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Small tendon tear


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Ok. Gonna try follow @Physlifter protocol here:

1) nature of injury. Not really sure when it happened. I honestly thought I slept funny on my shoulder one night about a month back. It’s not painful just annoying. 

2) symptoms. Just a irritating feeling in the muscle on my shoulder. Mostly notice it when I lay down to sleep. Hard to find a comfortable spot. But mostly I don’t even notice it in the day. 

3) no past history

4) what makes it worse. When I reach around my back it gets tighter feeling. Still not painful. Just uncomfortable. I feel it some times if I do close grip bench press or and incline press. But not always. And if I do it’s just the first rep. 

5) no scans. Went to see a doc. She said it’s more than likely a small tear in proximal bicep tendon. 

6) Goals. To get the irritating or annoying feeling to go away. It hasn’t effected my lifts at all or anything at work. Like I said I can feel it during certain lifts a bit but it’s mostly when I’m trying to sleep. 

7) medications. Diclofenace for the inflammation. She also said I could get therapeutic massage to help. 

So that’s my info. My big questions are:

1) what else can I do to help speed up recovery? Movements, products (legal or otherwise) etc  

2) the doctor said I didn’t have to do modified duties at work, just to keep an eye on it, so I assume I could do a down graded version of my routine at the gym yes? Or should I just shut it down all together?

Thanks. 

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18 hours ago, MuscleDummy said:

Ok. Gonna try follow @Physlifter protocol here:

1) nature of injury. Not really sure when it happened. I honestly thought I slept funny on my shoulder one night about a month back. It’s not painful just annoying. 

2) symptoms. Just a irritating feeling in the muscle on my shoulder. Mostly notice it when I lay down to sleep. Hard to find a comfortable spot. But mostly I don’t even notice it in the day. 

3) no past history

4) what makes it worse. When I reach around my back it gets tighter feeling. Still not painful. Just uncomfortable. I feel it some times if I do close grip bench press or and incline press. But not always. And if I do it’s just the first rep. 

5) no scans. Went to see a doc. She said it’s more than likely a small tear in proximal bicep tendon. 

6) Goals. To get the irritating or annoying feeling to go away. It hasn’t effected my lifts at all or anything at work. Like I said I can feel it during certain lifts a bit but it’s mostly when I’m trying to sleep. 

7) medications. Diclofenace for the inflammation. She also said I could get therapeutic massage to help. 

So that’s my info. My big questions are:

1) what else can I do to help speed up recovery? Movements, products (legal or otherwise) etc  

2) the doctor said I didn’t have to do modified duties at work, just to keep an eye on it, so I assume I could do a down graded version of my routine at the gym yes? Or should I just shut it down all together?

Thanks. 

So there's some good info here but a lot of info missing that's vital to a good diagnosis. Doctors like to throw around tears a lot but if it's a true tear you're going to be in trouble, plus your symptoms are not reflective of a tear (it being significantly more painful).

1) is your pain with active range of motion to the front over head? Side over head? External rotation? Or hand behind back only?

2) do resisted flexion at 90 deg, abduction (to the side), External rotation on the corner of the wall, or lift off with hand behind back. What's painful?

3) pretend your arm is out front, elbow at eye level direct in front of you, either put resistance on your hand with the opposite or allow it to fall into deep internal rotation. Any jabbing pain?

4) bring your arm up you the side, thumbs up, then pretend to empty a drink or can in that position allowing the hand to full turn down and in. Any symptoms?

5) tender and thick along the long head bicep where it goes in the front inner portion of the arm? What about the AC joint? Anything on the lateral side to that? 

Based on what hurts and doesn't, it's likely a mild tendonopathy. No tears. Give me some info back. 

 

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52 minutes ago, Physlifter said:

So there's some good info here but a lot of info missing that's vital to a good diagnosis. Doctors like to throw around tears a lot but if it's a true tear you're going to be in trouble, plus your symptoms are not reflective of a tear (it being significantly more painful).

1) is your pain with active range of motion to the front over head? Side over head? External rotation? Or hand behind back only?

2) do resisted flexion at 90 deg, abduction (to the side), External rotation on the corner of the wall, or lift off with hand behind back. What's painful?

3) pretend your arm is out front, elbow at eye level direct in front of you, either put resistance on your hand with the opposite or allow it to fall into deep internal rotation. Any jabbing pain?

4) bring your arm up you the side, thumbs up, then pretend to empty a drink or can in that position allowing the hand to full turn down and in. Any symptoms?

5) tender and thick along the long head bicep where it goes in the front inner portion of the arm? What about the AC joint? Anything on the lateral side to that? 

Based on what hurts and doesn't, it's likely a mild tendonopathy. No tears. Give me some info back. 

 

1) The only active range of motion the that cause the irritation as a constant is behind the back. Sometime something like reaching to pull my glasses off I feel it. (And like I said some presses in the gym) But it isn’t constant enough to say I feel it every time. It almost feels random. I feel it in my front shoulder delt when it happens and if there’s enough irritating movement the bottom of my mid delt in the shoulder. Again the only constant spot is the front  

2) lift of the wall behind back i can definitely feel it. Again front of shoulder. 

3)no pain with these movements 

4)no symptoms in this movements either. 

5)nothing is tender. As far as I can nothing feels thicker or swollen either. 

Hopefully this is what you’re after for more info. Obviously if there’s anything else let me know I’ll get it to you ASAP! Thanks again for the help!

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7 hours ago, MuscleDummy said:

1) The only active range of motion the that cause the irritation as a constant is behind the back. Sometime something like reaching to pull my glasses off I feel it. (And like I said some presses in the gym) But it isn’t constant enough to say I feel it every time. It almost feels random. I feel it in my front shoulder delt when it happens and if there’s enough irritating movement the bottom of my mid delt in the shoulder. Again the only constant spot is the front  

2) lift of the wall behind back i can definitely feel it. Again front of shoulder. 

3)no pain with these movements 

4)no symptoms in this movements either. 

5)nothing is tender. As far as I can nothing feels thicker or swollen either. 

Hopefully this is what you’re after for more info. Obviously if there’s anything else let me know I’ll get it to you ASAP! Thanks again for the help!

So that pain is likely your sub scapularis muscle. Long head biceps irritation is always palpable and thickened in the groove it sits in. Subscap sits deep under that and mimics it. That hand behind back movement that's painful is pretty much the test for subscap. Your description of what doesn't hurt also eliminates supraspinatus and infraspinatus/teres minor.

How to treat it? Obviously stay out of that range is one thing. Rep out internal rotation movements on the pullies at neutral position and up at 90 deg abduction as long as it's relatively pain free. No huge stretch loads from chest days. Heat as needed 2-3x a day to keep it warm and blood flowing to it. 

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13 hours ago, Physlifter said:

So that pain is likely your sub scapularis muscle. Long head biceps irritation is always palpable and thickened in the groove it sits in. Subscap sits deep under that and mimics it. That hand behind back movement that's painful is pretty much the test for subscap. Your description of what doesn't hurt also eliminates supraspinatus and infraspinatus/teres minor.

How to treat it? Obviously stay out of that range is one thing. Rep out internal rotation movements on the pullies at neutral position and up at 90 deg abduction as long as it's relatively pain free. No huge stretch loads from chest days. Heat as needed 2-3x a day to keep it warm and blood flowing to it. 

Sounds like a plan. I’ll get on that ASAP.!

Thanks again for the help as well very much appreciated!

As a note I gotta say, This boards resources have proven to be exponential time and time again this kind of stuff is definitely next level. So glad this place exists for guys like us.  

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