinks the way I have outlined above - meaning that they don't just treat locally at the site of pain and apparent dysfunction - they need to look at the whole kinetic chain as a totality to understand what's going on; this can b a PT, or chiro, osteo, ATC - anyone who reasons intelligently about these connections;

good luck...

[JamesC]

Awesome info TGY. Thanks a ton.

Never knew this. Seems like lots of heavy bag work and heavy sparring could have been contributing factors for me.

[taai gihk yahn]

Awesome info TGY. Thanks a ton. Never knew this.
glad it was useful for u - and just remember it's food for thot only - it's a somewhat idealized example of how the spot where u have the symptoms, in the absence of direct trauma to that area, can become symptomatic bec it's compensating for restriction elsewhere, and how u hav to take a big-picture look at things to manage it properly; to treat the shoulder w out clearing ribs, spine and pelvis is to ignore this perspective;


Seems like lots of heavy bag work and heavy sparring could have been contributing factors for me.
well sure, they absolutely could be - it may b a combo of direct trauma and compensating for other areas - the point again is to find a practitioner who thinks in a way that looks at the local issue but in context of the whole body - there are people out there doing this, u jus hav to keep looking until u find someone, and not sttle for cookie-cutter, assembly line therapy...

[Brule]

just goes to show you that the human body is not individual parts but more of one long link to make up the chain. everything is interconnected.

great info TGY.

[Oso]

3, 90% tears in the cuff, 2 tears in the labrum, a large bone spur removed from inside the joint, some arthritic spots scraped down and the shattered end of my collarbone smoothed up a bit.

do what they tell you to do. i couldn't afford to stick with the post-surgury rehab for more than the three months of insurance was paying for...and, I participated in a seminar 4 months post-op...stupid...

anywho, I stay away from martial arts these days. I still had chronic pain until I started crossfit. I credit just getting the shoulder stronger and, i think, the static overhead stuff like overhead squatting, turkish getups, etc. helped a lot, for me.

but, i've been a year away from weights of any sort...and my shoulder hurts again.

[IronFist]

I've been doing the exercises at home (stretching every day, exercises every other day) which means I don't get the benefit of the ultrasound machine at the PT office, but it seems to slowly be feeling a bit better. Maybe 10% better than it was when I made this thread.

I can't really do any upper body work in the meantime, but that's ok because I don't want to risk making it worse.

Slow and steady.

[Lucas]

i totally feel your pain, i just messed my rotator cuff up a couple weeks ago...sucks balls big time. im at about maybe 50% recovery but its tough. doing what i can, but its a beotch.

[wenshu]

I've had chronic rotator cuff impingement/overuse/degeneration issues for a couple years. The most recent issue took nearly two years to clear up (nearly pain free). Still have the popping and clicking but range of motion and stability are better then ever. Here are some of the exercises I have integrated into my shoulder prehab routine.

Y, T (http://www.youtube.com/watch?v=OvpQAdgLpEk&feature=related)

"L" (can be done prone on a bench)
http://danblewett.com/wp-content/uploads/2009/08/Picture-62.png

"Prone Skier"
http://danblewett.com/wp-content/uploads/2009/08/DSC015371-300x225.jpg


External Rotators (http://www.youtube.com/user/RobTrainSystems#p/u/36/DlhBgH24esM)
I often use bands or cable machine for external rotation work as well.

Standing raises:
http://danblewett.com/wp-content/uploads/2009/08/Picture-3-23-09-28.png
Sword Raise
http://danblewett.com/wp-content/uploads/2009/08/Picture-4-23-09-16.png

Forearm planks
http://1.bp.blogspot.com/-0IaB44dwehE/TeRUGIDuKAI/AAAAAAAAAIU/SHujevl7yCg/s320/forearm%2Bplank.jpg
forearm plank push ups (http://www.youtube.com/watch?v=n6_VU9fH9GA)

Scapula push ups. (http://www.youtube.com/watch?v=ALzFr2GT-Is)

Self Myofascial Release (http://www.youtube.com/watch?v=elWYsl-uE44)

"Sleeper Stretch" (http://www.youtube.com/watch?v=HU6bdtdDess&feature=related)

I've found these "Tea Cup" exercises to be great for shoulder mobility. We do them in Shaui Jiao as well.
part 1 (http://www.youtube.com/watch?v=uIdf6y_GiaM)
part 2 (http://www.youtube.com/watch?v=deU3_OUK4OQ&feature=results_video&playnext=1&list=PL09536803DADB9B2E)
part 3 (http://www.youtube.com/watch?v=JjoF0kva964&feature=related)
part 4 (http://www.youtube.com/watch?v=AFZsOz8jEXg&feature=related)

[Lucas]

thanks for posting that wenshu!!

[IronFist]

I can't do planks right now without pain but once it heals that may be a good preventative exercise.

Thanks for posting those!

[kungfublow]

I messed up my RC a couple of years ago in a bad moutain bike fall. I was reduced to just practicing sword forms because it was the only thing I could do with one arm. It took about 4-5 months before I was close to normal.

I'd say this! Make sure you are working on flexability and range of motion as this heals. I got lazy and didn't do my exercises and becuase of that the scare tissue built up and I lost some range of motion. To this day I cannot raise my arm totally straight above my head. The doctor tells me I might not be able to do it ever.

Lesson learned! Do your exercises and give it time to heal.

Good luck! It's a crappy injury!! Heal well!!

[Lucas]

I messed up my RC a couple of years ago in a bad moutain bike fall.

holy crap that is exactly what happened to me!!!!:eek:

[Ray Pina]

Dealing with this now and seeing a specialist later this week. Sounds like a rotator cuff issue.

Five years ago I broke my clavicle training for a fight without knowing it. There was some pain but full range of motion so I fought and lost a decision. The shoulder wasn't an issue, din't feel a thing.... learned a lesson there.

A couple years later I got a rib x-rayed and they informed me of the clavicle breakage, a chip off the end.

Two BJJ locks on the sam arm later, separated by about 7 months and a surf crash onto the same shoulder, I'm now out of action. Sucks..... though I am enjoying the time off. Holy cow is the work day easier knowing I don't have to rest up for training or that work can be picked up after dinner.

Now running to cut weight gained from the down time. I missed all last surf season so my concern is that I don't want to miss this season as well b/c of surgery.

Seems like you all are recovering without surgery.... that's promising.

I can paddle no problem but a little pain popping up. Push ups hurt. In that I can't do more than 5 without feeling like I'm doing damage so I stopped.

[kungfublow]

holy crap that is exactly what happened to me!!!!:eek:

Nice!! Martial arts and mountain biking! Is there anything greater? Well I guess there is but I have to actually talk to my wife for the other thing. These I can do on my own.

[IronFist]

4 months later and I'm still in pain. How annoying.

It's like 85% better but still.

I still can't squat because holding the bar in place requires pulling my shoulder back into the painful ROM, and I don't want to do anything that causes any pain at all. The only "exercise" I've done for the last 3 months is my rehab exercises and stretches.

I keep reading conflicting advice about tendonitis. Some studies say NSAIDs help. Other say NSAIDs are contraindicated. Others say they help in the short term but cause the tendons to heal weaker than if NSAIDs were not used.

Then there is advice to use other anti-inflammatory supplements, such as Curcumin and Bromelain.

Other studies say that inflammation is not even an issue with tendonitis and it's something else.

Some people say ice.

Others say heat.

Some say both.

Or neither.

Some people swear by this supplement called Cissus. Other people say it's a huge scam.

It's super irritating. I want to get back in the gym.

[Lucas]

4 months later and I'm still in pain. How annoying.

It's like 85% better but still.

I still can't squat because holding the bar in place requires pulling my shoulder back into the painful ROM, and I don't want to do anything that causes any pain at all. The only "exercise" I've done for the last 3 months is my rehab exercises and stretches.

I keep reading conflicting advice about tendonitis. Some studies say NSAIDs help. Other say NSAIDs are contraindicated. Others say they help in the short term but cause the tendons to heal weaker than if NSAIDs were not used.

Then there is advice to use other anti-inflammatory supplements, such as Curcumin and Bromelain.

Other studies say that inflammation is not even an issue with tendonitis and it's something else.

Some people say ice.

Others say heat.

Some say both.

Or neither.

Some people swear by this supplement called Cissus. Other people say it's a huge scam.

It's super irritating. I want to get back in the gym.

right there with you bro...its somewhat depressing...

[IronFist]

right there with you bro...its somewhat depressing...

How's your injury coming? You said you were like 50% back in October.

[sanjuro_ronin]

4 months later and I'm still in pain. How annoying.

It's like 85% better but still.

I still can't squat because holding the bar in place requires pulling my shoulder back into the painful ROM, and I don't want to do anything that causes any pain at all. The only "exercise" I've done for the last 3 months is my rehab exercises and stretches.

I keep reading conflicting advice about tendonitis. Some studies say NSAIDs help. Other say NSAIDs are contraindicated. Others say they help in the short term but cause the tendons to heal weaker than if NSAIDs were not used.

Then there is advice to use other anti-inflammatory supplements, such as Curcumin and Bromelain.

Other studies say that inflammation is not even an issue with tendonitis and it's something else.

Some people say ice.

Others say heat.

Some say both.

Or neither.

Some people swear by this supplement called Cissus. Other people say it's a huge scam.

It's super irritating. I want to get back in the gym.

Sounds like the inpingment I had that I now have AGAIN !
Yep it tends to re-occur.
It got worse because, like an ass, I didn't listen to my body.
I hurt it doing some LIGHT cleans and aggravated it doing, well...anything really.
I feel it more doing pull ups and overhead presses.
I can still do them and that is why I did them and made it worse.
Physio worked for me last time ( massage, accupuncture and rehab exercises) but I don't know when I will have time to do them this time around.

[Lucas]

How's your injury coming? You said you were like 50% back in October.

well i kind of aggrivated/reinjured it, but ive stopped being stupid...:rolleyes: im about where you are right now 80ish%, just doing rehabilitation exercises and stretching. this is honestly the first injury ive had where i cant just work around it. it seems like when ever i try train, i just do something in the wrong range of motion and mess it up..

im going to lay low and keep working at it until i feel confident i wont worsen

[wenshu]

This is a good reminder for me to keep up with the prehab exercises. Without the constant nagging pain it is easy to forget.

I still have some pretty drastic neuro-muscular adaptations to deal with.

I still make really "guarded" movements anytime I raise the affected arm throughout the ROM that would trigger the impingement. In fact I think this maladjustment prolonged the inflammation.

I have to do a lot of work really watching my shoulders and focusing on a relaxed, even and natural range of motion. Even then I catch myself tensing up in anticipation of the "pop".

[Neeros]

If I were you I would stop weight lifting and focus more on holistic exercises like the 8 piece brocade, etc and if possible see a (good) TCM doctor.

Western medicine may provide much conflicting advice.

Eastern philosophy provides simple, and direct advice, all ailments are caused by yin yang disharmony, restore the harmony and you are healed. :D

[Oso]

fwiw, i had the same issue with doing squats, back or front. some stretching helped...but not much.

[sanjuro_ronin]

fwiw, i had the same issue with doing squats, back or front. some stretching helped...but not much.

Rotator cuff impingement tends to make the position of "hands up" a bit painful and when you get under the bar to do a back squat it puts the shoulder in that angle.
Impingement syndrome (Rotator cuff tendinitis, Bursitis).

[Brule]

WTF is wrong with you guys? If you just stuck with doing just kung fu, non of this would have ever happened. MMA knuckleheads....:rolleyes:

[sanjuro_ronin]

WTF is wrong with you guys? If you just stuck with doing just kung fu, non of this would have ever happened. MMA knuckleheads....:rolleyes:

Know how I hurt it the first time?
Kung fuing the Heavy bag !!
LOL !

[Brule]

What, the PE fist to the bag? no wonder. :p

[sanjuro_ronin]

What, the PE fist to the bag? no wonder. :p

Nah, it was a simple closed fisted hook.
Just a little too much torque for the shoulder to handle.

Of course if I had been doing forms it never would have happened :D

[Brule]

Now i know you're lying. A hook? in kung fu? blah!!!!You were kickboxing and threw a shovel hook.

[Oso]

Rotator cuff impingement tends to make the position of "hands up" a bit painful and when you get under the bar to do a back squat it puts the shoulder in that angle.
Impingement syndrome (Rotator cuff tendinitis, Bursitis).

also known as JFO.

[Oso]

If I were you I would stop weight lifting and focus more on holistic exercises like the 8 piece brocade, etc and if possible see a (good) TCM doctor.

Western medicine may provide much conflicting advice.

Eastern philosophy provides simple, and direct advice, all ailments are caused by yin yang disharmony, restore the harmony and you are healed. :D

omfg...dude, seriously? I don't want to come off like i'm targeting you...but...****...you've already admitted you are young with minimal experience. just keep reading for a couple of years. and, not just here, i'm not trying to claim that this is the be-all, end-all for info.

[IronFist]

omfg...dude, seriously? I don't want to come off like i'm targeting you...but...****...you've already admitted you are young with minimal experience. just keep reading for a couple of years. and, not just here, i'm not trying to claim that this is the be-all, end-all for info.

In his defense, most kung fu people go through an "Eastern medicine has all the answers" phase when they first become interested in kung fu, and the idea of herbal formulas and special exercises that can heal injuries in less than 24 hours is pretty alluring. You know, stuff that western medicine won't accept or admit because it's too focused on "treating the symptoms" with expensive drugs to make the drug companies rich.

[Oso]

That's why I said what I said.:)

[taai gihk yahn]

If I were you I would stop weight lifting and focus more on holistic exercises like the 8 piece brocade, etc and if possible see a (good) TCM doctor.

Western medicine may provide much conflicting advice.

Eastern philosophy provides simple, and direct advice, all ailments are caused by yin yang disharmony, restore the harmony and you are healed. :D

haven't been around in a while;

I see that the rosy-colored glasses have been passed off to the latest patsy...

btw, impingement that doesn't go away strongly suggests that the primary issue is not at the shoulder itself: if there is restriction / dysfunction somewhere else (usually more proximally, e.g. - thoracic spine, rib cage, hips, sacroiliac, etc.), the shoulder will have to bear the brunt of the lack of mobility / strength of the more proximal structure; meaning you can do NSAIDs, rehab, acupuncture, tree-hugging to your heart's content, and it's not going to get better until you clear the other stuff; even if not, at the very least, you need to clear the sub-scapularis, latissimus and quadratus lumborum muscles, and get them to be bilaterally balanced with normal tone, as they all will adversely impact shoulder when they are screwed up;

in that sort of situation, typically unless you find someone who knows how to think globally and synergisticaly, your progress will be limited;

[Neeros]

haven't been around in a while;

I see that the rosy-colored glasses have been passed off to the latest patsy...



:D

Indeed, a patsy that is greatly enjoying the benefits of his training.

[Oso]

FTR, not that he won't throw his creds out there, but TGY knows more than we do about what he's talking about.

[taai gihk yahn]

:D

Indeed, a patsy that is greatly enjoying the benefits of his training.

apparently said training comes with the purview to speak authoritatively without qualification, but hey, whatever...

[Drake]

Hmmm... let's weigh the comparison...

Guy on the internet who thinks eastern medicine will solve all ailments...

versus...

Hundreds of years of study and research by REAL doctors, many of whom specialize in these particular types of injuries.

[Toby]

I've had both shoulders sort-of rebuilt. Acromioplasty on both, due to (at times) acute pain from bad lifting habits. The first one took about a year to come 100%. The second one is 4 months and counting. On the plus side, now that I'm the $6,000,000 man, I can finally try the Olympic lifts so I've finally moved away from powerlifting and am teaching myself C&J. I started lifting about 8 weeks after surgery.

Like you iron, I could barely do squats last year. It got bad until there was a point where I was doing a particular sport and couldn't lift my arms above shoulder height afterwards.

It's all coming good now.

[IronFist]

I can't remember what I posted in this thread already.

Anyway, I am currently like 96% better.

I added the following to my rehab program:

Ice massage (fill Dixie cups with water, freeze them, peel back part of the cup and rub it directly on the affected area)

Magnesium supplement (specifically magnesium taurate, since some types can have a laxative effect)

Resistance on the eccentric part of the rehab exercises (I started using a 32oz Powerade bottle which weighs like 2 pounds)


There have been studies showing that eccentric exercise can help tendonitis heal much more quickly than in people who don't do it, so I figured I'd give it a try.

I know that this kind of injury doesn't have a linear recovery time, but instead you will be sore at a certain level for days/weeks and then one day wake up and feel noticeably better, and then remain at that level for days/weeks months, until one day when you feel noticeable better, etc., but within 48 hours of adding the above three things, I was feeling noticeably better. So it could've just been a coincidence or it could be that they're helping.

It's to the point where it only hurts if I go to the edge of my ROM, or if I change directions in my shoulder really quickly, like if I snap my arm, for example if I was doing a backfist.

I've been doing sets of like 5 and 10 pushups every few days but I'm not going to go back to the gym until I'm 100% pain free because I don't want to make it worse, and I don't want to get into one of those reduced ROM exercise habits.

Can't wait to get back in the gym. I've lost a lot of weight in the last 5-6 months.