Shoulder Pain With All Chest Exercises and DB Shrugs, but Not with OHP

Bigger Stronger Leaner Injuries and Rehab
42

@TrainForPain

The book is All Gain, No Pain by Bill Hartman. It is very likely a significant departure from what you’re imagining a “rehab” program looks like, as there are no band pull-aparts, face pulls, clamshells, etc. As such, I understand if it is difficult to “buy in” all the way.

That said, when I decided to go all-in on the recommendations, including the 2x per day breathing exercises, the 15-20 minute warmup routine, lifting only every third day with less volume than I’m used to, etc, I was able to go from “I’m about 95% sure I’ll need shoulder surgery this year” to productive and enjoyable lifting in less than 2 months.

In the 5 years since then, I’ve had periods of good training and periods of training defined by pain and frustration. Every time I come back to the principles in this program, I’m able to pull myself back from the brink and get back on track.

3 Likes
43

Sorry, I have been incommunicado for several weeks trying to get some writing done and end-of-year stuff. @TrainForPain Thanks for the tag!

Everyone here has made many significant contributions, and a reasonably comprehensive book could be written just from the materials everyone mentioned. The videos and recommendations, including the book are excellent (John Rusin-like approach).

The shoulder is the most complicated joint to treat in the whole human body. The fact that the joint is so mobile also means it is inherently the most unstable joint in the body. Thus it is most susceptible to various forces and potential injury. Even if you do not have overt pain, oftentimes, there are deficits in ROMs and weaknesses that are not discovered until an injury occurs.

Because the shoulder joint is so complex, neuromuscular control is very intricate. The shoulder has one joint attaching it to the main skeleton (the sternoclavicular joint), and each muscle crossing the “ball and socket” shoulder (glenohumeral joint) is associated with at least two other joints and some more than a dozen (i.e. the traps and lats). Most of the shoulder mass is soft tissue, delicately balanced to provide range of motion, stability, and strength.

I say all this because the shoulder relies on the rest of the body to have adequate mobility, stability, and strength to operate correctly and be healthy. More so than any other joint in the body, in my estimation.

Here is my point… DO NOT get caught up in looking only to the site of pain (ever) for a solution. In the time between the current pain and getting a diagnosis or working to fix it yourself, find and improve other areas of the body. Concerning the shoulder, concentrate on the pelvis, spine (whole spine), breathing, and elbow/hand. By fixing mobility issues, posture, and breathing, you often will find improvement in shoulder function without more focus on the shoulder.

I will post a series of evaluative motions and muscle tests here soon, so check back.

Continue to work towards solutions for the shoulder. Get a diagnosis with a good diagnostician. Here is a link to find one near you: Find a Provider - Active Release Techniques
Look for this certification:
|86.4x86.4 |86.4x86.4

2 Likes
44

@bert2145 How you feeling?

45

Thank you for checking in on me! I had it on my mind for a few days now to update.

One thing that stood out to me from the book was the breathing, and how my ribcage is sticking out to the left quite a bit, except when I fully exhale.

Otherwise, I have been trying to work on my ROM, plus the 2 minute ultimate warm-up with Y raises, scap retractions etc, I think I have seen it in another thread on AC joints before starting this one.

It’s been getting way better, the inflammation is down, the ROM has improved, but it’s still sensitive even when doing push-ups. I haven’t been in the gym in the past 2-3 weeks because I got sick as well, so I’m about to return and will try to work around it. I’ll try to floor press with different grips, and maybe Smith machine press, if it’s pain-free. Otherwise it’ll be more legs, back, arms, and will dabble with some deadlifts to see if that’s OK with my AC, since squats are out of question for now.

46

Be careful with those y raises, scap retractions, etc. as those can actually make matters worse depending on what is limiting your shoulder motion. Often, a limitation in passive shoulder ER is indicative of “compression”/ excessive tension in the muscles of the upper back. I understand that this is counterintuitive and contrary to typical gym wisdom.

If this is the case for you, the exercises you listed can be counter-productive. If you’re feeling better, then by all means keep doing what you’re doing. That said, if you find that your range of motion and ability to exercise comfortably are not improving as much as you’d like, I’d encourage you to reconsider your approach.

Regardless – I hope things keep trending in the right direction for you!

2 Likes
47

Both my ER and IR has improved somewhat in these past weeks, but I’m also going to start adding the same protraction-retraction pattern in a push-up position and see what that does.So my thinking is, maybe I need to train pro and retractions both with pushing and pulling, maybe it’ll help. But it’s more something I put together in my head than research or science, and I don’t know if it actually has sense behind it.

So far, i find that if I really focus and find my groove, I can do half to 2/3 push-ups, upper range. Although, on better days, I can go all the way down, and as long as I keep my scaps in that retracted position and only do the bottom half range, it feels OK.

Also, I usually feel pain on the bad side when I’m trying to stretch in an IR angle, lose focus and let my shoulder rotate forward. I’m not sure if that makes sense but I can’t explain any better.

In any case, I’ll pay, attention to whether the Y raises and the likes are really helping or just temporarly making me feel better because the mild pump provides some stability.

48

If that scap protraction/retraction move is a problem you could try your external rotation moves lying on your side. This really helped me get the tension off my traps and onto the muscles that hold the shoulder blade tight to the ribs. Be sure to really try to inflate and expand your ribs on the right side, under your shoulder. `
image

The serratus wall slide is another move to build up that scap protraction, shoulder blade wrapping around the ribs, movement pattern. Again, big air into the ribs, especially on that right side, under your shoulder blade.

image
image1280×720 50.7 KB

2 Likes
49

While getting ready for a fight in September I already had some issues, and I used banded external rotations, hold, eccentrics, and it kept it under control. Given the volume of bag and pad work it could only do so much, but at least it kept it usable.

Then on the fight I popped my knee and completely forgot about the shoulder, and when I was back at the gym it was still giving me grief, but didn’t remember the externals.

I’ll try the DB version too, thank you for the reminder. I’ll try the wall slide as well.

1 Like
50

Bamboo bar several times a week and, as a last resort, Ibuprofen.

51

Update:

So I started a DC-esque program, obviously changing many exercises out for shoulder friendly options.

Even still, whether I press to a board, on the floor, whether I press in the Smith machine, chest press machine, it bothers my AC. I obviously don’t continue with painful movements. Incline is just about as bad. Close grip, mid grip, comp grip, doesn’t matter, it all sucks. The only thing that doesn’t hurt is overhead.

I’m also planning to give a good go to flat DB press with miniband around the wrist, that was fairly pain-free the last time I tried.

Most of my rehab is slow, controlled, full range shoulder circles, twisting the arm along with the circle, holding certain positions, with the elbow locked out. It’s definitely helpful in improving ROM, and it even seems to slightly improve the pain.

I will add the exercises I referred to in my previous post and go from there.

52

I don’t have a bamboo bar, but I’ll try and attach weight hanging on bands to a normal bar, although even holding a loaded bar after lifting it off hurts a lot of times.

Edit: ibuprofen doesn’t really do much, and I don’t really take it. If I truly needed it, it means I’m also too sure to train at all.

53

Here’s coach Phil Daru working with a boxer to redevelop that protraction/reaching movement. There might be something useful in there.

2 Likes
54

Quick Update:

I’ve paused training for most of this last month. Shoulder got a bit worse, got sick, just all falling apart so I decided to take a break.

Not even so much from training but the mind numbing hassle of packing for and commuting to and from the gym, all for a subpar, limited workout.

I’ve continued to do light band pumps, occasional vest walks, and almost daily shoulder rehab movements, focused on protraction, retraction, and stability, plus controlled arm circles for improving ROM.

It has gotten noticeably better, and I’ve recently started a home workout, mostly bodyweight stuff, and it didn’t hurt me yet. I need to train, but I have too many limitations to make it worth my while going to the gym, I can get plenty stimulus at home.

I’ve also invested in a pair of push-up handles, to eliminate imbalances and compensation patterns that come from uneven wrist mobility.

So far so good. I still feel that side a little, maybe in part because I know it’s there, but I had absolutely minimal bad feeling in my injured side while doing the likes of slow eccentric push-ups, or push-up loaded stretches.

Hope it continues on like this