[Prophylaxis]

Roosh V forum has given me an incredible wealth of knowledge. Now it's time for me the give a little back.

Throughout my time lurking and actively participating at Roosh V Forum I've noticed many questions regarding pains and aches. There are also plenty of misconceptions floating around, especially in the weight-lifting scene. "Take X Vitamin, and it will resolve Y condition".

I'm a trained physiotherapist who works closely with elite sports teams.

I've created this thread with the intent of answering any questions you may have about any aches or pains you experience.

If you could I'd like responses in:

Body Chart: (Where exactly does it hurt?)
Age: (DUH)
Mechanism of injury: Did the pain occur during ONE particular event? Or can you think of nothing that brought it on?
Aggravating factors: What makes the pain worse?
Easing factors: What relieves the pain?

Based on this I will then give you my provisional diagnosis with appropriate exercises. I may need a couple follow-up questions before I arrive at my diagnosis. I'm sure I don't need to tell you, that my advice should not substitute seeing a REAL LIFE health care professional

Feel free to also ask questions about physiotherapy in general. Other PT's or doctors feel free to contribute.

[elmanuel]

I'm studying to be a physiotherapist, awesome to have one on here!

I have inguinal hernia surgery in two weeks. I'm 24 years old. I contracted the hernia over a year ago but first chose the conservative route. I haven't been able to play sports at the level I want to again so I have opted for the surgery.
I want to be able to run, do Brasilian jiu jitsu and lift weights again without pain and restrictions.

Since you work with elite sport teams you probably did this proces a few times. How would your rehab schedule look like and what exercises do you feel are important to implement in the rehab?

[Titan]

(01-27-2013 12:31 PM)elmanuel Wrote:  

I'm studying to be a physiotherapist, awesome to have one on here!

I have inguinal hernia surgery in two weeks. I'm 24 years old. I contracted the hernia over a year ago but first chose the conservative route. I haven't been able to play sports at the level I want to again so I have opted for the surgery.
I want to be able to run, do Brasilian jiu jitsu and lift weights again without pain and restrictions.

Since you work with elite sport teams you probably did this proces a few times. How would your rehab schedule look like and what exercises do you feel are important to implement in the rehab?

I'm not trying to scare you or anything, but where do you have your hernia? I'm asking that because my dad had one near the spine and he ended temporally paraplegic.
_____________________________________________________________

To the op, I just started going to the gym, and since day 1 I've experienced a pain in my left elbow that doesn't let me to exercise well. I've always had it but going to the gym worsens it.

Body Chart: Left Elbow
Age: 15
Mechanism of injury: Always had it.
Aggravating factors: Stretching my elbow, having my arm on 90 degrees, having tension on my elbow
Easing factors: The pain is temporally reduced when I put enough tension on my elbow to crack it.

I was making some research and found that I may have some elbow syndrome or shit but I'm not sure.

[elmanuel]

(01-27-2013 01:05 PM)Titan Wrote:  

(01-27-2013 12:31 PM)elmanuel Wrote:  

I'm studying to be a physiotherapist, awesome to have one on here!

I have inguinal hernia surgery in two weeks. I'm 24 years old. I contracted the hernia over a year ago but first chose the conservative route. I haven't been able to play sports at the level I want to again so I have opted for the surgery.
I want to be able to run, do Brasilian jiu jitsu and lift weights again without pain and restrictions.

Since you work with elite sport teams you probably did this proces a few times. How would your rehab schedule look like and what exercises do you feel are important to implement in the rehab?

I'm not trying to scare you or anything, but where do you have your hernia? I'm asking that because my dad had one near the spine and he ended temporally paraplegic.
_____________________________________________________________

Inguinal hernia is located at your belly, so no chance of spinal damage forunatly: http://en.wikipedia.org/wiki/Inguinal_hernia
Still a very annoying pain nonetheless...

[Kickb]

What a cool way to give back
22
Lower interior ankles
Multiple sprained ankles growing up and I fractured my ankle once. I used to jump from pretty high places when I was a kid. (playhouses, swings, big hills etc)

Standing for multiple hours at a time.

Orthotics, standing on the outside of my feet, rest.





My feet are as flat pancakes which causes my ankles to turn inward unless I'm wearing orthotics. I sprained my ankles countless times as a kid and teenager. Is there anything I can do to kep my ankles from rolling inward? Back in high school, a sports trainer told me my ligaments were lose in both and that surgery was an option.

Is there anything I can do to correct my ankles? Or is it structural damage that can only be fixed with surgery?

[Prophylaxis]

(01-27-2013 12:31 PM)elmanuel Wrote:  

I'm studying to be a physiotherapist, awesome to have one on here!

I have inguinal hernia surgery in two weeks. I'm 24 years old. I contracted the hernia over a year ago but first chose the conservative route. I haven't been able to play sports at the level I want to again so I have opted for the surgery.
I want to be able to run, do Brasilian jiu jitsu and lift weights again without pain and restrictions.

Since you work with elite sport teams you probably did this proces a few times. How would your rehab schedule look like and what exercises do you feel are important to implement in the rehab?

Hey ElManuel,

Since you are becoming a physio I'll drop some jargon!

Sounds like surgery may have been your only option in addressing the underlying cause!

Firstly you want to avoid lifting anything over ~5kg early post-op and really take it easy for the first week. Keep active with plenty of walking, but avoid strenuous exercise.

To start with early post-op I'd look at gentle recruitment of Transversus abdominus (TrA). Start with 10sec holds for 10 reps. You can progress this by holding the TrA while gentle bringing 1 knee to chest (laying flat). Make sure you do this properly - I always tell my clients to pretend they're fitting into tight jeans and have them gently 'suck in' their belly button.

I'd then look at gentle scar massage or frictions to break up adhesions caused by the surgery. Perform gentle hip flexor stretches within your pain threshold.

My rehab would centre around improving force closure around the pelvis. This means gluteal strengthening and especially lower abdominal strengthening. Once you get the TrA firing well I'd look at performing bridges (start of double then single).

My end-stage exercises (one of my favourite) - and absolute MUST is lower abdominal strengthening. Which I'm sure you've lost being out for so long!


What you want to do is squeeze the ball between legs while performing a reverse crunch. I'd use a semi-deflated soccer ball instead of the swiss ball. Again this is something I'd probably introduce about 1 month post-op.

So in summary:
'Core' activation - TrA
Hip Flexor stretches
Gluteal strengthening - bridges - progress to weight bearing glut activation
Lower abdominal strengthening - reverse crunch with adductor activation

Getting everything firing is ultimately going to put less strain on the repair site when returning to sport and prevent recurrence. The biggest thing to avoid is heavy lifting without proper form. Identify what may have predisposed you developing a hernia and minimise the factors.

[Hades]

I had an inguinal "sport strain" at 15 that was basically a hernia. Went to a surgeon to get it looked at and kind of balked at the price of the surgery (since my medical coverage is pretty bad). While he did recommend that I get it surgically treated as soon as possible, I just did some research instead and found that it was caused by lifting heavy weights without the benefit of a strong abdominal wall. Since I worked construction as a kid this was not a surprise to me.

So I started to do a lot of crunches and leg lifts, and after about three months it disappeared. I do them to this day.

Just my two cents, not saying that it's going to work for everyone. Even if you do get treated for it, this will help prevent a future occurrence. Doing these saved me a lot of money and I can safely deadlift and squat without issue.

[Prophylaxis]

(01-27-2013 04:01 PM)kickboxer Wrote:  

Is there anything I can do to kep my ankles from rolling inward? Back in high school, a sports trainer told me my ligaments were lose in both and that surgery was an option.

Is there anything I can do to correct my ankles? Or is it structural damage that can only be fixed with surgery?

Hey Kickboxer,

Is pain more of a problem or instability?

If pain is a problem - where exactly on the ankles is hurting? Is it around the inside ankle bone? At the front or the back?

If instability is a problem.

I'm assuming you have torn the lateral ligaments and NOT the syndesmosis or anything nasty which may warrant surgery.

The important thing to remember with torn ligaments is that you loose joint stability or proprioception - receptors which feedback to your body where the ankle is in space. These are super important in preventing recurrent ankle sprains - as they allow the body to self-correct before you 'roll' your ankle again.

Since I assume you have had orthotics for a while and train in your othortics I'd recommend doing any ankle stability exercises with your shoes on.

The best way to train these receptors to start firing again - stand on 1 leg. that simple. try hold for 20secs and perform 10 reps on both legs.

Once you nail that I'd look at holding the single leg balance while altering your centre of gravity (i.e. moving/putting yourself off balance). Progress by doing a single leg balance clock exercise - so while holding your balance with 1 leg - 'tap' the other leg at 12 oclock and then work your way around until you get to about 7 oclock (slightly behind the other leg).

I'd then look at performing a single leg calf raise (no support). Do 10 reps by 3 and focus on loading through the big toe and not rolling your ankle out as your go up.

Following this - (my favourite) - I'd progress to doing hop on 1 leg. Pick a spot on the ground and try to hop high while landing on that spot 5 times. Do 5 sets of 5. Once this gets easy pick 2 spots and hop back and forth between them.

In summary:
Single leg balance
Single leg balance clock exercise
Single leg calf raise
Single leg hop

Some PT's I know use fancy devices such as wobbleboards etc for ankle stability. My principal around rehab is that it should be FUNCTIONAL. Unless you are operating a ship or a yacht, the ground is NOT going to be moving underneath you.

[ausnat]

Body Chart: right knee
Age: 26
Mechanism of injury: knee hurts inside when squatting, even with bodyweight once I get half way to parallel or below
Aggravating factors: squatting
Easing factors: mainly hurts when squatting, running and walking ok

[Prophylaxis]

(01-28-2013 04:15 AM)ausnat Wrote:  

Body Chart: right knee
Age: 26
Mechanism of injury: knee hurts inside when squatting, even with bodyweight once I get half way to parallel or below
Aggravating factors: squatting
Easing factors: mainly hurts when squatting, running and walking ok

Hey Ausnat,

A few follow-up questions.

Is the pain mainly exactly on the knee joint itself to the inside of the kneecap? Or more at the front of the knee?

Does it hurt going DOWN stairs particularly? Or going up more?

Is there any clicking/locking/giving way of the knee?

Is there any swelling?

Did you injure your knee twisting (i.e turning knee while foot planted on the ground)? Or have previously injured your knee twisting?

[ausnat]

Hey Ausnat,

A few follow-up questions.

Is the pain mainly exactly on the knee joint itself to the inside of the kneecap? Or more at the front of the knee?
Inside the knee

Does it hurt going DOWN stairs particularly? Or going up more?
Feels tight going one step up at a time, hurts if go up two at a time. No pain on the way down

Is there any clicking/locking/giving way of the knee?
No

Is there any swelling?
Feels tightness sometimes, which I assume is swelling

Did you injure your knee twisting (i.e turning knee while foot planted on the ground)? Or have previously injured your knee twisting?
No

[Prophylaxis]

Ausnat, if there is no noticeable swelling and it DOESN'T hurt when you touch the patellar tendon i'd say you have Patellofemoral Pain Syndrome. This is a very common condition where the patella (kneecap) doesn't glide properly over the surface of the femur (thighbone) - this maltracking of the kneecap causes pain as you bend and straighten the knee.

In your case - I'd definitely look at your form as you squat. Make sure you drive from the gluts and have your kneecap inline with your 1st/2nd toe. Try to keep your feet pointed relatively straight.

There is a lot of evidence to suggest now that pure ISOLATED quad strengthening is the best thing for PFPS and directly fixes the maltracking of the patella. So best thing - hammer the leg extensions.

I would also look at your knee control. Start by perfecting single leg squats with perfect form - making sure the knee doesn't collapse in and is in-line with the 1st/2nd. Keep the squats shallow to begin with - i.e don't go past 90deg, esp if it's hurting.



Do you also have flat feet? PFPS can often be associated with overly pronated feet which causes the shin bone (tibia) to rotate inward. If so, it might be worth investing in some orthotics, at least until the irritation subsides.

Finally, I'd work on hip strengthening - start with sidelying hip abduction (lifting up straight leg while on side).



In Summary:
Leg extensions
Single leg squat (shallow)
hip strengthening
Stretches - especially quad/calf/hamy!

Lay off the squats until you get all cylinders firing better.

Let me know how this goes!

[Frost]

Great idea for a thread.

I have a perpetually tight left posterior chain, if that makes sense. I need to stretch and walk around whenever I'm sitting for long periods of time, or I get a mild tightness in my left lower back. I also feel a bit of tightness in the upper back and neck sometimes. When I foam roll, I feel more of a 'burn' in my left IT band and left calve.

It barely impacts my life, but only because I manage it with regular stretching, 1-2 yoga classes a week, and 5 mins of foam rolling at the start of every workout.

Other activity, I lift 3x/week, mostly big barbell movements, and play hockey 2x/week. I'm 27 and it's been a minor issue for at least 2-3 years.

Thanks for making this thread.

[WanderingSoul]

I actually have no pain. However, I have lost a significant amount of range of motion in both arms. Hard to explain, but I believe it happened from hitting a heavy bag that was packed too tight a few years ago. Before, I had no problem throwing a hook with my palm facing me. However, now I can only throw a hook with my palm facing the ground. Like this photo:

When I try to turn my hand over so my palm is facing me, I can't. there is no pain, but the muscles in my forearm get tense and I can only turn it about 75% of the way over.

Before I never had this problem. It seems to be getting worse, as now it is hard for me to do chin ups (palms facing me). This is more recent.

In Jiu Jitsu, my wrists do tend to get sore easily when going for collar chokes. Which is where grab the thick collar around their neck, and use my wrists to choke them. It requires a strong grip, and your wrists will bend slightly around their neck. I can't do these as my wrists start to hurt. This isn't a normal problem for someone who does Jiu Jitsu.

My hands also go slightly numb/tingly fairly easily, especially my left hand. I believe this started a few years ago when I started training Jiu Jitsu.

Anyways, any advice you can give me is much appreciated. It really is a pain in the ass not being able to throw a hook in boxing. Let me know if I didn't describe this clearly enough.



Body Chart: No pain. Inflexibility in both wrists/forearms.
Age: 28
Mechanism of injury: I believe by hitting a tightly packed heavy bag, but not sure.
Aggravating factors: No pain.
Easing factors: N/A

[Gunner]

Nice, I've been going to a PT for heat therapy, massage and some exercises (planks, hyperextensions, cobra raise)

He diagnosed a contracture (spasm) around L3 vertebra.

I got my problem deadlifting, I was stretching and I felt a sudden pain:

http://farm3.staticflickr.com/2505/40939...10e9_z.jpg

Between 4 and 6. The pain was just in the left part of my lower back and extended to my left groin, I thought I had something in my left nut.

I had pain when sitting, standing up, making a stiffed leg flexion, squatting and rotating my core.

After heat therapy and some yoga exercises I feel better but I want to deadlift again. I am starting to squat again with less weight than before. Never used a belt

Age 25
Weight 158lbs
Squat 1RM 325lbs
Deadlift 1RM before injury 290

Recommendations?

[Prophylaxis]

(01-29-2013 09:49 AM)Frost Wrote:  

I have a perpetually tight left posterior chain, if that makes sense. I need to stretch and walk around whenever I'm sitting for long periods of time, or I get a mild tightness in my left lower back. I also feel a bit of tightness in the upper back and neck sometimes. When I foam roll, I feel more of a 'burn' in my left IT band and left calve.

It barely impacts my life, but only because I manage it with regular stretching, 1-2 yoga classes a week, and 5 mins of foam rolling at the start of every workout.

Other activity, I lift 3x/week, mostly big barbell movements, and play hockey 2x/week. I'm 27 and it's been a minor issue for at least 2-3 years.

Hey Frost,

Firstly you want to identify factors which may be causing your left side to tighten up. Since you mentioned you have tightness in the back I'd look at the mechanics around there. A lot of lifters I see have overactive back extensors, and are unable to seperate the pelvic movements from the spine. This can cause some back joints to become 'jammed up'.

Any jammed up back joints can directly lead 'neural tension' or basically the nerves going down the back of leg don't glide as well as they should.

I'd recommend doing posterior pelvic tilts to unlock these joints which may be jammed. You should feel relief doing these - I like to tell clients it's like you are trying to 'pee up the wall'.



Once you get these back joints unlocked i'd do neural glides - basically dynamic leg stretches of the posterior chain. These two here are the best






The last one, make sure you glide the ankle back and forward continously 2 sets of 30 reps should be fine before and after exercise.

Summary:
Unlock the back
Glide the nerves

Let me know how you go!


Rio, I'll get back to you by the end of the day. Busy day at work

[TheBulldozer]

Pain: Front of ankle slightly underneath the surface. Either just right of the third or fourth metatarsal, very high up on the bone.(I think)

Age: Mid 20's

Mechanism: I cannot remember a specific incident when it occurred, however it is a shooting pain only when in certain positions or performing certain exercises.

Aggravating factors: When my ankle is tensed up. Think as if I'm trying to push my ankle to the sky. The pain is compounded when my ankle is tensed up and I'm pushing my ankle into the ground. The times when it hurts the most are when I push away from a squat rack with the bar or when I'm cutting or turning the corner playing football or basketball.

Easing factors: Whenever I'm not cutting or doing an activity that places pressure onto a locked ankle.

[Prophylaxis]

(01-29-2013 11:43 AM)RioNomad Wrote:  

When I try to turn my hand over so my palm is facing me, I can't. there is no pain, but the muscles in my forearm get tense and I can only turn it about 75% of the way over.

Before I never had this problem. It seems to be getting worse, as now it is hard for me to do chin ups (palms facing me). This is more recent.

My hands also go slightly numb/tingly fairly easily, especially my left hand. I believe this started a few years ago when I started training Jiu Jitsu.

Hey Rio,

Sounds like there was definitely some trauma placed on the wrist joint over the years.

I'm assuming you haven't fractured any of your wrists or elbow joints before.

The movement you want to restore is called 'supination' - this one can be quite tricky to restore once it completely stiffens up - we are in the opposite movement (pronation) 90% of the day!

What causes stiffness - muscles and joints. You want to address both of these to loosen up the wrist. Perform deep tissue massage to the 'pronator' muscle group.



To loosen up the joints you want to provide a gentle traction (like below) while applying this traction, gently bend the wrist up and down.



I would also try to turn the palm up, but use the other hand to assist.

Finally I would add in some supinator strengthening - use some gentle weights ~2kg, similar to the pic below (try to have the weight unevenly distributed or 'top heavy') - then gently turn the palm up and down. again this is a strengthening exercise, so it shouldn't hurt.



Summary for the wrist:
Massage the forearm muscles (pronators)
Pull wrist/traction while bending wrist up and down
Use other hand to force palm up
Strengthen the forearm muscles (supinator)

Lemme know how you go!

Follow-up question: Just because you mentioned numbness I have to ask..
When do you notice the numbness in your hands? Do you ever experience shooting pain down the arm? Do you have neck pain? - Jiu Jitsu can put a considerable strain on your neck, and I have seen a couple of clients with 'pinched nerves'.

[Prophylaxis]

(01-29-2013 05:47 PM)bars Wrote:  

The pain was just in the left part of my lower back and extended to my left groin, I thought I had something in my left nut.

Recommendations?

Hey bars,

Backs are a little more complicated.

It sounds like you are over-recruiting your back extensors (back muscles).

Couple follow up questions:

Does it hurt to bend down and touch your toes?
Does it hurt as you straighten back up from the position?
Does it hurt to bend backwards?
Does it hurt to side bend from the back?
(do these all in standing)

If it hurts with ANY of these movements, squeeze your bum while you re-do the painful ones. Does it reduce the pain?

Regardless let me know which movement is the most painful.

Cheers,

Prophylaxis (I need a shorter name for a sign-off ey)

[Prophylaxis]

(01-29-2013 05:56 PM)MaleDefined Wrote:  

Pain: Front of ankle slightly underneath the surface. Either just right of the third or fourth metatarsal, very high up on the bone.(I think)

Hey MaleDefined,

Few followup questions:
Where exactly is the pain? Is it over the 3rd or 4th metatarsal or closer to the ankle?



Have you had an changes in your footwear recently?
Do you wear 'tight-fitting shoes'?
Does it feel better barefoot, or better in shoes?
Is there a 'burning or numbness' associated with the pain?

Cheers,

Prophylaxis

[Andreas]

I don't have pain but everytime I put pressure on my legs I hear a little "crack, crack crick" noise coming from the knee. Is it bad or good? It scares the shit out of me whenever I do light squad exercise with dumbells.

[Prophylaxis]

(01-30-2013 11:27 PM)Andreas Wrote:  

I don't have pain but everytime I put pressure on my legs I hear a little "crack, crack crick" noise coming from the knee. Is it bad or good? It scares the shit out of me whenever I do light squad exercise with dumbells.

Hey Andreas,

Any crack from a joint is air escaping out of the fluid inside the joint. It's perfectly normal - similarly like when you crack your knuckles. As long as it's not painful I wouldn't worry at all.

Regardless make sure your form is good during squats and your kneecap is gliding in-line with your 1st/2nd toe - this may reduce the amount of 'cracking' from the knee joint.

[bonkers]

Hi Prophylaxis,

thanks for offering your advice on here - very kind of you.

Just a couple of questions:

1. What do you think about sitting on a fitball when doing desk work to improve posture - is it worth it? or a waste of time?

2.

Body Chart: Right shoulder (I'm a left hander so non-dominant)

Age: 28

Mechanism of injury: While just doing a swimming freestyle I aggravated my right shoulder. It was a sudden pain, but it subsided pretty quickly immediately after and I didn't really think too much of it until the pain continued to persist in the days after from time to time with certain movements. If I had to pinpoint the time in the freestyle swimming stroke it happened, it would be as my arm was going past my right ear.

Aggravating factors: I'm able to do overhead presses and bench press without too much issue, and in fact I'm benching more than I have ever done.

But I'm definitely more conscious of it when I'm doing reverse grip chin ups (I'm still able to do 2-3 but it just doesn't 'feel right')

I'm also more conscious of it (initially) when I'm gripping the barbell for squats (after a few warm up sets it goes away though)

I can re-create/exacerbate the pain when I get to the horizontal on abducting my arm and then going above the horizontal and I adduct (or is it still abduct?) the arm towards me overhead.

Easing factors: The pain is non-existant at rest and it doesn't bother me in any ADLs except overhead activities.
It appears to be getting better, but very very slowly.

My questions:

1. what do you think I have strained with that kind of freestyle motion?

2. In the future, what kind of exercises should I do to strengthen the shoulder? currently, I do squats, deadlifts, bench presses, chin ups, overhead presses, bent over rows, farmers walks and I'm thinking of doing some bar dips as well

[Prophylaxis]

(02-02-2013 03:26 AM)bonkers Wrote:  

1. What do you think about sitting on a fitball when doing desk work to improve posture - is it worth it? or a waste of time?

2. I can re-create/exacerbate the pain when I get to the horizontal on abducting my arm and then going above the horizontal and I adduct (or is it still abduct?) the arm towards me overhead.

1. what do you think I have strained with that kind of freestyle motion?

2. In the future, what kind of exercises should I do to strengthen the shoulder? currently, I do squats, deadlifts, bench presses, chin ups, overhead presses, bent over rows, farmers walks and I'm thinking of doing some bar dips as well

Hey Bonkers,

Sounds like you have some anatomical knowledge under your sleeves .

First thing - by fit ball, I assume you mean the 'swiss ball'. These were very popular about 5 years ago, even Physios would advocate them. Short answer - waste of time. There's no added benefit of using a swiss ball compared to a chair with good lumbar support. (Most people cannot sustain a good lordosis in the lumbar spine with prolonged sitting unsupported).

How regular do you swim? Rotator cuff tendinopathies are very common the swimming population. Your description of symptoms could also be that of an 'impingement', as you mention pain at horizontal abduction or 90degrees, this is the position where the subacromial space is at it's narrowest.

Couple questions to help me out:

Does it hurt to externally rotate?


Try do this with resistance against the other hand, or by pulling a towel apart with both hands (elbows by your side). Does this hurt or feel weaker compared to the other side?

Now repeat the movement while squeezing the shoulder blades back. Has this improved the pain?

Also try lifting the arms in horizontal abduction. Now, try perform this while squeezing the shoulder blades back. Has this improved the pain?

[bonkers]

Thanks Prophylaxis for the quick response.

(02-02-2013 04:08 AM)Prophylaxis Wrote:  

Hey Bonkers,

Sounds like you have some anatomical knowledge under your sleeves .

Heh, thanks, I took an anatomy class back in Uni.

Quote:

First thing - by fit ball, I assume you mean the 'swiss ball'. These were very popular about 5 years ago, even Physios would advocate them. Short answer - waste of time. There's no added benefit of using a swiss ball compared to a chair with good lumbar support. (Most people cannot sustain a good lordosis in the lumbar spine with prolonged sitting unsupported).

Ahh, fair enough. Thanks.

Quote:

How regular do you swim? Rotator cuff tendinopathies are very common the swimming population. Your description of symptoms could also be that of an 'impingement', as you mention pain at horizontal abduction or 90degrees, this is the position where the subacromial space is at it's narrowest.

I don't swim very often at all. In fact the reason I went swimming was because a person that I workout with recommended that I do it after a workout. In fact I hadn't been swimming for about a year before this episode. - maybe it was a case of underuse.

Quote:

Couple questions to help me out:

Does it hurt to externally rotate?


Try do this with resistance against the other hand, or by pulling a towel apart with both hands (elbows by your side). Does this hurt or feel weaker compared to the other side?

The pain occurs at the end of my range of external rotation

Even with resistance, the pain occurs at the end of the range.

The right side feels a bit weaker and I feel a bit more conscious of it and it feels 'vulnerable'.

Quote:

Now repeat the movement while squeezing the shoulder blades back. Has this improved the pain?

Squeezing the shoulders back increases the range of motion, but the pain occured again at the end of the (greater) range of motion. Also when trying to internally rotate, I felt a little bit of pain (wasn't happening before)

Quote:

Also try lifting the arms in horizontal abduction. Now, try perform this while squeezing the shoulder blades back. Has this improved the pain?

the pain occurs at the very top of the abduction (ie arm facing up to the ceiling) and with the shoulder blades back the pain was slightly worse.

The pain does seem a bit better with some warming up. But the worry is still there with chinups.