Shoulder Pain AC Joint/Impingement Not going away Shoulder Pain AC Joint/Impingement Not going away

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Thread: Shoulder Pain AC Joint/Impingement Not going away

  1. #1
    Join Date
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    Default Shoulder Pain AC Joint/Impingement Not going away

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    Hi Coach,

    I know you have spoken a few times about pain and I wondered if you may be able to throw me an idea before I end up with surgery. I have pretty bad pain in my shoulder predominantly I think over the AC joint. Had it xrayed, shoulder was normal. Got sent to physio and told to do band exercises for RC. Did for 6 weeks no pain improvement. Had MRI, doc said basically, ac joint shows sign of arthritis and minor inflamatio also bone growth at top which accounts for the bump. He thought this wasnt the real probem though. MRI also showed subacromial bursa was pretty inflamed. He diagnosed a shoulder impingement did a cortisone shot and sent me back to physio. Anther 6 weeks on and no improvement. Pretty much any movement of the arm hurts a bit and lifting heavy hurts somewhat at the time but irritates the injury the next day. I am trying to avoid surgery as that was touted as the next step though I am not sure exctly what that would entail. Am I candidate for the Starr rehab, though I have seen you say thats only for muscle belly issues? How would you go about rehabbing this? I am tempted to start again with an empty bar and just see how bad the pain gets as I build back up each workout. Sorry this was long and thanks if you made it this far. I can provide more detail from the MRI if needed.

  2. #2
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    What are your lifts?

  3. #3
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    Aug 2010
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    I'd be willing to bet you have really bad bench / press technique. I use bench presses and "overhead" presses almost exclusively for rehabbing every pathology you listed here.

  4. #4
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    Just an Internet schmuck here, but I solved a pain like this (though probably lesser) through regular and generous use of NSAID and getting my presses stronger. Now, in hindsight, the pain is gone, but I don’t recall when it disappeared. I might get a zing now and then from the formerly problematic area, but form correction usually avoids it (in my case, a prouder chest at the bottom of the lift helps).

    51yo male, 5’7”, 195#

  5. #5
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    May 2019
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    Quote Originally Posted by Will Morris View Post
    I'd be willing to bet you have really bad bench / press technique. I use bench presses and "overhead" presses almost exclusively for rehabbing every pathology you listed here.
    Something else to think about: even if your bench technique is good, it's easy to aggravate impingement when unracking the bar on your own due to positioning and the angle of the humerus. It's a good argument for getting a lift off from a spotter. If I'm benching alone I try to make a point to set up farther under the pins to avoid that.

  6. #6
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    Quote Originally Posted by Mark Rippetoe View Post
    What are your lifts?
    They werent great but I was Benching 75kg x 5, Dead 105kgx5, Press 40kgx5 and Squat 90kg x 5. I also did Pull ups, curls rows and tri ext as assistance that was pretty mcuh it though I havent lifted at all for about 4 weeks now.

    As for technique, I am sure improvements could be made but I did have an olympic /powerlifting coach go over technique for the 4 main lifts and he thought I was ok, so not horrendous at least. Jut not sure where to go from here as the usual physio has done nothing, cortisone did nothing and surgery seems to be in the future just by default yet I cant shake the feeling that this should be resolved with the correct rehab from people that are speciaists in lifting.

    Thanks

  7. #7
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    Woah. Did not catch that OP is sharing my name.

  8. #8
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    Quote Originally Posted by mattjames View Post
    They werent great but I was Benching 75kg x 5, Dead 105kgx5, Press 40kgx5 and Squat 90kg x 5. I also did Pull ups, curls rows and tri ext as assistance that was pretty mcuh it though I havent lifted at all for about 4 weeks now.

    As for technique, I am sure improvements could be made but I did have an olympic /powerlifting coach go over technique for the 4 main lifts and he thought I was ok, so not horrendous at least. Jut not sure where to go from here as the usual physio has done nothing, cortisone did nothing and surgery seems to be in the future just by default yet I cant shake the feeling that this should be resolved with the correct rehab from people that are speciaists in lifting.

    Thanks
    I'd suggest that perhaps your Olympic / Powerlifting Coach is not doing his job. You are benching 75kg and deadlifting 105kg. Pull-ups, curls, rows, and triceps extension are not part of our program, especially with someone who has lifts in this range.

    I'd still suggest that your technique is probably not great. You addition of other exercises was not helpful. Your mindset with relation to your pain is troubling. You have already made your mind up that you need surgery. Now, as far as your last statement, as this" should be resolved with the correct rehab from people that are specialists in lifting".....I'd like you to expand on that thought. I'd really like to know where you are going to get this level of specialization in rehabilitation. There are very few Physical Therapists in the US that actually have a specialized knowledge base in lifting, and your usage of the word "physio" suggests you aren't in the US.

  9. #9
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    Aug 2019
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    Hi Will,

    The coach was a one off to assess technique as opposed to ongoing training. I probably shouldnt have added the extra exercises but it was only a couple of sets I didnt all of these each workout. You may well be right about technique, I only posted that to show I had at least tried to think of that as an obvious starting point ( Was asessed prior to to the injury) .
    As to mindset its quite the opposite, I am trying to avoid surgery. I am UK by the way so good spot! the process for rehab here goes .... DR/GP > physio ( band exercises ) > consultant ( MRI & cortisone shot) sent back to physio ( more band exercises ) still in pain so back to consultant who will offer surgery due to physio not working. It seems to just be the general process. I am trying to avoid this as I really dont think I have done anything that bad! Just cant seem to get rehab to work from what I have been given and thought I would ask here as I have seen some great advice in the past. I ask as I have often seen Rip say band exercises are a waste of time and they are pretty much all have been given but not sure if say Starr rehab would be worth a try or perhaps starting from an empty bar. Thanks

  10. #10
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    Quote Originally Posted by Matt James View Post
    Woah. Did not catch that OP is sharing my name.
    That confused me, too.

    Some pretty serious shoulder issues over here, too, and what’s done the best for them in my experience has been training through them with fairly conservative programming (low on accessories, mostly fives, microloading). One thing that definitely helps is to stay tight through the eccentric portion of the lift, even if something is starting to hurt - nothing screws me up worse than wussing out and divebombing an eccentric.

    If I were you, I’d start with an honest examination of my training log, check the first three questions, and probably find a new coach. Your lifts are bad and you’re not going to feel better until you’re significantly stronger. Imagine not being in pain all the time. Go get it done.

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