Frustrating Shoulder Injury

flexlovejoy · 07-14-2009, 10:22 PM

I'm 27 and in reasonably good shape. New to lifting, I started lifting regularly in January. Upon moving to Japan early March, I started lifting three times a week, Westside for Skinny Bastards.

Early May, I suffered a shoulder injury while doing max bench, no spotter. On my last rep, I felt a strange tweak in my left shoulder and couldn't finish the rep. This bench had a kind of safety rack at chest level, so i set the bar down and crawled out from under.

My shoulder was in a little pain, but I foolishly continued my workout. For the next few weeks, my shoulder hurt right about where my collarbone meets my scapula... it feels like its inside underneath that V. It's weakest and hurts most when doing any pushing forward, and to a lesser extent when raising my arm from the front up over my head. Range of motion was limited but came back fairly quickly. The weakness and discomfort was lessening slightly, so after a few weeks, I tried working out again, and I guess I re-injured it in a way, but identical symptoms.

Went to a doctor, but with the language barrier (living in japan), I'm not 100% confident that I came away with satisfactory advice. He moved my shoulder around and felt it, did an X-ray. He blamed "over-training" and said to wait until it heals completely (probably about a month) and then pick back up starting light. It's been 6 weeks since the visit (10 since the injury), and while it is considerably better, I wouldn't say it's "healed completely."

I'm not in the habit of questioning medical advice. But I'm a combination of nervous that I've got an injury that could be more serious or more permanent... and anxious to do what I can to get back on track with my fitness plan. Does anybody have ideas as to what they think the injury might be? Is it common for this type of injury to heal this slowly? Is there anything I can do to aid the process? Is there any lifting I can do that won't endanger my shoulder in the meantime?

Sorry for the novel... I hope the length doesn't discourage potential posters. Thanks in advance.

**Built** · 07-14-2009, 10:33 PM

<disclaimer> I am not a doctor </>

I've had a shoulder injury with similar-ish symptoms, and it's a real bugger, but you are going to have to back off ALL pressing for now. I went eight months where the only shoulder and chest work I could do were side raises and flyes.

There are a few resources I might offer you;
This one's in the wayback machine, but it's excellent:
Weight Training and Body Building - Shouldering Through The Pain

Also from Boris Bachman, a vid:

YouTube Video

Finally, P-funk is brilliant at this stuff - maybe see if you can bug him for some help figuring out how best to rehab this injury given the limited availability of appropriate resources where you are.

flexlovejoy · 07-14-2009, 11:43 PM

wow, thanks for the lightning fast and helpful response. I'll dig in to this info immediately.

**P-funk** · 07-16-2009, 08:04 PM

You need to find a doctor that can determine if you tore your supraspinatus or not or just to get an idea of what is going on. It sounds like you fired up the tissue under the subacromial space.

It is tough to just give you advice through the internet on this stuff. People always want info on injuries and the real answer is, "it depends!" So much of it is watching and evaluating and asking questions and palpating...and those things don't take place through the internet.

On a side note, from the videos above, given your description of what happened and the type of pain you feel there are a number of things in there I would stay away from. Once there is pain, all bets are off. Joint mechanoreceptors don't relay proper info and the joint doesn't function in a healthy manner.

While you are trying to heal (the tissue that is), I would focus on developing thoracic spine mobility. Use a foam roller to get thoracic spine extension (and roll the tissue of the upper back). Perform the thoracic spine rotation rib roll. Drop the pressing, work on scapular stability....the main thing here is that these muscles are muscles of timing, not of strength. So, while YTAs are not bad, they are not training the muscles in their appropriate function, as the concentric strength of the scapular stabilizers or rotator cuff musculature, will never be as strong as prime movers. So, use things like a 1-arm/1-leg deadlift, maybe even a rack pull or deadlift, to help teach those muscles to fire. Grip is critically important, as a stronger grip yields greater neurological activity (irradiation), and enhances stability. Focus on packing the shoulder down and back with your rowing movements. Stretch the upper traps to take their involvement out of it, as they typically develop tightness/hypertonicity in an effort to display shoulder stability - this may be also true for cervical muscles like scalenes and SCM, where lots of people try and draw stability from the neck musculature.

So many things to think about!

Start small.....

Foam roll the tissue
T-spine mobility
Scapular stability

rinse and repeat

patrick

**IainDaniel** · 07-17-2009, 10:41 AM

Quote:

Originally Posted by P-funk

....the main thing here is that these muscles are muscles of timing, not of strength. So, while YTAs are not bad, they are not training the muscles in their appropriate function, as the concentric strength of the scapular stabilizers or rotator cuff musculature, will never be as strong as prime movers. So, use things like a 1-arm/1-leg deadlift, maybe even a rack pull or deadlift, to help teach those muscles to fire. Grip is critically important, as a stronger grip yields greater neurological activity (irradiation), and enhances stability.

Hmmm. Interesting. First I have read of that, but makes complete sense.

**P-funk** · 07-17-2009, 12:14 PM

Quote:

Originally Posted by IainDaniel

Hmmm. Interesting. First I have read of that, but makes complete sense.

Yea, the postural muscles are muscles that have to fire first, or be quicker than, the prime movers - in this case the pecs, lats, deltoids, etc. That is why you need to have exercises that train their stability appropriately. So, there are progressions you run through. We (myself and Keats) have been putting together a bunch of progression so that we can streamline all of our soft tissue work and transition to movement. So, a little soft tissue work, then mobility work (get new mobility), the stabilize that new mobility, then develop full movement patterns. Each session looks like that (for the most part) and the goal is get mobility, then stabilize that new mobility and keep going until we have a fully functioning individual. I had a pro beach volleyball player come to me with shoulder problems - tore his labrum twice in the past and was having shoulder pain so bad that putting his arm up overhead felt uncomfortable and he had no strength to serve a ball (just extreme pain). In four sessions he was back out playing and this weekend is playing in a big tournament in California, going up against the guys who just won the gold medal at the last olympics.

patrick

Yanick · 07-18-2009, 12:29 AM

Quote:

Originally Posted by P-funk

Yea, the postural muscles are muscles that have to fire first, or be quicker than, the prime movers - in this case the pecs, lats, deltoids, etc. That is why you need to have exercises that train their stability appropriately. So, there are progressions you run through. We (myself and Keats) have been putting together a bunch of progression so that we can streamline all of our soft tissue work and transition to movement. So, a little soft tissue work, then mobility work (get new mobility), the stabilize that new mobility, then develop full movement patterns. Each session looks like that (for the most part) and the goal is get mobility, then stabilize that new mobility and keep going until we have a fully functioning individual. I had a pro beach volleyball player come to me with shoulder problems - tore his labrum twice in the past and was having shoulder pain so bad that putting his arm up overhead felt uncomfortable and he had no strength to serve a ball (just extreme pain). In four sessions he was back out playing and this weekend is playing in a big tournament in California, going up against the guys who just won the gold medal at the last olympics.

patrick

Wow thats awesome dude, I love hearing stories like that. The Sahrmann book has tons of little case studies like that and I love reading them and trying to figure them out before getting to the interventions and stuff. I want to do like a little case study, just for practice and such, on my GF like that. I just didn't really write much down when I did all the assessments and stuff before hand and was kinda fumbling in the dark/doing the shotgun approach until something stuck...which it did but by pure luck lol.

07-14-2009, 10:22 PM	#1
flexlovejoy Registered User Join Date: Jul 2009 Location: semi-boonies, Japan Posts: 2	Frustrating Shoulder Injury I'm 27 and in reasonably good shape. New to lifting, I started lifting regularly in January. Upon moving to Japan early March, I started lifting three times a week, Westside for Skinny Bastards. Early May, I suffered a shoulder injury while doing max bench, no spotter. On my last rep, I felt a strange tweak in my left shoulder and couldn't finish the rep. This bench had a kind of safety rack at chest level, so i set the bar down and crawled out from under. My shoulder was in a little pain, but I foolishly continued my workout. For the next few weeks, my shoulder hurt right about where my collarbone meets my scapula... it feels like its inside underneath that V. It's weakest and hurts most when doing any pushing forward, and to a lesser extent when raising my arm from the front up over my head. Range of motion was limited but came back fairly quickly. The weakness and discomfort was lessening slightly, so after a few weeks, I tried working out again, and I guess I re-injured it in a way, but identical symptoms. Went to a doctor, but with the language barrier (living in japan), I'm not 100% confident that I came away with satisfactory advice. He moved my shoulder around and felt it, did an X-ray. He blamed "over-training" and said to wait until it heals completely (probably about a month) and then pick back up starting light. It's been 6 weeks since the visit (10 since the injury), and while it is considerably better, I wouldn't say it's "healed completely." I'm not in the habit of questioning medical advice. But I'm a combination of nervous that I've got an injury that could be more serious or more permanent... and anxious to do what I can to get back on track with my fitness plan. Does anybody have ideas as to what they think the injury might be? Is it common for this type of injury to heal this slowly? Is there anything I can do to aid the process? Is there any lifting I can do that won't endanger my shoulder in the meantime? Sorry for the novel... I hope the length doesn't discourage potential posters. Thanks in advance.

07-16-2009, 08:04 PM	#4
P-funk Patrick Super Moderator Join Date: Dec 2002 Location: AZ Posts: 31,699	You need to find a doctor that can determine if you tore your supraspinatus or not or just to get an idea of what is going on. It sounds like you fired up the tissue under the subacromial space. It is tough to just give you advice through the internet on this stuff. People always want info on injuries and the real answer is, "it depends!" So much of it is watching and evaluating and asking questions and palpating...and those things don't take place through the internet. On a side note, from the videos above, given your description of what happened and the type of pain you feel there are a number of things in there I would stay away from. Once there is pain, all bets are off. Joint mechanoreceptors don't relay proper info and the joint doesn't function in a healthy manner. While you are trying to heal (the tissue that is), I would focus on developing thoracic spine mobility. Use a foam roller to get thoracic spine extension (and roll the tissue of the upper back). Perform the thoracic spine rotation rib roll. Drop the pressing, work on scapular stability....the main thing here is that these muscles are muscles of timing, not of strength. So, while YTAs are not bad, they are not training the muscles in their appropriate function, as the concentric strength of the scapular stabilizers or rotator cuff musculature, will never be as strong as prime movers. So, use things like a 1-arm/1-leg deadlift, maybe even a rack pull or deadlift, to help teach those muscles to fire. Grip is critically important, as a stronger grip yields greater neurological activity (irradiation), and enhances stability. Focus on packing the shoulder down and back with your rowing movements. Stretch the upper traps to take their involvement out of it, as they typically develop tightness/hypertonicity in an effort to display shoulder stability - this may be also true for cervical muscles like scalenes and SCM, where lots of people try and draw stability from the neck musculature. So many things to think about! Start small..... Foam roll the tissue T-spine mobility Scapular stability rinse and repeat patrick E-Book: Take Charge! Everything You Need To Know To Write Your Own Training Programs Online Consulting/Program Design Reality Based Fitness Podcast Check me out on Twitter! Subscribe to our free monthly newsletter! "In the beginners mind there are many possibilities, in the experts there are few." -Buddha's Little Instruction Book

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07-14-2009, 11:43 PM	#3
flexlovejoy Registered User Join Date: Jul 2009 Location: semi-boonies, Japan Posts: 2	wow, thanks for the lightning fast and helpful response. I'll dig in to this info immediately.