Shoulder Injured / In the middle of a cut- How to proceed?
- 07-03-2014, 10:08 PM
Look into Evan Osar. Chiro, author, masseur and personal trainer. I learned SO SO SO much from his book and his videos on YouTube and it has drastically changed my confidence while treating clients.
I recommend you do a manual muscle test on all your rotator cuff muscles to make sure they're strong enough and activates during movement. If they're not, compensations will occur and they can cause a myriad of troubles! Anterior glide and impingement are common symptoms of this muscular dysfunction.
Also make sure that your scapula is moving correctly to the pattern you're performing. I see dysfunction in scapular stabilization ALL the time.
If you have chronic tightness in your infra it's likely due to inhibited subscap. Giveaway will be plenty of available external rotation while the elbow is adducted.
Hope this helps your pains bro
- 07-03-2014, 10:09 PM
Ps these type of pains are usually a symptom of dysfunction and rarely heal up by themselves. That's why a patient will feel relatively fine for a short time after rest, and then the injury will return.
07-03-2014, 10:17 PM
07-03-2014, 10:27 PM
Also before school let out in may, all my classmates had to do a posture/gait analysis on one another. Looking back at that just know, i measured normal in external rotation in both arms, but internal rotation measured 55 degrees in right arm and 44 degrees in left arm! Left shoulder is the one in having problems with! What do you suggest about this?
07-03-2014, 10:34 PM
Can you lift your arms (both?) off your back when internally rotated? The higher dysfunction in a stabiliser the higher the up regulation on the other side to "create" stability. Definitely sounds like subscap inhibition to me mate.
Palpate your humerus and feel if more than 1/3 of it is anterior to the AC while extending the shoulder joint. That's a sign of anterior glide and definitely another sign of inhibitor of subscap. Bursitis and trouble with abduction may also be a problem because the subscap also keeps the humerus depressed in the glenoid fossa.
I'm writing on my phone, hope this wasn't too messy!
07-03-2014, 10:49 PM
And also note, my right serratus anterior is more developed than my left one. Im sure a tad of winging doesnt help this matter either!
07-03-2014, 10:51 PM
There you go buddy, clear sign if compensation. You got a lot of knowledge, so it will be no problem for you to follow up on this when you know about the cause of your symptoms
07-03-2014, 10:54 PM
07-04-2014, 08:48 AM
07-06-2014, 11:14 AM
07-06-2014, 11:25 AM
07-06-2014, 12:07 PM
seems like you have a reverse capsular pattern: loss of IR, then ab, and finally ER least restricted, very similar to an overhead athletes shoulder.
I agree with kjetil that you do not need to shy away from subscap strengthening, I think all RTC strengthening is warranted especially in dynamic movement patterns.
I would recommend re-evaluating all movements in the gym etc that elicit pain and figure out what biomechanically you can change. For example in many throwers whom present with impingement issues if you evaluate their mechanics you typically can find a mechanical issue which if fixed (usually too much horizontal abduction[hyperangulation], will reduce and eliminate the cause of symptoms. This is easily missed as on examine they most likely present with many of the above issues (weakness, scapular dyskinesis, instability) which you may feel are the cause, but in actuality are resulting from pain etc from poor movement pattern.
This approach is usually successful for many active lifters etc. Regardless of how strong you make the cuff etc it will never eliminate these issues until you find the source. The source can be an imbalanced cuff etc mentioned above, but in more cases then not the imbalance is resulting from injury, pain, inflammation, etc from a biomechanical issue.
Another tip is to not only perform standard RTC exercises for strength, but incorporate RTC exercises into similar movement patterns that you perform. For example in throwers you may toss a weighted ball over their shoulder as an eccentric movement pattern for the cuff. Remember specificity of training is very important once you come close to maxing out physiological gains such as hypertrophy and energy systems.
may be a good read for you (and free although im sure you have access to many database as a student)
07-06-2014, 12:35 PM
07-06-2014, 12:37 PM
07-06-2014, 01:15 PM
That's a typical report with impingement, strengthening the subscap will not result in loss of motion, its usually neglect of full AROM that results in motion loss. (Guy who squats/lifts a ton but never runs loses hip extension) as long as ur taking care of stretching and working thru full rom with prime movers u will be fine (pec, lat etc) the pec contributes little to IR strength above 90(minus some contribution from clavicular head)
07-06-2014, 01:19 PM
07-06-2014, 01:31 PM
No it could, ull be eliminating it by working at 90 degrees abduction, better isolating the subscap u just have to watch pinching in that position (hawkins kennedy etc all test at 90 degrees elevation)
07-06-2014, 01:45 PM
And by the way, if ur subscap was tight, you wouldn't lose internal rotation, you would lose external rotation ( your not going to lose the motion the muscle produces, tight quad does not result in loss of hip flexion, u lose hip ext) the loss in IR comes from posterior shoulder tightness
07-06-2014, 01:58 PM
Which comes from a misaligned resting scap postion (winged and abducted scap results in post shoulder tightness)
07-06-2014, 02:08 PM
07-06-2014, 02:09 PM
07-06-2014, 02:57 PM
Yes, id recommend following
Modified sleeper: 60,90,120 for posterior shoulder tightness (post shoulder tightness leads to post/supero humeral translation and resulting anterior laxity)
Pec minor stretch: 30. Degrees abduction
Long head of triceps stretch
Neuromuscular re ed of scap stabilization: this must take place before strengthening to ensure proper muscle firing sequence:
Pushups with plus, horizontal abduction,scap retraction, close grip rowing
Rtc strengthening: strengthening infra and supra and sub
Incorporation into movement patterns: work firing sequence into common patterns you perform
07-06-2014, 04:04 PM
07-06-2014, 06:30 PM
Shoulder Injured / In the middle of a cut- How to proceed?
The rotator cuff muscles are the only ones perfectly attached for pulling the humerus without potentially pulling it out of the GF, so when, for example, the lats, teres major and pecs are up regulated (especially the first two), (or there's serious restrictions in mobility) it may force the humeral head out of centration in the Glenoid fossa.
Poor scapular articulation may do the same. A common impingement problem is when the scapula is elevated during OHP, rather than bracing around the thorax.
Up regulation of the synergists and antagonists to create stability is usually the culprit of chronic tightness in the shoulder.
Last edited by kjetil1234; 07-07-2014 at 01:27 AM. Reason: typos
07-06-2014, 07:21 PM
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