T Nation

Two Chronic Injuries that Just Won’t Go Away


#1

Need some help here t-nation fam. 6 years ago I had a bad seperated shoulder that did not require surgery. Being the typical meat head I’ve just dealt with AC joint pain for half a decade. The ole rub some dirt on it mentality. Challenge now is that I’m now having trouble managing the pain. Anyone know of some rehabbing or mobility type routines for Chronic AC joint pain?

Lastly, golfers elbow on my right arm have been a problem for a while. Not constant or daily like my AC joint, but every few months I find myself having to voodoo floss daily to get by.

Same question from above, anyone know any more long term remedies or should I just bite the bullet on both and go see a doc or Ortho?


#2

Is the bad elbow attached to the bad shoulder?

If your shoulder hurts, its possible you’re moving it funny, or not keeping it stable or doing something to compensate for the pain. This limits your ROM. This makes your shoulder move funny. Then when you lift it gets more irritated and painful.

If you are one of these dudes who only does big compound moves, trying to progress weights without thinking about how you are moving, and how your muscles are working this can just get steadily worse over time.

Golfers elbow is usually from moving your arm around with a weird wrist alignment or hand position. Like when your shoulder hurts and you have to turn your elbow/wrist to a funny angle to press or pull to compensate for shoulder pain.


#3

For a shoulder routine, check out post 957 in my log.


#4

It’s not shoulder pain. It’s pain in the AC joint, mostly in the trap where it connect to the joint. I use pretty strict form with sub maximal weights when using lower reps. Keep in mind this was from an impact related injury and has been chronic pain since the initial recovery years back.


#5

Took a quick glance, Will defiantly go over those videos in depth. Thanks


#6

The A in AC joint is for acromion, or top of the shoulder blade(scapula).

The impingment happens when your scapula moves “up” and “forward” when you move your arm, mashing up all the tissue in the joint. The weird motion or “impingment” often/usually starts after an injury or impact to the shoulder.

Every lift or motion that uses your arm has to start with your shoulder blade in the right spot, or it will “move up”/impinge and cause pain. It doesn’t matter how the bar moves or where your elbow goes, you can’t have “good form” until the scapula is right and the joint moves correctly.

You want to hold that good neutral/poterior scap tilt.
1964568_orig
That way the acromion won’t roll forward and crunch up your shit.
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scap-ant-tilt

Once you can control your shoulder blade and hold it in the proper position, you can start with small, short motions making sure you don’t let your scap roll up and impinge. Gradually make the motions bigger while being sure to keep proper scap tilt and pain free motion. Once you have full, pain free ROM in your shoulder, you will be able to use good form in regular lifts.


#7

Lots to digest here and very appreciative of the info. Hard to make out from the photos what the proper position of the scapula should be during the movement. You know of any videos that show it better?

Also I never answered your other question, the elbow tendon issue is the same arm. While I obviously can’t see it, thinking about your comments I think it would be a safe bet that there is definitely something going on to favor that arm during a lift which could help explain why the tendon flares up with only my right elbow considering I don’t golf or do anything else that would predominately put undo strain and wear on one arm versus the other.


#8

I’m having a hard time finding good visuals.

Heres bad position. The bottom of dudes shoulder blade is way out behind and the top is more in front. He’s got a tattoo almost right on top of his scap, you can see the forward tilt.

This girl shows bad position/forward or anterior tilt. Then good position. It’s harder to see exactly where her shoulder blade is in the bad spot, but you can see how straight up and down it is in the “good” spot.
goodbad-posture


#9

That first video in your log post. Tried with the good arm first, actually surprised by the mobility in that side. Then I tried the right arm, no bueno


#10

Ok. This is the first time I’ve tried to explain the following, so I hope it’s understandable.

Stand sideways to the mirror. Hold your arm straight out to the side, fist towards the mirror. Hold your thumb out, pointing straight ahead of you.

Then, turn your thumb up. Actively rotate your upper arm to turn your elbow/wrist/hand and turn your thumb up. Rotate it up and down a few times.

Now, while you’re doing that, look at your shoulder blade. Is the bottom sticking out behind you, making it tilt forward? As you turn your thumb up (externally rotate your upper arm) and look at your shoulder blade Think about making it flatten out against your back. Use the rotation of your upper arm, squeeze your lat and figure out how to tilt that shoulder blade.

Watch your scap go from here(bad)

To here (good)
shoulder-exercises-3


#11

You may also find that you’re just a little bit off with your pulling technique. If you’re over working the biceps when you pull/chin etc. they attached to the coracoid process which is part of the scap. This could irritate the AC joint and the tightness in the biceps could affect your elbow. Consider changing grips to a supinated grip, working outer range as well to get some length in your lats etc.
Hope that helps.


#12

There’s a lot of good advice in this thread. However, a solution to half a decade of AC joint pain and a bad elbow is not the best thing to crowdsource on the internet. Is there any reason why you WOULDN’T go see an ortho/physio? Financial/insurance?
I’m not saying anyone on here is wrong, but with limited information - and no matter how many pictures you take and descriptions you give, the internet will always be limited - you will be better off with a medical professional that can put his/her hands on you, manipulate the joint, call for x-rays/MRIs, and properly diagnose your issues.


#13

How about Rugged Individualism for a reason? Tough guys take care of shit on their own.


#14

https://media.giphy.com/media/xHX546S4pQBPy/giphy.gif

…you’re right.


#15

Jokes aside, it’s good to go to the professionals. Sometimes stuff is broken or torn and needs to be rebuilt or re attached.

That said, it seems like these impingment issues are tough for medical bros to fix. Sometimes there is no injury or damage or cause. Then you get some exercises to do, but you can’t do the exercises without pain. Or the moves are too easy or too advanced for you. Because the root cause, the way the joint moves is ignored.

Or there is damage to the joint or connective tissue, that gets fixed, but the bad joint movement that caused the damage is not addressed. So it happens again.


#16

I generally don’t like going to doctors. Any information they can give me is out there on the internet. This isn’t a blood disease or rare brain parasite, it’s a bum joint from an accident in a pick up game years ago.

Also the supposed “best” ortho in central Florida who treats the NBA team in town etc is the one who treated me when first seperated my shoulder. He did such a bang up job I’m just dying to go see him again…

Sarcasm aside, I’d rate the pain at a 3/10. Doesn’t interfere with my life or lifting. Just a chronic soreness is the best way to explain it.


#17

How about physical therapy?