T Nation

Shoulder Rehab Questions


#1

Alright, to preface, I have probably read 5-6 articles regarding shoulder rehab before coming here. Some articles were from here, some were from bb.com, etc. This is my first post ever here, so go easy...

I think something went wrong at the end of July w/ my shoulder. I was doing Rippetoe Starting Strength, I was around 265 Dead, 255 squat, and was benching 205. During benching 205, i felt something wrong in my shoulder, but pushed through my sets (bad). I didn't bench for 3 wks, then started back up with bar weight, 55, 75, etc. Felt fine until I got around 155lbs, when i would feel the "twinge" in my left shoulder still.

I went to a sports med dr. in the area. I was reading in an article that if the first thing he does is prescribe NSAIDs, is to run away. Well, he took an xray first, then prescribed NSAIDs. I didn't even fill the script. He gave me a green stretchy band, and about 6 exercises to run through, and some rehab center which is booked up through forever. I did my band exercises religiously til the band snapped and i was basically like, eff it.

I guess my question is, what is the object of rehab? To me it would seem that if an area like the shoulder were torn, immobilization would be the best option, not working the area out. Every article seems to work counter to that. Is there one article out there that I am missing that is the definitive rehab article for shoulders? At what point does one consider surgical options? Right now my weak shoulder is bowed in, I notice the dull pain almost always, I guard it when lifting heavy objects, etc.

Last question is, can I still deadlift and squat? To me it seems counter productive to be deadlifting several hundred pounds when certainly the shoulder is bearing that weight as well.

Thanks in advance


#2

The key to successful treatment of ANY injury is an accurate diagnosis. That sounds simple enough, but it can be challenging. A really good and thorough physical exam will give a lot of information. Then that information can be expanded upon with the proper imaging (x-ray, MRI, etc.). So, to answer your question, the rehab is only appropriate if you are “rehabbing” the correct structure.

If you had a good rapport with the doc, go back to him and ask him to look again. Whether it’s wrong or right, docs will often start out with a vague diagnosis and general treatment (NSAIDS and “rehab”) because this fixes a lot of problems. Then, they will only look further if this doesn’t help.

Oh yeah, I forgot to address squatting and deadlifting. Believe it or not, deadlifting is pretty likely to be safe; it’s the squatting that may bother you. The relatively extreme external rotation required to properly place the bar can certainly bother a cranky shoulder. You can adapt temporarily by either front squatting or using a safety squat bar (this really helped me continue to squat while rehabbing my cranky shoulder).


#3

my pain is in my left shoulder on the front side “knob”, im assuming the top of my humerous. id hate to self diagnose because i also read that some of these pains can be kind of shadowy and misleading about the actual location. if i had to pick a spot though, it would be right there. secondarily down the side of my arm.

i will attempt to get myself doing my rehab, icing, and NSAIDs.


#4

That still doesn’t really narrow it down. It could be impingement, rotator cuff injury, or labrum tear. Need an ACCURATE diagnosis.


#5

[quote]Mudflaps wrote:
Alright, to preface, I have probably read 5-6 articles regarding shoulder rehab before coming here. Some articles were from here, some were from bb.com, etc. This is my first post ever here, so go easy…

I think something went wrong at the end of July w/ my shoulder. I was doing Rippetoe Starting Strength, I was around 265 Dead, 255 squat, and was benching 205. During benching 205, i felt something wrong in my shoulder, but pushed through my sets (bad). I didn’t bench for 3 wks, then started back up with bar weight, 55, 75, etc. Felt fine until I got around 155lbs, when i would feel the “twinge” in my left shoulder still.

I went to a sports med dr. in the area. I was reading in an article that if the first thing he does is prescribe NSAIDs, is to run away. Well, he took an xray first, then prescribed NSAIDs. I didn’t even fill the script. He gave me a green stretchy band, and about 6 exercises to run through, and some rehab center which is booked up through forever. I did my band exercises religiously til the band snapped and i was basically like, eff it.

I guess my question is, what is the object of rehab? To me it would seem that if an area like the shoulder were torn, immobilization would be the best option, not working the area out. Every article seems to work counter to that. Is there one article out there that I am missing that is the definitive rehab article for shoulders? At what point does one consider surgical options? Right now my weak shoulder is bowed in, I notice the dull pain almost always, I guard it when lifting heavy objects, etc.

Last question is, can I still deadlift and squat? To me it seems counter productive to be deadlifting several hundred pounds when certainly the shoulder is bearing that weight as well.

Thanks in advance[/quote]

No immoblization is generally frowned upon as it often will delay healing and can lead to other problems secondary to atrophy and the immobilization itself. Pain free rehabilitation techniques are generally indicated for acute injuries to restore motion, increase blood flow to the area, and reduce pain. Im not sure what your gripe is with NSAIDS. They can be contraindicated for injuries in which scar tissue needs to develop properly but in your case it does not sound like a problem.


#6

[quote]BHOLL wrote:

[quote]Mudflaps wrote:
Alright, to preface, I have probably read 5-6 articles regarding shoulder rehab before coming here. Some articles were from here, some were from bb.com, etc. This is my first post ever here, so go easy…

I think something went wrong at the end of July w/ my shoulder. I was doing Rippetoe Starting Strength, I was around 265 Dead, 255 squat, and was benching 205. During benching 205, i felt something wrong in my shoulder, but pushed through my sets (bad). I didn’t bench for 3 wks, then started back up with bar weight, 55, 75, etc. Felt fine until I got around 155lbs, when i would feel the “twinge” in my left shoulder still.

I went to a sports med dr. in the area. I was reading in an article that if the first thing he does is prescribe NSAIDs, is to run away. Well, he took an xray first, then prescribed NSAIDs. I didn’t even fill the script. He gave me a green stretchy band, and about 6 exercises to run through, and some rehab center which is booked up through forever. I did my band exercises religiously til the band snapped and i was basically like, eff it.

I guess my question is, what is the object of rehab? To me it would seem that if an area like the shoulder were torn, immobilization would be the best option, not working the area out. Every article seems to work counter to that. Is there one article out there that I am missing that is the definitive rehab article for shoulders? At what point does one consider surgical options? Right now my weak shoulder is bowed in, I notice the dull pain almost always, I guard it when lifting heavy objects, etc.

Last question is, can I still deadlift and squat? To me it seems counter productive to be deadlifting several hundred pounds when certainly the shoulder is bearing that weight as well.

Thanks in advance[/quote]

No immoblization is generally frowned upon as it often will delay healing and can lead to other problems secondary to atrophy and the immobilization itself. Pain free rehabilitation techniques are generally indicated for acute injuries to restore motion, increase blood flow to the area, and reduce pain. Im not sure what your gripe is with NSAIDS. They can be contraindicated for injuries in which scar tissue needs to develop properly but in your case it does not sound like a problem. [/quote]

I dont have any aversion to NSAIDs, other than I prefer to not medicate unless I need to. If they are in any way beneficial, other than pain management, then I will take them. I filled the script last night. If they are solely for pain management and eroding my stomach, I will probably avoid. I need to read up on them more I guess.

I will find a stretchy band and try to continue my rehab.


#7

Get an MRI. I’m heading towards my second shoulder surgery for a torn labrum so I’m especially sympathetic to your condition. Now I have to go find a SS bar…


#8

[quote]Mudflaps wrote:

[quote]BHOLL wrote:

[quote]Mudflaps wrote:
Alright, to preface, I have probably read 5-6 articles regarding shoulder rehab before coming here. Some articles were from here, some were from bb.com, etc. This is my first post ever here, so go easy…

I think something went wrong at the end of July w/ my shoulder. I was doing Rippetoe Starting Strength, I was around 265 Dead, 255 squat, and was benching 205. During benching 205, i felt something wrong in my shoulder, but pushed through my sets (bad). I didn’t bench for 3 wks, then started back up with bar weight, 55, 75, etc. Felt fine until I got around 155lbs, when i would feel the “twinge” in my left shoulder still.

I went to a sports med dr. in the area. I was reading in an article that if the first thing he does is prescribe NSAIDs, is to run away. Well, he took an xray first, then prescribed NSAIDs. I didn’t even fill the script. He gave me a green stretchy band, and about 6 exercises to run through, and some rehab center which is booked up through forever. I did my band exercises religiously til the band snapped and i was basically like, eff it.

I guess my question is, what is the object of rehab? To me it would seem that if an area like the shoulder were torn, immobilization would be the best option, not working the area out. Every article seems to work counter to that. Is there one article out there that I am missing that is the definitive rehab article for shoulders? At what point does one consider surgical options? Right now my weak shoulder is bowed in, I notice the dull pain almost always, I guard it when lifting heavy objects, etc.

Last question is, can I still deadlift and squat? To me it seems counter productive to be deadlifting several hundred pounds when certainly the shoulder is bearing that weight as well.

Thanks in advance[/quote]

No immoblization is generally frowned upon as it often will delay healing and can lead to other problems secondary to atrophy and the immobilization itself. Pain free rehabilitation techniques are generally indicated for acute injuries to restore motion, increase blood flow to the area, and reduce pain. Im not sure what your gripe is with NSAIDS. They can be contraindicated for injuries in which scar tissue needs to develop properly but in your case it does not sound like a problem. [/quote]

I dont have any aversion to NSAIDs, other than I prefer to not medicate unless I need to. If they are in any way beneficial, other than pain management, then I will take them. I filled the script last night. If they are solely for pain management and eroding my stomach, I will probably avoid. I need to read up on them more I guess.

I will find a stretchy band and try to continue my rehab.
[/quote]

Inflammation as well as pain


#9

I had a shoulder issue 18 months ago. Obviously it might be a different issue. But there is hope. The last 11 months i forgot about it.
First after some months i realized being my dominant side even my gym rest meant i still used it so i strapped my right arm to my body for a day to really rest it. For 5 weeks i kept that belt in view to remember not to use that arm. Than a few weeks of rehab was enough. I did pull-aparts and broomstick stretches daily. Also try to figure how it happened not to repeat that. For squatting dumbells on your shoulders or a packsack etc. Straightbars are not suited for all lifters.

Like you i do not pop pills because kids cut themselves and scratch their knees and we auto repair. If my smart body choose to inflame it is fine with me.
Rehab is about blood flow and sometimes supporting muscles(RC). I was doing about 6 sets daily between my 2 exercises but an hour apart. Rest is a part of a come back but mouvement is also beneficial. You have to find the amount of each that you need and i obviously do not have that answer. The general rehab mode is often and real light. If you feel it it is OK but if repetitions are increasing the irritation now is not the time for that exercise.
All the best !


#10

[quote]BHappy wrote:
I had a shoulder issue 18 months ago. Obviously it might be a different issue. But there is hope. The last 11 months i forgot about it.
First after some months i realized being my dominant side even my gym rest meant i still used it so i strapped my right arm to my body for a day to really rest it. For 5 weeks i kept that belt in view to remember not to use that arm. Than a few weeks of rehab was enough. I did pull-aparts and broomstick stretches daily. Also try to figure how it happened not to repeat that. For squatting dumbells on your shoulders or a packsack etc. Straightbars are not suited for all lifters.

Like you i do not pop pills because kids cut themselves and scratch their knees and we auto repair. If my smart body choose to inflame it is fine with me.
Rehab is about blood flow and sometimes supporting muscles(RC). I was doing about 6 sets daily between my 2 exercises but an hour apart. Rest is a part of a come back but mouvement is also beneficial. You have to find the amount of each that you need and i obviously do not have that answer. The general rehab mode is often and real light. If you feel it it is OK but if repetitions are increasing the irritation now is not the time for that exercise.
All the best ![/quote]

Like you i do not pop pills because kids cut themselves and scratch their knees and we auto repair.

You don’t pop pills because kids cut themselves and they heal…yoinks!

solid post otherwise