Shoulder Pain During Horizontal Pressing

Bigger Stronger Leaner Injuries and Rehab
1

Before I get scolded for asking for an Internet diagnosis, I have already seen an orthopedic doctor - I am just wondering if anyone else here has experienced the same thing as me.

About 6 weeks ago, I started having a pain in my left shoulder during a bench press session. It wasn’t too bad, and I didn’t appear to have lost any strength, so I (stupidly) pushed through the pain and finished the workout. But by the time I was done, the pain had increased from mild to kind of severe. I took it easy for the next three weeks and the pain subsided substantially, but my shoulder would still get aggravated during certain movements (yes, I avoided any and all exercises that caused any pain).

The pain is hard to pinpoint, but I can best describe it as a dullish pain deep inside the shoulder, maybe more towards the back of the shoulder. Below are exercises that do and do not cause pain:

Exercises that cause some pain:
(not an all-inclusive list, just a few I tried)
-All Bench Press, Flat & Incline (particularly the top half of the movement)
-Pushups
-Cable External Rotations
-Any bicep curl variation

Exercises that I have been doing pain-free:
-Cable Chest Press (elbows out)
-Cable Chest Flies
-Any Horizontal Rowing movement
-DB Shoulder Press
-Cable Pulldown
-Tri Pushdowns

So after 3 weeks, I saw an orthopedic surgeon, who did a 3-minute assessment and took an X-ray and told me it was probably some kind of rotator cuff tendonitis and/or an inflamed bursa. He gave me a cortisone shot and told me to take some OTC anti-inflammatories and take it easy for another 3 weeks. So my follow-up visit is this week, and after the additional 3 weeks of rest, it doesn’t seem to be any better.

Has anyone ever experienced anything like this or have any idea what it might be? I felt rushed in and out of the doctor’s office I visited, and felt like he didn’t seem to really care about my problem or listen to everything I had to say, almost as if he was just like “Shoulder pain? Must be the RC” and sent me on my way. Which brings me to my next question - anyone know of any good doctors in the northern NJ area? I may want to get a second opinion depending on what he tells me this week.

Thanks.

2

I just got done seeing my shoulder doc. My x-ray was negative, and he wants to do an MRI. My pain seems to be more generalized than yours. There aren’t specific movements that hurt, rather any use of the shoulder can cause pain. We tried anti-inflammatories, and they didn’t help. He won’t give cortisone shots to people that lift because he thinks they can damage the ligaments long term. I’ve tried rest, pills (over the counter and prescription) and nothing seems to help.

Anyone know of anything over the counter that helps? I’ve tried glucosamine/chondroitin/msm, zyflamend, and some others. Nothing seems to help with my joint issues. My elbows give me trouble too. It’s frustrating because I pay a lot of attention to lifting with good form.

3

Seems like this is the same thing I have going on and I’m getting mine checked out Monday. I will let you know if I find out anything that helps.

4

Based on what you said I don’t think the orthopedic surgeon did you wrong. Do you do as much if not more pulling than pressing? I suggest you incorporate some face pulls and really try to stretch out your pecs and see if that fixes it. A friend of mine had similar pain… he’s a physical therapist and determined it was something with his teres minor and did some exercises for it and it went away very quickly.

I would cut the flat barbell bench and any overhead pressing out of your routine for a month or so, along with those face pulls and stretches. If it doesn’t go away go back to the orthopedic surgeon. You can probably find a better one for your area.

Good luck

5

Ok so as I sit here in a sling 1 week post op from having both my suprapinatus and my infraspinatus completely detached from 20 years of training through what you are explaining and many cortisone shots… I have a few words of advice… First what you are all experiencing is either A: impingement or B: labral tear. Let me try to explain this as best I can without diagrams. Your rotator cuff muscles there are four of them and they are small in comparison to your deltiod.

Their sole purpose is to hold your humeral head in the socket and rotate the shoulder or aid in lifting the shoulder as in the case of the supraspintus. The problem is the Supraspinatus runs underneath the acromium process (where the clavicle and the tip of the shoulder blade process meet) and for many the space between the humeral head and the acromium process is not enough for the tendon to freely move… especially when extreme forces are applied to the shoulder and the shoulder ball moves up in the socket.

This will cause friction when you squeeze the supraspinatus between the acromium process and the humeral head. When this friction causes inflammation it causes micro tears in the supraspinatus and everything gets swollen. When you continue to train through the pain the friction on the now swollen tendon of the suprapinatus causes more damage. This needs to be calmed down first. People always say do more back work, more face pulls yada yada. These can work but not for everyone and when i say they can work they help to strengthen the muscles that assist the stabilization of the humerus so that you arent getting quite so much movement when you press and thus helping eliminate the squeeze that can cause the impingment.

When I say this doesnt work for everyone what I mean is when you start this process and cause this fricition many times you acromium process will fight back and grow additional bone (bone spur) which will decrease the space even more and tear the hell out of your supraspinatus until eventually it will tear and end if not change your lifting career forever. B> the labral tear… The labrum what stand between your humerous and the socket.

When your ball moves out of the socket to a degree based on the forces applied as described above you can tear the labrum or smooth surface that helps your humerus rotate smoothly in the socket… these tears need to be addressed if they are too big … but the face pulls, back work can help you to not aggravate these if you in fact do them properly and get your stabilization muscles strong enough to compensate…

ADVICE for anyone still flat pressing after having more than a few lasting periods of pain in the sholders from doing so… quite while you are ahead … drop the flat bar press forever… or pay the price… the choice is yours. It really isn’t one of the best muscle building exercises you can perform anyhow and it and dips are the two worst exercises for people with poor shoulder genetics.

I personally know many guys who are much bigger than me who do not barbell bench press or do dips ever… and their shoulders are in great shape. Overhead presses can be challenging as well depending on how your shoulders are… Find out what works for you and do those things… You will thank yourself… But I digress because you will all think hey this isnt me … im special, this is just a hiccup… I will never be that guy… Please continue and when you have 20 years or so under your belt let me know how your shoulders feel. Also avoid the cortisone … whoever posted above it will destroy your tendons… It is a band aid that will eventually cause more harm than good.

6

Great advice Swolle. I have the same issues with Bench + Dips. They never felt right. I stopped doing them long ago and have kept my shoulders in decent condition. I also do BJJ 3x/ week so my shoulders get a beating in terms of hyper-mobility and extension.

[quote]Swolle wrote:
Ok so as I sit here in a sling 1 week post op from having both my suprapinatus and my infraspinatus completely detached from 20 years of training through what you are explaining and many cortisone shots… I have a few words of advice… First what you are all experiencing is either A: impingement or B: labral tear. Let me try to explain this as best I can without diagrams. Your rotator cuff muscles there are four of them and they are small in comparison to your deltiod.

Their sole purpose is to hold your humeral head in the socket and rotate the shoulder or aid in lifting the shoulder as in the case of the supraspintus. The problem is the Supraspinatus runs underneath the acromium process (where the clavicle and the tip of the shoulder blade process meet) and for many the space between the humeral head and the acromium process is not enough for the tendon to freely move… especially when extreme forces are applied to the shoulder and the shoulder ball moves up in the socket.

This will cause friction when you squeeze the supraspinatus between the acromium process and the humeral head. When this friction causes inflammation it causes micro tears in the supraspinatus and everything gets swollen. When you continue to train through the pain the friction on the now swollen tendon of the suprapinatus causes more damage. This needs to be calmed down first. People always say do more back work, more face pulls yada yada. These can work but not for everyone and when i say they can work they help to strengthen the muscles that assist the stabilization of the humerus so that you arent getting quite so much movement when you press and thus helping eliminate the squeeze that can cause the impingment.

When I say this doesnt work for everyone what I mean is when you start this process and cause this fricition many times you acromium process will fight back and grow additional bone (bone spur) which will decrease the space even more and tear the hell out of your supraspinatus until eventually it will tear and end if not change your lifting career forever. B> the labral tear… The labrum what stand between your humerous and the socket.

When your ball moves out of the socket to a degree based on the forces applied as described above you can tear the labrum or smooth surface that helps your humerus rotate smoothly in the socket… these tears need to be addressed if they are too big … but the face pulls, back work can help you to not aggravate these if you in fact do them properly and get your stabilization muscles strong enough to compensate…

ADVICE for anyone still flat pressing after having more than a few lasting periods of pain in the sholders from doing so… quite while you are ahead … drop the flat bar press forever… or pay the price… the choice is yours. It really isn’t one of the best muscle building exercises you can perform anyhow and it and dips are the two worst exercises for people with poor shoulder genetics.

I personally know many guys who are much bigger than me who do not barbell bench press or do dips ever… and their shoulders are in great shape. Overhead presses can be challenging as well depending on how your shoulders are… Find out what works for you and do those things… You will thank yourself… But I digress because you will all think hey this isnt me … im special, this is just a hiccup… I will never be that guy… Please continue and when you have 20 years or so under your belt let me know how your shoulders feel. Also avoid the cortisone … whoever posted above it will destroy your tendons… It is a band aid that will eventually cause more harm than good. [/quote]

7

most weight room injurys are culmitive, and happen slowly over time. If somthing does’nt feel quite right it probably isn’t, real good advice here today, if everyone says an exercise is great, but it feels strange or painful, it’s probably not for you. I can’t overhead press ever, for five years I haven’t done a single overhead press, or high incline, but I can bench pain free, and it feels right, so thats what I do.

To many people stop listening to their own bodys, and follow certain routines, because they think thats what their supposed to do. At the end of the day if theres a million exercises for the body, and one doesnt feel right for you, it still leaves you alot of options. Good luck bro, remember this thing were doing is a journey, and its alot more fun when its pain free.

Stuart McRoberts book Beyond Brawn, is devoted to life long injury free training, if you not a HIT trainer, just ignore the routines, but it`s a great book for learning to listen to your body, for a lifetime of injury free training. 2cents

8

This is all right on… It all comes down to physics and mechanical advantages… everyone is built differently from the size of their joints, tendon size, angles at which their bones and ligaments have formed, tendon insertion points etc… all of this comes into play. There are no bad exercises … Simply bad exercises for some people. I for example have never been able to flat press well even with dumbells. I had issues with dips when I first started training. I am not as plagued with overhead work.

Especially if I stick to slight incline instead of straight overhead. Also my incline barbell press never hurt my shoulders and I was still repping 225 with both my infra and supraspinatus compeletly detached. The point is … Working out isnt about bench, sqaut, deadlift as so many powerlifters would have you believe (mostly because they more than likely have a mechanical advantage some of those lifts). There are many exercises to give you great conditioning and atrophy without destroying your joints in the process. I wish I would have known this 20 years ago instead of 5 or so.

This is and has always been a learning experience. I am a relatively bright guy and I have tried hundreds of different routines and utilized different methods. No one thing works for everyone… For me the key and what I have found in the last decade was lifting less weigth properly and utilize the mind muscle connection… Get a full contraction every time and controlled movements. I love the “I’ll never be a weightlifter” video from Kai Greene… This is the key for me.

9

This is a very good thread indeed!

10

[quote]JimmyC111 wrote:
Before I get scolded for asking for an Internet diagnosis, I have already seen an orthopedic doctor - I am just wondering if anyone else here has experienced the same thing as me.

About 6 weeks ago, I started having a pain in my left shoulder during a bench press session. It wasn’t too bad, and I didn’t appear to have lost any strength, so I (stupidly) pushed through the pain and finished the workout. But by the time I was done, the pain had increased from mild to kind of severe. I took it easy for the next three weeks and the pain subsided substantially, but my shoulder would still get aggravated during certain movements (yes, I avoided any and all exercises that caused any pain).

The pain is hard to pinpoint, but I can best describe it as a dullish pain deep inside the shoulder, maybe more towards the back of the shoulder. Below are exercises that do and do not cause pain:

Exercises that cause some pain:
(not an all-inclusive list, just a few I tried)
-All Bench Press, Flat & Incline (particularly the top half of the movement)
-Pushups
-Cable External Rotations
-Any bicep curl variation

Exercises that I have been doing pain-free:
-Cable Chest Press (elbows out)
-Cable Chest Flies
-Any Horizontal Rowing movement
-DB Shoulder Press
-Cable Pulldown
-Tri Pushdowns

So after 3 weeks, I saw an orthopedic surgeon, who did a 3-minute assessment and took an X-ray and told me it was probably some kind of rotator cuff tendonitis and/or an inflamed bursa. He gave me a cortisone shot and told me to take some OTC anti-inflammatories and take it easy for another 3 weeks. So my follow-up visit is this week, and after the additional 3 weeks of rest, it doesn’t seem to be any better.

Has anyone ever experienced anything like this or have any idea what it might be? I felt rushed in and out of the doctor’s office I visited, and felt like he didn’t seem to really care about my problem or listen to everything I had to say, almost as if he was just like “Shoulder pain? Must be the RC” and sent me on my way. Which brings me to my next question - anyone know of any good doctors in the northern NJ area? I may want to get a second opinion depending on what he tells me this week.

Thanks.[/quote]

I’m going to say the same thing to you I say to every single person I post a comment to on the beginners or injury forum.

But before I get to that, Let me ask you this. Forget your upper body for a second. How are your deadlifts. How are your squats.