T Nation

Shoulder Issues and Correct Rehab


#1


Alright so some of you here already know my shoulder situation. I hope some of them chime in here who have helped tremendously (dannyrat, shadowzz44, xydharth, kubo, and a host of others in the shoulder/rotator cuff pain thread)

Anyways I have a picture of the direct pain in my shoulder, this is the only thing that hurts me...it hurts when I pull my arm in that position to stretch it.

I also feel some impingement happening in my shoulder as well but not as much as before.

Main point here is I want to locate what exactly this is in my shoulder...is it supraspinatus? I don't think this is an infraspinatus issue here. ALTHOUGH when I tennis ball my armpit area and what not...there is tremendous pain lol but it seems that helps...I can feel a knot or something there. I think I am getting the infraspinatus with the tennis ball...not the posterior delt..but I'm sure it's okay if I get all areas in as I have a tight capsule.

I'm doing all the things recommended in the thread (the stretches, strengthening, and what not) if you would like to see all of them (I'm sure this would help a lot of ppl) in page 3 everything is in there with A LOT of great info!
http://tnation.tmuscle.com/free_online_forum/sports_body_training_performance_bodybuilding/shoulderrotator_cuff_pain?id=3670116&pageNo=2

Alright so all and any help would be greatly appreciated!


#2


2nd picture for different angle.


#3

Laslty I have re-evaluated my posture COMPLETELY. It is extrememly hard...I realized I have been shrugging up for everything I do in life. Not good. The correct way is to be BACK and DOWN. I'm forward and UP lol.

At work all day I had to watch my posture cause I move around a lot (electrical) and when I am drilling holes I am shrugging up, carrying things..shrug. Which means I didn't realize but I'm probably shrugging while lifting (curls etc).

2nd thing this is a great article on Upper and Lower Traps which states:

"Inhibition of the lower trap is often associate with inhibition of the deep neck flexors and shortening of the pectoralis muscles, upper trapezius, and levator scapulae. Attempting to address just one of these deficiencies will likely result in poor outcomes as the global issues have not all be corrected."

I have a tight neck/traps, my pecs are tight, so I've been stretching this all a lot now.

Here is the article link: http://www.mikereinold.com/2010/03/upper-and-lower-trapezius-imbalances.html

dannyrat is the one who gave me the link, I want to pass it on...only cause I didn't realize I do it this much.


#4

Bump...don't really like to do this, but I am eager for an answer lol


#5

Hey Rast,

I don't have much for you, but the suprasinatus is more towards the top of the shoulder. Do lat raises bother you?


#6

Try doing myofascial release with a foam roller, especially in that high lat/armpit region. I have pretty bad impingement in my shoulders and usually resorted to ART (active release technique) in the past, however anytime it acts up now I can usually correct the problem myself by use of the foam roller.

Try rolling on it and when you find a knot, stay in that spot with your weight on it for 45 seconds to a minute, and do this every day if you can. Also make sure you are stretching out the pec minor as well (different position that a pec major stretch). If that doesn't work I would try ART and see what the problem is. Possibly refer to the Neamderthal No More articles to fix your posture too.


#7

That is a tough one... it is possible thats toward the humerus attachment of the infraspinatus thats giving you issues... I've had it before but the place you have marked looks a bit too superior to be infraspinatus. I suppose allowing for individual differences it could be though... If I had to guess I would say infraspinatus.. I think its pretty rare to injure your posterior delt, usually the infraspinatus is going to be the weak link there... but I suppose its possible.

What you need is to get some ART man. I would also recommend using a 3lb weight for the external rotations, 5lbs for 8 reps is heavier than you need to go on that.


#8

I have had right shoulder impingement problems with various roaming pains in that shoulder as well over the years and have come to the conclusion that my problems are set-up issues. Cephalic_Carnage
has talked about it in several posts. I THINK it all boils down to letting my shoulders round forward during almost any lift, chest,back and even arm work. If I keep my shoulders back and DOWN with my scapulas contracted I have no pain at all, during or after a workout.


#9

Yup I have horrible posture..very rounded shoulders...the amount of pressing and well punches that have been thrown...neglecting external work, neglecting stretching, always being shrugged up and not having posture back and down...bench pressing 390 at 202lbs with traps shrugged up!!! which is not good...I do all my exercises being shrugged up a bit

In everything I do now I tell myself everyday back and DOWN! for the shoulders.

Shadowzz4 - is there ever a time where we will get strong enough to go beyond 3lbs - I will use the 3lbs, not go to failure, and fix it if I start to feel it wrap around the shoulder or in the front (cause then it's not targeting the right muscle)

I have been to the ART therapist, he did make it feel better..that was a bit ago...pretty much he said I have a motherload knot and LOTS of tension and he was fiddling around with my infraspinatus...he said this was contributing to a host of my problems (tight neck, etc etc.)

I don't think it is posterior delt..in the 2nd pic you can see my rear delt without me even flexing or anything and it's near it but not the delt that hurts it's beside it.

I will work the shit out of my infraspinatus with the tennis ball and see what happens, and continue with the stretching and other rehab work.


#10

Rast - check out this article on tmuscle:

http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/pushups_face_pulls_and_shrugs

You may have seen it but it explains a lot about that area if you haven't read it yet.


#11

chronos - thanks for this article man I have read it before, but it's been a while and I am reading it again right now to see if I missed anything...thanks for the support!!


#12

I can't really say what your problem is but based on my experience I had the same type of pain in the same area and it turned out to be a tear in the posterior labrum and also a torn rotator cuff which I had to get surgery for. Wound up getting same injury on my other shoulder but haven't got operated on yet. I would get an MRI if I were you.


#13

WHAAA lol don't tell me that kinda shit is goin on with me...would I be able to do anything with my arm...cause I did some db presses and did 115x10 with no problem or pain. It only hurts when I try to stretch my arm in certain positions...my strength is lower a bit cause I didn't press for 4 months but that's bout it...


#14

Rast get an MRI. I have horrible shoulders, what started out as feeling like slight impingement ended up needing 3 different surgical procedures to correct. And by correct I mean stopping the pain while not lifting. I can't bench, do push ups, or flyes.


#15

I had similar symptoms and ended up having a slap tear in my labrum.... not saying thats what you've got going on but I'd recommend you get a MRI. Hope you're shoulder issue gets resolved and that there isn't a tear or anything serious going on in there.

.greg.


#16

Mmmm well okay I will try my rehab for a couple more weeks and see how it feelts...cause rmember I went to the art therapist and he did his thing, I did a bit of rehab and it felt A LOT better...but now the pain is reappearing again (cause I haven't been focusing on rehab anymore) so I feel that me neglecting the rehab is maybe making it come back?

I will go to the ART doctor after the weekend, keep doing my rehab for a nother couple weeks and see if it feels better again. If it does and pain is not coming back, then I will have to stick to the stretches, external work, etc etc. to keep it going...WHICH I was planning on doing anyways because in the other shoulder thread a bunch of the guys went over numerous things and have helped out a tremendous amount.

I will come back to this thread in a couple weeks and give an update! May the healing begin lol.


#17

Yes you will get to that point where you can use more than 3lbs on the external rotations but two things. 1 I wouldn't do the seated version with your elbow on your leg, I know Poliquin has recommended that in the past but IMO its shit. Also, you dont look like your very tall, with prob pretty short levers (arms) so if you can only get 8 good reps with 5lbs and such a small amount of torque I would seriously recommend you stay at 3lbs to be at a weight that you can build some strength on without straining the infraspinatus even more, (if it is strained).


#18

Alright, sounds good I will stick to the lying down version...I will also stick to that 3lbs! lol Your right I am not very tall...just a hair under 5'9, but my arms for my height are descent, I have a 6 foot wingspan (72 inches) either way though...I've never really done much of any external rotation work, so yes they are very weak and I think making it fire correctly and gettin it all right I will definately stick to the 3lbs.

I know this question is kinda hard to say but do you think I could have somethin that is torn? Cause before it did feel better, but it's starting to creep up again...at the same time I still have quite a bit of strength in it (i did the dumbbells 115x10) that was also not pressing for 4 months, and I haven't done it again since a couple weeks ago..but I imagine if something was torn I would have a hard time raisining my arms and what not...but I raise my arms everyday to connect wires and put lights up.


#19

It's reaaly hard to say if you have a tear without getting an MRI. For example I can't do one pushup without pain but I can do overhead presses with 185lbs. And military presses hurt, but behind the neck I'm fine. Same thing with pull downs, pain to the front, comfrotable behind neck. Side latersl raises are a problem unless I lean over quite a bit, front raises are fine. But I think you get my point. Everyone is different and will hurt or feel good with different movements. And even with torn rotators and labrums I was still able to do a lot of movements without too much trouble, especially pulling movements. You have to get an MRI. It could be the start of tendonitis and if you keep pushing or working through it you will wind up with the overuse tears which is what happened to me.


#20

okay man thanks, i will take the advice and get the MRI on it n get it checked out. If it's a tear, I'll see what they say (never had one before) if it's not a tear then I guess I will have to keep rehabbing it.

I will have to wait a couple weeks before I get the MRI just because of work and stuff but I will definately get one booked in. Hopefully it's nothing too serious...thanks for all the help guys.