Why Does My Shoulder Keep Hurting?

January 6, 2019

You are not alone:

 

 

Shoulder injuries are one of the most common injuries, especially those who are active, are overhead athletes or who have been overhead athletes. Those who are active in the gym or even with recreational sports, there is an increased risk for “overuse injuries” that typically cause pain in the front of the shoulder or on top of the shoulder joint. These can be caused by damage/sensitivity to a number of different structures but most commonly the biceps tendon or one of the rotator cuff muscles.

 

I want to add a disclaimer here: sensitivity to these tissues does NOT mean you are broken and with a solid game plan to keep you moving and pain free you will most likely get back to your pain-free active lifestyle. We are much stronger and more resilient than we once thought. We know now that there is no significant difference in long term outcomes for those who have surgery vs. those who receive exercise and rehab therapy for rotator cuff tears (Here is one study that shows a 5 year follow up). 

 

How most shoulder injuries occur:

 

A question we often get in the clinic is; How did my shoulder injury happen? The real answer is quite complicated. However if I were to keep it simple, here is your answer: “Too much too often or too much too soon.”

 

So how do we keep this from happening? Well, both of these scenarios are combated with smart exercise programming, commitment and patience. Just because you have a shoulder injury does not mean you need COMPLETE rest (actually quite the opposite).

 

Keep Moving!

 

You need to challenge the tissue enough to increase blood flow and nerve impulse to the damaged or sensitive area as this helps the healing process. In most scenarios, you are NOT broken. In fact a review published in the Journal of Shoulder and Elbow Surgery that included 452 different people concluded that physical therapy and exercises for atraumatic full thickness rotator cuff tears had decrease in symptoms in 75% of patients at 6 weeks, 12 weeks and 2 years. (This is FULL-THICKNESS tears, not even partial!). 

 

The key is consistency and patience with a smart training program that progressively overloads the shoulder. Whenever you are in doubt, see a local specialist (chiropractor, physical therapist, physiotherapist) who can examine your shoulder, tell you what is damaged/sensitive and give you a clear plan to stay active and makes steps toward feeling better in the gym. 

 

This sounds great, but WHAT do I do now?

 

I won't be going to deep into the what in this blog as I really want to nail down the importance of the "why". However, I will pepper some movements in there to please the crowd. (Don't worry there will be more to come that includes much more details. Patience.) First I will talk warm up and I will wrap it up with a few movements you can try on your own. Again, if you are feeling unsure about your pain do not hesitate to reach out to a professional (we do online consultations too, just throwing it out there).

 

Warming up your upper body:

 

This is where I explain why you are either spending too much or too little time warming up. Let’s be honest, there are two types of people in the gym, someone that spends literally no time warming up vs the person that spends their entire time in the gym warming up and calling it a workout. Warming up is crucial for a couple of different reasons.

 

  1. It literally warms up tissues, which has shown to temporarily increase range of motion (ROM). (Click here for article)  

  2. It also primes the nervous system and readies the body to produce, resist and/or vary forces (however you may be moving for your exercise).

  3. Finally, a well-rounded warm-up can be geared to create a habit that helps with performance. For example, it should include all of the following: mobility, stability/control and resistance.

This can and should be done in a very efficient manner. So no more wasting time with a long winded warm up that takes away from the real work; getting STRONG. From here let's pick three warm-up movements that include mobility, control and resistance to create a solid upper body warmup routine.

**Keep in mind, this is not the only way to prime your upper body, these are just a few movements we like and find very effective.**

 

Upper Body Flow

1. Mobility: Side-lying Mid-back opener