[silverbirch]

Hello All!

The chiropractor has told me I have a bit of rotator cuff inflammation and that it had been lurking whilst we dealt with other things. I know some of you have dealt with rotator cuff issues and are wise in this area.

What's your advice?

What lifting should I avoid?

Could a particular lift have caused it in the first place?

Thank you for your help. It's not particularly painful but it's annoying and this shoulder's been niggling for a while.

[jamsk8r]

Wish I could help you, Birch, but haven't had that one myself. Maybe the chiro can tell you which movements to avoid. If you have a list of what not to do, we might be able to help you come up with subs that won't irritate it during active recovery.

[Mel]

Birch- Meg is the Empress of Rotator Cuff rehab. Hopefully she will see this post. I'm give her a poke. If she doesn't have time, I'll come back.

Just quickly: upright rows are THE WORST offenders for rotatory cuff injuries, but any exercise where you are doing internal rotation with weight above your head (think Arnold presses) can cause problems.

Here is a link with some good information.

Just be careful to use really light weights. 3-5 pounds for rehab. Use light tubing or band. You are not trying to stress the muscles.

Mel

[silverbirch]

Thank you, Mel. I thought you had some experience of this. I also remember Meg's injury. I'm not very bad at all but I think it's been grumbling for years.

I don't do upright rows. Bent-over barbell rows I do. Arnold presses - no.

Slight glitch on the link. Looks as though it's this: http://www.askthetrainer.com/rotator...exercises.html
I'll study it tomorrow. Past my bedtime here.

Cheryl. No need to bother having this injury. I'll do it for you if you cover biceps tendonitis for me.

[Mel]

Link fixed.

[Lydia227]

Hey Birch,

I've also heard that just bench pressing with a barbell can also cause aggravation. When my flares up I will either lay off from pressing exercises a little or use dumb bells for my chest presses. It's a little different range of motion with the dumb bells instead of the barbell.

Another thing I've read is that we really don't do enough pulling exercises and sometimes overly worked pushing muscles and weakened pulling muscles can also create painful imbalance issues. If it's not feeling better in a few days get it checked out. As your shoulder begins to feel up to activity ask the Physical Therapist if adding more pulling movements may help prevent future problems. They may have more to offer as prevention of future problems.

I follow blog posts by Eric Cressey who provides a lot of detail about shoulder problems and ways to enhance shoulder health.

http://ericcressey.com/tag/shoulder-pain

Hope your doing much better with this. Shoulder pain can be awful in keeping you awake at night. Or, sitting in a decline position at the dentist chair having your teeth cleaned. Murder. Just ask me about it.

[Meg]

Hi Silver! I feel your pain! I'm in the middle of a rotator cuff flare up right now and am doing everything I can to make it go away, so I'm happy to share what I'm doing.

First, as with any inflammation, rest, ice and anti-inflammatories are standard therapies. Beyond that, the best way to help rotator cuff issues is a two part program of stretching and rotator cuff muscle strengthening.

Keep in mind that I'm not a professional in this field and am just passing on my incomplete knowledge gleaned from my shoulder surgeon and physical therapists. As background, I partially tore my rotator cuff in 2002 doing close grip bench press. In 2005, I completely tore it, plus ripped my supraspinatus and infraspinatus doing too heavy of an upright row. It was surgically repaired in 2006 and I spent about six months regaining use of my shoulder. Since then, the repaired side has continued to be weaker than the other but relatively pain free. About two months ago, I got cocky and bumped up my weights doing DB chest press and flyes and bam, I was right back into problems. I'm pretty sure I didn't rip anything this time and it's just inflammation; in fact, I can feel the tendon "pop" over the bone when I raise and lower my arm, which is a sign of inflammation.

At this point, I've stopped doing all other upper body exercises except for the PT, moved my mouse to my left hand, and do the PT exercises for an hour every day. I also take a prescription anti-inflammatory. It's gradually helping but I can see it taking another 6 - 8 weeks to resolve. All because of one stupid workout. So results won't be fast, unfortunately.

Mel is absolutely right when she says that NO ONE should be doing upright rows or any exercise with internal rotation. It just places too much strain on the shoulder. There are plenty of safer alternative exercises.

So Rule 1 of rotator cuff rehab is no exercises with internal rotation (except for a few specifically designed for rehab). Rule 2 is to hold dumbbells in an upright position -- with thumbs up -- rather than horizontally. So if you're doing front or side raises, for example, the DBs are perpendicular to the floor, not parallel. This opens up the shoulder joint and reduces impignment.

A lot of us don't realize that standard shoulder exercises focus on the delts and ignore the tiny muscles of the rotator cuff and supporting muscles. The goal of rotator cuff rehab is to strengthen those little supporting muscles and to do that, we need to stick with light weights. Once we go over five pounds or so, the delts take over and that defeats the purpose of these exercises. So more weight is NOT better! In fact, even male bodybuilders are advised to stick to five pound weights for these exercises, despite them being able to bench 200+ pounds.

This is the routine that I've put together from all my past experiences with PT. I do a lot of the exercises as supersets because they're boring. I also mix in the stretches in between sets rather than doing all the stretches together.

I start with 60 Pendulum Swings, 30 in each direction - bend at the waist and let your arm hang down completely limply, make a circle about 12 inches in diameter. This exercise alone increases my range of motion.

Stretches - 5 each, 30 second hold

1. anterior bicep stretch - lace your hands together behind your back and raise as high as possible

2. cross body shoulder stretch - bring your elbow up and arm across your body, hold with your other arm

3. behind the back stretch - place your arm behind your back with your elbow bent at 90 degrees, grab your wrist with your opposite hand

4. doorway stretch - stand in an open doorway with your arms on the frame, bent at 90 degrees (goal post position). Lean forward to stretch.

Resistance Band Exercises - 3 sets of 15

1. superset of front and rear raises, internal and external rotation - fasten your band to a doorknob. Face away and do a set of front raises, turn toward the door and pull to the rear, turn sideways with your elbow at your side and pull from the middle of your body to the side, turn the other way and pull across your body to the middle.

2. lateral raises ("sword pulling") - stand sideways to the door and pull the band across your body from hip height to above your shoulder

DB Exercise - 3 sets of 15, use 3 - 5 pound DBs

1. Scaption, thumbs up and thumbs down - a raise with your arms halfway between a front and side raise. Do three sets with your thumbs pointing up and three with your thumbs pointing down, even though it feels awkward. Thumbs down is the only exercise that hits one particular little muscle (I can't remember which one).

2. External rotation - elbows at your waist, upper arms against your body, rotate out to the sides and back to the middle

3. Shoulder rolls, forward and back - arms holding DBs at your sides, all motion comes from shoulders like a shrug, except it's a complete circle in one direction

4. Reverse flyes

5. Front raises - remember to keep the DB vertical

6. Side raises - vertical DBs

7. I don't know the name for this one and it's the one I dislike the most, so it's probably the best one. Stand with arms in the goalpost position (DBs by your ears) and rotate DBs forward until they're parallel with the
floor, then back to start.

I have to run right now so don't have time to google for illustrations, but if you don't understand what I'm talking about from my very limited descriptions, let me know and I'll try to find some pictures or videos. Best of luck to you and let us know how you're doing.

[silverbirch]

Meg as you having a flare up and as an incomplete thank you for this detailed help. I am very grateful to you for taking the time to spell things out.

I've increased the DB weight on the chest press recently so that's my current suspect. I've been icing and resting and haven't done any UB for a while. I'll have a go with some of the PT exercises above and try to be patient.

Good luck with your rehab. I hope we're both back lifting UB sooner rather than later.

[Meg]

Silver, I'm not surprised if increasing weight on DB chest press caused your problem because it's exactly what set mine off this time. Thanks for your good thoughts and I'm sending tons your way too.

I wanted to add a few thoughts:

Another rule to add to the List Of Things Never To Do: never work shoulders to failure. My PT said that our shoulders are made up of all these tiny little muscles and so "going to failure is going to the edge of injury". It's one thing to do squats or pullups to failure because those use big, strong muscles, but never, never shoulders. And I'd add chest to that list since shoulders are so involved in chest exercises and you and I both seem to be vulnerable there.

Also, I do that list of exercises and stretches every day. Boring beyond belief but they seem to work. The usual rule about a 48 hour rest between working the same muscle group doesn't apply here because these weights are so light. When I was recovering from surgery, I did three hours of those a day.

Finally, Lydia made a good point about bench press and how it strains the shoulders because of the fixed position of your hands. When you start doing DB chest press again, hold them vertically (not in the standard press position of horizontally) or angle your hands on the DBs until you find a comfortable position. Just like when you do front and side raises with DBs in a vertical, thumbs up position, it opens up your shoulder and relieves the pressure on the joint. Sometimes just a change in hand position can make a big change in how your shoulders feel.

Take care and I'll be thinking of you!

[WaterRat]

Nice to see you Meg - and you don't look like a Grandma! Add my thanks to SB's Last week I had some issues with my right shoulder, though mainly in the scapular area, and today my right shoulder is feeling tweaked (probably from 4 days of square dancing). I have had impingement injuries twice on the right side, the first resulting in a "frozen shoulder" for many months. I'm printing these out to have when I start feeling like they're having problems.

I never lift more than 10# when doing shoulder specific exercises, and I know about not doing upright rows. I had no idea about holding DBs vertically (expect for doing hammer curls). I've been doing most of my chest presses with DBs which seems like it's a good thing.