Thank you! So the behind the back pullaparts are similar to dislocates but stop short of the waist, then perform a pullapart. I’ll have to give em a go. I do dislocates (and regular pullaparts) pre and post workout.
The other stretch you mention sounds like a scoop press. Am I imagining it correctly? I understand the nuances of resetting the scap and resisting the light load.
I have a tens unit. Would that suffice?
I came on to say I looked at my copy of Becoming a Supple Leopard and he demonstrates a foam rolling technique in which I essentially hug myself to get the scapula out of the way and roll the (now) exposed soft tissue. I had been foam rolling but this elicited much more of a sensation. I felt a knot that was quite sore to start but which diminished after maybe 5 minutes of rolling the general area. It’s been two hours and the area feels “treated” but not sore. I understand your difficulty in saying too much virtually but would you think this is a worthwhile practice in addition to your suggestions?
Do the first half of a dislocate, so the band is over your head. Now, instead of doing a “circle” to bring the band all the way down to your low back, pull the band apart so it ends in a similar position to the bar in a back squat.
This video is close, but he’s going too fast and not setting his scaps at each stage
Not quite. If you click on the red text in my reply above you’ll get a video of what I mean.
Yep, just turn the intensity/amplitude up high enough the muscle contracts. If you can modify the signal frequency, 35-50Hz will be most EMS-y. Typical TENS settings are 80-120Hz.
If you can only adjust signal amplitude, it’ll work like EMS but be extra tingly
If it feels good, you can probably safely keep going. You might enjoy this option as well:
Thank you. Again. I had them badly misinterpreted. I greatly appreciate the clarifications. I already tried (all) but “thread the needle” produces a tremendous stretch directly in the affected area. Feels right. In your opinion, can I use this technique rather than the foam roll technique I described earlier? I may try rolling with a tennis ball to hit it exactly.
Last question (I think) I have legally obtained THC. Do you have an opinion on its effectiveness as an anti inflammatory? Any recommendations for NSAID or other such supplements?
You’re terrific. Greatly appreciate your patience.
In my opinion, if there’s no suspicion of an acute muscle/ligament/tendon tear, choosing whatever stretch or “release” exercises feel good is safe
No recommendations other than typical over-the-counter pain relief (paracetamol, ibuprofen, diclofenac)
I typically recommend clients stick with paracetamol over other NSAIDs because it has fewer side effects if dosed safely. NSAIDs will also blunt hypertrophy and may negatively impact tendons if used chronically.
However, if your symptoms are primarily nerve-related it’s unlikely any typical over-the-counter medications will help (unfortunately).
THC isn’t readily accessible in my state, so I’ve never looked into or recommended it to a client
The list of exercises you posted has been very helpful. I also found scoop flies seem to help my shoulder mobility.
Do you have any thoughts on using slow eccentrics as part of rehabbing an injury? I think I read, on here, some coaches have clients do the aggravating exercise, in my case bench press, with absurdly long eccentrics.
I just look at slow eccentrics as a way to minimise load whilst keeping challenge high.
Say I have a client whose shoulder hurts when they bench >70% 1RM. Chances are, if I told them to lift <70% they wouldn’t listen because that’s fucking boring. In contrast, if I told them to do 4-5 x 8 with a 5s eccentric, they’d call me psycho but they’d probably still do it. At the end of the day, they’re still just getting good volume a load that doesn’t fuck them up.
In this manner, I don’t use it any different to pause reps, 1.5 reps, blood flow restriction, pre-fatigue or similar.
Hey @j4gga2
Been having some issues with my anterior delt and pain for a while, long story short I’ve been going to a physio whose diagnosed an anterior delt impingement and a torn infraspinatus been giving me some needling and exercises to do. My delt seems loads better and I’m gradually reintroducing some light bench work.
My Infraspinatus on the other hand is still giving me a load of gyp and is pretty painful most days, is there anything I should be avoiding doing? I can’t put my finger on anything other than sitting posture which aggravates it. How long should I give the treatment before I start challenging the process? I’ve had 3 needling sessions over about 5/6 weeks so far and I’m due back to see him again tomorrow.
Hey mate, I’ve got a couple of follow-up questions before I give any specific advice:
Are you 100% certain this, especially the “anterior delt impingement” was the diagnosis? What were your initial symptoms and how did the physio test this?
What’s been needled, and what exercises (exactly) are you currently doing?
Could you please reword this question? I’m a little unclear about what you mean here
Yeah he definitely said I’d got an impingement on my anterior delt, he may not have said torn infraspinatus it may just have been my translation of what I thought he was saying. He did several tests which I cannot remember all of the names for, there was an internal and external rotation test, one of the names I do remember was the O’Brien test which on initial assessment was fairly painful and weak. He’s done this with me today and had no pain and was pretty stable. I’ve got a noticeable size and strength difference between my shoulders and had been getting pain with various bench variations. He’s also said my infraspinatus feels pretty hollow, when comparing the two I can feel it myself from tensing the musculature in my back it’s different.
I’ve had my anterior delt needled twice and infraspinatus 3 times, I’ve also had my long head bicep and forearm needled.
I’ve been doing:
Shoulder flexion 3x10 with a 5 second eccentric - daily
Shoulder Extension with band 3x10 although I’ve been adding more reps for progressive overload - daily
Spiky ball thoracic massage x3 for 30 secs EOD
Hammer Curls with 5 sec eccentric every day, alternating between DB’s and bands
Ascended 90 degree rotation with band 5 sec eccentric - 3x15 daily
Drawing the sword with a band - 3x10, again been adding more reps for progressive overload - daily
Also been doing mid deltoid stretch and wrist flexion with internal rotation stretch daily, he’s given me a couple of others today do less frequently in the week which are prone lower and mid trap raises
Yeah I didn’t articulate myself very clearly. The guy seems very genuine and to be fair my bicep and delt are better than when I started, the pain in my infraspinatus is arguably getting worse. How long would you expect to do this sort of treatment and exercise/stretch programme before seeing improvements, I appreciate it’s not going a short term fix.
Appreciate you taking the time to reply and also I think it’s pretty awesome you offering your time up
Gotcha. He probably said this for clarity/understanding’s sake, but I think it’s important to clarify that the mechanical “impingement” in the human shoulder describes the pinching of the subacromial bursa and supraspinatus tendon under the acromial arch (a bony projection underneath the deltoid)
That’s all good! It sounds like he did a pretty typical diagnostic battery
This is pretty typical of rotator cuff-related shoulder pain, especially when suspicion of (large) cuff tears is high. So far, you definitely sound like a “normal” presentation. That’s a good thing!
Sounds like a decent early loading plan for the cuff. Are these still:
challenging?
At a tolerable pain level, or totally pain-free?
In general, population studies show that rotator cuff related shoulder pain has a typical time to resolution of 3-6 months, but unfortunately can extend to a year or beyond for a subset of the population
This post has a bit more context around rotator cuff-related shoulder pain
In your case, I would expect that you’re having pain with pressing motions because those are the movements where infraspinatus is most demanded to stabilise the shoulder.
You may want to trial some light, modified pressing to get back into the bench-type exercises. However, I wouldn’t try to force-feed it either. Some viable strategies to modify pressing include:
Restricting range of motion using a board press, floor press or Spoto press
Prioritising neutral grip options such as dumbbells, Swiss bars or similar
Pressing at a slight incline or slight decline
Using tempos, pre-fatigue or blood flow restriction to making lighter loads more stimulating
I’m not too sure what a mid deltoid stretch is. I’m assuming what you’re describing here is a sleeper stretch?
I’m adding reps or resistance to keep with progressive overload. The only one I’m struggling progressing on is the shoulder flexion.
Mainly pain free, I’m getting some pain in the bicep at the top of the contraction at times on hammer curls but that’s it.
Awesome, I’m gonna take some time this morning to digest this.
Sounds like I’m on the right track then, I’ve been floor pressing last few weeks and it’s not causing pain. I got some light incline and close grip bench done last week which hasn’t caused pain either. I do own a Swiss bar which has been my go to bench variation over the past couple of years.
Avoiding getting fucked up seems like a good plan.
Something I noticed yesterday is my technique had gotten a bit… soft. No hard arch when benching, less leg drive, less focus on engaging lats and retracting scapula. I tightened things up and my shoulders felt sooo much better… like they were years younger, almost begging to press more weights overhead.
Happy to help mate! Sounds like sticking with the “power technique” will be a good avenue for you. However, do consider that you don’t want to do all your pressing with that hard arch & retract technique. Definitely try and get exposure to some pressing in a more neutral ribcage position, with a more dynamic shoulder blade action as well. Calisthenics, dumbbell and Landmine exercises are ideal for that in my opinion
Funny. My physical therapist over the summer: “You’re not happy unless you’re hurting yourself!” Which to be fair is true of him as well, which he acknowledged.
Hello, I’ve been struggling with what appears to be golfer’s elbow/ medial epicondylitis for months. I believe it first started after a bout of weighted pull ups about half a year ago. I was pulling either 15kg or 20kg for 2-3 sets of 5-8 reps. This was at a body weight of around 70-75kg.
Using an elbow sleeve helped slightly initially but not for long. It got worse and I took close to two months off lifting. But when I restarted, even bodyweight pull ups triggered the pain.
And now the pain can flare up even when I am not doing anything. It flares up on pushing movements and even simple movements like lifting a suit case into the car.
Would be grateful for anything I can do to resolve this. Thank you!
I recently had a posterior right shoulder dislocation, did the smart thing and popped it back in myself (I know, I know,) and am currently involved in physical therapy, but wondered if you had any advice or recommendations, especially to get back in the gym.
Your plan looks reasonable for very early stages post dislocations. I would typically include some very light isometric rotator cuff work in neutral (arm by side) and/or 45 degrees abduction and/or 90 degrees of abduction depending on comfortable range of motion
I generally don’t start lifting until athletes have minimal inhibition when activating the rotator cuff and full comfortable range of motion.
Once you’ve cleared this, return to gym is starting super light in the most stable exercises possible and then building up slowly over time
Hey, no worries. I took another lay off from lifting for slightly over a month. The pain or ache seemed to have disappeared when I carry out daily activities. It had previously got to a point where it would have flared up if I had to get a suitcase out of the car or even grocery bags.
So I tried lifting once recently. Just the bench press, so no pulling movements yet. But I could feel it start coming back.
So the rest and period of no lifting seems to have brought the elbow back to normal vis a vis daily activities. But it looks like it will start flaring up if I restart lifting again.
I’m not sure how useful this information is but when I’m driving and I use my right arm to turn the wheel left, the ache was pronounced when my hand is turning through the 2pm to 10pm range of the wheel. Just something I happened to notice. I didn’t really feel as much when say I turned the wheel left between the 6pm to 3pm range
Everything you’re saying is pretty typical of medial elbow pain (aka medial elbow tendinopathy aka golfer’s elbow)
In terms of what to do about it: common sense is typically best. You’re already modified activity as able, and been gradual reintroducing provocative training.
Some work that might be valuable is adding some long wrist/finger flexor stretches and loading. Look up some floor wrist strengthening exercises for gymnastics & acrobatics for ideas
We do know that this usual rarely persists longer than ~1 year. Unfortunately, there’s no strong research guidance for ways to speed up recovery for this issue. Thus, giving any other advice without literally testing every possible exercise modification with you is a challenge
I would avoid PRP and cortisone injections. They at best have no effect, and cortisone might even make the issue worse long term.
