T Nation

Rotator Cuff Support Group

I’d like this thread to be for information gathering and support, for those who have some injury to the rotator cuff. Much of the information on this site is directed towards prevention, whereas I am seeking greater clarity on how I can fully rehab my injury. Hopefully there are others as well who can pose questions and offer information and experiences.

I have had pain to both shoulders for much of the last year. Currently, it is mostly in the scapular region. It can be exacerbated by upper body weight training. My doctor tells me there is not a tear on either side. I suppose that means the pain is from chronic impingement and inflammation.

This being the case, what should my plan be for maximum recovery?
Are there any rotator cuff strenghtening exercises that are contra-indicated during rehab? Would the routine from Eric Cressey’s article, “Cracking the Rotator Cuff Conundrum” be a good place for me to start? (http://www.T-Nation.com/readArticle.do?id=459577&cr=)

Thanks for any input!

Check out Eric Cressey’s Shoulder Saver series:
http://www.T-Nation.com/readTopic.do?id=1053531
http://www.T-Nation.com/readTopic.do?id=1055409
http://www.T-Nation.com/readTopic.do?id=1153915

Also this article from another site: www.wannabebig.com/article.php?articleid=265

  • if any mods want to clean up my links, I would appreciate it.

Have you had an MRI done? Is the doctor telling you it’s impingement? and if so what is his diagnosis as to cause?

I got arthritis in both shoulders and I can tell you it’s not the end of the world. My workout has changed a lot: no overhead pressing, mostly floor pressing instead of benching, etc but I think my workouts are better than ever now.

Below is my story, which I haven’t had the chance to tell in awhile and this being my first post, thought some of us “old” people might bea bale to learn something from my experience. But to cut to the chase, my rehab (see below) included very light side and front lateral raises, and dumbell shoulder press (standing or seated)very strict form (the OPPOSITE of what I did for the last 8 years).

Also, very light “arm wrestling” exercises with a 5 - 10 lb dumbell - this exercise used the forearm pad on the Universal ab/leg raise contraption, with the upper arm holding the weight up like the other guy’s hand in an arm wrestling competition and then lower and raise in the same kind of motion. This really strengthened my rotator cuff-area muscles.

Other exercises included using the lower cable and doing upright rows with arms extended and only slightly bended. Always using light weights and very high reps, slowly building up in weights but keeping the high reps. There were also a bunch of bodyweight-based exercises and stretches.

Hope this info helps, below is my story:

Last September (Sept. 23rd, 2006, to be EXACT!), I fell backwards, legs knocked out from under me, and landed on my armpit. At about 215lbs, gravity and age (37 at the time, it made for a powerful explosion deep inside my shoulder. Between laughing and near tears (laughter and pain!), didn’t think much of it …although having never breaking a bone before, thought something serious may have happened.

After laying off the weights for a couple weeks, it felt 50 - 75% better and started working out again. But slowly over approx. 4 weeks, I got weaker and weaker in excercises like bench, shoulder press, etc…

So, in early Nov. 2006, went to several doctors, MRI, etc…and was diagnosed with a torn labrum (look it up - I never heard of it either, but it is the cartilage that acts as a cushion in your shoulder socket (glenoid) and the upper arm bone. Basically, it makes everything fit and snug in there.

After 3 hour surgery in early Jan. 2007, doc tells me that when he went in to repair the labrum, he found torn rotator cuff also and “cleaned it up” by snipping off the torn area. Apprently, unless the tear is around halfway or more, we have enough to just clip away the torn part.

After surgery, then the fun started. My doctor was very aggressive in the rehab, IMO…and I viewed that as a good thing. He had me doing stretching exercises the morning after and I pursued them like crazy. I followed everything suggested to a tee. After 2 weeks post-op I went to more formal rehab and continued various stretching and bodyweight strengthening exercises. After 4 weeks, light weights, but crazy high reps…which was new to me.

Prior to this, “high” reps meant double digist, like 10 or 11!!!. After about 4 weeks of using very light weights and high reps (20 - 30 per set), at about the 8 wk mark, he gave me somewhat clearance to do any exercise but bench and shoulder press.

After 4 months formal rehab, mixed in with slowing building my strength back to more normal weights and reps, I was more cut than I ever have been, at about a leaner looking 210.

Here’s my overall take — if surgery is an option or recommended, ask yourself one question: Without surgery, am I preapred to live the rest of my life with whatever limitations I have found? I love lifting heavy and getting stronger…it has made me who I am. I saidf “No” to that question and with a surgery that had a 90 - 95% success rate to full strength, I jumped and jumped early. Glad I did, when I did. Best wishes in your recovery, strengthening and if you need surgery, glad to walk you through with more detail.

Seanholio, thanks a million for posting those Eric Cressey links. I thought I knew almost everything there was to know about shoulder rehab, but HE IS THE MAN. He’s given me some ideas to help me get that 15% more recovery I need in order to lift OL again, and possibly bench heavy again as well. And I totally agree with him that upright rows AND incline db curls are death to shoulders.

 By the way, I found my own Blue Gel-Ultra Blue with MSM and Emu oil, from the Vitamin Shoppe. It works better than any topical gel I've tried. 
Keep this thread going! I'm giving it some stars.        Doc

I’m not over 35, but sometimes my body feels like it, unfortunately. At 20, this isn’t good.

Anyway, I had a question about rotator cuffs that I posted on another thread but I’m sure it got lost in the shuffle…

Up until I got to my current university, I’d heard that baseball players shouldn’t do full-ROM on certain exercises (bench, DB bench, DB shoulder press, etc.), in order to save the rotator cuff. I know that that builds incomplete muscles, but I trusted that it would be good for my arm.

I got to my current university, and the strength coach ripped me for not using full ROM and then for my question (this one). Since then, my shoulder has been sore. Any idea if these two things are related?

Hey Guys,

I have a similar story and I’m in the middle of it.

I tore my shoulder benching dumbbells in Oct 2006. I then took a couple of weeks off and when I tried lifting again. It still hurt pretty bad.

My next step was an internet search of how to over come shoulder inbalances. I did that for 4 months without success.

I finally went to doctor in the spring of this year. He injected me with an anti-inflammatory and put me in PT. That didn’t work either.

The next step was an MRI in June which showed the tear. I just had surgery in early Sept and I’m now back in PT and working with light weight.

Bottom line: If I had to do it over again I would get an MRI immediately for anything related to shoulder pain. In retropect, I wasted at least 9 months trying to overcome it myself. I’d love to sue myself for malpractice but I can’t. haha

Carlsbad

[quote]StuGotts wrote:
Below is my story, which I haven’t had the chance to tell in awhile and this being my first post, thought some of us “old” people might bea bale to learn something from my experience. But to cut to the chase, my rehab (see below) included very light side and front lateral raises, and dumbell shoulder press (standing or seated)very strict form (the OPPOSITE of what I did for the last 8 years).

Also, very light “arm wrestling” exercises with a 5 - 10 lb dumbell - this exercise used the forearm pad on the Universal ab/leg raise contraption, with the upper arm holding the weight up like the other guy’s hand in an arm wrestling competition and then lower and raise in the same kind of motion. This really strengthened my rotator cuff-area muscles.

Other exercises included using the lower cable and doing upright rows with arms extended and only slightly bended. Always using light weights and very high reps, slowly building up in weights but keeping the high reps. There were also a bunch of bodyweight-based exercises and stretches.

Hope this info helps, below is my story:

Last September (Sept. 23rd, 2006, to be EXACT!), I fell backwards, legs knocked out from under me, and landed on my armpit. At about 215lbs, gravity and age (37 at the time, it made for a powerful explosion deep inside my shoulder. Between laughing and near tears (laughter and pain!), didn’t think much of it …although having never breaking a bone before, thought something serious may have happened.

After laying off the weights for a couple weeks, it felt 50 - 75% better and started working out again. But slowly over approx. 4 weeks, I got weaker and weaker in excercises like bench, shoulder press, etc…

So, in early Nov. 2006, went to several doctors, MRI, etc…and was diagnosed with a torn labrum (look it up - I never heard of it either, but it is the cartilage that acts as a cushion in your shoulder socket (glenoid) and the upper arm bone. Basically, it makes everything fit and snug in there.

After 3 hour surgery in early Jan. 2007, doc tells me that when he went in to repair the labrum, he found torn rotator cuff also and “cleaned it up” by snipping off the torn area. Apprently, unless the tear is around halfway or more, we have enough to just clip away the torn part.

After surgery, then the fun started. My doctor was very aggressive in the rehab, IMO…and I viewed that as a good thing. He had me doing stretching exercises the morning after and I pursued them like crazy. I followed everything suggested to a tee. After 2 weeks post-op I went to more formal rehab and continued various stretching and bodyweight strengthening exercises. After 4 weeks, light weights, but crazy high reps…which was new to me.

Prior to this, “high” reps meant double digist, like 10 or 11!!!. After about 4 weeks of using very light weights and high reps (20 - 30 per set), at about the 8 wk mark, he gave me somewhat clearance to do any exercise but bench and shoulder press.

After 4 months formal rehab, mixed in with slowing building my strength back to more normal weights and reps, I was more cut than I ever have been, at about a leaner looking 210.

Here’s my overall take — if surgery is an option or recommended, ask yourself one question: Without surgery, am I preapred to live the rest of my life with whatever limitations I have found? I love lifting heavy and getting stronger…it has made me who I am. I saidf “No” to that question and with a surgery that had a 90 - 95% success rate to full strength, I jumped and jumped early. Glad I did, when I did. Best wishes in your recovery, strengthening and if you need surgery, glad to walk you through with more detail.[/quote]

sounds like you had a good doctor whats his name?

I’m on my second go-around with inflamed rotator cuffs.

The first time was the result of heavy bag work, bad shoulder alignment. After it didn’t go away for almost three years I went in to see a doctor. A few exercises, an improved posture drill and a little weight loss and it was gone quickly, like magic. I felt like an idiot.

The second time was after I started Judo. That has lingered longer. They get worse while I’m sleeping if I sleep wrong. I’m discovering that shoulder exercises actually make them better (when I do my normal weights, which I laid off for several months, the pain goes away for 2-3 days).

If I take a motrin (for the anti-inflammatory effect of ibuprofen) I’m pain free the next morning. I’m tempted to try one a night for a month to see what that does.

Though I’m also thinking of splitting my routines up so I work my shoulders more often at the gym.

worse while I’m sleeping if I sleep wrong

This is a daily battle for me. Fortunately for you, you are in the pre-surgery, possibly can avoid it stage. 
 I have had some success "training" myself to sleep on my back (but I've been at this shoulder problem for a decade.) When I do (my wife calls it "mummy sleeping"), I awake with 80% less pain. Creative use of pillows has helped. You should try an Alleve at night, it's longer acting than motrin. And don't be afraid to use it every day for at least a month-because it you can't heal from your shoulder probelms, you'll be headed for surgery and daily pain meds.
                            Doc

Find a good, well-recommended sports chiro-practor. If there is no soft tissue damage so far then getting into alignment will solve most of your problems. Then be sure to keep your shit in gear by following EC’s Rx’s and keeping your chiro up. ART is hella beneficial as well.

You may think chiro is a bit hokey pokey but you have no idea how necessary it is. this is coming from a guy who gets injured training for MMA quite a bit. But my joints have never been better.

-chris

Chiro’s have helped me and hurt me in the past. If they know what they’re doing, I believe they are a good modality of treatment, combined with other things.
On the other hand, I have only read about ART, not had it myself, even though I am a big fan of sports massage and even have had rolfing, cranio-sacral, and Reiki. I’d enjoy hearing what those of you who have actually had several sessions of ART can tell me about what it has done for you.
Doc

[quote]Dr.PowerClean wrote:
worse while I’m sleeping if I sleep wrong

This is a daily battle for me. Fortunately for you, you are in the pre-surgery, possibly can avoid it stage. 
 I have had some success "training" myself to sleep on my back (but I've been at this shoulder problem for a decade.) When I do (my wife calls it "mummy sleeping"), I awake with 80% less pain. Creative use of pillows has helped. You should try an Alleve at night, it's longer acting than motrin. And don't be afraid to use it every day for at least a month-because it you can't heal from your shoulder probelms, you'll be headed for surgery and daily pain meds.
                            Doc

[/quote]

I actually developed an inpingment from sleeping on my stomach with my arms folded under my head. If I sleep too long on one side my shoulders hurt from inpingment and if my arms are too straight or bent too long my elbow arhtritis wakes me up. I basically have to sleep with my arms around a pillow and roll over often.

This post was flagged by the community and is temporarily hidden.

I’m not over 35, but I’ve had my share of rotator cuff woes. My advice boils down to this:

DO NOT WAIT TO GET AN MRI.

Oh, and one more thing:

DO NOT WAIT TO GET AN MRI.

It took me 2 years of physical therapy, chiropractors, and acupuncture before a doctor finally prescribed an MRI. Turned out I had a type 3 acromion process, which is basically a hook of bone digging into the muscle. One outpatient surgery and a few months of rest later, I was back to rock climbing, lifting – all the things that were painful before.

DO NOT WAIT TO GET AN MRI.

Airtruth -

I truly believe the key to my recovery…and so quickly back to 99% full strength in the “scary” shoulder exercises (bench and military press) was my doctor’s aggressiveness and my own will and desire to get my strength back. His name is Dr. Eric Aronowitz at Schenectady Regional Orthopedics (www.schenectadyregionalorthopedics.com) in upstate NY, about 3 hours North of NYC near Albany, NY.

Also, Carlsbad is 100% correct about not waiting. I hurt myself in late Sept., waited a couple weeks and it felt 50% better, then starting lifting in early Oct - early Nov. I went to doctors in early - mid-Nov and MRI showed most of the damage, and Dr. Aronowitz diagnosed me immediately my pressing on my hand/arm and having me push in all kinds of directions. He was correct on the labrum, although more damage once he got in and he found tear in rotator cuff, of which i did NOT have symptoms, which he attributed to my strength and muscular development.

GO TO A DOC AND GET AN MRI ASAP. I am glad I didn’t wait one day longer…plus surgery was in winter and I only missed skiing (and heavy lifting, obviously!!). Look at recovery as one more challenge or “bump” in life you have to jump over.

New (at least to me…) approach to RC training. Maybe someone will find it useful.

http://depositfiles.com/files/6526555

Nice stuff guys.

I’m going in for the surgery consultation in 6 days from now. I have a tear in my cuff musculature also. I asked for an mri straight away after injuring it and attempting my own rehab cuff exercises etc, but was given the cortisone initially. When, to the docs surprise, that didn’t do shit, I finally got the mri clearance, which showed the tear.

Luckily I had a good hookup, and now have the best guy in the area who only does shoulder surgeries. He was pretty backed up, but my incessant calling to his office, looking for cancellations, paid off, and my consultation was bumped up from Aug 26, to July 17.

Glad I found this thread, it looks excellent.
I would be happy to report back in on how my consultation goes and surgery after if anyone is interested.

Later guys.

ToneBone

Well so much for the mri initial reading. In all fairness it’s quite difficult to diagnose correctly what has happened to me unless one is a specialist. Here’s the lowdown if anyone is interested.

So I just got back from the consultation on my shoulder.
It looks like I have a pathology which is very common to weightlifters and athletes.

Distal clavicle osteolysis:

Heavy lifting, especially benching and overhead stuff, causes it. There are 2 or 3 theories on the exact cause but basicly they don’t really know why it happens. The bone starts to “self absorb” itself. It hypertrophys, and I believe it absorbs the cartilage at the same time. Becomes “spongy” so to speak. Where the enlarged clavicle then rubs against the ac joint or some such thing.

At any rate, there are only two options, the conservative cortizone shot directly into the exact spot,(done that), and the surgery. The surgery is called distal clavicle resection, and they take a little less than a centimeter off the clavicle so that there is no rubbing with full ROM afterwards.

My surgeon is damn good, works on pro athletes and so forth. He said he’ll be able to do it in 6-8 more weeks, and also via the arthroscopic method, which, for this particular surgery, is more difficult than open delt for most surgeons, but allows a much speedier recovery. The thought of having your delt cut away doesn’t sound too cozy now does it? Lol.

Downsides are that it’s not to say one won’t still have ups and downs with the shoulder as the years go on, you may, you may not. Also if lifting too heavy on overhead stuff, one might get shoulder seperation, or might not.

This is because some of the ac joint connections have to go bye-bye, to do the surgery. It stays pretty solid though, with the two main connections being left alone.

But bottom line, day to day activities and lifting which I can’t do presently, will be doable. The operation is pretty successful for most of the patients, and the conservative approach takes much longer to resolve, and the pathology pretty much comes back around once you resume the lifting of benching/overhead again anyways, so it really doesn’t resolve fully ever.

Now like most anyone else in this situation the thought had occurred to me “how did I do this to myself?”…

I can’t remember the actual day that I first noticed it, and most people don’t. I do know that I had been on a good stretch of DC training at the time, and was going pretty heavy with my benching and push press.

Also, kept training for a little while at first due to ignorance of not knowing how bad the injury really was. I think it was during a push press if I had to guess though.

Right now I’m just happy to be moving forward, and knowing finally what the heck had happened.

So, in closing, has anyone out there had this procedure done before, or know anyone who had it done? I’d be curious to know of any experiences if possible.

I have read plenty over the internet, but it’s always good to hear how people around here might have done with it too.

Later,

ToneBone