Rotator Cuff Tendinitis - Desperate Advice Needed!

[Velocity13]

So, 3 weeks ago today I badly hurt my shoulder. I'll give some background information first of all. This may be slightly long but I would REALLY appreciate the help and advice.

I'm a martial artist and body builder. Only at the start of this year did I get back to martial arts after 2-3 years properly because of a major hamstring tear that i then re-tore in between down to the awful NHS giving me bad feedback. During those years getting my leg back to a good point I was going to the gym a lot, mostly muscle building but cardio as well. The gym I go to wasn't very good until at the start of this year they revamped it all up and got a smith machine (no proper bench press still though mind...) which I for the last 6 months have been hitting hard, maybe 3-4 times a week, increasing my bench maybe a little too fast. Anyhow, I was getting into the habit of going up to my max of 130kg bench for 1 rep, this was my absolute max. I had good form to my knowledge but it was an incredible amount of strain but I would complete the rep each and every time taking the bar down to my chest. 3 weeks ago though after doing this I finished going up to my max and went to use some of the free weights, I then noticed just how sore my shoulder was raising my arm upwards with a dumbbell (sorry, not sure what the particular exercise is called). I figured I'd just over worked / pull / strained my shoulder which I've done a few times every so often and it would be fine in a few days but not this time...

I did, stupidly almost a week later thinking that it being the usual strain had healed and did some light 50kg bench press and heavy bag punching, although I did little that day. Since then I've done nothing at all apart from cardio and leg workouts. Anyways, I've now been to the doctors 3 times to try and get some information, help and advice to which I've had mixed feedback. One told me there was no possible way it was tendinitis as I could put my arm behind my back and honestly she just sounded like she had no clue. The other two told me it was tendinitis but didn't give me much info.

Today I began doing weights but ONLY about 3 exercises that require no moving of my shoulder E.G. dumbbell curling. I presume this is okay as I wasn't using the shoulder at really? I've also been icing my shoulder fairly regularly, using a ibuprofen gel and taking ibuprofen daily. It's also worth noting I am doing light rotator cuff exercises. I feel the pain mostly when my arm hits a horizontally level but I have full range of motion and if I wanted to I could actually still lift heavy.

My questions are, does this really sound like tendinitis? How long is this realistically going to take to get back to mostly fine? Is this going to keep re-occurring? It is the first time I've ever had an injury like this on my shoulder. My biggest fear is that this is going to go on more than 3 months where I can't do anything and that this will come up again and again despite not having this injury before. I'm not really sure how it's come up in the first place.

Any advice, feedback, things to do to help it would be very much appreciated. I'm kind of at a loss over this, martial arts and the gym are to be honest my life. I spent years being myself up to 100% after my last injury and now I feel like I'm back at the beginning with something else.

[Brenden061]

If I were you I would google "RC rehab protocol" and get to reading.

[Velocity13]

If I were you I would google "RC rehab protocol" and get to reading.

I've already done a lot of reading up but I see a lot of differing information. I was hoping someone here who's maybe had or is knowledgeable on it could help.

[PieWheatley]

So, 3 weeks ago today I badly hurt my shoulder. I'll give some background information first of all. This may be slightly long but I would REALLY appreciate the help and advice.

I'm a martial artist and body builder. Only at the start of this year did I get back to martial arts after 2-3 years properly because of a major hamstring tear that i then re-tore in between down to the awful NHS giving me bad feedback. During those years getting my leg back to a good point I was going to the gym a lot, mostly muscle building but cardio as well. The gym I go to wasn't very good until at the start of this year they revamped it all up and got a smith machine (no proper bench press still though mind...) which I for the last 6 months have been hitting hard, maybe 3-4 times a week, increasing my bench maybe a little too fast. Anyhow, I was getting into the habit of going up to my max of 130kg bench for 1 rep, this was my absolute max. I had good form to my knowledge but it was an incredible amount of strain but I would complete the rep each and every time taking the bar down to my chest. 3 weeks ago though after doing this I finished going up to my max and went to use some of the free weights, I then noticed just how sore my shoulder was raising my arm upwards with a dumbbell (sorry, not sure what the particular exercise is called). I figured I'd just over worked / pull / strained my shoulder which I've done a few times every so often and it would be fine in a few days but not this time...

I did, stupidly almost a week later thinking that it being the usual strain had healed and did some light 50kg bench press and heavy bag punching, although I did little that day. Since then I've done nothing at all apart from cardio and leg workouts. Anyways, I've now been to the doctors 3 times to try and get some information, help and advice to which I've had mixed feedback. One told me there was no possible way it was tendinitis as I could put my arm behind my back and honestly she just sounded like she had no clue. The other two told me it was tendinitis but didn't give me much info.

Today I began doing weights but ONLY about 3 exercises that require no moving of my shoulder E.G. dumbbell curling. I presume this is okay as I wasn't using the shoulder at really? I've also been icing my shoulder fairly regularly, using a ibuprofen gel and taking ibuprofen daily. It's also worth noting I am doing light rotator cuff exercises. I feel the pain mostly when my arm hits a horizontally level but I have full range of motion and if I wanted to I could actually still lift heavy.

My questions are, does this really sound like tendinitis? How long is this realistically going to take to get back to mostly fine? Is this going to keep re-occurring? It is the first time I've ever had an injury like this on my shoulder. My biggest fear is that this is going to go on more than 3 months where I can't do anything and that this will come up again and again despite not having this injury before. I'm not really sure how it's come up in the first place.

Any advice, feedback, things to do to help it would be very much appreciated. I'm kind of at a loss over this, martial arts and the gym are to be honest my life. I spent years being myself up to 100% after my last injury and now I feel like I'm back at the beginning with something else.

It definitely sounds like you are getting shoulder impingement. Which in itself pretty much is tendinitis (tendinopathy) or bursitis. It is seriously to hard to tell you what to do without looking at the way you move, but most often weightlifters have stiff thoracic spines, downwardly rotated scapula, and weak rotator cuffs in comparison to the pull of the deltoid.

So, that being the case, try lifting your arm up (the painful movement) in different positions. eg. with shoulders shrugged, with shoulder blades squeezed together, standing up really straight etc etc. Basically looking for the position of your shoulder or shoulder blade that doesn't cause that impingement. Then we need to work on the muscles that get you into that position.

[Velocity13]

It definitely sounds like you are getting shoulder impingement. Which in itself pretty much is tendinitis (tendinopathy) or bursitis. It is seriously to hard to tell you what to do without looking at the way you move, but most often weightlifters have stiff thoracic spines, downwardly rotated scapula, and weak rotator cuffs in comparison to the pull of the deltoid.

So, that being the case, try lifting your arm up (the painful movement) in different positions. eg. with shoulders shrugged, with shoulder blades squeezed together, standing up really straight etc etc. Basically looking for the position of your shoulder or shoulder blade that doesn't cause that impingement. Then we need to work on the muscles that get you into that position.

I decided to go to physio today. She said it was a particular Tendonitis with small impingement. I'm still not sure how this has happened, one second I'm fine, the next it's randomly awful. The most worrying thing is now my good shoulder I am feeling some weird feeling and very very slight pain, although no where near the other side, I worry this shoulder is going to go anytime also.

My other concern is how am I going to prevent this happening when I am finally fit again if I have no idea of the cause? :/

[Brenden061]

I decided to go to physio today. She said it was a particular Tendonitis with small impingement. I'm still not sure how this has happened, one second I'm fine, the next it's randomly awful. The most worrying thing is now my good shoulder I am feeling some weird feeling and very very slight pain, although no where near the other side, I worry this shoulder is going to go anytime also.

My other concern is how am I going to prevent this happening when I am finally fit again if I have no idea of the cause? :/

So you went to the physiotherapist, got an evaluation, and he/she didn't explain the mechanism of injury nor send you home with band exercises?

That doesn't add up.

[Velocity13]

So you went to the physiotherapist, got an evaluation, and he/she didn't explain the mechanism of injury nor send you home with band exercises?

That doesn't add up.

I never said they didn't give me exercises. They gave me plenty in fact with a resistance band. The only explanation I got on the actual injury was that I must have 'overloaded' it but honestly that doesn't really tell me exactly how I injured it or how to prevent it from happening again. She was a little arrogant and cocky and kind of didn't answer my questions as directly as I would have liked.

[Brenden061]

I never said they didn't give me exercises. They gave me plenty in fact with a resistance band. The only explanation I got on the actual injury was that I must have 'overloaded' it but honestly that doesn't really tell me exactly how I injured it or how to prevent it from happening again. She was a little arrogant and cocky and kind of didn't answer my questions as directly as I would have liked.

Send an email to the PT w/ your follow up Q's to clarify, or email the boss for a 2nd opinion on the eval.

[Velocity13]

In the last two days the pain has really started to die down in my shoulder, however I have noticed that for some reason I'm getting a weird ache / pain / throb in the top muscle of my other shoulder. It feels different to the tendinitis I have in my left shoulder where I would get a deep pain but only when I raised my arm, this seems to be fairly constant but quite subtle and is the same no matter how I use it. Any one have any ideas? I can't really afford to pay the physio to check out this other shoulder.

And lastly, this hasn't been recent but I believe I also have slight tendinitis in my right wrist and only when I apply pressure in very certain ways.

How have I managed to cause these many problems? I train as sensibly as I can.

[Velocity13]

Any advice from anyone?

I'm still getting major clicking in both shoulders although no pain. The aching in both shoulders is increasing also. The only thing that has considerably decreased is the pain in my rotator cuff when lifting my arm which is pretty much zero now.

It's been a month since the original 'injury'. I've yet to see my Physio again, will be in a couple of days but from when I did see her she mentioned Shoulder Instability. From what I've read that happens from dislocation which I've never had.

[SlowAnSteady]

I'm going out now but I'll be able to answer some of the questions you have as we'll as provide you with some information, tomorrow.

[gabrielsyler]

From my experience of shoulder injuries; (lots caused by sloppy form wieght lifting and general abuse from kickboxing/jujitsu)

go get an ultra-sound scan of the shoulder first up. It's not that expensive, and maybe reclaimable on your health insurance. This alone will save you endless sessions of incorrect physio. The scan should show inflamation or tears and how serious it is. Your phyiso can then give you the correct rehab plan.

I was getting shoulder pains last year and thought it was my shoulder (to the point where I had constant pain ), turns out it was my bicep that was causing the issue. Which meant I could focus on correct exercise (and rest).

If it's inflamation, you could get anti-inflam tablets, or just get a couple of cortisone shots which will reduce the inflamation and let it heal. Instant pain relief!!

I found these exercises are good for stretching and strengthening the shoulders/rcuff and do them once a week, never with heavy weights, just till they are fatigued.

mobility exercises


Shoulder Dislocations



also try dumbell press instead of bench press, it'll help strengthen the stabilising muscles.

You also may have to just take a break. As hard as a 6 week rest from ALL exercise might be, it'll save 6 months of inefficiency and pain.

[Velocity13]

I'm going out now but I'll be able to answer some of the questions you have as we'll as provide you with some information, tomorrow.

Thanks, that would be much appreciated!

From my experience of shoulder injuries; (lots caused by sloppy form wieght lifting and general abuse from kickboxing/jujitsu)

go get an ultra-sound scan of the shoulder first up. It's not that expensive, and maybe reclaimable on your health insurance. This alone will save you endless sessions of incorrect physio. The scan should show inflamation or tears and how serious it is. Your phyiso can then give you the correct rehab plan.

I was getting shoulder pains last year and thought it was my shoulder (to the point where I had constant pain ), turns out it was my bicep that was causing the issue. Which meant I could focus on correct exercise (and rest).

If it's inflamation, you could get anti-inflam tablets, or just get a couple of cortisone shots which will reduce the inflamation and let it heal. Instant pain relief!!

I found these exercises are good for stretching and strengthening the shoulders/rcuff and do them once a week, never with heavy weights, just till they are fatigued.

also try dumbell press instead of bench press, it'll help strengthen the stabilising muscles.

You also may have to just take a break. As hard as a 6 week rest from ALL exercise might be, it'll save 6 months of inefficiency and pain.

I'm pretty it is my shoulder / s but I'll keep in mind the possibility of it being my biceps.

I live in the UK so receive free health care through the NHS, albeit awful health care I may add. The doctors said they simply would not give any scans at all and nor would they show up any small tears if there were. I'm calling BS on that though.

I've been taking Ibuprofen and was given something a little stronger which I've forgotten the name of. I have no idea if the cortizone shots are available but haven't heard too great things. I read apparently they just mask the pain? Therefore giving you false sense of fitness, causing more damage to the rotator cuffs? I also heard it only last 6 months and can cause damage to the tendons / weaken them? Again, not sure how much of this is true or not.

So far I'm pay a hell load for private physio (NHS won't put out for it ridiculously) so I should hope she is doing the right thing. I have been since the injury doing literally almost no shoulder exercises, minus the odd time or two where I may have punched a punch bag for a couple of minutes.

The ache in my shoulders and clicking is the most concerning to me right now.

[SlowAnSteady]

I need to know exactly what part of your shoulder is bothering you.
Currently where is the pain if any at rest? Currently where is the pain during exercise (what's the movement)?

[Velocity13]

I need to know exactly what part of your shoulder is bothering you.
Currently where is the pain if any at rest? Currently where is the pain during exercise (what's the movement)?

Might be hard to explain well but I will try. Originally the pain was felt right on the front of the ball and socket and when I lifted my arm to almost shoulder height and when I generally rotated the shoulder. There was no pain in my shoulder resting unless I lifted my arm like I said. This pain has died down about 95% now. The pain I'm now having is a heavy ache across both the top of my shoulders, funnily enough more so in the shoulder that I had previously no problem with and has randomly started showing symptoms.

The clicking is in both shoulders and generally again when moving my shoulder. I get no pain from it but it's pretty loud and often and wasn't there before.

In terms of exercise I don't know if the pain would increase but I do know that any general exercise leaves my shoulders aching much worse.

[SlowAnSteady]

My speculation is that it may be a labrum and or biceps tendon issue. Do not worry about the clicking if it's noise without pain, you will drive yourself insane if you do. If your doctor doesn't want to send you for an MRI, request a shoulder specialist and they can send you for one. For now do not raise your elbows above shoulder level and everything you do should be done slowly and controlled. Rest is key until you identify the issue at hand.

[Velocity13]

My speculation is that it may be a labrum and or biceps tendon issue. Do not worry about the clicking if it's noise without pain, you will drive yourself insane if you do. If your doctor doesn't want to send you for an MRI, request a shoulder specialist and they can send you for one. For now do not raise your elbows above shoulder level and everything you do should be done slowly and controlled. Rest is key until you identify the issue at hand.

I imagine that's the Labrum although the Physio mentioned Supraspinatus.

What's concerning me most, is that although the original injury on my left shoulder has shown improvement, the right shoulder that was fine is now for reasons unknown getting worse and worse. I am not getting the sharp stabbing pains like I was in the left and the ache is getting heavier. I haven't really done anything with either shoulder for the right one to suddenly show symptoms let alone get worse. The physio just told me it's 'over compensating' for the left which certainly isn't it.

[Velocity13]

Been to doctor and they're finally going to give me a Ultra Sound although I imagine it will be a while before I have it.

As I've previously said, strangely the pain that randomly began in my right shoulder is still getting worse and is a lot worse than my left shoulder that was originally the only injury I had.

[Velocity13]

Just an update and some advice needed.

So it's been nearly 2 months since the original injury. I get no pain at all in my left shoulder and an extremely minor twinge in my right when I life my elbow up. Apart from that the clicking is still pretty bad but I was told that will go if I keep strengthening and doing the right rotator cuff exercises?

I'm still not doing any weights yet minus two small cable exercises with light weight which are part of my rotator cuff exercises.

I have started using the punch bag again though, I've used it for a while each time for about 4 times. I get no pain, maybe some slight aching on the top of my shoulders and high back but I don't think using a light punch bag is going to cause any problems? It's been almost 2 months and I get no pain at all doing it. Some feedback on whether it is okay to do this would be great. The physio told me I could go back to light weights in a couple of weeks anyhow.

[Velocity13]

Anyone?

Tried a couple of press ups today, literally just to test how my injury was coming a long. Slight pain / ache on the inside of my shoulders, which I guess is the Labrum. The clicking is by far worrying me most though and it's not going. Anyone know why this is happening since the injury almost 2 months ago and why it's not improveing. I've been strengthening my rotator cuff as per the exercises the Physio has given me.

[riseboi]

From my experience with the younger, active population (particularly "bodybuilders") I find that muscle length restrictions are often the culprit that causes or leads to altered scapulo-glenohumeral movement (basically restricted movement of the upper arm around a moving shoulder socket.) It's not my place to question a PT whose performed a physical examination, but a follow-up exam of the upper trap, pectorals, triceps, lats, etc. might be beneficial as they can alter proper scapular kinematics. I have found that active release techniques of these particular soft tissues have provided immediate increases in AROM without pain in the "bodybuilders" I have treated.

I did not read the whole thread, so this response may not even apply.

[skust75]

You are screwed. You better consider taking some substantial time off for this injury. Train legs and abs in the meantime. Keep pushing your shoulders and you will be sidelined forever. Consider taking 6 months off of upper body.

[Velocity13]

You are screwed. You better consider taking some substantial time off for this injury. Train legs and abs in the meantime. Keep pushing your shoulders and you will be sidelined forever. Consider taking 6 months off of upper body.

Wait, why am I screwed? I've taken off 2 months off, have no real pain now, only a slight bit of impingement when I raise my elbow in a particular way but it's next to nothing. I'm also still not doing any weights, a tiny bit of punch bag work and some slight rotator cuff cable pull stuff, about it. My physio seems to be pretty optimistic and thinks I now only really have some minor impingement left and mostly now just instability which is causing the clicking.

---

For anyone reading this, I've read face pulls are good for helping to rectify the instability and reduce the clicking? The clicking is still extremely loud. I also had a blood test that said I had no inflammation so I assume the tenonitis part is gone now.

[Velocity13]

Anyone?

[infinityplus1]

Have you read this thread?
http://forum.bodybuilding.com/showthread.php?t=529968

From the info you have told us don't know if it 100% RC injury, I currently have one which is probably in the final stages of recovery (been nearly 3 months), RC injury pain is usually where the delt meets the bicep/tricep

Try doing more back/trap/rear delt exercises, and starting and finishing your workouts with RC exercise (internal/external rotations etc light weight like less than 5lbs)

I've pretty much still been training through out my injury, the only thing I don't do is overhead presses or normal bench press (still been able to do close grip bench without pain) or heavy squats as I can't hold the bar properly without pain (just been doing light weight on smith so I can use one arm)

Fish oil tablets help I've been taking like 12 or so a day

[Velocity13]

Since this injury I've lost and incredible 9 lbs...Not in a good way also. I couldn't have really lost that much muscle in 2 months could I?

[kyoun1e]

Since this injury I've lost and incredible 9 lbs...Not in a good way also. I couldn't have really lost that much muscle in 2 months could I?

I just spent a year dealing with a pretty serious impingement situation that caused bicep tendonitis in the shoulder. MRI results showed some damage to the labrum and bicep tendon and I thought for sure I needed surgery. I had two cortizone shots to calm down the inflammation and basically did my own physical therapy for a year. And now, I'm out of the woods.

My advice to you:

1. Get an MRI -- An ultra sound will not tell you anything. If there is something serious going on in there the MRI will tell the story.

2. Rest & Reduce Inflammation -- You need to give these tendons a break and you need to let the inflamation subside before you start strengthening. Otherwise, you're just continuing to irritate the situation. Anti-inflamatories will help.

3. Loosen Before Strengthening -- Most PTs just hand you a theraband for rotator cuff excersices, but the first thing you need to do is loosen tight muscles. In many cases (like mine), my pec minor muscle is way too tight due to working out chest and shoulders too much. The result: The humeral head is pulled forward too much and this decreases the space available for the ligaments to move between the ball and socket. I would focus on stretching first...Google these:

- Pec minor doorway stretch.
- Pec minor release with a raquet ball against the wall of floor.
- Scalene stretching. Your anterior and middle scalene may be too tight pulling your head too far forward.
- Infraspinatus and Supraspinatus massage with a raquetball against the wall.

I did these stretches/massage work religiously.

4. Strengthening -- these were my go to movements for strengthening:

- External rotation with bands
- Internal rotation with bands
- Subscapularis work -- this to me was the missing ingredient. The subscapularis muscle acts to keep the humeral head down and back. Google "subscapularis pull with a cable." This movement was critical. There are other movements that work this muscle as well.
- One handed seated cable rows for scapular retraction.
- Straight arm pull downs for scapular depression.
- Scapular retraction with dumbells -- lay face down on a bench at 45 degrees. Use scaps to pull dumbells up so your scapula moves up but also down. Hold for 30 seconds. Repeat.
- Pushups for scapular stabilization -- start against the wall. Do isolation holds. Move to wall pushups. Then move to the table, etc. till you are down on the floor.

5. Time -- You need to be patient. Like I said, it took me a year to unravel my situation. I probably wasted 4 months (like you) trying this that or other.

Good luck.

KY

[ABCM]

Get the MRI. Popping/clicking associated with pain or limited range of motion is likely related to the labrum. I tore both of my labrums 5 months back (poor technique, unsafe lifting practices, too much weight), and wasted the past 5 months doing PT, meanehile losing 20 lbs of muscle and strength. Get the MRI, if torn labrum then get surgery ASAP!

[Velocity13]

I keep getting conflicted opinions but I'll explain where I am with my shoulder now and hopefully someone can reply based on what I've said now.

Currently I have zero pain, next to no impingement, zero possibly now even. The test result for inflammation came pack fine so I have no tendonitis (anymore at least). The thing I have is the clicking now, it's painless but can be quite loud. Everyone I have seen including doctors and physio said they really don't think I've torn anything, the physio believes the clicking is down to possible instability. It's important to note that any clicking I get is completely painless.

I'm currently still waiting for an ultra sound but the wait is taking a long time, I believe the aim is sometime next month. The doctors said over here in England that is only the thing they've give in terms of scans for the type of injury I have. I've gone back to weight lifting, mostly as I feel fine minus the clicking and because I want to test the injury. I've gone about 3 times building back up to fairly moderate weight and get no pain at all or weakness in my shoulders.

I'll certainly look at the exercises you've posted as one major thing I want to do is get rid of this instability. Before just starting weight lifting again I took 2 and half months completely off, did physio (resistance band strengthening), took anti-inflammatory tablets and used regular ice packs.

It's weird, I now feel completely fine, more or less but the clicking is giving me this uneasy fear something is going on. It wasn't there pre-injury.

[Velocity13]

Okay, so I went back to weight lifting a couple of times, lifting medium amounts. Was not too bad, had no pain or anything. Not saying it was absolutely perfect but certainly wasn't bad. I noticed the clicking a little. The reason I went back is my doctor basically said I'm absolutely fine and the blood test has confirmed no tendonitis.

Anyways, a few days later and my right shoulder (the one that wasn't originally injured or painful) has started aching really bad, with some possible general pain, although very small. I do have some new small pain on very side point of the acronian (I believe that's what it's called) which is tender to touch. I may have just banged my shoulder as usually I never have any pain in my shoulders that's tender to touch but any ideas what that could be?

I feel a bit stuck in a rut generally. My doctor is basically saying I'm absolutely fine from what he can see and the blood test said no tendonitis and my Physio doesn't seem to be that great, giving some conflicting, questionable views that I'm not too sure if she's right or not. So I'm pretty much having to make my own judgement but it's incredibly hard to. I think I'm going to pay to see another physio and get a second opinion. I'm still waiting for the ultra sound, which could be the end of this month or next month, I'm hoping this will either tell me a definite problem or at least put my mind to rest that there is nothing serious going on.