Advice on Training With Limitations?

**JAFMAS** · Posted On: 11/06/2012 10:49am

I had learned about the Strong Lifts workout and was doing that a couple years ago. To make a long story short, I was bench pressing one day and all of a sudden my right arm just gave out, and went numb.

After running around and finally having an MRI done, I was diagnosed with degenerative disc disease, specifically foraminal stenosis (severe), arthritis of the neck, and compression of the spinal cord from bone spurs. While in physical therapy it was suspected that I had some shoulder issues as well.

My right tricep and pec had atrophied, and finally I had a two-level anterior cervical discectomy in March and was cleared to go back to normal activities at the end of June. A shoulder specialist I saw also took an MRI and I have subacromial impingement of the right shoulder.

Here's the issue..I've been working out again, the pec and tricep are coming back, but the shoulder is a bit weak. The shoulder specialist doesn't want to do surgery at this time and told me just to avoid overhead presses, which to be honest I haven't and although the pain has been minimal, I don't have the strength I used to. This could also still be residual nerve damage from the neck issues and only time will tell if that heals fully or not.

I'm 52, in good shape, and just want to stay strong (strength is one goal) as well as maintain muscle. I'm 6 feet tall and weigh 185.

My question...what would you recommend? Just general training with compound lifts like squats, benches, rows, etc. or what?

I can't see myself right now doing strong lifts with the weak shoulder. As an example...prior to the neck issues I was working out with 175 pounds on a bench press, and now can do 8 reps with 130 pounds and get some pain during exercise. Pulling exercises, like rows, pose no problems but the pushing exercises do.

Physical therapists suggested just a general strength training program with the usual 3 sets of 8-12 reps. Feedback appreciated.

**Diesel_tke** · Posted On: 11/06/2012 2:05pm

Well, depending on your goals, you may be headed down the wrong path with your workouts. Generally at your age, your body has leveled out with the amount of testosterone it produces, and in some cases the production goes down. So that makes gaining muscle mass pretty difficult without some other type of hormone help.

So what you have to figure out is what your long term goals are. If you are just wanting to maintain muscle mass while keeping your joints healthy, adding a lot of weight into the mix is a bad idea. In that case you would do well with calisthenics. Like pushups, pull ups, dips, squats, lunges, burpies, pistol squats, planques, stuff like that.

If you are wanting to increase muscle mass, you will obviously need to add weigh into the mix with suplemental help(testosterone, creatine, BCAAs) and lots of food. But I would think this would be a sketchy route for you to take if you are having shoulder problems and after next surgery. Bench press puts a lot of stress on the neck and shoulders. If you try to avoid those exercises, you will start to put an imbalance into your muscle structure which could cause joint misalignement and other problems.

I would recomend the first option, but it's your life and only you know what you are wanting to get into. Hope that helps a little.

**JAFMAS** · Posted On: 11/06/2012 3:03pm

Right, at 52 I don't expect I'm going to become the next muscle magazine cover, but I do want to maintain muscle and not necessarily gain weight. I'm satisfied with the weight I'm at.

It's been an adjustment...I've always participated in some sport as well as lifted regularly, and returned to TKD in July, but I think given the neck repair as well as the shoulder issue, going heavy is out of the question. The orthopedic specialist recommends staying in the 10 rep range as did my physical therapists which will maintain muscle, provide some strength gains, without risking additional injury.

With the two-level ACDF to my neck, the biggest problem with that surgery is that it often accelerates degeneration at adjacent levels, so I agree with you...maybe lighter weights and just being sensible at my age is the right thing to do.

**Gypsy Jazz** · Posted On: 11/06/2012 6:24pm

Depending on your location there may be a good sports rehab person who can give you a better idea of what you should and shouldn't do. I know of (but don't know) a few people who are held in very high regards in the Mass area. Not all PT's, DC's, ATC's, etc are equal. I have a bias towards those who abide by the SFMA.

As a general modification, benching seems like it should be out with a straight bar. Dumbbells will be easier on the shoulders, especially neutral grip. An even safer option is push ups with a neutral hand position. If you catch the benching bug, neutral grip floor pressing with DB's will most likely keep things pain free.

In terms of broad general advice, mobilize your thoracic spine, foam roll/SMR your chest, lats, upper traps, levator scapulae, and back of your shoulder. A good manual therapist of any kind can obviously do this better. Though not my absolute favorite, tossing in some YTI type drills probably wouldn't hurt during warm ups and after workouts. Do more pulling work than pushing and maintain good position throughout.

If you're the type who likes to "fix yourself" I'd advise looking into Mike Reinold and Eric Cressey. They have a lot of free material available on shoulders specifically. Of course get clearance from a qualified professional before doing anything drastic.

**Hiro Protagonist** · Posted On: 11/06/2012 6:50pm

What the gentlemen above have said.

Best consult with a professional, and/or your doctors.
Also, think about hiring a qualified personal trainer, to literally guide you through the first few stages of the new training routine.
(PTs are not as expensive as one might think.)

Take care, and good luck!

**JAFMAS** · Posted On: 11/07/2012 11:35am

Jazz and Hiro, thank you for the sound advice. Both my neurosurgeon for my neck and the orthopedic specialist for my shoulder pretty much said no limitations, but the shoulder specialist said avoid overhead pressing...he put it this way...anything higher than a normal bench press shouldn't be done.

Part of it is just being used to my own habits...push ups just aren't the same as a bench press, and lateral raises?...really?

I actually had Physical Therapy with a manual therapist who gave me certain exercises and stretches to do which do help. Part of the problem is that the ortho specialist really isn't sure how much is still from residual nerve damage to the brachial plexus. The pain is actually better than it used to be and surprisingly my shoulder feels great after my taekwondo classes which i do 3x a week...go figure.

I'll try some adjustments such as the dumbell bench presses and perhaps contact my shoulder specialist as well for some additional consultation. I've had a good ortho guy who is actually at the university sports medicine center where i work and did my PT there as well, but it's always worth another consult. Thank you again.

**Diesel_tke** · Posted On: 11/07/2012 1:49pm

Originally Posted by JAFMAS

Part of it is just being used to my own habits...push ups just aren't the same as a bench press, and lateral raises?...really?

Not to have a pissing contest about bench vs. pushups, but honestly you said that right now you are doing 8 reps with 130lbs with pain. Pushups are easily as good as that.

I've been doing pushups with no weight for years. I went to my unkles house and he challenged me to jump on the bench and see what I could do. I could still do 315lbs for 4 reps. If pushps are too easy, elevated pushups, if those are too easy, one arm pushups, if those are too easy, hand stand pushups or suspended pushups. Throw dips in the mix too. One of Arnold's favorite exercises for chest and tricep development was dips.

This is a good article on pushups:

http://www.t-nation.com/free_online_...article_period

**PizDoff** · Posted On: 11/07/2012 1:51pm

Don't have anything to add in terms of advice but I commend your desire to keep working to improve despite what you've endured. Keep us updated.

**Gypsy Jazz** · Posted On: 11/07/2012 5:24pm

Originally Posted by Diesel_tke

Not to have a pissing contest about bench vs. pushups, but honestly you said that right now you are doing 8 reps with 130lbs with pain. Pushups are easily as good as that.

I've been doing pushups with no weight for years. I went to my unkles house and he challenged me to jump on the bench and see what I could do. I could still do 315lbs for 4 reps. If pushps are too easy, elevated pushups, if those are too easy, one arm pushups, if those are too easy, hand stand pushups or suspended pushups. Throw dips in the mix too. One of Arnold's favorite exercises for chest and tricep development was dips.

This is a good article on pushups:

http://www.t-nation.com/free_online_...article_period

I love the advice on push ups. I also love push ups. They are not a wimpy exercise by any means. Toss on a weight vest or get some resistance bands and they will crush some experienced benchers into the ground. There are major benefits to proper push ups on shoulder stability when compared to benching as well. Push ups allow the ability of the scapulae to move against the ribs and upwardly rotate, compared to a bench press which encourages a retracted and depressed position that can flare the scapulae and put them in a poor position for activities that aren't benching. Nerdy much? This isn't to say one is good or the other is bad, but it's worth noting.

I would however advise against dips if you have a sketchy shoulder. The bottom position requires a lot of shoulder extension and internal rotations, which tends to be lacking in people with shoulder issues. That's a broad generalization of course. If the issue is indeed a subacromial impingement, this isn't as big a deal as if it were AC joint impingement, in which case that is a provocative position, but it's worth looking out for this. In my mind the risk vs reward just isn't worth it because you can still challenge yourself in other ways.

Last and certainly not least, if there was damage to the brachial plexus, I would very highly encourage looking into some thoracic mobility drills. Those nervy bits are put on tension when the stuff it lives in is locked up. There are also manual therapists of many sorts who can help to work on nerve entrapment if that is the issue or part of the issue. Active Release Technique likes to claim they're the greatest in the world at this, and maybe they are, but as with most things in life, individuals are much more important than styles.

**HereBeADragon** · Posted On: 11/07/2012 6:02pm

I would suggest you focus your training on regaining the mobility and strength in your shoulder and surrounding area. Take a step back from the muscle and rebuild the mobility. Joint mobility programs would be of help as would yoga. I can recommend a few if you'd like. I could also possibly direct you to some great coaches, where are you located?