Injury Q & A with Dr. Joe

[Bobr]

Thanks, Joe. I'm still not sure how I will approach my training. I have a feeling that it may become painfully obvious(pun intended) at some point. I guess I will stay with the creatine.

[axioma]

Z noticed that the left side of my middle back was more developed, or at least pumped, that the other side. Didn't feel like a pulled muscle, so I am thinking an imbalance in legs/hips that is causing stress factors in that area? I wear orthotics, however they didn't look at relative femur length, hip girdle, nothing...just took mold of my feet. What if I need a shim? Joe, if you have any input here...a good sports related P.T. to measure and assess? Chiros around here are of the 20 min. in and out variety, nothing cutting edge.

[joedemarco]

Z noticed that the left side of my middle back was more developed, or at least pumped, that the other side. Didn't feel like a pulled muscle, so I am thinking an imbalance in legs/hips that is causing stress factors in that area? I wear orthotics, however they didn't look at relative femur length, hip girdle, nothing...just took mold of my feet. What if I need a shim? Joe, if you have any input here...a good sports related P.T. to measure and assess? Chiros around here are of the 20 min. in and out variety, nothing cutting edge.

Without taking a look, it is a little difficult to assess the situation. However, I can tell you that I have seen over developed sides of the back quite often. It can be the result of an anatomically short leg. That is a permanent condition that can't be changed and would require something like a heel lift to level out.

However, more times it is the result of a pelvic unleveling. I will also use a heel lift on the patient in this case, however only on a temporary basis (until I can get the pelvis to level off).

My former training partner (the one that I have mentioned with all of the aches & pains) had a very similar situation. I put a lift in his shoe and a lot of his discomfort went away. We are currently working on his pelvis so that we can take the lift out eventually.

Let me know if you have any other questions.

[axioma]

thanks joe, I will look for someone locally to help. I look forward to getting together with you soon, so I can have an expert evaluate me.

[KevinCouch]

thanks joe, I will look for someone locally to help. I look forward to getting together with you soon, so I can have an expert evaluate me.

Matt, my chiro had me use a lift in my left show because of my unbalanced pelvic area and I had to wear it for about 5 weeks (if I recall) until hips lined up with treatments. Now I wear orthodics on both feet. Never thought about lats being over or underdeveloped on one side because of the imbalance of your hips. My chiro is NOT a BB so he wouldn't have thought of that. Good chit Joe!!!

I have heard about improper blood and oxygen getting to the area will inhibit muscle activation and growth. That's why I get deep tissue and active release massages as often as I can afford to....

[axioma]

Joe,

I notice that when I bench in the 80% 1RM range that my left shoulder is extremely unstable. By this I mean the attachment of the rear delt, triceps area at the humerus. This occurs during the negative/loading portion of the bench. The pain starts rear delt and goes into tricep and biceps brachii as the load increases. Once I push/unload the bar, no pain. I have been diagnosed with a torn labrum and I tore the biceps/biceps brachii several years ago. Once this pain sets in, it compromises my strength on flyes, same pain. I don't seem to have nearly the issues with incline bench. Ideas?

[joedemarco]

Joe,

I notice that when I bench in the 80% 1RM range that my left shoulder is extremely unstable. By this I mean the attachment of the rear delt, triceps area at the humerus. This occurs during the negative/loading portion of the bench. The pain starts rear delt and goes into tricep and biceps brachii as the load increases. Once I push/unload the bar, no pain. I have been diagnosed with a torn labrum and I tore the biceps/biceps brachii several years ago. Once this pain sets in, it compromises my strength on flyes, same pain. I don't seem to have nearly the issues with incline bench. Ideas?

It is most likely the result of the labral tear. The shoulder is a very unstable joint. The labrum actually helps create some stability for the shoulder. With it torn, the joint is even more unstable then it already is. As the result of the tear, your rear delts, tricep, etc. is probably being over utilized to help support the joint. Thus, resulting in pain. Therefore, I would be careful, because if you are creating undue stress on those muscles you are increasing the chance of injuring them.

Do you know how badly the labrum is torn? My buddy had surgery on his labrum a couple of years ago because he actually had a 360 degree tear of the labrum. Doctor said it was the first time he ever saw that. Usually it is only partially torn.

[axioma]

No idea. Thanks.

[masterschamp]

Joe,
This is a copy of a post I had actually sent to Steve. Was wondering if you might have any other suggestions.



On a side note....the glute/ham pain I was experiencing was actually a sciatic? nerve problelm. Went to a chiro for the first time yesterday at the suggestion of someone at the gym after I told him the pain was moving around in my leg too. The doc showed me the x rays of my spinal column! Looked CRAZY!..... he said it is what he calls the "bodybuilder's question mark". Damn thing took about a 1/2 an inch turn to the right and then back in the lower back area.He said after 35 years of lifting heavy it really wasn't unexpected, if you lift that long all the compression over the years is going to have some effect.......said he could treat and it should resolve.Looks like regular chiro trips are now an official part of
my training regimen!


Keith

[joedemarco]

Joe,
This is a copy of a post I had actually sent to Steve. Was wondering if you might have any other suggestions.



On a side note....the glute/ham pain I was experiencing was actually a sciatic? nerve problelm. Went to a chiro for the first time yesterday at the suggestion of someone at the gym after I told him the pain was moving around in my leg too. The doc showed me the x rays of my spinal column! Looked CRAZY!..... he said it is what he calls the "bodybuilder's question mark". Damn thing took about a 1/2 an inch turn to the right and then back in the lower back area.He said after 35 years of lifting heavy it really wasn't unexpected, if you lift that long all the compression over the years is going to have some effect.......said he could treat and it should resolve.Looks like regular chiro trips are now an official part of
my training regimen!


Keith

Well, never heard of the "bodybuilder's question mark"..lol, however all of us beat our spines up by training heavy over the years. Regular chiropractic care will be a big benefit to your training. I know it has helped me over the years stay injury free. Let me know how you make out.

[Baldiewonkanobi]

Joe, thought I would throw out some facts/observations/and open up for listening.....

Its been a short 13 weeks since my surgery to re attach my left pec to the humerous bone. My thread in here has cronicled most of my healing. I am avoiding any wide pressing and doing close grip Hammer incline presses, olympic bar punches, high rep pec deck, high rep incline flies, high rep flat bench flies, light pull overs, high rep cable work. Weakness, no pain, and I have my ROM back.

I am healed. However I have a half a golf ball sized ball of tissue dead center of the pec. There was NO tear there. Doc says its dried blood and will disolve....really?? The ball gives me the visual dreaded "pec tear dimple". I must really pose carefully to hide this defect.

75 days 'till show time.

Ideas??


Baldie

[joedemarco]

A tremendous recovery for being only 13 weeks post-op. Your avatar picture speaks a 1,000 words. Is you question related to how to rid yourself of the blood mass in your pec or how to train your pecs at this point? Just wasn't sure what you were asking.

[Baldiewonkanobi]

Joe...I would like to diminish the dried blood mass in short order. I have iced, moist heat and daily massaged. What might be helping a bit is that my upper pec work is taking effect....I do some pec work daily. Press one day, flies next, pull overs next.

Thoughts?

Baldie

[joedemarco]

Joe...I would like to diminish the dried blood mass in short order. I have iced, moist heat and daily massaged. What might be helping a bit is that my upper pec work is taking effect....I do some pec work daily. Press one day, flies next, pull overs next.

Thoughts?

Baldie

Sounds like you have it covered. The only thing that I would be doing, in addition to what you listed, is hitting the area with ultrasound therapy. If you know a therapist who will do it for you, get it done.

[DR.BB]

I am in my 40s and have been training for 25 years. For the past 5 years I constantly tear muscles. Both biceps are visibly a mess from tears; my quad has a quarter sized hole from a tear; I tore my triceps off the bone, and have an ongoing hamstring tear.
I was treated by a leading pro sports surgeon, who was nonjudgmental and very cool about trt, but he could only suggest that aas as a possible cause. Another doc (works with athletes) guessed high cortisol. My cortisol levels are slightly above the normal range. I took 11oxo (adrenosterone) for awhile and no change.

While I still train hard, I am very careful with form (never bounce weights and have a very controlled range of motion). So, I really don’t think it is form or from trying to lift heavy. I don’t use any crazy weights anymore. I can still do 20 plus reps with 315 on squats, for example, but train regularly with 225 or 275 max, and stop when I do 315 at 8-10. I once pulled my quad squatting 185! I take a week off every six to eight months, and train a body part once per week.

Every other month I tear a muscle, sometimes real small, other times enough to avoid training that muscle for a month or more. Sometimes I feel like my quads will tear walking up stairs, no joke. My biceps tighten up from routine activities including brushing my hair, again, no joke, It is fuck'd up. I take a multivitamin, D3, omega 3, 200mg/wk trt dose.
My question: have you ever heard of constant muscle tears?