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Old 02-07-2010, 11:58 AM   #1
Gregory Norman
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Bilateral Rotator Cuff/Impingement

Hello Everybody,
I started doing crossfit in June of 2008. I went to a sports physician in October of 2008 and had an MRI of my left shoulder. I was told that I had a small tear and impingement. I didn't feel pain when I did push-ups, kipping pull-ups, bench pressing or ring dips so I continued to do crossfit. The pain came from doing overhead movements like overhead squats, push press, etc. I did PT with only a little improvement. I went to my sports physician in 2009 with pain in my right shoulder. It seems now I have bilateral shoulder pain and impingement. I stopped doing crossfit in November 2009 just to rest my shoulders. My sports physician told me not to do overhead movements and I find this request somewhat depressing. It's February and I'm getting restless and I definitely feel out of shape!!! I truly love the Olympic movements!!! Any advice from the crossfit forum? I thank you in advance.

With Great Respect for the Forum and the Crossfit Community,

Greg
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Old 02-07-2010, 03:50 PM   #2
Steven Low
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Re: Bilateral Rotator Cuff/Impingement

All of this will probably help you

1. Drop all pressing movements
2. Do lots of horizontal pulling (rowing.... except NOT upright rows)
3. Strengthen ONLY your external rotators... ignore internal rotators
4. foam roll thoracic spine
5. Ice after any exercise/swelling
6. Band dislocates & wall slides (youtube these)
7. Lots of massage/tennis balling/etc. from the scapulae to the anterior shoulders.
8. Stretch chest and lats. A LOT.
9. Fish oil for anti-inflammatory, joint supps if you need any (sections 4&5 describe these here):
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

Here's a good set of vids on scapular mobility and stability:
http://www.youtube.com/watch?v=y4Wo095zPnc
http://www.youtube.com/watch?v=1YHIV4a81Os

all links wfs
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Old 02-07-2010, 04:01 PM   #3
Ben Moskowitz
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Re: Bilateral Rotator Cuff/Impingement

Steve,
With respect to #3, what's your opinion on "Shoulder Saver #14: Prone Internal Rotations"

WFSish (T-muscle)
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Old 02-07-2010, 04:20 PM   #4
Steven Low
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Re: Bilateral Rotator Cuff/Impingement

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Originally Posted by Ben Moskowitz View Post
Steve,
With respect to #3, what's your opinion on "Shoulder Saver #14: Prone Internal Rotations"

WFSish (T-muscle)
IF it's weak and that's a big if... but then again it depends on what sports you played and how your body adapts to the exercises.... you may need internal rotation.

Otherwise, You don't.

In most people external rotators are waaaaaay weaker than internal even in the same cases. I would prefer to bring up the imbalance first, then focus on evening out after a better strength ratio is established.

This can all be done with some specific tests though... you should only be able to internally rotated maybe about 3:2 ratio of what you can externally rotate. So 15 lbs internal to about 10 lbs external. I've seen cases where it's 25 external and about 5 internal so... obviously you don't need internal work at least yet if that's the case.


OP -- also forgot to say that don't do anything that aggravates it. If any exercises aggravate it then lay off them for now.

REST + fish oil + massage is key to getting the pain and inflammation down.
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Old 02-10-2010, 07:18 PM   #5
David Tybor
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Re: Bilateral Rotator Cuff/Impingement

Quote:
Originally Posted by Gregory Norman View Post
The pain came from doing overhead movements like overhead squats, push press, etc.
How is your form? Keeping the shoulder "active?"
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Old 02-16-2010, 12:35 PM   #6
Jim Southwell
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Re: Bilateral Rotator Cuff/Impingement

I have been having exactly the same issue that Gregory describes but only with y left shoulder. My intention is the follow Steven's directions. However, I have a couple questions.

1. Unlike Gergory, I haven't had an MRI done. My Dr. suggested PT first to increase my ROM (which was horrible) and to try to alleviate the symptoms. Should I demand an MRI to ensure there isn't a tear that is causing pain?

2. Is there any sort of archive of WODs that won't impact the shoulders. I have been doing tabatas with air squats, sit-ups and then some track intervals but that is getting boring.

Any thoughts would be appreciated.
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Old 02-16-2010, 06:52 PM   #7
Steven Low
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Re: Bilateral Rotator Cuff/Impingement

Quote:
Originally Posted by Jim Southwell View Post
I have been having exactly the same issue that Gregory describes but only with y left shoulder. My intention is the follow Steven's directions. However, I have a couple questions.

1. Unlike Gergory, I haven't had an MRI done. My Dr. suggested PT first to increase my ROM (which was horrible) and to try to alleviate the symptoms. Should I demand an MRI to ensure there isn't a tear that is causing pain?

2. Is there any sort of archive of WODs that won't impact the shoulders. I have been doing tabatas with air squats, sit-ups and then some track intervals but that is getting boring.

Any thoughts would be appreciated.
1. Ehhh, it depends.

If your insurance covers most of it sure why not if you really want that much confirmation. Make sure you get contrast though otherwise you may not be able to see potential labrum tears.

2. Legs, core, flexibility.

If it's bilateral you can always do grip work. If it's only unilateral you can keep strength up wtih the othr arm.

IN general, don't do anything that aggravates it...
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Old 02-20-2010, 01:35 PM   #8
Lenora Galitz-Pfeffer
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Re: Bilateral Rotator Cuff/Impingement

Sorry that I haven't posted in months. I'd like to add that a "theracane" has helped me tremendously because trigger points were related to the impingement. I do joint mobility exercizes as part of my warm-up. Steven Low knows what he's talking about. He was helpful to me last year. Probably prevented tears. Myofacial release treatments have been helpful, and so is ice post-workout. Strict ring rows have helped me fix some of the strength imbalance. Good luck.
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