Panic: shoulder injury

Mar 1, 18 1:43

Post #1 of 27 (2840 views)

Hi,

I am starting to panic. Having an IM70.3 in end of May, I am now on my 3rd week off training due to a shoulder injury.
I was swimming 3 weeks ago and did a long drill with paddles 2x400m. Then I did a set of 20 x 100m normal swim. No problems... next day I started feeling burn on my shoulder. Couldn't run, couldn't swim. I rest for a couple of days and try biking but couldn't do that do as after 10 minutes of applying weight on the should it started annoying me. The pain is not sharp but it's there...

So, after a 4 days I managed a sports doctors appt, who told me it's a biceps tendon inflammation and that I should have 14 days off training with 1.2g of ibuprofen per day (2 x 600mg) until next Monday (march 5) at which point I am going to see him.

At this point I am panicking. On the one hand my fitness has seen a sharp decline already but I need to restart training and have no idea what to do. Any suggestions or experiences on how to get better faster? Problem is I don't feel pain with ibuprofen so the other day thinking I must be better I stopped it for 24 hours, got on the turbo and 10 minutes later the pain was still there. Got off the turbo and restarted ibuprofen. So, not sure how much effect it is having. It's hiding the pain but it seems to still be there. I keep thinking that it's a muscle tear and I should be doing something else. I did bring that possibility to the doctor but he assured me it was tendon, not muscle that was the problem.

Any comforting words while I tear my hair out? What actually drives me crazy is the lost fitness over these weeks. Non-stop training from October onwards, non-stop through Christmas and now this... :(

Paulo Matos

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 2:04

Post #2 of 27 (2826 views)

Sorry you are having troubles! Anyways if you have been training well so far over the last months, I guess that 2-3 weeks being out and then starting again leaves you sufficient time until end May.

How exactly do you bike? Sounds like you have a Tri-Bike on a fixed trainer? Maybe you can try a normal roadbike instead. The pro cyclist train on a fixed trainer with an upright body position when they are injured on the upper body parts, and arrest the injured body part (arrest the arm when the collar bone is broken, put a table above the handlebar and rest the hand there if a finger is broken etc). I am sure you can make something work that you can use you legs for light cycling and you don't stress your biceps. Just so you keep moving a little, especially for you head when you are close to tear your hair out =)

Also, what kind of paddles do you use? Are you overusing enormous huge paddles, possibly without proper strength training? A well known path to inflammations and injury. For triathletes who are swimming less than 10km/week, I guess smart use of small finger paddles in small doses is the way to go (injury free)

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 2:09

Post #3 of 27 (2825 views)

You might actually find that this block of rest is beneficial. I have had 3-6 week down times due to injury and have come back quickly and stronger. The trick will be doing a gradual re-start so you don't re-injure yourself.

Maybe try just sitting upright on the trainer and spinning easily for 30 minutes and try aqua jogging with a kick board to steady your arms. Maybe do some leg weights in the gym on machines. This will keep you from going nuts until you can get back.

Re: Panic: shoulder injury [Ben6] [ In reply to ]

Mar 1, 18 2:18

Post #4 of 27 (2823 views)

Ben6 wrote:

Sorry you are having troubles! Anyways if you have been training well so far over the last months, I guess that 2-3 weeks being out and then starting again leaves you sufficient time until end May.

How exactly do you bike? Sounds like you have a Tri-Bike on a fixed trainer? Maybe you can try a normal roadbike instead. The pro cyclist train on a fixed trainer with an upright body position when they are injured on the upper body parts, and arrest the injured body part (arrest the arm when the collar bone is broken, put a table above the handlebar and rest the hand there if a finger is broken etc). I am sure you can make something work that you can use you legs for light cycling and you don't stress your biceps. Just so you keep moving a little, especially for you head when you are close to tear your hair out =)

Also, what kind of paddles do you use? Are you overusing enormous huge paddles, possibly without proper strength training? A well known path to inflammations and injury. For triathletes who are swimming less than 10km/week, I guess smart use of small finger paddles in small doses is the way to go (injury free)

That's right. I have been doing it on my tribike, but the idea of cycling upright on the road bike is great. I will try that. Maybe I can also get an arm sling just to make sure I don't move the arm too much.

Yes, I shouldn't have used the paddles. I screwed up there. I have not been swimming enough and thought the paddles would speed up some strengthening of the swim muscles. Turns out I screwed up. Go figure!
But anyway, lets forget about that. Will try light cycling on the road bike with an arm sling.

Paulo Matos

Re: Panic: shoulder injury [grumpier.mike] [ In reply to ]

Mar 1, 18 2:18

Post #5 of 27 (2821 views)

grumpier.mike wrote:

You might actually find that this block of rest is beneficial. I have had 3-6 week down times due to injury and have come back quickly and stronger. The trick will be doing a gradual re-start so you don't re-injure yourself.

Maybe try just sitting upright on the trainer and spinning easily for 30 minutes and try aqua jogging with a kick board to steady your arms. Maybe do some leg weights in the gym on machines. This will keep you from going nuts until you can get back.

Yes, as I mentioned to Ben I am going the route of light cycling on an upright position.

Paulo Matos

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 2:49

Post #6 of 27 (2803 views)

Hey there,

First off, best of luck to your recovery!

I broke my collarbone now 6 weeks ago. But I was riding (collarbone style road bike handlebars flipped) after 2 days, and now, 5 weeks after surgery, already back to "higher" fitness than before I broke it. Sure according to your graphs/TrainingPeaks/etc it'll say you might not have as much fitness, but take that with a grain of salt. As others have said, the rest can be good if you had been training well.

Advice is to stay consistent, do what you can with the pain, and don't panic. The race is a long way away, and fitness is fitness. As well as reach out to good coaches who have the experience to handle it ;)

Cheers!

Carson Christen
Sport Scientist , Coach
Torden Multisport

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 8:50

Post #7 of 27 (2720 views)

I feel your pain - literally. There are alot of thing that are going on in the shoulder.

I've had problems with my left shoulder, and after an MRI it was shown that I had re-torn my supraspinatus muscle (part of the rotator cuff.)

The first thing my primary Doc wanted to do was 'give you and injection.'

I was not to keen on that Idea, so I went my Sports Med Chiro, who has been putting me back together for about 20 years.

His recommendation was to go through a course of PEMF treatments and then a K Laser treatment. So for 3x / week for 4 weeks I have been on this treatment.

I can tell you that it has helped, the pain that I had (like an ice pick into my shoulder) is almost totally gone through 100% of the movement of the shoulder.

It might sound like voodoo, but it has helped !

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 9:34

Post #8 of 27 (2708 views)

I will echo what others have said here, the short rest will likely be good for you. Like you, Ibuprofen tends to block pain really well for me. Since the doc has put you on a therapeutic dose for now, I would focus on the bike and run. When you start back in the water, I would forget the paddles as these things can put a lot of stress on the shoulders. You probably already have good form and only need to focus on endurance fitness so they likely are not beneficial. Also, don't take more than 400mg of Ibuprofen when you get back in the water. Of course I'm no expert so take it with the usual grain of salt.

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 11:03

Post #9 of 27 (2680 views)

I had issues like this last year, and still some minor amount of it this year. My problem was inflammation of the tendon, but in my case it was due to popping the upper part out of the grove it sits in, due to changing my swim stoke to match what a guy was telling me, then even after it was starting to tire, I kept at it and probably made matters worse. It caused so much stress it just slipped out of place. It had to be put back in a number of times, but I think it has gotten to the point of being stable finally. Just some light burning/weakness once in awhile now.

Hope it gets better for you.

Last edited by: tyme: Mar 1, 18 11:03

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 12:07

Post #10 of 27 (2663 views)

As my old hockey coach used to ask: "Are you hurt, or are you injured?"

Inflammation sounds like you're just hurt. HTFU

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 17:46

Post #11 of 27 (2608 views)

pmatos wrote:

Hi,

I am starting to panic. Having an IM70.3 in end of May, I am now on my 3rd week off training due to a shoulder injury.
I was swimming 3 weeks ago and did a long drill with paddles 2x400m. Then I did a set of 20 x 100m normal swim. No problems... next day I started feeling burn on my shoulder. Couldn't run, couldn't swim. I rest for a couple of days and try biking but couldn't do that do as after 10 minutes of applying weight on the should it started annoying me. The pain is not sharp but it's there...

So, after a 4 days I managed a sports doctors appt, who told me it's a biceps tendon inflammation and that I should have 14 days off training with 1.2g of ibuprofen per day (2 x 600mg) until next Monday (march 5) at which point I am going to see him.

At this point I am panicking. On the one hand my fitness has seen a sharp decline already but I need to restart training and have no idea what to do. Any suggestions or experiences on how to get better faster? Problem is I don't feel pain with ibuprofen so the other day thinking I must be better I stopped it for 24 hours, got on the turbo and 10 minutes later the pain was still there. Got off the turbo and restarted ibuprofen. So, not sure how much effect it is having. It's hiding the pain but it seems to still be there. I keep thinking that it's a muscle tear and I should be doing something else. I did bring that possibility to the doctor but he assured me it was tendon, not muscle that was the problem.

Any comforting words while I tear my hair out? What actually drives me crazy is the lost fitness over these weeks. Non-stop training from October onwards, non-stop through Christmas and now this... :(

So you can't swim and can't bike? What about running? It must be a pretty serious injury if you can't do all three. Yet the pain subsides with ibuprofen? I've had bicep tendonitis and rotator cuff tendonitis from swimming, but it didn't stop me cycling or running and I thought it was quite bad.

Last edited by: zedzded: Mar 1, 18 17:52

Re: Panic: shoulder injury [Dbeitel] [ In reply to ]

Mar 1, 18 23:30

Post #12 of 27 (2560 views)

Dbeitel wrote:

I feel your pain - literally. There are alot of thing that are going on in the shoulder.

I've had problems with my left shoulder, and after an MRI it was shown that I had re-torn my supraspinatus muscle (part of the rotator cuff.)

The first thing my primary Doc wanted to do was 'give you and injection.'

I was not to keen on that Idea, so I went my Sports Med Chiro, who has been putting me back together for about 20 years.

His recommendation was to go through a course of PEMF treatments and then a K Laser treatment. So for 3x / week for 4 weeks I have been on this treatment.

I can tell you that it has helped, the pain that I had (like an ice pick into my shoulder) is almost totally gone through 100% of the movement of the shoulder.

It might sound like voodoo, but it has helped !

Interesting, my doctor told me if the ibuprofen doesn't work until Monday (5th) and I still have pain, I should get an injection. I searched online and it seems to be a cortisone injection. Heard good and bad things about it. Not sure what to do if it comes to that. It seems you chose against it, but at least you have an alternative. I will probably need to look at someone else for a different treatment.

Paulo Matos

Re: Panic: shoulder injury [NealH] [ In reply to ]

Mar 1, 18 23:32

Post #13 of 27 (2559 views)

NealH wrote:

I will echo what others have said here, the short rest will likely be good for you. Like you, Ibuprofen tends to block pain really well for me. Since the doc has put you on a therapeutic dose for now, I would focus on the bike and run. When you start back in the water, I would forget the paddles as these things can put a lot of stress on the shoulders. You probably already have good form and only need to focus on endurance fitness so they likely are not beneficial. Also, don't take more than 400mg of Ibuprofen when you get back in the water. Of course I'm no expert so take it with the usual grain of salt.

Unfortunately I really can't run. Running, with the forwards and backwards movements of the arm kills my shoulder. I have not tried it while on ibuprofen but that's why I am wary of painkillers. Pain is there for a reason, I fear that if I go out for a run and feel no pain, I will still be seriously damaging my tendon all over again even if I don't feel it.

Paulo Matos

Re: Panic: shoulder injury [Culley22] [ In reply to ]

Mar 1, 18 23:34

Post #14 of 27 (2557 views)

Culley22 wrote:

As my old hockey coach used to ask: "Are you hurt, or are you injured?"

Inflammation sounds like you're just hurt. HTFU

Does it matter given it doesn't allow me to train?

HTFU?

Paulo Matos

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 1, 18 23:43

Post #15 of 27 (2553 views)

pmatos wrote:

Dbeitel wrote:

I feel your pain - literally. There are alot of thing that are going on in the shoulder.

I've had problems with my left shoulder, and after an MRI it was shown that I had re-torn my supraspinatus muscle (part of the rotator cuff.)

The first thing my primary Doc wanted to do was 'give you and injection.'

I was not to keen on that Idea, so I went my Sports Med Chiro, who has been putting me back together for about 20 years.

His recommendation was to go through a course of PEMF treatments and then a K Laser treatment. So for 3x / week for 4 weeks I have been on this treatment.

I can tell you that it has helped, the pain that I had (like an ice pick into my shoulder) is almost totally gone through 100% of the movement of the shoulder.

It might sound like voodoo, but it has helped !

Interesting, my doctor told me if the ibuprofen doesn't work until Monday (5th) and I still have pain, I should get an injection. I searched online and it seems to be a cortisone injection. Heard good and bad things about it. Not sure what to do if it comes to that. It seems you chose against it, but at least you have an alternative. I will probably need to look at someone else for a different treatment.

I had cortisone in my shoulder twice. The first time it flared up after a 10km OWS in Jan. In Feb I got the injection because I had a big 70.3 in May. It took 2 weeks for the cortisone to fully work, the pain was pretty much gone and stayed that way for 6 months when it flared up again. I rested it, then it came back and I eventually got another injection, this one was much less effective. So I gave up on the steroid injections and just learned to manage the injury. I went to a number of physiotherapists, but didn't get the injury fixed. I ended up "fixing" it using youtube and google and figuring out it was largely a technique issue.

I wouldn't say "no" to getting a cortisone injection, but ultimately there is some issue that caused the injury and when the cortisone wears off the likelihood is that the issue will still remain and the injury will reoccur. I would say in your situation, considering how it is effecting your training, get one, make sure it's ultrasound guided and get it ASAP. Also if it's swimming that caused your issue, modify your swimming. I can help you with that.

Re: Panic: shoulder injury [zedzded] [ In reply to ]

Mar 2, 18 0:41

Post #16 of 27 (2542 views)

I recently had shoulder problems during swimming - look up impingement syndrome. My PT (& Google) pointed me at rotator cuff exercises and it's worked. I'm back in the water.

Re: Panic: shoulder injury [RCCo] [ In reply to ]

Mar 2, 18 2:31

Post #17 of 27 (2519 views)

RCCo wrote:

I recently had shoulder problems during swimming - look up impingement syndrome. My PT (& Google) pointed me at rotator cuff exercises and it's worked. I'm back in the water.

They didn't work for me and actually seemed to make it worse.

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 3, 18 0:57

Post #18 of 27 (2418 views)

This thread is a good example of why I almost never reply with actual advice to this kind of query.
Mostly uninformed and uneducated n=1, pseudo-cientific woo, all the way to downright dangerous advice being given as if we're talking about someone having an extra slice of PBJ sandwich.

Re: Panic: shoulder injury [Thorax] [ In reply to ]

Mar 3, 18 1:39

Post #19 of 27 (2414 views)

Thorax wrote:

This thread is a good example of why I almost never reply with actual advice to this kind of query.
Mostly uninformed and uneducated n=1, pseudo-cientific woo, all the way to downright dangerous advice being given as if we're talking about someone having an extra slice of PBJ sandwich.

I understand what you mean, on the other hand as long as the OP (myself) knows how to deal with the suggestions, it sounds like it could benefit me by knowing what others tried and their results.

Paulo Matos

Re: Panic: shoulder injury [zedzded] [ In reply to ]

Mar 3, 18 1:43

Post #20 of 27 (2413 views)

zedzded wrote:

pmatos wrote:

Hi,

I am starting to panic. Having an IM70.3 in end of May, I am now on my 3rd week off training due to a shoulder injury.
I was swimming 3 weeks ago and did a long drill with paddles 2x400m. Then I did a set of 20 x 100m normal swim. No problems... next day I started feeling burn on my shoulder. Couldn't run, couldn't swim. I rest for a couple of days and try biking but couldn't do that do as after 10 minutes of applying weight on the should it started annoying me. The pain is not sharp but it's there...

So, after a 4 days I managed a sports doctors appt, who told me it's a biceps tendon inflammation and that I should have 14 days off training with 1.2g of ibuprofen per day (2 x 600mg) until next Monday (march 5) at which point I am going to see him.

At this point I am panicking. On the one hand my fitness has seen a sharp decline already but I need to restart training and have no idea what to do. Any suggestions or experiences on how to get better faster? Problem is I don't feel pain with ibuprofen so the other day thinking I must be better I stopped it for 24 hours, got on the turbo and 10 minutes later the pain was still there. Got off the turbo and restarted ibuprofen. So, not sure how much effect it is having. It's hiding the pain but it seems to still be there. I keep thinking that it's a muscle tear and I should be doing something else. I did bring that possibility to the doctor but he assured me it was tendon, not muscle that was the problem.

Any comforting words while I tear my hair out? What actually drives me crazy is the lost fitness over these weeks. Non-stop training from October onwards, non-stop through Christmas and now this... :(

So you can't swim and can't bike? What about running? It must be a pretty serious injury if you can't do all three. Yet the pain subsides with ibuprofen? I've had bicep tendonitis and rotator cuff tendonitis from swimming, but it didn't stop me cycling or running and I thought it was quite bad.

I can't swim, bike or run... although I can bike upright. However, running will cause me a hell of a burning sensation after 10mins and will swimming. Biking will take longer to cause burn if i am on the tribike but it's still not good.

I am starting to wonder if it's really a tendon inflammation or if it is possible that's some kind of wierd knotting. Maybe it was not caused by swimming at all, maybe I slept in a strange position?

I say this because, I just noticed the weirdest thing... if I look straight up by pulling my head backwards as far as I can, I feel a painful pull on my right arm. Not the biceps but something close to it... maybe the tendon. Will discuss this with my doctor on Monday.

Paulo Matos

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 3, 18 2:48

Post #21 of 27 (2409 views)

pmatos wrote:

I am starting to wonder if it's really a tendon inflammation or if it is possible that's some kind of wierd knotting.

Did your doc have you do an ultrasound? CT? MRI? My guess is none of the above. Another guess? That's what he'll tell you to do next since conservative approach did not work.
I could keep guessing, but you're 48h away from talking to the only person whom you should listen to.

Re: Panic: shoulder injury [Thorax] [ In reply to ]

Mar 3, 18 3:23

Post #22 of 27 (2399 views)

Thorax wrote:

pmatos wrote:

I am starting to wonder if it's really a tendon inflammation or if it is possible that's some kind of wierd knotting.

Did your doc have you do an ultrasound? CT? MRI? My guess is none of the above. Another guess? That's what he'll tell you to do next since conservative approach did not work.
I could keep guessing, but you're 48h away from talking to the only person whom you should listen to.

I saw 2 x GPs, 3 x Physios and 2 renown sports Doctors, none of which were able to resolve my Swimmers Shoulder. I fixed it with the help of Slowtwitch and youtube. Certainly take what you read in forums with a pinch of salt, but I wouldn't completely ignore it. A lot of medical professionals out there struggle to diagnose and fix a lot of the more complex injuries out there. Just browse this forum or a runners forum - "I saw 4 doctors and am still injured" etc etc etc

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 3, 18 13:33

Post #23 of 27 (2334 views)

If you are having shoulder pain with neck movements... you have a cervical derangement and your shoulder is more than likely not the problem. Since this was not traumatic and the pain actually occurred without movement, X-rays, MRIs, CT, ultrasounds are not needed and just a waste of money. You will show pathology that is consistent with anyone your age but this pathology is likely not pain generating. The pain you are describing that is provoked with neck movement is easily fixed in several days likely without the need for NSAIDs. You can do whatever you want without increasing your pain. Activity is generally good for spine related injuries.

Find a Mckenzie credentialed physical therapist, do your prescribed exercises and you will be fine. This is sooo easily fixed.

Re: Panic: shoulder injury [AndrewL] [ In reply to ]

Mar 5, 18 6:06

Post #24 of 27 (2266 views)

AndrewL wrote:

If you are having shoulder pain with neck movements... you have a cervical derangement and your shoulder is more than likely not the problem. Since this was not traumatic and the pain actually occurred without movement, X-rays, MRIs, CT, ultrasounds are not needed and just a waste of money. You will show pathology that is consistent with anyone your age but this pathology is likely not pain generating. The pain you are describing that is provoked with neck movement is easily fixed in several days likely without the need for NSAIDs. You can do whatever you want without increasing your pain. Activity is generally good for spine related injuries.

Find a Mckenzie credentialed physical therapist, do your prescribed exercises and you will be fine. This is sooo easily fixed.

Thanks. So, the doctor today said that this is upper back/neck issues and that I need a physio since he couldn't help me any further. 4th week on this without proper training.
Seeing Physio tomorrow.

Mckenzie physical therapist? Never heard of that. Will google!

Paulo Matos

Re: Panic: shoulder injury [pmatos] [ In reply to ]

Mar 5, 18 18:51

Post #25 of 27 (2216 views)

I just finished rehabbing bicep tendonitis. After trying everything else, I took 5 weeks off. No swimming, biking, pushups, pull ups or golf. I could not even strum my guitar without pain. Started with ice 3 times a day and ibprofen 3 times a day. Gradually, pain eased and I switched from ice to heat. I massaged my bicep and shoulder constantly. After 5 weeks, pain was completely gone. I am slowly adding everything to daily routine and, so far, all is well.

I realize that we all heal differently, just wanted to share my ordeal and I wish you the very best. Doing nothing was torture but I love being pain free.

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