Announcement

Collapse
No announcement yet.

Shoulder stability questions. What my physio said -Need help!

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Shoulder stability questions. What my physio said -Need help!

    So i have nagging shoulder issues. Im 19.
    Im experiencing pain in my right shoulder, what feels to be at the back of my deltoid. while I experience pain in my left shoulder when OH pressing with a barbbell which feels like its "inside" my shoulder.
    I also feel my shoulders are internally rotated slightly, and generally just shitty.

    I personally thought I had some scapula winging but the PT says that scapula winging is normal for my age and they dont fully develop till later. But he hardly examined my body, just said that...

    my problem was too much flexibility and not enough stability of the shoulders. Hes prescribed deadlifts, sumo dead lifts, kettle bell swings, overhead squats, pull ups and dips and eventually powercleans.(basically, crossfit as he mentioned it)to build strength and stability. He said use functional exercises. He said " be a caveman in the gym"

    I cant argue with that, it makes sense but he totally told me i was doing the wrong things when i said I was doing scapula pushups, wall slides and external rotations. He also said back work like rows were unessacary at the gym. That doesnt make sense to me when everything ive learned states javing multiple pull work to your pushes for healthy shoulders.
    Not only that, but pullups internally rotate your shoulder and that dips are bad for 'bad' shoulders.

    Im just confused as to what the hell I should be doing. And if what he says may be true??

  • #2
    I don't know what to tell you as I have very similar problems, really flexible but lack stability from an injury. I had crap (read army or maybe vice versa) physical therapists who old me to do rotations as wall stretches, but the last one I really liked. He is a master with needles. He didn't say go work out hard, but I am considering doing it anyway if it didn't hurt so much.

    Hoping to see where this goes.

    Comment


    • #3
      I'm 33, and working on fixing my weak back and shoulders. Nothing I've tried has helped my upper back and posture but for bodyweight rows (from under a waist-high bar, or TRX). I've done way too many pushups in my time, and now I'm getting the balance to put my shoulders where they ought to be.

      The one thing that has been helping my shoulders has been handstand work, just holding handstands against a wall. I'll be getting to freestanding pretty soon.

      I've tried bent-over rows and overhead press (as part of StrongLifts), but these two exercises have been far more effective at correcting the issues. My form on both of those exercises was poor, and doing more of it wasn't helping. Bodyweight rows definitely helped my bent-over row. I haven't done overhead press in a while, but I'm guessing it's better than it was.

      The other possibility is to consider Foundation One by Coach Sommers, the guy who wrote Building the Gymnastic Body. It's a beginner program designed to address weaknesses and imbalances and inflexibility preventing someone from becoming a gymnast. (Do an image search for gymnasts to see what their physiques look like.)

      Comment


      • #4
        I don't know you from Adam, and so can't really respond specifically, but here's what I got:

        Scapular winging at your age "can" be completely normal. Serratus anterior muscle and all Winged scapula - Wikipedia, the free encyclopedia

        Rows may not be necessary if you are doing chins and deadlifts, but that does not make them detrimental either. Done correctly they are a fine adjunct to your program if you like them. Pullups can produce a shoulder impingement sort of syndrome if done with elbows flaring, so I do recommend the supinated grip (chins) instead with a lean at the bottom of range. Here is a video on good mechanics for this The Congruent Chin Up - YouTube

        Dips "can" be rough on your shoulders. Again this is highly individual. Personally bench press is bad for my shoulders, but dips perform perfectly fine..... and I've had about 4 shoulder separations and 1 pec rupture, so I speak from much experience here.

        Otherwise I'm not hating on his advice. I'd say if you have not done the lifts he is prescribing before then you really do not to be doing them for time (i.e. crossfit wod). You need to do like 3 months - a years worth of form and building up on the basic lifts first, then you might entertain the idea of practicing the O-lifts. SS sort of program first basically. Good luck.
        Last edited by Neckhammer; 09-13-2013, 09:02 AM.

        Comment


        • #5
          Originally posted by Lockstock View Post
          So i have nagging shoulder issues. Im 19.
          Im experiencing pain in my right shoulder, what feels to be at the back of my deltoid. while I experience pain in my left shoulder when OH pressing with a barbbell which feels like its "inside" my shoulder.
          I also feel my shoulders are internally rotated slightly, and generally just shitty.

          I personally thought I had some scapula winging but the PT says that scapula winging is normal for my age and they dont fully develop till later. But he hardly examined my body, just said that...

          my problem was too much flexibility and not enough stability of the shoulders. Hes prescribed deadlifts, sumo dead lifts, kettle bell swings, overhead squats, pull ups and dips and eventually powercleans.(basically, crossfit as he mentioned it)to build strength and stability. He said use functional exercises. He said " be a caveman in the gym"

          I cant argue with that, it makes sense but he totally told me i was doing the wrong things when i said I was doing scapula pushups, wall slides and external rotations. He also said back work like rows were unessacary at the gym. That doesnt make sense to me when everything ive learned states javing multiple pull work to your pushes for healthy shoulders.
          Not only that, but pullups internally rotate your shoulder and that dips are bad for 'bad' shoulders.

          Im just confused as to what the hell I should be doing. And if what he says may be true??
          "I am a peaceful breeze. I am a peaceful breeze. I am peaceful breeze. 10-9-8-7...."

          Sorry I had to recenter myself because my head almost exploded. All I can say is Bad PT!!! Bad PT!!! Let me guess he was trying to teach you an over head swing for the Kettlebell too?

          So okay, not everything that he told you was horrible. But if you're looking to gain shoulder stability and stop internal rotation almost every exercise that he has prescribed is front loaded and every exercise he told you not to do is back loaded. BAD PT!!!! People that work in the exercise field should really have to read more.

          In adults, which you are, scapular winging is a disfunction caused either by nerve damage or severe muscle injury. I don't know you so I can't say this is the issue however from what else you wrote I don't think this is the case.

          Continue your scapular push ups, continue your rows with the TRX and on a stable bar. This is one use for the smith rack which is otherwise a waste of space. Lock the bar in place and do inverted rows. Wall angels, band pull aparts, pulls ups, seated rows, google posterior delt exercises and rhomboid press. High pulls, cleans, snatch and deads. Pull, pull, pull, pull and more pull!!

          Chest press, overhead press, dips, Kettlebell swings are all excellent exercises but NOT to fix internal rotation. Yes swings are a pull but the activation isn't strong enough in the upper back and if not done correctly can stretch upper chain musculature and exacerbate the problem.

          Total face palm.

          Comment


          • #6
            Actually after thinking about it I wouldn't recommend Deads either unless you retract your shoulders completely at full extension.

            Comment


            • #7
              I found this video quite informative.

              https://www.youtube.com/watch?v=cBPk4ADhg9k

              Comment


              • #8
                Originally posted by Neckhammer View Post
                .... and I've had about 4 shoulder separations and 1 pec rupture, so I speak from much experience here.
                .
                May I ask what was done to correct your shoulder separations?

                I found out yesterday that I have an AC joint injury and a fairly large calcium deposit in my bursa. The injury was not defined but I think it might be a separation because I can get pain relief when my shoulder pops and something moves. I've been referred to an orthopedist and am waiting to hear from them.

                Comment


                • #9
                  Originally posted by marcadav View Post
                  May I ask what was done to correct your shoulder separations?

                  I found out yesterday that I have an AC joint injury and a fairly large calcium deposit in my bursa. The injury was not defined but I think it might be a separation because I can get pain relief when my shoulder pops and something moves. I've been referred to an orthopedist and am waiting to hear from them.
                  Mine occured when I was in my late teens and early twenties. I've seperated each one twice. In my case I was put in a sling for a few weeks (too long ago to remember exactly). Then just eased back into normal level of activity. Basically it all depends on the grade of the separation as to what your options are. Grade I-III are the ones you see most in sports and such. My worst was a grade II. Really it sucks and I may need future surgery regardless...... BUT I'm not willing to just go that route lightly. I've found that keeping my support muscle strong really helps to keep that area from being painful. So a well designed strength program is what I'm relying on currently.

                  Comment


                  • #10
                    Originally posted by Neckhammer View Post
                    Mine occured when I was in my late teens and early twenties. I've seperated each one twice. In my case I was put in a sling for a few weeks (too long ago to remember exactly). Then just eased back into normal level of activity. Basically it all depends on the grade of the separation as to what your options are. Grade I-III are the ones you see most in sports and such. My worst was a grade II. Really it sucks and I may need future surgery regardless...... BUT I'm not willing to just go that route lightly. I've found that keeping my support muscle strong really helps to keep that area from being painful. So a well designed strength program is what I'm relying on currently.
                    Thanks Neckhammer.
                    I'll just have to wait and see what the orthopedist has too say. The doctor I saw Wednesday said the fact that I have cerebral palsy, and it's my CP affected shoulder, complicates things.

                    Comment


                    • #11
                      Originally posted by marcadav View Post
                      Thanks Neckhammer.
                      I'll just have to wait and see what the orthopedist has too say. The doctor I saw Wednesday said the fact that I have cerebral palsy, and it's my CP affected shoulder, complicates things.
                      NP. Hope yours is an issue that can be resolved with a conservative sort of intervention!

                      Comment


                      • #12
                        i kind of feel like he got the impression that because I was young I just needed to build muscle and get stronger. He seriously did not once examine my shoulders except to put tape on them. Though I explained I dont think he cared!!

                        I get shoulder soreness from doing the dishes because my arms and shoulders are out infront of me.
                        But he goes and tells me to do power cleans and push presses lol.

                        My shoulders feel good today, no pain. So I think Im just going to stick to the pull work for now except maybe pushups (that seratious anterior!!)
                        I really wanna OHP but that probably is not a good idea for the time being. I just dont know what else to do

                        Comment


                        • #13
                          Originally posted by Lockstock View Post
                          i kind of feel like he got the impression that because I was young I just needed to build muscle and get stronger. He seriously did not once examine my shoulders except to put tape on them. Though I explained I dont think he cared!!

                          I get shoulder soreness from doing the dishes because my arms and shoulders are out infront of me.
                          But he goes and tells me to do power cleans and push presses lol.

                          My shoulders feel good today, no pain. So I think Im just going to stick to the pull work for now except maybe pushups (that seratious anterior!!)
                          I really wanna OHP but that probably is not a good idea for the time being. I just dont know what else to do
                          Have you tried doing OH DB presses using a neutral grip ?

                          Comment


                          • #14
                            Originally posted by Lockstock View Post
                            i kind of feel like he got the impression that because I was young I just needed to build muscle and get stronger. He seriously did not once examine my shoulders except to put tape on them. Though I explained I dont think he cared!!

                            I get shoulder soreness from doing the dishes because my arms and shoulders are out infront of me.
                            But he goes and tells me to do power cleans and push presses lol.

                            My shoulders feel good today, no pain. So I think Im just going to stick to the pull work for now except maybe pushups (that seratious anterior!!)
                            I really wanna OHP but that probably is not a good idea for the time being. I just dont know what else to do
                            Well, and the reason I didn't go into specific advise is because I put a lot of stock into the actual physical exam. It's really impossible to get a clear picture with words and internet. I just assumed this fella at least put you through some sort of evaluation and based his recommendations on that. If he didn't even do that, well then I don't really have anything nice to say about how he practices....lets just leave it at that.

                            So yeah, going back to my vague sort of common issues response.... many issues with the shoulders are related to neck, thoracic, scapular glide, and the shoulder itself. In each of those areas you may deal with problems at the joint, muscle, nerve, or combination of them. So one, more than one, or all of those may actually need be addressed to take care of whatever issue your dealing with.

                            I don't see the sense in doing any movement that is overly dynamic with an unstable joint...so that nixes your kettlebell swings. I also don't like any movement for the shoulder that puts you in shoulder impingement situations. And I surely would recommend that you do keep pulls in the program as they are an important part of setting and balancing your posterior musculature with that of the anterior.

                            If you have pain with a particular motion then you need very specific advice. If you just want general shoulder strength advice then mine is to include at least an equal number of pulls to push work in comparative planes.... and if your fixing an anterior posture then you may even weight your pull work to twice as much as your push work. Lateral raises are OK if you do them at a slight (say 20 degrees) adducted angle and don't go up past 90 degrees and don't do the pinky up thing. Overhead press with a neutral grip may be doable... I'd recommend doing them as a very inclined press so you are not actually verticle, but leaning back just a bit.

                            Hope you at least get some helpful ideas from this thread!
                            Last edited by Neckhammer; 09-13-2013, 08:09 PM.

                            Comment


                            • #15
                              Originally posted by Neckhammer View Post
                              Well, and the reason I didn't go into specific advise is because I put a lot of stock into the actual physical exam. It's really impossible to get a clear picture with words and internet. I just assumed this fella at least put you through some sort of evaluation and based his recommendations on that. If he didn't even do that, well then I don't really have anything nice to say about how he practices....lets just leave it at that.

                              So yeah, going back to my vague sort of common issues response.... many issues with the shoulders are related to neck, thoracic, scapular glide, and the shoulder itself. In each of those areas you may deal with problems at the joint, muscle, nerve, or combination of them. So one, more than one, or all of those may actually need be addressed to take care of whatever issue your dealing with.

                              I don't see the sense in doing any movement that is overly dynamic with an unstable joint...so that nixes your kettlebell swings. I also don't like any movement for the shoulder that puts you in shoulder impingement situations. And I surely would recommend that you do keep pulls in the program as they are an important part of setting and balancing your posterior musculature with that of the anterior.

                              If you have pain with a particular motion then you need very specific advice. If you just want general shoulder strength advice then mine is to include at least an equal number of pulls to push work in comparative planes.... and if your fixing an anterior posture then you may even weight your pull work to twice as much as your push work. Lateral raises are OK if you do them at a slight (say 20 degrees) adducted angle and don't go up past 90 degrees and don't do the pinky up thing. Overhead press with a neutral grip may be doable... I'd recommend doing them as a very inclined press so you are not actually verticle, but leaning back just a bit.

                              Hope you at least get some helpful ideas from this thread!

                              I did some Face pulls today. 1 kilo, 15 reps for like 4 sets. I felt a nice burn in my left shoulder (the worse one) which just stands to reason my left external rotators are weak as hell. I also did some more Scapula push-ups. Fu$^ that physio.

                              What I plan on doing now is to do external rotations and face - pulls as warm ups on my upper body days and/or after my workouts.

                              Do you think rear delt flys are a good exercise? Some people swear by them for getting rid of their shoulder pain because it balances their back shoulders to the front.


                              If I gave you a write up of my program (on this thread) do you think you could have a look at it and critique it to the best of your knowledge. I realize not everyone can give me a 100% accurate response because they don't know my body but, if you could give it a shot that would be great!

                              Comment

                              Working...
                              X