T Nation

Suprispinatus & Overactive Traps

Hi all. I would like to ask what you guys suggest for this issue. I am going to go in-depth so that all the info is put out there so apologies in advance for the long post.

I have always had shoulder problems. First it was impingement in the left (treated by physio for a year, subsided); clavicle osteolysis in the right (clavicle resection surgery, 10 months into recovery). The factors which had contributed according to the sports people (doctor, surgeon, physios, biokineticists) are:

  • weak shoulder stabilizers
  • very weak suprispinatus muscles
  • lifting stupidly when I first started, was young, naive, and not self-researched/educated yet
  • winging of the shoulders

In essence, after around 5 years now, the left shoulder impingement (which affected mainly the chest, lats and biceps - and their respective insertion points at the shoulder girdle) has subsided; the right shoulder is not in recover after the resection (they say at least a year as the “new” bone and clavicle ending has to form and stabilize).

I am now going back into proper training and a problem I have is that the left shoulder is very weak, gets very sore and tires very quickly etc. The biokineticist and physio treating me say the causes are:

  • laxe left shoulder joint
  • overactive trap

To explain the issue, examples of what affects me are:

  • chest exercises: feels like shoulder and trap on the left take the grunt of the work and become very sore and tired
  • bicep and tricep work: same thing, left trap always takes over no matter how much I try isolate it or how low in weight I use.

The problem is that it is not an issue of trying to lift too heavy - the trap takes over and becomes tired/sore even when using low or no weights, or the resistance bands as part of rehab.

I would thus like to ask anyone who knows about this or experienced this, what can be done. It is very frustrating (not to mention painful) and, as mentioned above, even rehab exercises seem not to work as the trap still takes over, the shoulder becomes sore, the suprispinatus and other stabilizers seem not to fire at all.

Any help would be greatly appreciated and please ask if you need any further info

X

PS. even after years of the rehab and work with the bioneticist, the strength of the shoulder and balance has improved dramatically but the winging is still very prevalent.
PPS. I do a lot of work on posture too, both from biokineticist program and from articles here.

Hi,

I’m no expert on physiology or biomechanics, but if you can find a qualified ART (Active Release Techniques) practioner it will do you WORLDS of good. I don’t know if there are any in South Africa, but they focus on correcting exactly this type of thing (muscular/strength imbalances, impingements, joint issues of all kinds), and ART works more quickly and effectively than just about any other type of therapy. (Not counting surgery, of course).

Look for a practitioner on their website: www.activerelease.com .

Hi there. None in SA unfortunately. Been looking since I first had issues (with impingement in the left). Nearest thing is deep tissue massage.

We do have rolfing here though which has always piqued my interest. Honestly haven’t tried that yet as my wallet’s been shot from the costs of physio, biokineticist and surgery etc.

xenithon,

There are a few things you can try to do to isolate the involved tissue. First off, have you tried any isometrics or shortened range of motion movements? For example, stand against a wall and try to abduct your arm (while keeping it against the wall). As you get better at feeling the right muscles firing you can stand further away (thus becoming short ROM isometrics). These exercises can sometimes be beneficial when retraining muscle recruitment patterns.

Another route to try is to work on scapular stability without the use of larger movements (prone scap setting, blackburn series of exercises etc-these exercises are done with you face down and working on regaining control of your shoulder blade prior to any external loading). With those exercises, you can use your limb’s weight to slowly and progressively increase the lever arm, thus increasing the loading.

When you do your biceps/triceps exercises, try doing them in front of a mirror. Stop if you see your shoulder shrugging (train your body not to overuse upper traps). Use active assist with your opposite arm to help with the concentric and then try controlling the eccentric component. Try doing bi/tri work in a gravity eliminated position. For this you would need to use band/tubing (eg. lying on your side, tubing attached somewhere near your feet, complete bicep curl parallel to the ground).

For the scapular winging it would really depend on how it is winging to figure out which force couples are not working optimally (medial border? inferior angle? etc). To sort this out, you may need to lengthen your pec minor if it is shortened and/or strengthen serratus anterior, lower fibres of trap and rhomboids.

If you could give a detailed list of exercises that seem to cause you problems, it would be easier to figure out alternatives or modifications to limit upper trap/shoulder involvement.

hope that helps
dc

I am currently going to physical therapy for a left rotator strain. I figured I’d catch it early before it became a serious problem. I dumped a weight by accident and pulled a muscle.

I suggest going to physical therapy and having someone trained access what you need to do to correct. It’s like having a cheap personal trainer with a good education.

Actually I think almost everyone has problems with the traps taking over on most movements.

It may be a recruitment problem…the winging occurs not because of weakness, but because of lack of recruitment of the lower trap and rhomboids. This over time, leads to weakness.

I feel that developing exercises that force those inhibited muscles into eccentric action may give you the best results. Email if you want to discuss further…

Another thing you might try is doing one-arm lateral raises with your head resting on the same shoulder that your using during a set. This seems to negate the traps overactivity in arm abduction…

Hi all and thanks for the fantastic info! Here is some extra info which may assist, including the list of troublesome exercises:

  1. Firstly, an interesting observation - the left shoulder used to be very sore (especially at the insertion point), and felt more laxe. Since about a month ago when I started actually training properly at the gym (doing regular chest, back etc. exercises) it has felt better. The trap gets more sore and tired but the shoulder pain seems to have subsided. The best way I can describe it is that it feels as if the shoulder girdle is held much better.

  2. Troublesome exercises, which cause the trap/suprispinatus to get exhausted and sore, include:

  • benchpress exercises (especially barbell)
  • laterals (side laterals and bent over laterals)
  • bicep curls (especially barbell but also DBs)
  • tricep exercises (rope/bar pushdown, skullcrushers, close-grip bench)
  • shrugs
  • certain rows (seated cable rows, bent over BB rows with palms facing my body)…much less so with other rows (one arm DB rows, bent BB rows with palms facing away from body)
  1. As noted above, barbell work tends to make thing worse in the left shoulder/trap. It feels better with DBs (e.g. bench, DB curls)

  2. While I agree that the trap can take over often, it occurs substantially more in the left. I hardly feel it at all in fact in the right, whereas the left trap pain/exhaustion is often what causes me to end a set, before the actual muscle being targeted gives in (be it bicep, chest etc.)

  3. NB IMPORTANT…what I often feel in the left side, is a tightness which extends all the way from the trap, up the neck (side and front of neck) even up to the lower part of the jaw. This is especially so when doing things like shrugs (bottom of movement); bench press (right at the top of the movement)…so it feels as if the neck is really stretched and “catching”…not a pain, just a stretch, which is not felt at all in the right.

Pheww…not sure what else I can add. Right now I am at the stage sort of in between rehab and fully fledged training - I started training properly but with quite a few restrictions and many mandatory exercises as part of rehab. For example, shoulder-specific exercises I do none of (heavy laterals, shoulder press etc.).

The closest direct shoulder work I do is very light laterals with the arm 30 degrees in front of body; very light bent over laterals; and DB
external rotation with very low weight.

Oh yes, two other things which the physio mentioned:

  1. he said one of the causes of the issues and the winging is short/tight pectorals and lats. I am now doing a lot of stretching and exercises for both.

  2. for the weak stabilizers in the upper back / trap / scapula region I do stabilizing exercises. These include pushups on an exercise ball, and that exercises (cannot remember the name) with starting position like the top of bench press, and where you push forward as far as possible, keeping arms/elbows straight.

This works the high upper back muscles which stabilize the shoulder complex. I do these with DBs, BBs, bodyweight (pushup position) and the resistance band.

Cheers,
X

sorry if anyone mentioned already, but i tend to pinch my shoulders back and tighten up my subscap, rhomboids, etc, during chest exercises. Actually extending the arms and shoulders through the range of motion using push ups and or cable type movements really helps my traps and subscap area. ART is the winner for me though. Also my computer monitor is raised 6-8 inches off the desk and has helped drastically with my trap issuues. FUnny thing is i never had a problem with my traps when i was power lifting lol.

I also having upper traps that are overactive. I didn’t realize that when I raised my arm straight up, I was always shrugging! Now, I practice doing front raises with no weight, and keep my traps from being used. Also, working my mid and lower traps with therabands.

Hi all.

I also try and pinch the shoulder blades together. The problem I am finding is that, no matter how low in weight I go, it is always either the delts or traps or scapula region which give in before the chest. Also, the next day, I never have pain and/or tenderness in the chest (which I always used to get) which I believe is a sign that the chest is not firing sufficiently. The other muscles are taking over and in turn becoming exchausted and painful in the process.

How do you work the mid/lower traps? I would be most interested in that. My overworked trap (primarily on the left hand side) is the barrier now. I do not do front raises but do side laterals raises with the arm at around 30 degrees in front of body (somewhat in between a side and front raise). I also do them with thumb pointing down toward the ground.

I am also getting a niggling feeling in the right where the surgery was. It is not a pain, just a slight “discomfort” or awkwardness…the physio said that he believes it is still healing from surgery. It was a resection so a few mm of bone was cut away, so that end of the bone is still what he described as fibrous, forming into a solid bone ending on the scapula.

He said I should train normally as it would actually help form the final bone shape. Would you agree? I cannot get an appointment with the surgeon who did the surgery for a few months so will need to wait for his opinion (and will also give the shoulder some more time as I just starter training regularly a few weeks ago).

Cheers,
X

Quick update guys. For the past 10 days or so I have been doing EXTENSIVE shoulder work in terms of rotator cuff, suprispinatus etc. This has been primarily the exercises given by the biokineticist using light weights and resistance/physio bands.

This involved normally two sessions a days, with a little stretching mixed in for good measure. That primarily involved stretching the neck, trap and chest (especially on the left hand side).

I felt this was required as I could feel those areas getting “caught” during many movements (eg. doing shrugs would cause a great stress in the upp chest, up the trap and entire left side of the neck, which was not occuring on the right).

Also wanted to add that I was doing quite a bit of work the Waterbury article this week (http://www.T-Nation.com/readTopic.do?id=1379910) such as the DB external rotation. I also did the Chest Supported Shrug (exercise of the week) which is just what I was looking for to target the mid-lower traps.

Today I had an upper body workout (chest, back, rear delts) and it was one of the best in a long time. I still felt major stress in the left trap during chest movements, but not as bad as before, and after the workout I feel great (whereas before I use to have serious pains in the left neck/track/shoulder for the rest of the day).

Are you also doing internal rotations?

[quote]tweaker wrote:
Are you also doing internal rotations?[/quote]

No, found that I didn’t need it. Biokineticist also said that only weakness occurs with muscles involved with external rotation.