Q and A: If It Hurts – Stop Doing It (but you can still do other stuff)

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Q:  Hi Tony- Love your articles.  I am 50 years old and have been lifting since 1975.  Mostly bodybuilding programs.  Back in August of 2008, I was doing heay seated front presses when I twisted wrong upon pressing up.  A day later I had a lot of inflammation in the shoulder joint – pretty much zapping all my strength.

I have had off again on again intermittent pain aroind the shoulder blade which I have tried to work around.  I was told I had slight fraying of the tendon and some shoulder impingement, but nothing that warrants an operation.  Lately, though, squats or front presses seem to promote some achiness around the shoulder blade where I originally hurt it a few years ago.  It’s usually worse in the mornings, and about six weeks ago I started having some spasms on that side that eventually went away. 

Long story short, I was wondering if this sounds like anything you may have heard of before?  I really do not want to pursue any surgery if I don’t have to.

A:  For the sake of simplicity (and because I love making lists**) I’m just going to attack this with a few key points that come to mind off the top of my head:

1.  Are you making ANY effort to get any manual soft-tissue work done?  It stands to reason, especially after 3+ years of dealing with the same issue, that you’ve got some significant scar tissue accumulating in that area.  While daily foam rolling is a good start, it’s only going to take you so far – more than likely, you may need something a bit more aggressive.

To that end, finding a reputable manual therapist (whether it’s massage, ART, Graston, etc) that can get his or hers hands in there and dig around would be very advantageous in your situation.  This isn’t something that you just rub some dirt on, drink a shot (or two) of Tequila, add more weight to the bar, grit your teeth, and grind through.  Get it fixed!!!!

If, however, you’re unable to find a good therapist (whether you have limited access in your area, or just don’t have the funds), at the very least you may find some relief using the protocol in the video below.  Oftentimes, some dedicated work on the pecs works wonders.

NOTE:  Yes, ladies, Chris Howard IS single.

2.  Nix the overhead pressing and benching for 2-3 weeks.  Trust me, it won’t be the end of the world if you don’t press for a few weeks.  No, seriously, pigs won’t fly or anything!

A funny a side:  I had a guy walk into the facility yesterday who did an initial assessment with me a few months ago about some hip/leg pain he had been having while squatting and deadlifting.  When all was said and done, even though we cleaned up his technique, I suggested that he lay off the heavy loading for a while and instead, focus on some single leg work, toss in some dedicated corrective exercises, as well as HAMMER the foam rolling.  In all likelihood, I said, he should notice an improvement.

Same guy walked in yesterday, describing the exact same symptoms – pain when he squats and deadlifts.

Are you still squatting and deadlifting?  Yes

Have you done any of the foam rolling and stretches I suggested?  No, I don’t really like stretching.

The point is:  1). Some people just don’t get it,  and 2).

If it hurts, stop doing it – simple as that.

Anyways, back to matters at hand.  Instead, amp up your horizontal rowing (seated rows, 1-arm standing rows, chesy supported rows, etc) to a 2:1 (maybe even a 3:1) ratio.  Meaning, for every “pushing” movement you perform, you’ll want to counteract that with 2-3 pulling/rowing movements.

Almost always, making this minor adjustement in programming speaks volumes for one’s overall shoulder health. 

3.  If you’re like most, you’re still going to bench.  I’m not stupid.  If that’s the case, stick to board presses, or DB floor press (with a neutral grip).  Better yet, I’d be ecstatic if you just performed some closed chain pressing (push-ups), and just focus on loading them or making them more challenging in general.

4.  Chances are, you have some upper trap dominance (welcome to the club.  Population:  pretty much everyone) which is going to superiorly shift the glenohumeral joint into the subacromial space.  In other words, you have an ouchie, and you need to fix it. Because the upper traps are pretty much pwning your lower traps, that subacromial space is diminished, and you need to take some corrective steps to fix it.

Throw in some no money drills (off the foam roller), scapular wall slides (without shrugging), band pull-aparts, retraction to low rows, shoulder w’s, etc which place more of an emphasis on the LOWER traps, as well as scapular depression and posterior tilt.  Really, anything that doesn’t involve shrugging and improves scapular upward rotation will be good for you.

5.  Nix the back squats.  Due to the “at risk” position that back squats place on the shoulders (external rotation + abduction), you’re just setting yourself up for something worse to happen.  Instead, switch to a front squat which will be a lot more shoulder friendly in the long run.  Likewise, if you happen to have access to speciality bars like a giant cambered bar or safety squat bar, both would be a better option that your typical back squat with a standard bar.

6.  Stop doing bodybuilding splits……..;o)

Hope that helps!

 

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  • Mike A

    Stop doing bodybuilding splits. FTW.

  • gabe

    No comment about the actual article, just wanted to say I find your writing to be entertaining.

    I can't figure out if rocks are heavy or light though. What kind of rocks are we talking about?

  • Dave

    Will deadlifts contribute to upper trap dominance?

  • Tony Gentilcore

    Why didn't someone point out the fact that I titled the blog Post If IF Hurts….Stop Doing It.

    Thanks everyone…..GOSH!!!!

  • I just thought you were posting about what do if you have a sore “if”.

  • Tony Gentilcore

    @ Dave: Nope – not if you do them correctly….;o) Basically, don't “shrug” the weight up and you're golden.

    EC hit the nail on the head: http://ericcressey.com/correcting-bad-posture-are-deadlifts-enough

  • bryan boon

    hi guys. the description of the injury is vague but an x-ray will show if the acromion is a type 1, 2 or 3; 3 being 'beaked'. that means it points downward and may be the cause of the impingement. impingement is a catch-all word tho, as it doesnt actually locate the issue. a dye-induced MRI will reveal any labral or glenohumeral-area tears. the overhead motion is driving the humeral head into the joint which causes the issue. the capsular tightness likely is fibrolysis, which is scar tissue thickening under the distal end of the clavicle, hence your impingement. the only solution for that is a quick scope to debride the area. that means the inferior clavicle gets shaved so some ofthe bone and the fibers are gone, hence improved ROM. very common. the MRI will reveal the location of any tears, and depending on the size, could require surgery. a slight tear can be dealt with if you are older and non-active; PT can help only to reinforce surounding muscles to help in support. for a younger athletic person, a tear equals surgery. im a CSCS with a medical background doing an internship in orthopedic surgery, so i see this daily. im 40 and like you, plan on continuing to kick ass. best bet, get it checked to have a piece of mind and then make a plan!!

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