Infraspinous M.? Shoulder pain...inflammation?

  • Posted by a hidden member.
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    Feb 12, 2008 8:52 PM GMT
    I had something happen to my shoulder around Dec. I can localize the soreness to what feels like my infraspinous muscle (although could be Teres Minor?).

    I have classic rotary cuff symptoms: it hurts when I do lateral raises or military presses.

    I didn't work out for December, tried to work out again mid Jan but it began to hurt if I do chest/shoulder exercises (anything above 25 lb military presses hurt.) I've kept off it only working arms/back/legs and have tried anti-inflammatories...but ultimately to no avail in the long run.

    I attempted to just do light internal/external humerus rotary exercises (doesn't hurt..but doesn't seem to help much either)

    It doesn't hurt normally, and I have no change or pain with general motion.

    Does anyone have any other suggestions/ideas on how I can resolve this? I’m going into my 3rd month of this…and not pleased about it! How long should I be expecting this to be painful?


    Here's me pointing to the spot on my back:

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  • auryn

    Posts: 2061

    Feb 12, 2008 10:41 PM GMT
    Sounds like you might have a micro tear in the muscle near Teres minor (judging from where you're pointing in your pic). If you haven't had it looked at by now, I'd highly recommend that you start with an injury treatment specialist that will help to break up any adhesions around Lats in that area, Infraspinatus, and Teres and assist in the healing.

    If you go the doctor route and get an MRI, you'll likely be told that you have a tear (though you'll also be able to see it) and get anti-inflammatories prescribed to you. I say, just go get some treatment oriented massage for the location, and skip that step until you're told to do otherwise, and quit aggrevating it until you do.

    Homework that I give my clients (depending on the severity) includes switching between cold and hot compresses as long as the pain is dull to non-existent and not new and not sensitive to touch. This will help your body flush the area. Also moderate stretching to the point of pain but no further until a reassessment is done, to make sure that further injury will not occur because of overstretching.

    Hope that helps.

    Oh! and congrats on being the Man of the Day!
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    Feb 13, 2008 4:00 AM GMT
    You might work on improving your posture; I would almost guarantee that your shoulders round forward, though I can't tell from your pictures. As a result, this places the muscles of the rotator cuff in a very precarious position. Over time, performing any overhead activities along with those nasty lateral raises, the area becomes prone to injury. Hopefully you've already discontinued any lateral raises or military presses. In my opinion, only people who have excellent posture and control should perform them. The muscles of the mid back need work (low- to mid-traps, rhomboids, etc.). I'm not sure where you are in NY, but I would search out a biomechanics expert who can help you improve posture and will give you exercises to relieve tension and improve strength. Oftentimes this can be accomplished without surgery or any other invasive procedure. If I can remember tomorrow, I'll go through my list of colleagues to see if I can find one for you.
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    Feb 13, 2008 4:12 AM GMT
    I had a similar problem with my shoulder. I just tried to work around the pain and really get blood the flowing to the area while taking fish oil and that some Glucosamine stuff. The shoulder pain went away in a few weeks after taking the fish oil daily.

    I find if I don't work opposing sides of my shoulders equally that my shoulder gets out of whack. I think it was from some injured ligaments, about 20 years ago, that destabilized the joint. I also think I have subconsciously learned to stabilize the joint using the muscles in the area over the years. I always do better in my shoulders if I do lots of light weight warm up to get them pumped up with slow movements, before doing anything intense.

    The pain I have had under the scapula usually goes away within a few days.

    I found this link describing the shoulder joint with pictures ..

    http://www.med.mun.ca/anatomyts/msk/shoulder.htm

    I like auryn's suggestions of heating/cooling and massage. I need to get a good heating pad. Also I took some prescription strength ibuprofen before and it worked great. But yeah, you can't take that stuff forever.
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    Feb 13, 2008 5:33 AM GMT
    Thanks for the suggestions Auryn, I'll start the hot/cold compresses after my boards this week. And localized massage to the area doesn't sound bad either. I'll also start to do nightly stretches to see if that will help. Thanks for the congrates on man-of-the-day also!

    SDtrainer, I could have rounded shoulders. I've always been told I have great posture, however I'm a dental student so posture is always an issue! My only problem with seeing a specialist is I don't really have the $$$ to do that at this point. That's why I'm attempting to resolve it through other means if I can. Do you think if I just workout my back (traps, rhomboids, etc it'll strengthen up enough?

    ActiveAndFit, I'll go and get some glutamine, I have fish oil that I don't really take but will start to take it regularlly. I admit to not working my shoulders evenly...which I assure you when I'm done with this will be rectified! I'm a little paranoid about taking anti-inflammatories too much because I'm worried it'll feel better then I'll mess it up more accidently...


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    Feb 13, 2008 6:45 AM GMT
    Here's a way you can tell whether you have rounded shoulders. Stand in front of a mirror naturally and spread your fingers wide. If your thumbs do not point toward the mirror (and they are angled inward), then you have rounded shoulders. Another way to tell is to stand with your back against the wall with feet about an inch away from the wall. If the entire back of the shoulder does not make contact with the wall, then you most likely have rounded shoulders.
    Anything that helps you externally rotate the arms will help. One such exercise I use is to stand tall with abs tight, pull the shoulder blades together and then rotate the palms out away from the body (no external resistance is needed). You can perform repetitions or just hold in the contracted position. Low rows with lighter weights may also help. Make sure that you have set your shoulders as close to good posture as possible throughout execution of this exercise. Remember, if you feel any pain at all, discontinue the exercise. Because this is taking place over the internet and I cannot evaluate you in person, I cannot be totally sure of what's happening.
    Also, you mention you're a dental student. I imagine you spend a great deal of time bent over with rounded shoulders. Try to be extra vigilant about your posture as your studies and profession may be contributing to your injury. For the time being, I would discontinue any chest exercises, shoulder presses, etc. Focus on exercises that strengthen the muscles of the rear back and rear shoulders. As Auryn suggested, massage can be helpful to increase blood flow so as to help repair the damaged tissues more quickly. Tools such as a foam roller can be useful, but it would be best for you to get someone to show you how to use it. There are resources on the internet that can provide you with guidance. Feel free to message me if you have more questions or require clarification.
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    Feb 13, 2008 7:26 AM GMT
    Hey NYMan...

    FYI, recheck your posts: ActiveandFit mentioned Glucosamine, however your next post misstates his recommendation, as you wrote Glutamine back at him.

    Both are used as supplements; however, I'd get a medical professional's opinion before committing the cash...perhaps ActiveandFit is a pro (let's ask him).
  • Posted by a hidden member.
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    Feb 13, 2008 8:26 AM GMT
    mickeytopogigio said.perhaps ActiveandFit is a pro (let's ask him).
    Nope. I don't claim to be an expert. I mentioned those things in passing because I just tried stuff that is usually said to be beneficial for joints. I think something helped me out but am not sure which. I suspect the fish oil but not sure.

    There was another forum topic about it, but a Canadian study suggested there was no long term benefit to Glucosamine. You can find tons of those joint supplements at places like Costco. I would just google it if you want to know more .. here are some articles I found. I should say that most articles seem to stress its use for "arthritis" so I am not sure how that applies to other conditions. Fitness sites seem to push them for injuries ..

    http://www.insidesportscenter.com/joint_health/index.html
    http://findarticles.com/p/articles/mi_m0KGB/is_5_3/ai_98607111/pg_1
    http://findarticles.com/p/articles/mi_m0NAH/is_5_33/ai_104079970
    http://www.oilofpisces.com/rheumatoidarthritis.html

    I like trying supplements but like using exercise as a form of rehabilitation the best.
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    Feb 13, 2008 11:37 AM GMT
    I'd like to add two points of caution. As someone who's had a problem in the past with both Infraspinous and Rhomboid pulls/damage.
    First, go to a specialist who is familiar with this, such as a sports medicine Doctor. The back can manifest pain in a displaced manor so you want to make sure that your addressing the right area. (The last time I thought I knew exactly where the pain was, my Dr. proved me wrong and did it in a rather painful though not damaging way.)
    Secondly, I believe that the current therapy is Ice for 24-48 hours (every 4-6 hours) and then heat. The Dr. may also prescribe a short course muscle relaxant to prevent the muscle from contracting and hindering the healing. When in doubt, always go cold. Heat, used incorrectly can actually cause or prolong damage.
    Due to lack of knowledge (and a little arrogance) in the past, put me in a situation where a relatively small injury of this sort lasted 10 weeks and then 4 more weeks of healing time. Now, when it happens, I'm usually back up to speed in a little over two weeks since I decided to do what the Dr. said.
  • auryn

    Posts: 2061

    Feb 14, 2008 7:40 PM GMT
    You're welcome, NYMan! icon_smile.gif

    To be clear about the cold/hot alternating hydrotherapy treatment; start with 2-3min of cold compress then go to 1 min hot. Do this for 20 min at a time and always end on cold. I only recommend using the cold/hot flush combined with stretching to the point of pain or discomfort (and not beyond that) because the information that you have provided makes me believe that you are in a sub-acute injury stage and that you don't need to use ice or cold only.

    When you see a massage therapist for the spot treatment, he or she should not have to massage the area for more than 30 min at a time (10 - 15 min really) any thing else could result in either over work or fluff, and he or she will be better able to assess your needs for hydrotherapy home care and recommend if you should seek other care.