Injury and recovery advice needed

Before Christmas I had a little tendinitis. During the holidays, just as I was getting rid of this I got myself my first real injury (from training, that is). I blew my right shoulder. At first I rested it a little and stopped doing presses. I suspect the HeSPU. Before this I have had some minor injuries, without any long term issues, so I wasn't overly concerned. There was however no improvement, so decided to cut back even more. This didn't help either. So I went to the doctor, who sent me to see a physiotherapist.

After consulting the physiotherapist this is where the case stands:

I have an inflammation in the biceps tendon, right shoulder. The reason I got the injury in the first place is bad posture, or rather imbalance in my muscles. My shoulder blades tend to "wing". Which apparently has to do with a muscle-chain of m. serratus anterior and the rhomboids. Also the lower third of m. trapezius is under-developed in comparison to the rest of the trapezius. Also my front side is stronger than the back, "pulling" the shoulder forward.

I reckon I have always had a bad posture. I have built my strength in this non-optimal posture, which is now causing me a lot of problems. I have been given exercises, which I follow religiously, progress is however non-existent. One problem is that I have great difficulty controlling and retracting the shoulder blades, and I end up engaging the pectoralis which should be relaxed.

Apart from some incline sit-ups I haven't done any upper body work for the past couple of months. Even core work is out of the question, due to the need for shoulder tension. So basically I am reduced to exercising my legs. Also the outlook isn't exactly great, at this point I haven't had a decent work-out for 3½ months and the future looks equally grim.

Immediate action: How to get back control over these overlooked muscles? How to defeat that inflammation?

Long term action: How to get into muscular balance? How will this interfere with choice of exercise,s program, volume etc?

Any help would be appreciated.

What i did while having a shoulder injury was basically lots of squats and then had to rest my upper body. I worked my healthy side for a while but i'm not sure whether or not i'd recommend this. Also remember you can still do hyper extensions which is a great exercise.

nutrition wise fish oil may help the inflammation.

hope it gets better

Little general shoulder rehab for imbalance/posture related pain/dysfunction

Upper body posture, shoulder imbalance pain

Best thing you can do is focus on posture. Hold your shoulders back, retract the scapulas, chest up and out, chin tucked back. Do this all the time. Yes, you will be sore but your body will adapt correctly within a week most of the time.

1. Drop all pressing movements

2. Do lots of horizontal pulling (rowing.... except NOT upright rows)

3. Strengthen ONLY your external rotators... ignore internal rotators

4. foam roll thoracic spine

5. Ice after any exercise/swelling

6. Band dislocates & wall slides (youtube these)

7. Lots of massage/tennis balling/etc. from the scapulae to the anterior shoulders.

8. Stretch chest and lats. A LOT. Use a basketball to roll out your chest, especially the pec minor as well. If you can't get it well use your hands to massage.

9. Fish oil for anti-inflammatory, joint supps if you need any (sections 4&5 describe these here):

http://www.eatmoveimprove.com/2009/08/on-tendonitis/

9. Do nerve glides wfs

http://www.handhealthresources.com/Solutions%20Pages/Exercises.htm

10. Deep tissue massage to everything in your upper body. And by everything I mean EVERYTHING. Down into the forearms as well.

11. Correct your posture!!!!!!!

12. For serratus anterior specifically you want to add in scapular pushups or other protraction exercises such as serratus punches.

13. LYTP's will also be recommended as well.

http://davedraper.com/blog/2009/07/22/s ... ome-lytps/

Fryk,

I'm sorry to hear about your troubles and pain and I hope you work your way through it.

To supplement Steven's suggestion on strengthening external rotators and scap retractors, perhaps you might accompany this with Trap 3 and Powell Raises?

They're isolation exercises but you can scale them way down with light dumb-bells (i.e. starting with 5#x3x7-9 for sets for functional hypertrophy).

Due to the general imbalance in many people, I believe Poliquin has joked about starting people out on Trap 3 Raises with TV remote controls ... with no batteries.

best of luck,

jason

Thanks for the advice, much appreciated. The fish oil is a easy fix. What would the daily dosage for this purpose be? 10-15g?

I have been working on my posture constantly for the past weeks. I do think it has improved, but there's still some ground to cover.

The exercises suggested is post-inflammation? Or which is and which is not?

Having been at this point for some time I am not interested in aggravating the injury further by trying too much, too hard.

Long term perspective: Which exercises and skills should be removed from a training regime, and which should be promoted? I was thinking that BL and PL isn't exactly helping me out. I have been wondering if this imbalance could have hindered progress in the past in certain skills and exercises?

Fryk, things to be promoted.

- horizontal pullups or inverted pullups/body curls. You can also just do shrugs in these positions.

- shrugs. rotate your shoulders in circles (with them hanging at your sides) forward and backwards.

- if your pecs are very tight, german hang/seated shoulder extension is a good idea. Sit on your butt in a pike/L. Reach your hands as far back behind you as you can and attempt to walk your feet forward so your upper back gets closer to the floor.

- Yoga Cat and Cow's/Camel. In a pushup position (on your knees) push your shoulders into the air so they round like a cat when it's mad. Then shrug your shoulders so they sag. Do a lot of repetitions. I'm sure you could do these on your feet in a pushup position too.

Stephen, you know my love of the cuban press. I was looking at the "LYTP's" and noticed they pass through a similar plane of motion. Also when we do arch rockers, we simulate a rearward rings swing so we turn our arms out. Does this go through a similar ROM though the arms are straight, not bent?

- Take a baseball and roll out your pecs where they attach to the shoulders while lying on your back. Lacrosse ball works too. For more pain/stretch, lay so your face is at the ground with the baseball in the same area. Bend your knees and let them touch the ground at first.

Fryk by the way I know bodylab.dk sells fishoil from norwegian sardines (i think it is) and i trust their fish oil to be more clean than the supermarket ones.. besides it's pretty much the same price

Razz said:

Fryk by the way I know bodylab.dk sells fishoil from norwegian sardines (i think it is) and i trust their fish oil to be more clean than the supermarket ones.. besides it's pretty much the same price

Razz, you're quite fond of bodylab, one might think you had stocks in them ... I suppose we all have our favorite stores.

For me it is all about value, and I have found that particular store to be to pricey.

On the subject of fish oil: I have started eating 9-10 capsules a day. Content of one capsule: 500mg fish oil, omega 3: 175mg, DHA: 60mg, EPA: 90mg. These are just cheap store bought fish oil capsules until I can get some bulk. What dosage is dosage for anti-inflammatory?

I tried a few of the exercises.

The Trap3 with a light dumbbell turned out to agitate the shoulder, so I have to look into that when the shoulder is better. I reckon the Powell raises will have similar effect.

I don't quite get the ball stretch exercises, is there any links for these?

Whenever my arm was hurting, I couldn't squat. It hurt my arm to have my hand hold the bar. Apparently that was bicep tendonitis in play

I did seated leg press though.

braindx said:

http://davedraper.com/blog/2009/07/22/shoulder-ytwls-become-lytps/

wow theres some really good articles under rehab and recovery on this site.

Seiji said:

Whenever my arm was hurting, I couldn't squat. It hurt my arm to have my hand hold the bar. Apparently that was bicep tendonitis in play

I did seated leg press though.

I have had similar issues with the squat. I gave up squatting some time ago (years), because I couldn't place the bar properly, which gave me elbow pain. In hindsight this should have been a clue that somethings was wrong.

The outlook for me at this point is somewhat grim. I am fantasisying about what I'll do once I have gotten rid of the injury, or rather if. Basically I imagine that the progress I have made in gymnastics will have disappeared. Also the progress I did make was mostly in exercises lending them selves toward pressing, which is now a distant land alltogether.

Your progress will come back faster than the first time you made it, don't worry. As for squats, do front squats if you can't do back squats, and do deadlifts if you can't do anything else.

If you can go ass to ground on squats that's great. If you can't, work down to it with stretches and BW only work, and then slowly add weight until you can do your regular workout weight with the full ROM. The full ROM builds far greater hip stability and strength.

slizzardman said:

Your progress will come back faster than the first time you made it, don't worry. As for squats, do front squats if you can't do back squats, and do deadlifts if you can't do anything else.

If you can go ass to ground on squats that's great. If you can't, work down to it with stretches and BW only work, and then slowly add weight until you can do your regular workout weight with the full ROM. The full ROM builds far greater hip stability and strength.

I haven't had any issues concerning ROM for the squat, ass to the ground with-out problems. The reason why I gave up squatting was because of the I couldn't place the bar properly on my neck / shoulders. Perhaps due to shoulder inflexibilty, tight pecs and what not. Front squats was even more problematic. I would like to do squats again at some point, but with out good form it is a very easy way to get injured.

Besides I don't have access to free weights at the moment, so no squatting or dead lifting. Squatting would have been a good idea if I could do it properly. Also I think it would be stupid for me to dead lift hundreds of kilos at the moment. I can barely lift my school bag with out aggravating my tendon, I don't want to imagine what a heavy dead lift would do.

Wow. That sounds bad!