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Old 10-16-2006, 12:38 PM   #1
Greg Battaglia
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I finally got my MRI results for my shoulder injury. They found that I have an impingement of the supraspinatus. They gave me a cable and some rotator cuff exercises to rehad on my own. The only thing they really said to avoid was military presses and benching. The doctor also said that when deadlifting I should use alternate grips for each hand (one pronated, the injured one supinated) to avoid and undue stress. Other than that they told me nothing meaningful! So, what should I do? Is there any standard protocol for shoulder impingement? What should I avoid and what should I do? Thanks!
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Old 10-16-2006, 01:58 PM   #2
Ben Kaminski
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Sorry to hear about your shoulder.

I always try to learn as much as I can from my injuries, to prevent them from happening again. I assume you know what caused it?

Impingements are wierd among injuries. I had one once, from OHSing 95# with lousy form (let my shoulders sag down). Mine was minor, just a tingling in my thumb that lasted several days. But it made me take notice, that's for sure.

Similarly, I once slept on my shoulder wrong and my arm had a numbing/throbbing pain for two days. A friend of mine slept on his shoulder wrong and had his thumb go numb for 2 months or more.

Unfortunately, I don't know how to specifically rehab an impingement. In my experience, and from what I have seen/read on this forum, they simply take time to go away.

Do you have difficulty raising your arm above your shoulder, or any other ROM issues? This would identify some rehab exercises to focus on.

Good luck and keep us posted!
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Old 10-16-2006, 02:36 PM   #3
Greg Battaglia
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No, I have absolutely no pain for most movements at this point except for when I pull my arm back as far as it will go (think rowing). I can feel the pinch when I go this far. The impingement was basically caused by overtraining, I believe. More specifically, it occured one day a few hours after doing "fran" in a definitely overtrained state. I got mad or excited for some reason and tensed up my chest and back in anger a suddenly BOOM sudden shooting/achey pain right through the posterior side of my shoulder. That was about 4 months ago, it hasn't been the same since. When I rest on it for a while it seems to become fully recovered, no pain, full range of motion, the whole 9 yards. When I start workouting out again, the pain returns within a few days.
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Old 10-17-2006, 03:43 PM   #4
Elliot Royce
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I think one of the PTs will tell you that impingement can result from the way your shoulder is constructed and that it may therefore not be something you can work around entirely. The inflammation will go away (although I've found that mine takes a long time but of course I'm not your age) but that doesn't mean it can't flare.

Simple answer is to avoid things that cause it. I've found that subbing dumbbells for barbells is a big help because it allows your shoulder to rotate more naturally. So just work around it. Fortunately, I haven't found that O lifting is bad for it because there is momentum. But then again I haven't gotten to heavy weights yet.
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Old 10-17-2006, 04:29 PM   #5
Greg Battaglia
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Is there any known way to reverse impingement? I mean, it's just a piece of muscle being pinched off right? There must be some way to shift the muscle out of the pinch??
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Old 10-17-2006, 09:41 PM   #6
Elliot Royce
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Greg:

I have limited knowledge here because my supposed impingement problems were actually rotator cuff tendonitis. You need to wait for one of the PTs to chime in, or perhaps better still go see one. But while you're waiting, here are a few thoughts:

1) it's certainly possible that the impingement is misdiagnosed. My doctor was only able to diagnose a rough impingement or tendonitis. Of course, he didn't do an MRI. Still it's not a science.

2) The point I was making before is that the shoulder is not a "well designed" joint like the hip. I know you are a subscriber to the "evolution has designed us optimally" school of thought but shoulders and knees are Nature's joke on us. There are muscles and tendons trying to squeeze through tiny little spaces in the shoulder and some people have a bone formation which really limits the room for these. In this case, impingement is really just a matter of time. [This is my best understanding of what I've read but I'm no expert].

As you get older, you'll realize that sometimes we just have to make compromises with anatomy or age or both. If you have a shoulder prone to impingement, then there isn't too much you can do. Although the fact that the doctor's giving you rotator cuff exercises suggests that he may be certain about the diagnosis.

There are certainly lots of exercises you can do for the shoulders that would probably avoid impingement.

Crossfit cannot be taken unadulterated by everyone. Sometimes we have to make our own modifications.

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Old 10-18-2006, 07:59 AM   #7
Megan Greene
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I specifically asked my (sports-med) doctor if any sort of shoulder positioning would be healthiest for my shoulders (i have problems with bursitis, instability, frayed RC tendons, etc). He said he couldn't think of anything I could do that would make a difference. When you raise your arm, you are reducing the space around your supraspinatus . It's more or less trapped between bones so you can't move it out of the way.

My understanding is that inflammation makes impingement worse (because everything is bigger than usual), so rest, ice, and nsaids might help to "reverse" the impingement.
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Old 10-18-2006, 09:27 AM   #8
Jerimiah Childress
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The only way to "reverse" impingement is what elliot said. You have to lay off anything that agrivates it and let the inflammation go down. Then you need to get on a strict program to strengthen the supraspinatus so that it won't get impinged.
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Old 10-18-2006, 05:50 PM   #9
Greg Battaglia
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Yeah, he said it wasn't "serious". So I don't know. I was under the impression that impingement is what CAUSED inflammation/tendonitis of the supraspinatus? The muscle gets caught between the bones and the bursa sack becomes agitated, resulting in inflammation, thus placing larger pressure on the supraspinatus. Nevertheless, I've been doing the exercises and it already feels pretty darn good to be honest with you. I'm going to skip this week, but if things keep improving at this rate I should be back next week. That'd be great. Thanks for the help though, I appreciate it.
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Old 10-18-2006, 06:33 PM   #10
Mike ODonnell
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Just remember...anything so called medical condition that ends in "itis" is inflammation...so treat that first.
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