Posterior Shoulder Impingement

[GreenMachineX]

I’ve been able to get my shoulder moving again and now have full ROM, except pain at end range external rotation. Has anyone dealt with this and what should I do? I’ve been doing tons of research and tried tons of stuff but nothing is working.

 

[John Smeton]

have you had an MRI or know exactly where it is? Infraspinatus?

I had a pinhole tear in either infraspinatus or supraspinatus, i forget the MRI was in 2010. I rehabbed it and got it better I had to stop doing anything that hurt it and do physical therapy. Shoulder horn is an invaluable tool, its sold on amazon. along with other rotator exercises. The band behind the head and back is gold as well.

 

[bigsmall]

rotator exercises with light bands, high reps, make it burn and burn more. Isolate the area. Using dumbells or weighted cables or heavier bands - take away from isolating the area cause the form is comprimised. Its all about short range of motion, isolation and the burn. Changing angles of band, experimenting with different exercises. Work the area from all angles and separate (un-glue) the area from everything around it. I recommend doing this every second day forever. Three times a week for a while, do light (15-20 rep) dumbell presses where you go deep - so as to open up the front of the chest and set the shoulder. Grip the hell out of the dumbells always. After a few weeks, start to raise the weight for one of those workouts until you have one max day a week (3-4 reps plus 3-4 assisted reps) again....pressing deep. On press days - do 4 sets (one warm up). On max days, do 4 sets...with only 2 max effort sets. No other presses. Cut out all flys and lateral raises. Don't ever bomb the area with more assisted sets or lower weight high rep sets. Then start to introduce other presses - floor press, incline wide grip. Don't bomb the back or rear delts. Id back exercises that may be contributing to the problem (ie. reverse grip bent rows wrecked the area for me and killed the bicep tendon). This is what has worked for me - I am 50 years old and my shoulders are doing very well considering 30 plus years of power lifting.

 

[IronTitan41]

have you had an MRI or know exactly where it is? Infraspinatus?

I had a pinhole tear in either infraspinatus or supraspinatus, i forget the MRI was in 2010. I rehabbed it and got it better I had to stop doing anything that hurt it and do physical therapy. Shoulder horn is an invaluable tool, its sold on amazon. along with other rotator exercises. The band behind the head and back is gold as well.

great info john... gonna look into one of them shoulder horns as per your recommendation. just looked up some videos on it and it definitely looks like it can help me with my shoulder issues as well.

any good stretches you guys suggested incorporating from time to time that work better or more effectively than the traditional cross body and overhead shoulder stretches? my right shoulder always feels super tight and works its way up to my back and neck

 

[bigsmall]

The only stretch I would do is for the pec and pec minor - lay on a flat bench and with a 3-5lb weight in one hand - extend the hand out to the side as to stretch your chest - relax into the stretch and feel the nerves in the chest and across the top of the clavicle slowly stretch. I sometimes hold this stretch for 5 minutes or so until my arm reaches the floor. Deep breath into the area during the stretch. Do the same thing again now - but with the top of the arm at 90 degrees - which will stretch the pec minor and all the nerves in the arm pit - this is the money stretch. These two stretches done a couple of times a week will keep your shoulder set and keep the nerves free to move and allow you to get range of motion and control in your presses. i would avoid any stretches to the rotator cuff or rear of the shoulder. Stretching the rear of the shoulder should be avoided. It may seem like the right thing to do and may feel good in the short term, but it always ends up in the rotator cuff having more pain.

 

[IronTitan41]

The only stretch I would do is for the pec and pec minor - lay on a flat bench and with a 3-5lb weight in one hand - extend the hand out to the side as to stretch your chest - relax into the stretch and feel the nerves in the chest and across the top of the clavicle slowly stretch. I sometimes hold this stretch for 5 minutes or so until my arm reaches the floor. Deep breath into the area during the stretch. Do the same thing again now - but with the top of the arm at 90 degrees - which will stretch the pec minor and all the nerves in the arm pit - this is the money stretch. These two stretches done a couple of times a week will keep your shoulder set and keep the nerves free to move and allow you to get range of motion and control in your presses. i would avoid any stretches to the rotator cuff or rear of the shoulder. Stretching the rear of the shoulder should be avoided. It may seem like the right thing to do and may feel good in the short term, but it always ends up in the rotator cuff having more pain.

i'll give that a shot! thank you brotha

 

[bigsmall]

i'll give that a shot! thank you brotha

Your shoulder is better than you think - these pec stretches alone can completely change things. Good luck!

 

[GreenMachineX]

have you had an MRI or know exactly where it is? Infraspinatus?

I had a pinhole tear in either infraspinatus or supraspinatus, i forget the MRI was in 2010. I rehabbed it and got it better I had to stop doing anything that hurt it and do physical therapy. Shoulder horn is an invaluable tool, its sold on amazon. along with other rotator exercises. The band behind the head and back is gold as well.

My mri only showed supraspinatus tendinosis but it wasn’t a contrast mri. That was a year ago and that’s healed. I’m just left with that posterior shoulder pain, and the current chiropractor thinks it’s either the infraspinatus or teres minor being pinched on external rotation.

 

[GreenMachineX]

The only stretch I would do is for the pec and pec minor - lay on a flat bench and with a 3-5lb weight in one hand - extend the hand out to the side as to stretch your chest - relax into the stretch and feel the nerves in the chest and across the top of the clavicle slowly stretch. I sometimes hold this stretch for 5 minutes or so until my arm reaches the floor. Deep breath into the area during the stretch. Do the same thing again now - but with the top of the arm at 90 degrees - which will stretch the pec minor and all the nerves in the arm pit - this is the money stretch. These two stretches done a couple of times a week will keep your shoulder set and keep the nerves free to move and allow you to get range of motion and control in your presses. i would avoid any stretches to the rotator cuff or rear of the shoulder. Stretching the rear of the shoulder should be avoided. It may seem like the right thing to do and may feel good in the short term, but it always ends up in the rotator cuff having more pain.

You had posterior impingement? Your right, stretching the posterior area feels awesome, surprised to hear I should avoid it. Stretching the armpit area is really hard because of the posterior pinch/pain it creates.

 

[bigsmall]

You had posterior impingement? Your right, stretching the posterior area feels awesome, surprised to hear I should avoid it. Stretching the armpit area is really hard because of the posterior pinch/pain it creates.

Yes - still do after 20 years. Its about keeping it at bay. When I go too heavy too much - or shy away from maintenance - it rears its head. I think you will find stretching helps in the short term, but it ends up getting worse over the next few days. Overaggressive pec stretching against a wall or object will cause similar problems with the bicep tendon and its insertions in the back of the shoulder. As does pressing without going all the way down.

 

[GreenMachineX]

Yes - still do after 20 years. Its about keeping it at bay. When I go too heavy too much - or shy away from maintenance - it rears its head. I think you will find stretching helps in the short term, but it ends up getting worse over the next few days. Overaggressive pec stretching against a wall or object will cause similar problems with the bicep tendon and its insertions in the back of the shoulder. As does pressing without going all the way down.

Gotcha. So for exercises, which rotator cuff muscle should get the most work? The one that hurts, just go light enough that there’s no pain?

Also, any thoughts on the sleeper stretch?

 

[bigsmall]

Gotcha. So for exercises, which rotator cuff muscle should get the most work? The one that hurts, just go light enough that there’s no pain?

Also, any thoughts on the sleeper stretch?

Really hard to find video of these exercises being done right.
1) https://www.youtube.com/watch?v=23s4w6OfhuQ - external rotation: don't use a towel and keep the elbow tight tight tight to the body and only rotate out enough to grind away at the impingement and don't go beyond this point (cause you are not focusing on the rotator cuff). Think of a short range of motion to isolate. Make it burn and keep it light and be able to do 30-60 reps with good form. Do each side three times.
2) Sleeper stretch, but standing and as an exercise with a light band. With a light band tied to something around knee height. In a standing position with your arm in the same position as it would be for the sleeper stretch. While holding the band, move through the same range of motion as the sleeper stretch. Keep your arm and your elbow static. Make it burn and keep it light and be able to do 30-60 reps with good form. Do each side three times. You will most likely feel uncomfortable and feel pain while doing this - this is cause you have scar tissue causing your rotator cuff to be stuff to everything. This exercise is about peeling away that scar tissue through movement. The exercise is the stretch. Without doing the exercise, you never effectively make the area better.

I have two more...let me know how it goes.

 

[GreenMachineX]

The second exercise sounds more like having the arm in front of me to do external rotations, is that correct?

 

[bigsmall]

The second exercise sounds more like having the arm in front of me to do external rotations, is that correct?

Yes correct. Just like the Sleeper stretch position, but standing. Arm about chin height. Keep shoulder stable with elbow pointing forward and lift the cable (not important if you don't go to 90 degrees for the first while) and then let the cable down until your hand goes lower than your starting position -
and feel your the rotator cuff peel away from the lat and tricep tie insertions. Keep form tight and repeat. This is the exercise that will separate everything. You don't see anyone doing this and I could not find a video, but its old school from my powerlifting club and its the number 1 exercise to fix the area.

 

[Cgkone]

Can you explain the sleeper stretch?

 

[bigsmall]

Can you explain the sleeper stretch?

Their are some videos on you tube that describe it.