Injury: Shoulders, Back, Posture

Training Bodybuilding
1

Hi all. Just a quick summary of my situation:

I’m now 24. Had a number of problems with injuries, primarily due to training stupidly when I started out; ignoring pains; bad eating etc. (real newbie mistakes before doing any research). This included lower back issues, refered hip pains and primarily shoulder issues.

I wanted to have a “fresh start” from the beginning of the year. First port of call: shoulder surgery for clavicle osteolysis in right shoulder. It’s been six months. The left shoulder is acting up again (it was the first injury I ever had with impingement syndrome, which I thought was completely gone). It is most likely scar tissue together with postural problems.

I wanted to treat the root cause and not just symptoms. Went to both a chiro and a biokineticist he referred me to. The gist of the matter: posture is the root of the problems. He drew a side view sketch of me and what the problem areas were: went all the way from weak calves, imbalanced quad/ham strength, hip-flexor and psoas tightness, lower ab weakness, weaker upper back esp. supraspinatus, weak neck muscles. In general - bad shape :frowning:

So have embarked on a comprehensive program which will take around 3-4 months for a complete overhaul. Starting with just stretches for posture, neck, hips, quads/hams, calves etc. Then will start stability ball work, and then add weighted stuff again. I am bummed in that I thought after surgery I would be into training again after a couple of months, but at the end of the day - I am young and want to get the basics 100% sorted, before carrying on and causing more harm and am more than willing to wait and do whatever it takes for however long.

My question is: has anyone been in a similar situation…with bad posture being the root of numerous problems? Have you gone through a similar back-t-basic regime? Any suggestions or advice you may have?

Oh and one thing to add: the chiro says that the pain I have in the hip/lower back (normally right side only) is realted to the posture, as well as imbalances/weakness in the right hand stabilizers and muscles; and also an inflamed disc between L5 and S1 (not sure what it means exactly :frowning:

Cheers,
X

2

You are definitely on the right track. Posture is really important especially if dealing with injuries and post surgery musculoskeletal conditions. My only other recommendation is to start getting Deep Tissue Massages. Find someone who is trained in Neuromuscular or Trigger Point Therapy. Most often times failed surgeries (not that this is the case) are due to lack of understanding of the role muscular system plays in the pain equation. If you find someone who does this type of massage, they can probably cut your rehab time in half.

Trying to strengthen a muscle that is weakened by trigger points can be counterproductive and trying to overstretch a muscle with trigger points can be difficult. By dealing with myofascial trigger points you will both address some of the pain issues you may be dealing with and speed up any strength and posture imbalances you may have.

About the low back, the disc inflammation is something you really want to watch. Like he said posture is crucial, so dealing with that will help. The exercises they will give you will help too. You may also be getting referred pain from the quadratus lumborum muscle and or longissimus. Any joint or disc pathology in this region will trigger spasm in these muscles which will greatly contribute to the pain. Again trigger point therapy will address this.

3

One more thing the inflamation is just that. The disc that cushions the 5th lumbar vertabra and the sacrum is inflamed.

4

Thanks for the replies so far. Deep tissues / ART is virtually non existent here in South Africa, so I make do with the physios at the specialist sports center. They are really good though and do a type of deep massage, as well as accupuncture, ultrasound etc. I finally got myself a roller which I am starting to learn for self-induced myofascial release as per that “Feel better for $10” article.

In terms of the shoulder surgery: it was successul in that it eliminated the pain in the bone I had from the osteolysis. Now it’s a matter of getting back to training with everything right, posture specifically. The left shoulder started getting worse though, which the biokineticist attributed to: posture, very tight neck muscle in the left causing nerve pain through entire left side, weak suprispinatus causing trap to totally take over almost any movement in the left side; as well as scar tissue from previous impingment.

In terms of lower right back - I feel it most after cardio work like running/cycling, and hits me hard even when seated at work. I feel pain throughout right side hip, hip-flexor, psoas etc. This they attribute to sever quad/ham imbalance, and a little L/R quad imbalance (funnily enough, right one stronger). What happens is when I do a movement involving the hip, the right hip moves downward I think they said. The chiro said the cause was the inflamed disc and posture, the symptom was hip-flexor, ITB, and gluteus minimus.

5

Yea man they sound like they know what they are doing. Have the phisio dig into the QL and Long. It will not get to the root of the problem but may help with the spasm cycle and the myofascial pain, which can be a significant part of it. You may also want to try traction therapy. If you can get access to traction boots or someother device in which you can decrease pressure on that disc, it will help a great deal. Good luck .

6

[quote]chriscarani wrote:
Yea man they sound like they know what they are doing. Have the phisio dig into the QL and Long. It will not get to the root of the problem but may help with the spasm cycle and the myofascial pain, which can be a significant part of it. You may also want to try traction therapy. If you can get access to traction boots or someother device in which you can decrease pressure on that disc, it will help a great deal. Good luck .
[/quote]

Thanks for the support. The main difficulty was psychological - post surgery it has been a cycle of rehab for shoulder which was fairly painful, then the left shoulder acted up so I focused on cardio and legs whilst doing only rehab upper body work; and the cardio/legs work caused the hip/back problems again. Sort of a vicous cycle! But alas…starting from scratch, so hopefully the “clean slate” will do the trick.

Currently doing the biokineticist stretches, should be moving onto stability ball and light weighted work in the next couple of weeks. Going to the chiro once every 10 days or so to alleviate symptoms - this includes massage, accupuncture, ultrasound, dynamic traction (he finds it more useful for these issues than long, static traction) and he said I should consider a homeopathic mixture which will be injected into the disc. The idea is that, since the inflammation and englarged disc causes pain, the (homeopathic) substances in the injection aims to reduce the size of the disc by drawing out water as well as reduce inflammation.

Cheers,
X

7

No problem. Yea I agree with the traction method. There is a therapy here in the states called vax-d, it also goes by other names as well. Basically it’s a high tech method of what your chiro is talking about, and it may be the same thing. Most have never heard of it and it’s really expensive, so I usually just mention the more common forms known. Yea like I said you have the right guys/gals on the job. If only all care was that comprehensive here in the states, although we are coming along. Take care.

8

[quote]chriscarani wrote:
If only all care was that comprehensive here in the states, although we are coming along. Take care. [/quote]

I wish it was so freely available: I am actually going to the Center for Sports Medicine, where all the national sports teams go. That is why it is pretty comprehensive. Other than that it is quite disparate and a lot of quack jobs (such as the first chiro who gave me around 10 sessions only treating symptoms without bothering to look into causes. The new one - didn’t even treat me first time, said it would be a waste. Sent me to the biokineticist along with a detailed description of tests.

And the traction: I lie on a bench, straps my legs down, loosens the end of the bench (to allow movement) and - whilst putting pressure with one hand on certain vertebrae/discs - does dynamic traction/movement in various directions.

9

The upside of what you’re going through right now is that is will only make you better in the long run. You’re learning excellent information and getting great tools that will benefit you for the rest of your life.

I had rotator cuff probelms from imbalance and posture issues that manifested in my mid 30s (I’m 44), though what I learned from the problems was invaluable.

‘Patience’ and ‘One Step at a Time’ should be your mantra these days.

Best of Luck,
Scott

10

[quote]simon-hecubus wrote:
The upside of what you’re going through right now is that is will only make you better in the long run. You’re learning excellent information and getting great tools that will benefit you for the rest of your life.

‘Patience’ and ‘One Step at a Time’ should be your mantra these days.
[/quote]

Thanks! They are indeed. With the first injury, some 4 years back (impingement syndrome, left shoulder) I was impatient. After so much pain and troubles, with many periods of non stop daily pain, I am more determined than ever to get things right.

It feels really crap not being able to train and being limited to very basic things (just stretching, nothing else at the moment) but if that’s what it takes! I’m 24 now so don’t want to cause even further damage. My checklist now includes:

  • right shoulder back to 100% after op
  • left shoulder back to 100% esp. trap/suprispinatus and scar tissue from previous injury
  • lower back, esp. right side with hip and associated problems
  • imbalances and postural problems
  • right knee (x-ray shows slight calcification of ligament which causes pain, made worse by ITB which gets sore as refered pain from back/posture)

Will let you know once each is ticked off :slight_smile:

11

I know what you’re talking about. I’m 25 and had shoulder surgery in december 2004. They did not have a diagnosis before the operation, but it seemed to be some glenohumeral ligament damage. I did not fully recover from it, since they didn’t dare to do an open operation and couldn’t fix it completely.

Since the operation I am not only struggling with the shoulder. I also got loads of other problems. Knee pain, mostly medial but now also lateral sometimes, wrist pain which bugs me all the time when working on my computer, neck pain, due to a wrong movement when I tried to stretch my scalenes and which has not gone away since then, … The drama was my back which gave way when deadlifting about half a year ago and which has not really gotten better. All very annoying, since training is always searching for which few exercises I can do without pain.

In the end, I was diagnosed, by different doctors, to have :

  • generally instable joints, not really hypermobility but too much laxity, together with overactive muscles to compensate
  • overpronating flat feet, screwing up my all biomechanics from the basis
  • patellar tracking problems
  • overtight hams and hip flexors
  • displaced L5 vertebra and/or facet joint pain, microtrauma to disk at S1/L5
  • reduced thoraic mobility
  • scapular winging
  • general poor posture
  • some things I forget right now

I have seen a few doctors and doctors in osteopathy, but I am still searching for someone to put me on the right track. I try to work on hip mobility, shoulder stability, general flexibility where needed, improved posture, … But some guidance might come in handy. Tomorrow I will see a new doctor, and hope he will show me the way :slight_smile: .

So you see, you are not alone in this by far. You got the luck to find some decent guidance, whereas some people seem to spend a fortune before they get where they have to be.

12

Hi there,

I think we must be identical - looking at your list it seems that we suffer from about the exact same things!

[quote]Raistlin wrote:

  • generally instable joints, not really hypermobility but too much laxity, together with overactive muscles to compensate
    [/quote]
    I have instability due to weak minor/stabilizer muscles (such as the suprispinatus in the left) and a lax left shoulder joint

[quote]

  • overpronating flat feet, screwing up my all biomechanics from the basis[/quote]
    My feet are messed too, got orthotics (insteps) around 8 months ago and they definitely help

Same here. Also imbalances in quad vs ham strength.

I have inflamed/irritaed/injured disc between S1/L5

Same here. Diagnosed since the first injury 4 years back, and no treatment has helped thus far.

Yup…that is what they say now is the root cause of all the issues.

I would suggest, if you have access, going to a Sports Center such as what I went to here, where you have physios, biokineticists, sports physicians, surgeons etc. in one place with easy access to each other.

Hope you come right too!

Cheers,
X

13

Well, I think that is hard to find here in Belgium. We also have no ART practioners. Maybe there is some center somewhere where I can be helped, I hope the guy I’m seeing tomorrow can show me one.

14

Young men getting questionable surgery — it breaks my heart.

To anyone else out there: GET A SECOND OPINION!!!

Knees, shoulder, elbow, back — unless you’re talking about a catastrophic tear or something like that, surgery should be your last-ditch, back-against-the-wall option.

If it’s not a tear, then stretching, low-impact PT, ice-heat combo, chiropractic should be able to help you.

Tell those scalpel-happy MFs to stay away from you.

15

I fully agree. I only had one surgery and was the absolute last thing on the list. I tried: physio, deep-tissue massage, cortizone, accupuncture, as well as a new therapy where they draw out blood; spin it up to separate the plasma; mix it with numerous substances and inject it directly back into the affected area.

This was all over a period of around 18 months. The 3rd X-Ray I got revealed full clavicle osteolysis for which clavicle resection was the only option.

16

Well, it’s a fact that my surgery was not a solution. It did take one year before I did undergo surgery, but who knew things would get worse. Anyway, they won’t get me on the operation table anymore in the near future.

17

I have the exact same problems as you, pretty much down to a T. I’m finally figuring it all out now, after months of stretching and posture work. Out of experience I would say that you have to take care of the trigger points first. start with the hips, as they tend to have a huge effect on my neck and subsequently my shoulder placement.

Get a foam roller or something like it and use it as much as possible. Work on the largest, most balled up muscles (for me that would be quads and hip flexors, especially rectus femoris, IT band, vastus lateralis and psoas major, I imagine yours are similar.) I’ve had a lot of deep tissue massages, and some of them have been really good, but you should trust me in saying that you can do a better job yourself, once you get to know your body, muscle locations, pain tolerance, etc.

Though the symptoms are really widespread and shitty (I get tension headaches, joint pain almost from head to toe, fatigue), you’d be surprised how simple (notice I saed simple, not necessarily easy) the solutions can be. Definitely deal with the trigger points in the major muscles, this will reduce a lot of tension in other places and allow your body to fall back into place.

Because everything in the body is connected, a problem in one place (like the hip(s)) can lead to problems everywhere else. But by the same token, when you fix one problem, the others either resolve or are a ton easier to resolve.

I’ve done a lot of stuff for these problems even though they’ve only bugged me for a year or so. Like you, I wanna get my imbalances sorted out now instead of tearing a muscle later. So you’re definitely smart for deciding to take the effort to do this stuff.

Trust me in saying that a lot of this stuff is due to trigger points, they can have pretty profound effects on your body.

If you wanna get a good book that list every trigger point in the body, “The Trigger Point Therapy Workbook” by Clair Davies. No I’m not trying to peddle any particular book, just thought it’d be worth telling you because I got this book about 4 days ago and am already seeing good results working out muscle tension in trigger points and stretching afterwards.

Hope I’m not overwhelming you or anything, the post is really long because I feel for you, I’ve got the exact same problems and wanted to share what’s worked for me.

Good luck

18

Yup…I went to the chiro who said he won’t work on me until I go to a biokineticist. He started me on a long-term plan to fix up all the issues which are affecting my posture. For 4 weeks it was nothing but stretches and static holds. At the same time I got myself a foam roller and use it a fair amount…but since I stopped everything else (like cycling, running, weights etc) which triggered it, the pain has dissipated…aided with 4-5 sessions with the chiro which really helped. The issue he identified, as did another (useless) chiro a long while ago was that pressure and referal pain originating from the L5/S1 disc.

My main areas are the hip flexor (triggered by cycling and running), psoas, ITB and gluteus minor - that last one being the primary trigger for the back/hip issues the chiro found.

[quote]Though the symptoms are really widespread and shitty (I get tension headaches, joint pain almost from head to toe, fatigue), you’d be surprised how simple (notice I saed simple, not necessarily easy) the solutions can be. Definitely deal with the trigger points in the major muscles, this will reduce a lot of tension in other places and allow your body to fall back into place.
[/quote]
I agree. Fortunately (or unfortunately, depending on how you lok at it) with the injuries I have had in the past I built up a fair amount of patience, so have no qualms taking 3, 4, 5, 6 or however many months it takes to fix this once and for all.

Yes, I was surprised. I understand quite a lot about trigger points but not the extent they presented themselves. For example severe pain in the left (non-operated) shoulder…all stemming from tightness in the neck and related nerves, in turn caused by weak (almost non-functioning) suprispinatus and over-exhausted trap.

[quote]If you wanna get a good book that list every trigger point in the body, “The Trigger Point Therapy Workbook” by Clair Davies. No I’m not trying to peddle any particular book, just thought it’d be worth telling you because I got this book about 4 days ago and am already seeing good results working out muscle tension in trigger points and stretching afterwards.
[/quote]

I will definitely look into that. I fell into the trap on only researching on the net and asking doctors in the field - and have missed the goldmine of info in printed form. Will look into that book and see if I can get it locally, otherwise will try arrange it from overseas.

[quote]Hope I’m not overwhelming you or anything, the post is really long because I feel for you, I’ve got the exact same problems and wanted to share what’s worked for me.
[/quote]

Not at all…it is only overwhelming in the amount of support I feel. I hope you too come right ASAP…will keep posting progress as things change and (hopefully) improve.

Cheers,
X

19

Sounds like you made the best first step, X: Learn more about it yourself.

To further understand your condition, check out Paul Chek’s “Scientific Core Conditioning” and “Scientific Back Training” DVDs. You’ll learn more about what is going on with you and it’s a great first step to doing something about it!

20

X, there is a very good article about correcting posture on here. Search for “Neanderthal No More”. I think it’s split into 5 parts and the whole process lasts 3 - 4 months.

Clearly I’m not a doctor/trainer so I can’t say whether this suits your case or not, but have a read and maybe post a message to Eric Cressey, I’m sure he’ll be glad to help.

A