Derelict:
What are your current favorite exercises for partial rotator cuff tear rehab (with a hint of AC joint arthritis, tendonosis, and a slight labral tear)? Thanks in advance

Can you tolerate side planks? Kool, you are an ENT right?

aggiederelict said:

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Can you tolerate side planks? Kool, you are an ENT right?

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Just gave them a try, thanks. Definitely not fun with the affected arm down. Night time kills me. I wake up a few times with pain. Rubber bands internal and external and small weights anterior, abduct, and 45 degrees in-between with the thumb up or to the side (never down) are the main exercises I have been doing.
And, yes, I am.

Send me an email and I will give you some exercises to work on. Ben@axiompt.com

Done and thanks!
Who says you're a derelict, by the way??

Derelict, thanks for doing this thread.

I have a large L5-S1 Protrusion.

Dr is recommending I see a Pain Mgmt doctor but I am not wanting to do drugs yet. Any recommendations on how I can get on a good PT program for core strength?

Where are you located?

Sugar Land, but open to med center as well for infrequent visits.

I've been dealing with what I would call chronic bilateral forearm and biceps tendinitis. I've had it frequently over the last 10 years or so but it's come and gone. I've had it for probably 6-8 months now and it's become very painful to pick up and put down even light things.

I do low volume heavy lifting and have backed off anything that really involves elbow flexion lately. I really can't think of any over use of that joint that I have ever done.

I like to low bar back squat and when I'm straining I have injured my biceps before by gripping the bar too hard in the bottom of my lift. I am probably gonna get a safety squat bar and have immediately switched to lower weight using high bar.

Any suggestions? I've done some ice and lacrosse ball rolling but wondering if this is something I should see someone about.

Ice and lacrosse ball are fine but the question is why do you have it? It sounds like the weight is too much which is pissing of your bicep tendons.

You need to load the tendon without pissing it off. Is there a weight you can work with that doesn't piss it off? When you take time off and come back do you ramp up the weight?

I would find someone who works with athletes. I have heard good things about Plex in Mo City.

https://www.plexathlete.com/sports-medicine

I appreciate the response. I'm very consistent about linear progression training but if there ever is a period where I don't lift for a bit I am very conservative with reloading and building back up slowly.

My last heavy low bar squat was Dec 19. Since I've been high bar box squatting at about 70-80% of what I was squatting before the switch. It has helped me not to strain my biceps when squatting. I've also stopped pull ups and bent over rows for now.

I haven't noticed any real improvement yet but I'm hopeful this will be the ticket.

What's the scoop on tennis elbow and treating it? I'm pretty sure that's what I've got going on. Can still lift without pain and but with certain tasks (I.e. holding my battery op blower while squeezing the trigger and moving it around, especially above shoulder level while blowing snow off my truck) the pain is sharp.

Tennis elbow can be tricky and all over the place much look like you described your experience. Someone people will have pain with brushing their teeth and not lifting. Just speaks to what movements actually load that extensor tendon. I have found getting aggressive with stubborn cases with tissue work and needling to be helpful. Also progressive loaded exercises that target the wrist extensors can help the tendon remodel.

How heavy are we talking about with the low volume? Does any weight currently piss it off?

I was doing back squats 3 times per week and doing 3x5 at 265 (1.5x body weight) at my last workout. I've done quite a bit more than that in the last but at 43 that is very heavy for me and I probably would t go above 285 or so before switching it up and cycling back into heavy lifting down the road. I tend to do 3 month cycles (not by design but I usually just mentally am ready to switch ut up to do more HIIT/WOD type stuff as a change).

I always start back up VERY light and work up slowly. My legs and back can handle the squats but I do strain my biceps and forearms when squatting so obviously I'm gonna have to change something.

Howdy all- I would like to jump into this for a little advice, if that is OK.

About 12 weeks ago, I dislocated my left pinky (@ first joint from knuckle). It wasn't a severe dislocation, but definitely out and off to the side (towards the outside a bit). Due to my location at the time, I just pulled it and reset it myself. It wasn't too difficult, but hurt like a… you know what. I had to sit down for a while as the pain left me feeling nauseous. But it seemed to be OK after a while.

I ended up going to the ER the next day, just to ensure there were no breaks. X-Rays showed no fractures.

Everything seemed to be fine, and after the swelling went down, I stared testing the range of motion. After a few weeks without improvement in range of motion, I scheduled an appointment wind a Dr who moonlights in our town (she is a top doctor for the US Olympic team).

She looked at the pictures, and was not concerned. She said it can take 9-12 months to regain full pain-free range after a dislocation. She recommended continuing to stretch and work it every day.

I am asking if there are any specific PT exercises I can do to help? Right now, I am working on bending it as far as I can with my fingers extended straight, and also with them at 90 degrees. I will go as far as so can, and then use my other hand to push it a bit further. My range has not significantly increased, but I suppose is getting a little better. It still hurts when I stretch it, mostly on the outside, between the knuckle and first joint. It also hurts when it is cold outside or when I hit it- which is a problem as I live at altitude, and have to shovel snow a lot.

Any advice you guys can give me on PT, expectations for recovery, or living with these issues would be GREATLY appreciated.

Here is a picture showing the extent I can bend it after 8 weeks or so of stretching. Please ignore the sticking up index finger in the back- that is a precious injury which has left that finger unable to bend. Which is why I REALLY need to get this pinky working again- I'm running out of fingers on my left hand! Ha ha! It makes all sorts of daily tasks (like typing, and opening things) hard or painful.

Thanks!

Several months ago I was lifting one of my trombones out of the back of my truck at an awkward angle and it felt like I strained my shoulder. The pain has persisted since, to the point I've started getting nervous that I'll need rotator cuff surgery, which would be extremely disruptive to my ability to play trombone professionally (which is why I've put off having it looked at). Sometimes it hurts and aches pretty badly, and other times it's more mild, but I can play my instrument just fine.

I started using the elliptical at the gym recently and had some concerns about repetitive motion with my shoulder. However. I've noticed it hurts less and I have a better range of motion after using the elliptical. Is it possible I just needed some good exercise for my shoulder, or should I still be concerned about something much worse?

I would personally see a certified hand therapist to get a proper evaluation and some exercises to address this issue. Hands heal slowly in my experience. Hand therapists are usually occupational therapists but sometimes can be a physical therapist. I would ask your doctor for a referral. They should get you pointed in the right direction quickly.

Unless you have profound weakness in the shoulder I wouldn't be overly concerned. Email me at ben@axiompt.com and I can point in the right direction with exercises.

Thanks for creating this thread to let us ask questions.

For sure always glad to provide some insight.

aggiederelict said:

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I would personally see a certified hand therapist to get a proper evaluation and some exercises to address this issue. Hands heal slowly in my experience. Hand therapists are usually occupational therapists but sometimes can be a physical therapist. I would ask your doctor for a referral. They should get you pointed in the right direction quickly.

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Thanks for the advice, I appreciate it! My only hang up is that we live fairly remote, and specialists are usually a several hour drive away. We are also self-pay, so things add up quickly.

But, if that's the best direction, I will talk to my GP and get headed that way. Thanks!

Yeah it is trickier when you don't live in a major metro area. Let me know how your progress is coming along.

I have some pain in my leg that I thought was a shin splint, but it seems like sometimes it starts in the muscle and eventually moves to the front while I'm running. I've been doing calf stretches and ice but it's not seeming to help much. I just came off a two week rest period after doing 2 long races. Any ideas? Pls do not say more rest.

On the inside or outside of the shin?

aggiederelict said:

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On the inside or outside of the shin?

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inside.

Really tender to touch? Is it swollen? Any issues into the foot?

aggiederelict said:

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Really tender to touch? Is it swollen? Any issues into the foot?

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Nope. Only starts hurting when I run or walk quickly and it's a pretty small spot.

Doesn't sound like too big of a deal. If you don't have old shoes or over probation issues then I would just slowly ramp back up as tolerated.

Do you think doing exercise that doesn't cause pain, can prolong pain?

I threw a ball a few weeks ago and did something in my shoulder, and the pain isn't easy to reproduce, but it's there most noticeably when I put my hand behind my back, as if doing the lift off test, and then laterally tilting my head to the opposite side. Pain is in the front of the shoulder, but under the acromian, as I can't quite palpate anything. Another thing that sets it off is forced abduction when I'm rolling over at night and pushing off with my elbow. It's never bad or excruciating.

I seem to be able to still bench/do pushups/pullups/rows/and internal/external rotation without any pain. But this isn't getting any better. Was wondering if I should stop, or change up what I do. Or as long as there's no pain, I'm probably not making things worse (which is what I'm thinking)

Thanks

Any atrophy in the rotator cuff muscles looking at your scapular region from behind? Any neck issues of late or in the past? Any complaints of parasthesias or numbness?

The lift off test with cervical sidebending to the opposite side is what we use to tease out suprascapular nerve involvement but that is usually a diagnosis of exclusion.

No atrophy that I can tell. No, no radicular symptoms or paresthesias. Always have a tight neck, and probably subpar posture, but no worse than it has been. About 2 months ago did a bunch of pullups and developed a sharp pain in my left neck that prevented good posture for a couple days. But that was opposite side of current shoulder symptoms, and closer to C7/T1 area.

Does resisted abduction with lateral raises reproduce your pain? Is that worse than the lift off test with cervical sidebending?

Because stabilizing and abducting reproduces your pain possibly teres minor strain.

Nothing on dumbbell lateral raise. But just resisted abduction when I'm turning over in bed. This morning I woke up with a bad crick in my neck and upper back, but still no paresthesia's.

Does the lift off + cervical side bending pinch anything under the acromion? Empty can/hawkins doesn't really reproduce pain.

It tugs on the suprascapular nerve as it traverses across from the superior scapular notch. Not right at the acromion but not far off. But I still don't think you have that until proven otherwise. But the fact you have a crick in your neck is probably related to this. Start with that.