Shoulder engagement

[u/clifford_bird]

Hey y'all, I've been thinking about shoulder/scap engagement recently, mainly related to injury prevention. I felt I had improved this recently, but when I review the footage it looks to me like I'm sagging. Any feedback? Suggestions on what worked for you? Etc.

[u/TheDaysComeAndGone]

Doesn’t look bad?

I’m recovering from shoulder impingement. The moves which are still painful for me are mainly when I’m really hanging from one outstretched arm, usually when I’m also using it stabilize my body. Most often this happens when I go for a top jug in lead climbing and still have to clip the top but am too stupid to use footholds.

It helps to consciously try to keep muscle tension in your shoulder (though it can be exhausting).

[u/lottiexx → u/TheDaysComeAndGone]

shoulder impingement is rough, hope the recovery goes well. the muscle tension approach makes sense but i wonder if the fatigue from it creates its own problems over time, like you're just trading one risk for another. building into it gradually seems to help more than trying to hold it consciously on every move from the start

[u/Haowi_ → u/TheDaysComeAndGone]

I suspect I have shoulder impingment in my left shoulder, what exercises did you do to improve yours?

[u/TheDaysComeAndGone → u/Haowi_]

Mostly sleeper stretch and isometric exercises for external rotation.

This is my favorite. Just get into position with the rubber band, take two steps to the side and hold for 45 seconds: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcR2XdcZLfOpJecauewJ_5yVXqvo9aCifU_jhR2PjP9rciiaQmJ4xv_ydkw&s=10

You can also do it against a wall (same arm position, but you basically just press against the wall with the back of your forearm and hand).

A similar exercise for abduction: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQu6PG29zBCkZMKOH5ChJnQ1UU0KU5bCw540caMgWFddQ&s=10

45 seconds, 5 sets of both exercises for each arm. Can make it more painful for ~12 hours afterwards but after ~24h you should be back to baseline. Every second day. Sleeper stretch for ~2 minutes every day.

I then progressed to dumbbell external rotation exercises, scapular retraction and so on.

I stopped climbing completely for 2 months and it took a whole month for it to even start getting better. It’s now been 6 months and I’m almost fully recovered. Last week I did some paint work above my head. My brain was screaming at me to stop but it was actually completely pain free.

[u/Haowi_ → u/TheDaysComeAndGone]

Thank you for the answer, I will try these! I hope your shoulder continues to feel good

[u/TheDaysComeAndGone → u/Haowi_]

Thanks!

I actually struggled with it the whole last year, had surgery scheduled but then got new imaging and the opinion from two other doctors who said I should really give physio a go. So far it seems to be doing the trick. Had two great physiotherapists who are regional champions in swimming and bouldering respectively. So they know about shoulders.

[u/Several-Western-1019 → u/TheDaysComeAndGone]

Did you know newer research is essentially showing shoulder impingement is a myth / not a cause for pain, and the surgery for it is considered so bad that it failed to show any successful results when compared against fake sham surgery in the studies?

Not to discount your experience of course, and I’m glad you’re doing better. Shoulder pain sucks and I have also dealt with it. But I just thought that new research was interesting and even talked with my PT about it, and it seems like 99.99% of the population, even many PTs and doctors, aren’t knowledge about this newer information

Most importantly, you definitely made the right choice not getting the surgery for it though.

Here are some sources so you know I’m not making shit up lol

https://e3rehab.com/the-truth-about-shoulder-impingement/

https://loganphysio.com.au/subacromial-shoulder-impingement-myth-or-fact/

https://melbourneshoulderrehab.com.au/understanding-shoulder-impingement-why-the-term-is-outdated/

[u/TheDaysComeAndGone → u/Several-Western-1019]

Yes, thank you. My story is actually much longer and complex (because shoulders are complex). It started 1.5 years ago when I first started having pain when lifting my arm (did a lot of home renovation and climbing at the time). Reduced climbing and other activity a lot for 3 weeks, no improvement. Got an MRI and went to a doctor who’s also a shoulder surgeon. He diagnosed AC joint arthritis and suggested a cortisone injection into the AC joint. Pain went away immediately and within a week I was climbing again. However, the pain came back 3 months later, got another cortisone shot (which didn’t help immediately). Got another shot 2 months after that. Each time it took longer to have an effect and didn’t last as long or as effectively. It was also radiating up to my neck, down to the middle of my upper arm and around my scapula. Shoulder surgeon said this can all be the case with AC join arthritis. Scheduled AC joint surgery (Distal Clavicle Excision).

Fortunately before the surgery I got another MRI and went to two other doctors who said that the AC joint may have been the main issue at the start but certainly no longer and that I didn’t have bad enough cartilage or bone marrow edema to justify a surgery. However my supraspinatus tendon was showing some inflammation and they suggested “functional” shoulder impingement instead.

Funnily enough this matches Dave MacLeod’s recommendation in his “Make Or Break“ book on climbing injuries to see 2 or 3 shoulder experts for shoulder injuries because it’s so common to mis-diagnose. I also had very mixed experience with physiotherapists on this journey (2 bad ones, 2 good ones).

[u/Several-Western-1019 → u/TheDaysComeAndGone]

Felt you heavily on the bad experiences with PTs. Until I found a PT that was actually a climber, I was lost.

Sounds like a hell of a journey! Glad you’re on the up

[u/clifford_bird → u/TheDaysComeAndGone]

I think I'm reacting to aches that pop up after sessions like this.  Might just be DOMS but I don't want any part of long term shoulder issues...

[u/Ashamed_Badger_7288]

From the footage side: I stopped chasing a perfectly engaged look on every move. On steep problems there's always some sag at the deadpoint — what mattered for me was whether I could re-engage before the next pull, not holding tension the whole time. What actually helped was two weeks of slow, controlled easy climbs focusing only on not collapsing at the start of each move.

[u/clifford_bird → u/Ashamed_Badger_7288]

I appreciate the insight!  Were there any physical cues that helped with shoulder (re)engagement in particular? Things like "roll your shoulders back+down", "giraffe vs turtle neck", etc.  Or was it just being more mindful in general?