Tight Trap, Shoulder Impingement

  1. Tight Trap, Shoulder Impingement


    I've posted in various threads now about my shoulder issue over the past year. 2 orthos and 3 PTs misdiagnosed my severe shoulder impingement. The chiropractor I'm seeing now realized part of the issue was an inactive serratus anterior which we're working on.

    But another issue is my upper trap will not calm down. I've tried foam rolling and lacrosse ball on it as well as stretching. What else can I do with it? I'm also dealing with some neck strain from a roller coaster while at Disney a month ago which I'm sure isn't helping my trap.

    There's also something going on with the subscapularis and pec minor and my humerus falls forward out of place and hits something not letting my arm go higher than 45 degrees. I haven't taken anatomy and physiology for a long time so I can't be that exact repeating everything he said, FWIW.

    Anyone else successfully treat shoulder impingement without surgery? I do not want surgery at all and I'm not getting an MRI with contrast. Any suggestions on any of this would be greatly appreciated.


  2. I was hoping for a little more feedback than this lol.
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  3. Dry Needling combined with Estim should help activate and reaffirm the correct motor pattern. Not an easy spot though. How’s your reach roll and lift from a seated upright position?
    Current Log: http://anabolicminds.com/forum/workout-logs/291581-officially-chasing-abs.html#post5714196

  4. Quote Originally Posted by TheMovement View Post
    Dry Needling combined with Estim should help activate and reaffirm the correct motor pattern. Not an easy spot though. How’s your reach roll and lift from a seated upright position?
    I've had dry needling which only helped with pain but only done on trap and Supra and infraspinatus. I've had estim done on serratus more recently.

    What is reach roll and lift?

    I've done some additional reading and am convinced my shoulder problem started with posterior internal impingement, as opposed to the more common external impingement. Pretty sure there's more to it now with the scapular winging and all, but that's where it started.

    For the record, my right trap is better now but still have the rest of the issues which I will detail out later.

  5. For the traps, trigger point therapy:



    -First find the exact spot, while your wife applies pressure.
    -tell her to keep the spoon firm pressed onto the muscle, once you found the spot, spoon (or any rounded object) has to be pressed hard
    -you now move slowly, she does not move.
    -perceived pain should be 8 out of 10
    -it hurts
    -10-20 min after the trigger-point technique you should feel better
    -repeat twice a day, normally, after 3 sessions and a night sleep its gone
    Life is fair it's your expectations that aren't.
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  6. A ton of this applies to my case:
    https://www.ncbi.nlm.nih.gov/pmc/art...8/#!po=21.0938
    It's weird though, as I'm not a pitcher. But I do work in a warehouse with a lot of work overhead and overhead pressing and pull-ups were my favorite lifts...

  7. You could try trigger point therapy on the impingement with a smaller object. By micro trauma, blood flow is increased to the tissue, very beneficial.
    Life is fair it's your expectations that aren't.

  8. Quote Originally Posted by hairygrandpa View Post
    You could try trigger point therapy on the impingement with a smaller object. By micro trauma, blood flow is increased to the tissue, very beneficial.
    Has Graston or another form of Soft tissue mobilization been used?
    Current Log: http://anabolicminds.com/forum/workout-logs/291581-officially-chasing-abs.html#post5714196

  9. Quote Originally Posted by TheMovement View Post
    Has Graston or another form of Soft tissue mobilization been used?
    It is a form of Graston technique -without graston tools...
    Believe it- or not, it works.
    Life is fair it's your expectations that aren't.

  10. What should be done for posterior internal impingement?

  11. Quote Originally Posted by GreenMachineX View Post
    What should be done for posterior internal impingement?
    Rehab exercises and infrared light, I guess.
    Life is fair it's your expectations that aren't.

  12. Quote Originally Posted by hairygrandpa View Post
    Rehab exercises and infrared light, I guess.
    I meant like anything specific...

  13. Quote Originally Posted by GreenMachineX View Post
    I meant like anything specific...
    What I've just started doing (correctly that is) are serratus wall slides, both banded and not, going for maximum upward rotation of scapula, and banded wall walks and just started Saturday internal rotations for the subscapularis. Last night introduced the sleeper stretch.

    Just in the past day or two, pain has significantly improved, but still can't lift arm to the side at a very specific angle. Directly to the side and behind I can lift my arm to 90 degrees, but then it gets stuck. It definitely feels stuck whenever it gets stuck at any of these position. When my chiropractor pushes on the numeral head back into place, my arm is freed up and lifts out no problem. All that is if thumb is pointing forward. If thumb is pointed up/out, no problem with any range of motion.

    This article lays out pretty well part of my issue and the treatment.
    https://b-reddy.org/2013/07/25/musin...onsiderations/

  14. I've had success with shoulder taping in the past. I had an athletic/massage therapist that applied the tape a few times a week. It was kept in place most of the time over a several week span. It helps to take the strain off the shoulder joint, and relax overactive muscles as well. Over time as symptoms improved I was able to stop utilizing the tape.

    https://www.physioadvisor.com.au/hea...body/shoulder/

  15. Graston our the trap, do some serrates exercises and also strengthen the middle trap. All are involved in scapular rotation and if one muscle doesn’t work, aka serratis, the others will over work and become hypertonic, aka trap. You need to do a big combo of serratus and trap exercises as well as lower trap. A lot of Docs forget about the importance of lower trap and scapular motion

  16. Well, my traps are finally calming down. But after more thorough research, I’m pretty sure I have some serious anterior humoral glide.

    I’m now doing wall slides for the serratus, low rows for the anterior glide, internal rotations for subscapularis for the scapular winging, scapular retractions and external rotations for everything that does.

  17. Hey mate, I am quite familiar with your issue having also suffered from trap tightness & inactive SA. Every morning I do shrugs with 45ib plates (They have holes in the at the edge for grip, otherwise use kettlebells) to release traps, focusing on holding full contraction and then slowly releasing to a full stretch, so that you are literally reaching for the floor while holding the plates. I usually do 5 sets of 20 or so reps like this but started at 3x10.

    To strengthen my SA i have used 2 mivements, one is lying flat on bench and doing pullovers with a very light bar (10Ib or less) and compmetely straight arms, limiting rom to last couple of inches at full extension. The key is to press back into bench, brace core with neutral spine and allow movement thru bottom ribs so that chest opens up and scaps fully retract. It was quite painfull in the beginning for me. You will have to focus on allowing shoulders to rotate with the movement so that scaps van squeeze in together.
    The othe movement is cable pullovers but with 2 cables connected to the end of 1 wide bar. This is way better than using 1 cable and you will notice straight away any imbalances. GL.

  18. Thanks. Regarding pullovers, I wonder if those could be done on a wall instead. But the issue with pullovers is it works the downward rotators, correct? From everything I’ve read, I need to strengthen the upward rotators.

    Also, I figured out I also have glenohumeral internal rotation deficit. Couple that with the scapular winging and anterior humeral glide, and this has been a fun ride. Haven’t made any progress recently.

  19. Yeah maybe the pullovers aren't a good idea if you have excessive posterior rotation. I'm the opposite, my right shoulder had limited ER due to a posterior labrum tear. I couldn't bench for ages while I rehabbed it, and basically I think I just ground the scar tissue away to get that movement back. Still get a lot of inflammation but nothing like I used to and getting pretty close to hitting lifetime PRs with benchpress, pressing twice a week.

    I should add I have also been doing a lot of external rotation stuff using bands and cable weights, but the key for me has been reactivating my SA and opening up my ribcage. Once I regained this stability and mobility I feel the external rotation work became more effective, and I began to really make gains with my pulling movements. Also, I feel it is important to start with the bench pulllover variation, as this is really an 'active release technique' rather than a contraction. The idea behind using a light weight and working in the last couple inches of ROM with straight arms and braced core is to stretch internal rotators while squeezing scaps to allow ribs to open up and shoulders to rotate back. Performing the contractions rather than just passively stretching allows you to go deeper and offers the opportunity to your brain for remapping tight muscles and inactive muscles for better stability in that state. If your shoulder is too banged up for the lightest bar in your gym, I have seen this performed with some PVC tube with a band or a light weight in the middle. If you do try this movement, the most effective cues are push back into bench, roll shoulders back and squeeze scaps so that your ribcage is pinned from below and splayed from above.

  20. Thanks for all the info.

    After more research, it’s beginning to look like I have all the following:
    Posterior Capsular Contracture
    Anterior Humeral Glide
    Glenohumeral Internal Rotation Deficit
    Posterior Internal Impingement

    My rehabilitation is as follows:

    Overhead Shrugs/Slides
    Serratus Wall Slides
    High Internal Rotations
    Sleeper Stretch
    Crossbody Shoulder Stretch
    Doorway Chest Stretch

    Been doing this setup for a few days and range of motion has improved just a little. My serratus seems to be working now. The end of external rotation and overhead stretching don’t hurt as much, or at least the pinch doesn’t feel as severe. With shoulder abduction to the side there’s still a Impingement that prevents full rom unless I do something to go around (can’t exactly tell what I’m doing, but maybe pulling my humerus back and tightening subscapularis).

    Any other suggestions?

  21. I started with a chiropractor that does this thing called “nerve flossing”over the summer because I had really bad neck, shoulder and back pains that came out of nowhere. She has been amazing and has gotten rid of almost all of it. Why I say almost is because she just had a baby and had to take a leave of absence. But I will continue to see her and watch my diet because inflammation is a mofo. I’m starting to eat more plant based foods again, I was vegan for 2 years and ironically when I switched back to meat based my ailments came. I can’t say definitively that’s the reason why but I do accept correlation as my own personal theory. But watch chronic inflammation, it’s not always obvious, it’s underlying and most of us adapt without giving it much thought. Go heavy on omega 3’s, ACV, and eat more plant based foods along with your regular meals. Dairy, gluten are huge offenders so cut out whey for a few weeks to see if that helps.

  22. Little update here:

    I can now do push-ups plus without shoulder pain! Well, mostly...as long as I really concentrate at activating my serratus and not letting my shoulders retract and bunch together on the eccentric motion, then I’m good. I’m just doing 3 sets of 10 for now with those.

    My rehab is now:
    Overhead Shrugs/Slides
    Serratus Wall Slides
    Push-up Plus
    High Internal Rotations
    Sleeper Stretch
    Crossbody Shoulder Stretch
    Doorway Chest Stretch
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