Frustrating Shoulder Injury (Possible Tendinopathy)

[Devyn Stewart]

Explanation of the injury:

My left shoulder hurts when I squat. More specifically, it really hurts after I squat. It began when I was running SS a month or two ago. I would feel like my shoulder had an immense pressure on it, and the pain thereafter would last a few minutes in the beginning. Then it would hurt some more and last a few hours. Then it would hurt even more and last into the next day. Then it would hurt a lot and barely be feeling better by the next session. I'm now at the point where it hurts all of the time, and after trying a squat or variation, even a very light one, it's difficult to sleep because of the pain. It also hurts when I bench press, especially if I try immediately after squats have already aggravated it. The pain is in two places: my clavicle and my superior scapula, depending on the motion I perform to aggravate it. Scapular elevation nearly always causes pain. Scapular retraction also causes a bit of pain, but worst of all is scapular depression while they are retracted. Plain old scapular depression without retraction is not painful.

Possible cause for injury:
I've heard that playing with your grip can sometimes fix this. When the pain started, I was gripping the bar very tight, about 2 finger widths away from the start of the knurl (for reference I'm 6'3" with somewhat wide shoulders). I tried widening my grip an inch or two, and it did not seem to help/change anything. I also tried focusing on retraction and/or keeping my elbows up throughout the squat, and that doesn't seem to help much either. I'm guessing that it was caused either by a simple loading issue (I really pushed on LP and every single set of squats near the end would be RPE 11/10 'I might shit my pants and die', or it could have been caused by the fact that I have a bad habit of allowing the bar to tilt to the left (in the frontal plane) while it is sitting on my back. Either way, I don't know if I'm going to be able to squat at all without aggravating it now. Today I walked out 275 and just held it in place for about 15 seconds, and the shoulder flared up quite a bit, and I hadn't even tried to squat yet!

Current rehab:
I'm a pre-PT student, so I've seen tendinopathies before in clinics I volunteer at. I'm pretty sure this is a tendinopathy, so I've tried loading the tendons affected. I perform shrugs with a long eccentric, and I perform scapular retraction while holding on to a theraband. I've also been attempting to squat lighter and stop when there is pain, but my ego and desire to just pretend this injury doesn't exist get in the way of this quite often.

Questions/cries for help:
Is it realistic to think my therapy will be effective? If not, what should I try?
Has anyone experienced this kind of injury, and what did you do to overcome it?
What sort of programming should I do during this time? Would it be wise to stop benching and squatting entirely during this time? Possibly variations/accessories to keep atrophy from happening?
Any other comments about possible form issues or programming pitfalls that may be the cause of such a problem?


I really appreciate any wisdom on this subject because I'm just a young man who wants to get stronger, and this injury is demotivating and all around is robbing me of something I love.

Feel free to request videos of lifts if necessary. I'll get them to you as quick as I can.

[neilc1]

ya know somebody is gonna want a video of your squat, from a correct angle and view.

is your back as tight as possible, with a big proud chest ?

[Devyn Stewart]

315 Squat 1 - YouTube

YouTube

Here are some videos near the end of LP, when the injury first arose. I'm not sure if the angle is the best, but this is the best of what I have available right now. And I believe I do, yes. The problem is that extending my thorax hurts, and keeping my back as tight as possible right now with my scapulae depressed also hurts (I mentioned above that the retraction/depression combo is incredibly painful). But yes, I do believe I was doing it as you said when the injury developed.

[neilc1]

need video 45* from the back

[Devyn Stewart]

That I cannot provide, at least not right now. I will also have a tough time getting a video with a decent load on my back because it aggravates the injury. Could you possibly tell me what it is you're looking for?

[Dust Devil]

I had a similar problem years ago when running LP. Squats were agonizing, but it eventually impacted bench presses and presses.

It took months of research (and wasted time with a PT and orthopedist), but I finally identified it as a trigger point in the subscapularis. I could access the trigger point only to the rear of my left armpit and it took something pretty pointy to hit it. What worked at the gym was backing up to sharp corner of the arm to a captain's chair and letting it dig into the muscle. It took a few weeks of daily massages to totally get rid of the pain, but from the very beginning it was enough to get me through workouts.

I suspect tendonitis is a fallback diagnosis whenever no other cause can be found, but trigger points can produce similar symptoms.

[Devyn Stewart]

Thanks for your reply, Dust Devil.

I see. Well, one of the things that made me think it was a tendinopathy is that when I move through the range of motion that is painful, the pain tends to lessen and go away, at least temporarily. I was of the understanding that that was kind of telltale for a tendinopathy. Did you experience this as well?

[neilc1]

you mention above spreading your grip,
I'm thinking wrong direction,
looking for shoulders squeezed back, and bar on the muscles mass from same.
can't see from front,
FWIW, proud chest, squeeze back, helped my shoulders, there is / was a video or article here somewheres, grip or elbows, or something,
that and "crawling" in and back out from under the bar, slowing down getting under, and back out.

[Devyn Stewart]

I've tried some of that as well. It's possible that I'm not doing it correctly, but I doubt that it will even help unless this tendinopathy (or whatever it is) is healed. Just about anything, even weights I used to be able to handle just fine, pisses it off.

My original grip was quite narrow. I would put the center of the knurling on the crease of articulation point on my thumbs. Any closer and I'd be approaching my grip for the Press. Do you think that could be the problem when it was already so narrow?

[Will Morris]

I've tried some of that as well. It's possible that I'm not doing it correctly, but I doubt that it will even help unless this tendinopathy (or whatever it is) is healed. Just about anything, even weights I used to be able to handle just fine, pisses it off.

My original grip was quite narrow. I would put the center of the knurling on the crease of articulation point on my thumbs. Any closer and I'd be approaching my grip for the Press. Do you think that could be the problem when it was already so narrow?

Tendinopathy? Clavicular pain? Suprascapular pain? I think I may be missing something in your clinical decision making.