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Shoulder Injuries?

I agree with Bezoe... There is not much more I can say that he hasn't covered. I would just use it as a pain reliever if it helps you sleep more comfortably or to just relax.
 
I dont understand....my shoulder does not really hurt much anymore but I have pain that feels like its in the bone in back of upper arm and in my forearm. I don't get it....
 
triton185 said:
I dont understand....my shoulder does not really hurt much anymore but I have pain that feels like its in the bone in back of upper arm and in my forearm. I don't get it....
Click to expand...

I'm not going to pretend like I completely understand that one either, but I get similar pains in my acromion process (the bony prominence on the very top of your shoulder, seems to separate your upper trapezius muscle from lateral deltoid). I believe it is because I have a sprain/strain of the acromioclavicular ligament, that is its point of attachment, but it feels like bone pain, so I do understand what you are talking about. Here is a website that will help explain where my pain is: Invalid Link Removed So I believe you have a sprain/strain of a tendon (tendon attaches muscle to bone) if it is strained at the point of bone attachment it will simulate bone pain right at the point of attachment. Because I am not there to personally pinpoint where your pain is and determine which muscle/tendon attachments are hurting, you would probably do best Googling an anatomy chart of muscles and tendons in the area you are experiencing pain and do your best to figure it out that way, if you are trying to figure it out on your own. It also sounds like you have multiple stress points even though they are probably all inter-related/connected from one initial injury.
 
Since I have stopped benching my shoulder has been slowly improving.

If benching with shoulders out is impinging me does that mean rear delt raises would impinge aswell seeing as though it is the same movement but with the resistance in reverse.

Also for my RC exercises my Physio said to do them as a warm up before my workout but to me it makes sense to do them after my routine, what do you guys think?
 
Best way to prevent shoulder problems and treat shoulder pain based on research:

1. Strengthen your rotator cuff muscles, especially external rotators.
2. Strengthen your scapular muscles (specifically lower traps and serratus anterior)
3. Stretch your posterior capsule.
4. Avoid exercises which abducts and externally rotates your arm. For ex, behind the neck pulldown and press.
 
ItsHectic said:
Since I have stopped benching my shoulder has been slowly improving.

If benching with shoulders out is impinging me does that mean rear delt raises would impinge aswell seeing as though it is the same movement but with the resistance in reverse.

Also for my RC exercises my Physio said to do them as a warm up before my workout but to me it makes sense to do them after my routine, what do you guys think?
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yea leave flat bench alone lol

for rear delts, i suppose if you are warmed up properly they shouldnt be an issue. during the movement, i never go too far past the horizontal plane, ie, where my humerus is perpidicular to my thorax

thats good advice, IMO. if you are required to do the exercises, it might as well be before your routine to ensure those muscles are engorged with blood and the tissue is more extensible which will help prevent inury
 
ItsHectic said:
I have loss of ROM in transverse abduction and slightly in flexion. Is there a stretch for this?
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sure, you just stretch beyond your AROM in that motion/direction.

do whats called corner stretching for horizontal abduction- find a corner, place both hands on either wall and lean into the corner. This ultimately stretches the pectorals and of course the glenohumeral joint capsule. This will help you wipe your a** sufficiently lol

for GH flexion, get a towell and hold it with the arm you are going to stretch. Hold the towell over your head and reach behind your back with the other arm and grab the towell. Slowly pull down with that arm. This stretches the long head of triceps and the lat.
 
Thanks man, would rep you again if I could. Is it normal for an impingement to cause the pec on that side to tighten up?
 
ItsHectic said:
Thanks man, would rep you again if I could. Is it normal for an impingement to cause the pec on that side to tighten up?
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could be some "muscle guarding", the bodys way of protecting an injury. Not certain about that specifically though.
 
Well it doesnt really feel like muscle tightness it feels like what I imagine frozen shoulder would be like, I can force the ROM and then I feel a numb kinda feeling in my shoulder I have been trying to force it in the hopes to ward it off, it doesnt cause any pain at all, whenever I get spotted on bent over rear delt flyes I keep getting told "your not coming up as high enough on your right!" and my right rear delt doesnt get hit much because of that, instead I feel it more in my back.
 
Any "numb feeling" is definetely abnormal. Could be a indication of thoracic outlet syndrome- nerves and blood vessels impinged by the scalene muscles. Try some stretches of those muscles.

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hahaha im an idiot.. trying to figure out how to embed the video in the post lol

just click the link will work i guess... dammit lol

Anyway Im sure ScottyDoc has alot of input and is very cognizant of the issue as well and im not trying to jack his thread at all. Just throwing some unprofessional advice out there based on what youve told me.
 
I do that neck stretch already, its not a feeling of something actually going numb, its hard to explain, its just a feeling as though soft tissue with no sensory nerves are pressing against something when I force the ROM, again really cant explain it, the ROM loss is more noticeable when I have to lift against resistance but I have no loss of strength on any shoulder movement within usable ROM.
Next time I see my physio I'm not gonna leave without either a diagnosis or a referral for an u/s.
 
i think you need to do some exercises for scapular muscles. You are only working your rotator cuff muscles. More and more research is showing how scapular muscles are important in shoulder rehab.

If the scapular muscles are the underlying problem, even if you stretch and strengthen the cuff, you will hurt it again.

And do the sleeper stretch/cross body stretch for your posterior capsule too. Mind you, I am just going without a clear diagnosis here.
 
ItsHectic said:
I do that neck stretch already, its not a feeling of something actually going numb, its hard to explain, its just a feeling as though soft tissue with no sensory nerves are pressing against something when I force the ROM, again really cant explain it, the ROM loss is more noticeable when I have to lift against resistance but I have no loss of strength on any shoulder movement within usable ROM.
Next time I see my physio I'm not gonna leave without either a diagnosis or a referral for an u/s.
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Limitation during active movement but not passive is indicative of contractile tissue involvement, usually.

Capsular patterns typically manifest during passive movement. If your involved shoulder is more restricted than your uninvolved side during passive movements, then yes i say possibly adhesive capsulitis.

Sounds like a minor lesion of a rotator cuff muscle.

Be sure to post the diagnosis.. im interested to know
 
anoopbal said:
i think you need to do some exercises for scapular muscles. You are only working your rotator cuff muscles. More and more research is showing how scapular muscles are important in shoulder rehab.
If the scapular muscles are the underlying problem, even if you stretch and strengthen the cuff, you will hurt it again.

And do the sleeper stretch/cross body stretch for your posterior capsule too. Mind you, I am just going without a clear diagnosis here.
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true that scapular stabalizers such as serratus anterior can produce secondary symptoms, but im pretty sure itshectic works out regularly(?).. those muscles wouldnt be weak enough to cause shoulder problems in someone who trains with weights
 
I agree with Bezoe, using the same concept that someone who lifts weights on a regular basis is going to have stronger than usual abs whether they directly work them or not, they are core muscles that cannot help but be activated in most compound movements.
 
It has been shown in research that bodybuliders and weight lifters have weak lower trap muscles relative to upper traps. So it is more of a relative weakness of the muscle or muscle imbalances.

There is an increasing number of research showing people with shoulder pain have weak Lower trap muscle and serattus anterior relative to upper traps causing scapular, dysfunctions, especially seen in overhead athletes. They now call it as scapular dyskinesis.
 
anoopbal said:
It has been shown in research that bodybuliders and weight lifters have weak lower trap muscles relative to upper traps. So it is more of a relative weakness of the muscle or muscle imbalances.

There is an increasing number of research showing people with shoulder pain have weak Lower trap muscle and serattus anterior relative to upper traps causing scapular, dysfunctions, especially seen in overhead athletes. They now call it as scapular dyskinesis.
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come on man.. just like the thread on chest workouts lol. What "research"? And saying "bodybuilders and weightlifters" is ridiculously subjective and general.

I agree that muscle imbalances cause structural issues over time but to generalize bodybuilders as having weak lower traps as a population is absurd. The lower trap performs the actions of scapular depression; (dips, tricep pushdowns, decline bench) and i believe upward rotation; (lateral raises, military press, overhead press)

serratus is activated with any scapular movement.

Now if you just do shrugs all day then you might have a problem lol

With any routine you wanna balance out exercises, ie, work both agonist and antagonist muscle groups but to categorize bodybuilders as a whole of having muscle imbalances is asinine

please post the study and please let it be refereed and please let it involve a very large group of subjects
 
J Strength Cond Res. 2002 Aug;16(3):367-72.
Shoulder strength and range-of-motion characteristics in bodybuilders.

Barlow JC, Benjamin BW, Birt P, Hughes CJ.

Graduate School of Physical Therapy, Slippery Rock University, Pennsylvania 16057, USA.
Abstract

The purpose of this study was to compare shoulder range-of-motion (ROM) and strength values between bodybuilders and nonbodybuilders. Fifty-four men (29 bodybuilders and 25 nonbodybuilders) between the ages of 21 and 34 years participated in the study. Goniometric measurements were used to assess shoulder flexion and internal and external rotation ROM. Isometric manual muscle tests were performed using a handheld dynamometer. Shoulder flexion, internal and external rotation, abduction, and prone shoulder retraction and elevation strength were tested. Independent t-tests were used to determine levels of statistical significance between the groups. Bodybuilders showed an overall loss of shoulder rotation ROM (166 degrees vs. 180 degrees ) and a significantly decreased internal rotation ROM (-11 degrees ) compared with the control group. Bodybuilders were significantly stronger on all isometric shoulder-strength tests than nonbodybuilders, except for the assessment of lower trapezius strength when expressed as a percentage of body weight. The results of this study indicate that bodybuilders have imbalances regarding strength and ROM at the shoulder that may make them susceptible to shoulder pathology.

J Strength Cond Res. 2009 Jan;23(1):148-57.
Shoulder joint and muscle characteristics in the recreational weight training population.

Kolber MJ, Beekhuizen KS, Cheng MS, Hellman MA.

Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Abstract

Shoulder disorders attributed to weight training are well documented in the literature; however, a paucity of evidence-based research exists to describe risk factors inherent to participation. Shoulder joint and muscle characteristics in the recreational weight training (RWT) population were investigated to determine specific risk-related adaptations that may occur from participation. Ninety participants, men between the ages of 19 and 47 (mean age 28.9), including 60 individuals who participated in upper-extremity RWT and 30 controls with no record of RWT participation, were recruited. Active range of motion (AROM), posterior shoulder tightness (PST), body weight-adjusted strength values, and agonist/antagonist strength ratios were compared between the RWT participants and the control group. Statistical analysis identified significant differences (p < 0.001) between the groups when analyzing shoulder mobility. The RWT participants had decreased mobility when compared with the control group for all AROM measurements except external rotation, which was greater. Strength ratios were significantly greater in the RWT group when compared with the control group (p <or= 0.001), implying agonist/antagonist muscle imbalances. The findings of this investigation suggest that RWT participants are predisposed to strength and mobility imbalances as a result of training. The imbalances identified have been associated with shoulder disorders in the general and athletic population; thus, these imbalances may place RWT participants at risk for injury. Common training patterns are biased toward large muscle groups such as the pectorals and deltoids but neglect muscles responsible for stabilization such as the external rotators and lower trapezius. Exercise selection that mitigates strength and mobility imbalances may serve to prevent injury in this population. Clinicians and strength and conditioning professionals should consider the biomechanical stresses and adaptations associated with RWT when prescribing upper-extremity exercises.

The second one I quoted is not the one above. It seems to be a thesis and by the same author and I cannot get access to it. And I should have worded it as recreational weight lifters. My bad.

And this sort of scapular imbalance is seen a lot in overheard athletes.

And it helps if you can post some studies to back up your anecdotal evidences or claims. If you don't have any, don't ask others to.
 
I'd like to know the method and reliability of the MMT performed in the first study, i.e., the patient positioning and how many readings were taken. And weakness of lower traps relative to one's bodyweight doesnt mean much to me. Of course, (hopefully) a bodybuilder is gonna weigh more than the non lifter, therefore creating a greater marginal difference in the reading.

Im also guessing that in the goniometric measurements, "shoulder rotation" is referring to shoulder complex abduction? If so, i highly doubt most of those men couldnt reach a PROM of 180 degrees. Who were the testers? Did they have a premature bias and record the measurement short?

Yea, same goes for the second study. What specific muscles is it labeling agonist and antagonist to yeild those ratios? What were the methods used for strength assessment?

Again, to address what you highlighted in the second paragraph, these small rotator cuff muscles and stabalizers are engaged with every action performed by large muscle groups. An example is the inferior glide of the humeral head by 3 RC muscles during abduction. Im sure theres a disparity of strength between certain muscle groups but not significant enough to always cause injury. Question: How come a large majority of those subjects were not or had not experienced injury or pathology because of their grave muscle imbalance?

And I dont need to post anything as collateral except my personal intuition aquired from professionals whove practiced for years.

Again, I honor you sir for posting these studies as well as the studies in our other ongoing debate in another thread. Reps.
 
I have strong traps(upper and lower) and rhomboids but weak rear delts and external rotation in comparison to my front and side delts, so its more a bad balance than any type of weakness I guess.

The diagnosis is most likely impingement.

Went to physio today before working out shoulders, I gotta go back a day or 2 after my shoulder workout to get checked up properly cause thats when my shoulder feels its worst.
 
'd like to know the method and reliability of the MMT performed in the first study, i.e., the patient positioning and how many readings were taken. And weakness of lower traps relative to one's bodyweight doesnt mean much to me. Of course, (hopefully) a bodybuilder is gonna weigh more than the non lifter, therefore creating a greater marginal difference in the reading.

Im also guessing that in the goniometric measurements, "shoulder rotation" is referring to shoulder complex abduction? If so, i highly doubt most of those men couldnt reach a PROM of 180 degrees. Who were the testers? Did they have a premature bias and record the measurement short?
Click to expand...

All good questions and I agree there are a lot of unanswered questions. I have the link to the study:. just can't post it here. Type int he name of the study and there is a free text link in google.

And when they do relative measurement, they usually normalize th measurements. Here they used the percentage of the body weight. They used 3 measurements. They used standard PT measurements. And mind you, the validity and reliability of most of the manual therapy measurements in your PT field is questionable.

From the discussion part: "The bodybuilders’ average weight was found to be
significantly greater when compared with the average
weight of subjects in the control group. To make
strength values relative to the size of the tested subjects,
strength values were expressed in relation to percent
body weight. As hypothesized, bodybuilders had
increased strength values for almost all tested motions.
Bodybuilder strength values, expressed as a percent of
body weight, were found to be significantly greater in
all MMT positions except for the MMT that assessed
lower trapezius muscle strength. Despite the significance
of the findings, we were quite surprised to see
that the bodybuilders were only approximately 5.4%
stronger than the average control subject for abduction.
Furthermore, these same bodybuilders were not
much stronger than the nonbodybuilders on the 2
scapular retraction tests. When compared with subjects
in the control group, they were only 1.2% stronger
for retraction using primarily the middle trapezius
muscle group and only 1% stronger for retraction and
arm elevation in the prone position to test the lower
trapezius muscle group. These findings may indicate
that the training the bodybuilders were involved in
may be creating muscle-strength imbalances that are
a result of an overemphasis on lifting larger muscle
groups (e.g., pectoralis and deltoid muscles) and the
neglect of scapular stabilizers. This type of strength
imbalance in the shoulder girdle musculature has been
correlated to a variety of shoulder pathologies "

Question: How come a large majority of those subjects were not or had not experienced injury or pathology because of their grave muscle imbalance?
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That's a great question and that is a question which shows how pain is such a mystery. Most of the structural abnormalities causing pain is JUST a correlation. There are studies which shows disc herniations and bulges in healthy people with NO pain. That's a discussion for another day.

And I dont need to post anything as collateral except my personal intuition aquired from professionals whove practiced for years.
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Evidence based medicine is clearly NOT your personal intuition acquired from professionals. Come on and it's funny you ask for premature biases in the study and then you say "you don't need to post anything as collteral". lol

Evidence based approach involves both the best available scientific evidence and the intuition and experience of the practitioner.

And thanks for all the reps, bro~!
 
Any recommended stretches for a torn rotator cuff? Apparenlty, according to my MRI, I tore a tendon and it has been 4 months of pain.
 
anoopbal said:
All good questions and I agree there are a lot of unanswered questions. I have the link to the study:. just can't post it here. Type int he name of the study and there is a free text link in google.

And when they do relative measurement, they usually normalize th measurements. Here they used the percentage of the body weight. They used 3 measurements. They used standard PT measurements. And mind you, the validity and reliability of most of the manual therapy measurements in your PT field is questionable.
From the discussion part: "The bodybuilders’ average weight was found to be
significantly greater when compared with the average
weight of subjects in the control group. To make
strength values relative to the size of the tested subjects,
strength values were expressed in relation to percent
body weight. As hypothesized, bodybuilders had
increased strength values for almost all tested motions.
Bodybuilder strength values, expressed as a percent of
body weight, were found to be significantly greater in
all MMT positions except for the MMT that assessed
lower trapezius muscle strength. Despite the significance
of the findings, we were quite surprised to see
that the bodybuilders were only approximately 5.4%
stronger than the average control subject for abduction.
Furthermore, these same bodybuilders were not
much stronger than the nonbodybuilders on the 2
scapular retraction tests. When compared with subjects
in the control group, they were only 1.2% stronger
for retraction using primarily the middle trapezius
muscle group and only 1% stronger for retraction and
arm elevation in the prone position to test the lower
trapezius muscle group. These findings may indicate
that the training the bodybuilders were involved in
may be creating muscle-strength imbalances that are
a result of an overemphasis on lifting larger muscle
groups (e.g., pectoralis and deltoid muscles) and the
neglect of scapular stabilizers. This type of strength
imbalance in the shoulder girdle musculature has been
correlated to a variety of shoulder pathologies "
Click to expand...

oh there is a margin for error with any medical assessment. Its reducing that margin that makes a PT's practice professionally acceptable. For example: goniometry using a universal goniometer and considering the therapist is competent, is something like 98% valid.



Heres a little study from a quick search i did just to show how easily middle and lower traps can be equally trained. If bodybuilders use common sense (most bb i know equally distribute their exercises among muscle groups), they probably use: reverse flys, cable rear delts, seated row with stirrups, t-bar row with "t" handles.

Invalid Link Removed

Abstract
The trapezius muscle plays a crucial role in maintaining proper shoulder mechanics and is often considered a source of weakness and dysfunction in patients.

Objectives
The purpose of this study was to investigate the activation patterns of the middle and lower trapezius during four prone horizontal abduction exercises of the glenohumeral joint (GHJ).

Methods
The muscle activation patterns of 19 female and 13 male volunteers were measured using surface EMG during horizontal arm abduction exercises commonly used in rehabilitative settings. Each subject performed 10 repetitions of horizontal abduction (ABD) at each position using only the weight of the arm. Function was assessed during shoulder horizontal abduction while positioned at: 75°, 90°, 125° and 160° of GHJ ABD. Electromyographic activity was collected during the concentric phase during each test repetition in the lower (LTRAP) and middle trapezius (MTRAP). A repeated measure ANOVA was performed followed by Bonferroni's post hoc test.

Results
The MTRAP had significantly greater recruitment at 90° and 125°, compared to 160°. Similarly, results for the lower trapezius indicated that recruitment at 90° and 125° was significantly greater than 160°.

Conclusion
Most significant muscle activation for the middle and lower trapezius occurred at 90° and 125° of GHJ ABD. For the clinician, training at 90° is easy to identify, and provides maximal activation, negating the need for multiple training angles.




anoopbal said:
That's a great question and that is a question which shows how pain is such a mystery. Most of the structural abnormalities causing pain is JUST a correlation. There are studies which shows disc herniations and bulges in healthy people with NO pain. That's a discussion for another day.
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I wasnt necessarily implying pain when i said "experiencing pathologies". Functional limitation and disability is what i was getting at.

And thats an easy one: Majority of disc herniations are anteriorly bulging, where no spinal nerve roots are located= no pain and no awareness of a problem


anoopbal said:
Evidence based medicine is clearly NOT your personal intuition acquired from professionals. Come on and it's funny you ask for premature biases in the study and then you say "you don't need to post anything as collteral". lol
Evidence based approach involves both the best available scientific evidence and the intuition and experience of the practitioner.
Click to expand...

You are quite the research expert. Im on the verge of obtaining credintials (which in today's world may or may not mean much) and I just know that I can evaluate a situation based on my thorough education and then if need be, substatiate it with a study.


anoopbal said:
And thanks for all the reps, bro~!
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Sarcasm? Well if youve been here since '06 and thats all the points you have to show for it, i probably cant help you out much regardless.
 
Sarcasm? Well if youve been here since '06 and thats all the points you have to show for it, i probably cant help you out much regardless.
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No. It was you who gave me reps right in my PM. Just thanking you.

And it is not the strength but the strength ratio that matters. You have to pick exercises which have highest activity for LT & MT and lowest for UT (upper traps).

I gave the example of herniation to show how the biopsychosocial model of pain is more apt than the bio-mechanical model of pain. and it is not just herniations, there are lot of examples where injuries shows no pain. Chronic pain has very little to do with structural pathology.
 
SilverZ06 said:
Any recommended stretches for a torn rotator cuff? Apparenlty, according to my MRI, I tore a tendon and it has been 4 months of pain.
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Silver... I would not be trying to stretch a torn RC, you are more likely to make it worse. How bad is the tear, is it a complete avulsion (complete tear) or just partially torn?
 
Bezoe & Anoopbal,

Guys, can I just step in and say something here? I have read all your posts and both of you are making great points, I really believe from what I have read you are both very educated people and I know sarcasm and some other not so professional (nice) things may have been said, but lets just learn from one another and not bash.

Anoopbol... I would have sided with Bezoe when you first made your comment (the generalization of bodybuilders and weightlifters), but then after reading your study it made me think about it more and that is what these forums are for, so thank you for your posts. On the other hand, I am not saying that the study you found and posted is incorrect, but I still can't help agreeing with Bezoe about having weaker lower traps as they are used in almost every compound upper body movement. So I will leave it at... something I believe renders further investigation.

BTW... I'm a Chiropractor and Bezoe is correct that most disc bulges/herniations occur anteriorly causing little to no pain, it is the lateral and posterior disc bulges that put pressure on the cord or nerve root exiting the foramen causing pain.
 
anoopbal said:
No. It was you who gave me reps right in my PM. Just thanking you.

And it is not the strength but the strength ratio that matters. You have to pick exercises which have highest activity for LT & MT and lowest for UT (upper traps).

I gave the example of herniation to show how the biopsychosocial model of pain is more apt than the bio-mechanical model of pain. and it is not just herniations, there are lot of examples where injuries shows no pain. Chronic pain has very little to do with structural pathology.
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Yes it was me. It just looked like sarcasm via the keyboard.. my mistake.
 
ScottyDoc said:
Bezoe & Anoopbal,

Guys, can I just step in and say something here? I have read all your posts and both of you are making great points, I really believe from what I have read you are both very educated people and I know sarcasm and some other not so professional (nice) things may have been said, but lets just learn from one another and not bash.

Anoopbol... I would have sided with Bezoe when you first made your comment (the generalization of bodybuilders and weightlifters), but then after reading your study it made me think about it more and that is what these forums are for, so thank you for your posts. On the other hand, I am not saying that the study you found and posted is incorrect, but I still can't help agreeing with Bezoe about having weaker lower traps as they are used in almost every compound upper body movement. So I will leave it at... something I believe renders further investigation.

BTW... I'm a Chiropractor and Bezoe is correct that most disc bulges/herniations occur anteriorly causing little to no pain, it is the lateral and posterior disc bulges that put pressure on the cord or nerve root exiting the foramen causing pain.
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I apologize for flooding the thread Doc. I concurr... this forum is to educate eachother: "Learn, teach, lead".

Anoopbal clearly has a sound education and his posts/articles were indeed impressive- made me really reassess my persepective of shoulder mechanics. So as I said before, I honor you sir for putting up a well rounded argument.

Back to your thread Doc...
 
I wasn't trying to come in all high and mighty, just seemed like a un-winnable argument on both sides! That is just one of those things that we will all just sometimes "agree to disagree" On the bright side, my eyes were opened to something that I had never considered before, so in essence it was a good thing!
 
Bezoe,

You mentioned before that you were on the verge of obtaining your credentials? What do you mean? Are you about to be published... peer review article, book, I'm both curious and interested in reading whatever you write, if that is what you mean!

AL - ScottyDoc
 
ScottyDoc said:
Bezoe,

You mentioned before that you were on the verge of obtaining your credentials? What do you mean? Are you about to be published... peer review article, book, I'm both curious and interested in reading whatever you write, if that is what you mean!

AL - ScottyDoc
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haha no, no publication... ill become a liscensed physical therapist assistant in the spring. Its not a huge achievement but im proud of it and i plan to eventually pursue my doctorate in PT. love this stuff! :veryhappy:
 
bezoe said:
haha no, no publication... ill become a liscensed physical therapist assistant in the spring. Its not a huge achievement but im proud of it and i plan to eventually pursue my doctorate in PT. love this stuff! :veryhappy:
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Well you are definitely knowledgeable enough, don't let anything get in your way! I think you will be great at it! Oh... & your picts looked good, Nice Back! Also, LOL, just like a super-hero... maintaining the secret idently! :deal:
 
ScottyDoc said:
Well you are definitely knowledgeable enough, don't let anything get in your way! I think you will be great at it! Oh... & your picts looked good, Nice Back! Also, LOL, just like a super-hero... maintaining the secret idently! :deal:
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thanks doc! Yea i dont like revealing any pictures of my face (or tatoos) on the net lol
 
Here is my Un-Secret Identity!!!

Invalid Link Removed
 
holy s*** its you! haha.. a little bit of inadvertant advertisement lol

how long have you been practicing doc? a lot of people said i should pursue a degree in chiropractic medicine (?).. less schooling, more lucrative. would you highly recommend your career to others? i know its an open ended question but id like to know what you think
 
So it turns out I was impinging on 2 exercises, DB Bench and cable pull apart, which is kinda like DB bench in reverse but with the arms slightly externally rotated. Upright rows cause no impingement for me though.

So anyway my shoulder isnt getting any worse, but I definetely do have weakness in my supraspinatus, any lateral delt exercise I do, my right supraspinatus gives out on, when my right delt is stronger than my left, I also dont get much of a pump in my right lateral delt either.

I gotta ask here because my PT is very conservative with what he says always saying "could be" or "most likely" and is reluctant do imaging. Is the weakness just part of the impingement or would it be safe to assume its a tear?
 
ItsHectic said:
So it turns out I was impinging on 2 exercises, DB Bench and cable pull apart, which is kinda like DB bench in reverse but with the arms slightly externally rotated. Upright rows cause no impingement for me though.

So anyway my shoulder isnt getting any worse, but I definetely do have weakness in my supraspinatus, any lateral delt exercise I do, my right supraspinatus gives out on, when my right delt is stronger than my left, I also dont get much of a pump in my right lateral delt either.

I gotta ask here because my PT is very conservative with what he says always saying "could be" or "most likely" and is reluctant do imaging. Is the weakness just part of the impingement or would it be safe to assume its a tear?
Click to expand...

is it painful? the impingment can cause tendon lesion resulting in weakness and usually pain/discomfort.

abnormal weakness is a result of: nerve damage, circulation deficiency, or structural damage direclty to the contactile tissues (muscle belly or tendon)

you need to correct the underlying problem which in the case of impingment usually mean strengthening the other 3 RC muscles that assist in "inferior glide" of the humeral head during shoulder abduction. At the same time use ice and NSAIDS to treat the symptoms and do not do those 2 exercises
 
Thats the thing, I dont have much pain at all, sometimes pain while abducting up to 90 degrees without resistance, but its a 1 on a scale of 1-10.
My PT did some tests and he did one impingement test 3 times that the pain got worse each time and hurt a bit for the rest of the day, but any exercise I do does not cause any odd pain. I have been doing RC strengthening, my supraspinatus on both arms is actually quite strong in relation to the muscles around it, its just that my right is now slightly weaker, particurly noticible in certain planes of motion such as abducting from the scapular plane transitioning into the coronal plane.
 
thats all they did? some tests and sent you home with the same strengthening protocol? I think i would demand imaging if they havent made any conclusive diagnoses by now.
 
I agree with Bezoe, I think, based solely on what you have told us, that your PT is dropping the ball a little here! I would have definitely taken some x-rays of both shoulders in multiple angles and compared measurements from one to the other to determine the difference between the two to help better explain what, where and why, then based on the anatomy of the muscles/tendons in the area, have a better idea as to which are lacking! Again, as mentioned previously on other posts, x-rays are limited, MRI is the best for soft tissue injuries, but if measured and analyzed properly, x-rays can still divulge more information than most people give them credit for. Sorry you are going through all this **** Bro, wish I could be of more help, Good Luck!
 
So, it's been 2 months and I've still got some pain in my left upper trapezius! I guess the best description of what's going on in the area is as follows:

1) Keeping my head straight while facing forward, and then tilting my head far to the right produces pain in my left trapezius... almost as if I slept wrong. Pressing that muscle with my fingers also produces pain, like when you press on a bruise.

2) Feeling the muscle with my hand and comparing to the non-hurt right side, it feels like that trapezius muscle is a little bit bigger, and more tense than the good side.

3) Positioning my arms as if to do an incline pressing movement produces pain from that trapezius muscle, at the fully extended and fully non-extended positions of my arms, if that makes any sense.

4) Back exercises like barbell, dumbell, and cable rows, and lat pulldowns do not cause any pain at all. Only pressing motions (mainly flat and incline, less with decline). Dips produce pain as well, so I also stopped doing those.

5) On a couple occasions i have gotten someone to massage that muscle and really press the hell out of it, it's felt better for a short period of time. I'm hoping that all I really need is some good physical therapy for the area to get it back to 100%.

I haven't done flat barbell bench or incline exercises in a long time, though I have done some flat dumbell bench (probably wasn't a good idea yesterday, as I went a little heavier than usual because I hadn't been to the gym in a week) and decline about once a week, along with the chest press machine so that I at least can maintain my chest. Haven't done any heavy shoulder exercises in a while either. I plan to go back to the doctor sometime soon and maybe get a reassessment of what's going on, and I also really want to get a copy of my MRI results (from what I understand they will give it to you on a cd if you ask for it) just so I can provide it if I eventually start going to see a physical therapist to get this ironed out. I'm not sure if my trapezius was even MRI'd (they did it to my shoulder area because at the time I thought I had a serious rotator cuff injury), so that's something I need to find out too.

Today at work at my desk I'm doing the heat-ice-heat-ice 15 minute rotation that ScottyDoc recommended.
 
I've experienced 1, 2, and 3. Usually, in my case, caused by a deep muscle spasm and inflammation. I get them a lot on my right side. The spasm usually occurs deep behind my scapula. Because I'm having a muscle spasm, it pulls on everything all the way up through my trap, and into my neck. Extremely uncomfortable!!!!

Rest, message(thanks to the wifey), and muscles relaxers are how I deal.
 
buuzer0 said:
So, it's been 2 months and I've still got some pain in my left upper trapezius! I guess the best description of what's going on in the area is as follows:

1) Keeping my head straight while facing forward, and then tilting my head far to the right produces pain in my left trapezius... almost as if I slept wrong. Pressing that muscle with my fingers also produces pain, like when you press on a bruise.

2) Feeling the muscle with my hand and comparing to the non-hurt right side, it feels like that trapezius muscle is a little bit bigger, and more tense than the good side.

3) Positioning my arms as if to do an incline pressing movement produces pain from that trapezius muscle, at the fully extended and fully non-extended positions of my arms, if that makes any sense.

4) Back exercises like barbell, dumbell, and cable rows, and lat pulldowns do not cause any pain at all. Only pressing motions (mainly flat and incline, less with decline). Dips produce pain as well, so I also stopped doing those.

5) On a couple occasions i have gotten someone to massage that muscle and really press the hell out of it, it's felt better for a short period of time. I'm hoping that all I really need is some good physical therapy for the area to get it back to 100%.

I haven't done flat barbell bench or incline exercises in a long time, though I have done some flat dumbell bench (probably wasn't a good idea yesterday, as I went a little heavier than usual because I hadn't been to the gym in a week) and decline about once a week, along with the chest press machine so that I at least can maintain my chest. Haven't done any heavy shoulder exercises in a while either. I plan to go back to the doctor sometime soon and maybe get a reassessment of what's going on, and I also really want to get a copy of my MRI results (from what I understand they will give it to you on a cd if you ask for it) just so I can provide it if I eventually start going to see a physical therapist to get this ironed out. I'm not sure if my trapezius was even MRI'd (they did it to my shoulder area because at the time I thought I had a serious rotator cuff injury), so that's something I need to find out too.

Today at work at my desk I'm doing the heat-ice-heat-ice 15 minute rotation that ScottyDoc recommended.
Click to expand...

Have you tried massage at all? I'm talking a real deal deep tissue, not a feel good massage, it can do wonders! :deal: Big advocate!
 
also maybe try some joint mobilizations. Obviously it is now chronic and a lot of time theres an underlying problem. Scapular joint mobs may help the tight upper back. Losen up that joint and let it move freely. PT's do this.
 
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