T Nation

Need a Workout to Work around Shoulder Pain


#1

3 months ago I injured both of my Anterior and Medial Delts. I haven't been to a doctor yet.(procrastinating). I cannot do SGHP, or any kind of barbell bench with any kind of weight at all. So, for the last 12 weeks I've been doing Reactive pump Program with the idea that if I used less weight, more reps, and variations of the bench that I could handle, that maybe I could sort of Rehab them myself.

Anyway, doing 10-12 reps has never been my cup of tea. I get fatigued/pumped real quick. Heck, doing 10-15 singles has always been easier for me. Not to mention more fun.
So, I am trying to put together some sort of program that I can do.
For bench, There are 2 or maybe 3 machines that I can use with some weight and not have pain. Also, I can do Push Press, or Military, and I can do Power Cleans.
Any help would be sincerely appreciated.


#2

I hate people that say "go see a doctor!" when you ask for specific help. But if it was a simple muscle strain shouldn't it be cleared up in three months?

I know doctors, physios etc are often pretty useless at giving you programs to get you back to full functionality. But wouldn't it be best to go - just to get an opinion on what's wrong? Although I'm sure you have sound reasons for not doing so!

I'm sorry I can't give you any answers to your specific question. Other than perhaps suggest the use of chains or resistance bands - might that help in some way? I was out of action with sciatic pain for about 6 months and couldn't do anything with heavy weights simply because stabilisation was enough to cause pain. But by using weights with resistance bands I could get in and out of position safely (as the weights were comfortable) but the bands kept my muscles working hard. So just wondering if there's maybe some way this type of thing, with a bit of creative thinking, could provide a bit of a workaround for you?


#3

Thanks for the response. Much appreciated.
I generally don't go see a doctor if I feel it might be something that i can take care of myself.In this case, I'm gonna have to. It's been like this since April 20 or so.So, it's time to go see Dr. Lubliner. He's a Sports medicine doc. He's performed 2 of my 3 knee surgeries(first one in 1986) and has helped me with other injuries with a shot of cortisone or even just a stretch movement.I'm sure he'll get me fixed up.
What hurts is bench, anywhere from flat to incline. I can do decline machines, not bar.And I can do military.
I also cannot do any kind of explosive movement, like swatting a fly or trying to grab a mosquito out of the air, or SGHP. I can do power cleans
It's been hurting too much, for too long. Time to go get it checked.

In the meantime. I think I'm gonna start CT's Squat Blitz tomorrow. When he call for bench, I'll do the machine decline. SGHP, I'll do Power Cleans.
Thanks again


#4

Good luck!!

You just need to turn it into a positive. Rather than "can't bench" think - "what an opportunity - time and energy to take my squatting to a whole new level!" :wink:

Let us know the outcome with the doc!


#5

Yep. Hence the squat blitz.
hey thanks for the replies. You actually made me pick up the phone and make an appointment.. August 6 is the earliest.


#6

bilateral impingement. bicep tendon and rotator cuff. voltaren and pt prescribed


#7

Thanks for letting us know!

That's not so bad. Similar to me AND my husband!

It can take a while to get back to 100%, and really you need to be sensible and listen to your physio because doing the wrong things can make it much worse quickly. But on a positive note, once you get an understanding of why you're impinging (muscle imbalance as a rule) you can very quickly get back to hard training sessions - with just a few adaptations and workarounds.

Good luck with it!!!!


#8

yeah, he said if its not better in a month he will do an mri. you are right about a long time, its been almost 4 months. i never would imagine that just doing the bar could wreak such havoc.


#9

I may be wrong, but from what I understand of these things it's not really an injury as such.

More the case that it's a muscle imbalance causing the shoulder joint to track incorrectly - some of the bones end up too close together and tendons start to rub against bone. You get away with it for a long time, then one day it just decides it's had enough and you start to get pain.

Mine developed when I was doing a lot of running - hunched up in my pecs and upper traps and joint getting pounded with every step. Eventually I started to get pain and lost virtually all ROM in both sholders.

My husband had a very minor twinge for quite a while that he could easily train through. Then after finally mastering muscleups and doing 6 in a row the shoulder freaked out and he was unable to do anything.

Often there is no injury to heal. You just need to re-balance the muscles and get the shoulders tracking correctly and you'll be pain free. However, certain exercises (bench press is a bad one) can re-enforce your faulty movement patterns and keep you locked into the cycle of tissue irritation and pain. If you persist in training through these things you can eventually cause the tendon (that's rubbing against bone) to rupture - and that is serious! It can also lead to arthritic changes, rotator cuff tears and so on.

This is all just my understand based upon myself and my husband - don't take it as gospel. Look up Eric Cressey's "Shoulder Saver" articles on T-Nation to find out more. But I suspect that from now on you will need to give a bit of thought to keeping your shoulders balanced and healthy whilst training.

Good luck!


#10

thanks for the info.I am not really working through it. I would say I am working around it. If that makes any sense. I don’t do any movement that hurts. Some angles on bench variations do not hurt at all, such as the decline machine, or the hammer strength machine, so i use those.
Muscle imbalance sounds interesting. How would one know?
I have my first Physical Therapy appt on thurs. Let’s see how that goes. I have never been a big fan of PT, but, let’s see.


#11

I think your PT will explain all.

A common scenario is that you have very tight pec minor, biceps, front deltoid, poor scapular control, weak rotator cuff muscles (that was me!!!). Although there will be various causes for impingement. This pulls all the joints that make up the shoulder out of alignment and the little gap between the bones that the tendons run through get too narrow. The tendons can rub on the bones leading to pain (and potentially rupture). But also the pain could just be coming from trigger points in the tight, over-worked muscles.

This is all just based on my own experience, but probably you’ll get some massage to loosen off the tight muscles, some exercises to strengthen the weak muscles and stretch the tight muscles. I think typically you’ll see improvements quite quickly. The problem is, if you go back to normal training whilst you still have the faulty movement patterns it won’t be long before you’re back in the same situation again. So you really do need to work hard at resetting the firing patterns and learning to use the muscles correctly. Which tends to mean avoiding bench press for quite a while unfortunately!

Just telling you this as if it’s seeded in your mind you might think up some useful questions to ask the physio. As with anything I say - don’t take it as gospel!!!

Let us know the outcome with the physio.


#12

funny. You are absolutely correct!. PT guy did the exam and gave me the same explanation. He even “proved it to me” by pulling down on my shoulder while making me lift my arm, and -no pain-. Since then I am consciously pulling down , while lifting my arm. Weird thing is that, I believe it’s been like this for a long time but never gave me any pain. I had a video of myself doing SGHP, and I noticed that one side was higher than the other. I never felt it, but when I saw it, I was befuddled. Similarly in the bench, when I was working from pins, I noticed that when I put the bar down, it wasn’t straight. I just never figured it out.

Now, I realize probably where it came from… working on a desk, on computer for hours on end, with my elbows on the desk… Holy cow, I’m looking at myself right now, and I have my right elbow on the desk- kinds pushed up, and my left is off the desk, on the armrest.
Damn… I would have never imagined the problems that something like this could cause. :slight_smile:

Anyway, I now trashed my lower back doing squats day before yesterday, so, I’m basically in a screwed up situation. Guess I’ll have to find some sort of “conditioning work” to do.

Thanks again for sharing all your info… It has been very helpful!!!


#13

@domcib: I have been through this too. What helped me the most is to get good at skin the cat (best pec minor stretch their is in my opinion), look up some Kelly Starrett joint distractions, especially the snatch prep and the front rack position.

I’m not into isolation work, but I used a shoulder horn 3 sets of 25 every six hours for as long as you can progress increasing the weight as long as there is no pain (make sure you eat well, I tripled the weight I used in 3 days doing this, I can’t stand not being able to train lol) then every other day after my workout I rotated 3 sets of 25 with 1 set of 5-8 minutes straight only increasing weight after you can do 8 minutes straight.

I also would lay on a foam roller with dbs - think upper arms straight out and just let them stretch you into internal rotation like you want to tap the floor. I had success with the Kelly Starrett best IR stretch (it’s a barbell smash). Now I didn’t experience pain with this stuff and wouldn’t have done it if I had, and I’m sure you’re the same, but I feel better typing it out. : )

Before this I had went to an ART guy and he told me I had scapula winging and I shouldn’t do anything but a bunch of scapula retraction exercises for 3-6 months. I couldn’t stand the thought of taking that long off so I figured out a quicker way.

I started doing a lot of shoulder dislocations 1st with a band, then a rope or pvc after every set of bench as well. I became almost OCD with my form too.

All this started with me when I was at a computer for obscene hours a day because I quit my job to start my own business. So I became very aware of my posture because I figured if I didn’t I wouldn’t be able to workout and that wasn’t an option for me.

I hope you find this helpful and are able to do this stuff pain free so you can get back to being you in the weight room again.


#14

Ha ha…guess what my profession is? Computer Scientist!

I think sitting at a desk all day messes up your posture and muscle firing patterns. That’s not good. Then those of us that are into sports compound the problem because we do strenuous ‘work’ but with bad posture and messed up firing patterns. So rather than building the muscles we’re intending to build with a certain exercise or movement we’re actually strengthening up all the wrong muscles and teaching our nervous system to do things incorrectly.

It’s always the case I think. You have the problem for years without issue. You don’t bother to do anything about it because it’s not a problem - until one day…

Some tips based upon my own experiences:

  1. Don’t trust your physio too much. In my experience (and I’ve seen a few!) they miss a lot of things. They only see patients on their table and tend not to take account of the full picture. Do your own homework - discussions like this, read the articles and resources people recommend. Eric Cressey is the ‘shoulder expert’ on T-Nation!

  2. Have a permanent shift in the way you think about training. You can still train hard - harder than ever!! But always have the thought “How can I adapt my training to improve firing patterns and posture?”. One problem has come to the surface - if you don’t do something about it others will rear their ugly head soon. You’ll just put it down to getting older, but it doesn’t need to be that way. Turn the clock back so your have the body of a fit, healthy 20 year old!! LOL

I agree you need to get that pec minor stretched out (which is tricky). I agree re skin the cat - although I’m not ready to do that yet.

BUT in my experience you won’t get the tight muscles to stretch out until you’ve activated and strengthened the weak, lazy ones. I’d hazard a guess that, like me, you have weak and inactive lower traps. Do you feel as if you’re ‘hunched up’ a bit - as if your upper traps are working too hard? I’ve known I’ve had this problem for ages but never managed to hit the right spot whilst trying to correct it. UNTIL I discovered upside down dips and levers. It works miracles for me. I do it on gymnastic rings - it’s actually fairly easy to get into an inverted position as you can use the straps to assist with balance. You could do it on a bar too - maybe dip bars or even a pullup bar. It’s a wonderful exercise - it seems to get all the right muscles firing.

Another wonderful exercise is handstands. Just do a handstand every day. It takes seconds. If you’re not used to them it’ll seem hard at first but I guarantee you’ll be a handstand expert in no time - rattling out handstand pushups. They’re a great way to get your arms overhead whilst thinking about pulling your rib cage down at the front (tightening your core and stopping your low back from arching). Again, it seems to get all the right muscles firing.

Both these exercises whilst seeming quite extreme for someone with shoulder issues are extremely therapeutic for both my husband and I. But the precise details of everyone’s problem is different and they may not be safe for you. Do take care and don’t move ahead too quickly with your rehab!!


#15

@domcib: Another thing that has helped me that I left out before is when you get off of a computer or any time you have had a posture less than ideal, go lay on a foam roller for 5-15 minutes with your feet flat on the floor and your arms out to the side making a T with your palms up… this really stretches you out good and works on undoing the damage that our modern world brings us. Just lay there and relax & do some deep breathing.


#16

[quote]sput79 wrote:
@domcib: Another thing that has helped me that I left out before is when you get off of a computer or any time you have had a posture less than ideal, go lay on a foam roller for 5-15 minutes with your feet flat on the floor and your arms out to the side making a T with your palms up… this really stretches you out good and works on undoing the damage that our modern world brings us. Just lay there and relax & do some deep breathing. [/quote]
never used a foam roller before. how would you place it? where? lower back, perpendicular to the torso? along the spine, in line with torso?
thanks


#17

@domcib: Place the roller along your spine so that the back of your head and your tailbone are on the roller with your feet flat on the floor and your arms straight out (think reach out to the side as far as you can and then let them drop to the floor) with your palms up. I tried to post a picture but it didn’t work.


#18

Spurt79 - after you mentioning it on here I gave Skin the Cat a try. I’d assumed my shoulders wouldn’t like it at all - I cringe when I see others doing it. But it felt great!! It’s funny how (for me at least) the more extreme stuff that people tell you not to do is more therapeutic than the little gentle exercises they say you SHOULD do!!


#19

@susani: I agree totally… I just know from doing them and not doing them I am better off doing them. Those gentle exercises bore me to no end anyways.


#20

[quote]sput79 wrote:
@domcib: Place the roller along your spine so that the back of your head and your tailbone are on the roller with your feet flat on the floor and your arms straight out (think reach out to the side as far as you can and then let them drop to the floor) with your palms up. I tried to post a picture but it didn’t work.[/quote]
thanks
therapist had me do that the other day, along with all these little exercises.
reall boring stuff, but im starting to understand the process here. correct the imbalance yada yada. basically everything that susani said is what’s goin on. so, no pec work, and lots of mid back, and lat work etc.
at least i can do deads and rack deads :slight_smile: