The best exercises for healthy , pain free shoulders and how I cured my shoulder bursitis

If you are not interested in my experience with shoulder bursitis and want to skip straight to finding out how I cured it, go ahead and scroll down to “How I treated it”, I won’t judge you, much.

If you are; heres a timeline of events documenting how I went through various health care professionals and misdiagnosis’ to eventually getting a correct diagnosis, and then learning all about my condition and implementing my own rehabilitation program.

Late September 2015 Initial Onset: My program had me bench pressing twice per week and I also began learning Olympic lifting, doing lot of overhead movements. I started to experience very bad shoulder pain when pressing and raising my arm. I took two weeks off of all pressing movements hoping some rest was all it would require, as so often that is the case with injuries.

Mid November Physiotherapist #1: Still no improvement and by this point I could not bench press an empty bar without pain. Went to a physiotherapist for the first time. Was misdiagnosed with infraspinatus tear and given exercises to do. Commenced rehab program for infraspinatus.

Early January 2016 Physiotherapist #2: Still no improvement whatsoever with shoulder issue despite diligently doing all rehab exercises prescribed for a number of weeks. No pressing done since September. Went to physio #2. Was misdiagnosed with long head triceps tear, which was apparently giving referred pain to shoulder. Commenced rehab for tricep.

Mid-February Onset of Severe Impingement: By this time my shoulder had deteriorated severely. Not surprising considering I had spent the previous 6 weeks rehabbing a phantom tricep injury and doing no shoulder strengthening work. I developed a fairly severe impingement to the point where I couldn’t raise my arm.
As seen in this video:

Late February Doctor #1: Attended GP whom indicated I had torn supraspinatus and whom suspected I needed surgery, (he himself had had the same issue and procedure performed previously) he referred me for an ultrasound scan to confirm.

Late March Ultrasound Scan : Ultrasound scan returned indicating no tear, but did pick up some fluid and swelling on bicep tendon.

Early April Physiotherapist #3: Attended physio #3 and was again diagnosed with supraspinatus tear that required surgery regardless of ultrasound. He recommended I get MRI as he suspected this would confirm his diagnosis.

Early May Doctor #2: Presented to another GP in order to get a referral for an MRI.

Mid May MRI Scan : Returned to the doctor to be told I had:
Partially torn supraspinatus
Partially torn subscapularis
Shoulder impingement / shoulder bursitis
Bicep tendinitis
14708119_1828156497400361_4421203880358623281_n

The doctor told me my supraspinatus required surgery (the third health professional to say so) and referred me to an orthopaedic surgeon whom specialises in shoulders to carry out said procedure

At this time I still could not raise my arm and was still suffering with severe impingement and quite a lot of pain.

July 9th Orthopaedic Shoulder Specialist: I walked into the surgeons practice, determined I was not leaving without scheduling this surgery that 3 healthcare professionals had told me I needed. Today was going to be the day where the wheels were set in motion to finally get my shoulder on the road to full health. And indeed it was, but not in the way I had expected. The surgeon was not at all phased or concerned by my MRI scan results or pain/impingement. She calmly and blankly told me “you have shoulder bursitis”. After explaining briefly to me about the condition she recommended and scheduled a cortisone injection into the shoulder in 4 weeks; to reduce swelling, and this was her only suggested method of treatment.

Mid July Commenced Self Prescribed Rehab: I returned home and began learning as much as I could about shoulder bursitis. What causes it, exercises and stretches to treat it. I wrote down and made a small ‘library’ of all the exercises (about 24 in total) and began doing 4-5 of them 7 days per week for about 20 sets total per day. After my first session I felt a very, very, ever so slight improvement. This was hugely encouraging after suffering with pain that hadn’t improved for almost 11 months. By week 3 my shoulder was almost pain free and moving smoothly again, my impingement had been resolved by relatively simple exercises in just 3 weeks, having suffered with a lot of pain and lack of movement for almost 10 months and having seen numerous health professionals.

Mid August Corticosteroid: Despite being almost asymptomatic, after considerable thought, I decided to still proceed with the corticosteroid shot. I figured it would be the final nail in the coffin and reduce any remaining inflammation in the joint and help me heal up even further.

1st September: Gradually re-introduced bench pressing to my training program

29th October: Hit an all time personal best competition bench press of 180kg

What is Shoulder Bursitis?
In medical terms the suffix ‘itis’ refers to inflammation. As the name suggests, shoulder bursitis is simply inflammation of the bursa in the shoulder. The bursa is essentially a fluid filled sac found between muscles, tendons and bones within the joint that helps to cushion the area. The main bursa in the shoulder is the sub acromion bursa, found between the top of the humerus (upper arm bone) and the acromion (top of the shoulder blade)

What causes it?
Normally the tendons and bursa will slide effortlessly within this space between the bones however if the space becomes too narrow due to; postural issues, muscular imbalances or injuries to the surrounding tendons it will result in the bursa getting ‘pinched’ or impinged when moving through certain ranges or planes of motion. Each time the bursa gets pinched the inflammation becomes slightly worse, and gradually over time this condition can lead to “frozen shoulder” where movement at the shoulder is severely restricted.

Signs and symptoms?
The most obvious and common signs and symptoms of shoulder bursitis is quite simply pain in the shoulder however, in particular:
-Gradual onset of your shoulder symptoms over weeks or months.
-Pain when lifting overhead or lifting your arm overhead to reach something
-Pain made worse by sleeping on the affected shoulder
-Pain felt between 60-90 degrees of arm moving up and outwards (as in video)

How I treated it?
The primary goals of rehabilitation from shoulder bursitis should be:
-Activation and strengthening of the muscles of the upper back/scapula
-Strengthening of the external rotators
-Avoiding any and all movements that contribute to pain
-Cutting out, or at the very least reducing the amount of volume/exercises performed for    the internal rotators; pecs, lats, front delts etc.

Listed below are my go-to exercises that through trial and error I have found to be the most effective to relieve pain and improve posture, and that I still do weekly to keep my shoulders healthy.
All exercises should be performed for 3-4 sets of 10-20 repetitions.

 

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Cable No Money:

-Can be performed with band or cable.-Set band/cable to elbow height

-Squeeze shoulder blades together
-Keep elbow close to body
-Rotate arm outwards
-Return under control
NOTE: These are often performed standing up with a dumbbell, this is a waste of time and does not work the intended muscles to any appreciable extent. If you are using a dumbbell; lie on your side on the floor.

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External Rotation:
-Can be performed with band or cable.
-Set band/cable to shoulder height
-Squeeze shoulder blades together
-Rotate arm outwards
-Return under control

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Face Pulls:
-Can be performed with band or cable
-Set band/cable just above shoulder height
-Pull arms back so that hands are in line with ears
-Squeeze shoulder blades together and hold for   2-3 seconds
-Return under control

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Prone Posture Press:
-Lie face down on the floor
-Use a wooden dowel, or handle from a sweeping brush etc
-Start behind the neck as shown
-Press out slowly (for a count of 6)
-Ensure to keep elbows away from the floor by squeezing the shoulder blades together
-Return slowly (for a count of 6)

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Posture Planks:
-Assume the plank position
-Lower yourself slowly closer to the floor for a count of 6
-Raise yourself back to starting position for a count of 6

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Cable Retraction:
Set cable at head height or above
Start with shoulders being ‘pulled forward’ by the weight
Pull the cable closer by squeezing the shoulder blades together
Hold for a count of 3
Return to start position
Note: Think about putting your shoulder blades ‘in your back pocket’ squeeze them back and also downwards

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Sleeper Stretch:
-Lower the arm slowly using the opposite hand
-Only lower to the point where you feel a stretch
-Hold for 30 seconds, repeat x3

Disclaimer: I am not a health care professional, in this blog I merely demonstrate the exercises that worked for me with my specific injury. If you are experiencing pain, see a suitably qualified professional.

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