- 06-26-2010, 05:12 PM
The most common shoulder injury is the rotator cuff muscles. The two most common mechanisms of rotator cuff injuries for weight lifters are from behind the neck military presses, and from the bench press. Both of these exercises put strain on the rotator cuff muscles, especially if already weakened and/or performed improperly.
The rotator cuff has clinical importance because subsequent tearing of its tendons is a rather common pathology which results in restriction of the shoulder movement. The cuff is composted of four muscles, known as the SITS muscles: supraspinatus, infraspinatus, teres minor, and subscapularis.
VERY IMPORTANT - If a rupture of the rotator cuff muscle(s) is suspected, please see your primary health care provider or schedule and appointment with an orthopedist to have it properly examined.
If it is a sprain/strain injury, then the following are a few tips on rehabilitating the injured rotator cuff muscle(s). I recommend extremely light weights (surgical tubing/band work being my preference). This is a perfect example of less resistance and higher repetitionss being most beneficial, as these are very small, thin muscles that are not designed to be exercised for size and strength. They are quite vulnerable to injury, so treat them that way and by exercising them for endurance and stability, which is exactly what they are designed for. My recommendation is three sets, ranging between thirty and forty repetitions for the four rotator cuff exercises described below (no breaks or rest period required between sets or exercises). I typically instruct my patients to do one set of each exercise, then start over until three sets of each exercise has been achieved. These exercises should be performed at least every other day, three to four days a week for six weeks.
First, attach a band to fixed point at the approximate height between your waist and your shoulder. Next, stand at a point of tension facing away from the bandís attachment point, arm extended out from the shoulder and forearm flexed at the elbow (90 degree angle) so your fist is pointing straight up. Then internally rotate arm at the shoulder joint against band resistance. This motion should be similar to the forward motion of the arm when throwing a football. The second exercise is the exact opposite, with the arm in the exact same position, but now facing the point of band attachment, you are going to externally rotate the arm at the shoulder joint against band resistance. This motion should be similar to the backwards motion of ****ing back to throw a football. The next two exercises are opposites of each other as well, and can be used without changing the position of the band. With your arm down at your side and your forearm flexed at the elbow (90 degree angle) and facing away from the bandís point of attachment, internally rotate arm at the shoulder joint against band resistance (internal rotation is rotating inward towards the body). For the next exercise, while facing the bandís attachment point with arm in the exact same position, externally rotate arm at the shoulder joint against resistance (external rotation is rotating outward away from the body).
These above mentioned exercises are also very good warm-up exercises for the rotator cuff to prevent injury. If prone to these types of injuries, you should perform these exercises before every chest and shoulder workout. Also, it is quite common to have chronic rotator cuff injuries and pain due to incorrect posture; the most common is a slump or forward shoulder carriage. What makes this so common is the over-working of the chest muscles, without proper stretching, causing them to overpower their protagonist muscles (rear deltoids, rotator cuff, trapezius, rhomboids, & latissimus dorsi muscles). Therefore, proper stretching of the chest muscles, both before and after workouts, is quite important in preventing rotator cuff problems as well.
Sorry for no pictures, I will try to either find some online or scan them in on my computer and add them to later posts. If you have any questions or comments please feel free to share!
- 06-28-2010, 08:33 PM
Great post. I woke up one morning and thought i must of slept on it wrong. It was a bit stiff and sore and that afternoon tried to bench press and could not even lift my first light warm up set of the rack my shoulder hurt so much. I have been trying various rotater cuff exercises and exercises and it is getting slightly better.It now clicks and cracks when put in positions above shoulder height which i could no even do a first. I have not done bench press for 5 weeks and i am still unable to do chin ups either, which i think caused the shoulder problem as it was the last workout before i had any problems..... could chin ups(weighted) cause shoulder problems??? Thanks for any more info or comments on my situation.
- 06-28-2010, 10:29 PM
06-29-2010, 07:06 PM
Wood23 besides the exercises I listed in my thread, here are a few other things you can try that seem to work really well. If you have access to a pool, get in pool and with both arms extended straight out in front of the body do inward and outward circles with elbows locked out, therefore using shoulder joint. (Wax on... wax off young Daniel Son!) These exercises can also be done with arms straight out away from the body like in the gymnastic iron cross position, exact same inward and outward circles with elbows locked. If there is no access to a pool, these exercises can be performed using bands, attach band to a fixed location and facing the fixed location with arm extended outward in front of body perform inward and outward rotations, then same thing with right and left sides facing the fixed location perform inward and outward circles. The bands provide similar resistance as experienced in the pool, pool is the best, it is more natural. Hope these additional exercises help... "Keep on keeping on!"
06-30-2010, 01:47 AM
idk how much this will contribute to the thread but i realized some days that im scheduled to bench or do upper body assistance work etc.. And i feel anything in my shoulders even if i just slepped on em wrong i push training back a day. Its helped alot my shoulders havent been this good since i started lifting. Pushing threw and ignoring times where you need extra rest will kill your shoulders
06-30-2010, 02:12 AM
I have been training upper lower split every day 2 sets per body part, and my shoulders give me a lot of trouble and have had to take breaks from training which are defeating the purpose of the high frequency which I believe in. So upping my rep range from 8-10 to 11-14 keeping the same amount of sets, and gonna see how this goes.
I do DB bench with elbows flared out about 85degrees and have a spotter support a bit towards the bottom or dont bring them down too low.
I have also stopped all exercises which have the elbows above shoulder height apart from lat work, this includes:
Incline DB press
Skull Crushers and its variations(french press).
Face pulls with a high pulley, lowering the pulley puts strain off the rotator cuff.
I also make sure when lying in bed or sitting down I dont rest in a position where my elbows are above my shoulders.
I dont believe rotator cuff muscle strength should be neglected though, my physio has me on a 10 rep per set routine for them.
Another shoulder exercise which is a great compound for Teres Major(mostly), tricep long head and brachialis is an Iron Cross variation(shoulder adduction), standing in between 2 high pulleys hold them with your arms out directly to your side 90degrees to the ground and bring your arms down towards you, its like a side delt raise in reverse. This gives you nice width in between your lats and delts and improves shoulder health.
06-30-2010, 07:22 PM
IsHectic... that is a great exercise for the shoulders, I believe from the way you described it to be very similar to one of the exercises I gave with the bands originally, just you are using cables and doing them both at the same time instead of one at a time, great exercise though, finding a variety of ways to accomplish the same goal is great, not everyone has access to bands or cables or a pool, so it is good to be able to find something that works with what you have in order to accomplish your goals. Thanks for the add!!!
06-30-2010, 07:26 PM
brownstown, that is an excellent point as well. It is always better to take the day off, not be lazy, but not fight through pain which in the case of shoulders which never helps. I agree with you completely, if this happens to me, I either hit legs, or if I have already hit legs to recently, then I either do some bicep/tricep exercises putting little to no emphasis on the shoulder girdle or if that is already done for the week, I'll just do a calf, Ab, cardio blitz. So not being lazy, still doing something beneficial to my body, but not risking injury either! Excellent point!
07-04-2010, 12:14 AM
07-06-2010, 10:07 AM
Pretty sure I screwed up my left rotator cuff by raising my arms when on a roller coaster a few weeks ago. Hasn't been the same since and I've been stubborn about continuing to go to the gym after not taking enough time off. Haven't done any bench press or overhead lifts, but I think doing standing curls and tricep exercises was a dumb idea on my part. I'm going to continue to hit the gym and do abs/legs/and the exercises mentioned in the first post of this thread. Hope I can get it back to 100%, feels lame not being able to go and work my upper body like I have been for the past few years!
I was just going to take 2 weeks full off from doing any upper body, but I think I'm gonna use the suggestions here.
Should I be icing my shoulder down at night?
07-06-2010, 12:32 PM
Will rotator cuff injury cause shooting pains down the back of your arm? I have not been able to do a pressing movement in months. It hurts when I lay on it and when i raise my arms over my head.
A few months ago it hurt in my shoulder and the ortho said it was microfractures in one the bones in my should. Now it feels totally different. I think the fractures have healed but I may have injured my rotator cuff doing other shoulder exercises.
07-06-2010, 05:10 PM
07-06-2010, 05:15 PM
Anything is possible, but that is not the norm. or typical of rotator cuff pains. Now the pain can be very hard to pinpoint at times and be generalized to the entire shoulder girdle, but actually send shooting pain down the back of your arm, have not heard that complaint yet. But as I said before, anything is possible, if somehow an injured rotator cuff is inflamed and that inflammation is putting pressure on a nerve, specifically the nerve that runs down the back of your arm, then yes it it can happen and is very possible, again, not the norm. Good luck, keep me posted. I'll look through some of my books to see if I can help you pin point your problem!
07-07-2010, 08:36 AM
07-07-2010, 09:19 AM
Thanks for the advice ScottyDoc. Definitely need to pick up a heating bag today and will be doing hot/cold intervals every day after work now.
07-07-2010, 01:04 PM
So, I was talking a look at this page http://www.sportsinjuryclinic.net/cy...otatorcuff.htm
and it feels to me like the main muscle that is sore is the supraspinatus... the one that runs closest to my neck and to my shoulder, and runs down behind my left shoulder blade. Haven't lost any mobility, there's just sorness and it hurts to make certain movements. Trying to avoid lifting that arm over my head, as i think that's what injured it in the first place (stupid roller coaster). I realize that I need to see a physician to really pinpoint the problem though.
My question is would it be beneficial to take some some over the counter anti-inflammatory medication to help with recovery? Something like excedrin (acetaminophen, asprin) or ibuprofrin (as directed of course)? Definitely doing the hot/cold thing, but just curious if this would also help, not just with the pain but with healing faster by reducing inflammation.
07-07-2010, 08:44 PM
I just checked out the site you posted and it is a very good site, excellent pictures and descriptions, thank you for adding that!
OK, now to your question... I really don't think the products you mentioned will do anything to heal/speed up your recovery time, they will help with the pain, not to be confused with.. "if it doesn't hurt right now, I can lift" just because the pain can be blocked, does not mean the problem is not there, just don't want you to fall into that trap and further your injury. Now, my true suggestion is to try and find a reasonable clinic, one in which you can explain your financial situation and see if they can help you out with some real anti-inflammatory medication, with the trust that you are going to take x-amount of time off of certain exercises (I am sure they will tell you, if not you are not in the right clinic) and only do as instructed rehabilitation exercises, now that will help!
07-07-2010, 08:45 PM
IMPORTANT FYI FOR ALL: Most clinics are privately owned, therefore there prices can be negotiated (within reason) and payment plans, discounts, hardships, etc. can and should always be sought after when not using standard insurance (ie. paying out of pocket).
Also, let it be known, I am a Chiropractor, but I am not against pain medication when used properly! I will further explain by saying: they are designed to help get through pain, to sleep, necessary daily tasks of living. They are not designed to help get through a workout, because if pain medication is needed through to get through a workout, then you should not be working out! I know this may seem like a no brainer when I put it this way, but I also understand the mind set of a workout junky, I am one, and sometimes the desire to perform a workout is so great, it is hard to decipher between a smart and dumb decision. Just always remember, sometimes "The Juice is not worth the Squeeze!" (Working out while injured)!!!
07-07-2010, 08:54 PM
One more thing, it is impossible to determine which of the 4 rotator cuff muscles is actually injured by location of the pain. It can only truly be differentiated by performing orthopedic muscle testing, and even then it can be hard. The supraspinatus muscle is the most commonly injured of the 4 rotator cuff muscles, so I will agree with you from that stand point, that it is probably the supraspinatus! Good luck bro, one more avenue you might want to look into, even though I was taught in school that they do not penetrate deep enough to have an effect, is a TENS unit (EMS = electrical muscle stimulation). I used one during my recovery and I don't care if it is not supposed to go that deep enough or not, I felt a difference in my recovery/pain! Just don't get suckered into paying a high dollar amount, you should be able to find one under $50, if not contact me and I'll see if I can help you out!
07-08-2010, 08:54 AM
Once again, thanks for all the advice ScottyDoc. Definitely not going to use any meds to lessen pain so I can work out, I don't want to do anything that would further the injuries. Bought a heating pad and an ice bag last night and did the hot-cold rotation a few times, going to try that for the next week and hope that the soreness goes away. I have insurance through my job, just probably won't get a chance to go to the clinic to see a physician till next week. May try to get in there tomorrow after work if I come in early though.
I work a desk job, so I brought the ice bag with me today, gonna ice the shoulder and that muscle down throughout the day.
Yeah, I'm glad I found that website, so many others I was running acrsoss had absolutely no illustrations of what they were talking about!
07-08-2010, 09:09 PM
07-08-2010, 10:27 PM
another trick to penetrate to and expose the supraspinatus is to flex your elbow to 90 degrees and internally rotate your shoulder (put your arm behind your back)... modalities such as e-stim and ultrasound should then be applied to the anterior (front) portion of your shoulder
Suffer now.. and live like a champion later.
07-09-2010, 05:57 PM
Is scapular retraction a good idea for DB bench? I am somehow starting to suspect it is actually causing more strain on my delts during DB bench by deactivating my pecs.
07-09-2010, 06:07 PM
You always want to pinch your scalp's together when benching. You just gotta find the sweet spots. Let the peck contraction force that weight up.
07-09-2010, 06:44 PM
07-09-2010, 06:45 PM
I am gonna quit benching until I get my shoulders sorted, I dont wanna do DB bench PL style cause I wanna hit my pecs, as much as I have tried in the past weeks to help my shoulders they just get worse and its DB bench that really flares them up it seems, particurly the supraspinatus, I am certain if I continue its just gonna tear if it hasnt already.
07-09-2010, 06:48 PM
07-09-2010, 07:05 PM
i feel that with incline and decline presses (and flys), i am able to tear down all the muscle fibers of the pecs sufficiently
as for the eccentric (negative) movement during presses, it varies amongst individuals.. when i first started lifting, i could bring the bar down and touch my chest.. now, (even tho i dont flat bench) i wouldnt have as much ROM due to shortening of muscles and soft tissue bulk and would risk rupture or strain with such motion
Suffer now.. and live like a champion later.
07-09-2010, 08:03 PM
07-10-2010, 03:34 PM
Thanks, the help and advice in this thread is much appreciated.
I just filmed myself doing DB bench and it seems my arm is travelling at 90 degrees to my torso and with scapular retracted I am suspecting this is impinging the shoulder. Would I be right in assuming it has been and if so would it be worth getting imaging to check for a partial tear, because from what I have gathered, chronic impingement = scar tissue.
I never thought to compensate the angle of the arm when retracting the scapular because DB bench is suppose to be done around 85-90 degrees but its never shown with the scapular being retracted and it has never been mentioned.
07-10-2010, 06:25 PM
07-11-2010, 08:27 AM
Ok, so went to the doc and I'm scheduled for an x-ray and MRI on Monday.
I actually don't think the pain is really in my shoulder. I have full range of motion with my arms, there's just dull pain in certain parts of my upper back while moving. While at the doc I was able to pinpoint 2 sore points. Check out this back muscle diagram:
On the left side where it points to the two spots for "Trapezius Muscle" are pretty much EXACTLY where I'm having pain/soreness. When I take my right hand and press those points with my fingers, there is soreness, and it hurts when I stretch my neck by looking down and to the right. Other motions with my left arm/shoulder also cause me to feel the dull pain/soreness.
The doctor gave me a cortizone shot in the upper of the two points on Friday, but it's still sore today. I'm still heating/icing down those spots whenever I have the chance and taking time off from working upper body at the gym, which is extreeemely annoying. Can't wait to figure out how to get this healed up and so I can get back to the free weights.
Personal, nonprofessional theory: I got whiplash from riding the damn roller coasters at Islands of Adventure!
07-11-2010, 12:03 PM
What your describing does kinda seem like deep tension knots and inflammation in the muscle. I get them in similar areas. They're very aggravating, and annoying. Sometimes painful. I feel like I want a steamroller on my back, to flatten out the area.
I'm glad your getting it checked out Monday.
07-11-2010, 12:11 PM
(Damnit, I need 5 more posts before I can put a web link in a post, I'll PM it to you.)
Good Luck and listen to the doctor, he has more insight than I do, he is the one actually examining you, I am just doing my best with what I am being told to help you figure out what.. where.. & why.. and then the best course of action to take from there.
07-11-2010, 12:13 PM
07-12-2010, 04:53 AM
I saw my physio today, he didnt seem to be too worried that I have been impinging my shoulder and didnt run any diagnostics, he just said to lay off bench for a while and that there is no need to retract the scapular and its just not a good idea. I told him I think I have torn my rotator cuff, again no bells ringing until I mentioned loss of strength. I guess he may be more focused on the issue when he follows me up next week. He didnt really tell me to stop training or anything, but I think I will this week, and I have been icing it every day, the weird thing is I dont get any pain at all while benching or doing lateral raises or even training my supraspinatus directly, but then the next day the pain becomes worse.
I really regret retracting my scapular, I notice when I retract it I cant abduct my arm above 60 degrees, yet I am benching at 90 degrees by having my scapular forced to elevate.
07-12-2010, 07:53 AM
Yeah, it's definitely feeling like one of the sore points is the left trapezius, and the other, while looking at the "Shoulder Muscles" diagram on the first page, is either where the diagram labels "Rhomb. Maj." (rhomboids major?) or "Infraspinatus". I'm leaning toward "Rhomb. Maj." because it's in the muscel area between my spine and my left shoulder blade.
Anyway, i'm getting the MRI done today, so I'll provide what info I get from that here.
07-12-2010, 08:32 PM
Yes, Rhomboid Major, MRI should tell you everything you need to know, it will rule out any possible tears or ruptures, whether minor or major, doubt it is major by your description though! Hoping for you it is just a sprain/strain and the MRI comes out completely neg.
07-12-2010, 08:36 PM
07-13-2010, 07:15 PM
He already has me on a rehab program and is fixing my shoulder posture and shoulder balance.
I could describe some symptoms like sharp pain on overhead motion and a catching sensation on eccentric abduction but its not consistent at all, the biggest symptom is a feeling of discomfort thats always constant, it feels like I constantly have something stuck in my shoulder.
It definitely does not hurt while using it, but I have very bad feeling with my rotator cuff muscles, I cant tell if they are overtrained and inflamed unless I press on them and they are really sore.
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