Rotator cuff

I turned thirty. Now I hurt. Coincidence? I was doing great this spring, sending my hardest climbs to date and now I'm waylaid with a bum shoulder. I'm pretty sure it's the bursa. Anyone have some good advice for treatment etc.? I'm pretty sure my doc will tell me to stop climbing for a while and do physical therapy. But I will go nuts if i can't climb. The sooner this BS is over the better. So if anyone can chime in some words of wisdom or tell me about a magic potion please do.

I had shoulder surgery last August- They diagnosed a 75% tear, however, once in they found nothing but strectched and damaged tendons. Also, they tested for nerve damage(long thorasic nerve) and that was prevelent as well.

So, if your hurting, get it checked out. FULLY. MRI, nerve testing and multiple opinions. Surgery is a last resort- most problems unless severe can e fixed w/ good, consistent therapy. REST, REST, REST -sorry- isthe key. Your PT + the recommended strentgh training and conditioning is what you SHOULD follow, even though it sux. Still climbing and pushing it will only make it worse and take longer to heal.

At 7mo., I was released to start climbing(lightly) again. N0w at 9.5mo., I am climbing at the level I left off and am at about 95% which is maximum recovery for me. It feels good, but like wrecking your car- its never the same once you get it fixed. Oh, Im 35 btw.

Hope that helps. If you have any other questions, pm me. Good luck and I hope all turns out well!! Climb hard. Climb safe.

Shane

Since you just turned 30, I congratulate you on being young.
Your shoulder will heal and you will climb again soon enough if you take your medicine - the MRI, the PT etc.
I'm 53, tore my shoulder on an easy climb at the Gunks last fall, so I'm following my own advice to you - and now my shoulder feels good.
How good remains to be discovered this summer.
With discipline, you can put this behind you very soon - if not, you might join the many who never follow through and now enjoy "bum" knees and "trick" shoulders in their 40's & 50's.
Good luck.

I too am recovering from a shoulder injury. A lot of different things can happen to the shoulder and without an MRI, or specifically an arthrogram (where dye is injected), it is difficult to conclusively diagnose. When people say they 'tore' their shoulder, I think they are talking about the rotator cuff, but some people, like me, tear the labrum (the cartilage that is in between the joint and is the attachment point for the bicep tendon). You can also have tendonitis or an inflamation of the bicep tendon insertion point or a slew of other problems. I am not a doctor, but I know that the shoulder is super tricky. I would recommend finding the best shoulder guy around and see what the doctor says.

And by the way, although not climbing for several months seems brutal today, it will pay off. At thirty you start to develop the maturity to deal with these type of setbacks. Get used to it. If you do have to lay off for PT or recovery from surgery, you will give the rest of your body a rest and will have a renewed psyche for climbing. A legendary climber who has endured several 6+ month shoulder injuries said something to me last week that really pumped me up. He said that I should use the down time to become an expert slab and thin face climber. 'become the baddest slab motherfucker in town' were his exact words. When your shoulder is ready, you will be cranking even better.

Erik Murdock wrote:When people say they 'tore' their shoulder, I think they are talking about the rotator cuff, but some people, like me, tear the labrum (the cartilage that is in between the joint and is the attachment point for the bicep tendon).

I too just recovered from a torn labrum (SLAP lesion). It progressed to a point where the pain was affecting day to day activity. I highly recommend getting some PT before ever considering surgery. 6 weeks of rest, 8 PT sessions, and staying serious about the exercises the PT prescribes got me back to 100%.

I highly recommend Olaf at Active Solutions Physical Therapy in Boulder. He's a former climber and understands both the injury and the damper it puts on your lifestyle.

Desbien-

I think the important thing to remember here is that you can still belay. You can use your time off from climbing to really focus on your belay technique. If you like to boulder occasionally, I bet holding your arms up while spotting will also help strengthen the muscles that support the shoulder. I have also heard that carrying extra climbing gear in a backpack is good for the shoulder rehab.

Bjordahl wrote:Desbien- I think the important thing to remember here is that you can still belay. You can use your time off from climbing to really focus on your belay technique. If you like to boulder occasionally, I bet holding your arms up while spotting will also help strengthen the muscles that support the shoulder. I have also heard that carrying extra climbing gear in a backpack is good for the shoulder rehab.

Fantastic advice. I'm going to give your mice dexamethasone.

As a corrective exercise practitioner, neuromuscular structural integrationist, massage therapist, and chiropractic student, it seems that you have just over done it. Unless, however, you injured it, in which case you probably would have known it immediately. Typically, overtraining with imperfect biomechanics (which most avid climbers that dont do corrective exercises exhibit)will result in pain. Your lats are probably too tight due to the repetitive action of the muscle. Tight lats result in an imbalanced glenoid humeral joint alignment which is evident by your rounded shoulders. This means that you shouldnt be reaching up over your head over and over without resulting in a tendonitis or bursitis. You need a quality massage therapist (preferably one that does NMT or structural integration) to strip and stretch your lats, rotator cuff muscles, anterior throat, pecs, pec minor, serratus anterior, and biceps (both heads). After 5 or so quality sessions within 5 weeks, you should start some corrective exercises to offset the havoc you have caused on your body. These exercises should be done for 6 weeks minimum 3-4 days per week and would include some back rows, and reverse flys. Do not train Lats, chest, or overhead exercises until you are better aligned. Included with the exercises, you should stretch your lats, pecs, and neck. Get with a quality personal trainer or someone who knows what they are doing in the gym. Just because someone is a physical therapist, doesnt mean they know how to exercise (take note!!) Clean up your diet, quit eating refined foods (bad fat, flours, etc..) to reduce inflammation in your body. Drink plenty of water and eat some omega 3 fats. See your chiropractor to remove any proprioceptive deficits that is for sure going on. Dont take any pills. Warm up before you climb and quit if you start to hurt. Good luck!!!!

desbien wrote:I turned thirty. So if anyone can chime in some words of wisdom or tell me about a magic potion please do.

I'm not much with magic potions, but for $850 I can wave my fairy wand. (Fortified with extra special anti-reality powder for a small extra fee.)

D-
Shoulder injuries are of great interest to me so I thought that I would add my 2 cnts. I actually do work as a health care provider, have been climbing for about 12 yrs and work on climbers and their shldrs regularly.
Without doing a full history on the injury it's pretty difficult to get an idea of what's going on from your description... that being said it sounds like you still have use of your arm and can even climb on it some. I certainly suggest that you see a professional who is well versed in shoulder injuries and if they've got a climbing background even better.
With respect to having an MR done... for the most part the literature is pretty conclusive that MRI's suck when it comes to showing anything other than a full thickness tear of the rotator cuff. So if you have some use of your arm chances are an MR won't show much. If you've got good insurance and don't mind paying for it then go for it and be sure that it's done w/ a contrast medium where as a straight MR is pretty useless on a shoulder.
Once you've got a good idea of what's going on then you can choose who you'd prefer to address the issue of getting you back on the rock. I agree w/ the general sentiment that surgery, especially on a shoulder, should be a last resort. Besides surgeons like to have good outcomes and so if you're not a good surgical candidate you're going to end up being put through at least 6-8 weeks of conservative care before the surgeon will do anything else.
The shoulder is a super complicated anatomical structure that is mostly controlled by soft tissue structures and the surrounding musculature. Most of the shoulder injuries I see are a combination of muscle imbalances complicated by fascial adhesions. As far as the muscle imbalance goes I would say that 98% of climbers don't train their shoulders properly and nowhere near the intensity that they need to. Most climbers have way more pulling power than their pushing muscles can counter balance which inevitably leads to mechanical problems some where in the future. This can obviously be taken care of with a quality strength training routine and a little commitment.
As for the myofascial issue, that one pretty much needs to be addressed by a clinician that deals w/ fascial release techniques. Probably the best known would be Rolfing but there are many others.
If you really think that your injury is related to the bursa you can try some time off to let your body get the inflammation under control, or alternatively you can go see an M.D. or D.O. and a cortisone injection which should clear up simple bursitis pretty quickly.
I hope that the info helped, if you'd like to ask me any questions please feel free to send an email. Good luck w/ healing up and getting back at it.
p.s. if you're dosing yourself on Vitamin I for much longer than a week your liver is not going to like you, take some of your down time and do a little research on Bromelain, it's a great alternative and there should be plenty of info on the web as far as dosages and such.

Happened to me too last Fall (took me until I was 48). I had significantly limited movement and pain in everyday life and sleeping.

I too knew that surgery was a last resort so I hurried myself to Boulder Center for Sports Medicine. PT agreed that it was best to try intensive PT before MRI or surgery. I was also anxious to not miss an entire ice season due to surgery so I told the PT that I would do EVERYTHING he said no matter what. The first 3.5 weeks I saw very limited improvement and was beginning to despair and think about seeing a surgeon. Fortunately, shortly thereafter, things improved a LOT and I had a successful ice season and continue pain free with 100% range of motion today - though my shoulder does now occasionally "click" with some motions.

Bad news for you is that it was 6 weeks *completely off* of climbing or any other overhead motion (other than in PT). 2x/week PT, and obsessive adherence to doing the prescribed PT exercises (and icing etc.) on my own EVERY day. Re-habbing basically became my entire workout routine time-wise, but I'm still cut-free and pain-free (fingers crossed). Since that time, one of my buddies who is also a PT has told me that I'm a pretty rare case but that my level of adherence to the PT's limitations and prescribed exercises etc. was very rare too.

Kind of a drag to not climb at all but look at it this way, 6 weeks of PT or 3 months off after surgery THEN 6 weeks of PT. Good news is that the strengthening I did of the small muscles in my back/shoulder blade during PT *really* helped my climbing when I did get back.

I'm 46 and have had TWO should surgeries in the past year (90% rotator cuff tear and bicep tendon re-anchor). Since my last surgery in Novermber, I started climbing again in March and am just starting to pull hard again -- and it feels GREAT!

That being said, see the best orthopedic shoulder specialist that you can for an accurate diagnosis.

If you know with some certainty that an inflammed bursa is your problem, then an MRI may be unnecessary. Something that no one else has brought up is that many people (myself included) have a bone anomaly on their scapula -- a downward "hooked" acromion process that pinches the bursa sac against the humeral head. This causes inflammation and pain when doing overhead activities (like climbing) and is resolved surgically by an arthroscopic procedure called a sub-acromial decompression. A simple lateral view shoulder x-ray will demonstrate if this is the case with you.

If the bursa is inflammed, you may also want to consider a cortisone injection to quickly reduce pain and swelling, and to get you climbing again.

Also, this forum is a good source of information:
shoulder1.com/forum/index.c…

it is the rotator cuff when you feel/hear a grinding when you rotate your arm under some pressure... or is that normal?

I'm an orthopedic physical therapist who works in private practice. I see a large number of shoulder injuries, surgical and non-surgical. Very difficult to get a full understanding of your problem on an internet chat site, but people here are actually giving you very useful advice. Go see a good specialist, get an accurate diagnosis then you can see the appropriate practitioners or work on the problem with an independent program. Not all problems can be fixed with exercises and you may need to spend some money to see medical professionals who can treat the underlying dysfunctions. Good luck.

I partially tore my rotator cuff in 2003 so I went to a PT. It really sucked not being able to climb so I learned some valuable lessons that have so far kept my shoulders in good shape.

You must do exercises to correct your muscle imbalances - try getting one of those theraband thingies and do the exercises as demonstrated on the following video:

urbanclimbermag.tv/videos/v…

Also I have found that yoga has helped with opening up my shoulders.

good luck....

Alison Domnas wrote:Also I have found that yoga has helped with opening up my shoulders. good luck....

At the same time, if one has a shoulder impingement, yoga can really make this worse. The downward dog can impinge that supraspinatus tendon very, very well in some people. Additionally, if one has multidirectional instability in the shoulder, certain yoga postures can potentially make this worse by stretching the shoulder capsule further. So, depending on your injury, yoga can have many associated risks with certain movements that would be best to avoid.