Shoulder pain specific to certain pressing movement.

[JL]

I have been having some shoulder pain when doing regular pushups, and easier forms of pike pushups. Harder variation of pike pushups (more vertical), aggravate it much less. Pushups with elbows tucked close by and hands closer to hips don't bother it, and wall handstands never hurt. For stretching, I have no pain when clasping my hands behind my back, yet if my palms are facing forward (ventral) , and I try to stretch my left shoulder backward, I get pain after my arm gets more behind my body. Never hurts to massage it. What the heck do I have? Is it just muscle imbalances and the joint out of position slightly?

Also, when I perform a butter fly cross motion without resistance I get a clunk in the shoulder when moving past 90 degrees.

[Joshua Naterman]

Where in the shoulder is the pain?

If you feel clicking when rising above 90 degrees then there is probably something bad going on with the AC joint.

There is probably quite a lot of inflammation in the joint, and you are probably weak in your external rotators. The shoulder pre-hab is very important!

For starters, shrugs will help. Incline, decline, dead hang shrugs, body row shrugs, push up shrugs, dip shrugs. Straight arms at all time. That'll help to re-educate your scapular muscles, but you'll also need to work on your entire rotator cuff with emphasis on the externals.

You should probably work on the shrugs first, and once you have your scapula moving better work on the external rotators. Your internal rotators, primarily the lats and chest, are quite possibly very tight, and are almost certainly stronger than your scapular retractors. Between the two, your shoulders are probably working in the wrong position, which is slowly causing you big problems. You'll need to stretch the chest and lats as WELL as working on scapula retractor strength and then your external rotators. Work supraspinatus too, even though it isn't an external rotator.

Don't expect this to resolve in a couple weeks, more like 4-6 months if you're smart. That's complete resolution, you may well feel better in 8 weeks but don't think you're actually healed. You'll have only gotten far along enough for symptoms to disappear, and if you try to go back to regular training you will relapse. Spend at least as long as it takes for the symptoms to go away still doing the rehab and focusing on unrelated muscle groups, once the pain is gone. THEN slowly work back into strength work for the upper body.

[Nic Scheelings]

Because u're getting pain on extension of the shoulder it sounds like it could be long head of bicep tendon that could be the problem. Any pain on shoulder flexion/elbow felxion? Tho obviously if it really worries u go see someone, in the meantime stabilize your shoulders.

[Cole Dano]

The shoulder joint is the most complicated joint in the body. With such a limited description its very difficult to accurately diagnose much less prescribe correctly.

At the very least we'd need to know more precisely where the pain and sounds are coming from. I'd really encourage you to do a Google on shoulder injuries, shoulder impingement, rotator cuff injuries, ac joint injuries etc and the general anatomy of the shoulder. This is all very readily available and for anyone who is self-training (i.e. anyone who needs to ask this kind of question on a forum) i believe its absolutely essential to know.

One thing for sure most of us have had shoulder problems at one time or another and are happy to discuss what we've done to help. Band work e.g.

Ido Portals scapular mobility and shoulder ROM protocols have been very helpful and you might see if they (armed with knowledge of how the shoulder functions) help you.

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If the pain persists, reoccurs you might also consider having it looked at by a qualified professional who will be able to help much more than the most dedicated and knowledgeable forum member. If your not sure about the diagnoses etc feel free to discuss it here as well.

But remember at the end of the day you are responsible for your own body. Your question here is just a first step in the healing process.

Slizz's and Demus vastly different replies point to the complexity of the subject and the different experiences we've had in this area.

[JL]

Where in the shoulder is the pain?

If you feel clicking when rising above 90 degrees then there is probably something bad going on with the AC joint.

There is probably quite a lot of inflammation in the joint, and you are probably weak in your external rotators. The shoulder pre-hab is very important!

For starters, shrugs will help. Incline, decline, dead hang shrugs, body row shrugs, push up shrugs, dip shrugs. Straight arms at all time. That'll help to re-educate your scapular muscles, but you'll also need to work on your entire rotator cuff with emphasis on the externals.

You should probably work on the shrugs first, and once you have your scapula moving better work on the external rotators. Your internal rotators, primarily the lats and chest, are quite possibly very tight, and are almost certainly stronger than your scapular retractors. Between the two, your shoulders are probably working in the wrong position, which is slowly causing you big problems. You'll need to stretch the chest and lats as WELL as working on scapula retractor strength and then your external rotators. Work supraspinatus too, even though it isn't an external rotator.

Don't expect this to resolve in a couple weeks, more like 4-6 months if you're smart. That's complete resolution, you may well feel better in 8 weeks but don't think you're actually healed. You'll have only gotten far along enough for symptoms to disappear, and if you try to go back to regular training you will relapse. Spend at least as long as it takes for the symptoms to go away still doing the rehab and focusing on unrelated muscle groups, once the pain is gone. THEN slowly work back into strength work for the upper body.

The clunk occurs when moving my arms down to my side, not on the way up. I think it is something tight. I stretch my lats after every pullups workout, so the chance of it being over tight lats is very low. When I stretch my arms behind my back it goes away for a few reps, but then reoccurs. That, without resistance, does not hurt. Now if I imitate an iron cross pull in the corner of a pool, it only hurts when the hands/arms are slightly more forward. If I retract the arms backwards, and then press down, I get no sensation doing that movement, feels good. With that, it seems like the joint is out of place.

[Tarun Suri]

Look to give yourself some slack. Stretch those lats. ART massages or simply using a lacrosse ball will help getting those hard spots. Get in there with your pec minors also. But more important that all of that if to reduce the inflammation. Consider that a priority before even doing stretches/exercises. Give yourself a 5 minute massage with an ice cube. That 5 minute massage will do amazing things for your shoulder, you have no idea.

This along with the others posts on this thread should be a great start to start seeing results. Get on that for at least a week and notice the difference.

[Joshua Naterman]

Flexible lats with a tight anterior chain (pecs, front delts, etc) will probably be a recipe for disaster since that will allow your shoulders to get pulled even further out of position by tight and strong pecs. Anterior capsule stretches will help.

Lie down on the floor on your right side, with your right arm behind your body, palm down. Retract the right shoulderblade and start rolling slowly to try and put your back on the ground. You will quickly reach a point where you feel an intense stretch. Stay there, and try to keep actively retracting the shoulder blade and trying to pull the arm behind you and flat against your back. That obviously will not happen, but by doing this you are firing the antagonistic muscles (Triceps, scap retractors, rear delts, etc) and that causes the agonist muscles (in this case, the front delts, bicep, pecs, etc) to relax, which makes the stretch more effective. You should hold these for a few minutes. There are three angles you should use: Arm at 45 degrees below shoulder (low); arm at 90 degrees (right angle with body)(mid); arm at 45 degrees above shoulder (high). Work low, mid, and high on each side of the body every day. This should be a part of your warm up.

You want to concentrate on pressing your arm pit into the ground the whole time in all three positions. That means you have to pull your shoulder out of the way! This is tough, but the stretch is less effective when you allow space between the arm pit and the floor. It is tough for me to just tough my arm pit in the high position, much less roll back!

Keep your head in line with your spine, which means you look in the exact same direction as your sternum is pointing. If your chest is pointing at the ground three feet in front of you, that's where your eyes go. If you twist the head you'll end up getting a sore neck AND doing the stretch wrong. When you twist your neck, the scalenes(some muscles n the side fo the neck) get stretched and they will cause your body to pull the shoulder a little bit forward reflexively! That is not what we want.

For warming up purposes, 10-15 seconds is plenty. For rehab like this, you need to go for 60s at least. It takes a long time for muscles to release. Do not try to PNF this. Try to use the antagonistic contractions to make it more effective.

[JL]

Flexible lats with a tight anterior chain (pecs, front delts, etc) will probably be a recipe for disaster since that will allow your shoulders to get pulled even further out of position by tight and strong pecs. Anterior capsule stretches will help.

Lie down on the floor on your right side, with your right arm behind your body, palm down. Retract the right shoulderblade and start rolling slowly to try and put your back on the ground. You will quickly reach a point where you feel an intense stretch. Stay there, and try to keep actively retracting the shoulder blade and trying to pull the arm behind you and flat against your back. That obviously will not happen, but by doing this you are firing the antagonistic muscles (Triceps, scap retractors, rear delts, etc) and that causes the agonist muscles (in this case, the front delts, bicep, pecs, etc) to relax, which makes the stretch more effective. You should hold these for a few minutes. There are three angles you should use: Arm at 45 degrees below shoulder (low); arm at 90 degrees (right angle with body)(mid); arm at 45 degrees above shoulder (high). Work low, mid, and high on each side of the body every day. This should be a part of your warm up.

You want to concentrate on pressing your arm pit into the ground the whole time in all three positions. That means you have to pull your shoulder out of the way! This is tough, but the stretch is less effective when you allow space between the arm pit and the floor. It is tough for me to just tough my arm pit in the high position, much less roll back!

Keep your head in line with your spine, which means you look in the exact same direction as your sternum is pointing. If your chest is pointing at the ground three feet in front of you, that's where your eyes go. If you twist the head you'll end up getting a sore neck AND doing the stretch wrong. When you twist your neck, the scalenes(some muscles n the side fo the neck) get stretched and they will cause your body to pull the shoulder a little bit forward reflexively! That is not what we want.

For warming up purposes, 10-15 seconds is plenty. For rehab like this, you need to go for 60s at least. It takes a long time for muscles to release. Do not try to PNF this. Try to use the antagonistic contractions to make it more effective.

Sounds good. I am starting to believe tight pecs are part of the problem at the very least. I performed this stretch today (http://www.thebalancedbeing.com/files/2074088/uploaded/stretching_pectorals.gif), and the left pectoral felt tighter than the right, and oddly, the left shoulder is the problem. I like the idea of your stretch because it is versatile and I can get a lot of leverage on the shoulder. The clunk I get is lessening already from stretching it out with other stretches.

[Joshua Naterman]

Yea, that's a less effective version of what I wrote. Those anterior capsule stretches have helped me a lot, and I haven't been very consistent at all! Between the stretching, the loaded end-range stretching, and the isometrics that I am starting to implement, I should be ship-shape in 3-6 months! Interestingly, this stuff has noticeably increased my handstand and other FSP ability. Just yesterday I walked 30 feet in a controlled fashion in my handstand! I haven't practiced that since the end of May, and I got about 10 feet at the seminar! I can also hold a 2-3 second one arm handstand, but obviously not super controlled. I'm a long way from training that.

Anyhow, I think those anterior capsule stretches will help. You should probably use isometric holds with scapular retraction for the top of the bulgarian row, chin up, pull up, and standing dumbbell shrug to help strengthen and re-awaken your pulling muscles. That will work well with the stretches to re-balance your shoulder. I'd suggest basic shrugging, but until you get your shoulder balanced you're better off focusing on muscle re-education. I'd go for 15-30s holds for each of those that I mentioned. Pretty short, but it will do the job quickly. A month of that 5-6 days a week along with the stretching should have you more than ready to start moving correctly and then you can throw in actual shrugging work for pre-hab. The great thing about the isometrics is that they don't require hardly any recovery, so you aren't going to have to worry about overtraining if you choose to try that protocol. If the rest of your work isn't bothering you, you probably don't need to stop training. Just stop doing what aggravates the shoulder for a few weeks!

For the inflammation, which is there whether there is pain or not, fish oil will help. 8-15g a day is a good dosing level. Start low and work your way high so you don't get the explosive diarrhea like Razz did when he decided to go from no fish oil to 15 or 20g lol! He said he didn't have any problems like that when he started with 10g and slowly worked up.

[Razz]

Spreading my fish oil out in doses of 5-7g also helped instead of 2x10g but yeah fishy diarrhea definately wasn't fun!

[Joshua Naterman]

That is seriously one of my favorite stories from this forum!

[Razz]

HAHA yeah and what is worse is that there are embarrasing parts of that story that I didn't even share :oops:

[Joshua Naterman]

WE MUST KNOW!!!!! :twisted: :twisted:

[Cole Dano]

Razz, can i ask why were you taking the oil? Was it for your shoulder? Do you feel that taking bigger doses helped reduce the inflammation?

My left shoulder is pretty sensitive to impingement which is flaring up again and wondering if i should start upping my dosage.

[Razz]

Yes it was meant for recovery, if it helped I can't remember because all I remember is the diarrhea

Oh and well slizzardman just to keep this somewhat on topic check my log for more fish oil stories