T Nation

Front Delt Strain


#1

About a good month and a half ago, I strained/partially tore my right front delt doing heavy bench work at 3-5RM. The pain began on the 3rd to 4th rep on 95kg. I racked the weight on 5th rep and didnt think much of it. Then proceeded to do another set a few minutes later but had rack at 2nd rep due to pain now being quite intense.

The pain is isolated only to the upper front delt tendon and feels roughly like a "pinching" type of pain where tendon meets the acronomion-clavicula bone. I can trigger this pain by positioning my arm in a rear bench dip position or retracting the shoulderblade in a horizontal pulling movement. Similarily if I lift my arm vertically up in air (any of which stretches the front delt to its limit). Also front lateral raises annoys the tendon.

Flexing the front delt induces no pain, however flexing the front delt simultanously with the right trap, (most muscular pose) brings in the aforementioned "pinching".

Ive been to a sports physio therapist with this. I've been told to lay off direct pressing work for a while and do rotator cuff work and light blast strap pushups and various types of isometric strength work with focus on form in the meantime.

Now my question is, what can I expect from an injury like this? I realize internet diagnostics can be a shot in the wild at best. The first doctor at E.R. said 2-3 weeks(obviously clueless), the physiotherapist was unsure but guessed 2-4 months. The strain seem minor yet recovers very slowly. Getting CT/MRI scans around here takes forever, worth contacting family physician? (again, long ass queues for consultation)

Also, will heavy squats/DL's be detrimental to recovery? (passive trauma towards tendon/bone close to tendon.)


#2

Almost exactly the same happened to me 6 months ago when hitting 315 on my 3rd rep. Only now am I even able to press 185 for 6 reps. I still feel pinching and strain in the area. However it is quite less prominent and bothersome as before. I did not heed my physician's warnings and maintained heavy and explosive shoulder work but only did light flat bench work and flat dumbbells (could barely press the bar for the first month without agony). Deadlifts and squats did not seem to antagonize the situation. Then again, I was already antagonizing it view the aforementioned shoulder exercises.

Good luck.


#3

Warning: Wall of text.

Update. It's been appx 10 weeks since injury, and I still can't bench much more than 50-60kg for a few reps without pain, so ive laid it off completely untill further, doing suspended pushups in blast strap/TRX band configurations pain free for a while.
Maintained deadlifts, squats, farmer walks, and only excercises that inflict no pain to scapular manipulation.

Ive been to 2 different M.D's both of them seemed clueless (take anti-inflamatory, and youll be fine in 2 weeks etc) and 2 different Physio Therapists.

I can pinpoint the current pain to pulling the shoulder down with lats/teres major and other support muscles, while simultanously pulling the shoulder up with right trap. This causes something inside my shoulder to pinch, most notably feels like its right below or near the rounded AC bone on top of the right shoulder. Trapezoid AC ligament strained? I first thought this was because the front delt was attached here, but I can do 45lbs DB front raises for 10 reps painfree, which was my previous max lifts pre-injury, so front delt seems fully healed.

First PT notes weak subscapularis, consequently I've strengthend it for the last 6-8 weeks with cuban press like rolls with cable at high rep (15RM) protocols. Basically cable cuban press, and then reverse cuban press for the antagonist RC; infraspinatus.

Second PT notes possible scapular instability and weak supraspinatus, by having me raise both arms laterally to the side with thumb facing down isometrically pushing upwards. Also points out there might be a minor dislocation.

At this point ive spent quite alot of money (for a college students small budget), and gotten many different answers most of which points in different directions. All i want to is to pinpoint the exact location of pain and then figure out how to treat that problem, none of the 4 has been able to tell me the exact cause of pain.

I also cant feel any scar tissue lumps in front delt that might cause impingement towards bursae sac, but i still have some clicking/popping in right shoulder when manipulating the scap position as one would do when barbell touches chest when benching. Could this suggest internal impingement in RC hitting the inside of the bursae?


#4

Turned out i ignored the 2 telltale signs of subscapularis inflamation: rear stretch when bench dipping.
Diagnosed with gerber-liftoff test. Got nsaids of doc.


#5

Ironhard,

You said it yourself, asking for web medical advice is a crap shot. but here is my take for what its worth.

I have gone through AC joint surgery. I had an inch and a half sawed off my left shoulder

(still got it in a jar in my gym bag to remind me that the time to stretch and use proper form is not after you injure yourself, but before. Ben Franklin and all that shit about an ounce of prevention is worth more that a pound of an orthopedic's saw).

To the point. After my operation my surgeon told me to take 6 months off completely, then slowly ease back into things. He told me to not so much as even jog because the jarring could cause damage. Me being stupid, i actual took his advice. During the first month i read alot about Louie Simmons and how he recovered on his own for his severe back injury when he was an oly lifter. He said walking was one of the best forms of recovery from injury so i called my doc and he said fine. So i'd walk everyday for 5 to 7 miles. By leaving the shoulder alone to heal and using the walking to stay healthy my shoulder is stronger today than it was before the surgery. I'm hoping to push press 250 (for a single) by the end of the summer. I'm a buck seventy five. Oh and yeah i bend my knees.

Here is what i read in your posts. You injured your shoulder and to make sure that its still injured you keep trying to do stuff until it hurts so you can say "yep it's still injured"

Thats not smart

Next your trying all kinds of new exercises to either
A} fix the injury
or
B} strengthen the area around the injury

Neither of these are smart right now. Why? Because YOUR INJURED!!!

new exercise for an injured muscle is just going to injure it in new ways.

and strengthening the area around the injury is like trying to heal an injury by stretching it. That only causes more injury.

Stretching, and strengthening a weak area are GREAT things to do to PREVENT injury not heal injury. You change your car's oil to prevent engine break down. You don't drive your car till the engine seizes up and then start changing your oil every day.

You said yourself you have inflammation. New exercises with straps or foam balls or jingle bells will only prolong your inflammation.

Leave your damn shoulder alone for a while and let it heal. Make sure your omega-3/omega-6 balance is inline, get alot of sleep. Take alot of baths. Walk, unless of course you leg is injured. Simmon's said its chief benefit is it get the circulation going which helps in recovery. The length of time will depend on your age. Hopefully your not an old fart like me, i was 43 when i had my surgery so thats why i was told to LEAVE IT ALONE for 6 months. But it WORKED,

Then easy back into things, swallow your pride and start easy and this time take your stretching (i love activated-isolated-stretching) and lifting form seriously and daily, not just when you can squeeze it in or when you tweek something.

my stupid two cents worth.

LB


#6

For all its worth, thanks for those cents, i probably needed to hear it that way. Im in my "bulletproof-20's".
Got an MRI scheduled in 3 weeks, and nsaids to last about 2. Combined with LI-cardio untill then so ill heed that advice. I have barely any pain left now, but a good 3 weeks off till i get positive proof is probably smart.