injured girlfriend

[KingOatmeal]

I've been making considerable progress with getting my girlfriend to adopt a strength training program. Considering that she does not share the same passion people like us have for training and getting strong, I felt I made great progress by having her regularly squat (properly) and bench press. After that success, I began guiding her towards pressing and deadlifting regularly as well. Although I'm not arrogant enough to believe that I am good enough of a coach such that she had perfect form, I definitely erred on the side of caution and made sure she used extremely light weights during her first sets.

In any case she got injured recently and it looks like my progress is in danger. She believes she got hurt after her first week deadlifting which got exacerbated after pressing the following workout. She saw an ortho who diagnosed her injury as shoulder impingement possibly due to bursitis and stated she likely has type 2 or 3 acromion process and subsequently she should probably avoid overhead pressing, not surprisingly.

Unfortunately, as an MD herself, she also shares the notion that anytime you are injured you should wait until you are fully recovered before training again and completely avoid whatever it was that might have caused the injury.

So, I basically have two questions:

1) I'm not clear on how deadlifting or pressing could cause the injury she described especially with extremely light weights. Any thoughts?

2) As a coach, what are your strategies when you have trainees who adopt the traditional mindset that you must hold off on training when injured until you're recovered and completely avoid whatever it is that they think caused it? I mean, I respond well to the "nut it up, don't be a pussy" approach but obviously I don't think she will respond well to that. Frankly speaking, I'm happy that she's still squatting so I don't want to totally discourage her.

Thanks so much, I really appreciate the time you spend on this forum.

[Mark Rippetoe]

!. It can't. No way.

2. It has been the experience of everybody that has actually kept track of it that tendon/joint injuries of a chronic nature just don't go away with a layoff. The first or second workout back after the layoff and the injury always shows up again, and it pretty much doesn't matter how long the layoff is. If the injury is acute, the layoff will probably work, but if not, she'll just have to learn for herself.

[DirtyD]

2. It has been the experience of everybody that has actually kept track of it that tendon/joint injuries of a chronic nature just don't go away with a layoff. The first or second workout back after the layoff and the injury always shows up again, and it pretty much doesn't matter how long the layoff is..

I know I've posted something similar in a previous thread, but I am a living testament to this. I spent four weeks on my ass trying to allow the impingement syndrome in my shoulder to ?heal,? and that yielded about a 20 percent improvement (100 percent on 800 mg on Ibuprofen, but nearly anything will feel better at that dosage).

At the end of my lay off, I got antsy and made myself get under the bar again. I?d only planned on doing squats and deads. I was warned of impending death, maiming and dire testicular repercussions that would result from overhead excercises by doctors and experts. Luckily, I ignored good sense and ?educated? advice and did a 5 rep set of empty bar presses, and I achieved more long term relief from that one set of presses than in four weeks of rest and band exercises.

Now, I?m a pressing crackhead. Empty bar presses are a permanent member of my warm up.

Feel free to pass the story along.

[TravisRussellDC]

Did they actually xray the shoulder to see if she has a type 2 or 3 acromion process, or did he guess about that the way he's guessing it's bursitis?

And just in case you didn't know this already, doctors are the absolute worst patients.

[isis]

I had a sore shoulder last year following a fall and also had a diagnosis of shoulder impingement and bursitis from an ortho. Resting and physical therapy did me no good, but lifting weights following Coach Rip's directions has given me the healthiest shoulders I can remember having. But what's relevant to your girlfriend's situation is that when I was beginning to press I found it was very easy to aggravate the bursitis. I think the reasons for this were:

- tight posterior shoulder capsule (also part of my ortho's diagnosis)
- tight pec minor
- tight lats
- habitually flexed and stiff thoracic spine

This messed up the relationship of the bones in my shoulder, so if I didn't get all of it stretched out before pressing, I would feel a snap or twinge as my rotator cuff tendons hit the acromion during the press, and then my shoulder would get sore afterwards.

If this sounds at all like your girlfriend's problem, here's what worked for me:

1. the sleeper stretch, posterior capsule stretch, foam rolling the upper back, rolling teres minor and its neighbors on the lateral side of the shoulder blade with two tennis balls taped together
2. deep tissue massage (Rolfing, ART, Hellerwork -- these practitioners tend to know a lot about shoulders)
3. pressing with correct form and starting really really light (I started with 5 pounds on a broomstick and went up 2 pounds or less per workout) but only if it could be done without feeling the snap
4. Turkish Get-Ups

If she absolutely won't press you could try her with the TGU--it gets a weight overhead without pressing it, strengthens the rotator cuff and scapular stabilizing muscles through a wide range of motion, stretches tight pecs and lats, and might just get her shoulders feeling better enough to make her willing to try pressing again. 3 sets of 3 on each side starting at 5 pounds and going up 1.25 pounds per workout worked well for me--you will need adjustable dumbbells or platemates or something like that, and $25 for a Crossfit Journal online subscription so you can read Jeff Martone's articles on correct TGU form would be money well spent.

If she hasn't had an MRI, that ortho has no idea what type of acromion she has.

Mark, is continuing to bench if she won't press and has impingement a good idea?

[Mark Rippetoe]

No, it is always a bad idea to bench press without pressing.

[KingOatmeal]

Thanks everyone for your responses.

Travis - No, the ortho didn't x-ray her because she was getting better. So I think it's fair to say he probably took a guess on both areas.

DirtyD / Isis - Thanks for the suggestions. I am slowly trying to coax her back into deadlifting and pressing. Your advice and suggestions will be helpful. At the very least, in the interim, it'd be good enough for me if she did anything other than those silly arm waving movements her PT suggested for her.

Coach - You have a point. I was figuring the injury might have come from bench pressing rather than deadlifting/pressing. I think I made a mistake having her bench press for a few months before introducing presses to her.