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 Shoulder injury

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Pete
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PostSubject: Shoulder injury   Wed Mar 23, 2011 4:30 am

Damn & blast! Just over my back injury & now I hurt my shoulder! I was lugging sacks of rubble & top soil for a mate who had just got 3 really big raised beds put in & it seems my shoulder did NOT like it. It 'feels' like a rotator cuff injury, so I'm treating it as such (working on pain-free ROM, some self myofascial release, ultrasound & taking natural anti-inflammatory herbs, plus some extra vits & minerals). Seems my training life is all rehab at the moment Crying or Very sad
Oh well, hopefully I can fix it up better than before, then another weak link removed from the chain!
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PostSubject: Re: Shoulder injury   Fri Mar 25, 2011 5:52 am

Finally pain-free enough to actually see if I could work out the issue with the shoulder. As the pain is during internal rotation I could limit the tests. Actually, my first guess seems to be about right. I got my partner to do the bear hug test which is about the best test to find a subscapularis problem - all I can say is "Oh yea it was there alright!"

To check out the bear hug test click here

So it seems I'm in for some rotator cuff rehab over the next few weeks...

Luckily I had already just received some new shoulder & related info
so as well as the good old Athletes shoulder book, secrets of the
shoulder DVD & optimal shoulder stuff that most of us consult when we
have issues, I've just got the new Eric Beard shoulder DVD set, David
Wicker stuff (not heard of him before, but supposedly good?), Chuck
Wolf - Functional shoulder integration I believe that one's called &
NIck Tuminello - Joint friendly training so as luck would have it I
can put into practice what I'll be learning on myself first!
So, that'll be my weekend sorted out I suppose....
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PostSubject: Re: Shoulder injury   Fri Mar 25, 2011 7:23 am

Ah how I took the health of my youth for granted!

Hope your shoulder feels better soon.
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PostSubject: Re: Shoulder injury   Tue May 31, 2011 1:42 am

I'd love to hear what you ended up doing (of the things you listed) and how it worked out as I have a torn rotator cuff as well.
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PostSubject: Re: Shoulder injury   Thu Jun 02, 2011 6:13 am

I never had a torn rotator cuff, it was an impingement - that is the tendons were thought to be inflamed (possibly frayed), but no separation.
If you haven't already & suspect a torn rotator cuff, go see a physical therapist or doctor as some tears need fairly quick surgery for best chance of recovery! (in all honest I've never seen a very successful surgery, but I only have a limited experience in this area, so they are probably out there,I've just not seen them).
Having said that here's what I did - again I must state I don't suggest you do this as every condition is different & some tears will contra-indicate some of this stuff (also bear in mind I was coming back from a shoulder AND back injury at the same time!):

Stage 1

Pain-free range of motion. Wall walking with fingers up & down the wall through PAIN-FREE range of motion only, both with arm in front & to the side, I also had daily ultrasound in the region. That was done several times a day until pain-free full range of motion was achieved both to the front & to the side.
On the nutrition side you need to think about anti-inflammatory foods & other nutrients, so:
Take EFA's every morning (flax seed, hemp ,walnuts or whatever ALA source you prefer), in the evening take DHA pills every evening (get DHA from algae, not fish sources)
Take 4-5 grams of vitamin C a day
Have a protein shake or 2 a day as you're repairing
Do not diet, diet is a stressor on the body, so is injury, combining both will not aid recovery, if you are mid-diet I'd switch to maintenance for the duration, then go back to dieting after recovery
Eat extra healthily, so plenty of green leafy veggies, less junk, as you need decent fuel to rebuild
Supplements that might help:
L-leucine or BCAAs as these promote muscle protein synthesis they may aid recovery
Cissus quadrangularis IMPORTANT - this is no good if you compete as it gives a false positive!!! If you don't compete then this may well speed healing - I have written a piece in the VBB blog about this plant here
Try to avoid fried foods (but don't starve yourself, if fried is all there is, then tuck in!)

Finally for stage 1 (& this goes throughout the rehab & beyond) - do not do anything that aggravates the injury.

Stage 2

Introduce self myofascial release (with foam roller & tennis ball) & stretching to the area. Also start with some easy rotator cuff exercises like L-flye, internal rotation. Work of range of motion.

Stage 3

Continue stage 2 stuff, but add in some push-up plus (sometimes called scapular push-up), also some light chest expander stuff (you an use resistance bands). Also introduce some massage, start them on breaking down the scar tissue & improve tissue quality in that area (this WILL hurt you!!!). Check for asymmetries in range of motion & work on balancing out those issues. I also included the plank & side plank into my training about here (I know they are supposed to be core training, but if you think about they tax the shoulder stabilisers quite a bit so are useful & also because they are static, there is little chance of injury)

Stage 4
Continue with the earlier exercises, but now it's time to take the FMS (functional movement screen) or similar assessment to see if you are ready to get back into training. The FMS itself is too much to go into in detail right here (check out here for more details), but basically you'll be looking at the shoulder test, the push-up test, some quadruped stuff & some of the rotational stuff. Basically you are looking for all round "2's" in your result. There may still be some asymmetries & you'll need to work on them. Assuming you got 2's in the FMS, then you'll probably be working on dumbbells for a while, as well as some serious static stretching. Also you will have developed compensations (shoulder sag when you lift for example) these will have to be corrected so a mirror &/or video is useful. Also more painful trips to the massage therapist (& painful daily home foam rolling).
Take your comeback slowly, & you know that weight you've chosen to lift for the first session - well make it lighter - start 'pink dumbbell' light. Better to start too light & slowly work up over a couple of months than start too heavy & re-injure!

That's basically what I did (am doing). I've just started stage 4. My FMS was at least 2's across the board (shaky 2's in some cases, but 2's nevertheless!). My first press was with an empty shrug bar

Here's a shrug bar - mine is a tandem grip (so it has a 2" handles under the 1" normal thickness grip) I use the 2" handles to press

Basically I've got add on bits that make the shrug bar 7 foot (Look like this ) & fit on a power rack, then I can get under it & press (so you press with a neutral grip with a neutral centre of gravity). I find it really comfortable & you can get a better range of motion than using dumbbells, but the bar follows a neutral pathway unlike a barbell that you have to wiggle around you face. But you can use dumbbells, resistance bands, kettlebell, medicine ball. I wouldn't use a machine as it's the stabilisers that have failed, so having a machine stabilise may not be the best idea. Start MUCH lighter than you plan to & go up slowly. Basically look to how strong you'll be in a year, not in 2 weeks! Take it slowly & plan a decent undulating intensity program & within a few years you'll be stronger than you ever have been!

At least that's my plan Cool Very Happy But as I said, if you haven't, do go & get checked out & the best person to sort out your issues is a good physical therapist with some experience of athletes (some PTs think 'fixed' is being about to lift a can of beans & stand up from the can without help! So make sure they know what you're after in terms of results & if they seem doubtful, go find another one as some really do aim low in terms of recovery!).
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