The Five Biggest Contradictions in Fitness
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The Five Biggest Contradictions in Fitness

Itís no secret that when people contradict themselves, it has the effect of making the flaws in their actions or statements seem glaringly obvious. But what about when WE ourselves get caught contradicting ourselves by someone else?

By: Nick Tumminello Added: January 6th, 2014
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  1. #1
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    Anyone had much experience with shoulder pain/injury

    Might not be the right forum, but I'm not really looking for training advice.

    Had left sided shoulder pain for the past 9 months. Been doing very limited upper body pressing movements in this time.

    Layed off all pressing movements for about six weeks- Didn't help
    Layed off back squats for about 2 months- Didn't Help
    Did physio- Didn't help
    Stretching- Didn't help
    Ice- Didn't help
    NSAIDs- Didn't help
    Soft tissue work on pecs/lats- Didn't help
    Face pulls, **** tons of rowing and scapular stabilization stuff- Didn't help
    Zero overhead pressing for the past 7 months- Didn't help
    3 week total lay off from the gym at the moment with high dose NSAIDS- Isn't really helping


    I doubt this is gonna get better as we stand, and I guess steroid injections and surgery are my only options left.


    The pain isn't particularly bad in itself, and if I didn't lift I'd probably just get on with it, but it is preventing me from doing a lot of what I want to do in the gym.

    For the record I am a medical student 1 year from finals, so I have some understanding of shoulder pathology. I'm sure I have some form of impingement syndrome, possibly with a tear in my rotator cuff and/or labrum. Though I haven't had any imaging yet, but I don't think this really matters, as conservative management is pretty much the same amongst most shoulder pathologies.

    Finding it depressing since I'll be graduating and entering a very busy and stressful profession in just over a year, and I really wanted to reach a life long target weight/lifting numbers before then, but these past 9 months have been a total waste (lost a lot of size/strength), and I really don't want the next year to be the same.

    Heading back to the docs on monday, hope to get a referral to an orthopod or at least a steroid injection.

    Just wanted to find out what other lifter's experience has been with this sort of thing.

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  3. #2
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    Take this for what it's worth, but Steven Low has written a very nice book on bodyweight / gymnastic strenght training called

    "Overcoming Gravity: A Systematic Approach to Gymnastics and Bodyweight Strength"

    http://www.amazon.com/gp/product/146..._i00_details#_

    If you scan the table of contents, you'll note that Chapter 4 is devoted to "structural balance". Most notably shoulder health.

    Further along, Part II of the book is completely devoted to "management of health and injuries". The most common injuries in gymnastics are shoulder related.

    I have the book and it is very good IMO.

    I've had "significant" shoulder injuries twice in my life. I FULLY RESTED until I felt it was getting better and then did "physical therapy" I devised myself (more or less by feel). The first time, the injury was quite severe. It took almost one full year to heal completely. The second time (just last year in fact), it was much less severe. This took about 6 months or so.
    Last edited by r2473; 04-18-2012 at 10:39 AM.

  4. #3
    Rory Parker Behemoth's Avatar
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    Why in the world would you opt for a steroid injection without even knowing what's wrong with your shoulder.

    Get an MRI dude! Don't just keep throwing random shit at (so to speak).
    Last edited by Behemoth; 04-18-2012 at 02:51 PM.
    accuflex - LOLZZZZ!!!11one1!! SOEM PPL WORK THRE ARMZ!!!!11!! LETS KILL THEM111

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  5. #4
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    Quote Originally Posted by r2473 View Post
    Take this for what it's worth, but Steven Low has written a very nice book on bodyweight / gymnastic strenght training called

    "Overcoming Gravity: A Systematic Approach to Gymnastics and Bodyweight Strength"

    http://www.amazon.com/gp/product/146..._i00_details#_

    If you scan the table of contents, you'll note that Chapter 4 is devoted to "structural balance". Most notably shoulder health.

    Further along, Part II of the book is completely devoted to "management of health and injuries". The most common injuries in gymnastics are shoulder related.

    I have the book and it is very good IMO.

    I've had "significant" shoulder injuries twice in my life. I FULLY RESTED until I felt it was getting better and then did "physical therapy" I devised myself (more or less by feel). The first time, the injury was quite severe. It took almost one full year to heal completely. The second time (just last year in fact), it was much less severe. This took about 6 months or so.
    Interesting book, expensive though. Will see if I can get a library to order it in for me. That's encouraging to hear you made a full recovery, even if it took a while. That's my worry though, if I knew resting it completely or 6 months would guarantee recovery I'd do it, but we just don't know. I could take a year out from the gym and still have the problem. That's why something like surgery would be tempting, since it more or less guarantees recovery and 'apparently' normal function.



    Quote Originally Posted by Behemoth View Post
    Why in the world would you opt for a steroid injection without even knowing what's wrong with your shoulder.

    Get an MRI dude! Don't just keep throwing random shit at (so to speak).
    Well the clinical picture is highly suggestive of impingement syndrome with or without a tendon rupture or labral tear. It may be biceps tendonitis, but I don't really have the symptoms for it. An MRI is very unlikely to reveal anything surprising, given that I actually have very good function and not too much pain. So given that all the things it could potentially be are managed in almost exactly the same way, an MRI wouldn't necessarily help at this stage. Sure, I'd love to have one done, but I doubt that's what the doc's gonna do at this stage.

  6. #5
    Cardio bunny Alex.V's Avatar
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    Quote Originally Posted by Mad Max View Post
    Well the clinical picture is highly suggestive of impingement syndrome with or without a tendon rupture or labral tear. It may be biceps tendonitis, but I don't really have the symptoms for it. An MRI is very unlikely to reveal anything surprising, given that I actually have very good function and not too much pain. So given that all the things it could potentially be are managed in almost exactly the same way, an MRI wouldn't necessarily help at this stage. Sure, I'd love to have one done, but I doubt that's what the doc's gonna do at this stage.
    An MRI with contrast would show whether or not there is a rupture (and its precise location).

    Right now your DDx is pretty incomplete, doctor. If you DO have a tear, the degree of the tear and location would determine the best course of treatment, or even if surgery is indicated. That's probably worth knowing.

    Then again, I passed on the MRI simply because I wasn't about to change a bloody thing in my training, regardless of what I've done to myself.
    "Except Belial. He knows everything. This isn't a sarcastic attack, either. He really knows everything." -----Organichu
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  7. #6
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    Quote Originally Posted by Alex.V View Post
    An MRI with contrast would show whether or not there is a rupture (and its precise location).

    Right now your DDx is pretty incomplete, doctor. If you DO have a tear, the degree of the tear and location would determine the best course of treatment, or even if surgery is indicated. That's probably worth knowing.

    Then again, I passed on the MRI simply because I wasn't about to change a bloody thing in my training, regardless of what I've done to myself.
    You're right, I suppose if the MRI did show a large tear/rupture then we'd know an injection would be unlikely to resolves the issue. Trouble is, here in the UK with our frail NHS, GPs tend to opt for cheaper/safer stuff first when it comes to minor complaints like shoulder pain. If he offers me an MRI I'll go for it, and I'll probably request one if he desn't.

    You had shoulder problems too?

  8. #7
    Cardio bunny Alex.V's Avatar
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    Quote Originally Posted by Mad Max View Post
    You're right, I suppose if the MRI did show a large tear/rupture then we'd know an injection would be unlikely to resolves the issue. Trouble is, here in the UK with our frail NHS, GPs tend to opt for cheaper/safer stuff first when it comes to minor complaints like shoulder pain. If he offers me an MRI I'll go for it, and I'll probably request one if he desn't.

    You had shoulder problems too?
    Yes indeed, everything from minor pec tears to bicep tendon tears to a torn labrum (current).

    Your NHS may be frail, but it certainly beats out my $500 co-pay for an MRI... AFTER my deductible is paid down! (Hence my hesitation- I'd opt for one now with no hesitation to confirm the extent of the damage... if I wasn't certain I'd need another prior to getting surgery... and I don't feel like incurring that expense twice)
    "Except Belial. He knows everything. This isn't a sarcastic attack, either. He really knows everything." -----Organichu
    "Alex is all knowing and perfect"-----Jane (loosely paraphrased)
    -515/745/700 bench/deadlift/squat
    Current mile time: 4:23
    Marathons: 3
    Century races: 3
    Ironmans: 1
    Ultramarathons: 1
    Current supps: http://www.atlargenutrition.com/prod...covery/results

  9. #8
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    Sounds like tendonitis, most probably rotator cuff but could bicep or even both. I experienced something similiar a few years back and tried a similiar approach to what you've tried, the big mistake is that you are cutting out exercises that you feel might be the cause but even rowing will cause the tendonits to flair up.

    You need to stop everything, stop trying to work around it, it hasnt worked for you.
    You say you have stopped the gym completely for the last 3 weeks and taking NSAIDS, this is the right approach except it could take 6 months of beng out of the gym.

    The other alternative is the cortisone injection like you mentioned, i think this is probably a decent approach at this point if you are comfortable it is in fact tendonitis.

  10. #9
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    Quote Originally Posted by ftotti10 View Post
    Sounds like tendonitis, most probably rotator cuff but could bicep or even both. I experienced something similiar a few years back and tried a similiar approach to what you've tried, the big mistake is that you are cutting out exercises that you feel might be the cause but even rowing will cause the tendonits to flair up.

    You need to stop everything, stop trying to work around it, it hasnt worked for you.
    You say you have stopped the gym completely for the last 3 weeks and taking NSAIDS, this is the right approach except it could take 6 months of beng out of the gym.

    The other alternative is the cortisone injection like you mentioned, i think this is probably a decent approach at this point if you are comfortable it is in fact tendonitis.
    My concern is that 6 months out of the gym might not do the trick, and that would just be six months wasted. I would probably go for surgery if that didn't work, and given a 6 month minimum total recovery time, that would mean 12 months out of the gym.

    Anyway, did a bit more research, turns out training a muscle helps heal its tendon. Didn't know this, had assumed the role of physio was mostly to correct imbalances and restore function. Apparently lengthy immobilisation leads to poor healing. Though rest isn't the same as immobility, exercise as tolerated seems to be the way forward.

    Have decided that MRI is in fact the best step. 9 months of shoulder pain raises the suspicion of a significant tear, so this needs to be ruled out. Will ask the doc tomorrow and report back.

  11. #10
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    MRI results for those who are interested:

    Minor Impingement of supraspinatus tendon with subacromial bursitis. Everything else appears normal.

    Pretty much what I expected. Glad there a are no tears visible on MRI.

    The GP has referred me on to an ortho specialist. Didn't even need to ask, he just thought it the best step at this stage. I suppose it has been nearly a year.

    Waiting time is only about 4 weeks, which is good. I guess if there are no tears, then this increases the likelihood of it resolving on its own, still worried it might progress to a tear if things don't improve though. Will just have to wait and see.

  12. #11
    Rory Parker Behemoth's Avatar
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    Quote Originally Posted by Mad Max View Post
    MRI results for those who are interested:

    Minor Impingement of supraspinatus tendon with subacromial bursitis. Everything else appears normal.

    Pretty much what I expected. Glad there a are no tears visible on MRI.

    The GP has referred me on to an ortho specialist. Didn't even need to ask, he just thought it the best step at this stage. I suppose it has been nearly a year.

    Waiting time is only about 4 weeks, which is good. I guess if there are no tears, then this increases the likelihood of it resolving on its own, still worried it might progress to a tear if things don't improve though. Will just have to wait and see.
    Don't see an ortho just on a GP's referral. Research every last one in your area and find the best shoulder ortho's around. Trust me.
    accuflex - LOLZZZZ!!!11one1!! SOEM PPL WORK THRE ARMZ!!!!11!! LETS KILL THEM111

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  13. #12
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    Quote Originally Posted by Behemoth View Post
    Don't see an ortho just on a GP's referral. Research every last one in your area and find the best shoulder ortho's around. Trust me.
    He's referring me to a shoulder specialist I actually observed perform an operation on a guy with shoulder impingement, whilst I was on my ortho firm.

    Shoulder's actually been feeling pretty good this past week actually. Been two months since I've done any upper body work besides scapular physio stuff and cable rows. Think I'm gonna have to give basic upper body movements like push ups a go before I see him, just to see where I'm at in terms of training.

  14. #13
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    UPDATE

    A little update for those who are interested.

    I saw the ortho shoulder specialist abotu a month ago, and what he said was quite surprising.

    Basically my shoulder had been improving since the end of August and I had been back doing most things in the gym. What I found surprising was he said that significant rotator cuff pathology in the absence of an acute injury was actually very rare in my age group, and he thought it probably wasn't a rotator cuff problem.

    He said that my MRI was basically normal. Another surprising thing he said was that what he does see in young individuals with shoulder pain (when he actually operates and can visualise the shoulder space), is small separations of the labrum, that often do not show on MRI. He said this is what I may have, and as offered me another course of physio before he says I may consider surgery (which i probably wont')

    I took all this with a pinch of salt of course. But it is interesting to think maybe we give too much attention to the rotator cuff, even as lay people.

    Otherwise, I'm still getting some shoulder pain on certain movements (pressing in particular), and often a dull ache that persists for a few hours after a workout. But all in all, I think reintroducing lots of the old movements I used to do has been beneficial.

  15. #14
    Wannabebig New Member
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    Anyone had much experience with shoulder pain/injury

    That awesome that some of you guys used to play the piano

    I used to have play the violin and get weekly lessons but I stoppped cause I wasnt enthhusiastic about it enough. It just wasnt me. Got up to like Grade 4 Goes up to 8 and stopped. Its made me understand classical music more tho.
    And I wont forget how to play it.

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