Possible Knee Injury

[trivium]

I want to preface this by saying that I do have a medical background. I am just looking for guidance from professionals and guys who have had this happen to them.

So early in December 2013 I was doing stiff leg deadlifts. Due to my great ideas, I was doing them with hyperextended knees. The next day I had bad pain in my right knee. It should be noted that I played football with no problems after the lift and never had any pops or pain during the actual lifts. I did take a big hit to my knee during the game, but I was not injured at the time.

The next day I was able to do leg curls with minimal discomfort after a warm up.

I have had minor pain with some portions of my set up for various lifts and moving about the house, but never doing any of the lifts themselves after that.

I have since deadlifted 395x6, and squatted 365x4 in the last week with no pain during any of the lifts.

Today after sitting in the car for a while, that pain was present in my knee again. It is definitely present with hyperextension in some situations, but It is not present with any tests that I can do on myself (posterior drawer, anterior drawer, varus/valgus stress). This has been the case since that day when I did stiff legs and played football. Same exact pain.

I have dropped stiff legs altogether from my routine. I still do Squats, leg presses, deadlifts, and leg curls. I do not use any wraps on my knees for these lifts. I am pretty sure I have a hyperextension injury.

There is no pain with knee flexion while standing. There is some pain in my knee with knee flexion while sitting at the extreme of my ROM. Upon straightening in the seated position after the pain, there is an audible/palpable pop. This is not a bilateral phenomenon.

Any suggestions? It isn’t normal. Should I see ortho/PT or try to rehab it on my own. Is there any way of telling exactly what it is or the grade of the sprain without imaging?

I do not want to have to halt my training. Is it possible this is just some tendonitis?

Please ask questions! I want to answer them and try to do this the best I can!

Thank you in advance. Any help is appreciated.

[56x11]

[quote]trivium wrote:
I want to preface this by saying that I do have a medical background. I am just looking for guidance from professionals and guys who have had this happen to them.

So early in December 2013 I was doing stiff leg deadlifts. Due to my great ideas, I was doing them with hyperextended knees. The next day I had bad pain in my right knee. It should be noted that I played football with no problems after the lift and never had any pops or pain during the actual lifts. I did take a big hit to my knee during the game, but I was not injured at the time.

The next day I was able to do leg curls with minimal discomfort after a warm up.

I have had minor pain with some portions of my set up for various lifts and moving about the house, but never doing any of the lifts themselves after that.

I have since deadlifted 395x6, and squatted 365x4 in the last week with no pain during any of the lifts.

Today after sitting in the car for a while, that pain was present in my knee again. It is definitely present with hyperextension in some situations, but It is not present with any tests that I can do on myself (posterior drawer, anterior drawer, varus/valgus stress). This has been the case since that day when I did stiff legs and played football. Same exact pain.

I have dropped stiff legs altogether from my routine. I still do Squats, leg presses, deadlifts, and leg curls. I do not use any wraps on my knees for these lifts. I am pretty sure I have a hyperextension injury.

There is no pain with knee flexion while standing. There is some pain in my knee with knee flexion while sitting at the extreme of my ROM. Upon straightening in the seated position after the pain, there is an audible/palpable pop. This is not a bilateral phenomenon.

Any suggestions? It isn’t normal. Should I see ortho/PT or try to rehab it on my own. Is there any way of telling exactly what it is or the grade of the sprain without imaging?

I do not want to have to halt my training. Is it possible this is just some tendonitis?

Please ask questions! I want to answer them and try to do this the best I can!

Thank you in advance. Any help is appreciated.[/quote]

Here is the time line as you describe it:

1. performed stiff legged deads with hyperextended knees

2. felt pain the following day but ignored it and played football

3. during the game, you took a hit to the knee that was in pain

4. the pain, though noticeable, was not debilitating, so you resumed training

It reads like a classic case of not addressing a problem when it was a relatively small one. Now that problem has grown.

I’m rather curious why you chose to perform stiff leg deads on hyperextended knees. A bit of Monday-morning quarterbacking on my part; however, suffice it to say, I advise not taking the stiff-leg deads to its literal extreme from this point on. I’ve always cringed whenever I saw anyone doing these with locked knees you provide a real-world example as to why.

RDLs would be a good option when you’re healthy enough to resume training.

You did not mention the location of the hit you took on the knee when playing football.

The audible/palpable pop as well as other descriptions make me suspect damage to the acl, mcl, or both. This is just a theory and in no way shape or form should you infer this as a diagnosis.

The tests you perform on yourself has one significant flaw: it lacks objectivity. Despite your medical background, you’re also a lifter at heart and want to get back in the game asap. This desire will creep into and pollute any self-examination scenario. Therefore, I recommend an exam by an objective party who specializes in such cases. You can take advantage of the fact that you’re in the profession and discreetly ascertain which ones are good and which ones just treat the patient as their next house payment.

They’ll most likely run tests other than the ones you performed (the results of which I have reservations with) such as Lachmans or the pivot shift. Again, I strongly suspect there has been some damage to the connective tissue (such as the acl/mcl). For your sake, I hope I’m mistaken.

I do recommend imaging to confirm or disprove what the manual tests show.

And I give the strongest admonition against training with challenging load/movements until you know what you’re dealing with. If you ignore this, you may get away with it for a while as your body learns to move weight around the injury. However, sooner or later, these compensatory actions will create new problems for the inescapable fact that your kinetic chain is currently not working in ideal synchronicity.

[trivium]

[quote]56x11 wrote:

[quote]trivium wrote:
I want to preface this by saying that I do have a medical background. I am just looking for guidance from professionals and guys who have had this happen to them.

So early in December 2013 I was doing stiff leg deadlifts. Due to my great ideas, I was doing them with hyperextended knees. The next day I had bad pain in my right knee. It should be noted that I played football with no problems after the lift and never had any pops or pain during the actual lifts. I did take a big hit to my knee during the game, but I was not injured at the time.

The next day I was able to do leg curls with minimal discomfort after a warm up.

I have had minor pain with some portions of my set up for various lifts and moving about the house, but never doing any of the lifts themselves after that.

I have since deadlifted 395x6, and squatted 365x4 in the last week with no pain during any of the lifts.

Today after sitting in the car for a while, that pain was present in my knee again. It is definitely present with hyperextension in some situations, but It is not present with any tests that I can do on myself (posterior drawer, anterior drawer, varus/valgus stress). This has been the case since that day when I did stiff legs and played football. Same exact pain.

I have dropped stiff legs altogether from my routine. I still do Squats, leg presses, deadlifts, and leg curls. I do not use any wraps on my knees for these lifts. I am pretty sure I have a hyperextension injury.

There is no pain with knee flexion while standing. There is some pain in my knee with knee flexion while sitting at the extreme of my ROM. Upon straightening in the seated position after the pain, there is an audible/palpable pop. This is not a bilateral phenomenon.

Any suggestions? It isn’t normal. Should I see ortho/PT or try to rehab it on my own. Is there any way of telling exactly what it is or the grade of the sprain without imaging?

I do not want to have to halt my training. Is it possible this is just some tendonitis?

Please ask questions! I want to answer them and try to do this the best I can!

Thank you in advance. Any help is appreciated.[/quote]

Here is the time line as you describe it:

1. performed stiff legged deads with hyperextended knees

2. felt pain the following day but ignored it and played football

3. during the game, you took a hit to the knee that was in pain

4. the pain, though noticeable, was not debilitating, so you resumed training

It reads like a classic case of not addressing a problem when it was a relatively small one. Now that problem has grown.

I’m rather curious why you chose to perform stiff leg deads on hyperextended knees. A bit of Monday-morning quarterbacking on my part; however, suffice it to say, I advise not taking the stiff-leg deads to its literal extreme from this point on. I’ve always cringed whenever I saw anyone doing these with locked knees you provide a real-world example as to why.

RDLs would be a good option when you’re healthy enough to resume training.

You did not mention the location of the hit you took on the knee when playing football.

The audible/palpable pop as well as other descriptions make me suspect damage to the acl, mcl, or both. This is just a theory and in no way shape or form should you infer this as a diagnosis.

The tests you perform on yourself has one significant flaw: it lacks objectivity. Despite your medical background, you’re also a lifter at heart and want to get back in the game asap. This desire will creep into and pollute any self-examination scenario. Therefore, I recommend an exam by an objective party who specializes in such cases. You can take advantage of the fact that you’re in the profession and discreetly ascertain which ones are good and which ones just treat the patient as their next house payment.

They’ll most likely run tests other than the ones you performed (the results of which I have reservations with) such as Lachmans or the pivot shift. Again, I strongly suspect there has been some damage to the connective tissue (such as the acl/mcl). For your sake, I hope I’m mistaken.

I do recommend imaging to confirm or disprove what the manual tests show.

And I give the strongest admonition against training with challenging load/movements until you know what you’re dealing with. If you ignore this, you may get away with it for a while as your body learns to move weight around the injury. However, sooner or later, these compensatory actions will create new problems for the inescapable fact that your kinetic chain is currently not working in ideal synchronicity.

[/quote]

Thank you for the response!

The problem isn’t getting worse. It is just not going away. I have added 30 lbs to my 5 rep max squat since the injury without any discomfort.

Here is the timeline:

1. Stiff leg deadlifts with terrible form at 10 pm. (No pain.)
2. Football 2 hours later. (No pain or limitations.)
3. An hour into the game I took a hit to the lateral aspect of my right knee. (No pain. Immediately jumped up and got back into the game. I scored a touchdown on the next play running a fade route.)
4. An hour after the game I walked back to the dormitories. (No pain.)
5. Woke up the next day with a sore knee.
6. about 18 hours after my last lift, I went to do leg curls. (Was sore getting set up and going up and down stairs, but was able to lift without holding back. I felt like once I was warm, I was good to go with the small isolation lift.)
7. I have since been through almost 2 months of heavy leg days with no pain during any lifts, however I do notice that when I sit on the couch or am just moving about, every now and then I get a small stabbing pain in my knee 2-3/10 without radiations.

I cannot evoke any symptoms on my own unless I am sitting. I had almost completely forgotten about the injury until yesterday when it was sore from sitting still in the car for a long time.

I am going to make an appointment with an ortho guy for as soon as possible, but I am going to take my chances with training on it until then. Maybe it will not be a problem and it is a bit of tendonitis.

Any other recommendations would be welcomed.

[BHOLL]

[quote]trivium wrote:

[quote]56x11 wrote:

[quote]trivium wrote:
I want to preface this by saying that I do have a medical background. I am just looking for guidance from professionals and guys who have had this happen to them.

So early in December 2013 I was doing stiff leg deadlifts. Due to my great ideas, I was doing them with hyperextended knees. The next day I had bad pain in my right knee. It should be noted that I played football with no problems after the lift and never had any pops or pain during the actual lifts. I did take a big hit to my knee during the game, but I was not injured at the time.

The next day I was able to do leg curls with minimal discomfort after a warm up.

I have had minor pain with some portions of my set up for various lifts and moving about the house, but never doing any of the lifts themselves after that.

I have since deadlifted 395x6, and squatted 365x4 in the last week with no pain during any of the lifts.

Today after sitting in the car for a while, that pain was present in my knee again. It is definitely present with hyperextension in some situations, but It is not present with any tests that I can do on myself (posterior drawer, anterior drawer, varus/valgus stress). This has been the case since that day when I did stiff legs and played football. Same exact pain.

I have dropped stiff legs altogether from my routine. I still do Squats, leg presses, deadlifts, and leg curls. I do not use any wraps on my knees for these lifts. I am pretty sure I have a hyperextension injury.

There is no pain with knee flexion while standing. There is some pain in my knee with knee flexion while sitting at the extreme of my ROM. Upon straightening in the seated position after the pain, there is an audible/palpable pop. This is not a bilateral phenomenon.

Any suggestions? It isn’t normal. Should I see ortho/PT or try to rehab it on my own. Is there any way of telling exactly what it is or the grade of the sprain without imaging?

I do not want to have to halt my training. Is it possible this is just some tendonitis?

Please ask questions! I want to answer them and try to do this the best I can!

Thank you in advance. Any help is appreciated.[/quote]

Here is the time line as you describe it:

1. performed stiff legged deads with hyperextended knees

2. felt pain the following day but ignored it and played football

3. during the game, you took a hit to the knee that was in pain

4. the pain, though noticeable, was not debilitating, so you resumed training

It reads like a classic case of not addressing a problem when it was a relatively small one. Now that problem has grown.

I’m rather curious why you chose to perform stiff leg deads on hyperextended knees. A bit of Monday-morning quarterbacking on my part; however, suffice it to say, I advise not taking the stiff-leg deads to its literal extreme from this point on. I’ve always cringed whenever I saw anyone doing these with locked knees you provide a real-world example as to why.

RDLs would be a good option when you’re healthy enough to resume training.

You did not mention the location of the hit you took on the knee when playing football.

The audible/palpable pop as well as other descriptions make me suspect damage to the acl, mcl, or both. This is just a theory and in no way shape or form should you infer this as a diagnosis.

The tests you perform on yourself has one significant flaw: it lacks objectivity. Despite your medical background, you’re also a lifter at heart and want to get back in the game asap. This desire will creep into and pollute any self-examination scenario. Therefore, I recommend an exam by an objective party who specializes in such cases. You can take advantage of the fact that you’re in the profession and discreetly ascertain which ones are good and which ones just treat the patient as their next house payment.

They’ll most likely run tests other than the ones you performed (the results of which I have reservations with) such as Lachmans or the pivot shift. Again, I strongly suspect there has been some damage to the connective tissue (such as the acl/mcl). For your sake, I hope I’m mistaken.

I do recommend imaging to confirm or disprove what the manual tests show.

And I give the strongest admonition against training with challenging load/movements until you know what you’re dealing with. If you ignore this, you may get away with it for a while as your body learns to move weight around the injury. However, sooner or later, these compensatory actions will create new problems for the inescapable fact that your kinetic chain is currently not working in ideal synchronicity.

[/quote]

Thank you for the response!

The problem isn’t getting worse. It is just not going away. I have added 30 lbs to my 5 rep max squat since the injury without any discomfort.

Here is the timeline:

1. Stiff leg deadlifts with terrible form at 10 pm. (No pain.)
2. Football 2 hours later. (No pain or limitations.)
3. An hour into the game I took a hit to the lateral aspect of my right knee. (No pain. Immediately jumped up and got back into the game. I scored a touchdown on the next play running a fade route.)
4. An hour after the game I walked back to the dormitories. (No pain.)
5. Woke up the next day with a sore knee.
6. about 18 hours after my last lift, I went to do leg curls. (Was sore getting set up and going up and down stairs, but was able to lift without holding back. I felt like once I was warm, I was good to go with the small isolation lift.)
7. I have since been through almost 2 months of heavy leg days with no pain during any lifts, however I do notice that when I sit on the couch or am just moving about, every now and then I get a small stabbing pain in my knee 2-3/10 without radiations.

I cannot evoke any symptoms on my own unless I am sitting. I had almost completely forgotten about the injury until yesterday when it was sore from sitting still in the car for a long time.

I am going to make an appointment with an ortho guy for as soon as possible, but I am going to take my chances with training on it until then. Maybe it will not be a problem and it is a bit of tendonitis.

Any other recommendations would be welcomed.[/quote]

1. You probably don’t need imaging, a proper physical exam will suffice
2. Its not tendonitis, which is an overuse syndrome, you have one isolated event pointing towards your symptoms.
3. A hit coming from the lateral aspect could injure the MCL but your symptoms point more to either a.) a bone bruise or b.) a meniscal bruise

[56x11]

[quote]BHOLL wrote:

[quote]trivium wrote:

[quote]56x11 wrote:

[quote]trivium wrote:
I want to preface this by saying that I do have a medical background. I am just looking for guidance from professionals and guys who have had this happen to them.

So early in December 2013 I was doing stiff leg deadlifts. Due to my great ideas, I was doing them with hyperextended knees. The next day I had bad pain in my right knee. It should be noted that I played football with no problems after the lift and never had any pops or pain during the actual lifts. I did take a big hit to my knee during the game, but I was not injured at the time.

The next day I was able to do leg curls with minimal discomfort after a warm up.

I have had minor pain with some portions of my set up for various lifts and moving about the house, but never doing any of the lifts themselves after that.

I have since deadlifted 395x6, and squatted 365x4 in the last week with no pain during any of the lifts.

Today after sitting in the car for a while, that pain was present in my knee again. It is definitely present with hyperextension in some situations, but It is not present with any tests that I can do on myself (posterior drawer, anterior drawer, varus/valgus stress). This has been the case since that day when I did stiff legs and played football. Same exact pain.

I have dropped stiff legs altogether from my routine. I still do Squats, leg presses, deadlifts, and leg curls. I do not use any wraps on my knees for these lifts. I am pretty sure I have a hyperextension injury.

There is no pain with knee flexion while standing. There is some pain in my knee with knee flexion while sitting at the extreme of my ROM. Upon straightening in the seated position after the pain, there is an audible/palpable pop. This is not a bilateral phenomenon.

Any suggestions? It isn’t normal. Should I see ortho/PT or try to rehab it on my own. Is there any way of telling exactly what it is or the grade of the sprain without imaging?

I do not want to have to halt my training. Is it possible this is just some tendonitis?

Please ask questions! I want to answer them and try to do this the best I can!

Thank you in advance. Any help is appreciated.[/quote]

Here is the time line as you describe it:

1. performed stiff legged deads with hyperextended knees

2. felt pain the following day but ignored it and played football

3. during the game, you took a hit to the knee that was in pain

4. the pain, though noticeable, was not debilitating, so you resumed training

It reads like a classic case of not addressing a problem when it was a relatively small one. Now that problem has grown.

I’m rather curious why you chose to perform stiff leg deads on hyperextended knees. A bit of Monday-morning quarterbacking on my part; however, suffice it to say, I advise not taking the stiff-leg deads to its literal extreme from this point on. I’ve always cringed whenever I saw anyone doing these with locked knees you provide a real-world example as to why.

RDLs would be a good option when you’re healthy enough to resume training.

You did not mention the location of the hit you took on the knee when playing football.

The audible/palpable pop as well as other descriptions make me suspect damage to the acl, mcl, or both. This is just a theory and in no way shape or form should you infer this as a diagnosis.

The tests you perform on yourself has one significant flaw: it lacks objectivity. Despite your medical background, you’re also a lifter at heart and want to get back in the game asap. This desire will creep into and pollute any self-examination scenario. Therefore, I recommend an exam by an objective party who specializes in such cases. You can take advantage of the fact that you’re in the profession and discreetly ascertain which ones are good and which ones just treat the patient as their next house payment.

They’ll most likely run tests other than the ones you performed (the results of which I have reservations with) such as Lachmans or the pivot shift. Again, I strongly suspect there has been some damage to the connective tissue (such as the acl/mcl). For your sake, I hope I’m mistaken.

I do recommend imaging to confirm or disprove what the manual tests show.

And I give the strongest admonition against training with challenging load/movements until you know what you’re dealing with. If you ignore this, you may get away with it for a while as your body learns to move weight around the injury. However, sooner or later, these compensatory actions will create new problems for the inescapable fact that your kinetic chain is currently not working in ideal synchronicity.

[/quote]

Thank you for the response!

The problem isn’t getting worse. It is just not going away. I have added 30 lbs to my 5 rep max squat since the injury without any discomfort.

Here is the timeline:

1. Stiff leg deadlifts with terrible form at 10 pm. (No pain.)
2. Football 2 hours later. (No pain or limitations.)
3. An hour into the game I took a hit to the lateral aspect of my right knee. (No pain. Immediately jumped up and got back into the game. I scored a touchdown on the next play running a fade route.)
4. An hour after the game I walked back to the dormitories. (No pain.)
5. Woke up the next day with a sore knee.
6. about 18 hours after my last lift, I went to do leg curls. (Was sore getting set up and going up and down stairs, but was able to lift without holding back. I felt like once I was warm, I was good to go with the small isolation lift.)
7. I have since been through almost 2 months of heavy leg days with no pain during any lifts, however I do notice that when I sit on the couch or am just moving about, every now and then I get a small stabbing pain in my knee 2-3/10 without radiations.

I cannot evoke any symptoms on my own unless I am sitting. I had almost completely forgotten about the injury until yesterday when it was sore from sitting still in the car for a long time.

I am going to make an appointment with an ortho guy for as soon as possible, but I am going to take my chances with training on it until then. Maybe it will not be a problem and it is a bit of tendonitis.

Any other recommendations would be welcomed.[/quote]

1. You probably don’t need imaging, a proper physical exam will suffice
2. Its not tendonitis, which is an overuse syndrome, you have one isolated event pointing towards your symptoms.
3. A hit coming from the lateral aspect could injure the MCL but your symptoms point more to either a.) a bone bruise or b.) a meniscal bruise

[/quote]

trivium, do yourself a huge favor and get the imaging. This is YOUR body we’re talking about. Leave no stone unturned.

And why should you listen to me and not bholl…?

Here is a perfect example from another member on this subforum.

http://tnation.T-Nation.com/free_online_forum/sports_body_training_performance_bodybuilding_injuries/shoulder_injury_identification

The OP in this case suffered from shoulder issues. bholl gave the following advice:

[quote]BHOLL wrote:
Dont need ART, sounds like classic supraspinatus tendonitis, does not seem like a SLAP, REST, ice, NSAIDS, light rotator cuff work and rowing. [/quote]

And he followed up with:

[quote]BHOLL wrote:

[quote]irfhdah wrote:
Thanks for the great responses! I was starting to get really worked up after reading all those slap tear articles.

One last question: back squats are a little uncomfortable because they get my arm right in that angle/position that it doesnt like so I assume I should just lay off of them like everything else for the moment. Can I still deadlift though? I dont feel any pain when I do that. [/quote]

Front squat

Deadlift is ok[/quote]

Do you see what’s going on here…? In an effort to come off as the smartest kid in the room, bholl irresponsibly implies that an in person examination is unnecessary. In fact, NOT ONCE in the entire thread did he tell the OP to do what is basic common sense: find a doctor in the area who is relatively fluent in english and get your shoulder checked out thoroughly.

Well, guess what happened when the OP returned to the thread? Here is his most recent post:

[quote]irfhdah wrote:
My wife finally made me go get an MRI. The doctor said I have a less than 25% tear in my rotator cuff (it is right at the top of the subscapulus where it meets the superscapulus. He said just dont raise my arm laterally above my shoulder, avoid inward pressing movements and rest for 3 months. If it still hurts come back and see him.

So, what does that mean about exersizes I can perform? I did a pretty nasty deadlift session this morning with some light front squatting afterwards and my shoulder seemed ok. It is hard to tell though. When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again. Would deadlift, front squat, decline bench, seated rows, triceps pushdown, biceps curls all be ok? They avoid the motions the doc told me to stay away from. [/quote]

So let’s see here…Instead of a tendonitis as bholl surmised, it turns out to be a 25% tear.

Imagine if this OP had ignored his wife because some smart-sounding guy on the internet told him - and I quote - “…sounds like classic supraspinatus tendonitis.”

Now, trivium, if your imaging shows up negative, what have you lost really? If something does turn up, then it was definitely worth it.

And remember, I specifically stated the acl/mcl is just a theory and that further testing - including imaging - is what I recommend.

Take it from a guy who works with people when they’re done with the ortho, and done with the PT visits. I build that bridge to help them get back to where they want to be. Talk to most people who suffered serious injuries and, more often than not, they’ll tell you that once the PT visits stopped, they really didn’t progress. Often the pain actually returned. Until, of course, they learned to train in an intelligent manner.

I’m that guy who leads them to the promised land. And one of the fundamentally important things that I’ve learned is that, first and foremost, an injured person needs an in depth exam.

If we met for a lifting session, I can assure you that you will be impressed with not only my knowledge but the fact that I am genuinely strong and injury free.

So when you get an in person exam, leave no stone unturned. And, yes, this includes imaging to rule out any possible mistakes the ortho may make in his hands-on testing. Orthos are people, and people are fallible. Hedge the odds in your favor.

As for you, bholl, I don’t have the time nor the inclination to police this forum. However, be advised that if you challenge what I tell someone - especially regarding things such as imaging - I will gladly take you to task.

So unless you are willing to send trivium your PT license number/full name and let him officially know that you do not advise imaging, you’d be wise to tone it down.

[BHOLL]

YAYYYYY another peeing contest with 56X11:
So lets debunk these baseless claims why dont we:

a.) less than 25% tear of the subscap (if he even named this correctly considering he butchered the spelling) most likely he means the rotator cuff interval. LESS THAN 25% tear, jeezus crips, thats like a pimple on your shoulder its so mild. MRI’s on asymptomatic healthy individuals in the 40+ age range show this a great deal of the time, the cuff degenerates as we get older. The term itis and a small tear are not exclusive, in fact the small tear is most likely the cause of the itis, which would indeed indicate REST, NSAIDS, ICE, light exercise, nothing has changed, his treatment is still the same… … … duh

b.) If you get the imaging and nothing turns up what have you lost…hmmm… how about money and time. Depends on this guys insurance, deductible etc. And indirectly its people like you who cost us billions in health care dollars and raise our taxes. Do you really need an MRI for a 25% cuff tear, OP’s shoulder wasn’t bad enough to undergo surgical intervention, MRI’s are only necessary if the person is at the point of needing surgery.

C.) Lets look at the entirety of the advice.

Here was OP’s original question:
"Does this sound like something that rest will heal or is it something like the SLAP tear I saw in other posts that requires surgury? If it does sound like something that needs to be done surgically, is it urgent? I only usually get back to the US about once a year and I certainly would rather have it dont there than here. "

My response:
“Dont need ART, sounds like classic supraspinatus tendonitis, does not seem like a SLAP, REST, ice, NSAIDS, light rotator cuff work and rowing.”

Right (active release on the rotator cuff, zoinks), Right (it is an itis), Right (it is not a SLAP), Right- Advice: Rest, Ice NSAIDS cuff work and rowing are OP’s current plan of care.

That looks like 4/4 batting 1000%

This simply points out that despite OP receiving imaging, his situation was NOT URGENT as per his original question (he is in China), AND the advice provided IS the route OP should pursue.

Another couple grand in health care wasted due to unwarranted imaging, ZOINKS!!!

d.) Let’s take a look at this particular situation:
ACL/MCL imaging: the lachman’s test and pivot shift are just as or more sensitive and specific than an MRI, hence my suggestion of getting a proper physical exam, your lack of knowledge in this area is why you continue to offer poor advice. After proper physical examination if the examiner feels an MRI is warranted AND OP believes that his knee is bad enough to undergo surgery than proceed to imaging. MRI is never used to diagnose, they are used to confirm. MY ADVICE WAS HE PROBABLY DOES NOT NEED IMAGING WITH THE EMPHASIS ON PROBABLY, I stand by this statement PROBABLY, and a PHYSICAL EXAM WILL SUFFICE. Game, Set , Match

OP states he gets maybe 2/3 out of 10 pain with sitting and no instability, AND HAS FORGOT ABOUT THE INCIDENT UNTIL RECENTLY WITH SITTING because his symptoms are minute. OP do you feel your symptoms are bad enough to undergo surgery? To me that sounds like NO. THAT RULES OUT AN MRI ITSELF, YAY THOUSANDS MORE IN HEALTH CARE FOR USELESS IMAGING. MRI’s BTW are NOT 100%, more like in the 80’s and can be especially poor with small meniscus tears, funny how you think MRI’s are the end all be all.

e.) No one cares, at all actually, how many adrian peterson’s you’ve trained or how many people have signed pictures and given them to you.

f.) TRy not to take things so personal, MRI is not indicated until he undergoes proper physical examination, which is what I stated previously.

g.) PT naaaaa im not no personal trainer didnt even know they are licensed

h.) No thanks, im not a poofter, I don’t like meeting up with dudes, hopefully your training methodology is not as flawed as your injury advice.

I.) You don’t police, yet you continually try and create internet drama, this is not the first or the last time I’ve seen you do this.

J.) This forum is for advice, in the end the OP’s make the decisions themselves, no one is forcing them to proceed in any direction, they volunteer to post here and take the advice they are asking for any way they want.

[trivium]

Haha easy guys. I appreciate both people’s advice.

I have a long story to tell as I have been seen twice now for this since my last post, but I will have more time to elaborate later tonight.

Thanks for the responses! Try not to rip each other apart in the meantime haha.

[56x11]

bholl, the more you post, the more you lose credibility. If it was my knee or my shoulder. Or that of someone very close to me, I would leave no stone unturned. And that includes imaging.

And I specifically mentioned the Lachman’s or the pivot shift to the OP in my original response. However, I’ve seen too many fallible orthos as well as PTs and that’s why I advised him to confirm whatever the ortho finds out by getting imaging.

As for creating drama as you call it, I only raise my voice when I see hypocrisy and cowardice.

YOU give advice and strongly imply that your “opinion” is as good as a diagnosis. That is irresponsible.

YOU continually display this annoying tendency to come off as the smartest kid in the room yet when called out won’t back it up by sending your PT license number to those who you advise. If you don’t want to do this, tell them in the post that what you have to say is just an opinion. This is cowardice on your part.

[56x11]

And let’s get back to the topic of incompetence.

http://tnation.T-Nation.com/…_identification

You specifically advised that the following:

[quote]BHOLL wrote:

[quote]irfhdah wrote:
Thanks for the great responses! I was starting to get really worked up after reading all those slap tear articles.

One last question: back squats are a little uncomfortable because they get my arm right in that angle/position that it doesnt like so I assume I should just lay off of them like everything else for the moment. Can I still deadlift though? I dont feel any pain when I do that. [/quote]

Front squat

Deadlift is ok[/quote]

Not only did you lead this person to believe that an in person exam is unnecessary, you did NOT ask him HOW he performs these lifts.

And here again is his most recent post:

[quote]irfhdah wrote:
My wife finally made me go get an MRI. The doctor said I have a less than 25% tear in my rotator cuff (it is right at the top of the subscapulus where it meets the superscapulus. He said just dont raise my arm laterally above my shoulder, avoid inward pressing movements and rest for 3 months. If it still hurts come back and see him.

So, what does that mean about exersizes I can perform? I did a pretty nasty deadlift session this morning with some light front squatting afterwards and my shoulder seemed ok. It is hard to tell though. When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again. Would deadlift, front squat, decline bench, seated rows, triceps pushdown, biceps curls all be ok? They avoid the motions the doc told me to stay away from. [/quote]

And here is the most telling comment from him:

“When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again.”

NOT only did you fail to ascertain what style of deadlift or front squat the guy performs, you irresponsibly told him:

“Front squat Deadlift ok”

Well what if the guy performs front squat bb style with the arms crossed in front him in an X? This falls into the contraindicated motion as his doc advised.

And how close are his hands spaced when he deadlifts? Some people use a closer grip and this slight adduction can also potentially irritate his shoulder.

You FAILED to ascertain any of these subtle cues. And more importantly, you FAILED to tell this person to take it slow and easy for the time being and listen to his body.

By the way, it bears repeating that much of this could have been resolved HAD WE KNOWN WHAT THE EXACT ISSUE WITH HIS SHOULDER IS IN THE FIRST PLACE.

So thanks but no thanks. Little by little, post by post, you are exposing yourself as the incompetent who, for some reason, feels this insecure need to be the Alpha dog in this subforum. And should you troll me again, you’ve added punk to that list.

[CroatianRage]

I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated.

[56x11]

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

“prescription from an online persona who is completely unaccountable to the patient.”

And this is my point of contention with people who talk a good game and strongly imply that his opinion is just as good as an in person diagnosis.

And I disagree with your stance on imaging. If it was my knee or shoulder or that of someone I care about, I’ll do the imaging. It’s not as if I’m doing it on a daily or weekly basis.

I’ve seen first hand the ramifications of incorrect diagnosis. As stated before, orthos are people and people are fallible.

So after the manual testing, I for one would say to my ortho “with all due respect, I’d like a scan to confirm or disprove what we currently think the situation here is.”

Go to the shoulder injury thread in this subforum. The OP, because of his wife, got an MRI and found out that he had a 25% tear.

bholl and anyone else can justify that this isn’t much in the grand scheme of things. However, had the OP continued to train heavy and hard, more damage is guaranteed.

[CroatianRage]

[quote]56x11 wrote:

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

“prescription from an online persona who is completely unaccountable to the patient.”

And this is my point of contention with people who talk a good game and strongly imply that his opinion is just as good as an in person diagnosis.

And I disagree with your stance on imaging. If it was my knee or shoulder or that of someone I care about, I’ll do the imaging. It’s not as if I’m doing it on a daily or weekly basis.

I’ve seen first hand the ramifications of incorrect diagnosis. As stated before, orthos are people and people are fallible.

So after the manual testing, I for one would say to my ortho “with all due respect, I’d like a scan to confirm or disprove what we currently think the situation here is.”

Go to the shoulder injury thread in this subforum. The OP, because of his wife, got an MRI and found out that he had a 25% tear.

bholl and anyone else can justify that this isn’t much in the grand scheme of things. However, had the OP continued to train heavy and hard, more damage is guaranteed.
[/quote]

If you want imaging then that’s your prerogative, I’m coming from the perspective of clinical indications of obtaining imaging. A 25% or less tear in the rotator cuff would likely respond to halting activities and beginning rehab. If it didn’t, then imaging could be obtained after 4-6 weeks of no improvement or at any sign of the condition progressing. You and I obviously disagree on this point, but at the end of the day clinical intuition is going to give the best results for the patient.

I think we’re on the same page that this forum isn’t for brain flexing and posturing, but helping PEOPLE get to who or where they need to.

[56x11]

[quote]CroatianRage wrote:

[quote]56x11 wrote:

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

“prescription from an online persona who is completely unaccountable to the patient.”

And this is my point of contention with people who talk a good game and strongly imply that his opinion is just as good as an in person diagnosis.

And I disagree with your stance on imaging. If it was my knee or shoulder or that of someone I care about, I’ll do the imaging. It’s not as if I’m doing it on a daily or weekly basis.

I’ve seen first hand the ramifications of incorrect diagnosis. As stated before, orthos are people and people are fallible.

So after the manual testing, I for one would say to my ortho “with all due respect, I’d like a scan to confirm or disprove what we currently think the situation here is.”

Go to the shoulder injury thread in this subforum. The OP, because of his wife, got an MRI and found out that he had a 25% tear.

bholl and anyone else can justify that this isn’t much in the grand scheme of things. However, had the OP continued to train heavy and hard, more damage is guaranteed.
[/quote]

If you want imaging then that’s your prerogative, I’m coming from the perspective of clinical indications of obtaining imaging. A 25% or less tear in the rotator cuff would likely respond to halting activities and beginning rehab. If it didn’t, then imaging could be obtained after 4-6 weeks of no improvement or at any sign of the condition progressing. You and I obviously disagree on this point, but at the end of the day clinical intuition is going to give the best results for the patient.

I think we’re on the same page that this forum isn’t for brain flexing and posturing, but helping PEOPLE get to who or where they need to.[/quote]

I do agree with you regarding actually helping people as opposed to trying to show off how many text books and journals we’ve read.

And, yes, a 25% tear isn’t the end of the world for that fellow’s shoulder. And this tear would NOT have been discovered without the MRI. Furthermore, I contend that this is the EXACT type of fact (not opinion, not theory, but fact) that needs to be ascertained before we can safely and logically proceed to the next step. It’s the difference between having the exact gps coordinates and having a general idea of where the compass is pointing.

[BHOLL]

[quote]56x11 wrote:
And let’s get back to the topic of incompetence.

http://tnation.T-Nation.com/…_identification

You specifically advised that the following:

[quote]BHOLL wrote:

[quote]irfhdah wrote:
Thanks for the great responses! I was starting to get really worked up after reading all those slap tear articles.

One last question: back squats are a little uncomfortable because they get my arm right in that angle/position that it doesnt like so I assume I should just lay off of them like everything else for the moment. Can I still deadlift though? I dont feel any pain when I do that. [/quote]

Front squat

Deadlift is ok[/quote]

Not only did you lead this person to believe that an in person exam is unnecessary, you did NOT ask him HOW he performs these lifts.

And here again is his most recent post:

[quote]irfhdah wrote:
My wife finally made me go get an MRI. The doctor said I have a less than 25% tear in my rotator cuff (it is right at the top of the subscapulus where it meets the superscapulus. He said just dont raise my arm laterally above my shoulder, avoid inward pressing movements and rest for 3 months. If it still hurts come back and see him.

So, what does that mean about exersizes I can perform? I did a pretty nasty deadlift session this morning with some light front squatting afterwards and my shoulder seemed ok. It is hard to tell though. When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again. Would deadlift, front squat, decline bench, seated rows, triceps pushdown, biceps curls all be ok? They avoid the motions the doc told me to stay away from. [/quote]

And here is the most telling comment from him:

“When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again.”

NOT only did you fail to ascertain what style of deadlift or front squat the guy performs, you irresponsibly told him:

“Front squat Deadlift ok”

Well what if the guy performs front squat bb style with the arms crossed in front him in an X? This falls into the contraindicated motion as his doc advised.

And how close are his hands spaced when he deadlifts? Some people use a closer grip and this slight adduction can also potentially irritate his shoulder.

You FAILED to ascertain any of these subtle cues. And more importantly, you FAILED to tell this person to take it slow and easy for the time being and listen to his body.

By the way, it bears repeating that much of this could have been resolved HAD WE KNOWN WHAT THE EXACT ISSUE WITH HIS SHOULDER IS IN THE FIRST PLACE.

So thanks but no thanks. Little by little, post by post, you are exposing yourself as the incompetent who, for some reason, feels this insecure need to be the Alpha dog in this subforum. And should you troll me again, you’ve added punk to that list.
[/quote]

Now batting slaying no 3.

Exhibit A.) Arm uncomfortable during back squat, denotes taking a front squat position, pretty simple concept. Deadlift does not cause pain, sounds A OK to me.

Exhibit B.) OP is avoiding the positions the DOC told him to avoid, sounds AOK to me. I cautioned OP on decline bench, sounds AOK to me

Exhibit C.) OP reports front squatting and deadlifting and shoulder felt ok, sounds AOK to me.

Exhibit D.)Well what if the guys performs front squats blah blah blah, OP got advice from MD its his decision whether to abide by them, BTW your arms in front bodybuilding style is flexion, not abduction which is LATERAL movement, at this point your making yourself sound dumb, sounds AOK to me

Exhibit E.) I don’t care how he performs deadlifts, he reports NO PAIN. Game set match, sounds AOK to me

Exhibit F:) I guess REST, ICE, CUFF WORK, AND ROWS per my ORIGINAL ADVICE somehow isn’t taking it easy…Please son just go to bed, your making us all look bad

Exhibit G:) Refer to other thread, his Plan of care has not changed, it means nothing that he has a small cuff tear see EXHIBIT F:) for advice

Exhibit H:) Im a punk yayyyyy!!! 56 blumpkins to 11 dudes for the winnnn!

[BHOLL]

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

A.) What forum are you on? This isn’t Cosmopolitian no offense, we all train hard. Again You can refer to my original advice which I am not going to redundantly state again.

B.) lmao at ice, come on man

c.) No one has to consider advice given on forums, when you sign up for a website and ASK for it, then it is on YOU, no one else.

d.)Repeat to the original post, IS THIS URGENT was OP’s question, do you think a less than 25% cuff tear is something that is urgent or even a SLAP.

[BHOLL]

[quote]CroatianRage wrote:

[quote]56x11 wrote:

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

“prescription from an online persona who is completely unaccountable to the patient.”

And this is my point of contention with people who talk a good game and strongly imply that his opinion is just as good as an in person diagnosis.

And I disagree with your stance on imaging. If it was my knee or shoulder or that of someone I care about, I’ll do the imaging. It’s not as if I’m doing it on a daily or weekly basis.

I’ve seen first hand the ramifications of incorrect diagnosis. As stated before, orthos are people and people are fallible.

So after the manual testing, I for one would say to my ortho “with all due respect, I’d like a scan to confirm or disprove what we currently think the situation here is.”

Go to the shoulder injury thread in this subforum. The OP, because of his wife, got an MRI and found out that he had a 25% tear.

bholl and anyone else can justify that this isn’t much in the grand scheme of things. However, had the OP continued to train heavy and hard, more damage is guaranteed.
[/quote]

If you want imaging then that’s your prerogative, I’m coming from the perspective of clinical indications of obtaining imaging. A 25% or less tear in the rotator cuff would likely respond to halting activities and beginning rehab. If it didn’t, then imaging could be obtained after 4-6 weeks of no improvement or at any sign of the condition progressing. You and I obviously disagree on this point, but at the end of the day clinical intuition is going to give the best results for the patient.

I think we’re on the same page that this forum isn’t for brain flexing and posturing, but helping PEOPLE get to who or where they need to.[/quote]

LIKELY???

try 95+% of the time

Full thickness tears respond 75% of the time to conservative care, aside from MRI for partial thickness tears is spotty at best!

[56x11]

[quote]BHOLL wrote:

[quote]56x11 wrote:
And let’s get back to the topic of incompetence.

http://tnation.T-Nation.com/…_identification

You specifically advised that the following:

[quote]BHOLL wrote:

[quote]irfhdah wrote:
Thanks for the great responses! I was starting to get really worked up after reading all those slap tear articles.

One last question: back squats are a little uncomfortable because they get my arm right in that angle/position that it doesnt like so I assume I should just lay off of them like everything else for the moment. Can I still deadlift though? I dont feel any pain when I do that. [/quote]

Front squat

Deadlift is ok[/quote]

Not only did you lead this person to believe that an in person exam is unnecessary, you did NOT ask him HOW he performs these lifts.

And here again is his most recent post:

[quote]irfhdah wrote:
My wife finally made me go get an MRI. The doctor said I have a less than 25% tear in my rotator cuff (it is right at the top of the subscapulus where it meets the superscapulus. He said just dont raise my arm laterally above my shoulder, avoid inward pressing movements and rest for 3 months. If it still hurts come back and see him.

So, what does that mean about exersizes I can perform? I did a pretty nasty deadlift session this morning with some light front squatting afterwards and my shoulder seemed ok. It is hard to tell though. When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again. Would deadlift, front squat, decline bench, seated rows, triceps pushdown, biceps curls all be ok? They avoid the motions the doc told me to stay away from. [/quote]

And here is the most telling comment from him:

“When I work out I think my adrenaline takes over because my shoulder usually stops hurting at all. About an hour or two later it gets sore again.”

NOT only did you fail to ascertain what style of deadlift or front squat the guy performs, you irresponsibly told him:

“Front squat Deadlift ok”

Well what if the guy performs front squat bb style with the arms crossed in front him in an X? This falls into the contraindicated motion as his doc advised.

And how close are his hands spaced when he deadlifts? Some people use a closer grip and this slight adduction can also potentially irritate his shoulder.

You FAILED to ascertain any of these subtle cues. And more importantly, you FAILED to tell this person to take it slow and easy for the time being and listen to his body.

By the way, it bears repeating that much of this could have been resolved HAD WE KNOWN WHAT THE EXACT ISSUE WITH HIS SHOULDER IS IN THE FIRST PLACE.

So thanks but no thanks. Little by little, post by post, you are exposing yourself as the incompetent who, for some reason, feels this insecure need to be the Alpha dog in this subforum. And should you troll me again, you’ve added punk to that list.
[/quote]

Now batting slaying no 3.

Exhibit A.) Arm uncomfortable during back squat, denotes taking a front squat position, pretty simple concept. Deadlift does not cause pain, sounds A OK to me.

Exhibit B.) OP is avoiding the positions the DOC told him to avoid, sounds AOK to me. I cautioned OP on decline bench, sounds AOK to me

Exhibit C.) OP reports front squatting and deadlifting and shoulder felt ok, sounds AOK to me.

Exhibit D.)Well what if the guys performs front squats blah blah blah, OP got advice from MD its his decision whether to abide by them, BTW your arms in front bodybuilding style is flexion, not abduction which is LATERAL movement, at this point your making yourself sound dumb, sounds AOK to me

Exhibit E.) I don’t care how he performs deadlifts, he reports NO PAIN. Game set match, sounds AOK to me

Exhibit F:) I guess REST, ICE, CUFF WORK, AND ROWS per my ORIGINAL ADVICE somehow isn’t taking it easy…Please son just go to bed, your making us all look bad

Exhibit G:) Refer to other thread, his Plan of care has not changed, it means nothing that he has a small cuff tear see EXHIBIT F:) for advice

Exhibit H:) Im a punk yayyyyy!!! 56 blumpkins to 11 dudes for the winnnn![/quote]

You keep referring to this argument because it’s obvious you have no intelligent rebuttal concerning my comments about trivium’s case.

As for the other fellow with the shoulder issue, I specifically posted why your arguments there are just as impotent.

I will give the cliff’s notes version of what I said in that thread.

1. Having no pain doesn’t give you or anyone else to tell someone to just have at it

2. It absolutely DOES matter the exercise selection and how it’s performed. As I stated before, the manner in which he does his front squats (bb or Oly style) can absolutely effect his shoulder issue.

And by the way, tendonitis (which you surmised it to be) is different than a tear (the actual injury the OP ascertained by GETTING AN MRI). And don’t back pedal into this RICE argument just because both types of issues share that modality. Had the OP continued to listen you it’s obvious to any objective individual that he would not have take the best, most expeditious path to recovery.

3. You continue to show your insecurities with this behavior that you - above all else - has the right take on any given subject in this subforum. Your arrogance prevents you from prefacing your comments with statements such as ‘this is my theory’ or ‘this is my opinion’ and so on.

So if you claim that the information you’re vomiting here is so damn good, tell us your PT license number. I’m curious what the governing agency in your field would think about your actions.

[BHOLL]

[quote]BHOLL wrote:

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

A.) What forum are you on? This isn’t Cosmopolitian no offense, we all train hard. Again You can refer to my original advice which I am not going to redundantly state again.

B.) lmao at ice, come on man

c.) No one has to consider advice given on forums, when you sign up for a website and ASK for it, then it is on YOU, no one else.

d.)Repeat to the original post, IS THIS URGENT was OP’s question, do you think a less than 25% cuff tear is something that is urgent or even a SLAP.

e.) FACT??? Not once, a proper physical exam is more accurate than MRI, especially for partial thickness tears. However it seems as if your responding to more of the construed picture your boy 56 x 11 is painting. The orignial response to OP’s question, IS THIS URGENT? No in fact it is not and despite any shoulder pathology, REST, NSAIDS, CUFF WORK, AND ROWS can be performed safely irrelevant to differential diagnosis.
[/quote]

[BHOLL]

In response to the whole GPS analogy:
FACT? Not once, a proper physical exam is more accurate than MRI, especially for partial thickness tears. However it seems as if your responding to more of the construed picture your boy 56 x 11 is painting. The orignial response to OP’s question, >>>>IS THIS URGENT? No in fact it is not and despite any shoulder pathology, REST, NSAIDS, CUFF WORK, AND ROWS can be performed safely irrelevant to differential diagnosis.

[56x11]

[quote]BHOLL wrote:

[quote]CroatianRage wrote:
I don’t know about this argument.

First off, I don’t think anyone should give the ok for continuation of certain exercises based on the limited history received from this subforum. The most advice we should offer should be benign movements like rehabilitative exercise and pain free ROM and giving warnings when continuing movements could be potentially dangerous until they are examined. No one was ever hurt when they stopped deadlifting.

Even if someone here has a typical, hallmark, slam dunk history of X condition giving a diagnosis is irresponsible and unethical. Offering help on diagnosed conditions is acceptable, but should be limited to completely benign methods. What would happen if someone caused serious damage to themselves from improper NSAID or ice use because an online healthcare professional told them to use it? That is a prescription from an online persona who is completely unaccountable to the patient.

On the other hand, imaging is in fact over utilized. Sure you MAY find something, but that isn’t an indication to subject patients to the cost and often ionizing radiation of these tools. This specific situation would probably be better served getting an exam and lightly rehabbing the area for 4-6 weeks before any imaging is indicated. [/quote]

A.) What forum are you on? This isn’t Cosmopolitian no offense, we all train hard. Again You can refer to my original advice which I am not going to redundantly state again.

B.) lmao at ice, come on man

c.) No one has to consider advice given on forums, when you sign up for a website and ASK for it, then it is on YOU, no one else.

d.)Repeat to the original post, IS THIS URGENT was OP’s question, do you think a less than 25% cuff tear is something that is urgent or even a SLAP. [/quote]

Do YOU actually train hard? I don’t see any photos. And the only posts you vomit on specifically in this subforum. I don’t think you even know what hard training is.

As for laughing at CroatianRage’s ice advice, you’re dispensing similar advice on other threads.

And we all realize that advice given here should be viewed with perspective. Your fault lies in the fact that you talk a good-enough game that someone who is desperate for assistance merely takes what you say as fact. If you have an OUNCE of professional integrity, you’d stop implying that everything you say is all that needs to be said on the subject.

Whether or not the OP asked if it was urgent is not as relevant as you make it out to be. Any small problem can eventually become a large one if correct measures are not taken. And by NOT telling the OP to get an in-person exam (good thing he did too, because the issue turned out to be different than what you incorrectly thought) and just stamping your approval on certain lifts WITHOUT ASKING how the performs the movements (as well as what his current program looks like) just shows a deplorable level of irresponsibility on your part.