T Nation

External Rotator Injury


#1

This morning I was doing push presses and felt a small pop along the out side of my upper arm accompanied by dull pain.

I can still do lateral raises at half rom and full rom rear delt raises. Also flexing my bicep and tricep do not cause any pain. But doing anything thing that causes external rotation or stabilization of the shoulder joint causes pain.

Any ideas for rehabbing this? And any ideas on exercises to continue shoulder training? And any other thoughts in general would be appreciated.


#2

Read all the Eric Cressey articles that have to do with shoulders.


#3

Went and read through everything. Not really as much said on it as I was hoping.


#4

If you have medical insurance, make an appointment with a qualified MD (orthopedic). Trying to train around a shoulder injury can exacerbate the problem. Also, doing the wrong rehab can also make things worse. Get the facts first, then decided on the correct steps for recovery.


#5

On your own, your best bet is to work on your ROM without weights. Shoulder circles and whatnot. Really try to pump your arm up with blood.

Continue doing rear delt work. Lemme guess, you rear raise 45's but can push press 185?


#6

Get it checked out immediately... Don't fuck around with injuries like this, if you indeed tore something badly, waiting forever to get surgery done (if it's required) is just plain stupid.

You need to find out what exactly is wrong with your shoulder before deciding what to do, training-wise.

An MRI would be good...


#7

What do you do until you can get an MRI? I think he can still stretch his legs, do BW conditioning and such. Things like one arm deadlifts come to mind. I just want to provide something to keep him focused and challenged if he has a bum arm medical magic can't fix


#8

You PM BBB and ask if he can help you figure out what's wrong based on specific movements or something... :slight_smile:

Leg Press and whatnot... He can do what doesn't involve that shoulder of course... But trying to fix his shoulder himself or work through it when he doesn't even know what exactly is broken/wrong is not at all a good idea... The shoulder is so complex, what fixes one issue can really, really make another worse. So no rear delt work for that shoulder either... That might help if he had rounded shoulders or some such, but if it's indeed one of the external rotators that's injured then I would really avoid it until he knows more.

One-Armed training hmmm. I did read about the bilateral effect that is supposed to have, but I have no personal (or otherwise) experience with using only one arm for a longer period of time due to injury, so I don't know...


#9

Kanada- Damn how'd you know? About the rear delt raise and push press. Those are damn close to my numbers, when it popped his morning I still had at least 2 more sets and 20lbs higher to go. Imbalanced I know. I have a lot of these from years of poor training. Only recently trying to fix them. I figured I would keep training legs since it has nothing to do with my shoulder or I can at least find exercises that will not aggravate it.

Would doing back work be out of the question as well? Rows and what not?

I wasn't going to go in and try and rest it but I really do want to fix it right and not have it partialy fixed and bothering me and just waiting to be re-injured. Thank for your opinions and advice and anymore would be appreciated.

I want to be able to train as much as I can without keeping this injury longer than needed. This has come at a time when I have been making great gains in body weight and weight in the gym. Also I just love lifting so much the more the merrier.


#10

Ryan, whether you can do back work with that side depends on what you've actually injured.

And damn, 45 lb rear raises are really low... What is your strict press and bench?


#11

Yeah I know my back is really weak compared to chest and front delts. This comes from way to many years through high school only working the front and no back. Damn inexperienced football coaches, thats all they taught us and I never bothered to look farther because I was more into sports. Now that I look back it sucks.

Strict press I haven't done in a long time. Probably somewhere around 145 or so for 3-5.

Bench is my second chest exercise after incline bench. I ramp incline up to 205 using sets of 3. Then flat bb bench sets of 5 to 205. I don't really max so that's as good of numbers as I can give you.

Yeah I understand that what is injured will determine. But if I can do some exercises w/o pain you think I should/could?

To give an idea of what hurts. If i am stand with my arm at my side then bend at the elbow to 90 degrees palm facing medially, then rotate laterally pivoting at the elbow. Dull pain starts after 30-45 degrees from start. I can get it all the way to 90 and hold it and most of the pain will disappear after a couple of seconds. Maybe some pain in the background. (Not sure if that made any sense)


#12

I definitely think you should do rear raises if you can, I've had similar pain in my right shoulder five years after throwing a fat kid around in the pool and popping something. Muscles in my back weren't working, terrible form. I am really thankful though, I learnt a lot from trying to understand what my body was telling me.

C_C I guess you'd be amazed to hear that I see 10 people at the gym who can row 225 or more, but can't rear delt raise more than 45. Mind Bottling I know. Thankfully, I can raise 45 and press 115 so I'm more "balanced"

To be transparent, I don't think you tore anything. I'm not a doctor but I am confident in my diagnosis. I think you're a stupid trainer, and you have to make some changes in your training priorities no matter. In my mind, if you can preform a rear delt raise there is no reason you shouldn't, thats how I approach my tender areas.

The reason I believe the pain goes away is because your muscles surrounding the shoulder complex, especially those that preform a similar action as the hamstrings preform in regards to the quad, are tightening in an attempt to limit your ROM. When you "force" your arm into an uncomfortable position, the muscles are forced to fire, and after a few seconds the pain impulses will decrese as you arm relaxes. Your pretty much stretching your shoulder, which you probably never would have done without this injury.


#13

Well I agree my traiing approach up until 4 months ago was bad. But I have evened everything out mostly thanks to this sit. And only in the last month have I really started doing mobility work. I do stretch my shoulders. I do a 10min warm up and then mobility work before every session. Of course there is so much tension built up in many of my muscles that the mobility work cannot correct it fast enough.

I also do not think I tore anything. I think its just a strain. But with a shoulder I don't feel like guessing. The discomfort I feel is more than just stretching pain so there I believe there is a minor strain or something of that sort involved. My shoulders are very tight and will take a lot of work to loosen up.

I will continue doing what doesn't hurt for a week. I gave everything the day off today and am gonna check in with a doctor since insurance covers it and I don't feel like screwing something up that could have been fixed if I didn't just ignore it.


#14

Hooray insurance. May as well have a benchmark to go by anyways in the future.


#15

Well that was nice and quick.

Same conclusion. Probably pulled the infraspinatus or teres minor. Also the Doc commented on the mobility in my shoulders needing some work. So pretty much the same as what you all have thought. Also said do anything that doesnt hurt and maybe lower the poundages for a week or so on bench and shoulder work


#16

If this were just some light sprain or something, or bad posture or some such... But major loss of ROM, a pop in the area, dull pain... I personally would avoid working it for now, but it's your decision. I'm one of the more careful people around, usually...

Tell BBB... He hopefully knows some ways to test for specific issues...


#17

Ah, made my previous post before I saw this and the other post of yours.

Okay... If it's just a light pull/sprain, then by all means do whatever doesn't hurt.

Also, based on your strict press and bench numbers, your bent laterals don't look too weak anymore... Fairly average for that level of strength, the push press threw me off... You probably use a lot more leg drive than I used to back when I still did those.

So... Just focus on getting rid of that shoulder tightness, but it might be a good idea to not do more than the bar on overhead work for now... And make sure you learn proper pressing technique. Any chance that you have a vid of how you used to press?


#18

I'd actually call that very strong on rear laterals compared to your press. Interesting. Sure you aren't swinging too much or anything like that? Then again, making the right muscles work is the priority... Whether with loose form or strict.

Those can really impinge some of the cuff muscles at the top of the ROM though, depending on the path your elbows take etc... That's why I wanted him to be careful with what he does. Then again, if it really doesn't hurt and he hasn't actually torn anything...

My mother tore her supraspinates without realizing it at all, no pain, just can't raise her arm past a certain point. Never got surgery because she didn't know until much later. I'm mentioning that so that people don't forget that suddenly limited shoulder ROM can be due to many things, and quite a few of them are really damn bad. And you may not even notice that anything is seriously wrong, depending on whether you get pain or not etc... My mom was misdiagnosed several times too...


#19

Thank you CC for your advice. I do not have a camera up at school with be so It will be a little over a month before I can get one. I am going to be limiting the overhead pressing for a couple weeks. In your opinion do you think high incline DB press would be alright? I do need to work on my back and posterior delt. Also I think I will start doing more strict pressing once I give this some time to get back to 100%. That way I will be doing less weight while letting my posterior catch up.

I will be focusing a lot on trying to loosen my shoulders up. Anything i should focus on? I am doing a lot of what is found in this video series. http://articles.elitefts.com/articles/rehabilitation/did-you-know-youre-dysfunctional/

Thank you again


#20

Just an update. Did a killer back workout. Told myself I was gonna go easy and try and beat anything from last session. Well I guess I should know myself by now; i cant do that. Set some PRs no pain at all and I really worked on stretching the shoulders.

Had a bench session today. Incline aggravated it a bit so I didn't up the weight. Flat bench felt fine and DB incline i limited the ROM and it felt good. So all in in all I am happy. Really working on warming everything up better and stretching more. Also lots of foam rolling.