[Prophylaxis]

(02-02-2013 04:57 AM)bonkers Wrote:  

the pain occurs at the very top of the abduction (ie arm facing up to the ceiling) and with the shoulder blades back the pain was slightly worse.

The pain does seem a bit better with some warming up. But the worry is still there with chinups.

Ok Think I know what's going on, but couple more things to confirm:

Where precisely is the pain that you get? Is at the front of shoulder joint? The side of the arm? Or around the traps area?


1 more test -
Can I get you to perform this movement 'empty can test', but resist it yourself. Like you're 'emptying a can' and push up against your other arm. Does this hurt? Is it better with shoulder blade squeezed?

[TheBulldozer]

(01-30-2013 06:17 AM)Prophylaxis Wrote:  

(01-29-2013 05:56 PM)MaleDefined Wrote:  

Pain: Front of ankle slightly underneath the surface. Either just right of the third or fourth metatarsal, very high up on the bone.(I think)

Hey MaleDefined,

Few followup questions:
Where exactly is the pain? Is it over the 3rd or 4th metatarsal or closer to the ankle?



Have you had an changes in your footwear recently?
Do you wear 'tight-fitting shoes'?
Does it feel better barefoot, or better in shoes?
Is there a 'burning or numbness' associated with the pain?

Cheers,

Prophylaxis

It's definitely closer to the ankle.

No changes to footwear, and there's no difference when I wear, or don't wear shoes. No burning, no numbness. Just a strong, sharp pain when locking the ankle inward. The more pressure I put inward, the greater the pain.

It's closest to number four on the photo.

[bonkers]

(02-02-2013 08:37 AM)Prophylaxis Wrote:  

(02-02-2013 04:57 AM)bonkers Wrote:  

the pain occurs at the very top of the abduction (ie arm facing up to the ceiling) and with the shoulder blades back the pain was slightly worse.

The pain does seem a bit better with some warming up. But the worry is still there with chinups.

Ok Think I know what's going on, but couple more things to confirm:

Where precisely is the pain that you get? Is at the front of shoulder joint? The side of the arm? Or around the traps area?

If I had to pinpoint a spot it would be just deep to the superolateral aspect of the shoulder (deep to where the shoulder rounds on the side)

Quote:

1 more test -
Can I get you to perform this movement 'empty can test', but resist it yourself. Like you're 'emptying a can' and push up against your other arm. Does this hurt? Is it better with shoulder blade squeezed?

Yes there is some pain with the empty can test.

I found the pain was actually worse with the shoulder blades squeezed.

Thanks Prophylaxis

[Prophylaxis]

(02-03-2013 12:03 AM)bonkers Wrote:  

Yes there is some pain with the empty can test.

I found the pain was actually worse with the shoulder blades squeezed.

Thanks Prophylaxis

My provisional diagnosis would be a rotator cuff tendinopathy, most likely the supraspinatus.

Best exercises to perform IMO:

Adduction strengthening is imperative, you want to strengthen the unaffected part of the rotator cuff, to compensate for the injured part. Also this stretch targets the rotator cuff WITHOUT activating the superficial deltoids. Try this one with a band - 15 reps by 3



I'd also look at subscapularis/internal rotation strengthening (this is the largest anterior stabiliser of the shoulder! - and is often overlooked in rehab)



You would then have to make sure your posterior cuff is not tight and limiting shoulder range - try self massage to the back of the shoulder (around the infraspinatus). Because one of your rotator cuff tendons is irritated, the remainder of the cuff have to work harder to stabilise the shoulder. These will most likely be tight as a result.



Also do this posterior cuff stretch:



Summary:
Adduction strengthening
Internal rotation strengthening
Self massage to back of shoulder
Posterior cuff stretch

Let me know how you go!

Cheers,

Prophylaxis

[Prophylaxis]

(02-02-2013 12:57 PM)MaleDefined Wrote:  

It's definitely closer to the ankle.

No changes to footwear, and there's no difference when I wear, or don't wear shoes. No burning, no numbness. Just a strong, sharp pain when locking the ankle inward. The more pressure I put inward, the greater the pain.

It's closest to number four on the photo.

Hey MaleDefined,

A few more questions:

By 'locking the ankle inward' do you mean it is painful with any of these movements?



Or is it more painful when you point the toes UP or DOWN?

Is there any considerable morning pain?

Have you previously rolled your ankle?

[bonkers]

(02-03-2013 06:22 AM)Prophylaxis Wrote:  

Summary:
Adduction strengthening
Internal rotation strengthening
Self massage to back of shoulder
Posterior cuff stretch

Let me know how you go!

Cheers,

Prophylaxis

Fantastic. Thanks very much Prophylaxis.

In terms of the exercises you have suggested, is that something I should be doing daily? in between workout days? during (before or after workout days?)

Thanks again,
bonkers

[Prophylaxis]

(02-03-2013 11:17 PM)bonkers Wrote:  

(02-03-2013 06:22 AM)Prophylaxis Wrote:  

Summary:
Adduction strengthening
Internal rotation strengthening
Self massage to back of shoulder
Posterior cuff stretch

Let me know how you go!

Cheers,

Prophylaxis

Fantastic. Thanks very much Prophylaxis.

In terms of the exercises you have suggested, is that something I should be doing daily? in between workout days? during (before or after workout days?)

Thanks again,
bonkers

No worries bonkers,

It's something I would try to integrate into your daily routine. Try doing these following your workout - directly afterwards is fine - (I personally have horrible shoulders, and usually do them when watching TV/following workout).

Also I would avoid any heavy shoulder press or incline bench until your shoulder settles with the exercises

[Teedub]

Hi Prophylaxis, I have had lower back pain since September and have been to see a physio, she said it seems like something to do with a sciatic nerve. The pain is central mostly, but occasionally shifts ever so slightly left of centre. Also, my legs are really tight, specifically my hamstrings, and to a lesser extent my calves. I've never been flexible to be honest, but this is so stiff its ridiculous. I would go to the physio ever week but its expensive.

Do you know anything I can do to alleviate the problems? Do you know how I might have done the injury?

Thanks in advance...What a great forum this is!

Sorry, I've edited it so its as you asked:

Body Chart: Lower Back, mainly central. Extremely tight hamstrings.
Age: 26
Mechanism of injury: I moved house in late August, this could possibly be where I did it. Although I felt nothing until September.
Aggravating factors: Driving, sitting in certain positions for too long.
Easing factors: Walking can make it worse temporarily, but in the long term I think it helps.

[VUBBS]

Hey Prophylaxis, many thanks for this!

I was running and getting my cardio back.
When I started to feel some knee pain.

I went to the doctor and she told me I could run, no problem, but using a knee protection. Which I bought. And after running, put on some ice.

After a couple of weeks, the pain is really bad, now even when I walk I can feel It. Sometimes ice eases the pain, but sometimes it hurts more when I put Ice.

What the knee now does, is to click all the time, and not in a way of releasing the tension, but all the time when I bend it.

It hurts all over.

Body Chart: Knee
Age: 29

Mechanism of injury: Running / Joggin 3/4 times a week.
Aggravating factors: Intense use of the knee, walking, climbing, running.
Easing factors: Sometimes Ice. Sometimes clicking it.

Any suggestions? I know I have to go back to the doctor, but I feel already that her diagnose was not very assertive and algo I don't speak the language where I live wich makes it a torture.

Thanks again for any suggestion!

Cheers!
Ivan

[Prophylaxis]

(02-04-2013 09:34 AM)Teedub Wrote:  

Body Chart: Lower Back, mainly central. Extremely tight hamstrings.
Age: 26
Mechanism of injury: I moved house in late August, this could possibly be where I did it. Although I felt nothing until September.
Aggravating factors: Driving, sitting in certain positions for too long.
Easing factors: Walking can make it worse temporarily, but in the long term I think it helps.

Hey Teedub,

In your case, most likely the hamy and calf tightness is driven by the back, so until you address your back, I'd steer clear of hamy and calf stretches. There's a reason they stiffen up, and this is the protect the back from further irritation.

What exercises/positions have you found relieve your symptoms?

What exercises did the physiotherapist give you, did these help or have no effect?

Do you get any relief from doing this exercise below? Try it 20 times and let me know

[Prophylaxis]

(02-04-2013 11:10 AM)VUBBS Wrote:  

What the knee now does, is to click all the time, and not in a way of releasing the tension, but all the time when I bend it.

Hey Ivan,

I would immediately go to a respected physiotherapist or orthopaedic surgeon. No more running until you RULE OUT that you don't have a meniscal tear.

The meniscus (or cartilage) are shock absorbing rims inside the knee joint which help to evenly distribute load. It allows the thigh bone (femur) and the shin bones (fibula/tibia) to smoothly glide against one another. If the meniscus becomes torn it can interupt how well the joint glides. This can manifest itself in the form of: 'clicking/locking/giving way' of the knee.

I'm not saying you DO have a meniscal tear, but I'd strongly advise a second opinion.

[VUBBS]

(02-04-2013 05:41 PM)Prophylaxis Wrote:  

(02-04-2013 11:10 AM)VUBBS Wrote:  

What the knee now does, is to click all the time, and not in a way of releasing the tension, but all the time when I bend it.

Hey Ivan,

I would immediately go to a respected physiotherapist or orthopaedic surgeon. No more running until you RULE OUT that you don't have a meniscal tear.

The meniscus (or cartilage) are shock absorbing rims inside the knee joint which help to evenly distribute load. It allows the thigh bone (femur) and the shin bones (fibula/tibia) to smoothly glide against one another. If the meniscus becomes torn it can interupt how well the joint glides. This can manifest itself in the form of: 'clicking/locking/giving way' of the knee.

I'm not saying you DO have a meniscal tear, but I'd strongly advise a second opinion.

Thanks for the advice! Will do it ASAP!
Cheers!
Ivan

[Teedub]

(02-04-2013 05:28 PM)Prophylaxis Wrote:  

(02-04-2013 09:34 AM)Teedub Wrote:  

Body Chart: Lower Back, mainly central. Extremely tight hamstrings.
Age: 26
Mechanism of injury: I moved house in late August, this could possibly be where I did it. Although I felt nothing until September.
Aggravating factors: Driving, sitting in certain positions for too long.
Easing factors: Walking can make it worse temporarily, but in the long term I think it helps.

Hey Teedub,

In your case, most likely the hamy and calf tightness is driven by the back, so until you address your back, I'd steer clear of hamy and calf stretches. There's a reason they stiffen up, and this is the protect the back from further irritation.

What exercises/positions have you found relieve your symptoms?

What exercises did the physiotherapist give you, did these help or have no effect?

Do you get any relief from doing this exercise below? Try it 20 times and let me know

Thanks for the response. I will try the exercise you posted. Do you think that doing calf/ham stretches will make things worse?? I know they aren't making a difference, as when I stretch them, by morning they're stiff again. Will these stretches have made me more flexible once the back is fixed? Or are they utterly pointless with no positive benefits now or later?

I quite like the exercise/stretch where you stand up, put pressure on your back and sort of lean back. It feels good when I do it, although I don't think it is making a difference.

The physio just put pressure on certain points on my spine, to ascertain where the problem was, and to do therapy.

Then at the end, she asked me to stand next to the bench with my legs straight, and then try to lean over and place my palms on the bench. I was too stiff to be able to do this, so she said I wasn't ready and that i'd need more therapy.

I haven't been back since, and this was in October, due to work commitments.

EDIT- I just did the press-up style stretch exercise 20 times, no noticeable benefit yet obviously. Unless there is meant to be? Its not that I am in pain 24/7 or anything, just when I try to bend my back in any way.

[Jaydublin]

Prophylaxis, about 18 months ago I kinda tweaked my back lifting. It was just those sharp needle like, acute pains that I think many people get from time to time in their lower back. While doing standing shoulder press I noticed it got a little worse(when I racked the barbell). I went to my living room and picked something up and it felt like I had a needle go through my lower back except this time it didn't go away until I was limp. I hit the floor and it was a good hour before I was even able to even roll over. As long as my body was limp I could not feel any pain. 24 hours later I was good to go out drinking though still cautious and feeling it if I moved wrong/awkwardly. Since then I tend to run into this pain very frequently when I lift. It's not nearly as severe but it scares me and isn't the type of pain I can just push through. Deadlifting and Heavy rows always bring it back and I seem to get the pain a little on chest day but I have no issues squatting.

As I said it is a very needle like, acute, pain. If I feel it once then I will likely feel it a few times during the workout or maybe day. the next day I likely wont feel it again until I lift or not at all.

I assume I'm pinching something in my lower back??

Body Chart: lower back, spine??
Age: 27
Mechanism of injury: lifting... standing shoulder press was when I first noticed how severe it was, when racking the weights.... multiple times. I would say about once a year throughout my life I would have a 1-3 week phase where I got these pains when moving awkwardly. Never anything extreme and it seemed normal
Aggravating factors: lifting, normally when involving the back
Easing factors: relaxing or within a few hours of lifting I don't seem to have it anymore

[Single Dad Swag]

Thanks for this thread. I do have a quick question of my own:

Body Chart: Sternum, breast plate area
Age: 27
Mechanism of injury: I've had this weird pain off and on for years in the area. If I lean back far enough, my chest plate "pops" pretty loud. At times it feels like the only way to relieve the pain in the area is if I crack it.
Aggravating factors: Seems to happen commonly after rolling out of bed, or sitting at my desk for long periods of time. If spreading it out and cracking it helps, I would say the opposite is true also- when I bring my shoulders in towards one another, the pain can sometimes be worse. It seems to happen randomly, but I'd say more often than previously (I feel the urge to pop it at least once a day)
Easing factors: Cracking or popping the area is the only thing that eases the pressure/pain. Sometimes it actually feels worse after this happens.

Thanks for any insight.

[Prophylaxis]

(02-05-2013 08:00 AM)Teedub Wrote:  

Thanks for the response. I will try the exercise you posted. Do you think that doing calf/ham stretches will make things worse?? I know they aren't making a difference, as when I stretch them, by morning they're stiff again. Will these stretches have made me more flexible once the back is fixed? Or are they utterly pointless with no positive benefits now or later?


EDIT- I just did the press-up style stretch exercise 20 times, no noticeable benefit yet obviously. Unless there is meant to be? Its not that I am in pain 24/7 or anything, just when I try to bend my back in any way.

Yep. No point in doing the hamy/calf stretches, in some cases it can make the back worse. Get the back sorted, then you can ease back into stretches (hit me up for some great ones).

Try the 'press-up' style stretch 20 times for 3 times a day for the next week, and let me know if you notice a difference in your sciatic symptoms. Don't continue the exercise if it is causing or worsening the back/leg pain. Also continue doing the bending back exercise while standing, especially if it feels good.

[Teedub]

^ Thankyou mate, will do ^

[Prophylaxis]

(02-05-2013 10:11 AM)Jaydublin Wrote:  

Body Chart: lower back, spine??
Age: 27
Mechanism of injury: lifting... standing shoulder press was when I first noticed how severe it was, when racking the weights.... multiple times. I would say about once a year throughout my life I would have a 1-3 week phase where I got these pains when moving awkwardly. Never anything extreme and it seemed normal
Aggravating factors: lifting, normally when involving the back
Easing factors: relaxing or within a few hours of lifting I don't seem to have it anymore

Hey Jay,

Sounds like that initial episode was pretty intense. Have you seen anyone about it over the last year? If so, what have they said?

Apart from lying flat (?on your back), does any other position relieve your pain?

Does sitting down for a while bring on this pain?

Do you get any leg pain or shooting pain down the buttock associated with the back pain? Any pins and needles or numbness down the leg?

[Prophylaxis]

(02-05-2013 10:25 AM)Single Dad Swag Wrote:  

Body Chart: Sternum, breast plate area
Age: 27
Mechanism of injury: I've had this weird pain off and on for years in the area. If I lean back far enough, my chest plate "pops" pretty loud. At times it feels like the only way to relieve the pain in the area is if I crack it.

Easing factors: Cracking or popping the area is the only thing that eases the pressure/pain. Sometimes it actually feels worse after this happens.

Hey Single Dad Swag,

For chest pain, I'm assuming you have no existing heart/lung problems.

The popping is air escaping out of the thoracic (middle back) joints of the spine. Do you have a sedentary job, or sit down a lot?

The sternum pain that can arise is a common referral point from irritated back joints (as the ribcage attaches to these thoracic joints!)


I'd look at thoracic mobility/stretches and strengthening of lower traps and rhomboids (these guys are often weak from desk jobs). Strengthening these will assist in reducing the load through the thoracic.

Try these exercises:

Thoracic rotation - back and forth



Lower traps strengthening (you can neglect the chin tuck in this)

And for targeting the rhomboids - just do plenty of rows with good posture.

In Summary:
Thoracic stretches
Lower traps strengthening - the W exercise in the vid is awesome
Rows

If it feels good to stretch back and 'pop' your joints. Keep doing it!!

[Jaydublin]

(02-06-2013 01:49 AM)Prophylaxis Wrote:  

Hey Jay,

Sounds like that initial episode was pretty intense. Have you seen anyone about it over the last year? If so, what have they said?
First off, thanks for your help. No, I haven't seen a doctor because of no insurance.


Apart from lying flat (?on your back), does any other position relieve your pain?
On my stomach or back completely limp. It's very short and sharp but yea if I am limp I don't feel it at all.

Does sitting down for a while bring on this pain?
Standing up from a chair brings it on. Basically anything that puts my body in an awkward position.


Do you get any leg pain or shooting pain down the buttock associated with the back pain? Any pins and needles or numbness down the leg?

No, I don't. However, It feels like how a herniated disc is described except Ive never felt it anywhere except the center of my lower back.


I had it all evening since today was chest day(always seems to aggravate it). I noticed when standing up out of a chair I get the sharp, acute, pain.. especially if I do it off balance, on 1 foot or something.

Over the summer I was actually working out without issue until 1 day after back day(deads and rows)...It seems to have become more consistent since then though. Starting last January I was required to sit in an office chair all day at work(8 hrs). I am wondering if this is why it seems to be more consistent.

[Prophylaxis]

(02-06-2013 09:40 AM)Jaydublin Wrote:  

(02-06-2013 01:49 AM)Prophylaxis Wrote:  

Hey Jay,

Sounds like that initial episode was pretty intense. Have you seen anyone about it over the last year? If so, what have they said?
First off, thanks for your help. No, I haven't seen a doctor because of no insurance.


Apart from lying flat (?on your back), does any other position relieve your pain?
On my stomach or back completely limp. It's very short and sharp but yea if I am limp I don't feel it at all.

Does sitting down for a while bring on this pain?
Standing up from a chair brings it on. Basically anything that puts my body in an awkward position.


Do you get any leg pain or shooting pain down the buttock associated with the back pain? Any pins and needles or numbness down the leg?

No, I don't. However, It feels like how a herniated disc is described except Ive never felt it anywhere except the center of my lower back.


I had it all evening since today was chest day(always seems to aggravate it). I noticed when standing up out of a chair I get the sharp, acute, pain.. especially if I do it off balance, on 1 foot or something.

Over the summer I was actually working out without issue until 1 day after back day(deads and rows)...It seems to have become more consistent since then though. Starting last January I was required to sit in an office chair all day at work(8 hrs). I am wondering if this is why it seems to be more consistent.

Good news in that it doesn't sound like you have a pinched nerve, or anything too nasty.

Seems like anything involving the back bending forward (e.g. rows and deadlifts) is exacerbating your symptoms. And you get relief from lying on your stomach. This MAY be due to an underlying disc problem.

I want to trial the exercise I gave TeeDub and let me know how you go.



If it's too irritated in lying, try it in standing.



If these exercises aren't relieving the pain, don't continue them.

Dosage - Try the lying down press up one 20 times 3 times a day, and the leaning back one every 2 hours at work. Avoid sitting down for sustained periods as well (>30mins).

Let me know how you go

Regards,

Prophylaxis

[TheBulldozer]

(02-03-2013 06:37 AM)Prophylaxis Wrote:  

(02-02-2013 12:57 PM)MaleDefined Wrote:  

It's definitely closer to the ankle.

No changes to footwear, and there's no difference when I wear, or don't wear shoes. No burning, no numbness. Just a strong, sharp pain when locking the ankle inward. The more pressure I put inward, the greater the pain.

It's closest to number four on the photo.

Hey MaleDefined,

A few more questions:

By 'locking the ankle inward' do you mean it is painful with any of these movements?



Or is it more painful when you point the toes UP or DOWN?

Is there any considerable morning pain?

Have you previously rolled your ankle?

There is significant pain when moved straight upwards.

No morning pain.

I've rolled my ankle before. I've played high impact sports(basketball, football) my whole life.

I cannot think of a specific instance that caused the sharp pain.

[Prophylaxis]

(02-10-2013 12:30 AM)MaleDefined Wrote:  

There is significant pain when moved straight upwards.

No morning pain.

I've rolled my ankle before. I've played high impact sports(basketball, football) my whole life.

I cannot think of a specific instance that caused the sharp pain.

Hey MaleDefined,

Based on the information you've told me I'd say you have an anterolateral impingement of the ankle joint. Basically this is where old soft-tissue scar buildup occurs at the front of the ankle joint, and is pinched as you point your toes upward.

When you roll your ankle the ligaments preventing the main ankle bone (talus) shifts forward and closes the space inside at the front of the ankle, thus causing it to pinch.

What to do about it?

You want to loosen the joints around the ankle - here's an example

You also want to do some gentle soft tissue work and massage around the ankle joint to break up the adhesions and scar tissue.

Some calf massage would DEFINITELY benefit (as you being unable to point your ankle upwards will make them tight).


Given that a lot of treatment for this condition involves specific manual therapy techniques or taping, I would advise you see a good sports PT, as some conditions are too tricky to self-manage. You may also benefit from some orthotics, but it's difficult to say whether you need them or not over the internet.

Let me know if you have any further questions,

Prophylaxis

[Prophylaxis]

Hey fellas,

Just following up on how everyone is doing. How are the exercises going?

If there are any further questions, feel free to PM me

[Major Tom]

I just found out about this not too long ago, and have been adding this to my routine lately: http://www.youtube.com/watch?v=v5QZzCQg8P8. I have a left shoulder that occasionally flares up when doing any sort of heavy pressing, and lot of that is probably due to poor/unbalanced programming when I first got started (i.e. tons of chest work, without supplemental back/rear delt work to help balance out the shoulder girdle). In addition to doing band pull-aparts every day at home and in between sets of pressing, this has helped tremendously; I was able to hit a PR on the bench press without any issues today. The main principle (traction) is similar to the use of an inversion table for back pain; it helps decompress the joints of the arm and shoulder much like the table uses gravity to decompress the intervertebral discs. Might try this out for my knee on my next lower body day. I highly recommend it for any sort of rehab/pre-hab for all the lifters here.