Shoulders

DIAGNOSIS:

Typically, shoulder pain resulting from climbing is the result of either an injury to the rotator cuff or the biceps tendon where it attaches near the shoulder. The first step in treating shoulder problems is to determine if the pain is a result of biceps or rotator cuff tendonitis. To attempt to make this determination, read the descriptions below. For a true diagnosis, see an orthopedic surgeon or physical therapist. The shoulder is similar to a golf ball on a golf tee. The ball is the humerus of the shoulder and the tee is the glenoid (on the scapula). The rotator cuff muscles keep the golf ball at a short distance away from the tee. If the rotator cuff muscles are weak then the ball and tee rub together and pain follows. Overhead activities (like climbing) naturally shorten the distance from the humerus and Glenoid Cavity thus making the rubbing more likely. In summary…keep the cuff strong.

Rotator Cuff Tear – If you are unable to lift your arm above shoulder height and have pain while attempting this motion, you may have torn your rotator cuff.

Treatment: Oh boy! This is not a good one to have. You better go see your doctor immediately if you ever want to climb again. Often requires surgery followed by physical therapy

Shoulder tendonitis eccentric exercises:

Do the “Full Can” exercise as seen in the video but use the opposite hand to lift the weight up and then use only the injured arm to lower the weight.  Repeat 12-15 times, rest and do 1-2 more sets.  

NOTE:  USE the uninvolved arm to help the injured arm to lift the cable, then lower with only the injured arm.  Use the lowest weight on the machine.  Repeat 12-15 times, rest and do 1-2 more sets.  (You can do the exercise standing instead of kneeling).

 

Rotator Cuff Strain - If you have pain while moving your arm above shoulder height in front and/or to the side of the body, especially after a particularly traumatic event (hitting a dyno, followed by immediate pain or just pulling down too hard followed by immediate pain), you may have strained your rotator cuff muscles

Treatment: You need to rest. 3 weeks minimum for a mild strain. If it’s really bad, you’d better take 5-6 weeks off. You need to ice it 3x/day, 10 min. each time for 7-10 days. You should also consider taking some anti-inflammatories during this time period (2-3 days). If it doesn’t hurt when you are not doing anything then you can start a light weight training program to strengthen these muscles We posted a shoulder routine for the prevention and treatment of shoulder injuries. Check them out at www.urbanclimbermag.tv. If these exercises do not cause you pain, then try climbing lightly. If you have any pain, ice and take anti-inflammatories afterwards. Take another week off and continue the exercises (without pain). You need to be the judge about how bad the pain is and if you should be climbing, but try to be honest with yourself if you want to continue to climb for many more years. Whenever you have pain, it is usually caused by inflammation, which you can get rid of by icing and taking anti-inflammatories

Rotator Cuff Tendonitis – If you have dull pain with activity (rock climbing) that may get better as you climb, but always seems to come back, may feel “stiff” in the morning, may be worse in the evening if activity is done that day, you probably have the dreaded rotator cuff tendonitis

Treatment – Check out the video in the Exercises Section. Also, ice and anti-inflammatories are good post-activity treatment. Tendonitis is difficult to get rid of. If you do not see improvement after resting and trying these exercises, then I strongly recommend seeing a physical therapist. You may have different weaknesses that need to be addressed or a different problem entirely. Also, if you have some improvement, but still some pain, continue to do the exercises and make sure to decrease the inflammation after activity.The treatment for rotator and biceps tendonitis is basically the same. Strengthen the muscles that hold the shoulder together.

Bicep Tendonitis

Diagnosis - If you have dull pain with activity (rock climbing) that may get better as you climb, but always seems to come back, may feel “stiff” in the morning, may be worse in the evening if activity is done that day, and is slightly lower and in the front part of the shoulder you may have biceps tendonitis.

Treatment – Check out the video in the Exercises Section. Also, ice and anti-inflammatories are good post-activity treatment. Tendonitis is difficult to get rid of. If you do not see improvement after resting and trying these exercises, then I strongly recommend seeing a physical therapist. You may have different weaknesses that need to be addressed or a different problem entirely. Also, if you have some improvement, but still some pain, continue to do the exercises and make sure to decrease the inflammation after activity. The treatment for rotator and biceps tendonitis is basically the same. Strengthen the muscles that hold the shoulder together.

SLAP Lesion

Additionally shoulder pain can be caused by initial or recurrent dislocation, in which case you must seek medical help. Also, if you have very deep shoulder pain with sensations of “catching” when moving your arm, you may have a SLAP lesion (aka labral tear), in which case you also must seek medical attention.

Comments

  • Crystal Pritchett says:

    Thank you for this article! I’m researching in hopes of learning ways to heal a shoulder injury without surgery. X-rays reveal that I have a shoulder spur. That combined with weak shoulder muscles causes a lot of pain when I reach straight up. I’ve been exercising in hopes to increase the space between the bone and the nerve and I’m now pain-free if I don’t reach back too far or suddenly. The problem is that I can’t climb. Is surgery (shaving of the spur) my only option? Or should I continue to try to strengthen? I don’t want to miss out on summer climbing; I want to have the surgery asap if that’s what’s needed. I have to admit that, as a full-time teacher and a mom, I’m only working out twice a week.

    • kylerose says:

      Surgery should be your last choice. It’s invasive and could have complications. Conservative treatment should absolutely be your first try. I highly recommend that you give a 6-8 weeks of rotator cuff and general strength training before going under the knife.

  • Renae says:

    I tore my rotator cuff playing softball approx. 3 years ago and it still causes trouble from time to time. I have had to stick mainly to technical climbing because I’m not able to physically pull myself up using that arm. I can’t do either chin ups or pull ups without feeling like its going to pull apart. I’ve been in physical therapy but now I’m at the next step of returning to “normal activities”. I’m desperately avoiding any surgery. Are there any specific exercises/sports you would recommend to help me strengthen it?

  • anon says:

    “BLAH” in the first paragraph should be “Glenoid Cavity” or “Glenoid Fossa”.

  • David says:

    Hi, where is the exercise section that you speak of in the ‘bicep tendonitis’ section?

    Thanks!!!

    David

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