Brachialis & shoulder pain

[timelinex]

I know I know... another damn thread on a common topic. Arm pain from squats.

I'll cut to the chase.

-LBBS has been painful on my shoulders since day one because of inflexibility. With enough stretching and sucking up the uncomfortable pain, I still did it. Starting wide and then narrowing it a little.

-In the last month the pain turned from uncomfortableness while doing it to tendonitis in my left brachialis & shoulder. It's not tennis/golfers elbow as it isn't in my elbow (rather above it) The wide grip hurts the brachialis more, a more narrow grip hurts the shoulder more. I've seen an SSC a few weeks ago. My squats aren't perfect (still working on better hip drive). But my bar position is good and the only thing wrong with my grip is that he preferred more narrow. I have narrowed it since then.

-2 weeks ago the pain got so bad that after squatting I couldn't finish a workout. Never had that happen in my life. But my entire upper arm was throbbing in pain and i felt nauseous. The pain wouldn't go away for about an hour or more. This happened 2 workouts in a row.

-I took 5 days off as I went on Vacation. Came back and the pain was still there during lifts (duh) but it wasn't so bad that I had to stop the workout anymore.

-As per your advice in your literature and on this forum, I did the IB 3x-4x a day for 7 days. I feel like it was getting a little better as I was working on keeping my grip uncomfortably narrow and tight. It would still hurt after, but just a little. Benching hurt alot during the actual reps and sets, but would go away after a few minutes. OHP hurt but not as bad as benching.

-Yesterday morning was my last IB dose. By night time my arm ached a little and now today my arm has been aching all day. Never had it ache unprovoked before.

This is worse than when I had a class 2 pec tear. With the tear, working out would be painful but I could do more weight every day. Every day would be better than the last. This is just getting worse and worse.

At this point I have no idea what to do. It seems like it's only getting worse. It's been wreaking havoc on my squats, benching and OHP. I'm dedicated to try and continue getting strong, and I've sucked it up for over a month now because I want to get strong. But I can't keep going like this when it's only getting worse and worse. I'm about to stall simply because I'm being distracted by the strong pain during the lift versus actually lifting. I have already had to reset the squat while I worked on my grip. Everything but the deadlift is being severely effected.

I use to wakeboard weekly, which is obviously hard on the body and arms as well. But in the last 8 weeks or so I have basically cut it out of my life completely to prioritize lifting and getting strong. So I really want to keep lifting and growing but at this point things are starting to feel more bleak.

Any guidance of what I can try and do next would be appreciated.

[Scaldrew]

Your pain sounds really bad. I'd suggest switching to high bar for the time being. Meanwhile, read up on the relevant literature (the book again, the many articles and posts on this issue) and keep testing. Not lifting with, but testing the position. The biggest factors are bar position, elbow position, and grip width, so that's where I'd start if it was me. The good news is it's easy to test the position without lifting and making it worse. The bad news is there's probably going to be a lot of trial and error till you get it right. You mentioned an SSC looked at your bar position and said it was mostly fine. The problem with this problem (it's late) is that it's hard to tell just by looking and a coach can't feel your symptoms under the bar.

Feel free to report back with updates or additional questions. Good luck.

[timelinex]

Thank you for the reply!

I found a really old thread that has some other advice I might try:

Arm pain during and after Squats

I am considering learning front squats and doing those for the next 2 weeks. I REALLY want to continue LBBS but I think if I don't let the irritation subside first, it will keep hurting even if I find a "better" grip.

Any advice on what to do about benching? OHP hurts a little too, but nowhere near as debilitating as benching. Is it possible to do OHP 3x a week for 2 weeks? I imagine that will be too much to recover from. Any other variations I can substitute in for benching?

[Scaldrew]

Pressing instead of benching should be fine until you can bench again, at which point you simply repeat the last bench workout. Really, though, the pain shouldn't be terrible or even present if you're no longer squatting low bar. Low bar is the optimal choice, but second best is still good. At least until you find out exactly what's what. Continuing to squat with severe pain will only make it worse. I wouldn't recommend front squatting really. Not a valuable substitute, especially for this short a timespan.

As to specific advice, I found that merely correcting technique worked best. I say that knowing how hard and long a process this can truly be. None of the rolling or massaging or heating or cooling or pillsing or strapping or wrapping or praying or begging helped me one bit. Not at all. It sucks to not have a person there to tell you all about it, but if I can fix it on my own, gosh darn it, so can you. I was stubborn enough never to make the switch to high bar but for a few workouts and stubborn enough to say I don't regret it now. But technique was always a priority. I found out near the very end that my grip was a full hand width too narrow where before I wasn't in any pain at all. So this one and the placement of the bar on the back are going to be big big factors. Bracing and gripping and wrist and blabla are really more details, I find. Can be causes, but mostly aren't; at least not to this degree. Let's not rule them out, though.

[ColoWayno]

Get the thing imaged.

[timelinex]

Pressing instead of benching should be fine until you can bench again, at which point you simply repeat the last bench workout. Really, though, the pain shouldn't be terrible or even present if you're no longer squatting low bar. Low bar is the optimal choice, but second best is still good. At least until you find out exactly what's what. Continuing to squat with severe pain will only make it worse. I wouldn't recommend front squatting really. Not a valuable substitute, especially for this short a timespan.

As to specific advice, I found that merely correcting technique worked best. I say that knowing how hard and long a process this can truly be. None of the rolling or massaging or heating or cooling or pillsing or strapping or wrapping or praying or begging helped me one bit. Not at all. It sucks to not have a person there to tell you all about it, but if I can fix it on my own, gosh darn it, so can you. I was stubborn enough never to make the switch to high bar but for a few workouts and stubborn enough to say I don't regret it now. But technique was always a priority. I found out near the very end that my grip was a full hand width too narrow where before I wasn't in any pain at all. So this one and the placement of the bar on the back are going to be big big factors. Bracing and gripping and wrist and blabla are really more details, I find. Can be causes, but mostly aren't; at least not to this degree. Let's not rule them out, though.

I did benching today and it was painful but less so than last time. I'l work on everything you mentioned and hopefully can get it worked out as soon as possible.

Get the thing imaged.

I went to an Ortho 2 weeks ago. He moved my arm around in a bunch of different positions and I only had minor discomfort. He said I probably just have bad tendinitis in my shoulder and I don't have to stop working out but that he would stop squatting because the longer I piss it off the longer it will take to heal. I specifically asked if I was at risk at ripping my cuff or anything like that and he said at my age (29) the rotator cuff is so strong that it would have to be an acute event to rip it.

[JHG]

I have experienced this also and used the following strategies to allow my tendinitis to calm down while still training:

1) Press or Bench before squats - this helped as I found I could not perform the press or bench without pain after squats.
2) Squat with a SSB or camber bar to relieve shoulder and upper arm pain and tension if you have access to these specialty bars. Otherwise, switch to high bar squats and reduce the load on the bar.

As Scaldrew mentioned, no amount of passive therapy will help with this problem. What worked for me was pressing and benching before squatting and reducing the load on squats and continuing on my schedule. This will take a while (read 6+ weeks). Be patient and train smart.

[timelinex]

I have experienced this also and used the following strategies to allow my tendinitis to calm down while still training:

1) Press or Bench before squats - this helped as I found I could not perform the press or bench without pain after squats.
2) Squat with a SSB or camber bar to relieve shoulder and upper arm pain and tension if you have access to these specialty bars. Otherwise, switch to high bar squats and reduce the load on the bar.

As Scaldrew mentioned, no amount of passive therapy will help with this problem. What worked for me was pressing and benching before squatting and reducing the load on squats and continuing on my schedule. This will take a while (read 6+ weeks). Be patient and train smart.

I switched pressing and squatting long ago. Even before I had serious issues, the aggravation from the stretching of my shoulders in the LBBS would impact my ohp weight/reps by 25%+ (not even an exaggeration). As you can tell, this isn't a new problem. Overall flexibility has been a major issue for me since day one.....when I started the program I could barely reach my knees when trying to touch my toes.

I'm going to try the thumbs around grip with wrist wraps before giving up on LBBS and transitioning to high bar. Seems like that helped a few people. Maybe I'm just a stubborn fool.

[JHG]

Maybe I'm just a stubborn fool.

I say stay stubborn, as the current evidence supports loading the tissues in the management of chronic tendinopathies http://www.aafp.org/afp/2013/0401/p486.pdf

While your complaint is not listed in the article, a tendon is a tendon.

[Scaldrew]

I'm going to try the thumbs around grip with wrist wraps before giving up on LBBS and transitioning to high bar. Seems like that helped a few people. Maybe I'm just a stubborn fool.

I found this didn't help me one tiny bit. Something to think about instead is to lower the weights to where the pain is minimal even with the poor grip and then perform squat variations. Low bar paused squat, pin squat, tempo squats etc. This way, you can keep the training stress high on your lower body while still doing low bar and not fucking up your arm and shoulder. I never did this so I can't comment on the efficacy of this method, but in situations like these you do what you can. Coaches Feigenbaum and Baraki have released an intermediate template called The Bridge that provides a way to train submaximally with different squat variations, so if you're interested in this, I'd suggest looking that up first.

Obviously, the best solution would be to figure out how your grip is causing pain and then fixing it so as to completely eliminate the pain in that area. Everything else is just a temporary bandaid until you get rid of the cause. Going through my lifting log, I remember a lot of the cues I used and technique modifications I made like "need to make sure no pressure is on arms when unracking the weight", something I haven't told you you need to look out for. But ultimately, there's not an awful lot more I can do via text only. I'd need to see your positioning throughout a heavy set in order to make sense of your problem. Generally, I can tell you to not stop pressing or doing chins as this will cause your arms to become detrained which will make the pain worse. I know it sucks to keep on pressing and pulling with pain, but believe me when I say that not doing either will not help matters at all.

Once your squat grip is fixed, you can do the pin firing regimen to alleviate your pain a great deal. I wouldn't mess with high volume chins performed in this way until your form is good. Waste of time and resources.