Can we fix this, AM? (shoulder impingement)

[Torobestia]

Hey all. Basically, the issue I have is that I have a shoulder impingement according to an osteopathic doctor. She did not confirm this with MRI, but based this diagnosis upon my description of my problem (pain, where it hurts, how it affects articulation of the shoulder) and X-rays (to exclude I guess fractures, other gross injuries, ?).

I don't know a lot about shoulder impingements. I first heard of this concept when I joined AM and read some stuff by Zir. Shoulder impingements are likely caused by a variety of factors, not just one event, but to cut to the chase I think for me what causes the most damage, what always brings it on, is squatting, especially squatting with a straight bar.

I squat low-bar. I've tried narrowing my grip, widening, and nothing works. Even if I prehab with lots of external rotations, it will still go on me when I squat. Once the pain begins, then throughout the week any sort of chest or overhead pressing aggravates it, as well as squatting. The most obvious pain is in 3 places - front delt, somewhere inside my shoulder joint close to my armpit, and then a little soreness both around my trap and moreso somewhere behind my shoulder (one of the muscles around the rear delt, probably a rotator cuff muscle). Further aggravation just causes the pain to spread down through my bicep, and eventually the pain just feels like it's spreading throughout my whole body (this has only happened once when I was stubborn and tried to max bench with this pain).

Do you guys have any suggestions on what I can do to address this so I can straight-bar squat without wanting to die?

 

[ZiR RED]

Beyond the usual suggestions: stretch pecs and internal rotators, strengthen scapula retractors and external rotators, you might have a tight posterior shoulder capsule and limited internal rotation ROM. Check out the sleeper stretch for posterior shoulder capsule and do some active internal ROM mobility exercises. Stand against a wall with your arms out to your sides. Flex your elbow to 90 degrees, then keeping your shoulders and elbows in contact with the wall (and upper arms parallel to the floor) rotate your forearms downward.

Br

 

[Rodja]

You can make a psuedo SSB with wrist straps to help alleviate the shoulder pain while attempting to work out the kinks that are likely present in the bicep tendon and, possible, the supraspinatus as well.

 

[Torobestia]

Thanks for the input, guys. I'll definitely check all that out, Zir.

Rodja, what do you recommend for the bicep tendon and perhaps supraspinatus?

 

[Rodja]

Thanks for the input, guys. I'll definitely check all that out, Zir.

Rodja, what do you recommend for the bicep tendon and perhaps supraspinatus?

As much as it sucks, you have to cut back on pressing volume substantially and fill it in with extra rotator cuff work and horizontal flexion for 3-6 weeks, but it can take months to repair. Not quite the same topic, but it is related:
http://www.mindandmuscle.net/articles/rrective-methods-for-common-postural-deviations-the-shoulder/

 

[Mafesto31]

I squat with the bar low and ran into some shoulder problems. I began using a thumbless grip and it seriously made a huge difference.

 

[Doss]

I squat with the bar low and ran into some shoulder problems. I began using a thumbless grip and it seriously made a huge difference.

I'd second squatting with a thumbless grip if it doesn't bother you. I notice some agitation if I don't do that.

Seated power cleans are one of my favorite movements for the external rotators, you might want to think about adding them into your program. Link below shows the movement if you're unfamiliar.

http://www.youtube.com/watch?v=kvVEz-tBgvg

 

[Torobestia]

Thanks, but I do all of that already.

 

[Torobestia]

As much as it sucks, you have to cut back on pressing volume substantially and fill it in with extra rotator cuff work and horizontal flexion for 3-6 weeks, but it can take months to repair. Not quite the same topic, but it is related:
Corrective Methods For Common Postural Deviations: The Shoulder | Mind and Muscle Articles

Three to six weeks,

It pisses me off because in my head I think pressing has nothing to do with it, but of course if those important muscles in pressing are hurting during squatting, pressing with them isn't going to do anything to accelerate healing my problem.

Onto the question of pressing - do tricep extensions count as pressing (it's technically not a press, but what do you think)?

@ Zir Red - First link on the sleeper stretch was this: 3 Reasons Why I Don't Use the Sleeper Stretch and Why You Shouldn't Either - Mike Reinold What are your thoughts? Also, I wouldn't think I need to do this stretch if for no other reason than that's how I actually sleep. It's ever so slightly uncomfortable, initially, but for some reason my body always gravitates to laying in this position. Thoughts?

 

[ZiR RED]

Three to six weeks,

It pisses me off because in my head I think pressing has nothing to do with it, but of course if those important muscles in pressing are hurting during squatting, pressing with them isn't going to do anything to accelerate healing my problem.

Onto the question of pressing - do tricep extensions count as pressing (it's technically not a press, but what do you think)?

@ Zir Red - First link on the sleeper stretch was this: 3 Reasons Why I Don't Use the Sleeper Stretch and Why You Shouldn't Either - Mike Reinold What are your thoughts? Also, I wouldn't think I need to do this stretch if for no other reason than that's how I actually sleep. It's ever so slightly uncomfortable, initially, but for some reason my body always gravitates to laying in this position. Thoughts?

I have seen that article. Most weight trainers, PLers, bodybuilders have tight posterior shoulder capsules and lax anterior capsules. The sleeper stretch is (IMO) a good way to loosen the posterior capsule.

 

[Torobestia]

I have seen that article. Most weight trainers, PLers, bodybuilders have tight posterior shoulder capsules and lax anterior capsules. The sleeper stretch is (IMO) a good way to loosen the posterior capsule.

Roger. Thanks again. I'll start incorporating these.

As for the active internal rotator stretch, I can go google some, but taking the one you described - when I am rotating my forearm down to the floor, am I doing so while also rotating my upper arm (keeping the angle in my elbow fixed, in other words), or am I just rotating that forearm?

 

[ZiR RED]

Yes, keep your elbow at 90 degrees. You are trying to rotate your humerus.