Resources on Shoulder Injuries

I'm sure it's been posted before but I couldn't find exactly what I was looking for, so I ask MP this question.
Does anyone know of an online resource that has good info on body weight shoulder rehab and possibly a complete list of relevant antagonist workouts? I'm poor as hell and suffering from a shoulder impingement. I'm pretty sure it's from ignoring any antagonist work which is why I ask about that as well. No chiropractor or doctor for me. Thanks for your time guys!

There are very limited body weight shoulder rehab exercises. I would go to climbinginjuries.com -- I think they have videos of RC strengthening with a band. You really need to purchase at least a couple therabands to do what you need to do (pretty cheap usually).

Worst comes to worst, I would be willing to meet you and show you some things to do as I have a background in sports medicine and treated/helped treat many people with shoulder ailments (including myself, including a shoulder impingement).

That's very kind of you Aerili, but alas I have moved from Reno to my ancestral home for the winter.

I will take your advice and try to find some therabands. Who would sell them? Chiropractors?

Go to the theraband home site, it has a where to buy link. But before that, someone should inform you as to which colors you'll work with.
For my impingement I'm working with green (passed), blue (now) then black. thera-band.com/

i basically have a rainbow assortment at home and at my office. pretty clever, simple, inexpensive (sort of free in my case, got thme from my PT) invention.

Not being sure how bad it is tore I will leave it up to your to do what you can.When I tore my shoulder crack climbing I did this. First I stopped climbing steep rock for a while (six months off harder climbing). I got a deep tissue massage, about $5o-$75 Bucks. Iced it often for 20 min at a time a few times a day. Drank a lot of water and ate well. Walk if you can to get blood flowing a few times a week. Do Rubberband work to get strength and mobility.

• *REMEMBER that it can only heal after the swelling and/ or inflamation goes down. Once it has relaxed it will heal. If you had a separation( out of the socket) it will take some time.Take it slow. Good luck

PTZ, what sort of tear did you have? i'm dealing with a torn labrum (along with tendonitis, arthritis, impingement, etc) currently. i was doing pretty well with icing, PT (ionophresis), and theraband work. however, i had a pretty big set-back a couple weeks ago doing some really light bouldering. sometimes it feels kind of hopeless.

Aerili may be able to comment on this. If it's impingement - you could use bands and also maybe light objects (like soup cans) around 1 pound to work on the middle of the back. PTs call them I's, T's, and Y's. I don't know if they will work for your injury, but I had impingement from swimming and those exercises helped. Along with initiating movement from my upper central back muscles and not my deltoids.

Nut Stac, I have rehabbed several injuries with Theraband yellow, green, gray with excellent results.
Good luck with your shoulder.

Wow, thanks guys for all the great info! I have been spending too much time on the rest of the internet hah. I half expected to get trolled into oblivion but I should remember that when it counts MP has all the class in the world.

I dropped in at Theraband's website and there is a Chiropractor who sells them near me. I'm gonna swing by and see if I can't use my Dillinger charm to con some free PT advice from them.

Thanks again everyone!

Stefanie Van Wychen wrote:Aerili may be able to comment on this. If it's impingement - you could use bands and also maybe light objects (like soup cans) around 1 pound to work on the middle of the back. PTs call them I's, T's, and Y's. I don't know if they will work for your injury, but I had impingement from swimming and those exercises helped. Along with initiating movement from my upper central back muscles and not my deltoids.

Great advice, Stefanie: I's, Y's and T's strengthen the lower trapezius--an area that is usually weak in people who experience shoulder girdle problems!

I typically perform the I's and Y's while holding a towel between my hands and using body weight only with high reps (small soup cans would work well also to add load!). However, I usually forgo the T's and do W's melded with Y's instead--they are harder! (i.e. start with a W and make it into a Y, then continue the movements smoothly back and forth until form breaks).

Also to the OP: avoid aggravating movements. (This may include a common shoulder rehab exercise called 'empty cans'.) No overhead lifting either.

P.S. Forgot to add that shoulder impingements aren't usually from antagonist muscle weakness in climbers per your first comments--it's typically a sign of shoulder girdle stabilizer weakness. That is why I'm not telling you to do push-ups and shoulder presses.

The key to rehabbing a shoulder impingement is patience and diligence with strengthening.

Beth Rodden did a series of videos on the rehab exercises she did/does for her shoulder. Her descriptions aren't the best, but it's helpful to have the visual if you're figuring the movements out. Start here and follow the numbers: youtube.com/watch?v=Ox8aDYP…

(A list of all Beth's videos: youtube.com/view_play_list?…)

Oh, and when I was working with a PT after a shoulder dislocation, he recommended a more limited range of motion than Beth demonstrates, having me stop with my hands at shoulder level rather than raising them all the way up. Can't remember why he had me doing that; anyone have a good explanation?

Aerili, do you typically do the exercises standing or laying on an exercise ball?

aerili and others,

just curious to see what your thoughts are on this... last november i had an MRI done on my shoulder and i have a couple things going on; one definite labral tear in the lower front (or back, can't remember) area, one labral 'anomaly' that is on the opposite side of the tear (ie either lower front or lower back), arthritis, tendonitis, some sort of fluid tracking up/down my bicep tendon at the shoulder insertion, some impingement locations, and inflamation throughout the joint area.

my PT currently has me doing a bunch of theraband exercises, as well as anti-inflamatory gel using ultrasound and ionophresis. i am icing 3 or 4 times a day, taking advil, etc. i do my exercises and stretching pretty religiously.

things were going pretty well, my strength was improving a lot and i was having a lot less pain. however, my shoulder would sometimes 'catch' with a bit of pain when doing sort of more 3-dimensional movements with my arm/shoulder. my exercises tend to have more 'simple' movement patternds than some climbing movements.

my PT wanted me to start doing some light climbing again. at first it was going pretty well, but i re-aggravated it doing some really light bouldering.

i guess my main question is will these exercises do anything to prevent the labral tear from getting worse? i think that particular injury is my worst problem. my doctor wanted to avoid surgery if possible, but if i am just treading water and it is going to happen eventually, is it worth spending a lot of time trying to get around it with the exercises? i am in my mid 30's and would like to climb hard until i am 50 or so, and then scale back to climbing fun stuff until i am 90.

sorry for the long post.

JulianM wrote:Aerili, do you typically do the exercises standing or laying on an exercise ball?

Standing up fo sho if you are using bands or cables.

I would say your PT is right about the limited range of motion; for instance, Beth makes her external rotation range wider than necessary. You only need to do a 90 degree rotation for any given rotator cuff exercise. She makes a common mistake.

slim wrote:i guess my main question is will these exercises do anything to prevent the labral tear from getting worse?

Ummm...I am not sure. A very specialized question you have. :) I would say that yes, yes it should help prevent it from getting worse, but of course the muscles' strength around the joint cannot get endlessly greater.... and if your labrum is torn away (among other things), well, the muscles might not be able to hold the end of the humerus inside what's left of the "cup" if the applied loads are high enough (like in climbing).

Btw, what prompted you to decide BOULDERING was the best test??!

Also, you mention a 'catching' sensation....this could be a sign toward surgery since no physical therapy in the world can remove a flap of tissue that is getting caught in the joint space.

You should be glad your surgeon is not cut-happy right off the bat, and it is certainly appropriate to try "all the exercises" first-- mostly because it gives the doctor a better idea of whether you're a good surgical candidate (i.e. conservative treatment fails you!). Remember, cutting is forever, so it's better not to jump into it. But in some situations, it's the only thing that makes you better.

HTH.

I wonder what the percentage of MP'ers with shoulder pain is? I'm starting to think its really high.

thanks aerili. i agree that the bouldering was insanely stupid. for some reason i thought if it was easy graded it wouldn't be a problem, but even easy problems tend to be "shoulder-y". i'll stick with my exercises and try to really ease back in over the course of this year, and maybe re-assess the whole deal next fall.

I have some pain management questions for labral tear sufferers. I was recently diagnosed with a small posterior labral tear in my left shoulder and a partial tear of the supraspinatus tendon. Dr. Eric McCarty at Boulder Center for Sports Medicine examined me and does not think that the tendon is much of an issue -- that the partial tear may have been there for quite a while and is likely more or less asymptomatic. I would agree as most of my pain seems consistent with a labral tear -- dull ache, sometimes throbbing ache, in the back of my shoulder and sometimes on top by the collar bone with referred pain down the arm. He was not even sure my labral tear was really a tear and could just be a slight detachment but having had labral tears in both hips I am going to assume it is a tear because I am no stranger to deep joint pain.

Anyway, I am really in a bind because I'm 6+ months pregnant at the moment and can't do much in the way of treating it with surgery any time soon. I think surgery is inevitable as my pain is not just with overhead activities -- it hurts basically with any kind of repetitive movement, prolonged use, etc. I was in great shape prior to this injury -- backcountry skiing, nordic/skate skiing, hiking, trail running, yoga, etc through my pregnancy. I tore the labrum when I slipped on some ice at the Eldora nordic center and through my arm down to protect my belly when I fell. Since the injury 6 weeks ago I really have not seen any improvement and if anything it has seemed to get more inflamed despite a cortisone shot. I have not done ANY shoulder-aggravating activities such as yoga or swimming and even the few times I have been backcountry ski touring I have only poled with my good arm. I can get the pain down to a manageable level when I stay completely off it for 4 or 5 days (which means barely using it for anything more than typing) but that obviously isn't really a long-term solution. I tried starting the PT exercises with the theraband but it only inflamed things worse. I got a cortisone shot into the joint but it hasn't seemed to help at all. I'm going to try and get one more shot into the joint this time under ultra-sound guidance because I am skeptical that the shot even went into the right spot. I mean the pain in my case is coming from inflammation as I don't have any catching or sharp popping pain so it would make sense that cortisone should in theory help.

There seem to be a lot of people on this board who have managed this injury for quite some time with activity modification and PT so I'm looking for tips and even local treatment modalities that worked particularly well since I can't take NSAIDs or even painkillers at the moment. Did you find you really had to rest the shoulder completely for a few months before even beginning the PT? What level of pain did you have to push through to make some progress with strengthening? Did you find cortisone helped at all? I am more or less resigned to the fact that I am going to have to have surgery and its going to be incredibly inconvenient with a small infant when I have my arm in a sling for 4-6 weeks but the pain seems too much to live with long-term unless I can expect some gradual improvement at some point.

Thanks for any suggestions, comments, etc.

amy, i totally feel your pain (literally and metaphorically). our shoulder situations are pretty similar. are you going to the CU sports rehab place on broadway, across from NIST?

I've been going to the Boulder center for sports medicine at Mapleton (just below Sanitas). I have gone there for years for various things including rehabbing from 2 major hip scopes (labral tears!).

I think my story is important to share on this tread. I was diagnosed with a torn labral/ labrum 12 years ago. This is a story about what can happen if you do not take care of your injury. I was told to stay on top of the rehad exercises by two different surgeons after the initial tear. I also dislocated my shoulder the first time I injured it so it was a serious tear. I did a lot of the exercises describe in this tread to try and improve the overall health of my shoulder. My problem was that I kept dislocating my shoulder climbing, skiing, etc. The dislocations did not happen very often at first but as time progressed it started popping out on a much more frequent basis. Up until last year, the advise I received was to continue working my rehab. I was always told the same thing and that was that I could heal my shoulder through a natural strengthening approach. Now this is good advice for some and good for the pocket book of your PT but if you see increased shoulder instability please find a GOOD surgeon that will do the operation. In retrospect, I wish I had looked around for different advice from different surgeons, rehab specialist, etc. A torn Labrum can be fixed with a simple arthroscopic surgery that is a pretty straight forward procedure if that is the only damage in the shoulder. In my case, I waited way too long. Due to the multiple dislocation, I wore down my shoulder socket (gleniod), 50% gone. Last Tuesday, I went in for a brand new procedure, 5th person on the planet to have it done, where they use a ankle bone to rebuild the shoulder socket. Since it is a new procedure, they are unsure if I will be able to climb again or really do anything that involves putting a lot of stress on the shoulder. My other options guaranteed I would never climb again. I am a little bit of a risk taker so I went with the new procedure, to at least have a chance of a decent recovery. I am only one week out of surgery so it I am not sure what my future holds. I guess the message, I am trying to share is to take care of your injuries. If things are progressively getting worse then look at getting a surgery done. My current surgeon, which I found through an MP thread, told me that a full recovery from a Labrum surgery is over 95%. I would pay a lot of money to have that same percentage going for me right now. Take care of your joints or they will take you out of a life style you love.

WOW. That is scary stuff Josh. I cannot believe you were just the 5th person on the planet to have that procedure -- that is pretty amazing. I really respect you're taking a risk to get back to the thing that you love.

I am not concerned with instability at this point because my shoulder isn't unstable in the least for now. I plan to have the surgery as soon as I can (after my pregnancy) because the pain is just wearing me out and I don't really think any amount of strengthening can help it at this point. That deep searing joint ache just isn't going to go away with strengthening the shoulder -- PT can help with pain on certain movements but my experience is generally that removal of chronic aching pain is typically only achieved through surgery. I wish it weren't the case!

I hope your recovery goes well and you can get back to climbing. Thanks for telling your story!