The Slowest Progression The World Has Ever Seen (shoulder rehab)

[Mulgere Hircum]

So the other day I walked into a bar. My foot still hurts. (I'll be here all week, folks.)

Commercial gyms have been come increasingly impractical for me, so I bit the bullet and ordered a shiny new B&R bar. While waiting for it I snagged some plates on Black November sale from Play It Again; new plates for $0.75/lb ain't bad, and I bought only what I needed. Two 20kg bumper plates and a pair of OSO aluminum collars from ETE and a pair of Dead Wedges completes the kit. The bar came yesterday, so the new program starts today. For now, the program is primarily rehab, but I might as well keep a public log so as not to miss out on the traditional Starting Strength Forum-style shaming and abuse. :-) But at least people here will understand the fun of getting your first quality bar.

Goals:

1. See if I've learned enough about managing shoulder inflammation to build back up to a real program.

2. See if I've learned how to stay healthy enough to keep lifting heavy rather than get sick when I'm approaching a PR.

3. Work up to something approximating the intermediate program described in Brett Osborn's Get Serious. It would be nice if I could do SS back up to intermediate first, but what matters is that I get there.

4. Do the above on minimal equipment, since I'm going to spend slowly on the home gym until I've proven I can put the gear to good use. I also am going to keep the footprint to a minimum, since I am working out in my living room.

The first workouts will be some exploratory time which won't be training at all. Today is just minimal deadlifting, but not using a worn-smooth gym bar is still really nice.

Deadlift: 45lbx5, 65x5, 95x5

I like the grippy B&R knurling, and those Oso collars are *solid*. Yeah, I know I don't need collars (I rarely use them for anything in the gym), but I am going to love not feeling the plates move around on each deadlift rep. Yes, I've used loosey-goosey worn-out box gym bumper plates way too much.

Too bad I didn't even get up to one plate, but that's why the log is named what it is named. Obviously this isn't enough weight to even feel deadlifting normally. I stopped at this point because I could feel some pain on the back of the left shoulder from the static contraction. The big question will be about recovery--can I get the inflammation down far enough, quick enough to be able to do two strength workouts a week? We'll see.

I have a long drive to a business meeting tomorrow, so I may not get in a workout, but in general I want to do something on each day of the week. I expect three of them to be non-strength training so that the shoulder does no more than two days of work a week.

[Erok]

Good on you. As someone who's ripped up his shoulder many times, and never gone to the doctor for it, I can attest to the efficacy of The Program for shoulder health. OHP is just the best thing I've ever done for my shoulders.

[Mulgere Hircum]

Good on you. As someone who's ripped up his shoulder many times, and never gone to the doctor for it, I can attest to the efficacy of The Program for shoulder health. OHP is just the best thing I've ever done for my shoulders.

Thanks for the encouragement! My shoulder problems seem to be different and more complex than the usual. They've changed somewhat, which may indicate multiple problems or could be some degeneration from the chronic inflammation (I hope not the latter). At one time OHP did feel good on it, but the last time I worked up toward heavy lifts (last summer) I could feel that OHP does some damage. I suspect that's still true, but I will test most of the lifts and see where I am currently. I certainly look forward to OHP when I can do it. Bench will probably be the hardest thing to work up to, since it's more or less the angle that causes the most trouble, and I'm not planning to test it out in the near future (I haven't bought a cage yet anyway, let alone a flat bench).

I have a good chiropractor (he's a powerlifting judge, so he doesn't tell me to just quit picking things up and putting them down). His prescription (principally a lot of pulling to adjust my posture to reduce impingement) and therapy are somewhat useful, but a while back I discovered that the single most important thing is not to sleep on my side. On the left shoulder is really bad, but even its own weight when I sleep on the right shoulder is a problem. Since I've only slept on my side all my life, sleeping on my back was nearly impossible, but over the last year or two I've been learning to make that work (changing how you sleep turns out to be one of the most unfun things you can do). Before I discovered that, I apparently spent years trying to fix it while damaging it every night, which worked about as well as it sounds. But discovering that weights aren't the major source of damage is a good thing. So for now I'm spending money on gear instead of chiropractic, I clearly need to solve a lot of problems that no one else can help me with.

Another thing I learned is that it responds well to extremely aggressive icing, more than anyone has suggested I do. A dozen times a day isn't too much if I can find the time (it took me an embarrassingly long time to discover this because generally I usually don't have the time). Case in point: last night I managed to stay on my back all night after aggressively icing it all afternoon/evening, and this morning it feels about as good as it did before I deadlifted. So that suggests that I'm at least on the right track. The new things I am hoping eventually get me all the way are that I'm completely changing how I eat and working on as anti-inflammatory a diet as I can devise. I started down this road for general health reasons, but at some point I realized that it could also turn out to be the missing piece that lets me really lift again. We'll see if it helps. The diet thing is very much a work in progress, but I figured that there is no reason not to start testing its effects on my lifting now. I'd like to get to where I'm adjusting the diet to maximize my gains, but for a while it's simply about finding out how to make heavy lifting possible at all.

[Erok]

That's great that you've got some triangulation on causes & effects. I know I've hurt my shoulder sleeping on it, and it takes a while to come down from that. I am also a side sleeper, so I know what you're dealing with there. Bench pressing doesn't help either (although I just happen to be in a place right now where benching carefully with a moderate close grip doesn't seem to make it worse).

Rolling around on the floor mashing my shoulder mercilessly with a baseball (I think the kids call it "mobbing") has also worked wonders for me.

re: inflammation. Have you tried incorporating a turmeric supplement? Like a strong dose in a capsule as opposed to making the occasional curry. Both my wife and I swear by it. Much more effective than fish oil.

[Mulgere Hircum]

That's great that you've got some triangulation on causes & effects.

I've had time to learn while sulking because I wasn't able to lift. :-) Actually it wasn't all bad--two summers ago I had finally learned how to sleep on my back, and that got me to the point where it felt normal and was able to do some moderately heavy lifting, though I started feeling it when I got close to my limit (that's when I felt issues with OHP for the first time). Then we had our baby girl and with visitors I had to sleep in a normal bed, and somehow slept on it enough to screw it up completely again. Still, I got close without the inflammatory diet, so I might get over the hump this time.

Bench pressing doesn't help either (although I just happen to be in a place right now where benching carefully with a moderate close grip doesn't seem to make it worse).

I like that idea. I didn't have time to log it, but I had just enough time this morning to try a set of front squats with a pause all the way down to see about increasing the stress on the rest of the body relative to the shoulder. Since I'm detrained and have never front squatted, 95 lb felt heavy, so maybe by choosing the hardest variant of some of the exercises I could get some useful training effect. I hadn't thought about bench yet, but CG benches could have a similar effect if I get to the point where they're OK.

Rolling around on the floor mashing my shoulder mercilessly with a baseball (I think the kids call it "mobbing") has also worked wonders for me.

I tried some massage on the shoulder, nothing near the joint was good at *all*. I can get some good from someone who knows how to strip the rotator cuff muscles away from the joint, however I think I need to figure out the rest of the puzzle pieces before I spend money on that again. I may be able to get some of the effect myself, but I can't hit it hard enough with the other hand (the best sessions have always been the most painful) and I'd probably have to look up some anatomy to find where the muscle origins are. Maybe if I use the handle of a butter knife or something.

re: inflammation. Have you tried incorporating a turmeric supplement? Like a strong dose in a capsule as opposed to making the occasional curry. Both my wife and I swear by it. Much more effective than fish oil.

Good call. I haven't tried turmeric yet, but I definitely intend to. Here is one of the other puzzle pieces no one has yet had an answer for: I am apparently a very special flower, and not in a good way. I respond paradoxically to quite a few things, and the poster child is probably 5HTP, which is like kryptonite for me. One 150mg dose of that is a big bag of instant major depression that takes more than a week to go away--and it's just an OTC amino acid metabolite that makes most people feel good! I've ended up accepting that I have to test things one by one and very carefully, particularly anything that touches serotonin, probably dopamine, and probably other neurotransmitters. So I dropped everything and am titrating up fish oil now (FO seems to mess with dopamine, so I have to treat it as though it could do nasty things to me even though it may not to anyone else). I am absolutely going to try a lot of anti-inflammatory things including turmeric, I just have to be careful because things that mess with my head also seem to potentially interact somewhat. If I'm lucky, I'll be able to find a number of things I can use in combination to bias my body's responses away from excessive inflammation.

The good news is that I like curries, so I'm pretty sure that turmeric is fine. I'm just kind of gun-shy about assuming anything is OK if taken in higher quantities than in normal food after my experience with a 5HTP and a couple of other things. But food levels should be OK (I can eat as much turkey as I want, even though I'm pretty sure pure tryptophan would be just another color of kryptonite), and I think I'd be fine cooking up a batch of Panang in the mean time. Maybe it'll turn out to be one of the keys to this little shoulder project. What a great excuse to eat more Thai curry! :-)

Dustin

[vanslix]

Speaking as someone with complex spinal problems, I'd highly recommend getting in touch with Andy Baker. He helped me enormously both in figuring out what was tolerated and what worsened things and then developing appropriate programming around it.

Dr Petrizzo would be a good idea, too.

[Erok]

Yep, can't go wrong listening to Andy. Definitely check with him.

Also, for self-massaging trigger points and such in the shoulder region, I highly recommend the backknobber. If you get one, or something like it, make sure it's steel, and not plastic. Amazon.com: The Original Backnobber Regular by the Pressure Positive Company, Purple: Health & Personal Care

[Mulgere Hircum]

I'd better get down what I did yesterday and today before I have to go downtown.

Yesterday (Pearl Harbor Day, Wed. 12/7/2016)

"Halting Front Squats": 95x5

"Halting Front Squats" is in scare quotes because I don't think they really count--I haven't done them before, so the form was certainly wrong in detail. The experiment was to see if the clean from the floor (no rack yet, remember) was OK for the shoulder, if the hand posiition was OK to hold for a minute or so, and if making them front instead of back squats, going all the way down rather than just below parallel, and halting at the bottom so I have to come out of the hole from a dead stop all combine to make the squat hard enough to have some training effect at a weight I can clean and hold without pain. 95 felt heavy, which is sort of embarrassing (<sob>), but suggests I might be able to force the legs and posterior chain to do some work. I didn't feel any shoulder issues when I did them. I had some problems in the afternoon, but I believe that came from sitting in a meeting for three hours rather than the lifting itself (it took me a long time to realize that simple things like having my elbow on an arm rest for an extended period of time could be more problematic than lifting). In any event, aggressive icing in the evening got me back to no discomfort.

After I've tested some other lifts I will definitely have to break out Starting Strength and the training videos and learn to FS correctly (I already know I'm dipping my shoulders, probably because I'm used to driving the hips instead of the shoulders up). I should probably make them low box squats rather than pausing at the absolute bottom so I'm not resting on my haunches, too. Take that, legs.

[Mulgere Hircum]

12/8/16

Walk dog(*)
Running: 5min @ slow pace (for me around 10min/mi)
Play fetch with Blaze(*)
Jumping Jacks: 100

Post-workout: eggs and a glass of milk, ice.

* I probably shouldn't count these, but they do have a warm-up effect and my dog needs more attention anyway.

Experiment for today: I don't plan to use weights more than 2-3 times a week, so today I experiment with cardio. Not that much of an experiment, since I know running is fairly shoulder-neutral, but in the past I've started having ITB pain around 10 min/day. Since that does involve inflammation, I suspect that will respond to the dietary changes the same way the shoulder does (i.e. if one works the other probably will too). In any event, with only two cardio days per week there will be a lot more recovery time. My plan is not to go over 30 minutes of cardio twice a week, to avoid screwing up the strength gains too much, but I'd like to be able to do all that running if I wish. We'll see if I get there.

The Jumping Jacks are there because I should probably find ways of warming up the shoulder with light work before lifting. I will also experiment with some passive heat before working out. Icing afterwards is a no-brainer, but I have to leave in a few minutes so I'll do that in the car.

Finally, the milk is insulinogenic and thus at least somewhat inflammatory, but since it's also very anabolic I *think* I can do that once a day post-workout and still stay within Osborn's guidelines. I chose milk because it's more insulinogenic than straight carbs, so I guess that I can get less inflammation for the same anabolic effect. I should probably take a bunch of whey protein at that point as well, but I'm not lifting much yet. Also, this isn't really that important until I have a program that lets me lift heavy, so arguably I shouldn't bother with this for a while. We'll see.

[Mulgere Hircum]

Speaking as someone with complex spinal problems, I'd highly recommend getting in touch with Andy Baker. He helped me enormously both in figuring out what was tolerated and what worsened things and then developing appropriate programming around it.

Dr Petrizzo would be a good idea, too.

I know Andy Baker's name, I haven't talked to him. I don't know who Dr. Petrizzo is.

I used to get low back pain from extended sitting in certain chairs--some car seats were a real problem. Threw it out a couple of times too. Those problems vanished about 20-25 years ago and I never saw them after the day I deadlifted 200lb (and could do back extensions for reps with a 45lb plate). I didn't even know how to lift right then, I was mostly depending on bodybuilding exercises and not eating for it at all, but somehow I just liked deadlifting and kept pushing that lift more like a powerlifter than a bodybuilder. That was the single best thing weight lifting ever did for me.

I have some upper back issues, but they're not that serious (they got much better when I strengthened my back, they just didn't go away entirely) and I was ignoring them while I attack the big problem that I can't lift heavy because of the shoulder. Come to think of it, though, the anti-inflammatory diet is likely to help there, as will rowing (which I test tomorrow). I might be able to devise some exercises that would hit the spots with knots more directly and won't bother my shoulder, that would be a good thing all around. I guess right now I'm free to invent just about anything I like since I can't do the official program(s) anyway. Rowing with one end of the bar (like a t-bar) with one hand while lying on my side would give a really good stretch right between the shoulder blades, which would help a lot. I never thought of inventing new rows for my upper back until you just prompted me, thanks!

That all said about spinal issues specifically, Andy probably would be a good person to consult with on the shoulder, since it is indeed a complex problem. Makes sense.

Dustin