Rotator Cuff or Something Else?

Before getting descriptive, I will mention I am going to get this checked out. I am mainly just trying to figure out exactly what I injured. Seems like rotator cuff, but I am not sure.

I really upset my left shoulder area doing dips a couple weeks ago. They were weighted and I went down too deep apparently. It was more of a focus on tri’s, but I think I rolled my shoulders too much. It now hurts for different angles, everything from incline press, close grip bench press and any kind of curls hurt too. The pain during curls is why I question if it is rotator cuff, as I know the biceps insert into the shoulder region too. Surprisingly, bench press hurts too, but not like the others. Dips are out of the question. I’ve also noticed if I put my hand behind my back there is pain.

Obviously this won’t go away without rest, but any thoughts on what area could be hurt based on the pain occurring during different movements?

[quote]paulypaul wrote:
Before getting descriptive, I will mention I am going to get this checked out. I am mainly just trying to figure out exactly what I injured. Seems like rotator cuff, but I am not sure.

I really upset my left shoulder area doing dips a couple weeks ago. They were weighted and I went down too deep apparently. It was more of a focus on tri’s, but I think I rolled my shoulders too much. It now hurts for different angles, everything from incline press, close grip bench press and any kind of curls hurt too. The pain during curls is why I question if it is rotator cuff, as I know the biceps insert into the shoulder region too. Surprisingly, bench press hurts too, but not like the others. Dips are out of the question. I’ve also noticed if I put my hand behind my back there is pain.

Obviously this won’t go away without rest, but any thoughts on what area could be hurt based on the pain occurring during different movements? [/quote]

Sounds like you irritated the shit ouf of the front of the capsule. Does it hurt most when you’re at the bottom of the movements? Like for bench pressing does it hurt most when the bar is at your chest?

[quote]BReddy wrote:

[quote]paulypaul wrote:
Before getting descriptive, I will mention I am going to get this checked out. I am mainly just trying to figure out exactly what I injured. Seems like rotator cuff, but I am not sure.

I really upset my left shoulder area doing dips a couple weeks ago. They were weighted and I went down too deep apparently. It was more of a focus on tri’s, but I think I rolled my shoulders too much. It now hurts for different angles, everything from incline press, close grip bench press and any kind of curls hurt too. The pain during curls is why I question if it is rotator cuff, as I know the biceps insert into the shoulder region too. Surprisingly, bench press hurts too, but not like the others. Dips are out of the question. I’ve also noticed if I put my hand behind my back there is pain.

Obviously this won’t go away without rest, but any thoughts on what area could be hurt based on the pain occurring during different movements? [/quote]

Sounds like you irritated the shit ouf of the front of the capsule. Does it hurt most when you’re at the bottom of the movements? Like for bench pressing does it hurt most when the bar is at your chest?[/quote]

Pretty much, yes. I also didn’t mention I tried to do incline dumbell presses as an alternative to the bar last night, but found it to be extremely painful on the shoulder area when cleaning the weights from my lap to the start position…

What about over head movements? Mil press for example?

[quote]sexyxe wrote:
What about over head movements? Mil press for example?[/quote]

Yes, at the start of the movement if using the bar, down at shoulder level. If doing dumbells, the pressing itself is not too bad, but getting them into position is torture. Arnold Press is a no-no.

[quote]paulypaul wrote:

[quote]sexyxe wrote:
What about over head movements? Mil press for example?[/quote]

Yes, at the start of the movement if using the bar, down at shoulder level. If doing dumbells, the pressing itself is not too bad, but getting them into position is torture. Arnold Press is a no-no.[/quote]

Loosen up the posterior/inferior capsule of the shoulder and don’t do anything where your elbows are behind your shoulders. Ala the bottom portion of a bench press, the part where you lift the dumbbells to your shoulders, the bottom of a military press, etc.

Substitute some floor pressing and that should allow you to press while things calm down.

[quote]BReddy wrote:

[quote]paulypaul wrote:

[quote]sexyxe wrote:
What about over head movements? Mil press for example?[/quote]

Yes, at the start of the movement if using the bar, down at shoulder level. If doing dumbells, the pressing itself is not too bad, but getting them into position is torture. Arnold Press is a no-no.[/quote]

Loosen up the posterior/inferior capsule of the shoulder and don’t do anything where your elbows are behind your shoulders. Ala the bottom portion of a bench press, the part where you lift the dumbbells to your shoulders, the bottom of a military press, etc.

Substitute some floor pressing and that should allow you to press while things calm down. [/quote]

Thank you, good suggestions, I will give them a whirl. I wonder if the bicep tendon is affected too, certain curls cause major aggravation. I cannot curl a dumbell in a supinating style without getting major pain.

Going to a chiropractor tomorrow, he practices the Graston technique and A.R.T. I think, hope that may help. I remember Poliquin wrote once about how ART helped Milos Sarcev. His shoulders were supposedly so bad he couldn’t do a negative bench with an empty bar without pain. One ART session supposedly cured it. Think this will require more time.

Google the Neer test and Hawkins-Kennedy tests. If you get pain with these it might be impingement. Other thing it could be is a SLAP with a rupture/tear of the biceps tendon which inserts into the superior labrum. Otherwise do external/internal rotation and see if you have pain. If not then it likely isn’t rotator cuff.

Went to an orthopedic doctor today with less than overwhelming results. Got X-Rays taken, he did some quick diagnosis and recommended PT for 4-6 weeks. Pretty standard stuff. I was hoping to at least get an MRI so I could know what is going on. He thinks it could be rotator cuff and/or bicep related.

He thinks an MRI is necessary only after if PT doesn’t help. Don’t know what the big deal is, MRIs are just for a diagnosis I thought. One interesting thing he did mention is my left biceps (the side where the problem is) is shaped differently than the right (and slightly smaller), but that arm has been like that for a while now. Guess I just need to folow protocol, certainly can’t go on like I am.

I think the recommendation for PT first is a good one. But if the pain subsists or you notice prolonged weakness, get the MRI. Make sure it’s arthrographic. I tore my rotator cuff badly and elected to have it surgically repaired since it was a full-thickness tear off the bone. The subsequent recovery is not pleasant and is quite lengthy.

[quote]paulypaul wrote:
Went to an orthopedic doctor today with less than overwhelming results. Got X-Rays taken, he did some quick diagnosis and recommended PT for 4-6 weeks. Pretty standard stuff. I was hoping to at least get an MRI so I could know what is going on. He thinks it could be rotator cuff and/or bicep related.

He thinks an MRI is necessary only after if PT doesn’t help. Don’t know what the big deal is, MRIs are just for a diagnosis I thought. One interesting thing he did mention is my left biceps (the side where the problem is) is shaped differently than the right (and slightly smaller), but that arm has been like that for a while now. Guess I just need to folow protocol, certainly can’t go on like I am.[/quote]

Unless you had some bizarre case, or an awful doctor, you would know if you had a torn bicep. You’d be in surgery a week ago.

You may need to go very light on the bicep curls. If it the left bicep is smaller that’s a sign your bicep could use some work. However, you’ll need to loosen up the posterior capsule first. If the posterior cuff is really stiff the shoulder can’t glide backwards well, so it glides forward which puts pressure on the bicep = pain.

What are you doing in PT?

I wouldn’t be overly concerned with an MRI. If you’ve been an active person for a while chances are a shoulder MRI isn’t going to look good no matter what. That doesn’t mean you need surgery though. Nobody really has an idea what “normal” should look like on an MRI for shoulders. Something like 80% of baseball pitchers have tears in their shoulder on an MRI but only 14% are in pain. It’s a horrible indicator for whether or not something is really wrong.

Quoting James Andrews (world renowned surgeon) “If you want an excuse to do shoulder surgery on a baseball player just take an MRI of his shoulder.”