Inner Shoulder Pain: Causes and Rehabilitation Tips - Orthopedics

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Understanding inner shoulder pain can be quite complex, especially when it arises from activities like pull-ups or push-ups, as you've described. The sensation of heat, pain, and discomfort you experience during these exercises may indicate a strain or injury to the shoulder muscles or tendons, particularly the rotator cuff, which is crucial for shoulder stability and movement.


Causes of Inner Shoulder Pain
1. Rotator Cuff Injury: The rotator cuff consists of four muscles and their associated tendons that stabilize the shoulder. Overuse or acute injury can lead to inflammation, tears, or tendinitis, which can cause pain during overhead activities or lifting.

2. Impingement Syndrome: This occurs when the rotator cuff tendons are compressed during shoulder movements, often due to anatomical variations or muscle imbalances. It can lead to pain and restricted movement.

3. Poor Posture: Spending long hours sitting at a computer can lead to poor posture, which may contribute to muscle imbalances and strain on the shoulder. This can exacerbate pain, especially if you lean on your left arm for support.

4. Muscle Strain: Engaging in exercises like pull-ups or push-ups without proper warm-up or technique can lead to muscle strains, particularly in the deltoids or the muscles around the scapula.


Rehabilitation Tips
1. Rest and Ice: Initially, it's crucial to rest the shoulder and apply ice to reduce inflammation and pain. Avoid activities that exacerbate the pain, especially overhead movements.

2. Gentle Stretching: Once the acute pain subsides, gentle stretching of the shoulder muscles can help improve flexibility. Focus on stretches that target the pectoral muscles, deltoids, and rotator cuff.

3. Strengthening Exercises: After addressing pain and inflammation, gradually introduce strengthening exercises. Start with isometric exercises (contracting the muscle without movement) and progress to resistance exercises. Focus on the rotator cuff muscles and scapular stabilizers. Exercises like external rotations, scapular squeezes, and wall slides can be beneficial.

4. Posture Correction: Work on improving your posture, especially while sitting at a computer. Ensure your workstation is ergonomically set up to minimize strain on your shoulders. Consider using a chair that supports your back and encourages proper alignment.

5. Physical Therapy: If pain persists, consider consulting a physical therapist. They can provide a tailored rehabilitation program, including manual therapy, modalities for pain relief, and specific exercises to address your shoulder pain.

6. Gradual Return to Activity: As you progress, slowly reintroduce activities like pull-ups and push-ups. Ensure you use proper form and technique to avoid re-injury. It may be helpful to modify these exercises initially (e.g., using resistance bands or performing them with less intensity).

7. Listen to Your Body: Pay attention to your body's signals. If certain movements cause pain, modify or avoid them until you have built sufficient strength and flexibility.


Conclusion
Shoulder pain can significantly impact your daily activities and exercise routine. Understanding the underlying causes and implementing a structured rehabilitation plan is essential for recovery. If your symptoms do not improve with conservative measures, or if you experience significant weakness or loss of function, it may be necessary to seek further evaluation from an orthopedic specialist. They can assess for any underlying structural issues and recommend additional interventions, such as imaging studies or more advanced treatments. Remember, patience and consistency are key in rehabilitation, and with the right approach, you can return to your normal activities pain-free.