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  1. #31
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Default Diabetic Muscle/ Shoulder Biceps

    Quote Originally Posted by Diabetic Muscle View Post
    I have this shoulder/bicep issue that has been giving me problems for over a year now. I was suffering from some minor impingement in the left shoulder back in 09. Mostly due to lack of rear delt strength. Strengthened the rear side of the shoulder with a lot of direct rear delt work and external rotations. Fall of 2010 I started getting this bicep pain on the outside near the lateral head of tricep and brachioradialis. Primarily when pressing on the eccentric portion. It's been so bad I've had to stop the workout and take a week off from any upper body work. No has been able to tell me what this is or how to fix it. I've had an MRI done on the shoulder, no tears or abrasions on any of the tissues. Have some chronic inflammation of the bursitis. A neuromusclar massage therpist told me I had a sublaxation of the bicep long head tendon. Othro says to stop lifting. (haha like that's going to happen) Any ideas?
    DM,

    Well, a couple of things are clear. You have subacromial bursitis. (That is the chronic bursal inflammation in the shoulder.) The fact that there is no damage to the rotator cuff is good. And, you need to find a Sports Medicine Orthopedic that works with athletes. The MDs I work for have given several of my training partners shoulder injections pre-meet and removed spurs from my shoulder so I could bench heavy again. You need to ice your shoulder after every training session and if your are going to lay-off anyway get a cortisone shot. That will get rid of the inflammation and your rehab will be more meaningful. Also, you need to do some "jump stretch" band stretching and a little band compression work.

    Now to what is unclear. If you had a subluxation of the long head of the biceps, the pain would be more proximal and anterior then where you describe. However it makes sense with the pain during the eccentric load of the bench press. I wonder if there is a small SLAP tear in the labrum. An MRI may not pick out a small tear. That would account for some biceps pain during an eccentric load. Does your shoulder ever hurt after the press when you release your grip from the bar? Do floor presses hurt more then bench presses?

    Let me know,

    MJ

  2. #32
    BARBARIAN BROTHER Diabetic Muscle's Avatar
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    Quote Originally Posted by Mike Johnston, PT, CSCS View Post
    DM,

    Well, a couple of things are clear. You have subacromial bursitis. (That is the chronic bursal inflammation in the shoulder.) The fact that there is no damage to the rotator cuff is good. And, you need to find a Sports Medicine Orthopedic that works with athletes. The MDs I work for have given several of my training partners shoulder injections pre-meet and removed spurs from my shoulder so I could bench heavy again. You need to ice your shoulder after every training session and if your are going to lay-off anyway get a cortisone shot. That will get rid of the inflammation and your rehab will be more meaningful. Also, you need to do some "jump stretch" band stretching and a little band compression work.

    Now to what is unclear. If you had a subluxation of the long head of the biceps, the pain would be more proximal and anterior then where you describe. However it makes sense with the pain during the eccentric load of the bench press. I wonder if there is a small SLAP tear in the labrum. An MRI may not pick out a small tear. That would account for some biceps pain during an eccentric load. Does your shoulder ever hurt after the press when you release your grip from the bar? Do floor presses hurt more then bench presses?

    Let me know,

    MJ
    I would say it was equal on floor press and bench. Never any pain after only during. I am familiar with jump stretch band stretching but not compression, can you elaborate?

  3. #33
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Default Shoulder Pain

    Quote Originally Posted by Diabetic Muscle View Post
    I would say it was equal on floor press and bench. Never any pain after only during. I am familiar with jump stretch band stretching but not compression, can you elaborate?
    DM,

    Good then I would say that it is just the bursitis. And probably some lingering RTC impingement. The RTC impingement can cause some symptoms down the arm. You have have pain sleeping on that side as well as reaching behind your back, etc. Even though you did the posterior deltoid work and evened things out, you still have inflammation. Continue to ice, do the rehab work and I would inquire about the cortisone shot.

    The compression bands are also available at jump stretch. They are thin bands that you wrap around the injured area super tight. Then you move the shoulder with light band resistance through a variety of ranges for 2 to 5 minutes. the idea is that when you unwrap the compression band the shoulder will be infused with blood and promote healing. The compression itself will aid in reduction of swelling. At least that is the theory. I t feels pretty good and is a decent warm-up.

    Best,

    MJ

  4. #34
    GameofInches
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    I bought a reverse hyper this week, and it should be delivered this week. I am excited to start using it to rehab/build up my posterior chain. Should be fun

  5. #35
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Default Reverse Hyper

    Quote Originally Posted by GameofInches View Post
    I bought a reverse hyper this week, and it should be delivered this week. I am excited to start using it to rehab/build up my posterior chain. Should be fun
    G o I,

    Awesome! I use the reverse hyper twice a week. I personally never go real heavy, but boy what a blood pump in the back! I also have all my knee rehab folks do reverse hypers as well as my back people when they can tolerate it.

    Don't forget to stretch the hamstrings, calves and hips!

    MJ

  6. #36
    ASC Pro Strongman Ryan Bracewell's Avatar
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    I'm back for more free medical advice, haha. So last night in the shower, while pissing or farting or both, I had a sharp pain that rain from the upper left of my but crack to my low spine, almost like back side of my left hip. Didn't think much of it until this morning when doing squats and I started getting pains in my hip area, even with warm up weights. This seems odd that I would be having pains since I have not worked out in two weeks because of the newborn and I normally feel stuff like this when I'm overtraining. Thoughts?

  7. #37
    OLYMPIAN s2h's Avatar
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    Quote Originally Posted by Ryan Bracewell View Post
    I'm back for more free medical advice, haha. So last night in the shower, while pissing or farting or both, I had a sharp pain that rain from the upper left of my but crack to my low spine, almost like back side of my left hip. Didn't think much of it until this morning when doing squats and I started getting pains in my hip area, even with warm up weights. This seems odd that I would be having pains since I have not worked out in two weeks because of the newborn and I normally feel stuff like this when I'm overtraining. Thoughts?
    good grief bracewell..only you could get hurt pissing and farting....

  8. #38
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Quote Originally Posted by Ryan Bracewell View Post
    I'm back for more free medical advice, haha. So last night in the shower, while pissing or farting or both, I had a sharp pain that rain from the upper left of my but crack to my low spine, almost like back side of my left hip. Didn't think much of it until this morning when doing squats and I started getting pains in my hip area, even with warm up weights. This seems odd that I would be having pains since I have not worked out in two weeks because of the newborn and I normally feel stuff like this when I'm overtraining. Thoughts?
    Well, let's see, you are a big fella, and as such, are prone to extreme flatulence, however I doubt that ripping a a hard fart would cause back pain. And, since you were standing in the shower I presume you weren't holding your massive man parts while urinatining, so that probably didn't through your back out. Rather, I would guess the sitting around in hospital chairs made for "normal" sized people and all of the hunching over you did while holding the newest Bracewell, stressed your SI joint.

    Slow down your training and focus on some extension stuff for a day or two (i.e. RDLs, supermans, reverse-hypers.) Also stretch the hips, hamstring, and calves real well. I usually have SI joint dysfunction from getting out of position. It doesn't seem to matter whether it is while pulling heavy or sitting in a shitty chair for too long. Ice your back a couple of times a day while lying on your belly as well.

    Let me know how it goes!

    MJ

  9. #39
    BARBARIAN BROTHER Diabetic Muscle's Avatar
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    Alright lets see if I can explain this one. When benching on the eccentric movement my scapula move up towards my head. It's unseating me during benching. I've tried several angles of decent and all seem to have the same effect. I suspect it's caused by overly tight musculature on the front, (pecs and delts) but curious to hear your opinion.

  10. #40
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Default Scaular motion

    Quote Originally Posted by Diabetic Muscle View Post
    Alright lets see if I can explain this one. When benching on the eccentric movement my scapula move up towards my head. It's unseating me during benching. I've tried several angles of decent and all seem to have the same effect. I suspect it's caused by overly tight musculature on the front, (pecs and delts) but curious to hear your opinion.
    DM,

    I presume this is with a shirted bench? If so what type of shirt do you use? What is your set-up like? Just lie down? Arch under and pull yourself back into position? Is there any pain associated with this? Does the bar path change when the weights get heavy?

    Let me know.

    MJ

  11. #41
    BARBARIAN BROTHER Diabetic Muscle's Avatar
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    Quote Originally Posted by Mike Johnston, PT, CSCS View Post
    DM,

    I presume this is with a shirted bench? If so what type of shirt do you use? What is your set-up like? Just lie down? Arch under and pull yourself back into position? Is there any pain associated with this? Does the bar path change when the weights get heavy?

    Let me know.

    MJ
    Nope raw bench. For my setup I pull my upper body behind the bar set my feet and slide back under the bar rotating my scapula down as I go. There is no pain it's just a imbalance type thing, no pain, happens at all weights. Even as I sit at the computer if I do the same motion the same thing happens. Tuck the elbows and come down the scapula rise towards my head.

  12. #42
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Quote Originally Posted by Diabetic Muscle View Post
    Nope raw bench. For my setup I pull my upper body behind the bar set my feet and slide back under the bar rotating my scapula down as I go. There is no pain it's just a imbalance type thing, no pain, happens at all weights. Even as I sit at the computer if I do the same motion the same thing happens. Tuck the elbows and come down the scapula rise towards my head.
    Try adding some serratus anterior exercises to your RTC rehabilitation work. Things like push-up with a plus or scapular punches lying on your back. The serratus helps to control scapular motion. Add some more posterior delt and upper back work, like face pulls. (Really focus on squeezing the shoulder blades together.) Try that for 6 weeks and see how it affects your bench set-up.

    MJ

  13. #43
    BARBARIAN BROTHER Diabetic Muscle's Avatar
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    Quote Originally Posted by Mike Johnston, PT, CSCS View Post
    Try adding some serratus anterior exercises to your RTC rehabilitation work. Things like push-up with a plus or scapular punches lying on your back. The serratus helps to control scapular motion. Add some more posterior delt and upper back work, like face pulls. (Really focus on squeezing the shoulder blades together.) Try that for 6 weeks and see how it affects your bench set-up.

    MJ
    My Neuro massage guy found a huge knot/adhension of the trap to the scapula. After 2 1 hour sessions he got it broke up and 90% of the issue went away. Crazy I didn't even know it was there.

  14. #44
    ASC Rehab Guru Mike Johnston, PT, CSCS's Avatar
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    Quote Originally Posted by Diabetic Muscle View Post
    My Neuro massage guy found a huge knot/adhension of the trap to the scapula. After 2 1 hour sessions he got it broke up and 90% of the issue went away. Crazy I didn't even know it was there.
    The trick now is to strengthen the supportive musculature so the "adhesion" or trigger point doesn't come back.

    MJ

  15. #45
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    Hi Mike, my elbow hurts me when I bench press it SUCKS and is making me miserable cuz it is costing me strenth. Any help on how to fix this? I think it is the tricep tendon.

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