Chiropractic / Musculoskeletal / Joint pain Q & A...

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  1. Never enough
    EasyEJL's Avatar

    Quote Originally Posted by bezoe View Post
    Well.. the chiro is accurate in his suggestion to avoid shoulder abduction past 90 degrees. Because of the "impingement" findings via MRI, this precaution will help protect against reaggravating symptoms. So.. any movements that involve abduction past parallel with the ground should be avoided. If you want to perform an abduction movement like a shoulder lateral raise, do it with your thumb up towards the ceiling.

    As far as the SLAP lesion goes.. theres really nothing that will eliminate symptoms. Avoid shoulder internal and external rotation to end range. If you wanna hit chest thoroughly without exaccerbating the shoulder pain.. perhaps try some partial range movements like DB presses to only 6-8 inches off chest for a few sets then 6-8 inches from completely locking out. So ultimately, you arent completeing a full blown range of motion each rep.

    Give me some feedback on what you think of this
    Thats an interesting strategy, i'll give it a whirl. I had been trying some other ideas, using reverse grip (to end up with lower working weight but same stimulation) and more reliance on the smith machine so I can more easily play with working out which angle of upper arm and what grip position works best.
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  2. Sorry it took so long. I had to consult the literature on this one.

    Here are reasons why I dont like either of these exercises: Reverse grip presses put your shoulder in an inefficient vulnerable externally rotated position. With a reverse grip press, the biceps brachii vigorously contracts to pull the humerus into flexion. The BB originates on an area of the scapula (superior glenoid fossa) that also connects to the glenoid labrum (which you have ruptured):
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    Therefore I suggest conventional grip over reverse. HOWEVER, I dont like smith machine as a primary exercise because of its lack of planes of movement. It only allows one plane out of 3 dimentionally possible planes. So no matter how you position your body and arms etc. you are still limited to a single, vetical plane of movement. This, over time, creates faulty proprioceptive feedback which will result in faulty joint movement and undesired joint stress. Its called "pattern overload". So contrary to what people think- smith and other machines are good for rehab, they are not optimal for anyone.

    But, like I always say, listen to your body. If dumbbells irritate the shoulder dont do them. Im gonna try and compile a list of doable exercises for you.
    Suffer now.. and live like a champion later.
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  3. Never enough
    EasyEJL's Avatar

    The dumbbells usually aren't too bad, but when I go heavy I sometimes end up in a situation where a slight bit of upper arm angle off causes enough momentary pain that I end up dropping the dbs rather than completing. Its not super frequent, and more when i'm doing 90+ lb dbs. This week I had tried doing one arm db presses, and that was a total bitch even with 70s but not painful in the shoulder.
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  4. Yea im sure its a real bitch lol. That labral cartilage surrounds the humeral head so with any glenohumeral movement you risk aggravating that area. Unfortunately it may continue to bother you without surgery. That cartilage isnt real viable tissue so primary healing isnt likely. Good news is the MRI conclusions make it look pretty managable with surgery at this point.
    Suffer now.. and live like a champion later.
  5. Never enough
    EasyEJL's Avatar

    yea, i'm just still on the fence as to whether to go that route. I should do it this year, as i've already paid my deductible for the year on insurance.
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  6. Well if funds are the only thing holding you back.. I would say save money and go for it. Ive never heard of an alternative resolution to surgery for this injury.. especially if youre gonna keep lifting. If your insurance is good and pays a large percentage of the cost, I'd do it.
    Suffer now.. and live like a champion later.

  7. Quote Originally Posted by bezoe View Post
    Well if funds are the only thing holding you back.. I would say save money and go for it. Ive never heard of an alternative resolution to surgery for this injury.. especially if youre gonna keep lifting. If your insurance is good and pays a large percentage of the cost, I'd do it.
    EasyEJL... As much as I hate to ever recommend surgery to anyone, I will recommend it as a last resort and from what I have seen and read from what you are saying and how you feel etc. I have to agree with Bezoe, I mean if insurance is going to cover it or even a large percentage, it really sounds like the route to go as far as being able to continue lifting and solving the problem once and for all, I mean it will always be an area of predisposed weakness and you will always have to warm it up correctly and take care of it, but at least then if you do so, you will be lifting better and stronger and most importantly, with no PAIN!!!
    Dr. Albert Scott Representative for FINAFLEX
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    Redefine Yourself..... REDEFINE EVERYTHING!
  8. Never enough
    EasyEJL's Avatar

    How long is recovery on that likely to be? Not "ready for lifting" but recovery to where you don't have to do day to day tasks with adaptations?
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  9. Quote Originally Posted by EasyEJL View Post
    How long is recovery on that likely to be? Not "ready for lifting" but recovery to where you don't have to do day to day tasks with adaptations?
    That all depends on the technique they use when going in, the best I can give you is my own personal experience with having my chest ripped off the bone, which I would imagine is a longer healing process, but I could be wrong, Bezoe would be the best at answering this because he helps rehab people with these types of injury on a daily basis! Anyway, I would say the 1st week, I took off of work and was really babying the hell out of it, the 2nd week, I was functional, but as you said had to figure out ways to do things without really using my left arm, by the 3rd week, I was out of the sling and using it, but very little and very lightly, I still would not open doors with my left arm or try to lift anything heavier than like 3Lbs, by the 4th week, I was really starting to use it and only noticed things here and there, by the end of the 6th week, I would say I was pretty much back to normal as far as day to day use, minus lifting or pulling anything over 15Lbs, I was back in the gym by the end of my 8th week and spent 2 weeks only doing legs, core, & cardio, by the end of my 10th week, I was starting to do biceps & triceps real carefully, by the end of the 12th week I started doing shoulder presses, lat pulls and extremely light chest (more of just repetitive motion vs. weight). I would say by 18-20wks I was lifting everything the same except for chest, which I babied my chest for an additional 4 months at which time I contacted my doctor because I was 8mos post surgery and he said as long as I start increasing the weight very slowly and always keep my rep range around 15reps/set I should be fine and he was right, other than a left shoulder problem now, (which I believe is from compensation) I have no problems with my chest what-so-ever. Anyway, in a weird sort of way it was a good thing that happened to me, in the sense that it made me start lifting everything much lighter and I've made the best mass gains and fat-loss of my life since I made that switch in my workout style! Hope this helps Easy, no one person or one injury is ever going to be the exact same, but I hope this gives you an idea of what to expect!
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  10. Never enough
    EasyEJL's Avatar

    Thanks, i'm mostly thinking about when to try and schedule it, based on work and home plans over the next 6 months.
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  11. Hi i dont know if i can describe this very well, but will have a go

    I currently have a hip issue (on the left side).
    Feel pain when my left leg is raised upwards fast, meaning no jumping or sprinting. Squatting and deadlifting heavyish causes pain.
    Also feel pain when i turn my foot up towards my body (knee facing outwards).

    I regularly do kickboxing, jujitsu and mma so hip mobility is kinda useful to me lol

    I am not exactly sure how i injured myself was either sprinting or kickboxing (probably a combination)

    Any advice you can offer would be greatly appreciated,
    Thanks

  12. Quote Originally Posted by EasyEJL View Post
    Thanks, i'm mostly thinking about when to try and schedule it, based on work and home plans over the next 6 months.
    Sorry it took so long Easy. Recovery will depend on many factors (as you probably guessed). These are:

    1. Onset of instability- If the capsule/joint has been instable for much time and is atraumatic (this is your case, I believe) then more conservative postoperative managment is required.

    2. Severity of associated lesions- Whatever the underlying pathology is (rotator cuff muscle weakness, neuropathy, etc.) the rehab time will depend upon this.

    3. Previous failure of surgery- this doesnt apply to you

    4. Direction of instability- Im not sure how "unstable" your GH joint is. Unless you have had subluxations and dislocations this wont exactly apply to you.

    5. Type of surgical approach- all approaches yield quite similar healing times. Only difference is that arthroscopic is less painful

    6. If electrothermally assisted capsularrhaphy is used, progression will be slower. If bony reconstruction is implemented, recovery will obviously be prolonged.

    7. Patient variables- because you lift, your dynamic stabalizers (the muscles that surround the joint) will be stronger which will be a HUGE contributor to recover and rehab time.

    First 2 Weeks
    Initially you will be "immobilized" with a sling. This will stay on without ANY movement for 1-3 days. After that you will be allowed to temporarily remove the arm from the sling to perform Passive Range of Motion exercises (done by someone else of course) and "Pendulum" exercises. Because you will most likely undergo rotator cuff repair also, rehab interventions will be dictated by your surgeon (such as how much range you can move and how often you can remove the sling). You should recieve a "report" with these directions on it. You may even start exercises as soon as the day after surgery depending on whether the biceps tendon has to be repaired. During the first phase of rehab you will control inflammation (with ice and antiinflammatories), maintain correct posture (with trunk/spine extensions and scaplular retractions), and maintain mobility of structures proximal and distal to the shoulder (wrist/forearm and elbow ROM and scapular ROM). You may progress to self assisted ROM using "wand exercises" at the end of 2 weeks.

    Weeks 3-6
    "Muscle Setting" exercises can be initiated. (These are just isometric contractions of muscles around the shoulder). VERY LIGHT grade band exercises may be initiated for muscles below shoulder level. All band exercises should be open chain to prevent weight bearing on operated structures.

    Weeks 6-12
    Full active Range Of Motion exercises will be performed. Stabalization of the GH joint will be emphasized. Light stretching and grade III joint mobilizations (that do not sacrifice stability) will be performed. "Alternating isometrics" and dynamic resistance exercises with bands and weights for GH stabalizer muscles (rotator cuff and scapular stabalizers) will be started next. Your surgeon should provide info on "anteior" or "posterior" stabalization and what specific movements to avoid- it gets pretty in depth so I'd have to know what the procedure was.

    Weeks 12-16

    You should be "returning to function" at this point. Stretching needs to continue to attain preoperative ROM. (collagen synthesis will continue for 12 months so ROM can be achieved within this time range). Plyometric exercises and actual exercises you do at the gym can be started. 6 months is usually required to regain COMPLETE function.

    So, not a simple endeavor here. But as Doc and I explained, the surgery is the only option that we have available to regain function and eliminate pain. These surgeries, IME, have been overall successful and if you get a good orthopedic surgeon who does these every day you should be in good shape my man. If you have any questions about anything i put in this post, including exercises and terminology, I will be glad to elaborate.
    Suffer now.. and live like a champion later.

  13. Quote Originally Posted by EarthWormGym View Post
    Hi i dont know if i can describe this very well, but will have a go

    I currently have a hip issue (on the left side).
    Feel pain when my left leg is raised upwards fast, meaning no jumping or sprinting. Squatting and deadlifting heavyish causes pain.
    Also feel pain when i turn my foot up towards my body (knee facing outwards).

    I regularly do kickboxing, jujitsu and mma so hip mobility is kinda useful to me lol

    I am not exactly sure how i injured myself was either sprinting or kickboxing (probably a combination)

    Any advice you can offer would be greatly appreciated,
    Thanks
    How old are you bro? How long has this been going on? Where exactly is the pain? Tell me where on the illustration
    Name:  musc_cannulated-hip.jpg
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    Suffer now.. and live like a champion later.

  14. How old are you bro? How long has this been going on? Where exactly is the pain? Tell me where on the illustration
    Im 20, its only been going on for a little over a week. I feel pain in the very top of my leg, seems to be around the socket.

    thanks for your time man

  15. Quote Originally Posted by EarthWormGym View Post
    Hi i dont know if i can describe this very well, but will have a go

    I currently have a hip issue (on the left side).
    Feel pain when my left leg is raised upwards fast, meaning no jumping or sprinting. Squatting and deadlifting heavyish causes pain.
    Also feel pain when i turn my foot up towards my body (knee facing outwards).

    I regularly do kickboxing, jujitsu and mma so hip mobility is kinda useful to me lol

    I am not exactly sure how i injured myself was either sprinting or kickboxing (probably a combination)

    Any advice you can offer would be greatly appreciated,
    Thanks
    For ease of this, can you find a skeleton, or some kind of anatomical picture and put and X marks the spot where it hurts? Different people consider many different areas their hip and the hip itself is large with an anterior, posterior and lateral aspect all changing which muscles &/or tendons are involved!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  16. Name:  pelvis.jpg
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    seems to be around the joint, on the leg side (if that makes sense).
    pain felt in both front and outside of very to of leg depending on which way i move my leg.

    thanks

  17. Name:  pelvis2.jpg
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    not sure if this image is more useful,

    cheers for your time

  18. Quote Originally Posted by EarthWormGym View Post
    Name:  pelvis2.jpg
Views: 147
Size:  20.0 KB
    not sure if this image is more useful,

    cheers for your time
    Nice, now we are cooking with Gas, as in now I know where you are talking about! Hmmm, so it just came on suddenly or slowly started to ache? On a scale of 1-10 (10 being the worse pain you have ever felt in your life) how would you rate the pain? Would you consider the pain sharp, electric like, burning, dull, achey, stiff, sore (you can use more than one adjective to describe your pain)? I've already got the time frame, approx. 1 week. OK, so far, unless you were doing something or experienced a trauma (car accident, fall, blow to the area), I would suspect it is just a sprain/strain of the area. Something like this can take as short as a week or two or as long as 3-6 mos. to heal and feel better, with your age I'm hoping in just a matter of a few weeks. First off, I would start doing contrast baths of heat and ice as often as you can during the day, always heat first and ice after heating, if given the choice, it is always better to just ice if you can't ice after heating. Next, unless it causes sharp or severe pain, it is a good idea to stretch the area as much as possible while heating the area and just let it relax when you are icing, another good thing is compress the ice down, use suran-wrap if necessary, and I would avoid your MMA training and or any lower body weight lifting for at least two weeks and see how you are feeling at that point before deciding to start back at that time. I'm sure my buddy Bezoe will chime in and give you some more helpful advice, tips, & hints, he's a very knowledgable PT, when he speaks, I listen!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  19. its not too painful, i would only rate it a 4-5. But it instantly removes all strength around the area.
    the pain is sharp, but goes soon afterwards (not as fast as it comes though)

    there was no major trauma/experience. I first noticed it when sprinting (haven't got a great technique) although there was no 'pain' as such, it just felt wrong/discomfort. a few days later after multiple sets of squats, deads and possibly sled work (i can't quite remember), i started to experience a little bit of pain in the same area (but this time the sharp pain i get now).

    i will start icing it, and performing some light stretching.

    Thanks for the advice

  20. Quote Originally Posted by EarthWormGym View Post
    I will start icing it, and performing some light stretching.

    Thanks for the advice
    No problem, anytime my friend, I would take a week or so off for sure, and while taking the time resting from the gym and MMA, etc. I would be stretching it while you heat it, then end with ice, you can even massage it while icing it (ice-massage) all these things help losen up and stretch out the tendons and ligaments, as well as pumping healing oxygenated blood to the area and then pumping out any edema and inflammation, so all very good, but please make sure you rest it, or you will just continue to irritate the area!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  21. Quote Originally Posted by ScottyDoc View Post
    I would suspect it is just a sprain/strain of the area.
    This exactly

    Follow all the recommendations Doc gave and you should be G2G in due time
    Suffer now.. and live like a champion later.

  22. Just wanted to add that I got these ALL THE TIME when I played baseball in highschool. And Im quite sure it was from sprinting. Pain in the ass. Hip flexor muscle.. the same one in the picture you posted: "illiopsoas"
    Suffer now.. and live like a champion later.

  23. LOL im in the zone> this "strain" happens in the propulsive phase of gait, that is, when your back (extended) leg that is off the ground begins to forcefully swing forward to complete the next stride. These stretched hip flexor muscles vigorously contract and create "macrotears" within the fibers, usually around the musculotendenous area.

    To help prevent these in the future just be sure to warm up properly and gradually work up to sprinting.
    Suffer now.. and live like a champion later.

  24. I hope someone may be able to help me with this:
    Quads get sore and tender after my running training and intervals etc
    My glutes get a tad tight but i can't feel my hamstring firing while running

    What could i possibly do to try and help increase the hamstring firing so i get a reduction of hammering to my quads.

    P.S I have sprinters looking quads but smaller hamstrings.
    Such a burden on long distance training

    Thanks

  25. Quote Originally Posted by runner_79 View Post
    I hope someone may be able to help me with this:
    Quads get sore and tender after my running training and intervals etc
    My glutes get a tad tight but i can't feel my hamstring firing while running

    What could i possibly do to try and help increase the hamstring firing so i get a reduction of hammering to my quads.

    P.S I have sprinters looking quads but smaller hamstrings.
    Such a burden on long distance training

    Thanks
    Minus personally/physically checking you out and ruling out a possible nerve impingement, I would just based on what you told me, suggest on non-running days to get into a gym and do leg curls for the hamstrings, don't do any extensions, just leg curls and try very hard to make that mind/body connection with your muscle and mentally focus on only using your hamstrings to curl the weight, this will build strength in your lacking hamstrings as well as help you make the mind/body connection so you can control them better and get those buggers firing, like I said, this is the way to do it if there is not a true physical problem causing this lack of firing, which I could only determine if I was able to examine you in person! So I hope this helps you, if you have any further questions or comments, please feel free to post them and I'll always do my best to answer as quickly and as accurately as possible!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  26. Quote Originally Posted by ScottyDoc

    Minus personally/physically checking you out and ruling out a possible nerve impingement, I would just based on what you told me, suggest on non-running days to get into a gym and do leg curls for the hamstrings, don't do any extensions, just leg curls and try very hard to make that mind/body connection with your muscle and mentally focus on only using your hamstrings to curl the weight, this will build strength in your lacking hamstrings as well as help you make the mind/body connection so you can control them better and get those buggers firing, like I said, this is the way to do it if there is not a true physical problem causing this lack of firing, which I could only determine if I was able to examine you in person! So I hope this helps you, if you have any further questions or comments, please feel free to post them and I'll always do my best to answer as quickly and as accurately as possible!
    What i shall do. Tightness in hip flexors too...yoga to help?
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  27. Quote Originally Posted by runner_79 View Post
    What i shall do. Tightness in hip flexors too...yoga to help?
    Good advice from Doc.

    Stretch the hip flexors, strengthen hip extensors (glutes and hamstrings). No need for any extravagant stuff. Perhaps have your gait analyzed during running.. incorrect mechanics can cause issues like you are describing. You mentioned tightness in your back in the other thread, i believe. Improper mechanics can radiate problems all the way up and down the body.

    How long have you been running?
    Suffer now.. and live like a champion later.

  28. 1 yr. My 1m time is 5:05
    Will look at doing more hamstring work...curls and deadlifts?inch worms?
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  29. Also, it's my thoracic spine that's the problem and makes my neck tight during my run and pulls my shoulders forward I am fit but tight. I work twice as hard to get same results due to tightness
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  30. Quote Originally Posted by runner_79 View Post
    Also, it's my thoracic spine that's the problem and makes my neck tight during my run and pulls my shoulders forward I am fit but tight. I work twice as hard to get same results due to tightness
    I wish I could say something that would help you more, but my honest opinion is, maybe try going and seeing a sports specific Chiropractor in your local area, can definitely help with gait and alignment issues you may be experiencing besides the exercises I suggested and the stretching that Bezoe suggested!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!
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