Original_Demon,
Do you feel the tightness and popping where the collarbone meets the sternum or out toward the shoulder joint?
What position do you sleep in?
Have you changed daily activities or workout programs prior to the onset of symptoms?
Ryan
Greg,
First, if you haven’t already, read Mike Robertson’s article about setting up for the bench press. This would let you know if your set-up is right.
Second, the ulnar nerve does indeed innervate the pinky finger, it also innervates the ring finger in most people. The C8 nerve root, which makes up part of the ulnar nerve is usually associated with the pinky finger.
You would want to rule out impingement of the nerve at the level of the cervical spine versus somewhere in the thoracic outlet or further downstream.
The fact that the symptoms are very intermittent and go away with a change in position suggests that the problem is not severe at this time.
I would suggest that you get checked out by a chiro or PT that deals with sports med. There are some easy orthopedic tests that they can do to assess the problem. I would think that once evaluated they could perform some treatment and give you some stretches and exercises to do at home that should do the trick.
You should stretch your chest and neck in the mean time and see if that helps.
If you have any follow up ?'s let me know.
Ryan
Hey Doc!
Been having some nagging issues with my right shoulder lately. My chiro/ART guy did some work on it a couple of months ago, Monday I had some time and went back to him.
He spent a bit more time moving the arm around and feeling and listening.
He decided that I’m too young for “arthur-itis” but that I do have some inflammation in the joint which is contributing.
He loosened up a bunch of stuff all around the shoulder–front side and rear–and it feels a lot better. My question for you–and I didn’t get to ask him b/c he spent extra time with me as it was and was getting behind–is how bad is inflammation in a joint and what are some of the better ways to settle it down?
Thanks.
[quote]Dr. Ryan wrote:
Original_Demon,
Do you feel the tightness and popping where the collarbone meets the sternum or out toward the shoulder joint?
What position do you sleep in?
Have you changed daily activities or workout programs prior to the onset of symptoms?
Ryan[/quote]
It’s sore and pops on both sides, (once), where the collarbones meet the sternum. I sleep on my side… mostly. I can’t sleep on my back or stomach. What can I do without changing positions??? My pillow keeps my head level. Should I invest in a pillow that supports my head at a higher angle? Seems like it would effect my neck then… This is quite the predicament.
OD
Joe Weider,
Well, it would really depend on the amount of inflammation. If the joint has enough swelling to increase joint pressure, it will often cause a neurologic inhibition of some the the muscles surrounding the joint. It could also restrict range of motion.
Does he think the inflammation is in the joint, or in a tendon or bursa?
What movements or exercises cause you pain, and what kind of RH have you been doing?
As far as supps for inflammation, Fish oil does help. Glucosamine helps to maintain cartilage, but doesn’t have much anti-infl action. Herbal products containing curcurmin (tumeric) and boswelia have potent anti infl properties.
Let me know if you have any follow-up ?'s.
Take care,
Ryan
Hey Doc,
I tweaked my back out doing deadlifts about a month ago. My back spasmed when I had the weight about 6 inches off the ground, and I put the weight back down and went home. The pain originated in the lower left muscle, near the spine but not on it – probably about 6 inches or so above the tail bone, and and inch or two to the left of the spine.
After a couple days it felt much better. I’ve completely backed off squats and DLs – I was starting a KB program anyway, which I have been doing 3X a week – but I’ve found that I’ve had throbbing from the same area during the day when I’m sitting at my desk.
Do you know what that could be, and does that sound like something I should go get checked out?
I probably know the answer to the last question, but I’ve been avoiding it.
Thanks.
Thanks Doc.
I got the impression from the way he said it–kind of like “oh you have a shaved head and some inflammation in the joint” that he didn’t think it was a really big deal. But I’ve always had shoulder problems of varying degrees, so I was wondering. At first it was just flat bench, and then only with the elbows out. The last few weeks it’s moved to overhead work too, but I figured it was just time to change from grinding heavy weights and low reps to doing some higher reps.
I try to do things like the Cuban press and stuff as well, just to keep everything balanced up.
I take 4 grams of fish oil and 2 of flax/borage oil every day.
I tried the glucosimine but never really saw any benefits from it–but maybe I should try a different brand or something.
Should I take more fish oil?
And I’ll look into the other stuff you mentioned too, thanks.
My biggest question is whether a low grade inflammation is going to cause premature and excessive wear/damage, I guess.
Original Demon,
Deep breaths, repeat… serenity now, serenity now.
The important thing to remember is that the symptoms go away basically as soon as you get up and don’t restrict any of your activities.
Now, based on what you are describing, it sounds like your sternoclavicular joints are responsible for producing the popping sound. Most likely this is joint cavitation.
Sleeping on your sides can produce more compression on these joints and will place your pecs in a shortened position, which would make them tight when you wake up.
When sleeping on your side, I usually suggest placing a pillow snuggly behind your back and then rolling slightly back on to it so that some pressure is relieved from the down shoulder. This also causes the upper arm/shoulder to lay back some without wanting to flop forward. If it still wants to drop across, you can hug around another pillow to take stress off the upper arm.
Regarding your neck pillow, I usually recommend the contoured memory foam pillows, as they usually support the neck and cradle the head, which keeps the head/neck in a neutral position.
If you have any other questions, let me know.
Ryan
Take care,
Ryan
BB,
I’ll respond completely to your question tomorrow, as my wife is griping at me to help her with something.
However, check the Cool Tips archive for the Get on a Roll tip. The towel roll should help make sitting more comfortable.
Take care,
Ryan
Thanks Doc.
Please do go help the wife, or you’ll have a pain several inches lower than mine… At least that’s how it works with my fiancee.
Your post made me sleepy… It sounded so damn confortable I almost fell out of my chair.
I love the idea with the pillow behind my back. I’ll try it tonite.
Thanks Doc,
Wayne
Alright, late start tonight, so I’ll stay on a little longer.
Any questions?
Hi Dr. Ryan,
Could you provide your thoughts on the sleeping posture thread I posted a little earlier on this forum?
I also have another quick question. I went to see a chiropractor and ART practitioner in Florida who had a chair in his office that was tilted forward (the front legs were shorter than the rear ones). Sitting on it seemed to place the hips and shoulders more in line and seemed to promote much better posture than normal chairs. Any thoughts on this and would you happen to know of anywhere that sells such chairs?
Thanks in advance.
How about taking a message by one of the hard working mods pushing through all the Prime Time posts? 
What grip do you recommend on DB Military Presses to minimize impingement syndrome?
I limit bench pressing and MPs. 8x3 each, once per week. I do no other shoulder exercises. I do pulling of equal volume in all planes to balance out any pushing exercises I do.
T-Alpha,
No problem.
I usually have people use the neutral grip, ie. palms facing each other position. Also, instead of abducting your arms straight to the side, try keeping them 20-30 degrees in front of you. This position should help as well. If you are unclear on this, let me know and I’ll try to describe it better.
More importantly, how long have you had the problem? How was it diagnosed?
What kind of therapy/treatment have you been doing?
If you don’t have time to answer right now, feel free to drop me a PM and I’ll be glad to help you out.
Keep up all the good work you guys do day in and day out to make this site so great. I know that everyone really appreciates all your hard work.
Take care,
Ryan
Doc,
My wife had a severe fall and dislocated her elbow (what a hideous sight). It was hanging like a rag doll from the elbow. After 4 hours of stupidity in the ER, they finally got the Orthoped in and he doped her up and slammed it back in. Now her sling is finally off, but they say due to soft tissue damage, it may take up to 6 months to be normal again. They warn against passive extension. She is to begin therapy in two days and is to go for 4 weeks at 3x per week. What can she do/take to speed recovery?
I’m thinking fish oil, glucosamine/chondrotin, vitamin C, multiminerals etc…
She really wants to be training again much faster than they are saying. We all know that Docs are conservative ;-), but athletes aren’t.
What’s the down and dirty on some smart aggressive ideas?
thanks,
DH
Disc Hoss,
Sorry to hear about her injury.
Without knowing the degree of ligamentous disruption it is hard to give you any recommendations on how hard to push it.
The PT should do a full assessment of her and that would include some orthopedic testing of the joint to assess stability. Depending on what shows up, they would be the best ones to ask about how hard to push it. Make sure they know her pre-injury fitness level and degree of strength in the most appropriate exercises. This may allow them to challenge her a little more than they would an untrained person.
Your supplement suggestions look fine. I would say a good 4-6 grams of combined EPA/DHA, 1500-2000 mg glucosamine, at least 2000mg MSM. A good quality multivit/mineral and adequate protein intake. Some people have utilized proteolytic enzymes with good results (Wobenzyme is one brand that has a good reputation).
You may want to PM Tampa Terry as I thought TT had made a list of post-injury or surgery recovery supplements.
Also, Dave Barr has done work in the metabolism unit at UTMB/Shriner’s Hosp which does extensive therapy on burn patients. Therefore, he may have some info regarding new research on tissue healing.
Take care and if you have any other questions, let me know.
Ryan
T-Alpha,
When I do military press, with the barbell, I always keep the weight in front of me. The burn in the shoulders are still there without that kink you feel when you do the military press behind or above your head.
So keeping the weight slightly in front you takes a lot of stress off your shoulders.
OD
[quote]Soldierslim wrote:
I just started a new thread with this question, but since you’re here: my girlfriends knee doesn’t track properly when she walks or squats. It sway’s inward during these activities and she now has pain in the knee (I’m guessing due to the tracking problem). This week she decided to not do knee bending excersises and to ice the area. Assuming that this releives the pain, what excersises should she do to correct the tracking problem?[/quote]
Soldierslim, you have a PM.
I’m here for a couple hours, any questions tonight?