Shoulder

Mark

i've been following this thread with interest.

Don't have surgery before talking to a remedial therapist. Make sure you explain how you work as well as mentioning the hockey. My partner is a remedial therapist with 25 years experience. If you want to discuss it with her, I think you might save yourself some future pain and discomfort. Exercises need to be specific and perfectly executed to be effective. I had supervision for an hour a week for 6 months, just to perfect my technique. Practice doesn't make perfect - perfect practice makes perfect! Don't waste time with exercises that may make things worse.

Don't put it off any longer - get it sorted PROPERLY.
 
I´ve done my shoulder operation now. Showed out that it was the joint itself that was too flexible and instabile in addition to too little room for the sene. I´ve got an extencive trainingprogram ahead and am on a sickleave for six months before I return better then ever. Plan is to participate in next years Norwegian tcc (old boys class)
Svein
www.hogstogrydding.no /forum/images/graemlins/beerchug.gif
 
Mark, I caught this thread and quickly read through every post. Allow me to provide my input.

1) DO NOT HAVE SURGERY !
2) Follow the exercise routines that I will describe in a moment.
3) Consider the possiblity that your rotator cuff--whether it's one of these tiny muscles, or all four--has "forgotten" how to efficiently function. Because of all your pain and discomfort, it has no doubt atrophied (shrunk) and lost a lot of its efficiency and--what I refer to as joint integrity. You must rebuild it, and re-teach it how to be reliable.
4) Never, never work through the pain! The rotator cuff by nature is a spoiled, stubborn structure that needs to be outsmarted by you.

Day-to-day, everyday movements can either cause, or aggravate, a rotator cuff problem. These daily, routine motions include: reaching for a jar on a high shelf, reaching to the back seat of the car while you're in the driver's seat, and slipping your arm into a coat jacket.

While performing these routine motions, the palm is typically either downward, or facing forward. Visualize how you fight to get your arm through a tight coat jacket. Your palm is probably facing the floor. When you reach up to get that jar, the palm is facing down. The problem with the palms-down approach is that it causes the humerus bone to come in very close contact with rotator cuff tendons. If those tendons are already inflamed, the bone will rub against them and fray them. Palms-down closes the space in the gleno-humeral cavity.

Palms-UP, however, opens this cavity, providing more "air space" for the humerus to rotate. It then does not rub against the tendons. This will give the tendons opportunity to heal.

In summary, whatever you do in life, KEEP YOUR PALMS UP ! When you pick up brush, keep palms up. When you reach for the jar or whatever, keep palm up. Grab the item, then lower it with palm up. When you pick something up off the floor or ground, face palm away from you, not toward you. If you're carrying luggage or something heavy with a handle, face palm away from you (facing someone standing in front of you), rather than toward your hips. This will take conscious thought until it becomes a habit. When climbing, grab branches with a supinated wrist (palm facing you this time), rather than palm facing away from you.

How you handle dumbbells during workouts can also be preventing your shoulder from healing. If you do dumbbell presses, pay attention to how you enter and exit the routine. When you pick up the weights, keep palms facing away from you, not toward you. Keep upper arms pinned to your sides, not flaying out, as you enter and exit!

Guidelines for weight workouts:
1) Whenever you pick up dumbbells, regardless of the routine about to take place, pick them up so that your palms are facing forward (like how they'd face someone standing in front of you), rather than backwards or towards your hips.
2) Do not do dumbbell or barbell presses on a flat bench! Tilt the bench slightly to take stress off the RC.
3) If you do lat pull-overs, do NOT do them behind your neck!
4) For lat pull-overs, do not use a wide grip with heavy weights. If anything really disrupts the RC, it's wide-grip, heavy lat pull-downs.
5) For dumbbell presses, keep palms facing each other at all times.
6) If you do triceps push-downs, keep upper arms GLUED TO YOUR SIDE at all times. Do not let upper arms flare out. A person should not be able to slip a piece of paper between your upper arms and sides.
7) If you're doing the "pec-deck," adjust the seat to its highest level. A low seat stresses the RC.
8) If you do seated chest presses, again, adjust the seat to its highest point.
9) Avoid dips and pushups until your shoulder significantly improves.

REHAB EXERCISES
In addition to the routines described in this thread, here are some more. These will re-acquaint your RC with what it was meant to do: be reliable and pain-free.

Figure out what weight routines bring on the pain. You will be doing these, with the exception of dips, pushups, and flat-bench pressing motions.

For every one of these exercises that brings on pain, simply go through the motions of these routines WITHOUT any weights, to see if just the motion itself is painful or tweaky. If it is, then you are limited to just that. Pay attention to at which point along the motion, the pain starts coming on. This is your threshold point. Do not move past this point! Rather, stop a few inches short of it. That is where your range of motion is to end. Do several sets daily or every other day. In a few weeks, you will notice that your threshold point will start moving further out in the range. When you can conduct the entire range of motion free of pain, it's time to add weights. Do not get ahead of yourself. You are NOT ready for the 30-pounders at this point. If weight-less motions caused pain, then your next step up is 5-pound weights. This sucks. But remember, the RC is a spoiled little child that needs to be re-taught its purpose, one small increment at a time. Do three sets each routine, 20 reps. If weight-less motions, at the beginning, do not bring on pain, then in small increments, increase weight in order to find out at what weight brings on the pain. So, for example, suppose 25-pound dumbbell presses bring on pain, but the 20-pounders don't. Then you work with the 20 pounders, striving to perfect complete range of motion for 20 reps, before moving on to the 25-pounders. Do not even look at those 30 or 40 pounders.

In summary, you will have to abandon the heavy weights. And here's the toughest part to swallow: This rehab routine will take a minimum of six months before you can actually handle more "manly" weights without pain. If you get ahead of yourself for just one set, you can literally set yourself back those six months. Then you're back to ground zero again. BE PATIENT.

Lat pull-overs: Though wide-grip is out with heavy weight, performing wide-grip with light weight is actually very, very therapeutic. Keep neck and head straight. Do not crane your head up as you pull down the bar. KEEP FOREARMS VERTICAL !! Bring bar down only to chin level. Hold for two seconds. The weight must be light enough to allow 20 EASY reps. I'm going to guess that a good weight for you would be 30-45 pounds. Yes, that's sissy weight, but look at it this way: You've been fighting a losing battle with your shoulder for too long now. It's time to be humble and lift the girlie weight load. Three sets, 20 reps. You can continue to lift heavy WITH A NARROW GRIP. Lifting light with a wide grip will be your permanent warmup that precedes every back and chest workout.

Good luck.

Shellbi
 
Nice info there mate, makes me wonder what you do for a crust?

Now, you missed a critical part, what's the best way to hold your beer glass or should you change to a handled stein? /forum/images/graemlins/grin.gif
 
Sounds like the mar bars are far better than prussick or other ascenders for the rotator. I had problems with 2 rotator injuries that were wirked thru with light therapy and Shiatsu. I agree with shellbis' plan.
 
Good to see you in Minnesota Mark, as for the shouldar problems they suck either way. I had reconstruction on one shouldar and needed it on the other one. The one with out is doing fine now with just working and building up the muscles around it but it gets sore once in a while, as for the one with reconstruction it is a long recovery usually more than what the doctor said but i don't have anypain in it with the exception of the type of movement to throw a basball hard, soft is fine but hard just hurts, plus you don't want anyone to say you throw like a girl.
 
Good to see you to Jeff. So you had surgery on one and will get it on the other?

Shellbi, I never saw your post for some reason? Great stuff! Thanks for all of the effort. I am going to print it and keep it handy for weekly or daily reference.
 
No probally not, like i said it dosen't really bother me much at all the biggest problem is i just can't lay on it for a long time, as for every thing else it works just fine, any ways who wants to sit around for that long and i don't think anyone would want to put up with me for that time either. /forum/images/graemlins/grin.gif
 
Shellbi has given some great info there. I had a shoulder injury in the 70's that hobbled me for at least a year. I found the right orthopod who referred me to his physical therapist. The PT put me on a weight program and it got mostly better. When I showed the PT what still hurt, he added one exercise (all were for rotator cuff) and the problem went away in a few weeks.

I have worked out with weights since to maintain balanced strength around the joints...coupled with good stretching.

I had a tear in the labrum (a small hip cartilage) last year that the Dr. thought I would need surgery to repair (did a MRI to diagnose). We tried PT anyway...after about 3 months of assisted stretching and strengthening with the PT I am back to about 98%...no surgery necessary...hoorah!!

Give a good physical therapist a chance before going under the knife.
 
Shoulder pain??? Well you got the right person for that!!!! I had shoulder pain for awhile thought maybe i over extended my arm cause besides tree work I play softball. After about four shots of cortizone I had to have surgery that was april 2006 I am still going to get cortizone shots for the first two weeks after surgery it ached like a toothache. If you want to keep doing tree work I suggest you try to wait it out cause surgery does not fix the problem for our type of work plus you cannot do tree work for at least six months it really slowed my climbing up and now I am very frustrated I feel like I can do less now than before I had surgery. Please whatever you do make that your last option!!! you will thank me later! One thing my doctor told me is to try to cut down on over extending my arms over my head and a power pruner is the worst thing for your shoulder.
 
I just ripped my right rotator up last sunday. Looks like surgery,Ill know wed.next week...argg
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[ QUOTE ]
If you want to keep doing tree work I suggest you try to wait it out cause surgery does not fix the problem for our type of work plus you cannot do tree work for at least six months it really slowed my climbing up and now I am very frustrated I feel like I can do less now than before I had surgery.

[/ QUOTE ] could you lift your bad arm? my injury was specific not chronic and I cant lift the arm...its not a matter of pain.
 
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