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A shoulder question (Read 1420 times)

iain

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A shoulder question
November 01, 2017, 02:14:28 pm
I need your help UKB. I've just had an op on my right arm which is stopping climbing for a couple of months.

On the plus side this means I have the 'opportunity' to do something about my left shoulder.

The problem, and the question, is twofold.
Firstly, my left shoulder's flexibility is poor, both from hunched boulderer syndrome and an injury from a couple of years ago. I appreciate I could just stretch it out but I'd like to know how to do this properly in conjunction with doing something about ...

Secondly it's weak. To get any meaningful strength out of the left shoulder I always rotate it forwards on almost any kind of move, wide or otherwise, and it doesn't feel very stable. I don't understand what is weak to cause this and therefore what I can do about it.
Also, I'm guessing I need to retrain the shoulder to move properly.

Is how can I address both of the above, preferrably at the same time?

Any info or pointers to good reading welcome.
At home I have access to adjustable dumbells and a pullbar bar.

Cheers  :thumbsup:

erm, sam

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#1 Re: A shoulder question
November 01, 2017, 04:53:03 pm
stretching front stuff and strengthening / learnign to use the shoulder blade stabilising muscles would be my first port of call.

Rolling Lats, scapular hangs etc.

If you google Shoulder mobilisations Kelly Starrett, you will get some good stuff.

iain

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#2 Re: A shoulder question
November 01, 2017, 05:57:55 pm
That's the kind of thing I'm after, thanks

SA Chris

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#3 Re: A shoulder question
November 01, 2017, 06:01:45 pm
My advice is go see a good climbing physio. Can help with a & b in a considerably more productive way than you a) guessing at where exactly the issue lies and b) figuring out what exactly what you need to do. Shoulders are an incredibly complex joint even before you start climbing on them.

nai

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#4 Re: A shoulder question
November 01, 2017, 07:05:47 pm
Both the weakness and lack of flexibilty could be caused by certain muscles not working properly due to tightness, impingement or posture.  I'd go see a physio/masseuse and get an assessment and bit of a work over then spend the couple of months you have on any recommended remedial work and hopefully you'll be good to go.

Dan Cheetham

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#5 Re: A shoulder question
November 01, 2017, 08:04:14 pm
What was the injury? It may be the source of the problem?

iain

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#6 Re: A shoulder question
November 01, 2017, 11:29:56 pm
What was the injury? It may be the source of the problem?

It's definitely the source of the instability and inflexibility.
When it happened I went to see 2 different physios, neither of whom were able to tell me what the injury actually was and both gave me what seemed like generic theraband work (which I did), I didn't go back to either because of that. I appreciate the shoulder's complex but was I expecting too much from them?

Given that my thought was to start with some basics and work from there, but someone knowledgable would be really good if anyone has any suggestions around Sheff?

mrjonathanr

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#7 Re: A shoulder question
November 02, 2017, 03:49:01 am
Ian at HP clinic, Broomhill. Jeff Ross of Harris and Ross, Wilmslow.

Dan Cheetham

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#8 Re: A shoulder question
November 02, 2017, 06:35:18 am
What was the injury? It may be the source of the problem?

It's definitely the source of the instability and inflexibility.
When it happened I went to see 2 different physios, neither of whom were able to tell me what the injury actually was and both gave me what seemed like generic theraband work (which I did), I didn't go back to either because of that. I appreciate the shoulder's complex but was I expecting too much from them?

Given that my thought was to start with some basics and work from there, but someone knowledgable would be really good if anyone has any suggestions around Sheff?
 

How did it happen? There's always a potential for labral tears that might benefit from being excluded as much as possible. They can grumble for years as soon as you start to push it.   

Also if you're going privately - Manchester shoulder clinic in Wilmslow is the place I'd recommend. You could also check out 'shoulder doc' - it's the very good website linked to the clinic

https://www.shoulderdoc.co.uk/
« Last Edit: November 02, 2017, 06:41:38 am by Dan Cheetham »

mrjonathanr

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#9 Re: A shoulder question
November 02, 2017, 07:58:17 am
[quote author=Dan Cheetham link=topic=28473.msg559306#msg559306 date=1509604518

Also if you're going privately - Manchester shoulder clinic in Wilmslow is the place I'd recommend.
[/quote]

What is the Manchester shoulder clinic Dan? Do you mean Harris and Ross? They aren't specifically for one part of the body, though they are excellent.

Shoulderdoc is Leonard Funk, they're not related.

Dan Cheetham

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#10 Re: A shoulder question
November 02, 2017, 08:03:49 am
Hi there, looks like they're known as the arm clinic now

https://www.thearmclinic.com

This is the team of shoulder / upper limb physios that work at the same clinic alongside the consultants

 https://www.manchestershoulder.com/about-us/

mrjonathanr

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#11 Re: A shoulder question
November 02, 2017, 08:48:42 am
Ah I see, unrelated to Harris and Ross, wasn't aware of the Arm Clinic, thanks.

duncan

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#12 Re: A shoulder question
November 02, 2017, 10:21:41 am
In what direction(s) is the shoulder inflexible?

Can you expand on what you mean by 'rotation forward' as the compensatory movement?

Weakness and inflexibility are the ying-yang (or chicken-egg, if you prefer Scottish food) of shoulder problems but before I attempt an answer a little more detail might help.


iain

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#13 Re: A shoulder question
November 02, 2017, 02:12:48 pm
Dan & mrj, thanks.


Hey Duncan  :wave:
I can't help think that truly scottish food would be batter-mars bar.

By 'rotation forward' I mean that applying any sort of force (whatever direction) I pull the shoulder forward towards the pec. With downward pulls I then rotate the elbow out making it feel like I'm rotating the shoulder forwards, almost like I'm pushing down onto a hold even if it's above my head. I will do this with even 'easy' things like eg. opening a fridge where I'm pulling down and out. I didn't realise how bad it was until being forced to use that arm over the last couple of weeks.
I will also hunch the shoulder up towards my ear to get more force, including with undercuts where it's shoulder to pec then to ear.

The flexibility is mostly overhead but, unsurprisingly I guess, hampered by the above in other directions.
When doing downward dog and rotating the left arm anti-clockwise the left shoulder feels like it hits a solid stop that I don't want to push past with the deltoid, bizarrely, feeling very tight and strained. When doing this I'm trying to keep the shoulders down back.
I can push much further on the right and easily reach 1-2 inches higher.

Does that make sense?

duncan

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#14 Re: A shoulder question
November 09, 2017, 09:31:15 am
Iain, it's hard to explain this kind of thing using text and I'm still not 100% clear, so usual advice about seeing an effective physiotherapist applies, but i think your original analysis is correct. You say you are firstly stiff and secondly weak/'doesn't feel very stable'. How can that be?

Think of your shoulder area as having two 'joints', one between the arm and the shoulder blade and one between the shoulder blade and your trunk. It's likely your shoulder blade is not being controlled effectively when you exert force with your arm (sometimes called muscle imbalance, 'instablity' and similar terms), you can think of this as 'too much' movement at the shoulder blade/trunk joint. Conversely the shoulder joint itself, between the arm and shoulder blade, has 'too little' movement. Too much and too little movement in adjacent joints reinforce each other. Which came first, the mars bar or the batter, is probably irrelevant now.

I think you firstly need to retrain the muscles controlling movements of the shoulder blade, then work on shoulder joint flexibility. It's hard to do the latter if the former are not up to snuff. What you don't need to do, yet, are classical rotator cuff exercises.

It might be useful for you, and anyone treating, you to get videos of your shoulders from your back whilst you perform a variety moves and climbing related exercises: lock-off narrow and wide, gaston, lay-away, wide and narrow pull-ups, dips. Ideally you would do these on a system board to enable you to compare left and right. We’re particularly interested in what the shoulder blade is up to, have lighting to show this.
 
I think there are several generic things you can do. Exercising the serratus and lower traps. is usually helpful, these are usually the scapular controlling muscles that become weak/fatigable.  I generally prefer to focus on these first before doing too much stretching or rotator cuff work. Lots of planks, side planks, and shoulder-blade retractions (sometimes called “setting”). The latter described , stop at 1’00”. Does the injured side feel weaker? Focus on working on this until you feel left and right are as strong as each other.



iain

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#15 Re: A shoulder question
November 10, 2017, 08:13:49 am
That's really useful Duncan, much appreciated.

kelvin

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#16 Re: A shoulder question
November 12, 2017, 12:50:12 pm
I've just been diagnosed with degeneration and calcification of the tendon, which would explain the weakness issues I've been having with my left shoulder. After two years of searching the web, physio appointments and getting movement back into the scapula and getting all the related muscles to engage - turns out the tendon was kaput also. I can't express enough how important seeing a good professional is.

*Having said that, lots of the advice and threads in here have been fantastic and helped hugely

sheavi

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#17 Re: A shoulder question
November 12, 2017, 07:16:56 pm
Can I ask how this was diagnosed and your age?

kelvin

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#18 Re: A shoulder question
November 12, 2017, 08:43:37 pm
52 years old and most certainly age and work related.
Hands on diagnosis, which from what I've read is perfectly possible by a good physio and he thinks I can avoid surgery and make a good recovery, at the cost of some discomfort in the shorter term. I had ShockWave therapy on it a few days before I came to Font and have to massage every two days to keep it agitated and my brain engaged in the healing process. Not the best for Font but there are plenty of stupidly hard easy slabs to keep me laughing.

sheavi

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#19 Re: A shoulder question
November 14, 2017, 09:52:24 am
Great - sounds like you're on the right track. Rotator cuff pathologies do respond really well to exercise but they take their time!  Stick with it.

kelvin

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#20 Re: A shoulder question
December 01, 2017, 12:54:09 pm
Great - sounds like you're on the right track. Rotator cuff pathologies do respond really well to exercise but they take their time!  Stick with it.

Just wanted to say thanks for the comment, it was greatly appreciated - when I read it, I was having a real downer after trying a few sit starts, getting nowhere fast and seriously considering not massaging the tendon that evening. The "stick with it's comment kept me on track. Home now, after a month in Font where the shoulder has recovered beyond my expectations, from struggling on oranges the first day to only climbing on blacks the last day. There's a long way to go still but I'm optimistic.