Alternative/rehab exercises for shoulder girdle issue

[birdiefu]

I realize that the first thing anyone will say regarding my problem is to see a doctor. However, having Tricare and seeing military doctors before with a muscle/joint/injury issue, I know that it will take weeks before I get to see anyone who will tell me anything other than take some ibuprofen and RICE. In the meantime, I would love to hear advice on the best way to modify my program to relieve my issue while still being able to get some training done.

I am a couple of months into the Starting Strength program, and about a week and a half ago, noticed after squatting that my left shoulderblade muscle (infraspinatus) was quite tender immediately after a set. I shrugged it off as just a bruise (I bruise easily, my back constantly has squat bar bruises). However, as I was leaving the squat rack I noticed that my left thumb was sorta numb, and up my forearm was also tingly. Made me kinda nervous, but I rested and massaged the shoulder later. It got better over time, and my next workout day I adjusted my grip wider as I had a very close grip before, and made sure to pay attention to see if I felt any pain, to stop. No problems.

Everything went well, until yesterday (so, almost a week since I was symptom free). I'm not making a lot of increases in weight lately, as I am cutting at the moment, so did the same weight (145) as I did on Wednesday. I was able to do all my sets on Wed at 145, but had a bad day yesterday partly due to bad pre-workout nutrition timing, and embarrassingly had to dump the bar on the pins. Aside from really trying to get out of the hole before dumping, I didn't feel like I strained anything in particular at the time. Later on that training session I also did some wide-grip pullups on the assist machine, which I had just added to my routine. I felt an odd sensation in my left armpit area (teres major, I believe), and called it a day.

Later that day the tingly thumb, forearm, and biceps came back. I also developed horrid trigger points in my left infraspinatus, rhomboid, and teres major, with aching referring pain. Today it's a tiny bit better and I have spent a large portion of the day foam rolling, using my Theracane, and stretching. the numbness fades from time to time.

Since, as I mentioned above, it will be ages before I can see a competent doctor, I don't want to completely stop weight training. I was wondering if anyone had any advice on exercises that will not stress this area out while being able to address as many muscle groups as possible. I was thinking leg press instead of squats, but would (light) front squats maybe be okay? Deadlifts are out? I will also avoid any pullups, probably rows too (I usually do bent-over rows). I have not had issues with bench pressing making this worse the first time around, so I don't know if I should avoid that as well. I just don't want to be stuck with doing cardio only while trying to heal, especially as I am cutting for another month and want to conserve muscle mass.

Any input would be appreciated, thank you!

[birdiefu]

Still looking for any advice for my workout tomorrow. I was also wondering if perhaps a Manta Ray would be a good investment for my situation? I prefer to not use "devices" much at all, but I have heard good things about this particular one.

[Euqinom]

Still looking for any advice for my workout tomorrow. I was also wondering if perhaps a Manta Ray would be a good investment for my situation? I prefer to not use "devices" much at all, but I have heard good things about this particular one.

I like the manta ray, it gives your shoulder a little freedom. The bar comes up a little higher, so be careful the first time(s) around.

[Euqinom]

I am a couple of months into the Starting Strength program, and about a week and a half ago, noticed after squatting that my left shoulderblade muscle (infraspinatus) was quite tender immediately after a set. I shrugged it off as just a bruise (I bruise easily, my back constantly has squat bar bruises). However, as I was leaving the squat rack I noticed that my left thumb was sorta numb, and up my forearm was also tingly. Made me kinda nervous, but I rested and massaged the shoulder later. It got better over time, and my next workout day I adjusted my grip wider as I had a very close grip before, and made sure to pay attention to see if I felt any pain, to stop. No problems.

Doesn't the numbness point to a pinched nerve (neck area?)

I was thinking leg press instead of squats, but would (light) front squats maybe be okay? Deadlifts are out? I will also avoid any pullups, probably rows too (I usually do bent-over rows). I have not had issues with bench pressing making this worse the first time around, so I don't know if I should avoid that as well. I just don't want to be stuck with doing cardio only while trying to heal, especially as I am cutting for another month and want to conserve muscle mass.

Any input would be appreciated, thank you!

Okay, I'm NOT a physician, nor do I pretend to be a know all. I have had a few shoulder issues, and I am only telling you what I did/would do, okay?

Squats: don't do a wide grip, as you'll hyperextend your shoulder if you go wide. Slightly wider than shoulderwidth should be fine. Check form, mainly barbell positioning.
Front squats or goblet squats should be fine, but I wouldn't start using Oly-grip.
If you insist on trying pull ups after the pain has gone: try neutral grip. I never use pronated grip, as it forces me in a range that triggers my impingement (do you think that could be what's going on with your shoulder?). I would not cut out rows altogether, as focussing on anterior shouldermuscles can increase problems with stability and posture.
Have your posture checked (plenty online, Eric Cressey in Neanderthal No More). Maybe switch to dumbell work rather than barbell work. Avoid shoulder isolation work, except for maybe Poor man shoulder horns, high rep, little weight (and I mean little! 5lbs is more than enough)

Rehab could be:
Push Up Plus, Dynamic Blackburns, No Money Drills, etc. But again, it's really no use if you don't know what is going on.

Also: getting injured this much in this short a period of time is worrisome. When did you have your last de-load (is your system exhausted?), how strictly are you cutting, how bad is your posture?

[birdiefu]

Yes, I agree that the tingling/numbness (now just a general "odd" sensation in my thumb mostly) is probably due to a nerve getting pinched somewhere. But where the actual pinch is occuring or from what I am not sure, I'm sure a doctor will have to narrow down the specifics. Though I am guessing anywhere from my scalenes (had 2-year history of neck issue from forward neck position nursing my youngest, past year has been pretty good, though I have to stretch/exercise my neck multiple times a week still), infraspinatus, or teres major, or somewhere else. I just know that those three muscles have trigger points that all refer pain to the same regions on me - front/back of shoulder and down arm to thumb. I have a feeling I should have rested longer when I first noticed the issue, and only compounded the problem by going right back to trying to add weight once it wasn't acutely painful anymore.

Why I mentioned widening my grip with the squat, is that the biggest problem seems to be when I externally rotate my humerus and reach back. Pain/tingling is relieved putting my arm forward as well as stretching it up (stretching by pulling elbow across behind my head helps). My usual grip was pretty close, with thumbs (thumbless grip, lowbar position) about an inch on either side of the knurlings. That, and shoving my elbows up behind me, I think really compressed/stressed that muscle back there. I will make sure not to go too wide when I finally do return to back squats, but I think perhaps I was too close before for my particular anatomy.

Regarding your questions on posture, ever since my neck problem began 3 years ago I have been very aware of posture and work on it constantly. However, the fact that I have a long-standing problem with my neck (I think it is managed as well as it will ever be, but still aches time to time) may predispose me to have issues with nearby structures, the left had always been a little worse. Thank you for reminding me to work front and back pretty equally - I know I don't want to cause any further muscle imbalance that would make this worse. I am also very anal about trying to get perfect form while working out, though with no actual coach (the person my gym gave my for me free training session didn't even know how to do a conventional deadlift!), I may be missing something even if I think my form is great.

As of today, since my thumb was still feeling weird, I didn't want to do any arm work at all, I'm getting paranoid of causing a chronic condition if I fiddle with my arm too much right now. I have noticed that as I get older, it's not as easy to push off the little aches and pains, they like to linger rather than disappear while still working out like they did 10 years ago! So, I resorted to leg machines and the stairmill. I am not familiar with some of the exercised you mentioned, so will look them up, thank you for the suggestions!

Since I have only been doing Starting Strength for not quite 2 months (I haven't done serious weights since a few years ago before my kids), I figured I wasn't in need for a deload yet. I'm not increasing in weights as quickly, but there is still some progress (either increase in weight or I add another set). However, I think my body is probably telling me it needs a bit of a break. My long-term goals are to increase muscle mass, but I am currently cutting for vanity (my wedding is in June), I would like to lose another 1% bodyfat to be about 21%, then maintain for a little. I can probably work on starting to maintain now, I just don't want to actively bulk until after the wedding. I'm currently at about 1700 cals per day, with a free day (above 2100 maintenance) once a week, with about a 33/33/33 macro ratio. I put some stat info into my profile, and a pic if you want a general idea of my body and recent changes.

Thank you so much for the reply, again, I will be looking into the exercises you mentioned, but will try to rest, massage, and stretch as much as possible while I still have nerve involvement. Hopefully I can get in for my first doctor appointment (likely ibupropen and "come back in 2 weeks if it doesn't improve" speech) tomorrow.

[summertown74]

I think you should rest! Your body is trying to tell you something. If it were me, I would avoid anything that caused pain until I got the trigger points released. You can still do the leg press, bodyweight stuff, and plyometrics to kick your butt.

Yes, you may go back with lighter weights and some muscle loss, but wouldn't you rather have a small setback in muscle gains than develop a chronic injury? Being a massage therapist, I see LOTS of people who didn't listen to their bodies and years later, wish they had

I hope it gets better soon!

[birdiefu]

Thanks! Actually, I just looked into booking an appointment with a neuromuscular massage therapist, hopefully to get *something* done with it in the meantime waiting on the Tricare docs. I think you are very right in this case on resting. It's sometimes hard to balance the "train, train, train!" mentality with a more conservative approach, but I do think it this case I can put muscle/weight increase desires to the side for the long-term benefit of my body.

[movefree_Brian]

I agree with putting muscle/weight increase desires to the side, but I don't think that means leaving weight training out of the equation.

I will say that my experience with acupuncture points your thumb, forearm, bicep chain to the lung channel, but unless you're into that it's just a side note.

As for getting yourself working in the weight room again, don't leave the weight room just yet! You need to work antagonizing muscles to the ones that are overacting after using joint mobility drills to loosen the overacting muscles.

For an example dealing with the Rhomboid Major check out movefreeblog.com/shoulder-mobility/shoulder-movement-and-the-rhomboid-major-muscle

and then for any other pain points, look at an image of the muscle that hurts to get an idea how to mobilize it, then identify the antagonizing muscle and use your bodybuilding knowhow, an image or anatomy reference to get an idea how to strengthen the antagonist.

Thanks! Actually, I just looked into booking an appointment with a neuromuscular massage therapist, hopefully to get *something* done with it in the meantime waiting on the Tricare docs. I think you are very right in this case on resting. It's sometimes hard to balance the "train, train, train!" mentality with a more conservative approach, but I do think it this case I can put muscle/weight increase desires to the side for the long-term benefit of my body.

[velveteenrabbit]

I've had that- from sports and computer work, but exactly as you describe. either a pinched nerve or more likely an inflammed nerve or area around a nerve. you need to rest and ice it regularly- ice it after every workout, a few times a day, whenever you can take a break and lie down, and before bed. don't use heat, as that increases the inflammation. a regular doc will probably just give you meds (although you could try some ibuprofin, but don't use it as a crutch to work out), go see chiro, physiotherapist, and/or massage (but not just massage alone). the physio can look at the way you are doing your work out and give you adjustments. I use all three.

It might be the way the bar is resting on our back/shoulder blade area when you do your squats that's irritating it. try smith squats, I find they aren't as much pressure on my back (I know they are controversial but if that's all you can do right now, that's all you can do).

I wouldn't think that you need actual shoulder exersizes right now, you need rest.

[birdiefu]

Thanks guys for the advice! I saw a regular doc on Tuesday, and he of course didn't have much to say about it. Gave me pain meds/muscle relaxers, said don't do anything that causes pain, and come back if it doesn't get better. Yesterday at the gym I did relatively light front squats and pretty light bench and standing presses, and some HIIT. It didn't seem worse, but not better either. Today I saw a NMT, and he gave me a plan including *no weights*, just resting and stretching (but lower-body cardio ok) for a week, then he will work out the points and it "should be" a simple fix (hope so!). With my pain pattern, history, and sleeping posture he says it is most definitely the scalenes leading to a cascade of events down my shoulder and arm. Oh, it will be hard to force myself to not try any weights, but I gotta be nice to my body so it can work hard for me in the future, I suppose!