MRI results & upcoming doctor visit

[Grazing Marco]

Hi all,

About a month ago I posted about some shoulder pain with benching. The pain also got really bad the last time I tried to work out during front shoulder raises.

Since that workout I’ve had a doctor visit and a subsequent MRI because the doctor said I had symptoms of a bicep tendon and/or labrum injury.

I have not met with the doctor yet about the results of the MRI, only a brief conversation with the nurse, over the phone, about what the MRI showed. There are no tears but the MRI showed “tendinopathy,” and I’ll be meeting with the doctor again to discuss treatment options on the 25th. I don’t know which tendon(s), specifically, is messed up.

Despite researching tendinopathy on the Internet, I haven’t found a whole lot of good information - some of it sounds contradictory as I go from one source to another. So my questions are: As I head into this doctor’s appointment on the 25th, what should I expect to hear? How long should I expect to be on the mend, considering I haven’t been lifting for 2 months now, aside from one light weight workout about 3 weeks ago.

Thanks,
Alex

[Nick D'Agostino]

The good news is knowing exactly which tendons are involved doesn't really change the rehab process too much. Tendonopathy is not something that generally goes away quickly or with time off. You need to continue training with it but managing the loading to the area to nudge the pain. If you do this correctly at the 3-month mark, you will probably be in a much better position than you are now. Avoiding it and pushing through it don't very well as strategies. I would hold off on the front raises if they are particularly sensitizing. I would start benching, pressing and using the lat pulldown now with light weights using a controlled tempo through whatever range of motion you can tolerate. You can use pins/safeties in the rack to gradually increase your ROM if things are very sensitive. If you can do a full ROM just start light with higher reps (10-15), train every 48-72 hours, and gradually increase the load and drop the reps until you are back doing heavy 3x5s. I would alternate bench and press each session.

[Grazing Marco]

Thank you.
How light would you suggest I start benching and pressing? I would guess my first time benching would be something 3 sets of 10 with just the 45 pound bar. And when pressing I’d start off with a 20 or 30 pound bar for 3 sets.
Should each workout see about a 5 pound increase from the last time I did the exercise?

[Nick D'Agostino]

You can start at those weights if you want. Load selection really depends on what is tolerable to you as you are performing the movement. Your previous training history and how sensitive the area is will both play a role in where you comfortable starting.

[Grazing Marco]

You can start at those weights if you want. Load selection really depends on what is tolerable to you as you are performing the movement. Your previous training history and how sensitive the area is will both play a role in where you comfortable starting.

The sports medicine doctor I’ve been seeing for my shoulder confirmed your plan of attack - I was surprised given the “shit doctors say.” I can’t wait to get started back in a couple days, even if it is light weight for a while. He recommended increasing about 10% of weight each week after starting very light.

[Will Morris]

It should not surprise me as much as it does that a sports medicine physician is not up to date with the best available evidence for the treatment of tendinopathy.