Shoulder pain

[Frank Menendez]

I'm starting to be bothered a lot by a pain in my right shouder, around where the clavicle protudes. There is definitely sensitivity when I press into it. Movements like push-ups also hurt. Ideas

[Steven Low]

Rotator cuff exercises.

All vertical pushing and horizontal pushing movements work the internal rotator cuff muscle, the subscapularis. All vertical pulling movements besides inverted pulls work the lats mainly which are also an internal rotator of the humerus. This means that only horizontal pulling movements (e.g. rows), olympic lifting and a slight bit in deadlifts work your external rotators. If you can see that your routine is not balanced for both or either your shoulders and rotator cuff muscles, then you are probably developing some sort of imbalance which can often lead to pain and injury.

Since your pain is in a horizontal pushing movement, it probably means that:

1. Your chest and shoulders tight so you need to stretch them especially to remove residual tension in the muscles.
2. Your subscapularis is overpowering your infraspinatus and teres minor which is causing pain.

You can fix these by doing external rotator cuff work, and probably a bit for your suprapinatus as well.

Infraspinatus = cuban presses
Teres minor = lying side DB external rotation or standing external rotation with a theraband
Suprapinatus = lying side abduction to 45 degrees with a DB or standing cable raise to 45 degrees. It is better horizontal though because the supraspinatus only work in approximately the lower 30ish degrees of the lateral abduction.

One way to tell if your internal rotators are much stronger than your external is to do both the internal rotation and external rotation for a set of 10 reps on one of the machines WITH GOOD FORM. If they are not within 5 lbs of each other (I've seen people have 25 lbs for internal and 5 lbs for external), then you know you have a pretty large imbalance. I think Charles Poliquin had an article where you should be able to externally rotate approximately 10-12% of your bench press or something like. I think that is a good thing to keep in mind, but I usually just go with trying to keep them even as it simplifies things more for your average layperson.

I was developing some pain my my shoulder around the subscapularis and supraspinatus area which are both related to horizontal pushing and vertical pushing respectively, and when I started doing external rotator cuff exercises for my infraspinatus and teres minor, the pain all but went away. I stopped doing them though, so the pain is back. I need to start up again.

[Matthew McCarty]

Ice it -- every day; pain or no pain.

[David Wood]

http://www.activerelease.com/

http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/157224375 9/sr=8-1/qid=1158108930/ref=pd_bbs_1/002-6059927-4876046?ie=UTF8&s=books

http://www.amazon.com/s/ref=br_ss_hs/002-6059927-4876046?platform=gurupa&url=ind ex%3Dblended&keywords=trigger+point+therapy

Wish I had started much, much earlier in my own shoulder pain history.

[Mike ODonnell]

Had same sort of issues..bad mnt bike crash...probably seperated something. Healing will all depend on your body...some goes fast, others not so fast. Eat right, take fish oil (anti-inflammatory), cut out sugar (pro inflammatory). Mine still acts up if I am not eating right or get too much sugar.

As for exercises I found stability stuff to work the best, holding pushup on bosu ball/med balls/rings...static hold, work slowly into full ROM pushups. Also overhead work is good for the rotator cuff such as DB press overhead (or static hold if the full ROM hurts).

Chances are you have very tight internal rotators, anterior delts and chest. Also you probably have very weak external rotators and scapula retractors (as most shoulder injuries comes from the inability to stabilize the scapula). Stretch the tight ones, strengthen the weak ones. Also try massage to loosen them up.

[Greg Hamilton]

http://www.orthoassociates.com/shoulder1.htm

here are illustrations of what allen suggested (i think, allen?), plus a couple more good exercises. half of my family and i have shoulder problems and these helped me tremendously, plus a posterior raise to 45 degrees with the thumbs up which is not shown here. i haven't had shoulder prolbems in a while, but i haven't played racquetball or swam competitively in a few years. at the first hint of pain other than muscle soreness, i would immediately begin performing these light exercises before and after any workout.

you might want to check out the recent thread in this same section of our forums as well: genetic predisposition to shoulder impingement, http://www.crossfit.com/discus/messages/27/29853.html

[Darrell E. White]

Bump...need to keep this on top until I get to my computer with my CF files so I can bookmark David's links!!