Scapular Depression And Rotator Cuff Pain

[Biren Patel]

Hello all,

I am suffering from two problems and I've been doing some research on my own, but I think I am in need of a more experienced person.

The first problem:

I discovered this problem 3 weeks ago when working Ido portals scapula drills from Youtube. I noticed from the mirror that when performing overhead straight arm pulldowns (basically a butterfly pull with resistance bands) (band is 5 lbs resistance), when I pull down, my right shoulder would depress completely but my left shoulder stays elevated. I thought this was a little wierd for my body to naturally do, so, what I tried instead was depressing before beginning the pull. I noticed then that when I depressed my scapula, my left shoulder would pop. There is no pain whatsoever, it would just make popping sounds. Also, I have noted that when I perform dislocates with a belt, my right shouler has a tendency to naturally elevate higher than my left shoulder. I have to force the left shoulder to elevate at the top of the movement.

Then, the next day, I was working on some hanging work. I was working one arm hangs and I noticed that I can hang easily with just my right arm with depressed scapula, and I can perform scapular pullups with just that one arm easily. But when I try to hang with only with my left arm, with depressed scapula, there is pain in the shoulder (top of mid-delt, supraspinatus area, past the acromion), and when I try to perform scapular pullups there is the same pain. There is no pain in a relaxed dead hang. Also, I have a hard time controlling my body rotation with left arm hangs but I don't with right arm hangs. As for two arm hangs, there is no pain in a dead hang or when the scapula are depressed in the dead hang. However, when I perform the two arm scapula pullups, the popping sounds appear in my left arm (but no pain. Pain is only in one arm work).

I have no clue how to solve this.

The second problem:

This problem has been around since I started working out 11 months ago. When I perform full hanging leg raises and front pulls, I get pain in my shoulder during the first 10-15 degrees of shoulder extension. So this basically means I have shoulder pain throughout the entire movement of the hanging leg raise, and in the bottom intial pull in the front pull. I am still learning anatomy, so I think my best bet to describe the location of the problem is to say that it is around the supraspinatus area, the tip of the top of the shoulder - on the most outside portion of the top of the shoulder past the acromion. Hopefully that helps describe the location. Same area of discomfort as in the first problem.

For about 2 weeks, I have been doing a lot of external rotation work. Like I said, I have no idea what exactly the problem is, but I figured this couldn't hurt. So I do band work focusing on external rotation, and abduction focusing on the first 20 degrees of motion. I have also been doing Joshua's shoulder stretches, and wall extensions (I have bad rom in this exercise). But, the pain during the exercises hasn't gone away.

I should note, there is no pain during the day in the shoulder area, the pain only happens during these specific exercises, and it subsists as soon as I stop the exercises. The pain is not terrible, its more like a sting or impinging feeling (I know by using the word impinging I've kind of just loaded the answer to this problem, but that's the best word I can think of to get across the type of pain). 3 out of 10 on the pain scale. I can do other exercises just fine - muscle ups, back lever, curls, FL rows, PPP's, dips, planche, etc...no pain. Just pain in front pulls, HLL, and scapula depression work like in one arm hangs. And pain is only in the left shouder.

I appreciate any insight! I just have no clue what the problem is here. I can post up a video of specific movements if anyone needs to see my form - I am not so keen on positing videos of myself, but I'll man up if need be.

Also, maybe worth noting that I've been unable to progress to past tuck FL since I started working out, considering that i can hold it for 60 seconds, and perform multiple rows, yewkis, and fl pulls for 5+ reps each. My advanced tuck FL is 3 seconds at best. Might help out in this problem? Because all other exercises have progressed outstandingly by my standard.

[Eric Heiden]

This is very interesting to me as I'm working through an issue with uneven depression/elevation in my scapula as well.  I posted about this some time ago (here's the thread), got some good feedback, and was definitely not as diligent or spot on with my online prescribed rehab as I should have been.  I fell off of GST for a while, and have returned to it recently.  After 3 weeks of a Killroy style program I started experiencing pain again in my right scapula, and a definite impingement feeling up near my anterior deltoid.

 

I didn't feel any pain during the first 2 weeks of FSP/FBE work - but it wasn't until the day before I aggravated something that I really did a 5x5 dip day.  I think a combination of weak scapular stabilizers and weak pressing ability in that plane, and generally poor muscle activation in the left scap (or maybe over-activation on my right?) - as displayed in my PB support videos in the other thread) are the reason for my issue.

 

I was trying scapular dips (I was playing with band resistance for deloading) the other day and filmed it - I was not happy with what I saw my right scap doing at the bottom of the dip: (watch at around 30s-39s)

 

I'm not sure if my problem and yours are at all related but as they both have to do with uneven scapular depression so I'm curious what we have in common - if there's something to learn from this.  I'm going to try your listed diagnostic exercises tonight to see if we have crossover.  

 

For comparison to you - here's my band pulldowns, retrations, and whippits:

 

I'm curious - I've found that now that my shoulder is aggravated/possibly impinged that my right side shoulder flexion is extremely weak. My left has no problem lifting a band attatched to a doorknob, but my right will barely raise above horizontal (and then it is painful to attempt more).  Do you experience this as well?

 

I have an appointment this Friday with a PT so I plan on making an informative post with the diagnosis for others to learn from.  I'll be sure to follow up here with a link to that discussion.  Maybe there'll be some correlation between my and your problems.

[Biren Patel]

Hi Cannister,

Thank you for the link to that thread.

I will post some videos tomorrow evening showing the same movements you have posted (I need to create a youtube account and figure out how to transfer these video files to my computer). But, it looks like we are indeed having similar problems in regards to this issue. While you are having trouble with depression in the support positions, I am having trouble in the hanging positions. From a video I have just taken, my traps and shoulder musculature look aligned and fine in the dip, support, and l-sit positions. From your video of the pulldowns, you look fine but my video shows that I am having the problem in the pulldown that you are having in the support and dip. So, it seems that are issues are related, but in different planes of movement. Whereas you are having trouble with pushing, and I am having trouble with pulling. But the same thing is happening to our scapulas in both instances. We have the same uneven depression happening, one scapula stays elevated above the other.

What is strange to me, though, is that I am much worse in FBE pushing movements than I am in FBE pulling movements. I wonder if you are the opposite?

Again, thanks for that thread link.

[Joshua Naterman]

You are probably suffering from a partially frozen shoulder.

 

This is currently a difficult thing to treat, and there seems to be little difference between waiting it out and trying exercises, if you read the current research.

 

I think you will find that Kit's lat stretch will help, and so will ART on the subscapularis.

 

Take it easy, take it slow, and make sure you're doing internal rotation work too. The external rotators are probably fine, subscapularis seems to be a bigger issue with frozen shoulders.

 

Go find a professional, this isn't really something you can deal with on your own very effectively. Find a specialist for frozen shoulders, or find an ART practitioner, and make sure you remember that you're always in charge when they are stretching you. Trust them, but also trust your body.

 

Subscapularis ART hurts like you won't believe, so know that in advance. There's going to be a lot of burning pain, but it will feel different than tearing. make sure you communicate what you are feeling, and work with the practitioner.

 

Laughing loudly on purpose can help dull the pain, but let them know you're going to try that ahead of time

[Eric Heiden]

The more I learn about my shoulders the more they scare/amaze me.

 

For example - it blows my mind that something as simple and seemingly unrelated as

can be the cause of the problem for some people with frozen shoulder.  I'm actually excited to visit the PT tomorrow.  That's a first.

[Eric Heiden]

Back from the PT.  He said that he didn't find glaring problems in my ROM or muscle weaknesses.  He said I'm suffering from some pretty mild impingement.  I actually tested negative for all of the classic impingment tests.  He found some weakness in my external rotation, especially on my right side, but besides that he couldn't really narrow down the cause.  He didn't seem terribly concerned with the uneven depression either.  Also - he told me not to "work too hard" to open up my shoulders - that my relatively closed shoulders could simply be genetic - and working to open them if that is the case could cause more impingement - I don't really buy that.  He suggested resting for about a week or two and then coming back in for another strength/ROM test and then he would give me a routine to work things out.

 

I'm kind of disappointed that I'm not really any closer to understanding what caused my shoulder irritation/impingement, nor do I have any plan of action to prevent it in the future other than external rotation & general rotator cuff work.

[Joshua Naterman]

This is standard, and unfortunately inadequate. When you look at the shoulder, it is made of tissues that adapt over time depending on the demands placed on them.

 

It is true that you, like me, may have a longer road ahead of them in the quest for open shoulders, and that we need to take it slow and steady.

 

He is right that improper opening procedures can cause impingement, and here's why:

 

If you don't have upward rotation of the scapula, you are going to impinge.

 

Kit's LAT stretch is a very good way to stretch not just the lat, but also serratus anterior, which happens to be a very powerful scapular depressor. And guess what: You can't upwardly rotate very well when the entire shoulder blade is being pulled down.

 

I will not go further than that, because it gets extremely technical and would take a huge time commitment on my part.

[Eric Heiden]

Joshua - thanks for the feedback.  I've looked all over Kit's Youtube channel but can't seem to find "the" lat stretch you're referring to.  Could you point me in its direction?

[Joshua Naterman]

Turns out that video is now private, for reasons unknown.

 

I will eventually make a video for what I am doing.  I'm not going to try and convey this in words

[Biren Patel]

You are probably suffering from a partially frozen shoulder.

 

This is currently a difficult thing to treat, and there seems to be little difference between waiting it out and trying exercises, if you read the current research.

 

I think you will find that Kit's lat stretch will help, and so will ART on the subscapularis.

 

Take it easy, take it slow, and make sure you're doing internal rotation work too. The external rotators are probably fine, subscapularis seems to be a bigger issue with frozen shoulders.

 

Go find a professional, this isn't really something you can deal with on your own very effectively. Find a specialist for frozen shoulders, or find an ART practitioner, and make sure you remember that you're always in charge when they are stretching you. Trust them, but also trust your body.

Scary!

I've got a scheduled appointment now for next Tuesday with an ART specialist.

I thought that internal rotation work beyond the main workout should never really be necessary? Because it gets worked by so many gymnastics movements to a high degree.

Interesting that you bring up that serratus anterior is a powerful scapular depressor. When I had started working on those one arm hangs I experienced lots of soreness on days after in the serratus anterior, but not so much in the traps. Interstingly, I find that I get no pain in the shoulder when I practice one arm hanging shrugs in a pronated grip. But when I start to turn towards a neutral grip (practicing on the rings), the pain comes on. Also, if I shrug upwards diagonally so that my body lifts away from the working arm, I find that the pain goes away. But if I shrug straight up and down, it comes back.

I can't remember kit's lat stretch very well, but I remember it requiring a partner. I'll look forward to your video. And I look forward to this ART appointment, I think...scared about the pain!

 

[Biren Patel]

The more I learn about my shoulders the more they scare/amaze me.

 

For example - it blows my mind that something as simple and seemingly unrelated as

can be the cause of the problem for some people with frozen shoulder.  I'm actually excited to visit the PT tomorrow.  That's a first.

Yea - the more I visit the mobility forum, the more paranoid I become about shoulder injuries

[Joshua Naterman]

Shak:

 

We should all be concerned with shoulder injuries, because they are extremely common in athletes.

 

Many of us do not have the same range of motion we had as children or teenagers, and we will have to work to get it back. Just a fact of life and aging!

 

As you supinate, you start impinging the shoulder, so it does not surprise me that those grips (neutral and chin up) are not comfortable for one arm shrugs. Don't do them.

 

Same goes for the more vertical hangs with your current shoulder mobility: You don't have the scapular mobility to allow enough upward rotation to avoid impingement. You're experiencing reflexive muscle contractions and reinforcing an activation pattern that will not help you. I suggest you stop doing that and start working slowly on the scapular upward rotation. This is the single biggest factor in impingement avoidance with this kind of work (open shoulders, whether hanging or in a handstand).