Keys to Managing Your Shoulder Pain

Shoulder pain is a game changer. A painful shoulder can quickly limit the activity level for athletes and non-athletes alike.

The shoulder joint is the most mobile joint in your entire body.  With that being said, eliminating the pain in such loose joint is no easy task.

7 Sports Medicine Tips to Manage Your Shoulder Pain.

Pendulum Swings – With the hand of the pain-free shoulder resting on a chair and a 10-15 lbs weight in the other hand, slowly move the weighted hand in a slow circular motion.  This will distract and relax the muscles surrounding the painful shoulder joint. Swing the hand/arm like a pendulum in both clockwise and counter-clockwise directions.

Pliable Chest Muscles – Longer and more flexible chest muscles are vital for a happy pain-free shoulder. Start by aggressively massaging the deep chest muscles with fingers or a baseball (warning; it hurts but it works). Next, stretching the superficial chest muscles in a door frame is a simply way lengthen your broad, strong chest muscles.  By doing so, the more flexible chest muscles will now allow for greater mobility of three (3) bones which make up your shoulder girdle (upper arm bone, shoulder blade & collar bone).

Strong Shoulder Blade Stabilizers – You have 17 muscles anchored to each of your shoulder blades.  Keeping your upper back strong helps protect the shoulder joints by controlling the intricate motions of the shoulder blade.  To do so, seated rows, bent-over flies, cable “T’s” and good ol’ scapula squeezes need to be part of your shoulder plan.

Enduring External Rotators – Of the four (4) muscles forming your rotator cuff, the two external rotators are the most important when it comes to prevent shoulder injury.  The key factor with shoulder external rotators is not just strength. Hence, having great endurance of the external rotators should be your goal.  Doing high repetitions (>15 reps) using cable weights or simple exercise bands will help accomplish this.

Overhead Stretches – Add low-intensity pain-free overhead stretches to your routine. Examples include 25-50% body weight hangs from a pull-up bar/door frame or bend-over stretches with hands on a high counter.

Limited Overhead Strengthening – Anytime you perform strength work above your shoulder level, you’re increasing the stress on your rotator cuff. You can sufficiently strengthen all your shoulder, back and chest muscles without ever elevating your elbows above your shoulder.

Strong Posture – Daily tasks like driving, working on a computer and carrying objects all contribute to poor posture and shoulder pain.

Strong posture = Shoulder blades “back and down” + chin over ribs

The Quest for Happy Shoulders

Most of the painful shoulder joints I treat have key problems related to their shoulder girdle. These 7 sports medicine tips will help you protect two very important joints.

Remember this simple formula: Happy shoulders have mobile shoulder girdles, great endurance of their external rotators and strong upper back muscles.

Jimmy Graham’s Shoulder Injury Plan

Graham Jimmy716As New Orleans Saints tight end Jimmy Graham prepares for Sunday’s 2015 NFL Pro Bowl, he’s still dealing with an injured right shoulder.  As with many players suiting up for the annual event, most of them have injuries, aches and pains from the long NFL season which started playing games 25 weeks ago.  Pain and professional football are common bedfellows.

Graham nor the Saints have not completely divulged the exact details of his season-long shoulder injury.  He wore a shoulder harness, which stabilizes his shoulder joint by limiting his range of motion, the entire season.  He did not miss a game all season for the second year in a row.

I like Jimmy Graham’s plan for his shoulder by using the Pro Bowl as a test to determine if he needs surgery.  “Damn, isn’t a 16 game season a long enough test?” you might ask.

No and let me explain why.

A Look Behind the NFL Medical Curtain

During a long NFL season, a tight end with an injured shoulder has no time to truly rest his shoulder.  Meanwhile he never has ample time to regain the strength in his rotator cuff.  Both reducing the swelling in the injured shoulder AND increasing the muscular stability of that shoulder are clearly the two most important rehab needs for Jimmy Graham’s shoulder.

During the season, I’m sure the Saints’ athletic training staff were busy just maintaining Jimmy’s range of motion and controlling his pain.  But now that Graham has had a solid four weeks to both reducing his shoulder swelling and increasing the shoulder muscle strength, he’s ready to realistically test his shoulder.

Surgery or No Surgery?

Based on his position, the shoulder harness, the manner in which he used his right arm during the season and his comments, it’s very likely Graham has some type of shoulder labral injury.  It’s been my experience during my 26 years in the NFL that most teams have multiple labral injuries every year.  Most of these labral tears do not need surgery unless joint instability or joint “catching” directly limits the player’s ability to do his job.  If the instability or the “catching” are significant, the player’s surgery is scheduled in days not months.

When a player ends his season with an injured shoulder and stops banging on it, his shoulder quickly feels better.  The difficult decision for the player/team is: Even though a rested shoulder with a labral tear will certainly feel better, will the limitations and symptoms return in Mini Camp when he starts hitting again?

I’ve had 30+ discussions exactly like this with players in the last 20 years.  I can tell you that it’s rarely a crystal-clear decision.  The player wants to be healthy and he trusts his ability to heal.  Meanwhile, he obviously wants to avoid shoulder surgery with 3-6 months of rehab if possible.

What Jimmy Graham is doing by rehabbing for a month and then taking advantage of a rare opportunity to truly test his injured shoulder 4-5 month before his spring Mini Camp is brilliant!

The Question

The question for Graham’s injured right shoulder:  Is rehab enough or does he need surgery to truly correct the problem(s)?

After Sunday’s Rehab Bowl, Jimmy and the Saints’ medical staff will have their answer.

 

How to Shorten Your Shoulder Scope Recovery Time!

Shoulder - AC sprain 281Today is a true day of “role reversal” for me.  Instead of being the physical therapist, I’ll be the patient rolling into the operating room for surgery to fix a chronic shoulder injury by Jacksonville Jaguars Head Team Physician Dr Kevin Kaplan at Jacksonville Orthopaedic Institute.

I have to admit, consulting others about a shoulder scope is much more fun than being the one starving yourself after midnight and wearing the paper-thin johnnie!  I’ve had my share of surgeries.  I find them all to be great opportunities for me to learn better ways to help athletes recover quicker when they have to “go under the knife”.

The AC Joint Injury

I’ve had a chronic grade 3 acromioclavicular (AC) joint sprain for many years that needs to be fixed.  How did I get it?  Here comes the entertaining part of the blog post.  I crashed hard on my mountain bike doing a downhill slalom race at Mt Snow in Vermont……in March….in blizzard conditions!  No, it truly wasn’t my smartest day, but it sure was a fun event until I slammed on the ice with my shoulder.  As a fan of extreme sports I might not be any smarter today than I was back then but I’ve learned how to crash more gracefully.

Here’s my game plan for a successful shoulder surgery:

Loosen Up the Good Stuff

I started doing extra shoulder, upper back, neck, rotator cuff and chest stretching during the past week.  Those ligaments, joints, muscles, fascia and tendons are the very things that will dictate my shoulder function after the surgery.  Therefore, I want those structures to be limber, strong and relaxed going into the operation.

Get Rid of the Bad Stuff

Inflammation and edema are bad so my shoulder filed a Restraining Order against them just last week.  Meanwhile, I’ve focussed on icing, controlled exercises and massage as key steps to start the recovery process from my  surgery before I even get to the hospital.

Hydrate the Right Way

Healing tissue needs to be happy tissue.  Approximately 60% of the human body is water.  Staying well hydrated starting three days before the surgery will make the doctor’s job easier and my recovery faster.  I take my hydration serious in any type of weather so when it comes to recovering from surgery, water is my best friend.

Tune Up My Rotator Cuff

Resisted rotator cuff exercises such as external rotation, forward flexion and side raises will continue to be done 3 times per day right up to 2 hours before the surgery.  I want “my cuff” to be as active and as strong as possible before Dr Kevin Kaplan sticks that scalpel into my arm.

Listen to Your Commanders

The surgeon and his staff are your commanding officers so listen to them closely.  They know best so read their memos and listen to their tips.  They will ultimately play a huge role in your outcome so be a great patient before, during and after your surgery.  Post-surgery rehabilitation is priceless.

Plan the Recovery

I have my ice, bottled water, pillows, books and, most importantly, my beautiful wife ready before I leave the house today.  Limping in the door with my arm in a sling is not the time to be setting up my recovery zone.

Think & Be Positive

Healing and recovery starts between the ears.  Positive thoughts and self-talk about my shoulder is dominating my mind today and will continue for the next four weeks.  Those healthy images involve much more than just my body and mind.  They include a strong sense of gratitude for Dr. Kaplan and his highly skilled staff involved with my care.

In Closing……

I view my involvement with today’s surgery as an active process, not a passive event left to the skills of others.  I’ve prepared my body, mind and home to both maximize the benefits of the surgery and accelerating my body’s recovery from the trauma of the operation.

I have way too many exciting things I want to do this off-season with this better-than-new shoulder and just laying around isn’t one of them!