Cross post from ETI: Hyper-mobile shoulders pt. 6

So I went back for a consultation a week ago.

Things are looking good. My shoulders are sitting a little higher now (I'll aim to post photos eventually). I have more control overhead now too. The exercises are still tough though. The exercises I had been doing are (I go for 10 reps, but the reps listed are the reps when I feel a little bit of soreness, this is what I give the physiotherapist because it is a better gauge of endurance):

90 degree backward red band rotation - 6 to 8
90 degree forward double red band rotation - 10 without feeling tired
Single arm overhead press (0.5kg) - 6
Side lying external rotation (2kg) - 8
45 degree bent over row (3kg) - 6
90 degree bent over row (2.5kg) - 8
Mini fly (2kg) - 8

Bolded are the ones I have improved in since the previous consultation. It appears that I had been misjudging soreness for my overhead presses. I am supposed to feel sore in my deltoids and traps, but I was feeling some kind of tightness in my lats and I assumed that was fatigue. I have been told to increase the weights to 1kg, then 2kg, 3kg and 4kg, from week to week.

I have been told to ditch the forward band rotations, side lying rotations and mini flys because they have done their job. This is now my routine (bolded are new exercises):

90 degree backward red band rotation
Single arm overhead press, elbows out (same as in the previous routine) - 1kg
Single arm overhead press, elbows in (like I'm doing neutral grip chin ups) - 0.5kg
45 degree bent over row - 3kg
90 degree bent over row - 2.5kg
Incline push ups - Focus on keeping shoulders set throughout the entire ROM.

I can now do wide grip lat pulldowns (narrow grip is bad because that position is when my shoulders are most vulnerable) and half ROM cable flys (stop before my arms enter the vulnerable zone).

Next consultation is mid-May.

Cross post from ETI: Hyper-mobile shoulders pt. 5

Forgot to post about the previous consultation. I saw the physiotherapist on the 24th last month.

My 90 degree bent over rows were still at 0kg and this worried my therapist. He gave me a new exercise, and revised my routine to focus on my weaknesses.

90 degree band rotation - Red band (8-12 reps)

Side lying external rotation - 1.5kg (15-20 reps)
Bent over row (90 degrees) - 1kg, now at 1.5kg (10 reps)
Bent over row (45 degrees) - 2kg, now at 2.5kg (10 reps)
Bent over row (0 degrees) - 3kg, now at 4kg (10 reps)
Mini flys - 1.5kg (15-20 reps)
Shrug - 4kg (15-20 reps)

The therapist asked me to raise my arms out to my side until my hands are overhead. He can see that my scapula is now controlling my shoulders a lot better, except for when my arms are overhead. The 90 degree band rotation is expected to improve this. I find that exercise very difficult myself.

Next appointment on 17/2.

Cross post from ETI: Hyper-mobile shoulders pt. 4

I went for another consultation on the 6th.

My shoulders and upper back were sore as hell. Therapist advised that I get regular massages because I have knots all over my upper back from the rehab exercises. I was having trouble increasing on weights for the movements, so he has split the exercises up into an A/B routine. My exercises were also taking me way too long - I would spend around 50 minutes a day.

So here is my routine now (goal weight in brackets, underlined are new exercises):

Day A

Shrug x20 3kg (4kg)
Side lying external rotation x20 1kg (1kg)
Band external rotation x20 Green (Green)
Band row (elbows out 90 degrees, partial ROM) x20 Red (Green)

Day B

Bent over row (elbows in) x10 2.5kg (4kg)
Bent over row (elbows out 45 degrees) x10 1.25kg (4kg)
Bent over row (elbows out 90 degrees) x10 no weight (4kg)
Mini flys / bent elbow lateral raises x20 1.25kg (4kg)

Cross post from ETI: Hyper-mobile shoulders pt. 3

Had a consultation with my physio on the 23rd. He had to remove some knots in my left shoulder area (around my traps mostly) because my shoulder was so tight. Here is the list of exercises that I have been doing since, and also the weight I am currently at (starting weight in parantheses). I have been told to do 20 reps (with a 5 second hold) for all these movements, once a day.

1. Shrug - 3kg (0.5kg)
2. Bent over row (elbows close to my body) - 2kg (1kg)
3. Bent over row (elbows angled out by 45 degrees) - 0.5kg (0.5kg)
4. Side lying external rotation - 1kg (0.5kg)
5. Band external rotation - Green band (Red band)
6. Mini lateral raise (bent elbow, half ROM) - 1kg (0.5kg)

I am over half way through this program, which is 12 weeks minimum. My physio has given me my goals for all these movements. I am meant to hit 20 reps without fatigue for all these exercises.

1. Shrug - 4kg
2. Bent over row (elbows close) - 4kg
3. Bent over row (elbows out) - 4kg
4. Side lying external rotation - 1kg
5. Band external rotation - Green band
6. Mini lateral raise - 4kg

Rules at the gym have not changed. No vertical push/pull and no horizontal push.

Cross post from ETI: Hyper-mobile shoulders pt. 2

Back to Lyn today! She got me to rotate my arms outwards and she actually saw improvements in my shoulders (!!). Looks like my scapula (I think) is controlling the movement of my left arm up properly now, and the ball of my shoulder isn't pushing out too much, except for the last bit of ROM. Not sure if I've mentioned this but my left shoulder is worse than my right and I think she's not too concerned about my right.

I mentioned that I get radiating soreness in my left shoulder, the area where the lat meets the rear delt. She said that's because the ball is pushing against something. I wish I could give a better explanation but I'm shit when it comes to anatomy. She gave me a bit of treatment (the usual rub around the shoulder blade area).

I have now been given another exercise: dumbbell rows. I start from a relaxed position with my arm fully stretched out (like during a Kroc row). I then "set" my shoulders (slight pull in shoulder blades, and then slight shrug) and row. My arm should only go parallel to my body, unlike the usual dumbbell row where I aim to contract my shoulder blades. She said that I can do the usual dumbbell rows with heavy weights still. The goal of this exercise is to reset my central nervous system. I am told to start with a 1kg weight, then eventually 1.5kg, 2kg and 3kg.

So I am now doing the following exercises. I do not need to do them in sequence.

1. Dumbbell shrug (supinated) - 2kg (from 0.5kg a month ago)
2. Side lying external rotation - 1kg (from 0.5kg when this topic was made)
3. Band external rotation - Red band (I have been told to use a green band to wrap around my shoulders, but use a red one for doing the external rotation. Green is heavier than red by the way.)
4. Dumbbell row - 1kg

Next appointment is in 3 weeks.

Cross post from ETI: Hyper-mobile shoulders

Posting about this here in case this information is useful to the lifters here.

Some background

I have been lifting for 2 years. I got rotator cuff impingement a year ago, and it was bothering me in a lot of things, e.g. bench, push ups, curls, press, etc. That became less of a problem around March this year, after seeing a physiotherapist. I rehabbed using band rotations.

However, I was still experiencing a lot of shoulder issues. I get a lot of clunking and clicking especially in my left shoulder when doing lateral raises. I started benching powerlifting style and that took a lot of the pain away from my front deltoids, but my right front deltoid would still click (even today) when I bench. I would get tightness in my shoulders (front, mid and rear) the day after benching. Overhead pressing is fine though, but I get a lot of high pitch sliding and clicking sounds during the movement. No pain, however.

A month ago, I decided to see my physiotherapist again. The clicking in my left shoulder was really bothering me outside of the gym. I get clicking around my front delt area when I put on my T-shirt, when I reach over to the passenger's seat to open the door, etc. I was told that it is a tendon flicking over. My physio referred me to see a shoulder specialist, who is well renowned. Her page: https://www.lynwatsonshoulderphysio.com.au/practitioner.php?id_practitioner=22

Diagnosis

I saw Lyn 2 weeks ago and turns out I have hypermobile shoulders. This means my shoulder blades are sitting very low in my body. My shoulders are loose and unstable in the posterior. This has been there forever (if I am not mistaken, 40% of the population has this condition, to a certain extent), but it hadn't been stressed until I started lifting.

I have been advised to stay away from exercises where:

- my arms go behind me (e.g. parallel bar dips)

- my arms are extended out straight (e.g. flys, lateral raises, front raises)

- my body weight is on my arms (e.g. push ups, planks)

- I am pushing (e.g. bench)

- my arms are overhead (e.g. OHP, chin ups, skull crushers)

I have been told that I can however do machine presses with partial ROM (without extending my arms fully). 

Lyn recently submitted a paper about this for her doctorate and it is undergoing review, which is why there is not much information about this on the Internet. Apparently the clinic has treated a few people with similar conditions with much success.

Rehab

Oh, so the goal is to get my shoulder blades to sit higher up my body by (I am paraphrasing here) teaching my body to activate the right shoulder muscles. 

I was given the following exercise to do for a week:

1. 0.5kg dumbbell shrug with palm facing forward, and shoulder blade retracted. One arm at a time for 20 reps.

After that, I saw another physio from her clinic (as advised by her), and I have been given the following exercises which I have started doing:

1. 1kg dumbbell shrug as above.

2. 0.5kg external rotation while laying on my side (5 second hold up the top at 45 degrees, and then back down to parallel to floor).

3. Band external rotation, with a band round my shoulder and another that I hold onto. The bands join up at the same point, e.g. a door handle. I do an external rotation to a 45 degree angle, and hold for 5 seconds.

All these exercises for 10 to 20 reps.

I have been told that our aim is to get to 4kg for exercise 1 and 2 without fatigue at 20 reps. 

Not sure if anyone is interested in this, but I find this intriguing because it changes the way I train so much. The rehab programme is estimated to take around 3 months. No benching and pressing until I am done with it. 

Photo 1: Relaxed

Photo 2: Right shoulder shrugged.