Typically, shoulder pain resulting from climbing is the result of either an injury to the rotator cuff or the biceps tendon where it attaches near the shoulder. The first step in treating shoulder problems is to determine if the pain is a result of biceps or rotator cuff tendonitis. To attempt to make this determination, read the descriptions below. For a true diagnosis, see an orthopedic surgeon or physical therapist.

1) Rotator Cuff Tear- If you are unable to lift your arm above shoulder height and have pain while attempting this motions, you may have torn your rotator cuff. (See Treatment)

2) Rotator Cuff Strain- If you have pain while moving your arm above shoulder height in front and/or to the side of the body, especially after a particularly traumatic event (hitting a dyno, followed by immediate pain or just pulling down too hard followed by immediate pain), you may have strained your rotator cuff muscles (See Treatment).

3) Rotator Cuff Tendonitis- If you have dull pain with activity (rockclimbing) that may get better as you climb, but always seems to come back, may feel “stiff” in the morning, may be worse in the evening if activity is done that day, you probably have the dreaded rotator cuff tendonitis (See Treatment).

4) Biceps Tendonitis - You may have the same symptoms as rotator cuff tendonitis except the pain is lower and to the front of the shoulder (where the biceps muscle turns into the tendon as it attaches to your shoulder, see photo) (See Treatment).

1) Rotator Cuff Tear- Oh boy! This is not a good one to have. You better go see your doctor immediately if you ever want to climb again. Often requires surgery followed by physical therapy.

The next two conditions you may attempt to treat on your own, however, seeing a good physical therapist will greatly increase your chances of healing faster and better. They can properly diagnose your condition, give you exercises to improve your weakness and use modalities (ultrasound and electrical stimulation) to improve healing.

2) Rotator Cuff Strain- You probably don't want to hear this, but you need to rest it, 3 weeks minimum for a mild strain. If it's really bad, you'd better take 5-6 weeks off. You need to ice it 3x/day, 10 min. each time for 7-10 days. You should also consider taking some anti-inflammatories during this time period (2-3 days). If it doesn't hurt when you are not doing anything then you can start a light weight training program to strengthen these muscles

We posted a shoulder routine for the prevention and treatment of shoulder injuries. Check them out at www.urbanclimbermag.tv.

If these exercises do not cause you pain, then try climbing lightly. If you have any pain, ice and take anti-inflammatories afterwards. Take another week off and continue the exercises (without pain). You need to be the judge about how bad the pain is and if you should be climbing, but try to be honest with yourself if you want to continue to climb for many more years. Whenever you have pain, it is usually caused by inflammation which you can get rid of by icing and taking anti-inflammatories.

3) Rotator Cuff /Biceps Tendonitis- Again, time off is important. Tendonitis is an over-use injury, so you need to stop using the tendon to let it heal. It is recommended to take 4-6 weeks off during which time you need to strengthen certain muscle groups

We posted a shoulder routine for the prevention and treatment of shoulder injuries. Check them out at www.urbanclimbermag.tv.

Also, ice and anti-inflammatories are good post-activity treatment. Tendonitis is difficult to get rid of. If you do not see improvement after resting and trying these exercises, then I strongly recommend seeing a physical therapist. You may have different weaknesses that need to be addressed or a different problem entirely. Also, if you have some improvement, but still some pain, continue to do the exercises and make sure to decrease the inflammation after activity.