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Shoulder Injury

Shoulder Injury

21 November 2017

Shoulder Injury

Previous post on shoulder injury

So the shoulder injury has been back since early September – 2.5 months. I went to see a specialist, Mr Mark Jeffery @ Wimbledon Clinics last week and he gave this provisional diagnosis and then requested an ultrasound which I had two days later and seem to confirmed what he had predicted.

Impingement, bursitis, rotator cuff tendinopathy as drawn by the specialist.

Impingement, bursitis, rotator cuff tendinopathy as drawn by the specialist.

The ultrasound person said I have a small tear but he doesn’t think that is the issue, and more likely to be age related. The bursa is thickened and there is shoulder impingement.

What is shoulder impingement? It is caused by the tendons of the rotator cuff becoming impinged as they pass through the shoulder joint. In this case it happened through overuse, although funnily enough it came on a few months after I stopped doing regular weight bearing exercises for my shoulder at home (T25 mostly). So I’m going to get back into that routine once this is fixed.

Sports Injury Clinic – Shoulder Impingement Treatment and Rehabilitation

For the last two months or so I have been careful. I took a month off Capoeira and took Naproxen to see it would bring the inflammation down. I stopped Naproxen on the 5th of November and the pain came back same as before (while on Naproxen it was more an ache than pain) that’s when I decided to see a specialist with a view to getting another injection or surgery if it was a ruptured tendon, which, thankfully, it is not.

I have been back to Capoeira for 2 weeks now, avoiding movements such as queda de rins, volta por cima, aú de cabeça, ponte… Anything that involves weight bearing and arm bending, anything that hurts basically. But now I can do bananeira and aú again. It’s been a challenge changing my game and training and working around the injury. At first I was really scared to play in the roda and it felt a bit pointless being in class when I couldn’t do so much of the floor work – hence taking the month off for rest, although by rest I just mean not going to class, I was training at home, doing leg work and physio for shoulder. But it’s also been interesting having to change my game and play with restrictions. I can’t play the berimbau for too long either because the shoulder starts to feel really tight after a while.

I’m seeing the specialist again on Wednesday. He thought injection was probably the best, fastest solution in conjunction with physiotherapy (injection without physio is almost pointless as the pain will soon return if the underlying issue isn’t addressed).

Remember: I’m not a doctor and the info here is particular to my case and the research I have done and for me to refer to.

More links
(NHS) Shoulder Impingement Syndrome

Common Shoulder Injuries

Shoulder bursitis and impingement

Exercises:
Rubber band rotation
Pendular exercises with weights (restore shoulder socket movement)
Shoulder push ups (no arm/shoulder joint bending)
Armchair shoulder press ups
Wall push ups (gently bend the arms, stop if it hurts)
Cobra push ups

2 exercises to do throughout the day
shoulder blade squeeze and desk walk down
I kinda like these guys, this video is hot off the press, only one day old!

Rotator cuff theraband exercises – 3 sets of 10 to begin with.

26 November 2016
So I had a cortisone injection on the 23rd but it hasn’t taken full effect yet, but it does seem to be working. I was referred to a physiotherapist at Parkside Hospital and had my first apt. this morning. The physio is originally from Portugal so he knows Capoeira! Yes! What a good start. He explained how the shoulder works aided by this:

The Shoulder!

The Shoulder!

He said it’s fine to do the exercises I’ve been doing but unless I correct the posture/alignment it will keep happening. He looked at my MRI and because I have mild scoliosis he thinks that contributed to the issue. My right shoulder blade sticks out more than the left and it’s not moving as it should, the wrong muscles engage to stabilise it. So that’s what I need to focus on for now. These three exercises:

Firstly position the shoulder blades: down away from the head and squeeze. Then lift the left (non injured) arm into this position.

Firstly position the shoulder blades: down away from the head and squeeze them (towards the back, we are trying to open up the shoulders) . Then lift the left (non injured) arm into this position.

Get the shoulders into position, down, squeeze and pull rib cage in with core muscles engaged.

Get the shoulders into position, down, squeeze and pull rib cage in with core muscles engaged.

Shoulders down, and squeeze gently, ribcage in, core engaged, then push hands down onto thighs on the out breaths.

Shoulders down, and squeeze gently, rib cage in, core engaged, then push hands down onto thighs on the out breaths.

So I’ll be doing these little and often until next visit on the 5th. Lesson 1: no point in doing all the physio exercises if the shoulders aren’t in the right position. The right position feels very unnatural to me and stiff!  IMPORTANT to note that squeezing the shoulders into position should not result in the back curving and the belly sticking out, always remember to pull the rib cage in and engage the core muscles (like the zip and hollow in Pilates/Abdominal bracing).

This explains it well

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