General guide to arm and shoulder injury and prevention

bigredlemon · Oct 3, 2004

wedgewenis said:

I think thats exactly why i am having problems right now

I was doing Upright Rows - wide grip bench press... these and badminton lead to pain in my shoulder which i've had for atleast 2 and a half weeks.

here is a short list of Whight Lifting Exercises to Avoid or Alter if you have problems w/your shoulders (or trying to prevent getting)

I only wish i had known this a month ago when i started doing all this stuff :crying:

bigredlemon I have a few questions - first i would like to know your opinion on my injury

the level of pain is about 1-3 out of 10 .. so its not that painfull - i still have full range of motion ..and i actually played the other night for 2 hours and did'nt feel a thing - (i mean my shoulder felt great)...but after the pain came back and seems to be worse now ... so i've had this feeling of pain for just over 2 weeks

i feel the pain mostly in the front of my shoulder it seems below the collar bone and today i noticed a slight sensation of pain at the very top of my bicep (on the front and inner arm where the shoulder meets the bicep) ... its very consistent sensation.

i have been iceing it for the last 2 days after playing .... if i just rest it should it get better on its own?

also if i workout w/running (exercises that dont include shoulder movement) will the added blood flow help the shoulder to heal itself

please advise
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The first thing you should do is make sure you are exercising in a manner that is not damaging to your rotator cuff. They are weak and slow to heal.

Upright rows should generally be avoided. There's exercises that hit the delts alot more effectively. Upright rows also forces your arms into most vulnerable position in the socket, which makes getting injured very easily.

For bench press, keep the elbows inward to minimize rotator cuff strain.

As for healing:
- heat packs will bring more blood to the area so it's a good idea.
- avoid lifting weights and badminton for a month and it'll go away.
Takes about 3 months to fully heal IIRC. Keep pushing it and it'll become a permanent injury. (Which is why many tennis players require shoulder surgery.)

bigredlemon · Oct 3, 2004

Casper said:

That's some great info.! I have been doing treatment on my shoulder for awhile now, but the problem seems to come back all the times. I have pain when I do smashes and clears (sometimes), also when I do my overhead smashes. I think it's whenever I do fully extended motion that causes pain. I also lift weight when I am not playing, would that give more pressure on the shoulder and injury it further more?

I have been border by this for more than two year now, nothing seems to help! Hoping someone can help me out . Thanks
Click to expand...

Take a long break. Just because you aren't feeling pain doesn't mean it's healed. It takes 2 months from when the pain stops to fully heal, so if you're aggrevating it as soon as the pain stops, then it'll almost never go away.

liew19 · Oct 10, 2004

Does it felt like dislocation.....something like dislocation...??

It seem like having a dislocated joint,but, it is not dislocated joint. It felt like something "pop" out and then "po" back again, then, the shoulder sore but no inflamation......this is wat my injury felt like.....so, is it impingement syndrome?

bigredlemon said:

Detailed look at impinged nervers. This is the first step in shoulder injury, and usually comes before others.

What is Impingement Syndrome?
If you experience impingement syndrome in your shoulder, the bones and tissue in your upper arm are improperly aligned ? narrowing the space between the acromion and the rotator cuff. It is often a precondition for many common shoulder ailments, including bursitis, tendinitis, arthritis, as well as injuries to the rotator cuff tendons. One of the common signs of impingement syndrome is discomfort when you raise your arm above your head.

The normal shoulder joint is a very elegant, complex machine ? it has the most mobility of any joint in the body. The ball and socket design of the shoulder allows the arm to rotate, enabling us to reach and swing our arms, hit or pitch a baseball, use a tennis racket, wash our hair, and lift and carry a child. It is because of this flexible design that we are able to use our hands and arms in many so different positions.

The design of the shoulder joint gives it great range of motion but limited stability. It is prone to injury as we age. As long as the parts of this elegant machine are in good working order, the shoulder can move painlessly and easily. When injury or conditions such as impingement syndrome, tendinitis, or bursitis affect the shoulder joint, pain and the loss of mobility result. Because we depend on flexible arm movement for so many of the activities that are important and pleasurable to us, injuries to the shoulder joint can be very disruptive.

To understand impingement syndrome, it is important to know something about the anatomy of the shoulder. Anatomically, the shoulder is like a cup and saucer. The cup is the head of the humerus (arm bone), and the saucer is the glenoid socket of the scapula, or shoulder blade. The tendons of four muscles form the rotator cuff, blending together to help stabilize the shoulder. The fibers of the rotator cuff bend as the shoulder changes position.

Tendons attach muscles to bone and are the mechanism enabling muscles to move bones. It is because of the rotator cuff tendons, which connect the long bone of the arm (the humerus) to the scapula (the shoulder blade) that we can raise and rotate our arms. The rotator cuff also keeps the humerus tightly in the socket (glenoid) when the arm is raised. For normal function, each muscle must be healthy, securely attached, coordinated, and conditioned.

Another important structure within the shoulder joint is the bursa, or lubricated sac of synovial fluid that protects the muscles and tendons as they move against each other. There is a bursa between the part of the scapula that makes up the roof of the shoulder (known as the acromion) and the rotator cuff tendons. The bursa simply allows the moving parts to slide against one another without too much friction.

Causes of Impingement Syndrome?
People who continuously work with arms raised overhead, or who engage in repetitious throwing activities, are especially vulnerable to this condition. Activities requiring overhead reaching put particular pressure on the rotator cuff tendons, and any form of repetitive movement, chronic misuse, or recurring stress may result in impingement.

When the space between the humerus and the acromion above it is narrowed, the four rotator cuff tendons, the cartilage on the ends of the bone, and the bursa are all impinged upon, or squeezed. This results in one or more forms of inflammation of the joint. Bursitis, tendinitis, and arthritis, are all inflammatory conditions closely related to impingement syndrome, often occurring in combination with it. Impingement syndrome also contributes to the tearing of rotator cuff tendons, as it weakens the rotator cuff and makes it more susceptible to injury.

Another problem that may contribute to impingement is the development of bone spurs. Bone spurs can further reduce the space available for the rotator cuff and cause wear and tear of the acromioclavicular (AC) joint between the collarbone and the shoulder blade. This joint sits directly above the bursa, and any bone spurs developing beneath it irritate the bursa, making impingement worse.

Symptoms of Impingement Syndrome?
To some degree, impingement occurs in everyone?s shoulder as the result of daily activities we do that use the arm above shoulder level. But people who continuously work with arms raised overhead, or who engage in repetitious throwing activities, are more vulnerable to this condition. They may become aware of a generalized aching sensation in the shoulder, or pain when raising the arm out from the side or in front of the body.

Most people with impingement syndrome complain of difficulty sleeping when they roll over onto the affected arm. A sharp pain when trying to reach into a back pocket is also a very reliable indication of impingement. As time goes on, discomfort increases and the joint may become stiffer. There may be a ?catching sensation? when the arm is lowered. If the arm is so weak that you are unable to lift it on your own, the rotator cuff tendons have probably been torn.

Impingement syndrome usually results in the slow onset of pain and discomfort in the upper shoulder, especially when the arm is raised. If tendinitis or bursitis develop, there may also be pain when the arm is lifted away from the body. Sometimes tendinitis develops in the biceps tendon, the tendon located in the front of the shoulder that helps bend the elbow and turn the forearm. If so, pain may travel to the front of the arm and down the forearm.

Treatment of Impingement Syndrome?
In diagnosing impingement syndrome, your doctor will ask about your medical history and any other previous or persistent conditions of the arm and shoulder. He or she will inquire about your activities and occupation, as they usually play a major role in the onset of impingement. A complete and competent exam involves considering the possibility of associated injuries or conditions such as tendinitis, bursitis, arthritis, and rotator cuff tears.

X-rays may be taken to examine the site for bony abnormalities or evidence of arthritis. Some people have an unusual anatomy of the acromion, in which the bone tilts too far down and reduces the space between it and the rotator cuff. X-rays will indicate this, and will also reveal any bone spurs in the acromioclavicular (AC) joint. If the shoulder is noticeably swollen, your doctor may aspirate the joint, testing the withdrawn fluid for infection.

A test called an arthogram may be used if your physician suspects a tear of the rotator cuff tendons. For this test, dye is injected into the shoulder joint before x-rays are taken. If dye leaks out of the place where it was injected into the joint, there is likely to be a rotator cuff tear at that location. An MRI scan is another special test, involving the use of magnetic waves to create pictures that look like slices of the shoulder. The MRI scan can also show whether there has been a tear in the tendons. Sometimes ultrasound is used to examine the shoulder joint.

Another common test for impingement involves the injection of a small amount of local anesthetic (such as novocaine or lidocaine hydrochloride) into the space under the acromion. This test helps eliminate the possibility that the pain results from a problem in the neck. If pain subsides immediately after injection, impingement syndrome is likely to be the cause of discomfort.

The first step in treating impingement syndrome and its related conditions is to reduce pain and inflammation. The commonly preferred treatment protocol involves rest, ice, and over-the-counter anti-inflammatory medication such as aspirin, naproxen, or ibuprofen.

Your doctor will also want to see how well your shoulder responds to physical therapy. In some cases the doctor or therapist will use the gentle sound-wave vibrations of ultrasound to warm deep tissues and promote the flow of blood to the shoulder tissue. As pain subsides, you will be asked to try specific stretching and strengthening exercises. These are often preceded and followed by use of therapeutic ice.

If these treatment methods do not offer significant improvement, your doctor may inject a corticosteroid medicine into the space under the acromion. Steroid injections are a common treatment that nevertheless must be used with caution because they occasionally lead to tendon rupture. For this reason, and because steroids are associated with other side effects over time, they do not represent the best long-term solution to impingement syndrome or other persistent shoulder injuries.

Surgical Treatment for Impingement Syndrome?
Surgical intervention is usually recommended if there is still no significant improvement after 6 to 12 months of conservative treatment. Contemporary surgical methods include either arthroscopy or open surgery, or sometimes a combination of the two. Either form of surgery can repair damage and relieve impingement pressure on the tendons and bursa.

When surgery becomes necessary, the major goal is to increase the space between the acromion and the rotator cuff tendons. The first thing the surgeon will do is to remove any bone spurs under the acromion that chaff the rotator cuff tendons and the bursa. In most cases a small part of the acromion will be removed as well, to give the tendons more space and enable them to move without rubbing on the underside of the acromion. People who have an abnormal tilt to the acromion will probably need to have more of the bone removed.

Surgery for impingement syndrome offers an opportunity to correct other related conditions as well. If there is degenerative (wear and tear) arthritis in the acromioclavicular (AC) joint in addition to impingement, the end of the clavicle may be removed. This procedure is called a resection arthroplasty. After about one inch of the clavicle has been cut away, scar tissue fills the space left between the clavicle and the acromion to form a false joint. This usually puts an end to arthritic pain in the acromioclavicular (AC) joint, as the scar tissue forms a stable, flexible connection between the clavicle and the scapula.

Today, arthroscopy is frequently used for the surgical procedure. One or two small incisions are made on the shoulder, but repair in the joint itself is done with an arthroscope, a fiberoptic telescope. Pencil-sized instruments containing a small lens and lighting system magnify and illuminate the structures inside the joint. The arthroscope is inserted into the joint and attached to a miniature television camera, allowing a magnified view of spaces in the joint that would otherwise be inaccessible. This technology makes possible very precise treatment of specific parts of an injury, using a laser to cut away damaged tissue. One advantage of arthroscopy is that you can often go home the same day.

The orthopedic surgeon, who takes into account the many factors that go into each individual case, determines the surgical method used. Sometimes open incision is preferred to arthroscopy. In these cases, a cut of about 3 or 4 inches is made over the top of the shoulder and the same procedures are followed in repairing the joint. Open surgery usually requires that you stay overnight in the hospital.

After surgery, your arm will be protected with a sling, an immobilizer, or a splint or cast. In most cases your shoulder therapist will begin working with you the morning after your surgery, showing you how to do simple exercises to help prevent stiffness and swelling. Even if the shoulder itself is not exercised right way, it is important to gently move your fingers, hands, and elbow -- this controls swelling and helps prevent stiffness. You will be asked to refrain from lifting anything at first, as this may strain the muscles as they heal.

If your doctor has prescribed a sling, you should remove it only at those times during the day when you perform home exercises advised by the physical therapist. Exercising the joint is critical to prevent a stiff or ?frozen? shoulder. The use of ice, which decreases the size of blood vessels in the sore area, helps prevent inflammation.

Your physical therapist will work with you to develop strength in the tendons of the rotator cuff. Stabilizing and strengthening the muscles of the shoulder through the consistent practice of a series of exercises decreases the possibility of impingement or other related conditions returning to the shoulder or upper arm.

Possible Complications of Surgery for Impingement Syndrome?
Although surgery for impingement syndrome is usually without any significant problems, there may occasionally be unforeseen complications associated with anesthesia, including respiratory or cardiac malfunction. The surgery itself may be complicated by infection, injury to nerves and blood vessels, fracture, weakness, stiffness or instability of the joint, pain, or the need for additional surgeries.

Improvement to the shoulder is determined not only by surgery but also by your general condition and rehabilitative effort. In many cases, the tendons and muscles of the shoulder have been weakened from prolonged misuse or degeneration, and strengthening them will require a gentle, steady process of changing habitual ways of moving your arm.

Keeping in mind that it is likely to be several months before you achieve maximal results, you can almost always look forward to a more mobile, pain-free joint. Taking care of impingement syndrome also means you are less likely to be subject to chronic bouts of impairment from related conditions such as bursitis, arthritis, or tendinitis.

The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.

(c)2000 DynoMed.com, LLC, Indianapolis, IN
Link from: http://www.dynomed.com/encyclopedia/encyclopedia/shoulder/Impingement_Syndrome.html
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coops241180 · Apr 24, 2005

tricep injuries?

hey BRL - any info on tricep injuries.. i was worried i was getting tennis elbow, but from your notes i'm pretty much ruling that out.. the pain is pretty much through the tricep muscle, a little worse as i get closer to the elbow - but it comes and goes, usually after a bad smash. sort of a like a dull throbbing pain, deep heat and stretching helps a great deal, but if i pull it during a match, smashing isn't an option.

any thoughts?

lsk_rulez · Apr 24, 2005

My rotator cuff injuty is 95% healed

Some of you may remember me asking about rotator cuff injury treatments a few months ago. I looked and searched long and hard, high and low for a cure. Tried almost everything, even considered acupuncture. Got an MRI only to be told the thing I already knew.

I am happy to share that my injury is healing nicely.

The two things that really helped my case were:

1. Broomstick strecthing - do a google search on this

2. I accidentally stumbled upon this exercise: I was carrying a heavy bag, and had to use my injured arm due to the circumstances. I remembered thinking to myself: I am going to tear the tendon right off, so better be careful. I lifted the bag (about 25 pounds in weight), being very careful not to swing the bag as I walked.

Basically, I was holding the bag by its handle, let it hang to my side, slightly away from my body so it won't rub my leg. Because of the weight, I had to tense my arm muscle a little bit to stabilise the bag. I was very careful to avoid the position that would cause pain to my shoulder/arm such as swinging the bag in front of me, etc. After a few hundred feet (it was a long walk), I started feeling the burn/fatique on my arm muscles, but felt no pain. I kept on going. Lo and behold, when I finally put down the bag, my shoulder felt really good. Literally, my tendonitis got about 50% better in that 10 min of carrying the bag. I regained a lot of the flexibility and mobility of the shoulder.

I kept doing similar exercise everyday by carrying my 9lbs laptop plus all its accessories and lunch box using my arm instead of using the shoulder strap when going to work for the next few weeks. Now I can say that my shoulder has 95% recovered from this exercise. The only pain I felt was when doing a backhand smash, and only a slight one at that. My doubles partner commented on how well I played lately. No ****. Being able to swing the racket without fear of pain has a lot to do with it.

I am glad I stumbled upon this exercise. I was considering going to a physical therapy before, but now I am well enough not to worry about it.

I think the key is to train the muscles around the tendons, without imflamming the tendons. My doctor's advice is: do not do anything that feels painful. It will damage your tendon even more.

My advice to you with rotator cuff injuries is to get a professional physical therapy ASAP. Your injury may not be the same as mine, and the exercise above may not work for you.

j_e_thompson · Apr 25, 2005

Thanks bigredlemon for posting all this information. It is really helpfull.

Kwun, could this be made sticky?

Glacyus · Nov 19, 2006

I'm mainly posting to find if there are others with a situation similar to mine. First off, I do not believe it to be an injury, as I've had it since puberty as far as I can remember. Most of my joints tend to make a popping noise when I move them past a certain point. My right shoulder, which happens to be my playing arm, has this problem most magnified. If I lift my arm in front of me in a straight line, I can actually feel the point where lifting further is heavily opposed by the joint. Passing this point, I feel a shift in the shoulder and slight pain as I can again lift my arm further. This condition is not noticeably painful unless I insist on this motion, and furthermore, seems to rarely manifest, much less impede in daily activities including badminton. Seems that a wider arc in moving my arm precludes this barrier point I feel in range of motion. Only time I am clearly affected is if I do front shoulder lifts with dumbells, lifting them beyond this point which is slightly higher than parallel to the ground. I've asked a general practicioner what it might be during a regular check-up, and he was really vague, concluding basically that a lot of people have similar problems with varying degrees of seriousness, and that it doesn't evolve into an issue for most.

Just curious to find out if others share this ailment, and perhaps get some more info on it.

david14700 · Nov 20, 2006

Definite Sticky material

Thanks Bigredlemon, this stuff is comprehensive and clear.

This is exactly what I suffered from for SEVEN years:crying:

I thought I was just getting old and suffering fatigue from smashing too much. So I bought lighter rackets, smashed less, and used everything I could to treat my shoulder muscles.

Then I finally got around to seeing a physiotherapist and after two weeks, I was completely cured. It felt so fantastic to be completely pain free and be able to smash as hard I want without any worries.

Like you said in your post, the problem was solved by stabilising the shoulder so that the joint wouldn't rub and become inflamed. It had nothing to do with my arm or deltoid muscles being sore.

Anyway, I wish I'd read your post years earlier and saved me a lot of pain.

Great job!

westwood_13 · Dec 5, 2006

thank you very much, very helpful.

unfortunately, I can only gain from the prevention... smashing seems to have brought me a bicep tear, which is a bit more unusual in this sport, I think.

spicynudles · Jan 27, 2007

Hi there,

I played cricket last season in the UK, after 13 years gap. Did some warmup and in the first week, I was ok with batting. Next I just got my chance to bowl. By the time I finished the 4th ball, there was severe pain in the right forearm between the wrist and the elbow.

Before this I had been playing badminton once a week for about 6-8 months. Everything was ok. After this cricket match, this peculiar pain remained. I could not lift small things by arm strength. I could not hang clothes in the wardrobe. I felt the arm falling off kind of experience.

Finally went and saw the doctor. She recommended an X-Ray. The X-Ray showed no bones broken/fractured. So she prescribed a cream MOVELAT for pain relief. But I was feeling the pain only when I did some lifting activity and not otherwise.

So, after looking up the symptoms on the web, I suspected it to be tennis elbow. I stopped playing and limited myself to small activities on the paining arm. Early this month, I was feeling perfectly normal, so decided to play badminton again.

I just took one serve and that's it. The pain came back and I felt my arm had lost control. There was shooting pain.

So, I stopped playing immediately. Haven't had the chance to see the doctor yet. Meanwhile, I came across this forum. Found it very informative.

Can anyone please tell me, what exactly is my problem? It's the area 2 inches below the elbow, back of my arm that pains. I'm able to do my normal activities except playing.

Any help will be highly appreciated.

Many thanks

Raj

azn_123 · Jan 27, 2007

Thanks for the great thread..I learned a lot!

pepe54 · May 4, 2017

taneepak said: ↑

This may seem strange, but I have been playing badminton for close to 47 years and I have never had any shoulder or elbow pain or strain of any type. The only injuries I have had were twisted and badly bruised ankles, knee problems, and blistered skin on my thumb and finger when the humidity is dry, plus the infrequent hard knocks from crashing into your partner. I am of the opinion that the knees and ankles are the most highly stressed and injured parts of the body when playing badminton, simply because these parts bear the full weight of your body, not only in a static state but also dynamically.
Click to expand...

If you don't mind me asking, could you describe your build / physique in as much detail as possible?
I am starting to wonder if there is some correlation or association between physique types and these shoulder / elbow injuries.

I would imagine that players with well developed large arms and broad shoulders (like Fu Hai Feng) have a certain tolerance against attaining these injuries versus smaller players with weak frames.

rockkyle11 · Sep 16, 2022

What are Rotator Cuff injuries?
A rotator cuff injury is an injury affecting the muscles and tendons in your shoulder. It’s a common cause of shoulder pain, especially in older and active people. There are surgical and non-surgical options for treating rotator cuff injury.
About rotator cuff injury
Your rotator cuff is the group of muscles and tendons that surround your shoulder joint. Tendons are strong bands of tissue that connect muscles to bones. Your rotator cuff helps to keep your shoulder stable and working well.

You can injure your rotator cuff suddenly, or it can happen over time, due to wear and tear on your shoulder joint.

General guide to arm and shoulder injury and prevention

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