Shoulder impingement _ How to adapt primal training page

[William]

In the last 15 years I have indulged in every form of chronic cardio training from IM triathlon, long distance cycling and marathons. In the last 2 years, I adapted my diet from a typical endurance athletes high carb diet to about 90% PB and saw a significant reduction in body fat and a huge improvement in my performance. The switch to PB whilst still training above 80% MHR for 7 to 10 hours a week have left me very thin with minimum muscle. I would now like to switch entirely to a PB lifestyle by changing my training.

The only problem is the many years of swimming have left me with a reoccurring shoulder problem that prevents me lifting heavy with my upper body. I am able to sprint and lift with my legs no problems. Could sprinting and squatting combined add a bit muscle to my skinny frame or will I end with bigger legs and skinny upper body. Any suggesting on a primal training plan considering this limitation. Thank you.

[EGYnutrition]

Here are a few links I give to clients w/ shoulder problems including impingement, Hope it helps:

http://www.youtube.com/watch?v=kDd6fwUgJIE
http://www.youtube.com/watch?v=A0ONHZmsFec&feature=fvst

And if you go to this page, search shoulder in the box, these guys have a lot of video and instruction on how to do plenty of rehab exercises:

http://www.youtube.com/user/smittydiesel#p/search

Lots of self-massage!

And as far as exercise goes, do what you can. Exercising improves bloodflow, which helps with injuries. I don't really support stopping all training unless it's a major injury.

[William]

Thanks for the links and advise.

I am having physiotherapy at the moment and the therapist has given me scapular stabilizing exercises and latterly rotator cuff exercises. I have no pain at the moment but at my last examination the therapist advised against any upper body lifting because he said it will take another 3 to 4 months of rehab to fully stabilize the scapular and strengthen the rotor cuff.

My dilemma is whether to continue with my bike training and racing (high end extended cardio) whilst rebuilding my shoulder and switch fully primal in the autumn when hopefully my shoulder is fixed, or switch to primal fitness now without the upper body lifting. My main worry is that shoulder never improves enough for me to lift.

[Scrogs]

My experience has been that when someone states they have a "shoulder impingement" they have been given a dumbed down diagnosis. What exactly and where is the impingement? The shoulder is not exactly specific. What kind of assessments and testing have you had done. Have you had an EMG? Is it a nerve, bursa or some other type of soft tissue impinged?

[EGYnutrition]

William as with any injury, disorder, disease, ect... the body will need the correct supplies to help fix it. That means calories, micronutrients, macronutrients... so as long as you're eating enough, and practicing excellent recovery and rehabilitation routines, then I don't see the problem with continuing to bike.

[Stu]

William: In regards to your statement about your therapist instructing you to avoid upper body lifting. I would say that that assertion is only half correct. If you have the most common form of shoulder impingement than you would do well to avoid all overhead lifting and most pushing exercises. Aka push ups, bench press etc. You should be fine to do most pulling exercises, with the exception of lat pull downs because the overhead portion may be irritating. Pull ups I would avoid as well because of the traction that gets created at the shoulder. You are correct about achieving scapular stability and rotator cuff strength but there are plenty of upper body lifts that can still be done. Also remember that the primary role of the rotator cuff is a dynamic stabilizer so proprioceptive and stabilizations exercises are the best. The role of scapula is to position the glenoid in the optimal location for the shoulder to function properly. Eventually your therapist should progress you into overhead activities.

From years of swimming you probaly have a bit of a kyphotic posture, rounded shorters, tight anterior muscalature. Spend some time improving your posture, as well as relieving those tight muscles. Look up stretches for the pectoralis minor, and thoracic mobility drills. Good luck hope you get better.

[MikeEnRegalia]

I think you might want to reduce the chronic cardio considerably ... it interferes with your body's capability to repair. I guess that for many athletes who are used to chronic cardio it might be difficult to cut back on it because they're afraid to atrophy ... but I guess that with keeping Mark's physique in mind one could make a leap of faith and give it a try for a month or two. :-)

[William]

Thank you all for the replies.

At the moment, I can feel no pain in my shoulder whist lifting my arm above my head and I can no longer feel the clicking sensation when I lift my arm in front of me, which may suggest that the tendon is no longer impinging. . However, I do feel the affected shoulder is weak and it aches very slightly if I use the computer mouse or leave my arm in a similar position for to long. I am still nervous about introducing any upper body work in case I set my rehab back.

I was thinking about the affect of the chroic cardio training was having on my recovery. Particularly in respect to building the muscle to stabilize my scapular. I have no real muscle as such in my upper body despite my high protein, high fat PB diet. I was thinking if I stopped the 10 hours of cardio per week and introduced short high intensity bike sprints and lower leg weight works this combined with rehab might help my progress. My dilemma is whether to focus entirely on repairing my shoulder and following the PB lifestyle in total from today or spend the summer training and racing the bike whilst working on rehabbing my shoulder and then start PB in full in the autumn.

Thanks again for the help and advice

[Mainer]

I crashed my mountainbike in 2006, speared a tree with my shoulder at at high rate of speed, left me with a third degree separated shoulder. My PT rehab'd me with the Total Gym, elastic bands, and isometrics. I took it slow and easy, very committed. I then progressed to pushups which I do to this day. I no longer bench (how much ya bench) but I do plenty of pushups, pullups, squats, and deadlifts. Believe it or not, squats and deadlifts will grow your upper half of your body as much as the lower half, at least in my experience. Good luck and listen to your Physical Therapist, a little sacrafice now to do things right hopefully will get you to where you want to be.