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Supraspinatus Injury (Doing DB front raise)

Posted: Thu May 01, 2008 3:28 am
by cha1n
Hi,

I think i have this injury: http://www.exrx.net/Kinesiology/Weaknesses.html

I hurt myself doing DB front raises and lifted too heavy on my left side. Now i've got constant pain - feels like it's on the inside(like looking out from inside my rib cage) of my upper shoulder blade.

It hurts when i put my arm forward to change gear in the car and i'm pretty sure there's no way i could do a front raise.

Do you think i can just stop doing front raises for a few weeks or am i going to have to stop doing chest as well?

Also, how often should i do the corrective exercises that website suggests and am i ok to do them whilst it's still hurting? Thanks



Ross

Posted: Thu May 01, 2008 5:02 am
by KPj
Hows your posture? more specifically, your shoulder blades?

http://www.exrx.net/Kinesiology/Posture ... hor3102554

The front raise could of just been the straw that broke the camels back.

You have probably just sprained the supraspinatus but it's hard to tell. I would recommend you see a good physio.

But yes, drop front raises. Bench pressing will most likely hurt, if you do dips, they'll probably hurt, too. Even back squats might hurt - Just drop everything that hurts!

You MIGHT get away with DB bench press using a neutral / hammer grip. I would suggest doing it on decline, too.

But if everything hurts, just drop all of it. Sounds brutal but you'll only make it worse. Try push ups and see how they are. Take the opportunity to really hammer you upper back and legs as long as it's pain free.


What's your training program like?

KPj

Posted: Thu May 01, 2008 7:42 am
by cha1n
Hey KPj, thanks for the reply.

I'm currently following this program http://www.exrx.net/Workouts/Workout3PPL.html and on push i use DB presses (Incline/Decline) and a fly (slight incline) and a DB front raise for anterior delts.

I did see that article on the shoulder blades, i think although not as extreme as that pic my shoulder blades have always protruded slightly like in that picture and i have a very limited ROM on pressing exercises (i.e. i can't come down very low on a DB press, can just about stretch upper arm parellel with floor).

I've only recently (within the last 6 months) learnt the importance of good posture and try very hard to hold my shoulders back with blades pinched together during exercises and generally when sitting at work etc.

I'm half tempted to drop all exercises that may effect that area and just work hard on all the other areas i can perform (Legs, Abs, Biceps, is back ok?).

It's my fault i pushed to hard on the DB front raise. With my right arm it felt like my anterior deltoid was doing the work, but on my left side i could really feel it straining around the shoulder blade area to get it up.

I tried just raising my arm to my side using the other arm for a little bit of resistance and it's very painful. Also changing gear (reaching arm forward specifically with thumb down) is painful.

I do reconise the type of pain though from other injuries and i would say its a sprain not surgery material.

I may just leave that area for 2 weeks and diet during that period so i can start my training from a lower BF (about 18% atm).


Ross

Posted: Thu May 01, 2008 10:01 am
by Jungledoc
You should hold off on any lift that hurts. Rest the shoulders until they are pain free. The "corrective" exercises should be approached like any other exercise. Start with gentle range-of-motion movements, then light weights, and increase. Don't do them any more often than every second day.

The classic advice to use ice for the first 48 hours and then heat is pretty good, but not set in stone. Use whichever works best for you, even alternating ice and heat. Acetaminophen or over-the-counter anti-inflammatories can be useful, but pay attention to the label warnings, if you choose to use them.

By the way, when I say rest, I don't mean to stay immobile. Keep doing ROM, and advance to the exercises as quickly as you can. I've seen people "rest" a shoulder to the point that they developed movement restrictions, even a few "frozen" shoulders.

Andy

Posted: Thu May 01, 2008 10:40 am
by corless319_
andy i have heard of that frozen shoulder crap. Thats what I think it is, crap. haha my gf once lifting weights injured her shoulder and then was told about frozen shoulder and then wham she had it I told her to get over it and stop creating problems. She eventually had it miraculously go away. I think half of the problems most people have now a days is mental. Not saying his supraspinatus problem isnt an injury I just wouldn't even bring the frozen shoulder thing up just one more thing for a slightly injured weight trainer to worry about haha. I try to be as care free easy going as possible I dont take medicine or antibotics usually cause I'm never sick but when I get sick I let the body fight it off thats how we were made to begin with. I dont know let me stop rambling.

Posted: Thu May 01, 2008 11:15 am
by KPj
cha1n wrote:Hey KPj, thanks for the reply.

I'm currently following this program http://www.exrx.net/Workouts/Workout3PPL.html and on push i use DB presses (Incline/Decline) and a fly (slight incline) and a DB front raise for anterior delts.
OK. All of those are most likely going to hurt. Try doing the DB bench press on Decline with a neutral / hammer grip. See if push ups hurt, too. When doing DB bench press, drop the weight and concentrate on keeping your shoulder blades down and back. If you get into position correctly, your rib cage will pop up slightly and your back will be arched slightly. This is a good thing. Also, don't let your elbows flare out to the sides (90 degrees), keep them tucked, at about 45 degrees.

Another thing is to do DB bench press on the floor (to restrict ROM), with a neutral grip. All the above applies to - elbows tucked, scapula back and down and tight throughout the whole ROM. You actually will think more about your scapula than your chest or shoulder if you do this right. But again, only do any of these if it's pain free and if you can lift pain free, then go for it.

Lastly, I would say in this case, use a tempo just until you get used to it or know it's painfree or not (basically to force you to use lighter weight). Take 2-3 seconds to lower, and 2-3 seconds to press the weight - so that you can make sure you are stabilising via your shoulder blades, and not your shoulder JOINT.
cha1n wrote: I did see that article on the shoulder blades, i think although not as extreme as that pic my shoulder blades have always protruded slightly like in that picture and i have a very limited ROM on pressing exercises (i.e. i can't come down very low on a DB press, can just about stretch upper arm parellel with floor).
Your internal rotators are most likely very tight. Same with upper traps. Some pec stretches and upper trap stretches will do the trick. But again, only if pain free - you might need to give it a few days / week before you can do anything pain free with the shoulder.
cha1n wrote: I've only recently (within the last 6 months) learnt the importance of good posture and try very hard to hold my shoulders back with blades pinched together during exercises and generally when sitting at work etc.


This is good! keep it up! You can have the best program in the world to correct posture, but if you don't try and fix it the other 23 hours your not in the gym, then it's almost pointless.
cha1n wrote: I'm half tempted to drop all exercises that may effect that area and just work hard on all the other areas i can perform (Legs, Abs, Biceps, is back ok?).
This would probably be best. 'Pain Free' is the key. If you can train all of these pain free, then go for it, especially back. But if you can't, you need to just bite the bullet and take time off.

cha1n wrote: I tried just raising my arm to my side using the other arm for a little bit of resistance and it's very painful. Also changing gear (reaching arm forward specifically with thumb down) is painful.
If you have the means to see a physio, I would strongly advise it. I had a similar thing ages ago and it ended up to be a partial tear... It's always good to get a specialist in their to have a look, even if it is just a sprain.

I know from direct experience, if you can train pain free, then train. But make sure you don't kid yourself, your shoulder will be in a delicate state right now, so be GENTLE with it, whatever you do.

If it aches constantly, then Ice it every few hours. Simple advice but it is effective. Anti Inflammatory cream, like deep heat, is worth buying, too.

KPj

Posted: Thu May 01, 2008 11:26 am
by ironmaiden708
andy i have heard of that frozen shoulder crap. Thats what I think it is, crap.
Definition of a frozen shoulder:
Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff.
A frozen shoulder doesn't seem like a crock of $h!t. Do some research before saying that.
I think half of the problems most people have now a days is mental.
I don't consider my friends quad injury or my stiff aching lower back a mental issue nor his issue with his shoulder.

People taking injuries and saying it's normal or w/e and think they can work it out of their systems are the ones who end up tearing up tissues and end up partially disabled. See a doc or let it rest and if it doesn't go away then see a doc or a PT.

Posted: Thu May 01, 2008 10:14 pm
by Jungledoc
Coreless--I think you may be reading me the wrong way around. Sometimes people take the advise to rest a joint too literally (and, well, some people don't take it seriously enough, for that matter) and completely immobilize the joint. That's often what leads to the frozen shoulder, being afraid to move it. Each person has to feel their way along the fine line between frequently re-injuring themselves on the one hand, and becoming less and less mobile on the other.

Having said that, joint injuries are rarely "mental," especially among serious lifters, who are much more prone to ignore things that they should deal with. Trying to tough it out while in pain is often a formula for making a small problem worse.

Posted: Thu May 01, 2008 10:18 pm
by Jungledoc
Oh, and by the way, the way we were made in the beginning involved dying before age 40. I see lots of people who waited for their body to take care of a problem until after irreversible damage was done.

Posted: Fri May 02, 2008 8:50 am
by KPj
Jungledoc wrote:Coreless--I think you may be reading me the wrong way around. Sometimes people take the advise to rest a joint too literally (and, well, some people don't take it seriously enough, for that matter) and completely immobilize the joint. That's often what leads to the frozen shoulder, being afraid to move it. Each person has to feel their way along the fine line between frequently re-injuring themselves on the one hand, and becoming less and less mobile on the other.

Having said that, joint injuries are rarely "mental," especially among serious lifters, who are much more prone to ignore things that they should deal with. Trying to tough it out while in pain is often a formula for making a small problem worse.
Good post. I was very similar to Corless when I first started training and when i first started posting here. I would always here friends complaining of joints feeling funny or having slight pains that wouldn't go away and would tell them it's all in their head. When it started happening to me I thought the same and ignored it. It gradually got worse over the course of 6 months to the point where any pressing would cause pain. Then I started to think 'hmmm... maybe there's something not right here'....

Then one day it just went, and I literally couldn't hold a cup of coffee with experiencing a lot of pain. Things like reaching over head (with no resistance) would be very painful. At least 6 months of progress wasted before I could even take my head out my a$$ and realise I might have a shoulder injury. During my 'rehabilitation', I constantly made it worse and started getting aches and pains in my lower back and knees and the other shoulder didn't feel great, either.

Needless to say it was a lesson well learned.

The only people who realise the significance is the people that have experienced it.

I don't think anyone can blame Corless or anyone else for having that kind of attitude, but maybe i'm biased. There's a huge lack of conflicting information out their and an abundance of bad information. After all, we're all here to learn.

KPj

Posted: Fri May 02, 2008 11:12 am
by ironmaiden708
I'd prefer if that approach to aches and pains is avoided. The pain means something, always. As stated before, that mentality that the aches and pains are nothing is what causes serious injury.

A lesson well learned usually comes after a person realizes that they are not invincible, and that usually occurs by a serious injury or traumatic situation. I've never experianced any serious injuries myself. I've always taken the safe approach to lifting and will continue to. The smart approach IMO.

Posted: Fri May 02, 2008 12:08 pm
by KPj
ironmaiden708 wrote:I'd prefer if that approach to aches and pains is avoided. The pain means something, always. As stated before, that mentality that the aches and pains are nothing is what causes serious injury.

A lesson well learned usually comes after a person realizes that they are not invincible, and that usually occurs by a serious injury or traumatic situation. I've never experianced any serious injuries myself. I've always taken the safe approach to lifting and will continue to. The smart approach IMO.
Agreed, I would prefer if it was avoided too but i would be a hypocrite to criticise people that have the mentality to train through things. When you first start training, injuries means that one day you are lifting and BANG, something goes. But the majority of injuries don't happen that way. Overuse injuries come on gradually - they accumulate over time. I never even knew what a Rotator Cuff was until I injured it - this site is where I first learned about it, actually.

My definition of training smart is avoiding injuries in the first place by having a balanced program that is based around your own strengths and weaknesses - I think one of the biggest problems is that people don't know how to determine what their strengths and weaknesses are. When you do get some aches and pains which is inevitable if your in this for the long haul and serious about what your doing then you should be able to train around it WHILST letting the affected area heal AND actually correcting whatever the problem is.

Kpj

Posted: Fri May 02, 2008 12:17 pm
by KPj
Just remembered about this. Recently on T-nation there was a great article on training whilst injured,

Creating a Training Effect When Injured
http://www.t-nation.com/article/perform ... ceTraining

I love this section of it
If you're like most people, you deal with an injury in one of the following three ways:

1. Still train, but fail to make the proper modifications and end up only exacerbating the problem. We call this "being misguided."

2. Still train, but you go way too easy on yourself. These are the people who do nothing but "functional" exercises for an hour, then hop on the elliptical to watch the nightly news. This is known as "being a baby."

3. Stop training altogether, hoping that by doing so the pain will just go away. The clinical term for this method is "being a pussy."
To give an example of the effectiveness of this, the last 2 months i've had a knee injury. So i've had to drop Bilateral movements due to the nature of it. Needless to say, i've probably lost a bit of ground in my squat and dead lift - arguably really, but we'll find out soon.

However, in the last 2 months, my Bench press numbers have went up, as have my DB bench press numbers, all pressing actually. My Rows have went up, all variations. Weighted Pull ups have went up.

More specifically, my balance in lower body has vastly improved - single leg unsupported exercises being completed with perfect form, every rep, and load is increasing. Single leg unsupported stuff would normally be in my program, but not a focus - now it's a focus and results have been great. My Pistols have came on drastically - can do Full ROM to the floor with a 3O3 tempo for 3 sets of 10, including the injured side. I could already do them so progress would be fast anyway, but had to re learn and start with a restricted ROM.

My body weight has went up about 4lbs with no noticeable changes in body fat. This isn't a focus of mine, more a side affect to my other goals.

The upper body progress sounds too good to be true. To be honest I was already pulling things back from 3-4 weeks of pretty bad illness. I also put that progress down to the extra recovery from not squatting, front squatting, and deadlifting.

If I trained through the original pain I would be in a bad way now. If i just took time off, I would end up at tleast 6 months behind from where I was...

KPj

Posted: Fri May 02, 2008 9:52 pm
by Ironman
corless319_ wrote:andy i have heard of that frozen shoulder crap. Thats what I think it is, crap. haha my gf once lifting weights injured her shoulder and then was told about frozen shoulder and then wham she had it I told her to get over it and stop creating problems. She eventually had it miraculously go away. I think half of the problems most people have now a days is mental. Not saying his supraspinatus problem isnt an injury I just wouldn't even bring the frozen shoulder thing up just one more thing for a slightly injured weight trainer to worry about haha. I try to be as care free easy going as possible I dont take medicine or antibotics usually cause I'm never sick but when I get sick I let the body fight it off thats how we were made to begin with. I dont know let me stop rambling.
??????

You make about as much sense as a condom machine in the Vatican.