View Full Version : Another Shoulder Impingement...

March 12th, 2011, 10:25 PM
Hi everyone,

I'm new to the formums but have been reading a lot of the posts related to shoulder injuries over the past week or so (first found the forums searching for information on shoulder impingement). I am a lifelong competitive swimmer, and swam through college. This is my fifth year out of school, and my fifth year swimming Masters. I have been one of the lucky few to get through my swimming career with no major injuries, but unfortunately, I started having pain primarily in my right shoulder this past October. It also occurred very minimally in my left shoulder. When it continued to reoccur and gradually get worse, I tried two weeks of rest in Dec. The pain worsened during the rest period so I finally saw a doctor at the end of January. At that point my right shoulder was so painful that I was barely using it. Predictably, I was diagnosed with bilateral shoulder impingement and prescribed PT, and told to ice when when it was painful, but try to stay active as long as I wasn't in serious pain. On my own, I cut out butterfly, kickboards, diving off the blocks, and pulling (all painful things). I was told to stay away from NSAID's because they delay healing.

Up until a week ago, my shoulders had been improving gradually and I had been doing PT and targeted rest pretty strictly. The right one was still very mildly painful, but just barely. Then, a couple of things happened. Over the past two weeks, I've had to do some heavy lifting for work, and I also stupidly decided to do a fun dryland-integrated practice where we were starting off of the blocks and repeatedly climbing out of the pool. I also pulled with small paddles. (yes, I know... dumb). My left shoulder hurt during this practice but I figured I'd just ice it and take the consequences, because I was enjoying myself.

Now, my left (not the original one) shoulder has been in pretty bad pain for the past 4 days or so. I can feel what I think is it subluxating with certain motions (particularly if I squeeze my lats together and pull my shoulder back), and I get a popping sensation inside the joint. It hurts with almost any motion, even washing my hands. The worst is how it aches inside the joint; that is keeping me up at night. Icing makes it a little better for half an hour or so. I also started taking ibuprofen, which helps a little, but not much. I'm worried about a SLAP tear to my labrum because of these symptoms.

This is a lot of background information.... but what I want to know is how long I should wait before I go back to the doctor? I am trying to see if rest, PT, icing and NSAID's will help. Unfortunately getting time off from school/work is very difficult for a doctor's appointment so I don't want to go unless it's really serious. I'm pretty strongly anti-surgery if there is even a slight hope of medical management improving things, just because I know surgery is not benign and requires a long recovery time.

March 13th, 2011, 01:42 PM
Could be a SLAP injury. I really discourage integrating dry land work in swim practice (dips, push outs, push ups, etc.) for that reason. If you are in that much pain, you should consider an MRI.

March 13th, 2011, 10:13 PM
Hi everyone,

.... but what I want to know is how long I should wait before I go back to the doctor?

Go back to the doctor now. Describe the pain exactly and try to avoid minimizing the issue. Shoulder problems can get bad fast if not dealt with.

March 15th, 2011, 06:04 PM
Update: I just reposted, because I thought this never actually did post! Sorry about bringing up this issue twice.

Thanks for the responses. I have an appointment for Thurs with an MRI, and I just described what has been going on in the other post. Basically the pain was severe through yesterday, but the deep ache inside my joint just dissipated last night, and has been absent today even without NSAID's. I'm worried I jumped the gun going to the doctor, but my shoulder is still definitely painful and not normal. I'm just used to pushing through pain as an athlete (you all know how it is), and I'm one of the lucky few that hasn't dealt with injuries, so I don't know when to ignore versus pay attention to the pain.

gull, I had done dryland-swimming integrated practices all my life and never had a problem. I also used to be a lot stronger than I am now and I really think that's the big problem.

thanks, again!! I'll let you know if I get an answer from the MRI.

March 15th, 2011, 11:37 PM
I posted about a shoulder impingement last week...I ended up going to get a massage and she knocked that sucker right outta there!! Its amazing! Been swimming 2-3 times a week with no pain!

PT doesn't have any appts till April, so I'll stick with massages till then!

March 20th, 2011, 11:50 AM
Wow, calisummer, that's great that massage worked well for you!

So I had my appointment and they suspect a torn labrum in the both shoulders (the right was much more painful on physical exam). My left one has continued to recover, and is mildly painful now. They'd like to do bilateral MRI arthrograms, but I might have to wait until I have more funding to do this, unfortunately. I am kicking only at the pool with my hands by my side, for the time being, and continuing PT. Maybe I'll try massage, too!

Thanks for your help!

March 20th, 2011, 02:05 PM
It sucks that you have to wait (and save up) to have an MRI (and then pay twice as much as someone with insurance) but that's our so-called health care system for you. That said, it seems to me that an MRI is more for the doctors' benefit than yours, i.e, it is a diagnostic, not a therapeutic, tool. In your place I guess I go ahead and take the doctors' best guess as a given, and act accordingly. Maybe invest in PT, rather than an MRI. Best of luck to you!

March 20th, 2011, 03:33 PM
It sucks that you have to wait (and save up) to have an MRI (and then pay twice as much as someone with insurance) but that's our so-called health care system for you. That said, it seems to me that an MRI is more for the doctors' benefit than yours, i.e, it is a diagnostic, not a therapeutic, tool.

Many facilities offer cash discounts for uninsured patients.

If the tear is significant (as determined by the MRI), it is unlikely to heal without surgery. Of course the surgery, too, will financially benefit the physician, who should be providing his services free of charge.

March 20th, 2011, 04:53 PM
Let us know the outcome !!:cane:

March 21st, 2011, 11:30 AM
Have you had a coach really look at your stroke? As a "volunteer" assistant in HS coaching, giving classes and clinics for Masters/triathletes, a former college coach,and swimming myself, I believe it is very important to look at entry of hand(s) on freestyle, as well as closely monitoring the other strokes. Hand, elbow, arm position as well as lack of body roll can aggravate shoulder problems, especially if the if there are variances in anatomical "groove" of the rotator cuff. Moderate strength training to develop muscular strength of all the muscles needed in the pull, including deltoids and lats and traps, as well as the smaller muscles involved, can help take the strain off the shoulders, when those muscles are strong. Changing entry positions and/or pull patterns, and strength training have had enormous effects, a LARGE DROP, in shoulder problems/injuries with most of my swimmers, including myself; particularly with females who might not have developed the muscular strength in that area, naturally (less testorone), that males have. Hope that helps! JP

April 3rd, 2011, 12:21 PM
Thanks again everyone!

Update: I am now 3 weeks out from when I really hurt myself. I've been doing literally nothing (stopped PT because it kept making them more painful), and while I still have mild discomfort in both shoulders with certain motions, they are MUCH less inflamed and painful. My sister-in-law is an orthopedic surgeon and although shoulders are not her expertise, she showed me just how much laxity I have in both shoulders, which I have been feeling on my own and is something completely new for me.

cheakamus and gull, I am actually going to wait on the MRI's. I am insured but unfortunately my insurance only covers part of it, and because I am finishing school but don't have a job yet, I am financially limited right now. Don't get me started on health insurance - I feel so badly for doctors & their patients. I am about to be a veterinarian and I feel so incredibly lucky that we don't have the insurance issues human physicians do. I sincerely hope it stays that way.

Anyway, I plan to restart PT today, and do 3 more weeks of just rest and PT. I'll just do what the therapist has told me so far and maybe slowly add in strength training and gradually start swimming again, if I continue to improve. The hardest thing for me is patience and taking it slow, but I'm doing my best.

JPSWMCCH, we actually have a coach who gives us technique instruction at my masters club, and he's pointed out that I cross over midline a lot on entry. I've been working on that (prior to not being able to swim). I think by far the biggest issue is that I have ALWAYS lifted and done strength training and was very strong up until about 2 years ago. I dropped lifting, and I stopped doing core strengthening, and I think the weakened muscles around my shoulders, combined with core weakness placing more stress on my shoulders, has finally caught up to me. I've learned an important lesson - once I get through this, I will strength train for life!

April 8th, 2011, 07:03 PM
Sorry to bump this thread again, but thought it was better than posting another...

Does anyone have any clever workout ideas for the land-bound swimmer? What have those of you who have had shoulder problems done while resting them? I can't really bike right now because it hurts, and I have been running as much as I can (about 4 miles, 3 days a week), but I have patellofemoral pain syndrome as well (long-standing knee pain I've had since a teenager, which generally won't bother me unless I run or hike too much uphill/downhill).

I've also started lifting legs-only, but from there on out.... I have no idea what to do :(

Any fun ideas would be wonderful.

April 9th, 2011, 08:12 AM
I swam right through a bad shoulder injury. They call it kicking. I had plenty of time to work on my whip kick, and my dolphin, as well as the flutter kick. I do admit I didn't make three practices per week. and I often got out early. I found that the bad arm could be floated up into streamline even though I couldn't make it move on my own. I did rotation drills and rode over my arms till I got my strength back. It too six months before I could fully use my arm and I'm still strengthening it.
The key is to pay attention to the pain. Is it a muscle soreness that can be pushed a bit? Or is it a joint pain that needs to rest?
Good luck with the shoulder.
PS I had a wonderful Chiropractor who worked on the spasmed muscles and helped the healing.

April 10th, 2011, 02:22 PM
I've been kicking, too... I'm losing patience. Been going 5 days a week, but have reduced it to 3 and now think I might take a break altogether because not being able to swim with everyone else is really upsetting me. Did you do sets with everyone when you kicked? I had been doing fins/no fins/some snorkel kick, etc. Every time I think I'm feeling a bit better, I try and streamline or just swim a tiny bit, no more than 1,000 m, and it flares up immediately again. So I guess that's my body telling me it needs rest (and it's def joint pain, not muscle soreness).

Thus... I'm looking for other things to do.

April 10th, 2011, 02:23 PM
6 mos! what did you do to your shoulder, btw? I barely have patience for 3 weeks of rest, this is a whole new ball game.

April 10th, 2011, 03:06 PM
I don't know if you would consider this, Water-For-Life, but if it were me, I would invest in an Aqua Jogger and do suspended running training in the pool. That way you could stay in shape, while resting the knees and the shoulder. I injured my shoulder in 2009 and it took 3 months to rehabilitate and 8 months before I swam fast again. Physical therapy, ice and rest worked very well and I swam, but much easier and less frequently as it healed. I also ditched paddles and webbed gloves...