T Nation

Shoulder Has Been Out of Whack for 5 Years


So basic history is that I use to only bench press and do biceps like every dumb kid in highschool did. One day I was benching and felt a weird feeling in the front of my left shoulder basically along the line that shows if you are ripped. Ever since that day I havent been able to bench without a feeling of extreme fatigue in that shoulder and a weird sort of feeling on the first couple of reps. It isn’t a crack, or a tear, its more of a loud stretch that I think releases gas.

So I’ve gotten an MR arthrogram with contrast which is the highest imaging possible and a very good orthopedist told me that he didn’t see anything wrong. I’ve been through PT but I had already been using those exercises myself to try and correct the issue. The past year and a half I have been training pretty consistently and have gained an extensive knowledge of various workout strategies, methodologies, etc. and the anatomy of the human body (pertaining to muscles especially the shoulder).

I have recently been seeing a very knowledgable physical therapist that was referred to me by Eric Cressey and he thinks my problem is with my inability to stabilize my scapula. He seems to think that the muscles surrounding my scapulae, particularly the left scapula aren’t strong enough to move my scapula correctly, therefore not clearing up enough space for my arm to move and some sort of impingement is the problem. I definitely agree with these thoughts but I have been focusing on my middle back and lower traps etc.

So the problem with working my middle back (rhomboids middle trap/lower trap) is that I can get a feeling of my left rhomboid (for lack of a better term) I only feel the right rhomboid on rows etc.

When I pull back my shoulder blades I often get an impinging feeling in the front of my left shoulder.

I have brought up to him that I think he is correct and that I also thing a lack of rear delt and tight chest are causing the problem. I tend to think my chest is tight because I cant keep my hands on the wall for scapular wall slides without my lower back really arching and compensating. I will provide pictures below, but there is a large space in my delts a little behind my acromion and I think this may be another factor. I have been doing medial/rear delt oriented shoulder workouts and avoiding all anterior delt and pressing movements as much as possible. I also know that my rotator cuffs are very strong because I was told this by two seperate physical therapists.

I have read a ton on the topic and I am just wondering if someone has either gone through this or knows someone who has, and can really shed some in-depth specific light on how I can go about finally fixing this nagging problem. (Pics and video below)

Another note: My left pec is visably more developed than the right and my right delt is visibly more wide than my left.

First off, you’ve seen 3 different therapists and an ortho and you think you’ll get a better answer from someone online who isn’t actually touching and feeling your shoulder and doing a full exam? I hope you realize how worthless my response will be but just had to get that out there. (I am also an Orthopedic Physical Therapist)

Anyway here goes, unless your purposely shrugging at the top of the dumbbell press in your video, you have some weakness, “possibly” in your lower traps. They could not be weak but may just be too weak in relation to your upper traps. Also, not being able to keep your hands on wall for scap slides usually means lack of mobility from t-spine, tight pecs as you mentioned or weak lower traps. The space between your acromion and delt is usually whats called a sulcus sign which indicates some instability of the glenohumeral joint, or honestly could be anything since I can’t really see much from the picture.

Try this for a few weeks, it will work your lower traps better than all those simple stuff most PTs give such as Y raises. Grab a pulldown bar, now lock your arms and imagine squeezing your shoulder blades down/back and towards each other. Another good one is getting on some dip bars, keeping arms locked and just letting yourself sink down while not bending your elbows and then pressing yourself up as far as possible. If you know what a push up plus is this is the same thing in a different plane of motion. Work on some t-spine mobility and get someone who knows what they are doing to give you a good pec stretch. If your still seeing a PT, ask him if he’s mobilized your GH joint to stretch your posterior capsule, because that is one of the main causative reasons for anterior impingement which you may also have described.

Again, this may help you or may be worthless because I’m trusting your own exam of yourself. Good luck.

Could you elaborate more on how one would do this? “mobilized your GH joint to stretch your posterior capsule”

bump

That was meant for you to ask you therapist. He/she should know exactly what that means.

I am not a PT and it sounds like DaBeard already gave you some solid general advice. I am just going to share my personal experience with shoulder problems.

I dealt with shoulder pain for a couple years in high school and into college. Unfortunately, it progressed to the point where I had some chronic tendonitis in both shoulders and noticeable atrophy of my left delt and lat before I made myself go see someone. Like you, I also did extensive reading into the anatomy of the shoulder joint and did my best to construct my own rehab routine. Like you, the PT I finally settled on seeing was highly recommended in the area of shoulder rehab from reputable sources. If you have reached this point then my one word of advice is PATIENCE. Trust your PT and follow their instructions consistently and diligently despite any doubts you might have as to how your treatment is progressing.

I can tell you that it took me 4-5 months to discontinue regular icing. It took me 6 months to see a noticeable difference and it took me a year to say my shoulders were back to 90%. They continued improving from the one year mark and onwards. During the recovery time I had plenty of moments were I was unsatisfied with progress and felt like I was stagnating. If you have a good PT then just stick in there.

It is great to take the initiative and educate yourself. Use that knowledge to tweak your workouts so you can continue to train during the recovery time. But leave the actual rehab to your PT. I know the last thing someone passionate about training or sport wants to be told is to wait it out. However, besides consistently putting in quality work to your rehab assignments, giving it time is all you can do.

Montecaj. Please if you can read this answer. We need to get in touch.

I have something extremelly similar if not the same for 3 years now. It is destroying my life.

Please I need to know your progress.

Please answer.

Talk to you soon brother.

Hey man,
It’s kind of strange getting an email for a topic I discussed 6 years ago but I’m here if you have some questions. You can private message me if you’d like. I’d be glad to help. Welcome to t-nation, wish you joined 12 years ago during the golden era (that’s for all you veterans)

Cool to see your reappearance, but there hasn’t been a PM system for several years.

Are we allowed to share contact info?

Posting contact info (phone number, e-mail, etc.) on the forum isn’t allowed. Some members put their e-mail address in the About Me section of their profile preferences and that info will appear when anyone clicks your username or checks your profile.

Or you can, like, just ask questions and give answers in threads. That’s sort of what they’re here for.

Whoa, now I feel old.