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Scott Kustes
06-20-2005, 01:39 PM
I've had a left shoulder injury for some years now. About once a year, it likes to flare up. Well, about a month ago, after the OHS/front/back squat workout and bw bench/pullups for reps WOD in the same day, I was in pretty bad pain. I thought it was from laying the bar on the shoulder bone during front squats, but once the bruise subsided, the pain continued. It died off over the next couple of weeks and then a little over a week ago, we had the same bw bench/pullups for reps WOD. I had to quit during the 3rd set due to severe pain. I had also been doing alot of handstand and L-sit practice.

So now that I've described how it occured....the pain is only in "pushing". Bench, pushups, jerks, push press, etc. I can do pullups, kb swings, cleans, and snatches with no pain at all. I've been avoiding handstands since overhead presses hurt...probably shouldn't be supporting 185 lbs on it. It comes and goes, being quite intense in the morning due to sleeping on it (unfortunately, I'm a left side sleeper causing me to lay on it constantly) and not moving it.

So given that, is it my rotator cuff causing the pain or is there something else in the shoulder that could be causing problems? Is there a doctor in the house that can diagnose me? My health insurance kicks in on July 1st, so should I go see a doctor for an xray at that point?

Thanks

Michael Rutherford
06-20-2005, 07:11 PM
Here is what I think you are dealing with http://www.exrx.net/Muscles/Subscapularis.html
http://www.sportsinjuryclinic.net/cybertherapist/front/shoulder/subscapinflam.ht m (http://www.sportsinjuryclinic.net/cybertherapist/front/shoulder/subscapinflam.htm)

You need to stay away from HOW MUCH YOU Bench press. In general the rotator cuff is very avascular. IMO- Ice the crazy thing until you can't stand it. SLOWLY begin to work those external rotators and STAY away from benching.

Here are is a primer http://www.bodyresults.com/E2RotatorCuff.asp
I've also had good luck using a device called THE SHOULDER HORN.

Since you are a young gun you should be good in no time flat.

Brian Hand
06-20-2005, 08:09 PM
Rut, just curious, what makes you suspect subscapularis in particular? Subscap is the internal rotator in the rotator cuff, I thought it was less prone to weakness, more prone to tightness.

Michael Rutherford
06-21-2005, 03:17 AM
I got out my virtual water stick and pointed towards the monitor to come up with this diagnosis.

Honestly, ten months ago I started having all the same symptoms and experiences. After a trip to the orthopedic surgeon and the physical therapist this was what we all concluded.

It’s a just a guess. I don’t think you can go wrong with ice in any case.

Scott Kustes
06-21-2005, 05:09 AM
Thanks Rut. I'll give those exercises a try and see if the pain starts to subside. It has been a bit better (but not good) the past couple days. Another question: when dealing with medial rotation, how far out should the lower arm be able to go? My left arm is certainly tighter than my right as I can get my right forearm to about 75 degrees, but my left only slightly past 45 or so (before entering pain range). Should I be able to turn those out to close to 90 or does my right arm sound about right?

Michael Rutherford
06-21-2005, 06:49 AM
Bilaterally, your ROM/strength should be similar. Robb Wolf has the PT experience. Maybe you can encourage his input.

John Walsh
06-21-2005, 10:43 AM
Scott,

I have the exact same thing. Non-dominant side shoulder, left in my case. I did it benching back in my PL days. I rest, rehab and just when I think I can bench again it gets aggravated. I also notice that it can get aggravated during cleans. Fortunately I can work around it pretty well. My benching days may be over.

Michael Rutherford
06-21-2005, 11:32 AM
Scott-

We use this at our place for prehab/rehab purposes. It's from Dave Tate at Elite Fitness

Start with the cuff complex which is listed below.

Use 5 pounds for all the movements.

Overhead press

Overhead triceps extension

Side raises with thumbs up

Side raises with thumbs middle

Front raise with thumbs up

Front raise with thumbs middle

Bent side raise thumbs up

Bent side raise thumbs middle

Bent front raise thumbs up

Bent front raise thumbs middle

Zottsman curl – this is like a curl with an extra twist at the top.

External rotation – only top half

External rotation – only bottom half



Start with one set of 10 reps with 5 pounds and work up to 2 sets of 20 with 20 pounds over time - months.

Scott Kustes
06-21-2005, 12:10 PM
I'll give these a try. I did the 3 that you posted earlier today and I'm hitting it with ice too. I usually refrain from ice since it numbs and I feel like that could keep me from feeling a warning. But I don't suppose I'm gonna be doing any damage to it sitting on the couch with the laptop.

Can you explain "external rotation"? What is meant by top half and bottom half?

Thanks! I'll be back in commission trying to figure out O-lift form soon.

Michael Rutherford
06-21-2005, 02:57 PM
We stabilize the upper arm with the shoulder horn or a bench perpendicular to the floor. From here it's a short movement at the top back. It’s the last 10 degrees of the moment. Same with the bottom-It’s the first 10 degrees of the movement. Use light weight so the larger muscle don’t take over the movements.

Jim Howe
06-22-2005, 03:54 PM
I've been layed up with a couple of bad shoulders for over a month now. I was having trouble for a month or so before that but tried to just "back off" some. That did'nt work, I just had to stop the upper body stuff totally. I spent the better part of a month waking up in the night with pain.
I've improved and am starting rehab now with the exercises provided through this blog and hope to be fully back in the game in a couple of months.

I'm over fifty and recovery is slower than it used to be. The injury is chronic but can be controlled with those specific exercises that I left behind in my quest for WOD immortality. It has been a tough lesson, but I think despite the overall conditioning and huge ROM exercises offered by Crossfit, I can't neglect my rotators that were injured in a climbing fall 25 years ago.
On the plus side, my running and rowing PR's are falling as my upper body loses some of that hard earned muscle.
Thanks for the links and timely posts....