shoulder impingement syndrome

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tjmac

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shoulder impingement syndrome

hi guys,
i have had shoulder pain in my bowling arm (right shoulder) for the best part of two seasons and have recently been told by my doctor that it may be impingement syndrome.

i am aware that certain exercises can help this out and just wanted to know if anyone knew of where i could find out how to do them correctly? my doctor was not very clear on it. perhaps a video or something along those lines?

the pain is fairly sharp and i feel it at its worst at the top of my bowling action as i let go of the ball. i have an extremely upright arm at the point of delivery and occasionally it will even move past the perpendicular (more to the left side of my body over my head), the pain is again worse on these particular deliveries. i am making an effort to change my action to become more side arm and this seems to help, however there will always be the occasional delivery which i seem to revert back to the old way. the pain then comes back and remains for the whole session.

the day after i will often be unable to do simple things without pain, such as writing in class at uni. putting physical pressure on it is also painful. would you recommend getting an MRI? i opted not to just yet as a few bills have hit me all at once! i should probably mention also i am a fast bowler, around 6ft 3 and slim build

thank you, any help would be greatly appreciated :)
 
Re: shoulder impingement syndrome

Hi tjmac... welcome to the forum.

Before we look at your options, would you do something for me...

Stand in front of a mirror with your arms by your side. Your shoulders should be relaxed, low and at even height [retracted and depressed].

Slowly raise your right arm out to your side... make sure it goes straight out and does not drift forward or backward.

Keep your eyes on your shoulders in the mirror; they should not move...

Tell me how far you can raise your arm without moving your right shoulder upward, eg if you can raise it so that it is parallel to the ground then that would be 90 degrees, if your arm can raise perpendicular to the ground [without rotating at the shoulder] that would be 180 degrees... and anything inbetween.
 
Re: shoulder impingement syndrome

thanks for the reply liz

i would say i can move the arm up to somewhere around 40 degrees before my shoulder moves upwards
 
Re: shoulder impingement syndrome

OK tjmac.

I would love to see some photos of you but that would probably not be possible. I need you to be totally honest with me here... would you say your posture was not quite 100%; are you a little rounded at the shoulders?
 
Re: shoulder impingement syndrome

yep i would say that is definitely true. i may be able to get hold of a digital camera, i will see what i can do
 
Re: shoulder impingement syndrome

No worries tjmac... of course, I cannot be 100% sure without seeing you but, in my opinion, we are talking overuse injury here. I will try to keep the post short but get yourself a coffee before you start reading... just in case :D.

Before I begin, let me make it clear that overuse injuries are not caused by overuse :eek:.

An overuse injury is just a symptom of something else... in your case muscle imbalance. [Another symptom... not the cause]. This occurs when mobilising muscles take over the work of weak, long stabilising muscles and movement is transferred elsewhere. In your case, your scapula stabilisers; lower trapezius and serratus anterior are the culprits, transferring movement to the actual GH [ball and socket] joint. Along with this movement, comes a lot of force that this joint is not capable of sustaining.

However, this is difficult to correct on your own but is possible... you have two options; one quick with little effort on your part, but will cost you... the other needs determination and dedication on your part but will cost you very little, if anything at all. Which would you like?

I suspect the latter but will cover the former just in case ;).

You will not need an MRI but book an appointment with a Sport and Remedial Massage Practitioner. You can do this reasonably cheaply [sometimes free] if you offer yourself as a body at a massage school. I do not know where you are but a well qualified practitioner will cost approximately £50 per session in the UK and $86 in Oz. Most of the work will be done within the first session but you may need to return for one more session, depending on degree of difficulties.

Otherwise... before you can strengthen the stabilisers, you need to open your pectoral muscles [I can guarantee these are tight without even seeing you :)]. This is caused by your poor posture. The door frame stretch is a good start. You need to begin by doing this several times a day, with your arms at different heights up the door frame to reach all the muscle fibres.

Then you will need to work on your rotator cuff muscles. The top one (supraspinatus) is tight. This is what is pulling your humerus head under the acromiom of your scapular... causing the impingement. This is compensation for the weak stabilisers.

Have a read of this: How to protect your shoulder from cricket injury | Cricket coaching, fitness and tips and work on the exercises at the end.

If you have any questions, please do not hesitate to ask. Otherwise, have a go at these and come back when you see improvement and we can progress from here. Of course, all this will be much quicker if you think 'posture' at all times... shoulders back and down ALWAYS!!!
 
Re: shoulder impingement syndrome

thanks heaps liz this post is very helpful :)

i will start on those exercises right away. my mum is also good friends with lady who does remedial massage so i might be able to see her for next to nothing.

appreciate your help, thanks a lot :)
 
Re: shoulder impingement syndrome

thanks, i already do that doorframe stretch as part of my warm up but i will make sure i do it every day. yep an increase in pace would be very nice lol. i find at the moment i can bowl flat out for a small period of each session then the pain in the shoulder kicks in and it drops right back.

i have had a brief meeting with my mums friend who does remedial massage and she echoed all of your diagnosis. i'm seeing her on saturday hopefully.

in the meantime should i be attending any training sessions? and should i refrain from bowling at all, or even batting? and also can the exrecises fix the problem without the need for massage at all? and if so how long would that take? i am attempting to perform the stretching and exercises at least 3 times a day...
 
Re: shoulder impingement syndrome

That's great!

Firstly, if you are doing the door frame stretch as part of the warm up, make sure it is dynamic. Doing this stretch statically prior to activity will make the condition worse.

You can attend training, you need to keep the joint mobilised but perhaps it would be better not to overdo it.

With respect to batting... I assume you are a RH bat... what degree can you raise your left arm? Do you find you are a little bottom hand heavy?

To get this sorted quickly, you really do need soft tissue release (STR) and some post isometric relaxation (PIR) or reciprocal inhibition (RI) and possibly positional release (PR). You can deal with this without treatment but it will take you months, if you are dedicated :(.


NB: If left alone, we are talking surgery within ten years!
 
Re: shoulder impingement syndrome

ok no worries i will definitely book in some massage sessions then. by dynamic i guess that is just shorter length of time in different positions/heights?
i am a RH batsman, the left arm is nowhere near as bad as the right arm but i get in to trouble sometimes defending very high up on the backfoot.
the bottom hand is probably a little bit heavier
 
Re: shoulder impingement syndrome

With the treatments mentioned, most of the work should be done during the first session, then it is up to you how many more you need. The more YOU work and exercise these muscles, the less sessions you need... probably one more. However, I am not sure how qualified your Mum's friend is and what treatments she can do.

Getting the other shoulder sorted will also help with your batting :D.
 
Re: shoulder impingement syndrome

hi liz.
i have been having sessions with the remedial sports therapist for the last 3 weeks. the amount of motion i am getting in my shoulder has definitely improved. she has given me stretches to complete and suggested that i may benefit from strengthening my back muscles. she also showed me how to tape my shoulders back a bit to help with my posture.

however with all that said i am still feeling a small sharp pain when i bowl even at a dribbling pace, and at occasion in every day activities as simple as a writing or reaching out to grab something. the pain feels as though it comes from the outside/back of the shoulder and moves down the outside of my arm, it feels as though it runs alongside the outside of my tricep.

i still suspect that this is from something pinching inside or near my shoulder? i have another session with the therapist in about an hour and i will be asking her about it then too. at the start of the sessions i was unable to pinpoint an excat location but after training last week i found out where it was coming from.

i got the coach to the record myself bowling as well and i might be able to upload that on here after thursday if he remembers to burn it for me. i was able to bowl at probably 3/4 pace but i still felt like i was restricted. it felt like the shoulder was in slow motion, and there was also pain in it all night and afterwards.

probably a bit of useless drivvel but thought i'd keep you updated haha!
 
Re: shoulder impingement syndrome

tjmac;404601 said:
...she has given me stretches to complete and suggested that i may benefit from strengthening my back muscles.
Click to expand...

Absolutely, as mentioned in my post [11 Jul 2010 12:28] this is the cause of your issues :).

tjmac;404601 said:
...she also showed me how to tape my shoulders back a bit to help with my posture.
Click to expand...

Not that keen on this and would never do it myself but if it works... fair enough!

tjmac;404601 said:
...however with all that said i am still feeling a small sharp pain when i bowl even at a dribbling pace, and at occasion in every day activities as simple as a writing or reaching out to grab something. the pain feels as though it comes from the outside/back of the shoulder and moves down the outside of my arm, it feels as though it runs alongside the outside of my tricep.
Click to expand...

This sounds neurological to me and your therapist should be able to release this quite easily if you mention it.

tjmac;404601 said:
...i got the coach to the record myself bowling as well and i might be able to upload that on here after thursday...
Click to expand...

Look forward to it.

Thanks for the update :)
 
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