Shoulder pain any thoughts

[Bard1]

Doc and David,
  As an Orthopedic Massage Therapist I have to agree with what David is saying.  However I also agree with Doc in that imporper stretching techniques will creat more inflimation, or to agressive stretching, as I have often seen done by P.T.'s who feel pressured to create results quickly because of a limited number of visits imposed upon them by insurance companies.  Though I have not studied the same specific system of stretching David has, I do believe, and research will support this, that properly applied stretching would be very beneficial.  However, I think stretching alone wouldn't be enough.(re-reading I see David touched on this as well, it's late.   :p  )  
   First thing to ask here is Why did the impingement occur?  I would first make sure the client/patient has sound stuctural balance using soft tissue techniques some of which would employ gentle isolated stretching of very specific muscles or regions of muscle.  This should in turn release muscle hypertonicity, trigger points, etc. and then creat more room for the tendon and the sheath it is running through.  This then will greatly help with the decrease of inflimation.  I would recomend to the client/patient that they do gentle and slow range of motion exercises, but refrain from heavy straining of the shoulder (in this case archery) for at least a couple of weeks. Add to that good old fashioned ice for 20 min 3 times a day. Once the inflimation and pain were gone, and the client had full range of motion, is when I would recomend the beggining of strengthening the weak muscles.  
  Though I agree that keeping the shoulder imobile for two weeks is probably not going to creat adhesive capsilitis, I also disagree with it.  I believe the key is to find a balance between movement of the joint with out causing further irritation/inflimation.  

Respectfully,
Derek Wrigley.

[doctorbrady]

Gentlemen,
In an effort to keep this from being a doctor vs. massage therapist disagreement, I will bow out.  It is not unusual to have differing opinions stemming from our individual experiences and training.  I suspect that David and I will never convince one another that the other is right.  I guess Don can decide whether to see his doctor or massage therapist for this problem.
Derek, I do believe that you made many good points.  There are certainly adjuncts to healing such as ice, and I even agree that some stretching with the arm lowered to avoid reimpingemet is probably beneficial. But no matter how slow or careful you are about stretching, if you continually slide the inflamed tendons or muscles (there are actually 4 rotator cuff muscles) along the acromium as you would with full range of motion stretches, they are not going to like it, and are more likely to stay inflamed. If you keep pinching them they are likely to stay irritated longer.
Don, best wishes on your recovery.
Brady

[jack benson]

It sure sounds like impingement. After laying off shooting to "recover" with no resolution, I saw my doctor and I was referred to physical therapist and was examined this past Monday. I didn't realize until shown during the exam that my left shoulder had significant mobility restriction (and strength)compared to my right (almost 50% in some movements).

I'm scheduled for 4 weeks (2-3X per week) of rehab, which initially will consist of specific stretching to loosen up the shoulder, followed by strengthening for rehab.

I agree with all David said above. If you do see a therapist, take along a bow with you. I did, which both pleased and surprised my therapist. Having it and being able to demonstrate helped her greatly in identifying where my problem was located.

jack

[Owlgrowler]

I agree with the above post, Stretch until it hurts. Weight training should never hurt. M.D.'s are trained to treat symptoms with medicine/surgery, and alot of times you never really get cured. JMO

[alligatordond]

I'm not a doctor but I did sleep in a bed last night:-)

I suggested to my internist that I see an orthopaedic doc, I was ready for the knife. She instead sent me to PT. PT worked-IN MY CASE- Something about strengthening muscles to realign the shoulder to lessen the impingment etc etc etc. I still feel it from time to time but it is very manageable. Probably the best tip I got was to NOT sleep with my arms above my head. Apparently a big source of shoulder pain.

[David Bartholomew]

DocBrady,

  In response to your last post, this discussion has very little to do with “a doctor versus massage therapist disagreement”, but comments/suggestions on threads like these allow everyone to see different view points.  
     Then, “whoever” can read a thread (like this) and then decide on what course of action he/she will take concerning their minor soft tissue (meaning, “Muscle, tendon, or ligament”) injury.

     First thought: If “whoever” has an acute injury, my first suggestion is for them to seek out a doctor they can trust (I’ll just leave it at that).  We are all getting older, and we will all have soft tissue injuries at some point.  

     Second Thought: If “whoever” has a minor (meaning, non-surgical) injury and wants to “rest it” … with the hope that the problem will go away (at least for a little bit) …fine!  
     If “whoever” is reading this chooses to face the injury concern/problem and address it… with slow, thinking stretches (to stretch the tight tissues, and at the same time work on muscle tone) … AND then, work on strengthening the weak side… AND then work on muscle balance / stability… fine!  
     Either way, the choice is always the patient/clients.  And yes, common sense states you do rest a bit,  move slowly…use Ice, heat, and meds (I said that earlier… see above threads).

Sincerely and with respect,
David

P.S.  Tad, you stated, “stretch till it hurts”.  The answer is simply, “No”.  There is a difference between PAIN, and a GOOD HURT.  In proper stretching, there should never be PAIN.  (And yes, there is a fine line there.)

[NightHawk]

had shoulder surgery in march torn labrum and had to reconnect the labrum to the bone also had to have part of the shoulder bone ground off. Wasn't shooting a bow in 6 weeks. I hated therapy it helped but.......

  To anyone facing this problem Good Luck and hope things work out for you.

[cahaba]

I had laproscopic surgery done on my right shoulder. I was having alot of pain and the surgery stopped it. Took about a month to heal. No incisions just hole marks about the size of a pencil. I had developed some bone spurs and they cleaned them up and my shoulder is fine now.