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Old 02-16-2009, 10:09 PM   #1
Stephen Russell
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Shoulder flexibility issue when transitioning overhead

This is my problem. I have a shoulder flexibility issue with my left shoulder when moving overhead. I have a wierd notchiness on the way up. It's most obvious when I do wall extentions (ie Gymnastic Bodies Wall Extentions). I have used the search function but most threads seem to deal with an inability to actually get a load all the way overhead. I am wondering what causes this and what I can do to get rid of it/reduce it?

Is it possible my AC joint tendonitis from competitive swimming plays a role in this? I get a bit of clicking in my shoulder when doing a bench/pushup movement and there is a dull pain. If I rotate my arm at full ROM when it is fully extended straight out to my side I get a prominent clicking as well on the top of my shoulder. Already had an Xray and MRI when it was worse and the doc said it was just AC joint tendonitis. Any suggestions/comments are greatly welcomed as I need to solve my shoulder issue with the training I'll be doing this summer. Thanks!
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Old 02-16-2009, 10:19 PM   #2
Steven Low
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Re: Shoulder flexibility issue when transitioning overhead

Foam roll your thoracic spine & practice some elevating and protracting your scapula. See if that helps.

Clicking is fine if there's no pain, but if there's pain then something is going wrong in there, heh.

Check your external and internal rotation angles if you can. If you're deficient in one or another it could indicate something.
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Old 02-17-2009, 01:01 AM   #3
Christian Lemburg
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Re: Shoulder flexibility issue when transitioning overhead

Hi Stephen,

get educated about the rotator cuff muscles and their function. Search around for trigger points in them and self-massage (see link in my sig for more info). Since your X-ray and MRI show no structural damage, this is all about cramped muscles and inefficient movement.

When the rotator cuff muscles are cramped, they will prevent smooth movements in the shoulder joints - this is what is happening to you and has also caused your AC joint tendonitis problems (and you bet those are connected to the problem you describe here). The crampening of the muscles happened due to misuse of those muscles. The only way to get this fixed long-term and stay as active as you are is to understand what caused the problem in the first place and address that issue by modifying your movement patterns accordingly.

But to allow this, massage (foam-rolling, self-massage with wall-hook or ball lying on floor, massage from some partner or professional) is needed to free up the muscles.

I also would highly recommend to go to a Feldenkrais practitioner and pay for one individual session on this issue. Have him explain what he does when he does it, and do your anatomy homework before so you understand what he is talking about. That will probably fix the movement issue very fast.

Good luck, and fast recovery,

Christian
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Old 02-17-2009, 02:38 PM   #4
Stephen Russell
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Re: Shoulder flexibility issue when transitioning overhead

Thanks for the input! I really appreciate it. I will definately get a foam roller and make the tennis ball contraption to see how they work for me. Is professional myofacial release worth looking into, or can I just take care of that myself with smf using rollers/balls?

I am going to the orthopedics Thursday for a 3rd opinion, this time with a sports orthopedic who was a physician for the SEAL Teams for a time. Last two ortho's I saw didn't really give me much other than, "get back into it slowly and see what happens." Even after X-rays and an MRI. I'll see what this doc says and keep on with the overhead presses and shoulder rehab. Thanks again!

Stephen
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Old 02-19-2009, 10:23 PM   #5
Stephen Russell
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Re: Shoulder flexibility issue when transitioning overhead

So I had my third opinion with an orthopedic this afternoon. He looked at my xrays and mri with arthrogram and played around with my arm for a bit. It was reaffirmed that I have an inflamed AC joint but he deduced that the clicking when I do pressing movements in the horizontal plane (pushup/bench) was bursitis in my coracoacromial ligament. I received a cortizone shot to see how that would affect my inflamation/bursitis. He referred me to see a real PT, not a trainer at my school, of which I have no problems doing. If the physical therapy and rest does not work, then surgery is an option. This procedure would include releasing the coracoacromial ligament if its bursitis persists and shaving of the distal clavicle to address the AC joint inflamation. I'm pretty sure I got that all right..

As a believer in the CrossFit way of life I am a bit skeptic of many in the medical community and don't want to see some joe-blow PT. What should I look for in a physical therapist? Should I focus on certain treatments? I plan on getting the book on SMR and getting the tennis balls and foam rollers working for me for the mobility issue, but I am curious to treatment options on the bursitis/tendonitis?

If anyone has any input on finding a good PT (I'm in Lexington, VA) and/or what to look for in a PT that would be spectacular. Also, treatment ideas for AC joint tendonitis and ligament bursitis would be awesome as well. Thanks!!
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Old 02-20-2009, 09:18 AM   #6
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Re: Shoulder flexibility issue when transitioning overhead

I just found my PT referral and my problem other than the AC joint is anterior sub-acromial bursitis from overuse. From what he said, and what I've researched, it seems only rest and anti-inflammatories are the only treatment other than injections. Anyone have experience with this?
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Old 02-20-2009, 05:15 PM   #7
Steven Low
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Re: Shoulder flexibility issue when transitioning overhead

Quote:
Originally Posted by Stephen Russell View Post
I just found my PT referral and my problem other than the AC joint is anterior sub-acromial bursitis from overuse. From what he said, and what I've researched, it seems only rest and anti-inflammatories are the only treatment other than injections. Anyone have experience with this?
Yup... bursitis goes away with rest... and ice/anti-inflams. Basically, inflammation of the bursa sacs that help lubricate movement (so there's not a lot of friction). When they get inflammed.. movement hurts.

Work on some weaknesses like flexibility and do lower body work.
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