Understanding Front Side Shoulder Pain in Climbers
Let’s talk about front-sided shoulder pain.
Shoulder pain is the #1 complaint in climbers.
This pain often has something to do with the contents of the rotator interval. The rotator interval improves the shoulder's stability, limits external rotation, and stabilizes the bicep tendon.
It's important to note that pathology can be the source of pain in the short term. Long-term pain, however, becomes more complicated.
Common pathologies around this space include:
Bicep tendon pathology (both with and without labral involvement)
Subacromial pain syndrome (supraspinatus tendon, subacromial/subdeltoid bursal irritation).
Subscapularis tendon pathology (both with and without bicep tendon displacement)
Glenohumeral ligament sprains (high-rate load injury)
It is common for athletes with shoulder pain to have similar findings on the non-injured side. Unfortunately, we can't always understand why people hurt. This does not mean that it's ok to not pay attention to it. There's a reason the organism is providing that response.
some practical modifications for climbers with shoulder pain
Note: Modifications are necessary but temporary (often 3-6 weeks). You won't "pre-hab" your pain away until you make some adjustments.
Get away from vertical climbing terrain. If you're an athlete who only sport climbs on vertical terrain, the high-volume, low-intensity full-motion is a likely source of irritation.
Modify the velocity used with climbing. High-rate loading promotes strain on the connective tissues (tendons and ligaments). Also, in conjunction with direction change (shoulder positions) is a bit riskier.
Stop doing so many damn pull-ups, push-ups, and dips. Your dosage is likely massive already. Instead, focus on heavier loaded movements that promote high levels of recruitment.
Don't stop climbing. Taking part of your identity away when you have pain isn't helpful. This tends to be more stressful.
Be patient! This is the crux. Stop trying to force the pain away with "therapies". Those things mainly change pain tolerance.
Key takeaways:
Pay attention to your pain.
You can’t pre-hab your pain away.
Train with modifications as you heal.