Training with shoulder/arm pain

[timelinex]

1.) Unless you like cortisone shots, being punted to 3-6 weeks of physical therapy, being given bad weightlifting advice, and wasting money, I'd cancel that appointment. Unless you think you need surgery, of course (then keep it).

I don't really expect much from the appt other than hopefully finding out what the source of the pain is. It sounds dumb but I can't actually tell. I think it might be 2 separate sources at the same time (elbow and shoulder). Knowing the actual source might help my decision on what to do or change.

2.) Based on the information you've provided, it's likely your bar postion is causing the problem. Read these two articles and watch these two videos thoroughly:

The Elbow Problem | Jordan Feigenbaum
Preventing Elbow Pain in the Squat | Nick Delgadillo
A Clarification on the Squat Grip | Mark Rippetoe
Low Bar Position Stretch | Paul Horn

I have read those articles already, but I'll skim through again to see if I missed anything.

3.) Post a video of your squat, preferably to the coaches forum so you won't get too much conflicting advice, and ask them about your bar/chest position.

I've posted many videos on here (including on the couch subforum). I've received alot of advice on the squat, but nothing on the grip or arm position I dont think. I've also seen an SSC coach recently and he didn't have any issues with my grip or bar placement.

4.) An inflammatory condition can be helped by taking an anti-inflammatory. 800mg of ibuprofen 3x daily for about 5 days is the general recommendation we see around here.

I know it's standard practice on these forums, but I'm not personally big on taking a ton of NSAID's. Even if they don't necessarily slow healing, they don't speed it up either. I'm not worried about the pain, I'm worried about whether its simply an extra bad case of tendinitis (Which I have no problem lifting through in pain) or an impending tear/strain. I've had tendinitis several times in my life and it's never been nearly this painful. I dont know. I guess we will see.

I actually squat on an 8' bar and use a competition squat rack or monolift so I can move the hooks in. I am almost at the end of that bar, so I squat with a wide grip like you do. In a normal gym situation where I have to squat in a power rack I have problems, but I found a few work arounds.

You could give high bar squats a shot for right now. You don't need to put the bar way up on your neck either. It can sit towards the back of traps, so it isn't that much higher than low bar. Bending the wrists with wrist wraps should help get some pressure off too. You could also try a grip outside the hooks, where your hands are on the collars. I do this on a 7' bar. I normally put a pair of of clamp collars on the inside of the bar before I put weight on (like these: https://www.walmart.com/ip/Olympic-D...&wl13=&veh=sem ). This allows you to take an even wider grip and get your hands away from the hooks a bit. So essentially you have one pair on the inside and one on the outside.

It would be nice to widen my grip by a few inches. Unfortunately I don't have anywhere I can use an even wider grip on. There are only a few inches on the sides past the rack; Not enough to fit my hands. Maybe I can get my hands on the raised part of the bar by the weights, but I think thats too wide and I wouldn't be comfortable or stable.

[hollismb]

See if this helps. I went and found one of your videos from the coaches forum:

The Elbow Problem – when a lifter raises his elbows up too far during a squat – has the potential to produce numerous deleterious effects on the squat, including movement of the barbell on the back, sub-optimal back angle, flexion of the thoracic spine, and elbow/upper limb pain...

Pain in the shoulder, elbow, and/or wrist can occur in those who have improper positioning of their grip and arms during the squat. This is obviously not the only cause of upper limb pain, but I have found that how the lifter carries the bar during the squat is more likely the cause than anything else barbell-related. Through observation and discussion with other coaches, I’ve observed that the correct angle of the arm during the squat closely approximates the back angle, and – this is important too – it does not change during the movement. Yes, Virginia, the angle of the humerus relative to the floor should be about the same as the back angle in the low-bar squat, the elbows should not move up or down during the squat, and the aforementioned criteria on grip width, hand position, and wrist neutrality should also be observed.

Having your hands too wide necessitates overextension of the shoulder (elbows way up) and excessive forward pressure by the hands into the bar to hold the bar in place, because the wide grip artificially shortens the forearm and reduces support from the elbow up to the bar. The shoulder overextension causes you to round your upper back as you approach the bottom of the squat, requiring you to flex your wrists at the bottom and on the way up so that the bar feels secure on your back. The stress at the elbow caused by the excessive loading of the externally rotated upper arm, the flexed wrist and loaded wrist flexor muscles, or the internally rotated forearm results in lateral or medial epicondylitis – tennis or golfers elbow – a nasty, painful condition....

At the top, you are in mild flexion. Your upper back is round and your lower back is a little, too. I would like to see you drop your elbows and stand up a little straighter.

https://startingstrength.com/resourc...uat-check.html

See also: Identifying and Correcting Thoracic Spinal Flexion in the Squat | Bill Hannon

[timelinex]

See if this helps. I went and found one of your videos from the coaches forum:







See also: Identifying and Correcting Thoracic Spinal Flexion in the Squat | Bill Hannon

Thanks for going the extra mile and finding my videos. I see he says that and I guess I read over it as a small blurb. Regardless, I don't realistically know how it can change. I'm not holding my elbows like that on purpose. It seems like the articles mention that part of the reason for this is wide grip. I'm lucky to be able to get into the low bar position even with the grip as wide as it is! In the past, I would have to stretch extensively just to get there and still be in pain. I can't move my hands in any further. It's not uncomfortable, I'm just at my limit as it is.

I do like that last article you posted. It seems to hit the nail on the head with my upper back flexion. I DO look completely down and I do round my upper back a bit I think. I started doing this because I wasn't going horizontal enough and this helped me go horizontal. However maybe I should try to get tighter up there and look a little less "straight down". Maybe this will also take the load off my arms/shoulders. Thanks for this link. Seems like every time I correct one problem it causes a different one!

Edit: I've got a PVC pipe in my office to do shoulder disconnects and I just used it as a mock bar to experiment with the grip placement.... Left arm kills now. No weight, just a light pvc pipe. It's quite obvious this stems from my shoulder flexibility versus a bad grip inadvertently placing a heavy weight on my arm. If it turns out to just be tendinitis, the only course of action might just be to keep on moving forward until my shoulders are more flexible. (and obviously fix my upper back flexion)

[timelinex]

I saw the Ortho today. He was pretty down to earth. He had a slightly different philosophy than people on SS, but he was actually reasonable. He did some xrays (I'm guessing to make sure nothing wrong with bones) and basically patted me on the back and sent me on my way. He said it's nothing torn because that would be very apparent and that at my age (~30) the rotator cuff is super strong and it would most likely have to be torn from an acute event rather than over time. Obviously his opinion is that if squats cause the pain, don't do squats until you can. But he acknowledged that doing things that cause it pain (even if it is intense pain) won't lead to injury, just more inflammation and more pain. That last sentence is what I was really looking for. I don't care about pain. I just didn't want to permanently injure myself or require surgery by being hardheaded.

I leave town on fri-tue and will take those days off, but I will go to the gym today and tmrw. I'll skip the upper body movements and try to atleast do squat today and deadlift tomorrow.

It sounds like I have to work on holding my "chest up" and lowering my elbows (but keeping my position horizontal enough).

[timelinex]

I went to the gym to atleast get my squats in. Arm and shoulder killed during it and for a good hour after, but I did finish my 3 sets.

Now that I am paying closer attention, I see the issue is definitely that my arms ARE taking a part of the load of the bar. I can feel it. But I'm not really sure what I can do about it. I tried moving my hands around all over the bar and no matter what I do there is significant bar pressure. I can't go any wider because of the rack. I tried going more narrow and that didn't help. I tried lowering my elbows, but thats not really that possible. When I'm already at the end of my flexibility, there is no room.

I did fix my upper back flexion alot, as per the article provided here. The problem is that I can't just fully stand up at the top and really do a full "chest up" extension because the bar definitely starts rolling. I'm fairly certain it is in the right location as I did have an SSC look over my squat in person just 2-3 weeks ago. It did help my tightness though and I felt more solid coming out of the hole.

This really sucks, because instead of me focusing on completing the rep with the higher weight, I'm being distracted by this BS and most my focus is on it. I'm still progressing every heavy squat day at the current time, but thats probably because I must not be nearing the end of my LP yet. I'm guessing pretty soon I will need all my concentration on the squat just to keep progressing.

Any advice? Am I missing something?

[Les Hahn]

It would be nice to widen my grip by a few inches. Unfortunately I don't have anywhere I can use an even wider grip on. There are only a few inches on the sides past the rack; Not enough to fit my hands. Maybe I can get my hands on the raised part of the bar by the weights, but I think thats too wide and I wouldn't be comfortable or stable.

That is what the clamp collars are for on the inside. You do grab the bar up on the sleeve, but it isn't too bad. The extra clamp collar gives your hand space, since the plates are stacked to the end of that collar, not the inside end of the sleeve. Ideally, you can do something else to fix this, but the work around would let you heal up a bit. Then you could try a better grip.

[timelinex]

That is what the clamp collars are for on the inside. You do grab the bar up on the sleeve, but it isn't too bad. The extra clamp collar gives your hand space, since the plates are stacked to the end of that collar, not the inside end of the sleeve. Ideally, you can do something else to fix this, but the work around would let you heal up a bit. Then you could try a better grip.

Hmm OK, I see exactly what you are saying now. I didn't understand you the first time around. I will definitely give this a try, but I think I might not have any control/stability of the barbell at that extreme of a width. Thanks for the tip though.

[timelinex]

Well I took a week off for vacation and when I came back I deloaded from 290lb to 270lb on the squat. I thought I was gonna be a rockstar with that weight, but turns out it was just enough of a deload. Barely made the last rep. How disappointing.

Anyways, my arm still hurt just a little after benching (I squat 2nd because otherwise I wouldn't be able to do anything with my arm after squats kill my arm/shoulder). Then after squatting it definitely still hurt alot all over again. Not as bad as last week. It was tolerable this time. No sure if it's because I let my arm cool off for a a few days or from adjusting the grip (after some stretching I was able to straighten my wrists better and narrow my grip a little). Regardless, it was still painful and becoming a big drag on my workouts.

So I think I'm gonna take your guys advice and start taking ibuprofen till the tendinitis subsides. Since it doesn't hurt outside of training, do I only take it before a training session. An hour before sound about right?