Rotator cuff injury recovery?

[Torpedo]

Hey, everybody. I was wondering if anyone had any tips to help speed up the recovery from a rotator cuff injury. I hurt it a couple of years ago while doing LOTS of pushups 6 days a week for about two months (didn't have a choice.) It's been a little unstable ever since.

I'm finally trying to nip it in the bud, because I want to get my pushup numbers back up, and I can't really do them with this shoulder. A physical therapist gave me some exercises to strengthen the rotator cuff, and I've been doing them, but it's improving really slowly. And I've gotten VERY out of shape in the meantime. My muscle has all turned to fat, and I'm really eager to get back to some real training.

Has anyone else bounced back from something like this?

[PepeLePew]

Hmmm...not really sure man. Was it due to bootcamp or ROTC?

[Torpedo]

ROTC Ranger Challenge tryouts/training. Our school had a very fitness-based approach, rather than a technical approach. We dominated in the more physical events at the competition, but lots people got overuse injuries. :lol:

[PepeLePew]

Dang, sorry to hear about the injury man.

[thegrezdog]

Been there done that man...

Chances are that if you lift weights/exercise, at some point in your life, your rotators cuffs will act up. Hell, being an experienced weightlifter, I know PERSONALLY how difficult these injuries can be. So for what I am going to tell you, its very important you read everything and cautiously approach the situation. Please be VERY careful.

Its very VERY tricky recovering from such injuries. Here are some tips that I have employed in the past:

1) Ice/Warm the area. Constantly. Warming is more important, icing helps. Its very important to get blood flowing in the area...but constricting the blood vessels via ice will help in this case. We are aiming for contrast here (COLD ice pack, WARM/ALMOST HOT heat pack). Vasoconstriction followed rapid heating is very effective on a cellular level for recovery.

2) On the same token, take contrast showers. Used to do this back in my power lifting days to recover from extra-tough workouts. 30 seconds cold water, 60 seconds water as hot as you can stand. Repeat several times. It may not be pleasant, but it can help a lot. :puke:

3) This is a very effective exercise that can cure your shoulder problems about 90% of the time. Take a large towel or broomstick and hold it with straight arms for entire duration of the following motion:

Grab your broomstick with your arms fully straight and extended. Use a significantly wide grip. Hold it with your straight arms in front of your body resting on the front of your legs. Now slowly take the broomstick and put it overhead - but MAINTAIN your fully-extended, straight arms! :evil: Continue with the motion by going down your back as far as you can. So the broomstick should be behind you now. Now, go back to the initial position by reversing the motion. Keeping your fully-extended arms straight throughout the motion is of paramount importance!! :twisted: What we are really focusing on is the tightness that you will feel when the broomstick is in the overhead position. Okay now that you are back to where you started, you have completed one rep. Complete a total of 50 reps every night if you can. After 2 - 4 weeks your shoulders should be feeling GOOD. :cool:cool:cool

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On a more long term note - PLEASE look into external rotation exercises to keep these parts of your body strong. Prevention is ALWAYS superior to treatment. :D

[Torpedo]

Hey, thanks for the advice. A few questions:

1. Should I do that broomstick exercise in addition to the exercises that the PT gave me?

2. How do you bring the stick down your back, if you're keeping your arms straight?

3. I did a few short sets of pushups (not deep) yesterday, and now my shoulder's a little sore. The thing is, even though the injury is a couple of years old, the PT said that the instability is causing some tendinitis in the front of my shoulder. So there is some pain now that I'm really using it again. So is the injury too old for a warm/cold alternation, since it's mostly a stability issue now? Or should I still do that in case there's some tissue damage that needs to heal?

4. The PT said that part of the reason I had this problem was because I have a naturally lax shoulder joint. He recommended doing external rotation exercises periodically if I ever have to do lots of pushups without much rest for extended periods of time. The problem is that in some of the selection/training courses I plan on going through, you're not allowed to bring extra things like exercise bands. Does anyone have any tips to avoid re-injuring the shoulder during something like this? I guess I could try to find things to use as improvised dumbells...

And I don't understand what I should be so careful about. I've put quite a bit of post-injury wear and tear on this sucker. :lol: Thanks again for the help.

[Torpedo]

Woops, I forgot to say that this injury is about 2 years old. I switched to weights for awhile, because I had an easier time with them. But I finally made it to a physical therapist to get it assessed about a month ago. The biggest problem with it has been instability, and he promised a quick recovery. But it's progressing slowly...

[thegrezdog]

1) Most likely yes. I don't see why it would clash with his prescribed exercises. Posting what he told you to do would help.

2) Your shoulder should be rotating. Like I said, start with a wide grip. If you try the exercise you'll see what I mean.

3) I would say continue to do the warm/cold treatments. It is not as important though, since it seems like there is no tissue problem. Since it is tendinitis, focus on the warming part more. Also...think about mild use of some anti-inflammatory drugs.

4) I don't understand your situation. What do you mean "you're not allowed to bring extra things"? Are you talking about your physical therapy sessions? I'm confused :shrugs:

As far as avoiding injury...there are extreme options and mild options. For instance my brother had rotator cuff problems around age 22, and he no longer bench pressed or did pushups. These exercises involve a lot of scapular movement which can be dangerous...Personally I would say stop doing pushups or any other type of horizontal pressing movement. Also, try and strengthen your back (upper back specifically). Work on strengthening your rear delts, traps, neck. <THIS IS IMPORTANT

Lastly as far as "being careful"....your really not in danger, but its a personal liability thing. If you follow my advice and somehow fuck yourself up (which you'd have to be a dumbass to do so anyway), I don't want that on my karma :cool:cool:confused::confused::mrgreen:mrgreen

Good luck man and continue to ask questions if you need help

[Torpedo]

Thanks again for all the help, thegrezdog. Reps were sent after your first post.

I was talking about training in the Army. Take Ranger School, for example. It's about two months. At least the first third of it (at Benning) will probably involve lots of pushups with very little sleep at night. Hence, it'll be lots of wear and tear on the shoulder without much chance to recover. And you're not allowed to bring anything with you that's not on a very strict packing list - so no exercise bands or anything to do external rotation exercises. If anyone has any tips for avoiding injury during a situation like that, I'd be very grateful.

I have to get to where I can get my pushup numbers back up AND be able to do them quite a bit without injury.

[Torpedo]

OK, here are the exercises. I'll do my best to describe them.

Exercise 1: Attach the middle of an exercise band to a fixed object, and grab one end with each hand. Stand so that your hands are out in front of you, holding onto the bands. Your arms should be at maybe a 45-degree angle to your body. Keeping your arms straight, bring your hands down to your sides, next to your hips. Squeeze your shoulder blades together as you do this. Allow your hands to be pulled forward again, and repeat the movement.

Exercise 2: Identical to Exercise 1, except that it is only done on the injured side. It seems to work different muscles.

Exercise 3: Attach one end of the band to a stationary object. Grab the band and stand facing perpendicular to it, so that the band pulls your arm out to the side. Keeping your arm straight, bring your arm down to your side. Let the band pull it back up again, and repeat.

Exercise 4: Attach one end of the band to a stationary object. Grab the band in such a way that you are facing perpendicular to the band, with the band pulling your forearm across your body to the opposite side. Keeping your elbow at a 90-degree angle, bring your hand forward and across your body until it goes a little past parallel to the direction you're facing. Do this by rotating your upper arm. Let the band pull your hand back across your body again, and repeat.

Exercise 5: Grab an exercise band in both hands with your arms by your sides and your elbows bent forward at 90 degrees. Pull on the band with both hands, so that your hands move apart from each other a little ways. Let the band pull your hands back toward each other, and repeat.

Exercise 6: Grab an exercise band with both hands with your arms extended out in front of you. Pull your arms apart, rotating your hands forward a little bit as you go, until they are extended out to either side. Squeeze your shoulder blades together. Let the band pull your hands forward again, and repeat.

He had me doing 20 reps of each exercise twice a day for awhile. I was wearing myself out, so now I go every other day until I start to lose my form.

[Torpedo]

Well, I just realized that I was doing some of the exercises wrong. :lol: On the first two exercises, I brought by hands a little closer in, and it totally changed the muscles that were being worked. My shoulder's starting to feel better. So I'm gonna keep doing the physical therapist's exercises + the broomstick thing (which does make my shoulders feel good.)

We'll see how it goes.

[Torpedo]

Well, I just realized that I was doing some of the exercises wrong. :lol: On the first two exercises, I brought by hands a little closer in, and it totally changed the muscles that were being worked. My shoulder's starting to feel better. So I'm gonna keep doing the physical therapist's exercises + the broomstick thing (which does make my shoulders feel good.)

We'll see how it goes.

[thegrezdog]

ok torpedo sounds good :cool

[Torpedo]

It was feeling a LOT better, until I scratched my back with that arm. I sort of bent the shoulder in a weird way behind me. Now I'm back to square one! :neut:

Should I see an orthopedist?

I'm weaker and look worse than I have in years. This is starting to get frustrating. I need to work out!

[thegrezdog]

when you bent your arm back to scratch your back, did your hand go over your shoulder, or stay under your shoulder with a bent elbow?

i'm guessing the second...that specific position tweaks the rotator cuffs/posterior delts quite a bit. its impossible to say what you did. it could simply have been irritation, or maybe something more serious.

based on your post i am leaning towards the fact that what u did was relatively minor...if you had re-torn your rotator cuff or f***ked up your delts, you would probably be in more pain than you described in your post. :twisted:

at any rate, i highly advise seeking the opinion of a professional. like i said, it could have simply been irritation, but why take a chance? :shrugs:

good luck and don't delay seeing a professional. the faster you seek an opinion, the faster your recovery will go :cool

[Torpedo]

Well, it's some sort of instability that I'm struggling with. The shoulder rounds forward and feels unstable. And somehow what I did aggravated that.

Well, I managed to get in to see my doctor today. He looked at it and said that the rotator cuff muscles seem pretty strong and that there's no sign of an impingement. He gave me a referral for some physical therapy. (The other PT was just a free consult, but he acted like I shouldn't have to come back.) The doc said that if additional PT doesn't help, then it's time to go to an orthopedist to see if things need to be surgically tightened-up. :( So I'm keeping my fingers crossed.

I guess I'll start working closely with a PT until this gets resolved. Thanks for the help, grez. Reps coming your way as soon as I get the ones I'm waiting for. (You'll get more that way. :wink:)

[thegrezdog]

lets hear some updates, torpedo

[Torpedo]

Well, I've tried all sorts of stuff. I've been to physical therapists and orthopedists, I've had tests done, and I've gotten nowhere. All I've learned is that nothing is torn, and everything seems to be structurally normal. So what I'm dealing with is purely a muscular problem. I'm guessing it all comes down to inhibition of my scapular stabilizers. I might have to just self-treat it. All of these people are so preoccupied with common shoulder problems that they totally ignore my symptomology.

[Torpedo]

Brief update:
The injury is still there, but it seems to be improving. It'll improve for awhile, then regress, then start improving again. Stretching the posterior capsule has REALLY helped, in conjunction with strengthening/activating the rotator cuff and scapular stabilizers. I think I'm going to start doing more targeted work on the infraspinati and supraspinati.

[Torpedo]

Hey, does anybody have any experience with ART?

[Shane_Bos]

I used to finger paint alot when i was little.

[Torpedo]

:neut:

Active Release Techniques

[thegrezdog]

Torpedo, read these:


p. 37, 39, 42 of
http://www.robertsontrainingsystems.com/downloads/SMR-manual.pdf

for more info on self-myofascial release:
http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/feel_better_for_10_bucks%3bjsessionid=B8842AF37A63 D42DAAFEEB8A82F3EBDD.hydra

[Torpedo]

Interesting... Thanks for the info. I'm going to try this out as soon as things die down a bit at work.

[thegrezdog]

so torpedo have you started yet?

[Torpedo]

:lol:

No, I forgot. I'm still bouncing back from my 2-week overtime bonanza. And since I'm an aspiring vegan now, that's easier said than done. Don't ask... :lol::lol: