Tears and tears: Shoulder impingment

We’ve all done it. “I know I should stop but I’ll give it one more go”, “I haven’t warmed up but I’m so excited to get on my proj or jump in on this chinup/pushup/onearm comp”, performance and stoke is deeply ingrained in our sport. At some point, however, it is time to listen to that voice in your head that says “Stop, come back another day, you won’t regret this decision”. Today my shoulder is on the mend, probably at about 60% and I can finally see the light at the end of the tunnel. This post documents my shoulder injury and recovery to-date over the past 7 weeks.

As we zeroed in on the end of 2015 my stoke got the better of me. After an initial shoulder tweak fuelled by booze and bravado I did not take the hint to rest. Climbing at an all time personal best after a year of training, my drive to boulder challenging fun routes had me ending every session with a worse and worse shoulder until just before the local TDB comp when I cried “Uncle”. It was time to stop and get serious about my shoulder.

Having just turned 30 I am for the first time experiencing climbing injuries that take more than a night of rest to recover from. I’m not saying they are related but clearly 30+ is going to require more smarts than strength.

The first thing I did was try to self diagnose my shoulder, reading internet forums, climbing blogs, shoulder rehab sites, the best decision I made was to read Dave MacLeod’s shoulder injury chapter. It begins by telling you to put the book down and go see a professional! If you’re reading this right now and you have shoulder concerns please go do the same! The shoulder joint is super complicated and super critical and injuries are extremely difficult to diagnose – the wrong diagnosis will lead to less than optimal rehab and a prolonged injury.

My initial limitations were mobility, sharp pain, and weakness in nearly all positions that weren’t resting by my side. This had a tremendously negative effect on my climbing life but also regular life. Putting on a coat, lifting a bag, brushing my teeth all became very painful trials. Needless to say, I was scared for the next training season and beyond, who knew if I would ever crimp again!

My first session with a physiotherapist (Plug Lifemark) was helpful and encouraging. It was an assessment where I was bent and contorted all in the name of confirming a supraspinatus (rotator cuff) impingement. There are a million resources to learn about this but basically one of your rotator cuff tendons becomes inflamed and then rubs against the upper bone of your shoulder joint leading to more inflammation and more pain. Without intervention it will only get worse and can eventually become a full tear* (*this is bad). The classic sign of this type of injury is a “painful arc” where you have pain through the middle 60 degrees of a side arm raise where the head of the Humerus is trying to clear the shoulder joint.

Shoulder impingement bouldering activities
Shoulder impingement bouldering activities

After the each physio session I came away with a number of exercises to perform every day. As the weeks progressed so did the difficulty of the exercises. If they were too painful to complete I was given less difficult substitute exercises. The hardest note of all was to stop climbing all together – NADA. The prospect of no climbing added to the hardship. It not only removes my stress reliever and most enjoyable activity, but also removes me from my social group. On a number of occasions I would come just for the hike and take pictures while my core climbing crew would flail on boulders in the cold. Here are my notes from various twice daily exercise rehab programs prescribed by physio each improvement is separated by about two weeks.

Week 1:

  1. External rotation light pressure against wall (standing) – 10 seconds on/off x 1
  2. Forearm against wall in front, track shoulder blade with other hand – 10 reps x 1
  3. Band tree hug – 10-20 reps x 1

No improvement, went back to gym to exercise what was possible. Everything with a shoulder was out – chins, dips, press, deadlift, even back squat put my shoulder in a painful place. The only exercise I can work is front squat and core.

Week 2-4:

  1. External rotations with a 5lbs weight laying on side with ball between arm and body – 10 reps x 3
  2. Lacrosse ball Pec minor stretching – until it hurts
  3. Pressing out on band roll ball up wall – pay attention to shoulderblade tracking – 10 reps x 3
  4. Pushup Plus – 10 reps x 3

Now my “painful arc” is OK with palm facing up, palm down is still very painful. External rotation painful at the end of range.

Week 5:

  1. All from previous
  2. Shoulder held by band and push up backwards (This I find too painful to continue)

Week 6 – Present:

  1. External rotation progression (standing with arm at 90 if possible)
  2. Lacrosse ball pec stretching
  3. Pec stretching in doorway
  4. Lat / pec stretching on wall
  5. Wall slides

Week 6: Try some light climbing (mostly easy slab). Followed by moving winter tires and hurting shoulder.

Climbing attempt (baby them):

  • Warm up shoulders for 40 minutes prior to getting on the wall.
  • Climb light for 30 min (nothing with wide shoulder moves)
  • Cool down / stretching / ice shoulders

The factors that predispose you to shoulder impingments (Of which I tick all but one). If you’re interested read more on scapular rhythm and scapular tilt.:

  • Repetitive overhead activity
  • Strong / short internal rotators (Lats, pecs major / minor, teres major)
  • Weak rotator cuff muscles
  • Poor posture / alignment
  • Poor shoulder movement pattern
  • Poor sitting position at work
  • Genetic factors (hooked acromion)

My biggest take away from this is to thoroughly warm up ALWAYS and to listen to your body, push yourself but take required rest. As we push ourselves to find our limits and improve we walk a thin line between pushing ourselves out of commission and acquiring enough micro traumas to get stronger. OH and Dips are bad for your shoulders.

Happy new year! Good luck in 2016!


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