I Think I Have a Shoulder Impingement

Training Injuries
1

I’m new to this area of the forum, but after reading through some of the threads I think I gained a lot of insight in some aspects. Some of the articles and posts have been extremely helpful.

To briefly explain my situation- I started noticing a shoulder issue around late 2008. It looked like my right shoulder was slouching down- I knew it was a problem, but I didn’t know how big of a problem because I never experienced any pain in my shoulders. I saw multiple chiropractors about the issue (due to moving across the country) and had two or three sets of x-rays taken. All of which were basically inconclusive.

Finally in January of this year I started experiencing excruciating pain after and during my chest & shoulder workouts. It got to the point where I had to leave the gym on the verge of tears after my third set of bench. Saw my regular chiropractor again he suggested I get checked out for physical therapy- I made the appointment, but it was with a regular doctor? He took x-rays of my shoulder- even after I explained I’ve already had them done multiple times. After he got the x-rays back he said something to the effect of no pulls, no tears, no bone or muscle issues. He offered NO solutions or help- I told him this is a serious problem and I was leaving the gym in tears and couldn’t hold anything in that arm over 10 lbs, his response was, “I’m not going to give you a cortizon shot if that’s what you’re looking for.” I couldn’t believe what I was hearing. My insurance was up that month so I knew I was basically screwed. I was mid-way through my second-cycle and he told me to stop lifting for 6-8 weeks. I got better advice from my chiro who said to stop flat benching and dips (since those were the exercises that really made my shoulder BAD) So I’ve been decline benching ever since with no pain.

I do flat db bench w no issues and I sometimes do dips, but only bodyweight and not often. Although I no longer had pain, it didn’t solve the issue and my strength has declined ever since. Most recently I’ve noticed an extreme loss of strength in my traps which at one point were my strongest muscle relative to everything else. This article I just found today in another thread sort of made a light bulb go off in my head:

I know I have weak rear-delts and weak shoulders in general- and shitty posture. So I’m trying to make a point of going through with this shoulder re-hab, but my question for you guys is HOW OFTEN should I be doing this stretching? Every day? Just before shoulder & chest day? Should I ever do it afterwards? Should I ice my shoulder after workouts? Should I go completely light weight? Do I need to do more back work and less chest? I feel like my bb rows are really weak (and have only gotten weaker in the last couple months) Seriously, anything you can tell me I’m going to follow. I know it won’t be a quick fix by any means, but how much time should I roughly expect before things get substantially better? And at that rate- will I ever be able to safely bench heavy again without regressing?
If you need me to lay out my workout routines and how much I’m lifting for each exercise I can do that as well.
I’m going to try some of those exercises tonight like the neutral grip face-pull and some ‘shrugs I’ve never done before’.

Thanks for all your input

2

It’s a five part series.

3

Basic things to look at:

  1. Soft tissue quality/work on the rotater cuff muscles
  2. Check for glenohumeral range of motion (external+internal rotation)
  3. Adequate thoracic mobility
  4. Adequate scap stability.

Be sure to check out Eric Cressey’s stuff as well.

4

[quote]Fletch1986 wrote:

It’s a five part series. [/quote]

I took the time to read all five of the articles…and was pretty over-whelmed- both by the terminology and outlined workouts. The majority of the workouts/exercises seem to be focused mainly on stretches and stretching-movements with really no focus on strength. I’m just wondering if there’s anyway to incorporate that stuff into a regular workout. I’m fine with giving up certain heavy lifts, but extremely skeptical of giving up what seems like nearly everything I do now.

I tried to search for posts of people who had completed the program and their results but didn’t find much. I did however find this from the author:

"The Neanderthal No More program would be a starting point, although it’s pretty old and both Eric and I have changed our thought process a bit since then.

I’m working on more of a mass appeal program that should be released in the next 1-2 months, but that may be longer than you care to wait.

Regardless, good luck!

MR
"

5

From the description of your original post, it sounds like you shouldn’t be doing any heavy pressing at the moment. Get healed, then worry about gaining strength. The only kind of barbell bench pressing that I can think of that might not hurt you is reverse band presses with little to no weight at the bottom of the movement.

When my shoulders are banged up, I focus on one arm shoulder presses and one arm bench presses with a reach at the end of the movement along with lots of face pulls and cable rows with a pause and cuban presses and rotator cuff work. But it sounds like your shoulders are a bit more than a little banged up…

Lots of pulling relative to pushing. As much as a 3:1 ratio is what a lot of the authors suggest for those with shoulder issues.

Also, learn how to bench like a powerlifter. Look up Dave Tate’s articles for benching along with his YouTube video. While it doesn’t put as much focus on your chest, it does reduce shoulder strain. I bet you can barbell bench if you use this in combination with my idea above.

Big problems call for big solutions.

IF YOU PUSH IT NOW, YOU COULD FUCK UP YOUR SHOULDER PERMANENTLY

I’m not trying to be rude, I’m just trying to emphasize my point.

Can you find a different doctor? Can he refer you to a specialist? It doesn’t sound like he’s very familiar with sports injuries.

6

[quote]Fletch1986 wrote:
From the description of your original post, it sounds like you shouldn’t be doing any heavy pressing at the moment. Get healed, then worry about gaining strength. The only kind of barbell bench pressing that I can think of that might not hurt you is reverse band presses with little to no weight at the bottom of the movement. [/quote]

In one of the neanderthal training articles it said to do close-grip bench. I believe it said somewhere around the six rep range, but didn’t say how much weight though. Do you think that’d be ok?

[quote]When my shoulders are banged up, I focus on one arm shoulder presses and one arm bench presses with a reach at the end of the movement along with lots of face pulls and cable rows with a pause and cuban presses and rotator cuff work. But it sounds like your shoulders are a bit more than a little banged up…

Lots of pulling relative to pushing. As much as a 3:1 ratio is what a lot of the authors suggest for those with shoulder issues.

Also, learn how to bench like a powerlifter. Look up Dave Tate’s articles for benching along with his YouTube video. While it doesn’t put as much focus on your chest, it does reduce shoulder strain. I bet you can barbell bench if you use this in combination with my idea above.
[/quote]
I have read some of dave’s stuff and changed the way I bench. I no longer do wide-grip bench (which may have led to this injury in the first place) and definitely focus a lot more on contracting my shoulders. I’ve never tried one-arm bench presses- and actually a lot of the exercises from the articles. By any chance do you have an example of a split for this? Going through the articles again I saw there was basically nothing for biceps (aside from some rows) and triceps. Again, I’m not entirely clear on whether or not I’m suppose to stop everything I’m doing and just do the exercises outlined in that program. It sounds like you too were doing other exercises when you were having issues.
Giving it “rest” doesn’t seem to matter much. There was a period this summer where I was on tour for about two months and could only do body-weight exercises and some kettleball stuff. I did absolutely NO heavy lifting during that period. I do remember at one point trying to do weighted push-ups and my shoulder started acting up really bad, so I stopped. I lost a ton of weight and strength on that tour and have been trying to recover ever since.

[quote]Big problems call for big solutions.

IF YOU PUSH IT NOW, YOU COULD FUCK UP YOUR SHOULDER PERMANENTLY

I’m not trying to be rude, I’m just trying to emphasize my point.

Can you find a different doctor? Can he refer you to a specialist? It doesn’t sound like he’s very familiar with sports injuries.[/quote]

That video that you posted is very interesting. When I first got my foam roller (for my knee) I asked my chiro if there was anything I could do with it that would help my shoulder. He said no. But that video just showed otherwise.

As far as the doctor goes, he wasn’t my doctor. I made the call to a specialist within physical therapy and they just set him up with me. I thought I was going to see some sort of sports medicine guy and they would look at how my shoulder was functioning and how flexible I was, but all this guy did was some worthless “try to keep me from pressing your arms down” tests. I was benching 350+ at the time and this guy looked like he didn’t work out at all and I remember laughing to myself about what a waste of time and money it was.

7

Some good advise given above. I’ve had a similar shoulder problem off/on for the last year also. Some things that made significant differences for me were :

All rowing is hold the contraction for +2 sec each rep. This helps strengthen the middle back and pull the rounded shoulders back into place. +10 years of computer work had my shoulders WAY rounded/internally rotated.

Changed pressing to all dumbells - shoulders rarely get inflammed from this.

Any barbell work I do to pins or do floor presses to limit ROM. (Full range is likely my form & I’m working on that)

3 to 1 ratio pull to push.

Chiro work has helped to adjust shoulers back also.

Lateral raises, with slightly bent elbows and to the front of body say 20 degrees

With any pressing, if the shoulders start to act up, I move on the next lift and don’t push it. When I have, its screwed the next many workouts.

Hope this helps.

8

I would imagine close grip bench pressing might work. If it doesn’t, you could try close grip floor presses. The reverse band idea is one I love because you’re still going through the whole range of motion thus maintaining your groove and slowly building strength at the bottom position if you slowly add more and more weight in the bottom by adjusting the band set up.

I’d like to give more suggestions, but I’m not a doctor and even if I was I couldn’t diagnose you and prescribe a program or anything over the internet.

If it’s really bad, I would do the program as outlined.

If it’s kind of bad, I would borrow pieces from the program and incorporate into what you’re doing now.

9

Did you actually get assessed for impingement? Does your shoulder hurt during an empty can exercise and not a full can exercise? Does your shoulder hurt above 90 degrees of abduction. Does it hurt with horizontal adduction and resisted flexion?

Also, how’s yer posture? If you do have impingement, I bet fixing some common postural issues might fix the problem. Also, if benching hurts you so much, why do you do it?

10

[quote]derf wrote:
Some good advise given above. I’ve had a similar shoulder problem off/on for the last year also. Some things that made significant differences for me were :

All rowing is hold the contraction for +2 sec each rep. This helps strengthen the middle back and pull the rounded shoulders back into place. +10 years of computer work had my shoulders WAY rounded/internally rotated.

Changed pressing to all dumbells - shoulders rarely get inflammed from this.

Any barbell work I do to pins or do floor presses to limit ROM. (Full range is likely my form & I’m working on that)

3 to 1 ratio pull to push.

Chiro work has helped to adjust shoulers back also.

Lateral raises, with slightly bent elbows and to the front of body say 20 degrees

With any pressing, if the shoulders start to act up, I move on the next lift and don’t push it. When I have, its screwed the next many workouts.

Hope this helps.[/quote]

Thanks for that. I think the 2 sec. hold on rows sounds like a good idea. I’m going to try that out today…as well as 3-1 push-pull. Both you and the article mention “rounded-shoulders” I’m not exactly clear on what that is or looks like (though I’m sure I have it).

11

[quote]Fletch1986 wrote:
I would imagine close grip bench pressing might work. If it doesn’t, you could try close grip floor presses. The reverse band idea is one I love because you’re still going through the whole range of motion thus maintaining your groove and slowly building strength at the bottom position if you slowly add more and more weight in the bottom by adjusting the band set up.

I’d like to give more suggestions, but I’m not a doctor and even if I was I couldn’t diagnose you and prescribe a program or anything over the internet.

If it’s really bad, I would do the program as outlined.

If it’s kind of bad, I would borrow pieces from the program and incorporate into what you’re doing now.

[/quote]

According to the newest article on the main page today, it said in regards to decline bench “There’s virtually no shoulder involvement in the exercise, and you can hit the sternal pectoralis (what some might call the “lower chest”) really damn hard.” The whole article is on shoulder health, I’m sure you’ve already read it. It basically said to give up flat bench altogether (which I did 11 months ago and have stuck with decline as my heaviest chest exercise.)

I don’t think there’s really any way that I’ll be able to set up reverse bands for bench at my gym. Do you have any other suggestions for chest during this rehab phase? I’m trying to think of things I can do that involve minimal shoulder work, but I’m having a hell of a time trying to come up with things (Except maybe for light incline db press)

I did see my chiro yesterday and tried to get some advice, but he really only told me stuff I already knew and didn’t offer much in terms of solutions other than seeing him on a weekly ba$is. So far just using what I’ve got from here seems to be helping. I just don’t know how I’m going to know when I’m “fixed” and if I’ll ever be able to regular bench again.

12

Like I mentioned earlier, floor presses. Maybe with a closegrip.