Your thoughts on dealing with shoulder impingement....

[Kiknskreem]

If you're already inflamed and the swelling is such that the tendon is bigger than the space it normally occupies, then yes, you'll have to take some steps to get the inflammation down before you start back.

I think that is definitely the case with my situation. I can't seem to catch a break, even hurt it again today when I slipped and was forced to catch myself with my bad arm.

As for steps to get the inflammation down further, what would that look like...ice, more rest, continued IB treatment?

I am eager to start rehabbing but don't want to waste my shot.

The training acts the same way a friction massage does, by physically mashing the inflamed tissue to push out swelling, edema, and increase the normal circulation provided by the peritenon. In fact, if you have not yet had a friction massage you need to get one.

From a quick search I've gathered a friciton massage is just running your hand or a hard object over tender areas, followed by icing? Something that I can effectively do myself? I almost do something similar already... dig my thumb or the back of a Bic into the front of my shoulder and sort of run it across what I guess is tendon and muscle.

Do you have any information on friction massages at hand, or know of a good place to start looking?

In a related line. would you consider ART/sports massage something worth looking into?

Here is another way to think about inflammation that has some potentially interesting implications for the management of chronic inflammation: http://www.answerbag.com/q_view/185648

Interesting stuff... that sounds sort of on par with something I've just heard about "prolotherapy". Injecting oil or another substance to induce inflammation on purpose.

[Mark Rippetoe]

I think you need to see an ART guy as soon as possible concerning all the above questions. If it's bad enough that your shot hasn't helped already, it needs to be looked at by somebody with an approach different than another shot.

[Kiknskreem]

I've made an appointment with a second shoulder specialist to look at my MRI's (in case the tear actually is an issue) and am scheduling an ART session.

I started rehab yesterday.. 2x25x25 presses. Continuing to follow the protocol, the shoulder feels fine.

A bit of warmth in the shoulder during the later reps of the set, but it isn't an acute pain and so far isn't flaring up or getting worse. I couldn't even do a press with a 15lb bar before without acute pain, so hopefully things are looking up.

I took vids of today's session, the presses start 30 seconds in, taken at a few angles and from different parts of the sets.... anything that needs to be corrected?

[youtube]6fZphpwPxGM[/youtube]

[Mark Rippetoe]

The presses look fine. See how you're getting your head through at lockout? Do the same thing when you stretch into the top of the hang and the lat pulldown.

[Kiknskreem]

Went to a chiropractor where they do ART today.

I asked about friction massage and basically they said they do ultra-sound and electro-stim for the same effect. I got that followed by a brief bit of ART.

A bit sore from the RoM tests that they did... hopefully it doesn't bite me in the ass.

They want me to go in a few times a week for a few weeks.... something worth looking into or waste of money?

[Mark Rippetoe]

It's worth it if they do the ART. Make them dig on you.