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Fix your shoulder pain!


Joshua Naterman
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Joshua Naterman

Ok guys, this is part 1 of at least a 3 part series I am working on. This video covers three versions of two stretches that will be used to help restore a healthy shoulder position.

This is not a complete rehab routine, but postural correction MUST be the first phase of rehab. If your posture is off, you will have less space in the shoulder socket and you will be contributing to the inflammation if you focus on something like external rotations or whatever else if you already have pain. I am not saying those are bad, but you must first correct shoulder position and get rid of excess inflammation. This video will help a lot with that. I have helped several of our members with this via private messaging and quite a few around town at the gyms.

By the time this series is finished it WILL be a fairly complete rehab routine complete with explanations on how each exercise affects the shoulder and what the purpose is within the context of rehab.

In the meantime, enjoy this video! I plan on having part two up by Friday.

gnAsnVNh0C0

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Joshua Naterman
Thank you Slizzardman, if we ever meet I'll buy you a beer, or two :mrgreen:

Done. :) Though I rarely drink because I would rather spend the money on random equipment projects or flowers for my girlfriend, I love Guinness, Newcastle, and anything from the Czech Republic. :D

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Joshua Naterman

I would like to thank Coach for showing us that stretch at the Seminar. It has helped me immensely. I was trying the wall stretches and they just sucked, I can't believe I never thought of using the floor on my own!

There is quite a long list of stretches that we went through and they are all wonderful, but this one I showed everyone needs to know. I call it two stretches because the palms up and palms down are so different in how they affect the body, but it's really just one stretch done with two hand positions and three arm positions. 1+2+3=6. 1*2*3=6. How mathematically beautiful and irrelevant!

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I call the positions, horizontal, diagonal up/diagonal down. However, after working my series of shoulder in/dis-locates with a stick, I find that stretching in those positions is as about as loose as it gets. This is for warmup, though.

If I wanted to get more flexibility, say holding 30-180s, it might be productive. I haven't tried yet.

As well, the bent arm 90-90 stretch is especially useful.

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Joshua Naterman

Yes, bent arm is good once the shoulder is closer to neutral and inflammation is down some. I admit, I take a somewhat cautious approach to shoulder issues because I find that trying to move too quickly just doesn't work well.

Obviously anyone with healthy or at least asymptomatic shoulders is going to benefit from the full program right away and won't need to take much time to implement the whole thing.

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Gavin Strelitz

Thanks Slizzardman,

If you ever make it to Sydney there is a Guinness waiting for you.

Scapular retraction has become a focus for me and these streches will help alot. Looking forward to the next clip.

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I tried the part 1 stretches last night at the gym and I was shocked at the feelings I encountered. I consider myself fairly flexible but there is something in your methodology that is different to what I have done previously. Specifically, in yoga there is a similar stretch but it always emphasized coming up onto the outer edge of the shoulder and clasping the hands behind the back. More of a "chest opener". If I am understanding your video correctly you want us to keep the front of the shoulder planted on the ground while rotating the torso up which showed I still have some opening to do.

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Joshua Naterman

Yes. The ball of the humerus will move somewhat towards the middle/back of the shoulder socket as a part of the stretch. You won't be moving all the way back, but simply rotating the ball of the humerus in the socket can not fully correct improper position. That's part of why all the other stretches can not fully correct these issues by themselves! EVERYTHING has a purpose, but when many things have a similar purpose something is being missed. Certain variations of this stretch that are shown just takes care of one of those things that is being missed, specifically resetting the position of the actual ball of the humerus to its correct position in the middle of the socket.

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Nic Scheelings

Bit down on physio's in this post Slizz, i'm not sure if i should be offended (being a physio student) :).

I do like the stretches tho, gave em a go and definitely felt good.

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Archbishop o balance

Cheerio, folks!

Good post, Slizzardman. I love that you adress the problem of forward rolled shoulders and poor posture in general, which is something I see with pretty much everyone at my local gym these days. Poor posture is almost an epidemic. I just realized the importance of correct posture myself a few months ago and started implementing some corrective work in my training schedule. Though it can be a long journey after years of maltraining it is definitely worth the effort!

Don't mean to nag, but what do you think of wall extensions as part of a trap activation routine?

Can't wait to see what you have in store for you next video! Great stuff!

-Oliver

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Joshua Naterman

Sorry Demus! The truth is that I talk to people who are PTs or in PT school on a regular basis and they don't think this way. It's not that the knowledge isn't there, it's that the approach to the problem is not holistic in terms of shoulder health! I believe that this is changing, but there is still a long way to go. I hope that you and I will represent the generation that takes a step forward in this respect!

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Good stuff slizzardman looking forward to seeing the rest.

As for PTs this highly varies from PT to PT. I know some people that are powerlifters and strongman competitors that are PTs, those guys help a ton of athletes and their protocol wouldn't differ much from slizzardman's suggestions plus fixing imbalances and so on. But if you go to a PT that primarily works with the older crowd and only once in a while sees athletes you'll get pretty crappy advice. I've been on the receiving end of the latter myself and struggled with shoulder pain for a year straight until I did my own research.

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Sorry Demus! The truth is that I talk to people who are PTs or in PT school on a regular basis and they don't think this way. It's not that the knowledge isn't there, it's that the approach to the problem is not holistic in terms of shoulder health! I believe that this is changing, but there is still a long way to go. I hope that you and I will represent the generation that takes a step forward in this respect!

I see it all the time too. In fact its just crazy, i have for example a student who had shoulder surgery 11 years ago, they just got the arm to move somewhat, and then sent him on his way. He been afraid to lift his arm over head for 11 years! This is a fairly young guy.

The thing is in just a couple of months, getting him doing what is basically what we call Ido's band routine and helping him with getting his scapula to move right, i'm sure pretty much the same as Slizz will show in the next video, his range of motion is now normal and the guy.

The thing is i've just done allot of research but am in no way a medically certified person. So its a shame that its down to someone like me to actually get folks like this functional again.

I do think that there needs to be a second tier of physical therapy that addresses the movement problems, and gets people all the way well after being released from the trained PTs immediate care.

Now its falling on folks like me and Slizz, which though great for my ego, maybe isn't the best possible situation.

Of course i suppose allot will always depend on how much money one has to throw at the problem.

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I've been dealing with chronic shoulder/back/arm pain for about a year and recently Slizzardman gave me some very great advice. I'm positive that this will help me to finally resolve this issue.

Thank you very much for everything! I really appreciate it.

I'm looking forward to the next videos as well!

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Joshua Naterman

Very true. This kind of approach is gaining momentum in the community, I'm certainly not the first to come up with any of this.

Poor posture is a massive epidemic and you don't realize it until you start taking a look at everyone with musculoskeletal dysfunctions on your mind. Read through Pain Free and then start watching people. You will start seeing all sorts of little things!

If I am actually talking down at anyone, it would be the AMA. Advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses, whether you are AMA or not. Source: Berlant, Jeffrey (1975). Profession and Monopoly: a study of medicine in the United States and Great Britain. University of California Press. ISBN 0520027345. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1081816 You can not try to get people to come to you if you are a progressive physician by pointing out the deficiencies in the practice of other physicians. The AMA controls the codes that determine whether or not treatments are paid by insurance. These codes are not public domain. You can look up a limited number of codes but can not get detailed information on them without paying a licensing fee. Is that nuts or what? You can't even look up what the hell the legal requirements for billing are without paying?! The AMA certainly serves a purpose as a governing body, but looking at what they approve and what they do not, and where their attention goes they are only interested in treatments that make substantial profits for doctors. That, my friends, is not ethical and is a massive problem that there seems to be no solution for. Money trumps our health.

It falls to US, those who are interested in doing what is best for people and not what is best for our wallet (It's not like we're going to be poor you know!), to start raising awareness of these issues and bringing them to the national stage. The media is how we will change these regulations to be more patient-oriented. What the media pays attention to, the voting public pays attention to, and what they pay attention to is what gets legislated. The media does, in a large and direct way, influence what our public policy is, and this is supported by decades of research. Just look at the "war on drugs." During the years of media attention the statistics showed that drug use in America was DROPPING. This is BEFORE the "war on drugs" got officially mandated and funded! As media coverage waned, so did public interest. As media focused more on the issue of anti-drug campaign funding so did the public! Eventually we got a money pit that is well known as the "war on drugs." Why not start using the same mechanism to enact positive change?

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Hey Slizzardman- great video, I'm looking forward to the next parts. I'm curious- when you retract the scapulae during pull ups, do you arch your back and pull to the sternum? Whenever I've heard about scapular retraction during pull ups, its always included with the extended range of motion of pulling to the sternum.

Mr. Brady also taught me to keep my shoulders depressed during pull ups. I should do that, but keep my shoulders elevated in vertical pressing, right? It seems that a rule of thumb might be to neutralize shoulder position by opposing whatever force is acting on it. When I think of it, the same might apply to horizontal pressing/pulling and scapular protraction/retraction

I actually bought pain free at your suggestion a few months ago. I've read through most of the chapters, but its confusing exactly how I should implement the routines. I've had occasional shoulder issues and pain in my thoracic spine. I can't really identify a dysfunction or misalignment, which is what the "E-cises" seem to be focused on. Do you think I would benefit from the shoulder routine without having immediate pain or dysfunction? I think I might read through all of the chapters to get a better understanding of them

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Joshua Naterman

Absolutely on all counts. You will definitely benefit from part 1 almost no matter what, but if you don't see anything specific wrong just do part 1 of this (until I get more up) and the maintenance routine from Pain Free! It's in the back I think. You definitely want to read straight through the book, you get a much more complete understanding that way.

Pull ups: You don't have to arch your back, but it often helps to arch very slightly and look up slightly. Just remember, the arch is in the thoracic spine and not the lumbar. You will always start with an extended shoulder dead hang, but the very first part of the ROM is pulling the arms back down by retracting (somewhat) and depressing(a lot) the scapulae. Very important, that is. This will take conscious effort for a while.

Overhead pressing: At the very bottom of the rep, which should be bar on the upper back or collarbone, your shoulders should be fairly well depressed. That's natural, you can't touch a bar to your collarbones if your shoulders if they are shrugged way up! However, as you start to push up your shoulders will start to elevate. This will continue steadily as you press up until the shoulders are extended at the top of the rep. Just let this happen naturally, don't try to control it too much.

If you're doing HeSPU you will never have fully depressed shoulders as you are not going all the way down, just have the shoulders elevate and depress naturally. You will probably always be slightly elevated. In full ROM HSPU your shoulders will depress to a more neutral elevation at the bottom, but again that will happen naturally. The biggest thing is to consciously press away from your body at the top!

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Pull ups: You don't have to arch your back, but it often helps to arch very slightly and look up slightly. Just remember, the arch is in the thoracic spine and not the lumbar. You will always start with an extended shoulder dead hang, but the very first part of the ROM is pulling the arms back down by retracting (somewhat) and depressing(a lot) the scapulae. Very important, that is. This will take conscious effort for a while.

Overhead pressing: At the very bottom of the rep, which should be bar on the upper back or collarbone, your shoulders should be fairly well depressed. That's natural, you can't touch a bar to your collarbones if your shoulders if they are shrugged way up! However, as you start to push up your shoulders will start to elevate. This will continue steadily as you press up until the shoulders are extended at the top of the rep. Just let this happen naturally, don't try to control it too much.

Feels weird reading this,

a while back i began chinning in a similar way, "shoulder baldes down" as i used to call it,then pull from the upper arm. My only real reason for doing so was that it seemed to fatigue my biceps less and i could do more chins.Like-wise with the HeSPU i felt i was missing out on alot of ROM , so i started pressing with a barbell really focusing on full ROM.Whether it's helped my shoulders i'm not sure,but my upper back has developed more in the last few weeks then it had in about the last 2 years of seemingly similar exercises.

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Joshua Naterman
Pull ups: You don't have to arch your back, but it often helps to arch very slightly and look up slightly. Just remember, the arch is in the thoracic spine and not the lumbar. You will always start with an extended shoulder dead hang, but the very first part of the ROM is pulling the arms back down by retracting (somewhat) and depressing(a lot) the scapulae. Very important, that is. This will take conscious effort for a while.

Overhead pressing: At the very bottom of the rep, which should be bar on the upper back or collarbone, your shoulders should be fairly well depressed. That's natural, you can't touch a bar to your collarbones if your shoulders if they are shrugged way up! However, as you start to push up your shoulders will start to elevate. This will continue steadily as you press up until the shoulders are extended at the top of the rep. Just let this happen naturally, don't try to control it too much.

Feels weird reading this,

a while back i began chinning in a similar way, "shoulder baldes down" as i used to call it,then pull from the upper arm. My only real reason for doing so was that it seemed to fatigue my biceps less and i could do more chins.Like-wise with the HeSPU i felt i was missing out on alot of ROM , so i started pressing with a barbell really focusing on full ROM.Whether it's helped my shoulders i'm not sure,but my upper back has developed more in the last few weeks then it had in about the last 2 years of seemingly similar exercises.

HeSPU together with barbell work for the lower portion of the ROM is, in my opinion, excellent and certainly is helping me a lot. You definitely want a very, very well developed upper and mid back. If it attaches to the scapula, you want it to be as strong as you can get it, so long as it doesn't unbalance the shoulder joint! As long as that goal is pursued equally in all muscles you should be better than ever! Just like we only focus super hard on HS work once every 7-10 days you really only need to do the full ROM shoulder presses in the same time frame, preferably between HS workouts in my opinion. Of course you could do more, and the ideal thing to do would be assisted full ROM HSPU, but given most peoples' limited access to such things I think that working at least from the collarbones to just above the head for shoulder presses is an excellent idea. If it is an area of particular weakness for you, you should probably work that a little more often but don't go nuts, there's lots of pressing in the WODs that helps too!

As far as general shoulder health, strength in the retractors and flexibility of the anterior shoulder girdle is a bit more important than the depressors, which are primarily what is working in the pull up. Still, pulling up as you describe has probably had some amount of protective effect for you.

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That was an excellent vid, and some great stretches. I have found that this is an area of primary focus for me for the foreseeable future.

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Joshua Naterman

It should be for everyone here, since we are a very shoulder-girdle centered community!

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  • 4 weeks later...
Archbishop o balance

Hey, Slizzardman =)

Whatever happened to the the rest of the shoulder re/prehab series? I've been checking in daily for part 2 ever since you posted the first one, and I'm sure I'm not the only one!

This forum truly is a plethora of invaluable information! Many thanks to all you who contribute to our journey of physical exploration.

-Oliver-

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