My client had shoulder pain for a few years. Being a competitive swimmer made it seem a common injury with the mileage and intense training schedules. Luckily it didn’t exactly stop him from swimming, but the pain was enough to seek help. Each time the imaging showed a different diagnosis.
Having several diagnoses didn’t help. The pain wasn’t going away. The treatments for the shoulder weren’t helping either. Eventually he didn’t just feel it while swimming but also during daily activities. He felt hopeless.
After all these years with pain, he thought this will be with him forever.
His last visit with the Doctor suggested a break from swimming. Perhaps that would help heal the shoulder. The break was difficult as it was a part of his life but the pain made the decision easier. The break ended up being longer than expected when all sports were put on hold.
The break ended up being 5 months long. In terms of rest time for most injuries, that should have been plenty. He was just starting back at the pool when the pain came back.
That’s when he was referred to me by a client of mine. After getting all the information that I needed. I tested the shoulder and the muscles were strong. Strange I thought. I continued my search.
Given all the information and all the testing I did, there were two major things happening to his shoulder.
The movement of his right shoulder was very different from his left. There would be lots of shoulder muscle compensation.
The second was that his body pain tolerance for his shoulder was very low. Imagine you kept poking a bruise. It would take longer to heal but it would also be sensitive.
I decided to “ignore” the diagnoses since 4 years is a long time and they should have healed by now. Also having good strength was also a clue that we were dealing with something else.
We started with exercises below shoulder height. The shoulder is very flexible but with less stability. The muscles have a hard time supporting above the shoulder, especially if you’re injured.
My client had to learn how to use the shoulder in a way that wasn’t “natural” for him. He had to think about how his arm moved with each movement. That’s very hard when reaching for a cup is automatic.
At first his shoulder still hurt even concentrating on his movement. This was because his pain tolerance was so low. As the weeks went on, his body adapted to the new movement and his pain tolerance increased.
Here are some exercises that I gave to my client:
Bear Plank: While this is does not look like it can work on the shoulder, it really does. My goal was to stress the shoulder joint in supporting the body weight. Goal is to hold it 4x10seconds.
Elastic Pull apart: This is a great exercise to work the endurance of the rotator cuff. The goal is to lift the arms above the head while keeping the forearms parallel. Goal is 3x10.
Although we’ve made so much progress after so many years of pain, there are still some advanced movements we need to achieve.
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