Right Shoulder Impinging.....I think

[Bond007]

Bill,

I need your advice. Lately, my right shoulder has been getting slightly inflamed, although I wasn't all that sure it was from any impingement kind of pain as the pain also felt like "normal" lifting soreness. Today, I'm positive that something I'm doing is impinging my right shoulder, which underwent surgery twice in 2000. My workout routine is broken down as follows:

Workout A:
Superset 1: DB Bench Press (55# db's) & Full Squats (150#) (3x10)
Superset 2: Cable Row (100#) & Glute/Ham Raise (BW) (3x10)
Superset 3: Weighted Empty Can (10# db's) & Incline Situp (BW) (3x10)
Superset 4: Zottman Curls (25# db's) & Standing Calf Raises (150#) (3x10)

Workout B:
Superset 1: Lat Pulldown (110#) & Leg Extensions (120#) (3x10)
Superset 2: Triceps Pushdowns (90# at cable crossover) & Leg Press (360#)(3x10)
Superset 3: Lateral Raises (12.5 db's) & Back Extension (BW)(3x10)
Superset 4: Dumbbell Shrug (75# db's) & Reverse Crunch (BW)(3x10)

My workout schedule is:
Week 1 (MWF): ABA
Week 2 (MWF): BAB
Week 3 (MWF): ABA
Week 4 (MWF): BAB
Week 5: Rest

On Tuesdays and Thursdays, I'm doing Taekwondo. I also do steady-state cardio on Mondays & Fridays. Saturdays and Sundays are active recovery. Currently, I'm in week 4, so next week is my "rest" week. I'm wondering if my routine is to blame for this impingement pain, or if I just need to take a step back and do some shoulder-specific exercises for the right shoulder for a while, or if it's something in my daily routine that could be the cause of the pain, or if it's TKD that is not good for me. I do get my sunshine fix from a tanning bed every day and I've been putting my hands above my head for almost 20 minutes so that I don't get some strange tan lines and I know my shoulder feels a little achy after that. Also, I have been manually lifting my convertible top up with my right arm while I'm sitting in the driver's seat -- it's basically reaching completely behind me, grabbing the top, and pulling it over my head to a closed position.. Perhaps, this is a combination of all of the above?? The left shoulder feels just fine, but my recovery from it's last surgery involved me doing a considerable amount of the exercises you and I have discussed over the past year. I didn't do those exercises with my right shoulder.

Please help me!!

[Bond007]

Also, I've noticed two thick red "lines" along my traps about half-way between my neck and shoulder. Each of them are about an inch long (or longer) and they both run length-wise down the muscle. I first noticed the one on my right shoulder about 2-3 weeks ago, and then it went away. Just last night, I noticed the right one had re-appeared and it now had a "twin" on my left trap. I'm guessing that these are blown blood vessels and probably have nothing to do with my impingement, but I thought I should mention it here as well.

Any other opinions????

[Bill Hartman]

Always remember that acromioplasty (that is what you had done right?)does not fix the problem. It just treats the symptoms by making more room under the acromion to prevent impingement.

First things first, shift back into rehab mode and quit lifting your convertable top with your right arm (overhead pressing??)and laying with it over your head.

There could be a couple things going on and certainly your TKD could affect it. High velocity movements, especially some of the blocks that require quick shoulder rotation and some forms that require overhead reach can irritate the crap out of your shoulder (that's one of the reasons why Bill only made it to Purple belt ).

My first thought is that your scapular mobility is probably less than ideal (the laying with your hand overhead causing pain and then reaching overhead -car top- causing impingement because the scapula is tilted forward). This will of course cause weakness and compensations. So again, back to rehab mode.

If you're doing empty cans with your thumbs down, don't...ever! Lateral raises should be performed in the plane of the scapula - about 30 degrees or so in front of the plane of the body.

Test your external rotator strength/strength endurance between sides and make sure they match. If the "new" painful side is weaker, no lateral raises until they match. Also, have you noticed that one side of your neck feels tight yet?

Bill

[Bond007]

Originally posted by Bill Hartman:
Always remember that acromioplasty (that is what you had done right?)does not fix the problem. It just treats the symptoms by making more room under the acromion to prevent impingement.

Yes, I had acromioplasty. No, this is the first time I remember hearing anyone say that. SHIT!! Okay, so rehab mode it is.

Originally posted by Bill Hartman:
First things first, shift back into rehab mode and quit lifting your convertable top with your right arm (overhead pressing??)and laying with it over your head.

An excellent reason for me to re-acquire the "other" convertible from my wife....the one with the POWER top!!!

Originally posted by Bill Hartman:
There could be a couple things going on and certainly your TKD could affect it. High velocity movements, especially some of the blocks that require quick shoulder rotation and some forms that require overhead reach can irritate the crap out of your shoulder (that's one of the reasons why Bill only made it to Purple belt ).

I'm currently at Orange belt and I test tonight to move on to Yellow belt. Orange belt form is full of "HIGH" blocks (double outer form, mostly) and "HIGH" punches (back fist, forward punches, etc.). Not to mention that I work VERY hard to move quickly and accurately through the form, basically, I'm VERY aggressive at it.

Originally posted by Bill Hartman:
My first thought is that your scapular mobility is probably less than ideal (the laying with your hand overhead causing pain and then reaching overhead -car top- causing impingement because the scapula is tilted forward). This will of course cause weakness and compensations. So again, back to rehab mode.

Ok, so I'll lay in the tanning bed with my arms at my sides again and live with the funny underarm tan lines. I can deal with that. They'll eventually go away when I start my weekends out on the lake anyway. I was just trying to get "jump" on the summer tanning season. See, I guess cheating really never does pay!

Originally posted by Bill Hartman:
If you're doing empty cans with your thumbs down, don't...ever! Lateral raises should be performed in the plane of the scapula - about 30 degrees or so in front of the plane of the body.

I'm doing the weighted empty can exercises exactly as the description of the ones you sent me where the thumbs start in the down position and then externally rotate upward. Are you saying that I can do the empty can exercise, but to start with the thumbs already pointing outward? Or, should I just avoid this exercise altogether, and, if so, why are you retracting this suggestion?

Originally posted by Bill Hartman:
Test your external rotator strength/strength endurance between sides and make sure they match. If the "new" painful side is weaker, no lateral raises until they match. Also, have you noticed that one side of your neck feels tight yet?

Any suggestions on a decent movement to conduct that test with? And, yeah, the right side of my neck is feeling just a tad tight. Just a few minutes ago, I had a pretty intense shooting pain through the backside of my right trap so I put my finger on the pain and applied pressure and oddly enough the soreness that appears to be impingement pain went completely away. Now, my right trap is literally on FIRE! And, while we're speaking of necks, mine has literally sounded like Rice Krispies cereal for weeks/months now. I asked my family doc about it, he took x-rays, and simply told me that I've probably got some arthritis starting, but nothing really showed up in the x-ray to explain the "snap, crackle & pop" I get almost every time I move my neck. Now, I'm wondering if there's a more direct correlation???

Thanks for the speedy response, bro! I'm still going to test (TKD) tonight, but I'm going to dump my Friday workout altogether, take Sat, Sun & Mon off, and go back to the rehab routine you worked up for me last year on Tuesday. I'll probably do that for the next 2-3 weeks and see how I progress from there.

Jamie

[Bill Hartman]

I'm doing the weighted empty can exercises exactly as the description of the ones you sent me where the thumbs start in the down position and then externally rotate upward. Are you saying that I can do the empty can exercise, but to start with the thumbs already pointing outward? Or, should I just avoid this exercise altogether, and, if so, why are you retracting this suggestion?

Just wanted to make sure you were doing it correctly. You're cool doing it as is.

Nail the forms, break the board, and slap on that new belt.

Bill

[Bond007]

Originally posted by Bill Hartman:

quote:

---

I'm doing the weighted empty can exercises exactly as the description of the ones you sent me where the thumbs start in the down position and then externally rotate upward. Are you saying that I can do the empty can exercise, but to start with the thumbs already pointing outward? Or, should I just avoid this exercise altogether, and, if so, why are you retracting this suggestion?

Just wanted to make sure you were doing it correctly. You're cool doing it as is.[/quote]Whew! Thanks for the clarification!!!

Originally posted by Bill Hartman:
Nail the forms, break the board, and slap on that new belt.

Thanks, bro! The results for my White belt test were "Yellow Belt, Decided". I plan on passing each belt test with that "decided" tacked on the end. I want that black stripe on my brand new belt!!!