Shoulder rehab in the Denver area

kit laughlin said:

@ phrak: I live in Australia, but come to the U.S. once or twice a year, both to attend workshops (like Coach Sommer's, this year in AZ) and to present my own work.

@ Joshua: thank you for your kind remarks. If there's interest, I will expand on the rotator cuff strengthening aspects, too.

That would be awesome. Would love to hear what you do.

I was very interested in the low frequency, because for some reason I have noticed better progress when I have rest days between any kind of serious efforts and sometimes even between trying to do rehab movements at all where my faulty recruitment patterns are concerned. To some extent this is just because the muscles and nerve pathways are fatigued, but I was wondering why you have settled on 1-2x per week. I am very curious about this!

Joshua Naterman said:

kit laughlin said:

@ phrak: I live in Australia, but come to the U.S. once or twice a year, both to attend workshops (like Coach Sommer's, this year in AZ) and to present my own work.

@ Joshua: thank you for your kind remarks. If there's interest, I will expand on the rotator cuff strengthening aspects, too.

That would be awesome. Would love to hear what you do.

I was very interested in the low frequency, because for some reason I have noticed better progress when I have rest days between any kind of serious efforts and sometimes even between trying to do rehab movements at all where my faulty recruitment patterns are concerned. To some extent this is just because the muscles and nerve pathways are fatigued, but I was wondering why you have settled on 1-2x per week. I am very curious about this!

The explanation I remember Kit giving was that super-compensation for the stretching occurs a week after the event. Therefore additional work does nothing to speed up progress. It's about 8-12 weeks of the stretching to "own" it and have your body recognize this as the new normal ROM. What's neat about Kit's approach is that the stretches self select the limiting factor to flexibility. The first time I had this sort of stretching done by a friend and certified teacher of Kit's P&F, I was amazed at how the myofascial tissue had a release identical to structural integration work. I've been doing his exercises faithfully for about seven months every week and I am drastically more flexible than the last seminar.

I've already discussed folding Kit's responses into a blog article, so in the future it will all be in one place.

An update: I had an MRI done last Thursday, and just got back from the orthopedic where he looked over it explaining to me what was what. My problem isn't due to impingement, imbalanced development or kyphosis, but instead a tear in the labrum. When doing pulling motions the tension on the long head of the biceps tendon pulls on this labrum and aggravates the tissue, and when doing pushing motions ball of the humerus presses into the shoulder socket cushioned by the labrum, also aggravating the tissue. Depending on the configuration of the shoulder in the pull or push (eg, handstand v. dip, FL v. BL) the labrum can be stressed in different ways, sometimes causing pain sometimes not, depending on where exactly the tear is. It was very informative to see the images, and have the doc explain where the labrum looked good, and where fluid had entered into the joint because of the tear. The orthoscopic surgery that repairs the damage has a very high success rate (90-95% of patients return to full ROM, full strength), and has about a 12-week recovery time. Compared to 12-16 months of chronic pain and perpetual frustration with PT (and frustration of staying motivated to PT when it seems -- and actually was -- ineffective), 3 doesn't seem so bad. I'm hopeful.

Orench was on travel, but thanks to your prodding Coach, he gave me a call. Thanks for putting us in touch, I will definitely be working with him in the later stages of rehab and forward development, and am looking forward to learning from him.

Dude that surgery is totally worth it IF you actually do what they tell you and take the rehab really show! Don't do ANYTHING before they say it's ok. Even a single push up before the right time can undo the surgery.

Sounds about the same as my problem, except I also had torn some other stuff than just labrum. Getting surgery was the best choice ever, although my shoulder is not 100% even now 2½ years after it's still better than before. Guess it's just part of the challenge working around a semi-functioning shoulder, as if gymnastics wasn't hard enough

Yea, I can't tell you how many times I've read "take it slow! Better to not get injured in the first place than recover." I *thought* I was taking that advice to heart ... I guess this is a lesson in what is slow enough. Ah well. I definitely intend to rehab slowly, and with complete compliance with the ortho and PT's. When I am eventually strong enough to re-start the BtGB progressions, I also intend to re-evaluate "slowly."

This is an excellent thread. Other than visiting a PT, does anyone have advice about how to self-identify which of the possible causes of 'impingement' might be occurring?

I got an impingement-like injury suddenly, and it seemed to doing daily arm hangs somehow reconfiguring my tissue. Any movement of my arm away from my body, particularly overhead, became very painful and this has persisted for a month with limited relief. 

With my elbow tight to my side, and a 90 angle at the elbow so my fist is the same height, try to rotate my forearm externally is also quite painful and I have limited ROM. By contrast, internal rotation is strong and pain-free.

Doing the chair stretch @Kit Laughlin does not cause pain. 

Moving my arm behind and bending me as though doing a dip seems to strain something in the front shoulder, if I have body weight on it. 

If I need to hold my arm out to stabilize my body, as when hiking and slipping on a slope, causes severe pain.

Trying to move my arm above my head as for a tricep stretch is painful and causes guarding.

I'm wondering if there are exercises that are indicated or contra-indicated for different root causes of the impingement as mentioned by Kit. Are there books or YouTube videos that would help with such self-diagnosis?

Thanks for any additional insight!