Shoulder issues (again?!)

So, where to start? I've been down this road time and again and as frustrating as it is has been to keep coming back to square one, I hope I'm eventually going to get closer to figuring out the issue so that I can craft and put into practice a more exact solution.

The problem(s):

- nonexistent upper thoracic mobility

- Tight (read: very tight) pec minors

- Tight rear shoulders (I hesitate to say lats, but very well may just be tight lats) in RC/PE2>im--the shoulder into which I lean feels an intense stretch and not at all on the opposing lat muscle

Current reason for posting:

- HS/PE1>im exhibits serious issues with consistent flexibility/mobility. My performance with this element has gotten me to mastery form and in passing form checks three times now but the ease of the movement shows to be about as consistent progress and success as pin the tail on the donkey. Some days 5lbs at +1-1.5hands shoulder width distance is easy as pie; today, +2 hands shoulder width distance with 3.75lbs was darned near impossible to do easily (read: pain-free)

- The anterior deltoid felt sharp, shooting pain (which is why I went further and further out with the hands until it was no longer 'unbearable', though how it still wasn't 'easy').

- HS/PE2>im requires more strength and flexibility. I can get into the end range of motion if my palms/hands are supported, however doing so with 2.5lbs standing upright requires extensive flexing of the triceps, noticeable forward flexion of my neck, and flexing of the lats in order to ably retract my lats to keep the elbows down while the arms go up.

- SSE from TBs has me seated almost upright. I've begun (since starting PT) to focus more greatly on engaging the thoracic back on SSE and table (FL/PE2), but am unsure to what extent it has or will improve shoulder extension

- Oddly enough, HS/PE1 and PE2 aren't hard for me and I can do both for full sets and time with ease at this point, which indicates that the issue may be one of mobility and not strength, at least not in the areas I can notice.

Things I'm currently incorporating either every day or after my HS workouts to slowly (read: very slowly) improve my shoulder mobility:

- HBP/PE15>im for sets of 30", everyday (moderate stretch)

- RC/PE2>im for sets of 30", everyday (moderate stretch)

- Capsule stretch for sets of 30", everyday (to balance the pec minor stretching) after HBP/PE15>im

- Sleeper Stretch for sets of 30", everyday

After my HS workouts

- Dislocates and inlocates x10 -- as per Coach's suggestion (with just the dowel and a very wide grip until this becomes easier and I can bring my hands in)

- Wall extensions with knees bent (to help with ensuring full contact with the wall) x8 -- as per Coach's suggestion is his essay on the exercise (with arms just below 90 degrees to just about 90, given my nonexistent mobility, my arms only move minimally and that's hard enough)

PT exercises I'm performing 2-3 days a week:

- 3x20 (w2-2.5lbs) standing Chest flies

- 3x20 (w/2-2.5lbs) standing rear delt flies

- 3x20 (w/2-2.5lbs) lat pulldowns

- 3x20 (w/1-2lbs) Side lying lateral shoulder adductions

- 3x20 (w/1-2lbs) side lying front to lateral adductions

- Midback extensions on foam roller (~2')

- Pec minor stretch on foam roller (~2')

I also incorporate TBs, and did it yesterday with focus on having the stretches 'stretch' but to not be overly intense and to also try and localize most of the stretch to be felt in the upper back and not the elbows and lower back. Doing it this way felt really good. Never the less, after the fact my shoulders were in need of some more stretching (and so I did a couple rounds of the stretches I explained above).

As can be seen this is a lot of different things to be involved for my shoulders, so maybe cutting back would be good -- yet, that only leads to stiffness as I'm bound to a desk for most of the day with school. So, my question in all of this is what are people's objective thoughts and observations on what to work on or where to best put my focus. I'm plugging and playing higher elements, I'm seeing a PT, I'm doing rehab/prehab work, yet still the beginning >im is not pain-free, not consistently. Is there a regression for this element?

TL;DR: my shoulders hurt, I'm doing all the preventative things I can think of (looked to later foundation elements and mobilities; seen a PT; focused on the areas that have been shown to be overly stiff/tight) and have effectively localized where I'm tight but certain elements are still quite painful and others quite difficult. So, I'm looking to see if given my insights if any people know of certain stretches or regressions that can better address my shoulder deficiencies for flexion (pain-free mobility) and extension (more moderate levels of exertion to reach full ROM)

Daniel,

You have a plethora of options and I recommend honing in on a few. 

Right now, I would like to focus on quality warm up;  healing blood flow to the region, without pain.  How is your warm up?

Hi

youve been dealing with this for a long time now. Seems like you take one step fed and two steps back. All the stuff you're doing sounds like it would be helpful but maybe it's just too much right now.I'm assuming you ruled out any structural damage like a tear, if not maybe you should just get checked out to rule that out. I was in a similar boat as you with my shoulder but what finally helped was first going to see an ART practioner. He was really able to work on all the tight spots and breaking up all the junk I had going on with my tissues. That helped a great deal but along with that I cut foundation back to one day a week and even dropped to regressions to pe/1 in a few exercises. The rest of the week I do basic movement type exercise like rolling,rocking, crawling neck nods. This stuff is also good to do in between your computer work. I don't have movement 1 but sounds like that stuff is in there. I also do some hanging on stall bars and some of the beginning exercises in the TB series. All this has gently strengthen and mobilized my shoulder while giving it time to heal. My shoulder pain is pretty much gone and I've been starting to actually make some progress( by progress I mean at least not getting injured) in foundation after years of struggling and getting injured. Hope this helps. 

2 hours ago, Ryan Bailey said:

Daniel,

You have a plethora of options and I recommend honing in on a few. 

Right now, I would like to focus on quality warm up;  healing blood flow to the region, without pain.  How is your warm up?

 

My foundation warmup is as follows:

- 5 minutes of jumping rope

- 10 minutes of warmup exercises (21/15/9 set up of previously mastered elements)

My handstand warmup is as follows:

- 5 minutes of jumping rope

- Stretching/mobilizing HBP/PE15>im 30 seconds; RC/PE2>im 30 seconds, sleeper stretch 30 seconds; dead hangs from a make-shift stall bar situation (I use a smith machine and hang atop it while using the bar to keep my upper back in place)

1 hour ago, PhilipP said:

Hi

youve been dealing with this for a long time now. Seems like you take one step fed and two steps back. All the stuff you're doing sounds like it would be helpful but maybe it's just too much right now.I'm assuming you ruled out any structural damage like a tear, if not maybe you should just get checked out to rule that out. I was in a similar boat as you with my shoulder but what finally helped was first going to see an ART practioner. He was really able to work on all the tight spots and breaking up all the junk I had going on with my tissues. That helped a great deal but along with that I cut foundation back to one day a week and even dropped to regressions to pe/1 in a few exercises. The rest of the week I do basic movement type exercise like rolling,rocking, crawling neck nods. This stuff is also good to do in between your computer work. I don't have movement 1 but sounds like that stuff is in there. I also do some hanging on stall bars and some of the beginning exercises in the TB series. All this has gently strengthen and mobilized my shoulder while giving it time to heal. My shoulder pain is pretty much gone and I've been starting to actually make some progress( by progress I mean at least not getting injured) in foundation after years of struggling and getting injured. Hope this helps. 

I've been seeing a PT at NYU, where I'm a grad student. Their diagnosis was that my rotator cuff was in fact quite strong and that no structural tears or damage have occurred (at most it feels quite sore or similar to "impingement") but that because of seriously lacking strength and mobility in my upper back and thoracic it ends up putting undue pressure on the front of my chest (thanks to desk patrol--which I cannot do anything to lessen these days). What I've found is when I'm doing HS/PE1>im on days where I may feel stiffer/not as limber (namely on days after I've done TBs) I feel pain in the anterior deltoid to the point where lifting my arms overhead is almost impossible. This occurrence happens fairly consistently. 

So, I'm fairly resigned to continuing with my stretching/strengthening protocol. I'm not sure how best to gain consistent progress. But time will tell I suppose. My strength in the HS work surely isn't the issue as the first two PE's aren't difficult at this point...

glad to hear there are no tears. Does your PT do any manual therapy work? For me this really was the key to getting on the road to being pain free. Wasn't the total solution but helped immensly. Doing the lacrosse ball stuff on my own didn't cut it like seeing a professional. You say your resigned to continuing with your stretching/ strengthening protocol but this protocol is causing you impingement pain. Even though all the exercises you are doing should be excellent mobility exercises,How can you expect consistent progress if what you're doing is causing you pain? You really should just take a step back and give your shoulder a rest. Just keep the movements that never cause pain and try and do these movements to break up your desk patrol. If you can try to do your computer work in as many different positions as possible that can also help. Sit on the floor, lay on the floor, sit in a squat with the computer on a low desk. Stand up. Just keep moving. I also find simple neck nods and segmental rolling which you can google freed up my shoulders and neck. 

Thanks. You are also correct. The things that honestly cause my pain are the overhead flexion -- not HBP/PE2>im, but when I have to do them together as in HS/PE1>im. The below link, along with wall extensions done supine seemed to really target what I'm affected by, which appear to be overworking pulling muscles (that have become tight and lacking flexibility)in my shoulders and upper back and underworking pushing muscles (that have become weak and unable to counteract the bad positioning/tightness of the rear of my shoulder and upper back).

I'm likely to delete this post as I realize that doing the mobilities in the below link and also supine wall extensions (read with no weight beyond my arms) was hard and definitely exposed my weakness in trying to get my arms overhead -- my lats don't want that happening at the present moment. I think I'm going to curtail my specific handstand mobilities until I can shore up this issue by doing more unweighted mobility and stretching for the upper back and chest until all this madness loosens itself up. 

So, in sum, what I intend to work on after thinking about it more:

- Supine wall extensions for 10 reps

- Rocking Cat stretches for 10 (with a pull-up and chin-up/dorsal grip) reps

- Supine raises with bent arms for 10 reps

- Standing arm raises from a bent arm position 10 reps

- Standing arm raises from arms parallel to the ground 10 reps

- Standing arm raises 10 reps

- RC/PE2>im 30 seconds

- HBP/PE15>im 30 seconds

http://b-reddy.org/2013/09/05/a-progression-to-lifting-your-arms-overhead-pain-free/

I'll likely also include dislocates/inlocates as a cooldown after F7 days for 10 reps with 2.5lbs (and a very wide grip); as well as the PT exercises I mentioned in my first post. I hate to sound frantic but thinking through it all and not knowing from where to best attack this issue that's been plaguing me it causes a feeling of being overwhelmed. Hopefully taking this conservative approach will warrant some progress in a few months time. We'll see....

A few weeks on and supine wall extensions, dislocates, bridge work, dead hangs,perpendicular lat stretches, and twist holds have seriously helped my shoulders. Just yesterday in my self-crafted PT session, I could neary get my arms fully overhead with proper ROM in supine wall extensions (this coming from after a month of work, where upon starting 90 degrees was quite intense). My ROM with dislocates also hasn't improved much but the quality and form of each rep has and now even with wide grip there's little discomfort or noisiniess in the shoulder. Minor progress, but still progress. The handstand mobilites disposition me to impingement so I have to be careful, but it is coming along. I've found what works and am just staying the ocurse. 

Some days they are still sore but this is most commonly due to sleeping on my side which tightens up my chest and after waking up a bit that usually subsides. My lats are still quite tight and RC/PE2>im is a mother trucker. Little by little...