r/overcominggravity 14d ago

AC Joint Pain

Hello !

Unfortunately, about 2 months ago (approximately), I somehow injured my right shoulder during a chest day. I did my usual warm-up, and the first exercise was a variation of the bench press on a machine where I had a full ROM. I didn’t feel anything during that exercise. When I moved on to the second exercise, the incline machine press, the pain started during the first working set. I don’t remember exactly what the sensation felt like, but it wasn’t as if my shoulder was “locking up” or anything like that—it just hurt, so I reduced the weight.

That day, honestly, my right shoulder felt like it was burning. That evening, I woke up and my shoulder felt like it was on fire, so I put a bag of frozen beans on it to help calm it down. I also tried using cold compresses that day.

I tried to do some research on what I could do and what exercises might help, but, well, I'm not a medical professional so I tried to do my best researching online, so I chose some physiotherapy/rehab exercises I found online. I took about 1–2 weeks off from upper-body exercises and then gradually started training again.

I know you might be wondering why I haven’t gone to a physiotherapist or another specialist during all this time. Honestly, I simply can’t really afford it. I did go for a massage because it was cheaper. Where I live, in order to get a medical check-up, you have to go through your family doctor. Since I’m originally from another county, I would have had to travel back there, and at the time I had university, so it was pretty difficult. Then, after that, you have to go to the hospital, where, if you want the examination to be free, you have to wait around 3 months. Then you need an X-ray, then another consultation, and it’s a loooooong process of going from one place to another and so on :(( I’ve been through something similar before with my lower back.

Before I started going to the gym, right after my birthday, I was hit by a car while crossing the street, and my left shoulder was dislocated. I did physiotherapy afterward, although it was my first time dealing with something like this and the doctor didn’t really explain that I needed to keep doing those exercises afterward and so on. About two months later, I started going to the gym with some friends from my dorm. I didn’t really train shoulders, and when I did, it was quite rarely because I was afraid of dislocating my left shoulder again.

Now, most likely, in order to protect my left shoulder, my right shoulder—the one I’ve kind of messed up now—ended up taking most of the load and eventually gave out.

Honestly, I don’t know what to do. I don’t know what I’m doing wrong, and it’s becoming overwhelming. I still can’t financially afford to see a physiotherapist, so I’m trying to figure things out myself. Maybe I need to add something, remove an exercise, replace something with a different exercise—I really don’t know.

At the gym, when I train chest or other muscle groups, I try to do everything slowly. If I feel pain, I stop and reduce the weight, or I try to brace/tighten all of my muscles :((

Right now, the pain is around the front/top of the AC joint (I hope I’m not getting the anatomy wrong, but basically that little bump where the shoulder starts). Unfortunately, I can’t attach a picture here, but if I can post one in the comments, I will.

I feel pain during incline pressing and when I bring my elbow very far behind me (I have a relatively large ROM), although that one isn’t as painful. I also feel pain when I bring my arm toward my upper chest—this is probably around 7/10 pain.

If I lie on my side or on my left shoulder in bed and put my arm next to my ear, then try to raise my entire arm overhead, it becomes quite difficult to lift it, and the pain is around 8/10.

If you have any recommendations on what I could or should do, I’d really appreciate it. I do warm up and don’t immediately jump into my working sets.

Someone recommended that I try isometric exercises. I haven’t done many of them—what do you think about them, and are there any exercises you would recommend?

If you have any questions, I’ll answer them. I’ll do anything—I just want to get my right shoulder back to normal.

I also asked Claude AI to give me some tests to try to figure out what might be wrong. From the tests it gave me, I think I only passed about two of them, but that was around a month and a half ago. Honestly, I could probably do them again.

My current warm-up:

  • 2×10 Cat-Cow Pose
  • 2×10 The World’s Greatest Stretch (I do a slight variation, but it’s similar)
  • 2×10 Shoulder External Rotation (cable)
  • 2×10 Single-Arm Face Pull (cable)
  • 1–2×10 Scapular Retractions

What I’ve added to my warm-up:

  • Scapular Push-Ups — 1×10
  • “Loaded external rotation and internal rotation of the glenohumeral joint” — 2×10 (with a resistance band or cable)
  • Loaded serratus anterior work via shoulder protraction — 2×10 (with a resistance band or cable)
  • Banded posterior movement
  • Pendulum — 2×10–12. I use a 10 kg dumbbell with a strap, and honestly, my shoulder feels better afterward. If I “simulate” an overhead press, it seems to hurt less.

What I want to integrate:

  • Banded Wall Slides — when I first injured my shoulder, I incorporated these the following week, but they hurt and were extremely difficult (although I was using a black/heavy band). Recently, I tried them again because I found several different resistance bands at my gym, and they seem much better now. They’re still difficult, but nowhere near as difficult as when I first tried them, and I can do more than 10 reps.
  • Banded External Rotations — 5-second hold

PS: During lateral raises, I don’t really feel much pain in my shoulder. During pressing movements, I do feel some discomfort. Sometimes the pain also travels toward my neck/trapezius.

EDIT: I posted the video in case you notice anything about my right shoulder; I was trying to figure out if I have any instability in my shoulder blade, but I don't know.

3 Upvotes

8 comments sorted by

2

u/eshlow Author of Overcoming Gravity 2 | stevenlow.org | YT:@Steven-Low 13d ago

At the gym, when I train chest or other muscle groups, I try to do everything slowly. If I feel pain, I stop and reduce the weight, or I try to brace/tighten all of my muscles :((

Right now, the pain is around the front/top of the AC joint (I hope I’m not getting the anatomy wrong, but basically that little bump where the shoulder starts). Unfortunately, I can’t attach a picture here, but if I can post one in the comments, I will.

I feel pain during incline pressing and when I bring my elbow very far behind me (I have a relatively large ROM), although that one isn’t as painful. I also feel pain when I bring my arm toward my upper chest—this is probably around 7/10 pain.

If I lie on my side or on my left shoulder in bed and put my arm next to my ear, then try to raise my entire arm overhead, it becomes quite difficult to lift it, and the pain is around 8/10.

If you have any recommendations on what I could or should do, I’d really appreciate it. I do warm up and don’t immediately jump into my working sets.

Someone recommended that I try isometric exercises. I haven’t done many of them—what do you think about them, and are there any exercises you would recommend?

If you have any questions, I’ll answer them. I’ll do anything—I just want to get my right shoulder back to normal.

If you want a guess on potential injury and rehab, need more info on the injury. You've given some but more information is needed especially the marked picture/video

  • Mechanism of injury, as best you are able if there isn't discernable one. For instance, what movements or exercises were leading to the week of the injury
  • Upload a marked pic/video of exactly where symptoms are to an image host (google drive, icloud, imgur or others) and post a link to it (Note: I will not make any guesses unless I can see exactly where the symptoms are because text is hard to decipher and people describe things wrong all the time). It needs to be a photo of YOU, not a random photo you got online of someone else's body because everyone is different.
  • Describe all movements that hurt
  • What is the current rehab program you started with and the progressions, if any. If a flare detail what happened with the rehab program
  • What helps and what makes it worse

1

u/AndreiBalanoiu 9d ago

"Mechanism of injury, as best you are able if there isn't a discernible one. For instance, what movements or exercises were leading to the week of the injury"

On the day I got injured, the first exercise was horizontal machine press — I felt nothing there. What I can say is that my right pec was always weaker. After finishing with horizontal machine press I moved to incline machine press, I did a gradual weight increase up to my working set, and at the working set is when I got injured — I felt that discomfort.

"Describe all movements that hurt"

  • End range shoulder abduction: pain as arm gets closer to ear
  • Scarf test: pain as arm goes further across the body (I have an exercise for the posterior shoulder that I do at the cable — to be able to do it, I go next to a wall with my arm at 90 degrees and stretch the pec)
  • Incline pressing movement
  • Shoulder press: I feel the pain at the beginning of the movement; to perform the exercise I have to fully focus on bracing my lat and controlling the scapula as best I can
  • Arm against the body moving it behind my back as far as possible
  • Elevating the scapula upward (not shrugging)
  • I also feel pain with dips (machine) but I don't do that exercise
  • Putting my palm behind my back (at the start of that movement)
  • Hawkins-Kennedy test
  • Face pull with load
  • Shoulder CARs (hurts when I'm at the bottom position where my palm needs to be as low as possible, as far as my body allows)
  • Scapular CARs (when I protract the scapula forward)

"What is the current rehab program you started with and the progressions, if any"

Progress made so far:

  • At the beginning I couldn't put my palm behind my back at all — it hurt. Now I can, and I can reach my palm to the middle of my scapula
  • Couldn't bring my arm behind my back; now it's at the same level as my right arm
  • Couldn't do Banded Wall Slides; now I can
  • Couldn't do any kind of pressing (though the pain has decreased over time); couldn't do pull-downs / pull-ups or hang from the bar; now I can
  • Couldn't do cat-cow pose in warm-up; now I can

What I tried at the beginning:

  • Banded extension with external load
  • Band arm rotation (struggled at first but it improved over time)
  • Kettlebell bottoms-up switch backs
  • Bottoms-up kettlebell

What I do now:

+ my normal warm-up (external rotation, face pull, cat-cow pose, a version of The World's Greatest Stretch, and scapular retractions on the pull-up bar)

"What helps":

  • Pendulum
  • Cable serratus punch
  • Loaded external rotation and internal rotation of the glenohumeral joint

Link to Google Drive: https://drive.google.com/drive/folders/1rHbQNBMiAEZT0NILA_Fsl2wIdSvasA7I?usp=drive_link

1

u/eshlow Author of Overcoming Gravity 2 | stevenlow.org | YT:@Steven-Low 7d ago

You need to provide access to the photos:

You need access Request access, or switch to an account with access. Learn more

1

u/AndreiBalanoiu 7d ago

2

u/eshlow Author of Overcoming Gravity 2 | stevenlow.org | YT:@Steven-Low 7d ago

https://drive.google.com/drive/folders/1rHbQNBMiAEZT0NILA_Fsl2wIdSvasA7I?usp=sharing

Ok, so the area you highlighted it more into the Acromion than AC joint, although some of the images do include the AC joint in the area.

Did the PTs think it was AC joint or something like impingement or supraspinatus?

Because a lot of your symptoms also overlap with impingement and supraspinatus issues.

You can try some AC joint mobilizations off Youtube and see it it helps. If it is AC joint pain they should help alleviate some of it right away. My wife had some AC joint pain from taking a fall during martial arts and hers went away after I mobilized hers.

Otherwise, I think it's more likely that the majority of your pain is potentially from some impingement and/or supraspinatus pathology

1

u/AndreiBalanoiu 6d ago

I asked a few PTs in the gym, but they said they had no idea, so I tried to do some research on my own.

I'm going to try a few AC joint mobilization exercises I found on YouTube.

Thanks for the help!!

2

u/eshlow Author of Overcoming Gravity 2 | stevenlow.org | YT:@Steven-Low 6d ago

Hopefully that helps, otherwise impingement/supra tends to be a longer rehab