Shoulder Impingement and Scapular Health

I think that's happened to me. I don't know what's going on with my shoulder right now, but I think me prioritizing reprioritizing my training to focus lats over chest. Cause my chest is, I think my, my lats is something that I can always improve for the classic physique, but I think my chest is in a good place. So I can, I'm doing what you said earlier I'm repartitioning a lot of my volume into my lats and I think doing so has put my left shoulder in a really weird place where I'm having like stabilization muscles like like overtaking and I'm not sure what exactly is going on whether or not they're trying to overcompensate for maybe tightness in a place that's putting it in a place that's not in homeostasis but i'm i'm in this weird area where it feels like the the external rotator the muscle and like my back that's kind of close to the lat and close to the rhomboid is extremely tight and i think that's also causing tightness in like the left trap and then maybe a little bit of weird shit going on with maybe my internal rotator and muscles here around like the chest upper chest shoulder area and it's just causing this crazy tightness that just feels like it's fucking you know ramming my my my arm into my shoulder yeah so yeah can you lose that subacromial space we talked about yeah right so you basically humerus is getting sucked in the acromion yeah and now okay what what runs through there that's really important for your shoulder supraspinatus yeah so you start ramming into that now the supraspinatus can't stabilize the head of the humerus now your delt has to try to do what the super spin is supposed to be doing and then it sucks it in even more right so you now you start getting grinding in there so your brain goes i don't like this this is all inflamed i have no space and now it turns up and that starts to tighten stuff up so the over the last few years everybody's gotten really obsessed about training their lats and like everybody like everybody is like masturbating to laugh i'm like okay first everybody was you know you know it's a bench press bukkake now it's lats right and that these are all these are all going to promote internal rotation and i don't think people are focusing enough with about their upper back focus more on your upper back because if your lats if your lats are pulling you into an extension internal rotation you're going to end up with that watermelon farmer look that people get when they bench press and work less too much yeah like They're walking through like they're holding a couple of watermelons in their arms. It's like then they try to externally rotate and they can't externally rotate anymore. Then when they try to bench or do anything in this position, fuck, that's destroying my shoulder. Trying to get my arm overhead, fucks my shoulder. There's a lot of muscles that people don't normally think about because when we go to the gym, we train what we can see. So you're going to train your pecs. You're going to train your shoulders. You're going to train your lats. but what about the muscles that are deep that a lot of personal trainers don't even know about like what about okay people talk about pec minor tightness but what is that actually doing because that if you're doing a lot of lat and a lot of direct pec work the pec minor is a is a tonic muscle it's a stabilizer muscle so anytime you have a tonic muscle they are really prone to hypertrophying and shortening when the origin and the assertion of the muscles get closer. So if you're doing a lot of this and you're starting to get that watermelon farmer look, that pec minor sitting at the coracoid process and attached at your ribs, it's going to pull the scapula toward the ribs. So your scapula is going to start to anteriorly rotate. It's usually going to elevate and then smash down in your rib cage. So then when you try to go the opposite direction, it doesn't want to let the scapula move. So then you go, okay, this hurts. This really hurts. I feel like my external rotator.

rotators really tight, they're probably at length. They feel tight, but they're actually just stretched all the time. So we have to work on getting the pec minor. And I would say anything, I call it the coracoid gang. So pec minor, coracrobrachialis, short head biceps, work on trying to get those things to calm down with like stretching and possibly manual therapy, then train everything on the opposite side so we can try to get this stuff rotated back. okay that's exactly i went to my active release therapist dr michael he does like work for a lot of other people in the industry including all the guys at young elantra and he he did all he did active release therapy on the corticoid um just that entire area oh god it's horrendous oh yeah it was painful as fuck too um but i mean it definitely helps but it's like man now i'm trying to think about like what do i do moving forward what's the best route would you recommend me personally i know other people don't need this but me personally like just not prioritize only like do i do need to continue hitting you know my mid upper back at the same frequency my chest i would say the same frequency yeah focus focus a lot more on the back of your shoulder a lot more on the upper back like for sure because it most nine times out of ten when somebody comes me with this type of problem it's the same thing everything's inter rotated immediately rotated the scapula is out of position and the the shoulder is dictated primarily by what your spine is doing and what your scapula is doing so like it goes spine scapula glenohumeral joint so if you're if you're getting it like traditional typical bodybuilder position to be a little bit extra kyphotic because we do a lot of stuff that's going to promote flexion not being able to expand the chest, not being able to extend the T-spine, that's going to affect your scapula. So now if your scapula moves out of position, that's going to affect your glenohumeral joint and where your humerus is positioned in there. And so if that's all screwed up, a lot of people try to work directly on their shoulder. That's probably not going to fix things. We have to look at it from reverse back to spine and scapula first. If we can get the spine and the scapula to work better, then it's naturally going to trickle down to the glenohumeral joint and then you can work the glenohumeral joint. Because in a case like yours, where somebody has let it go this far, because you're like, I mean, I just came on. It's a chronic issue. It's like you woke up one day and all of a sudden you're like, well, that's different. And then it just started getting worse. And you're like, I don't actually know what started this. I don't know how to fix it. So we have to kind of go back to the past to see how we got there. And then we have to unwind that. But everything tends to go proximal to distal. Most everything. So you have proximal distal sequencing of movement where things are initiated in the core, like spinal, it's like spine to scapula to glenohumeral joint to humerus, forearm to hand. So with that proximal signal sequencing, I usually see distal to proximal dysfunction. So where it started here and worked its way down here, now it's kind of wound up and coming back. So we have to look at it from this area, but also this area as well, which means we might need to change hand position. We might need to change arm orientation. We might need to reinforce a different position when we do things like, I'll give you an example. Let's say you're going to do a single arm pull down. I'll see guys that when this happens, they can't pull down like this. They'll pull down. They run out of room in the joint, so they scour, and they end up pulling down like this. so what i'll and rose too instead of being able to just pull in the shoulder extension they have to do this because they they have no joint space anymore so what i'll do is i'll set them up in an externally rotated position so instead of doing it here we might do it pull down here or we might row here so we try to get the brain to understand how to get back into external rotation instead of pulling and and having to scour out to achieve internal rotation okay but a lot of it has to do with do i have the available joint space or not gotcha if i don't like you still have to train like if you're getting ready for a show you can't just take time off and try to rehab a shoulder you have to find a way to keep training because you have a date you have to compete but if you keep doing the same thing you're doing maybe you get injured before you get there or maybe you don't get as much hypertrophy and as much development because you now have to compensate and focus on other muscles that you didn't want to focus on. Right. So then instead of it being a lat movement, you start becoming primarily biased to, I don't know, Terry's major or something like that. Now, if we can set it up a little different and put you in a position that reinforces what you want to do. Now I can still train. I'm still working the lats, but I'm working a position where I don't have to worry about it irritating the joint and then the brain making compensations for that. Gotcha. Yeah Okay This might be a little bit too specific Just a quick question though because we running about out of time and there one thing I wanted to ask you That actually kind of like unrelated but my shoulder I don have any issues with range of motion now with this, with the shoulder, I can do overhead presses. I can do all my lap movements properly and everything. But whenever I reach up to this guy for my left hand, say that I wanted to do, which I never do, but say that I wanted to do like a, a clean and press and I wanted to bring my hands behind my back i do have this pain that happens on my left shoulder when i try to bring my hand behind my head okay um and that kind of happens like right around here and stuff and i'm trying to determine like it's it's a it's a it's a unique place for me to feel pain because i can still overhead press properly it's just like it's like this sharp pain that shoots right down the middle of my delt when i'm holding it up behind my head so in this area yeah i would say So again, like I said, super spinatus is one of the most problematic muscles in the shoulder when you see a shoulder issue. Right. And I've had problems with that, like I think for the last seven years or so. Yeah. And I think most of what you're seeing is like just overly compressed and not able to move the humerus out of the way of other tissue. And that happens, right? If you are constantly smashing all the bones together and you have soft tissue between it and muscles and tendons between there, those muscles and tendons are going to get inflamed. When you get inflamed, you draw fluid to it. So it's going to get thicker, which is going to create more issues because now you have even less space to move in. Right. So I think the your ART guy is already working on that pec minor. So that would be that would be a big one. What I would talk to him about is what can I do if I want to go overhead, especially behind the head? I find that I can't actually get there without feeling some type of impingement, pinchy type thing at the top of my shoulder. do you have something i can do for my pec minor so he's used to getting in there and like mangling you and making it work but you can do you could do the same type of stuff not not the same exact thing but you can do something before you train that's going to be helpful i would take like a golf ball and put it in that area and then lean into like the corner and just roll it around so kind of do a junkyard dog art thing you're just trying to mangle it calms down i do a lot of this junkyard dog shit yeah it's worked right yeah like it's not like you can't say hey can you can you come into the gym with me every time i need to train and work on me right um so it's like part of it is getting that tissue to calm down so it lets the bones now move right and then and then working on don't think think about it kind of going back to our tonic muscle type of thing you have tonic muscles and phasic muscles. Tonic muscles are kind of your internal stabilizers and the phasic muscles are more of your dynamic mover and gross stabilizers while you're in movement. Okay. So if you have these muscles that are connecting the bones together and they're being hyperactive or hyper stimulated, we need to figure out a way to calm them down. Stretching is a good way. And also like just like self myofascial release is a good way of doing that. Do that and then try to go overhead. But just remember that if I do release some of this stuff or I fatigue it, I am going to have less stability. So that means that if I'm overhead pressing 225 pounds, I'm probably going to want to go with just try the bar after that and see how it feels and then start loading it up to comfort because you're not going to be pressing the same amount if you lose that stability. And you could try, but you're probably going to open yourself up for injury. I think the big thing, and not looking at you, I'm just going to make an assumption based on experience of seeing bodybuilders like this, that scapular issue of the scapula being too anteriorly rotated and not able to posteriorly rotate. If I bring my arm overhead, the scapula has to get out of the way of the humerus. So if you go, say, 110, maybe 120 degrees of shoulder flexion, you're going to have joint to joint closure. And then as you come up, you need rib cage expansion and T-spine expansion. But that also assumes that the scapula can actually move with all this stuff. If the scapula is smashed into your ribs and you try to move it, it's not going to go anywhere, which means you're just basically ramming your humerus even further into that tissue. So almost every time, it's just, how do I get something out of the way of something else. Because if I can't get it out of the way, the body has to figure out a way to move around that. Okay. So let's say you move in a position there's pain. You can probably manipulate where the bones are and not feel the pain, but then it might be a completely different exercise. So like, for instance, if you go like this and you go, okay, that hurts, but you go like this you go well that doesn hurt Okay What the difference Well I move the bone into a different position that has more available space so the brain doesn see that there a problem it doesn need to alert you by giving you a pain response but i would say if you because you been focused on lats and i'm assuming like the first first six years you were like most guys he's benching like crazy like what most guys do um well i i think we'd be on the same page with some slight differences i bench but like i caused myself a lot of shoulder impingement issues so i stopped benching and overhead pressing because of the shoulder issues maybe like seven years ago so like the initial jump into it like all guys bench press and curl bench pressing exactly so it's like all right so that's creating a lot of tension on one side of the joint okay we need to equalize that with tension on the opposite side of the joint now it it would make sense if i said okay if this was overpowering everything so lats and chest internal rotators and I'm getting pulled in internal rotation. Well, I'll just, I'll get my external rotation stronger, right? I'll get shoulder flexion stronger. I'll get my scapula stronger. But the problem is once you've done this for years and you're relatively strong, remember what I said, the stronger you get and the more hypertrophy you get, the harder it is to fix. So it's not going to be typically not going to be as productive to just strengthen the antagonist side. You also need to do something that's going to temporarily weaken the agonist side so if you need to do pec minor stretches if you need to do self-myofascial release whatever you need to do i think that's the problem i'm running into because i was doing external rotating strengthening exercises as well like i was doing a lot of like front raises and stuff but i think doing so has just completely over overstimulated both my lat the external rotator and the internal rotator yeah so this entire shoulder has just this entire area has just been fucked for like weeks And I think the stretching, the myofascial release, going to an ART more frequently has been basically a lot of the things that I needed to do in order to solve this. Now you just have to be consistent with it long enough. And the times you go in to see your ART guy, he's going to do a lot of good work for you. But you have to understand, you have to maintain that stuff. And every time you go into the gym and you don't do that stuff, you're just fighting his treatments that he's trying to do to help you. Yeah. So it's like going in and not being afraid to stretch before you train, especially look, if you're going to go do a back workout, if you stretch internal rotators, if you stretch your chest, is that going to have a negative effect on working your back? No, it's actually going to make it easier to get a muscle contraction in your back. It's going to make it easier to get in the range of motion, the positions you want to get into. so you probably don't want to go and like mangle your chest with a bunch of stretching and then try to bench press but you could mangle your chest and then work your back yeah and i think again for a lot of people that don't put enough emphasis on working what's between the shoulder blades they're too busy working on the lats and that is important like lats also stabilize the spine stabilize the glen or humeral joint stabilize the hip um but you know a little bit goes a long way. So if people are doing a lot of lat work and they're just, they're ignoring the fact that the meat between their spine and their shoulder blades is what's actually holding all that together and stabilizing it. They're just doing like lat specific this, lat specific that, and they're not doing anything for rhomboids, middle traps, lower traps, left scap. They're not doing anything that's actually attached to the spine and the middle part of the scapula. that's going to pull that back and keep it in position. Yeah. So I think, yeah, going through a specialization phase where you do work the upper back is probably going to be a massive benefit. Do you think using a Theragun with like a more pointed end or one with like a little surface, less surface area, do you think that's, that's valid? Yeah, a hundred percent. I, so I have a friend that's a physio in Australia and I was talking to him about it and because I, I don't do it anymore cause I don't have time, but I used to do manual therapy, facial stretch therapy, massage, ART, all that stuff. And he, I had some issues where he was using a Theragun and we were talking about how we like to use the Theragun. And he, he made a valid point that he uses his Theragun exactly like he would massage, but he, he can do it faster with a Theragun without mangling, mangling his own hands to do it. I was like, okay, that's, that's pretty good. And he said, just treat it like you're doing a massage. so if you wanted to use it on say your pec minor right you could put it under here and go on the ribs you could put it on top and try to get it through there but don't just hold it people will just hold it down and go or they'll just go like this you're not doing anything like get good pressure and work up the muscle if we know that muscle is here we want to work up and down the muscle this way or get onto the ribs and do it that way right instead of instead of just across the fibers? Yeah so just work it up and down the fibers work it across do cross friction work it up and down the fibers Because what you realistically trying to do is create some overstimulation so the muscle calms down so it relaxes right So that's a good way of doing it and then move into your stretch. So you might even do something like hit it with a Theragun pretty aggressively, then do the self-myofascial release, then do the stretching, then go work your back. Gotcha. What do you think about the 10-7,000 unit? The what? The 10-7000, do you know that? Is that a new TENS unit? Was there an old TENS unit? Yeah, TENS unit's been around forever. What was the... I thought... I didn't think 10-7000 was new, though. I thought it was me in the 2000s or something. But yeah, it's a TENS. Just a TENS unit? Yeah, TENS are fine. Yeah. It's fine. I mean, I think if we're doing what we're thinking about, like TENS sitting at home, use a TENS unit. Yeah, I don't use them, But because it's just an extra expensive piece of equipment to use. Right. But one of my friends bought it for me for like a gift for my birthday. So that's nice. I have it. Yeah. I mean, try it. Yeah. Everybody's going to get a different response to it. But like, I wouldn't, I wouldn't be going like, I wouldn't go with the gold's gem and be sitting there with a tens unit, like hanging out. Yeah. Yeah. But I mean, sometimes I wonder though, like, is it actually going to help with, with a release or is it really just for pain? You know, I like to keep things simple. If I can't fix it with stretching and self-motor fascial release and maybe a Theragun, then it's probably something you need professional help for anyways. But the only way to find out is to try it. And I think the most productive thing to do is find a number of tools that work. Because years ago, I did a cadaver course with Tom Myers from Anatomy Trains. It was in Boulder, Colorado. It was five days, eight dead bodies, untreated. We just got our guys out of the freezer and just started cutting them up. Right. And he said some statements that changed the way I view some of these things. One of those is that he says, look, are there 600 muscles in the body or is it one muscle in 600 compartments? And I was like, OK, so that's interesting. So what you do in one area of the body is going to affect everything else. and at one point he had he was i cannot remember what he was pulling in the hip but you could see the guy's foot moving just from something we were doing in the hip and you would never think like you would never think that some small muscle in the hip is going to have that much of an influence on the foot but he would show that yeah or like someone have a scar and he'd pull on the scar and you could see it move somewhere else in the body so all these things are related right it's yeah sorry i was just thinking about one thing i had this a tendisovitis issue that's all the way down here to the thumb but my active release therapist was going all the way up the forearm and even up here just to work on that because it literally goes all the way down absolutely it was just a thought i was having while you were talking you get people with um what's the what's it called uh carpal tunnel where what are they going to fix they're going to go in here and they're going to they're going to route it out to give more space in the in the in the um in where the nerve is coming through to the hand now i learned a long time ago that most of people's carpal tunnel has nothing to do with the wrist. It's usually a tight pronator teres. So you see it with people that have repetitive like flexion and pronation issues like mechanics. And nine times out of 10, it's tight, tight pronator teres that's causing the carpal tunnel. If you send them to an ART guy and they release the pronator teres and they work on more supination, the carpal tunnel goes off. Sorry, we went way over time. That's crazy. My bad. No, that's a good thing. I think we went like an hour over what I normally normally go for. That's how you know this shit's good though. But I had one last question that I want to ask because I was very curious when I heard you talking about this. But you were discussing, man, there's a lot of things I actually wanted to ask you. Fuck.