Sternoclavicular Ligament

[Kaiser]

Bill, yesterday I had a problem around the collar bone rear its head again. I usually see it about once a year, often when I am trying to bench in the heavier range.

Yesterday, I warmed up with some of your upper body mobility and went on to do a normal workout. The only bench press type activity I did was DB closed grip (palms facing each other) presses. By the end of the workout, I had a dull pain in my collar bone. I recall this from before, but I had only had it show up when I pressed heavy with a bar... never DBs. It hurts at the end (middle of my chest) bony protrusion on my right clavicle. It's not too bad, but I don't want it to get worse.... can you help virtual diagnose? I remember asking someone knowledgeable before and they mentioned that it could be the sternoclavicular ligament. Does that sound right? What could it possibly be and what should I/should I not do?

PS: I have recently added a climbing strength exercise called typewriters - you hold in a contracted pullup with a wide grip and then swing back and forth (like a typewriter rack) while holding the concentric pull. I don't know if this is a possible irritant as well.

[UConnJulie]

Kaiser, the region you mention is the sternoclavicular joint ... and it is possible to strain it ...

Does it hurt there when you shrug your shoulders up and down?
How about protract and retract?

[Keith Scott]

I'm not Bill, nor do I pretend to be, but I will jump in anyway . The SC joint is not a very strong joint at all, and allows some accessory motion (which is a good thing), but because of this sometimes you can get some excess movement beyond the norm. Might you have sprained the ligament? Sure, but I would use over stretch in this case (same thing, but this fits what you did a little better IMO) I have seen this joint re-injured more times than I would like by many of my athletes over the years, so go easy and don’t start back until it is fully healed and feeling pain free with all motions of your shoulder complex.

Stay away from what bothers it...which is probably bench press, and most things with the shoulder movements right now.
You do need to keep in moving gently but within a safe ROM.

[Zig]

Kaiser,

I would start by saying I hope all is well, but instead. I hope all gets better.

If bench pressing bothers you, it could mean that you need to increase your anterior (front) deltoid, Pec major and minor, and potentially your bicep mobility. Most of the time in the gym when I see people working on the bench press, they will spend about 3 quick seconds stretching their front side (which is working as an active participant) in comparison to 15 to 20 seconds on the posterior deltoid (which is working, but more as a stabilizer) in that movement.

If your pec muscles get too tight or overloaded, your sternoclavicular ligament can begin to absorb stress un-necessarily as these larger (stronger) muscles begin to apply pressure from being too tight. And once that starts our typical plan or treatment is to begin to agressively attack that area. I see pitchers all the time who suffer from similar issues and other athletes who bench and typically a lack of mobility in attached muscles are creating the problem. Remember Bills references to synergistic relationships. Everything is attached to something else and the problem could be in the attached area, not necessarily the problem area.

So basically, have someone massage your chest, deltoid, bicep and tricep areas, and your pain could go away quickly. And you could be back to benching quickly.

Have a positive day!

Zig Ziegler
Motion DNA

[Bill Hartman]

Most likely a capsular ligament sprain from the typewriters.

The capsular ligament resists upward movement of the clavicle under load. Keith is correct that the SC joint is pretty unstable.

Zig makes a good point in regard to anterior musculature so follow it, but I would also add a great deal of lower and mid trap work. Upper traps are more fast-twitch dominant and in cases such as this can be overpowering. As the scapula elevates as you fatigue with the typewriter, you lose scapular stability and increase load on the SC joint (among other areas).

Drop the bench presses (even DB bench). Great for hypertrophy, lowsy for shoulder function. Shift to push-up variations, prone T's, L's, and Y's, and face pulls. Practice the postural correction exercise in I/O.

Bill

[Kaiser]

Wow - I am humbled to have these responses from the level of experts here! And Zig, thanks for checking in and giving me an answer! I hope all is well with you and going great for MotionDNA.

Keith, sure it may be a sprain (or may have been as you read down below).

The problem doesn't appear to be typewriters Bill. I had this issue last Thursday, and Saturday after a spin class, I did some fingertip pullups (as I am prone to do) on a Metollius board, and also did typewriters; more than I have ever done, actually. No pain, no problem and as of today (even yesterday) I cannot push down on that region and have any discomfort (so I cannot tell you anything UConnJulie).

What I am trying to say is that it doesn't appear to be the typewriters, but rather the pressing motion (which would be supported by the fact that when I have had this show up in the past, I had not even known about typewriters).

I will drop the pressing movements this week and focus on what all of you said - mobility and shoring up associated areas. Thank you all very much!