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Thread: Shoulder Impingement and/or Tendinopathy/Tendinosis

  1. #1
    Join Date
    Nov 2017
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    Default Shoulder Impingement and/or Tendinopathy/Tendinosis

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    So I've tried to do my homework on this as much as possible over the last few days and ended up finding the following threads that are most relevant to my situation:
    Your thoughts on dealing with shoulder impingement....
    shoulder tendonitis

    Some other searches showed similar recommendations for shoulder tendonitis and tendinosis.

    My situation is this: I was a competitive swimmer since 4 years old (then D1 in college) and a pitcher for 9 years, and I have had great difficulty getting my arms into the overhead position ever since I was about 11 years old. Try as I might, my humerus never gets into perfect alignment with my torso. In addition to very poor shoulder flexion and extension, I also have very poor internal rotation. Overhead pressing is difficult not only because my shoulders are so weak (I can bench 235x5, squat 345x5, yet only overhead press 135x5), but also because the "shrug" at the top is incredibly difficult for me to accomplish. I would venture to say it is nearly impossible, and because of that, I feel a pinching sensation at the top of an overhead press near my acromium.

    See this laughable video of my press as an example. While there are several things wrong with this, the main focus is the lack of extension I achieve at the top of the press: YouTube

    I went through PT once when I was 15. An MRI back then resulted in a tendonitis diagnosis. Several weeks of light external rotator work and bands did nothing. In college, I went through PT again. No MRI, but I didn't do any overhead work for 4 weeks, and I did lots of stretching. That briefly gave me the ability to put my arms directly overhead (so at least I know it's possible for me to accomplish). The problem then came back within a week.

    Now, I'm trying to figure out what the recommended rehab method would be from the SS perspective for long term improvement. Recently, I have continued benching and incline benching (since those do not hurt), and I have been doing shoulder dislocations with a heavy band 30-50 reps per day for about 3 weeks. My flexibility seems to have plateaued. Should I get another MRI or X-ray to get an up-to-date diagnosis? Or is it safe to assume I have some shoulder tendinopathy that is creating a blockage near the acromium? Are NSAIDs recommended if there is not chronic inflammation (as would be the case if it is tendinopathy)? I would love to press in order to rehab the shoulder, but doing the press correctly is the issue since I cannot shrug at the top. I have found that I can Klokov press (behind the neck press with a snatch grip) comfortably, however. If I bring my hands even an inch closer than my snatch grip and try a Klokov press, I feel the pinching near the acromium again.

    If I were to guess a recommended rehab method, I would assume it would be 15 seconds of hanging from a pull-up bar in both prone and supine grip followed by 20 sets of 5 with the Klokov press and maybe tons of shoulder dislocations with the band. Possibly many light pull ups and chin ups with a focus on the eccentric portion as well. Would continued benching and incline benching be recommended? I'm assuming the goal would be to increase scapular mobility and function as well as bringing inflammation to the area to break up whatever's in there.

    Sorry for the long post, just wanted to be as comprehensive as possible. Would greatly appreciate any help since this has been nagging me for 15 years and I just want to fuckn press.

    - Wes

  2. #2
    Join Date
    Jul 2007
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    North Texas
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    Default

    Take a picture of yourself hanging from a chinup bar with relaxed arms and a press grip and post it here.

  3. #3
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  4. #4
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    You can lock out a press just fine. Find a weight you can start with and do the program.

  5. #5
    Join Date
    Dec 2010
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    Default

    I can bench 235x5, squat 345x5, yet only overhead press 135x5
    Isn’t that a pretty normal spread?

  6. #6
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    It is, for somebody who hasn't pushed his press training.

  7. #7
    Join Date
    Nov 2017
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    Default

    Ah, I thought I was especially weak overhead. Just weak in general, but that's fixable.

    So I have done regular pressing before (per the SS novice program) twice, and always included regular pressing (2-3x per week) before. This has been over the course of 3 years. Today, I attempted to press again with the empty barbell (have not done this for about 6 weeks). It's very hard to explain, but there is a noticeable pinch once I'm trying to squeeze the bar overhead. It is incredibly difficult to truly lock my elbows out as well. Without the aid of my 225lb beneath me like in a hanging position, my shoulder is at an even worse angle of flexion. This pinch is what I'm trying to avoid, and being able to reach behind my neck in life in general would be useful too. If the normal overhead press has not fixed this in the past, is there another recommended protocol that can help train my shoulder to comfortably achieve the position illustrated in all the pressing examples?

  8. #8
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    When I started pressing regularly, it took a couple of years before I had a semblance of a decent lockout at the top. Hang between sets, Take your time at the top of each rep. It will eventually improve.

  9. #9
    Join Date
    Nov 2017
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    7

    Default

    starting strength coach development program
    I'll do that, thanks for your time Rip.

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