Finding someone to work with on shoulder issues

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Kirk
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Finding someone to work with on shoulder issues

Post by Kirk » Mon Sep 03, 2018 12:55 pm

I'd like to find a decent trainer, PT, etc to help me get my shoulder health under control (I'm thinking pretty typical rotator cuff issues). I'm just not getting it done on my own and haven't been able to in a couple decades of trying on and off. The thing is I have no idea how to find someone good. I'm willing to travel a little to find someone good. I'm in the general MD/DC/VA/WV/PA area. Anyone got any recs or some ideas on how to locate someone?

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syaigh
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Re: Finding someone to work with on shoulder issues

Post by syaigh » Mon Sep 03, 2018 7:51 pm

My first bit of advice would be to see an ortho and get a recommendation for a PT. Shoulders can be tricky, I've rehabbed mine a couple of times and its always come down to paying attention to postural imbalances, modifying or avoiding exercises that hurt, and trying to push-pull in as many directions as possible and emphasizing pain free reps over weight. My latest rehab involved a lot of upper back work, specifically rows and face pulls. And then a whole lot of very light direct shoulder work. Bodybuilding basically. I'd be happy to chat with you to troubleshoot your approach thus far. I'm in NC so a bit of a haul, but I find just being able to review training history and observe posture and execution of a few different exercises helps a lot in determining the right path. I would also recommend finding a bodywork (massage, chiro, whatever) specialist that helps. Studies have shown that it all works, its just a matter of personal preference.
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Re: Finding someone to work with on shoulder issues

Post by JimZipCode » Tue Sep 04, 2018 1:15 pm

syaigh wrote:
Mon Sep 03, 2018 7:51 pm
... and trying to push-pull in as many directions as possible and emphasizing pain free reps over weight. My latest rehab involved a lot of upper back work, specifically rows and face pulls.
Any rotational work?
“War is the remedy our enemies have chosen. Other simple remedies were within their choice. You know it and they know it, but they wanted war, and I say let us give them all they want.”
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Re: Finding someone to work with on shoulder issues

Post by syaigh » Tue Sep 04, 2018 2:28 pm

JimZipCode wrote:
Tue Sep 04, 2018 1:15 pm
syaigh wrote:
Mon Sep 03, 2018 7:51 pm
... and trying to push-pull in as many directions as possible and emphasizing pain free reps over weight. My latest rehab involved a lot of upper back work, specifically rows and face pulls.
Any rotational work?
Not so much. I find lateral external rotations help a little, but I mainly do those as a warm-up.

The first time I rehabbed my shoulder I did a lot of rotations, protractions, retractions, etc. And while it helped, they didn't get stronger and they've been getting tweaky off and on. And I would often have pain at night. Weird thing was I would routinely dislocate the rib heads between my shoulder blades when I would compete in Highland games, caber seemed to do it routinely. That hasn't happened in a long time despite getting back to throwing. It wasn't until I really focused on strengthening my upper back that it got consistently better.
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Kirk
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Re: Finding someone to work with on shoulder issues

Post by Kirk » Wed Sep 05, 2018 12:57 am

Ok, I'll try starting with an ortho this time. Even there I don't know how to find a good one though. ;) NC is a pretty good stretch for me although, strangely enough, I was in Raleigh for a few days last week (where I didn't sleep well due to my shoulders hurting).

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Re: Finding someone to work with on shoulder issues

Post by Shafpocalypse Now » Wed Sep 05, 2018 3:07 pm

Good luck. I had a chiro who seemed to get frustrated at the lack of progress. While at the Crossfit games, one of the guys in the airrosti kiosk just lived up the road from me, and he strongly recommended a local airrosti practitioner, so I'm going to try that out.

My issue is simple, yet fixing it permanently has eluded me for 6 years now, or maybe 7.
-tissue needs some treatment to release the tension
-the opposiing tissue needs to be strengthened so the new ROM becomes permanent
-maintenance work needs to be done.

I've put together 2 of those pieces on a regular basis but not 3. Don't ask me why, laziness, fear of finding out my middle aged self isn't capable of lifting like my younger self was, etc.

So maybe I need psychotherapy as well along with it.

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Re: Finding someone to work with on shoulder issues

Post by Bram » Thu Sep 06, 2018 7:28 pm

For what it's worth, this is my standard procedure for training clients, I have a fairly successful track record of helping people with shoulder pain get back to full function. Don't work through painful ROM, take a day off between workouts, start light...even no weight if necessary.

Anterior shoulder pain

2 sets cable or band reverse fly's x 10-20 reps (setting the shoulder blades prior to each rep)

2 sets external rotation - elbow by side x 10-20 reps each arm (I strongly suggest side lying with a dumbbell, next is standing with a light cable, lastly is standing with a resistance band)

---

Once you can do 2 sets with a 5lb dumbbell, add:

2 sets external rotation - elbow elevated x 10-20 reps each arm (either elbow resting just below shoulder height, like you are arm wrestling - with a dumbbell, or elbow at shoulder height like you are about to do a shoulder press with a dumbbell...this version is harder)

Posterior and anterior shoulder pain:

3 workouts rotating through A, B and C

A:

2 sets internal rotation - elbow by side x 10-20 reps each arm (cable or band)

2 sets cable or band reverse fly's x 10-20 reps (setting the shoulder blades prior to each rep)

2 sets external rotation - elbow by side x 10-20 reps each arm (I strongly suggest side lying with a dumbbell, next is standing with a light cable, lastly is standing with a resistance band)

B

2 sets cable or band reverse fly's x 10-20 reps (setting the shoulder blades prior to each rep)

2 sets external rotation - elbow by side x 10-20 reps each arm (I strongly suggest side lying with a dumbbell, next is standing with a light cable, lastly is standing with a resistance band)

---

Once you can do 2 sets with a 5lb dumbbell, add:

2 sets external rotation - elbow elevated x 10-20 reps each arm (either elbow resting just below shoulder height, like you are arm wrestling - with a dumbbell, or elbow at shoulder height like you are about to do a shoulder press with a dumbbell...this version is harder)

Posterior and anterior shoulder pain:

C

2 sets internal rotation - elbow by side x 10-20 reps each arm (cable or band)

2 sets cable or band reverse fly's x 10-20 reps (setting the shoulder blades prior to each rep)

---

Once you can do 2 sets with a 5lb dumbbell, add:

2 sets internal rotation - elbow elevated x 10-20 reps each arm (either elbow resting just below shoulder height, like you are arm wrestling - with a cable, or elbow at shoulder height like you are about to do a shoulder press with a cable...this version is harder)
Last edited by Bram on Fri Sep 07, 2018 12:41 am, edited 1 time in total.
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Re: Finding someone to work with on shoulder issues

Post by JimZipCode » Thu Sep 06, 2018 8:39 pm

Bram wrote:
Thu Sep 06, 2018 7:28 pm
For what it's worth, this is my standard procedure for training clients, I have a fairly successful track record of helping people with shoulder pain get back to full function.
This shit is timely. I've just decided I likely have a rotator cuff problem in my right shoulder, just at the front. Not critically serious, but not great either.

Thanks for the program.
“War is the remedy our enemies have chosen. Other simple remedies were within their choice. You know it and they know it, but they wanted war, and I say let us give them all they want.”
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Bram
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Re: Finding someone to work with on shoulder issues

Post by Bram » Fri Sep 07, 2018 12:53 am

Right on Jim. Tack the exercises on at the very end of your workout as a finisher. I also edited it for clarity and to correct a typo.

Good luck, anterior shoulder pain is the most common gym ailment, hope it helps!
"Therefore, the sage does not fail in anything since he does nothing; Does not lose anything since he holds nothing. Therefore, the sage's desire is to have no desire." - Lao Tzu

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Re: Finding someone to work with on shoulder issues

Post by JimZipCode » Fri Sep 07, 2018 1:27 am

Bram wrote:
Fri Sep 07, 2018 12:53 am
Good luck, anterior shoulder pain is the most common gym ailment, hope it helps!
Thx. One question:
Bram wrote:
Thu Sep 06, 2018 7:28 pm
Once you can do 2 sets with a 5lb dumbbell, add:

2 sets external rotation - elbow elevated x 10-20 reps each arm (either elbow resting just below shoulder height, like you are arm wrestling - with a dumbbell, or elbow at shoulder height like you are about to do a shoulder press with a dumbbell...this version is harder)
I think I'm reading too much into the bolded part. Do I do those with my elbow out to the side, same as the side-lying, or with my elbow out in front like arm wrestling position?
“War is the remedy our enemies have chosen. Other simple remedies were within their choice. You know it and they know it, but they wanted war, and I say let us give them all they want.”
― William Tecumseh Sherman

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Bram
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Re: Finding someone to work with on shoulder issues

Post by Bram » Fri Sep 07, 2018 2:49 am

Here you go...I prefer to stop at elbow height on the way down (same height as in the screen cap on the video), otherwise that's it:

"Therefore, the sage does not fail in anything since he does nothing; Does not lose anything since he holds nothing. Therefore, the sage's desire is to have no desire." - Lao Tzu

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Re: Finding someone to work with on shoulder issues

Post by Grandpa's Spells » Fri Sep 07, 2018 3:04 am

I have a couple "don't's". MAT and ART were both big for a while and both provided me only temporary relief. ART was particularly painful as they worked through the armpit. Not recommended.
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Bram
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Re: Finding someone to work with on shoulder issues

Post by Bram » Fri Sep 07, 2018 7:13 am

Jim, just to clarify - this is the side lying exercise. I prefer to stop when the hand is at elbow height at the top ROM, then lower back towards the belly:

"Therefore, the sage does not fail in anything since he does nothing; Does not lose anything since he holds nothing. Therefore, the sage's desire is to have no desire." - Lao Tzu

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