The anatomy of shoulder pain

Happy Memorial Day everyone! Hope you are enjoying your day off but at the same time being sure to pay homage to the ones who have passed on before us.

On a less serious note, I lifted today and continued my pursuit of healing a bothersome left shoulder injury. My last bench press session was in April and to my dismay the lift has not tested well since. The Gym Movement pain protocol is to find out what is not moving and get it to move. Some body parts need to be more rigid, while others need to become more elastic. For me, my shoulder feels a bit frozen so I know that my goal is to improve shoulder elasticity. My plan of action was to balance function and re-work the tissue, so working the hips was also a consideration.

At my next workout I did try to bench (my specific goal) and it tested poorly. So in my experimental stage I decided to hit the problem area with some direct shoulder work. I started with the barbell press. It tested well but I felt a twinge of pain when performing them. Barbells are more restrictive than dumbells so I moved to regular old dumbell presses. After a few workouts of basic two hand pronated pressing I decided to increase the load by trying see-saw walking dumbell pressess. This quickly broke me out of a slump as I was able to do nearly 50% more reps in the same amount of time! However, moving up in weight was not in the cards as of yet and after only a few workouts of this variety the pain began to get worse. Thinking the load was too heavy or my form was not as strict as it should be, I tried a couple workouts doing seated pressess. Changing the base of support like this can be a good option, and I even contemplated sitting on the floor and doing them. Maybe next time.

Onto standing alternating dumbell pressess with the left hand in a more nuetral position and the right hand in the regular pronated grip. This seemed to get me in the groove and enabled me to FEEL the movement and not the weight so much. Adam Glass says you should feel "nothing", just perform the movement. Not surprising, my shoulder got a little bit better. In fact, the shoulder pain seemed to move from my anterior deltoid to pain in my upper back, anatomically close to the infraspinatous muscle of the rotator cuff.

Sensing that the tissue was indeed moving, I finally tried to sneak in some bench pressing today. It did not test well, and neither did dips. Asymetric Pushups with my left arm higher than my head tested decent so I was able to get 48 reps in. While not a PR for pushups it was a PR in an asymetric position. I'll take it! I was also able to get 10 reps in the chin up with 25# tied to me. Again, not a PR but it is showing progress. Note that I have been sneaking in reverse lunges over this entire time frame, as hip extension is a key component to improving my shoulder flexion issues.

All in all, sometimes avoiding the movement all together for a while is the answer. Just look for ANY exercise that tests well and give it a go. It's all about experimentation. WHAT movement made my pain go away is much more important than WHY it worked - nobody really cares! I just want to be out of pain. Delving into the history of WHEN the pain started and HOW you go about your normal everyday activities are also important. I noted that I often slept with my head on my left shoulder, with my shoulder adducted and over my head. Driving in my car, I tended to put my left arm cross body on to the steering wheel. This helped cause the tissue to overcompensate in this area as Wolff's law states that tissue will be laid down along lines of stress. This can be either good or bad, but being this was done all one way it added up to pain and dysfunction. I will keep you posted as I attempt to rebalance my body out!