Deadlifts & Shoulder Impingement?

Bigger Stronger Leaner Over 35 Lifter
1

Do deadlifts nominally have an antagonizing effect on shoulder impingement?

I have an MRI-diagnosed case of impingement syndrome, with inflamed bursa, in my left shoulder. (No rotator cuff tears detected; the MRI was the “enhanced contrast” where they injected dye.) I can’t bench press a nickel without pain in the outboard side of my upper arm. Pretty much anything that pushes forward and overhead aggravates it a lot.

Any other arm exercise, except for bicep curls, seems to aggravate it a little. So I’ve stopped doing all of these. (I’m almost all legs and abs/core now.) Deadlifts, or anything where my arms stay at their sides, do not cause any pain or aggravation that I can feel. But, the condition is not going away.

Since arms are involved in almost anything (even stacking the plates on to the inclined leg press machine) I should basically stop all lifting for 6 to 8 weeks. But, I really don’t want to do that.

What exercises, if any, can be safely done while I am in a holding pattern for shoulder impingement recovery?

2

I have been where you are many times. When I have to “call a retreat,” I cease upper body lifting but do stretching and rehab exercises for the shoulder, as well as hot/cold packs daily, and electrical stimulation if available. Physical therapy of the impinged shoulder is controversial, and I wouldn’t feel confident telling you exactly which exercises you should do.

But I found, through trial and error, which ones I could do, without significant pain, which helped strengthen the various rotator cuff muscles. Also I emphasize working the posterior shoulder muscles (which are typically underdeveloped in relation to the anterior delt muscles in most impinged athletes.)

Interesting your mention of DL’s. I have found DL’s and heavy cleans recently to at times elicit a different pain in my shoulders than my familiar rotator cuff/bursitis/impingement pains. I believe it involves the anterior capsule, partly based on reading of T-Nation articles plus a stretch of the anterior capsule reproduces this pain. Search “anterior capsule stretch” on this site and see if you have this problem. Doc

3

I never had any problems with shoulder impingement until I found a hammer strength shrug machine. I could load that sucker to the limit and I think that is what brought the scapula down upon the ball joint as it were.
I got some cortisone and stay the hell away from heavy shrugs. No shoulder problems…I doubt that you are the first to suspect this.

4

Thanks for that reply, Doc. I looked up “anterior capsule stretch” both in the forum and on the Internet. This looks like an exercise I have been doing in conjunction with my physical therapy. The version I was given by the therapist was to lay face-up on top of a foam roller with the roller lengthwise to my body and centered on my back. I hold my arms straight out (like a Jesus-on-the-cross pose) and palms up and let gravity pull my hands down. This puts a significant stretch across my whole chest. I was to do this fifteen minutes a day in five minute sessions.

Also, I was supposed to do exercises that strengthened muscles around the scapulae. The rationale for this was that weak upper backs conspire with tight chests to pull the shoulders forward and down into a perpetual hunch, thus contributing to impingement. I do have a tight chest, but I have a strong upper back also (from bent-over flyes and various rows). The exercises they were giving me were trivial compared to my weightlifting. I think they’re intended for old ladies who are sedentary. These weren’t sports injury specialists. But, I digress.

I was really motivated to get back to working out, so I did all these exercises to the letter and abstained from workouts that aggravated it. No relief. After two cortisone injections (one in the front and one in the rear of the shoulder - these were weeks apart) and about 12 weeks of physical therapy, still no relief. After two MRI’s (the first inconclusive, and the second with the injected dye that was better) I was kicked up to the surgeon.

The surgeon suggested that the physical therapy exercises themselves (which I continued on my own after the sessions with the therapist were over) may have been contributing to the slow progress, so he ordered me to stop these. He put me on a buttload of Advil and said “see me in six more weeks”. When I go to see him on Monday Nov. 26th, I will report no real relief.

I have had this condition since February of this year and am frustrated beyond belief. I’m the opposite of most lifters now - I’m all legs and no upper body. And fatter since this thing has thrown my whole workout psyche out of whack.

6

Many people on T-Nation bemoan that most doctors suck (and I agree, but I get tired of reading it). Now its my turn, MOST PT’S SUCK! They have no understanding of a lifter’s need to get back to real lifting, acting as if we will be content to play with little colored rubber bands and pink seven pound dumbells forever. Fuck them.
I realize there are exceptions, here on T-Nation and elsewhere.
I don’t have all the answers, but I can tell you that yesterday, with my bilaterally surgically reconstructed shoulders, I benched heavy and did heavy overhead jerks off the rack. I’m fine this morning, no major pain. Every PT said I could never do this again, even a couple who were lifters.
Doc

7

I have the same condition. I got a cortisone shot in my right shoulder last December and that really made a difference. I also continue to take fish oil and Glucosomine/Condroitin on a regular basis.

8

Update: After an appointment with the Orthopedic surgeon today, I have decided to get the impingement surgery. I don’t yet know if the inflamed bursa will be removed or if the coracoacromial tendon will be removed. I do know that he will trim/grind away the bottom of the acromian bone at the locus of the impingement.

I have been fighting this since February of this year, and we’re within striking distance of the next February. By then, I will not have been able to do any serious lifting for a year. I’ll try to throw updates on here if anyone cares to read them.

It’s a one-hour procedure with a three month recovery time. The earlier I start, the earlier I can finish. I’m looking a having the procedure done on December 7th or 10th.

9

Hi Jgundrey,
You should have had the surgery by now. how are you? I was in a similar positon to you just 2 months ago (check out my post " recovering from shoulder surgey ")
Keep us updated,
Nobby

10

OP,

How do you hold the bar when you DL? I’ve noticed that a switch grip can irritate an old impingement I had in my shoulder. A normal hook grip is much easier on my shoulder so I reserve switch grip for max-pulls and other extreme fatigue situations.

Also, I’ve been reading a little about a supp called Cissus Quadrangularis. Some people are calling it a miracle etc… I’ve never tried it, but you may want to ask around.

11

[quote]Nobby wrote:
Hi Jgundrey,
You should have had the surgery by now. how are you? I was in a similar positon to you just 2 months ago (check out my post " recovering from shoulder surgey ")
Keep us updated,
Nobby
[/quote]

Hi, Nobby:

Yes, I went under the knife on Tuesday the 11th of December. I haven’t had surgery of any kind since my appendectomy when I was in the 10th grade (I’m now 44). So, the whole experience was interesting.

Out-patient. 45-minutes of pre-op. One hour and five minutes of surgery. (General anesthesia.) Two hours in recovery. And I was home acting like a big baby before 10:30 a.m.

The surgeon removed the left shoulder bursa and performed “acromioplasty” on the left side (debridement of the lower surface of the acromion). He said he removed “a few millimeters” of bony material. This was all arthroscopically performed with the usual three incisions in the left shoulder - one in the front, one on the side, and one in the rear.

I didn’t know that the bursa will grow back!

Very limited range of motion for the first few days. The pain profile was as the surgeon described - little pain on surgery day; lots of pain the following morning; decreasing pain every day thereafter. Haven’t taken any Vicodin since Thursday. Applied ice for all waking hours for first two days after surgery - 20-minutes on, 40-minutes off.

At seven days out, I’m no longer using the arm sling. Resting pain is intermittent, but is never severe enough to warrant any meds. I can lift my arm to just short of horizontal to the floor before pain stops me. Can’t really reach behind. Gotta go real slow putting on shirts and opening and closing car doors.

Post-op appointment - surgeon pleased with progress. Showed me the arthroscope pictures and described what went on. Prescribed six weeks of physical therapy (PT) - Passive Range of Motion. Will have six week follow-up visit where he expects to call for six weeks further of Active Range of Motion PT. Says 100% recovery takes six months.

Should be light lifting with that arm after three months. When resuming the gym after Christmas (or possibly New Years) will do legs, abs and cardio for a few months. Won’t even risk anything with the left arm.

All in all, not a bad experience so far. I’ll try to add anything interesting as it comes up.

I have been following your shoulder recovery thread. Lots of good info in there.

[quote]beebuddy wrote:
OP,

How do you hold the bar when you DL? I’ve noticed that a switch grip can irritate an old impingement I had in my shoulder. A normal hook grip is much easier on my shoulder so I reserve switch grip for max-pulls and other extreme fatigue situations.

Also, I’ve been reading a little about a supp called Cissus Quadrangularis. Some people are calling it a miracle etc… I’ve never tried it, but you may want to ask around.[/quote]

Hey, beebuddy:

I use a switch grip, alternating which palm is forward with each set. I notice no aggravation with this, or the conventional grip.

I’ve heard of Cissus, but haven’t really considered it. Perhaps I’ll fire up Google and revisit it now that you bring it up.

Thanks, all!

Jim

12

I can sympathize. I’m 42, and have bone spurs in both my AC joints as well as a 25% tear in my right rotator cuff.

I’ve been lucky enough to be able to continue lifting with only occasional times where the pain becomes too great and I need to rehab the shoulders. Ice, heat, avoidance of certain movements and therapy exercises have kept it just under control, but surgery is tempting even if it means 6 months to a year before I can get back to intense lifting.

I have never had a problem with deadlifts. Pressing is what hurts me.

Good luck with the recovery.

13

HAPPY HOLIDAYS and good luck with your road to recovery…you may find you end up better than ever!
Art

14

Three-and-a-half weeks out from surgery. Pain is drastically decreased from week one. Right now I’m up to nine (9) PT exercises that I must perform twice per day. This is mostly Passive Range-of-Motion (ROM), with the beginings of “assisted” ROM and some scapular exercises. My PT’s are really into scapular strengthening for impingement relief.

Reaching overhead still hurts, as does reaching behind (like to scratch an itch on my lower back). It is also painful to reach across to my right shoulder.

I know that pain will decrease at a lesser rate as time goes on, and I’m looking at two more months of PT before pain goes down more and I can start to do real strength work again. I know that shoulder recovery is along road.

For now, it’s ROM exercises, ice - ROM exercises, ice. Evey day. I throw down some Advil every now and then to really keep inflammation down.