Shoulder trouble

[PurpleStix]

I am hoping someone here can help me design a program to fix my shoulder.

My doctor says it is a muscle strength imbalance, and to fix it mainly with strength work and massage therapy. There are no complicating injuries, just muscle.

The massage therapist found that the muscles needing work are the supraspinatus(top of shoulder) and subscapularis(under scapula), and to a lesser extent, the infrospinatus and teres major. I also need to build strength in the rhomboid muscles. And I have bilateral anterior shoulder rotation - the shoulders are rotated forward from high computer use. The pectoralis major may be too strong relative to the injured muscles, but I am to work that muscle as well but strive to maintain a balance of strength.

The injury first showed up when I was using a computer 48 hours per week, and doing Muay Thai kickboxing, and a bit of swimming, yup, high upper body use. At kickboxing, we do a lot of crunches, planks and pushups besides cardio and self defense training. I recently restarted swimming fairly vigorously. At public swimming I just jumped in and swam a mile - Zone makes you feel like doing things like that. It went well so i joined master swim, and swam several 25m butterfly sets that were in the day's workout. :doah:

It's at least a decade since I have been in a weight room. Finance is an issue, since I already have membership in the martial arts studio and master swim. The most I can manage is 10-visit passes to the community centre gym, without a personal trainer. I would be happy to supplement 2 visits per week with exercises I can do at home.

By the way they feel, it seems rowing would be a good option for the weight room, and back stroke in the pool. Possibly flyes and presses. I would appreciate any suggestions of what to include or avoid, and how (# sets, reps, times/week).

[LisaS]

those muscles are the classic rotator cuff muscles - so it might be that the classic rotator cuff exercises would be appropriate - internal rotation, external rotation, cuban presses, the "emptying a can/thumb down" raises.
These are typically done pretty low weight compared to what you might be used too - very doable at home with things like cans of beans, smallest dumbbells, or elastic bands.

here are a couple of sites that talk about the rotator cuff & appropriate exercises:
AAFP patient info: http://www.aafp.org/afp/20030315/1315ph.html
Sportfit rotator cuff: http://www.sportfit.com/tips/rotatorcuff/workout_shoulder.html



ps: are you sure it isn't teres minor rather than teres major ?

[PurpleStix]

My massage therapist wrote them all down for me. It's teres major. Interesting though, because that breaks up the set illustrated at the second website you posted, and adds a muscle from another group.

Teres major is a minor muscle that works with the lats, pecs and deltoids, so I will likely have to work those groups a bit too. I got this at http://www.exrx.net/Muscles/TeresMajor.html

[Arie]

PurpleStix,

I use to have thsoe problems.. a few things help:
1) streach well BEFORE you start exercising, and after.
2) warm up your shoulders with a very light weight or rubber cords
3) do more reps and less weight...

But to begin with, I would also sugest to give yourself a break for 10 days or so, and let the muscles recover well. Advil therapy is also going to help.. and once you feel no pain, start the steps above..

[PurpleStix]

Thanks Arie and Lisa. I haven't done kickboxing or swimming for over a week, so rest is definitely the thing. Next week I will do self defense only (less brawn more brain), but stay away from the pool and the punching bags.

Here's my first progress report. Yesterday I used 600mL pop bottles for the four exercises posted at http://www.aafp.org/afp/20030315/1315ph.html with about 20 to 30 reps. If I wasn't low carbing, I could work out a way to do it with cans of beer. :p It sure doesn't take much weight to exercise those teeny muscles. :agree:

Today I did a circuit at the community centre. For chest and shoulder exercises I took it easy. For shoulder press and pec dec I had to keep the weights really low. It turns out rowing benefits the rhomboid muscles, among others, so I will use that for warmups and cooldowns. :thup:

I'll do the rotator cuff and circuit exercises on alternate days this coming week, and see how I feel next Saturday. :)

[cs_carver]

Hold on to the door frame, feet in the frame, lean back. Stretches the infraspinatus. Then palms against frame, feet in frame, lean forward. Pec stretch.

Check out Erich Schiffman's book on yoga--Living in the Silence? From the library, or amazon if you're buying. He has some really good arm stretches too.

1. Hold towel, shoulder width apart, over your head. Move arms backward.

2. Tighten up to head-width apart, bring towel down behind head.

3. Arm twist I can't begin to describe.

plus others.

[PurpleStix]

Well I've been at it for a couple of weeks, and getting better slowly. Swimming is still out, but I am doing some martial arts now. My massage therapist found something else though - trapezius muscles. For this she recommended rolling up a towel, and lying prone on it for ten muinuts or so, so that it follows my spine. That lifts the back a little so that gravity pulls the shoulders down to the floor.

[amaciosek]

Boy, can I empathize with you!! I was having the same trouble and am a kickboxing teacher. Basically, it comes to this: make sure your form in kickboxing is impeccable. Ask someone to watch your hooks, especially. That's where my trouble was the worst. Also, start working on strengthening your back. With kickboxing, our front sides get overdeveloped and our back muscles are weaker causing this imbalance that leads to pain. If you want, you can reach me via my e-mail and I'd love to discuss this more with you. I tend to ramble on and on and on....
amaciosek~wi.rr.com

Hope you feel better soon, a sore shoulder really stinks!

Andrea

[PurpleStix]

YAY! I am finally feeling much better. Yesterday I had my fourth and last(?) massage therapy session. I am going to give cardio kickboxing a try. I will use the bag to stop my fist rather than try to punch through the bag though.

The massage helped loosen my shoulder, and she thought the exercises were really helping. Hopefully if I keep doing them, the problem won't reoccur.

:yay: :yay: :yay: :yay:

[westernwil]

Hi Purplestix, I too have had a very similar problem. I have tried a lot of things over the years, but after a really bad time when I found myself almost in tears in the grocery store, worn down from the pain/tension cycle, I tried a new chiropractor and he has really helped.

That towel excercise really helps, as does stretching out the pecs.

On my last visit I asked him how I should approach strengthening and injury-proofing the area. He said that it was better to take an all-body approach and just do a bit of everything. Essentially, improve the whole and the parts would fall into line.

I think that was stellar advice. We tend to focus in so tightly on "the problem", it came as a surprise to get such friendly, general advice. I have adopted an all-body strength training program, just adding a few moves for the weakest spots (core, rotator cuff, upper back). Seems to be doing the trick.