Boxing and grappling with a sub-par rotator cuff

[death pig]

Hi,

Thanks to an accident roughly 8 or so years ago, along with poor form doing behind-the-neck lat pulldowns when I had no clue, my left rotator cuff is in slightly dodgy shape.

Bringing my fully straightened arm up in the manner of a front raise causes an audible (to me, at least, with bone conduction and what not) click, as does bringing it back down. I do have some day-to-day pain but nothing serious. My doctor gave me the all-clear to lift weights, which I have been doing for a while now - I do reps at around 175 bench, 320 squat, 330 deadlift and have no problems with pullups or weighted dips, though I avoid overhead presses as they seem to cause noise and mild pain. She did say, however, that I would likely need surgery at some time in the medium-term future but that strengthening my muscles would help the overall situation. I am 6'1" and 220 pounds.

I am looking at starting Muay Thai and grappling training at a local MMA gym. I have no experience with full contact MA and am a little wary of getting in a situation where I could do my shoulder more permanent damage. I notice some clicking in my shoulder when I punch with my left hand but heavy bag work doesn't leave me in any real pain.

I know you no one can give me specific advice on my situation but am wondering about anyone with similar experiences to me. I will talk to my doctor about this but I find they tend to give very general advice and would like to have it augmented by someone who has actually walked the walk, so to speak.

:karated:

[Flash Jackson]

Alwyn Cosgrove has an awesome shoulder routine on T-Nation.

[Tom Kagan]

Joint clicking without pain is not considered to be a problem or symptomatic of anything. It can start happening shortly after an injury, so you situation should not be surprising.

Before you agree to go under the knife, go get a couple of sessions of deep-tissue manipulations on your shoulder/arm/neck/upper back which can only charitably be called massage. (It's godawful painful.) These modalities go under a few different names: Rolfing, Active Release Technique (ART), NeuroMuscular Reeducation (NMR), etc. If you don't see dramatic improvement of pain relief and/or range of mobility within 2-3 sessions, they can't help you. (Some of the better Physical Therapy places will also do some form of a deep-tissue massage if they feel it may help.)


Specifically targeting your rotator cuffs with weight training/band training is probably not a bad idea. People speak highly of a book called 'The 7 Minute Rotator Cuff Solution.'

I essentially have shoestrings where others would have rotator cuffs in my left shoulder. For me, two sessions of ART did more for the problem than 4 months of PT. I stretch my shoulder out with a couple of things I learned at PT every once in a while and have a stretch band at home I play with from time to time. Also, what helped a lot for me is the speed bag with elbow and back-hit combinations.

Assuming your shoulder is not 'busted', I don't see anything that I know or can find using Google Fu which would prevent you from pursuing what you want to do. It is possible the mechanics of your shoulder will hinder you in training. You may never be great with it. But, that alone is no reason why it should stop you.

Good luck.


Caveat: I am not a doctor nor do I play one on TV.

Caveat 2: I suck at fighting, so I don't know whether I 'walk the walk' in the fashion for which you were hoping.

[LI GUY 1]

You don't do any shoulder work because it hurts? I understand but have you considered starting very light (just the bar) and adding 5 lbs a week? Strengthening the shoulder joint should help I would imagine. Working the chest and back without shoulder work might aggravate the shoulder due to imbalance maybe? Just questions, I don't have answers, but they are worth looking into.

[HackingYodel]

I had a similar injury and have been trying club bell type exercises the last two weeks with great results.

I use small sledgehammers and focus on my form and movements. I can really feel a difference in my jab and have much less popping during overhead presses now.

Here is a website with a few routines: http://www.expertvillage.com/intervi...b-training.htm

and my favorite: http://www.expertvillage.com/videos/...g-stirring.htm

(of course you should consult you doctor, etc... and good luck on your recovery)

[death pig]

Thanks everyone for the advice

You don't do any shoulder work because it hurts? I understand but have you considered starting very light (just the bar) and adding 5 lbs a week? Strengthening the shoulder joint should help I would imagine. Working the chest and back without shoulder work might aggravate the shoulder due to imbalance maybe? Just questions, I don't have answers, but they are worth looking into.

I avoid military press because it seems to require movement that specifically aggravates my injury, and the doctor told me to stay away from anything that actually causes the click to occur. I avoid close grip bench press for the same reason. It's definitely the snap of something moving in a way that it shouldn't, and doing that under load causes me to have a "you shouldn't be doing that" feeling. Push press does seem to be a lot easier, I occasionally do that in my off days along with cleans and clean and jerks. My shoulders are pretty good anyway, I think they get enough synergist work from incline bench and rows.

I agree though that I should be trying to strengthen my shoulders more specifically, I will look into some light exercises.

@Tom Kagan: I don't get pain specifically when the click occurs, but I do get a dull ache in that shoulder from time to time and it definitely hurts more than the other after bench, rows and pullups/downs. According to my doctor, that's just a symptom of the weakness of that shoulder and nothing to worry too much about.

I guess the only thing that worries me is that the clicking feels pretty wrong, like a tendon sliding over a bone and I am concerned about degeneration.

[Tom Kagan]

I avoid military press because it seems to require movement that specifically aggravates my injury, and the doctor told me to stay away from anything that actually causes the click to occur. I avoid close grip bench press for the same reason.

"Doc, it hurts when I do this."
"Well, don't do this."


That's the oldest dumb joke in the medical book. He went through 4 years of medical school just so he could punk you. :smile: Yeah, don't do it if you have more than just a click. But, not suggesting what to do beyond resting, getting cut, and taking lots of NSAIDs has always bugged me about certain doctors.


I remembered an article I came across a long time ago which you might find useful to strengthening your shoulders. A little Google Fu helped me find it:

http://www.t-nation.com/readTopic.do?id=459454


Here's a short blurb from the same author which also might be useful to you:

http://www.t-nation.com/readTopic.do?id=459700


Good luck. If you could, please post updates on how your shoulder saga unfolds. I don't know about anyone else, but I'd love to hear about the specifics of what happens and any items of note you find along the way.

[PirateJon]

I avoid military press because it seems to require movement that specifically aggravates my injury, and the doctor told me to stay away from anything that actually causes the click to occur.

Typical doctors treat typical Americans. What you are doing is not typical. See a sports med specialist.

[death pig]

I'm not American, nor is my doctor :)

But yes, you are right, they tend to give very conservative advice for obvious reasons.

[Dr. Fagbot Q. MacGillicuddy, PhD]

I also have problems with the connective tissue in one of my shoulders. In my case, it's the right. Lifting my arm in front of my body vertically also produces an audible click -- in my case, one clearly noticeable by others -- as well as a sensation of unusual bone-on-bone contact. It's very different from the crepitation in my knees, which is just harmless crackly noise. (I learned that fancy word six months ago, after going to work in the orthopoedics field, specifically joint replacement.)

For fun, I do a bit of casual full-contact kickboxing, under both American and muay thai rules. At my gym, where there are a number of competitive boxers, our kickboxing style uses modified traditional boxing as its base. As a result, in any given (productive, at least training-wise) week I throw a lot of punches.

I'm also 38 years old, roughly death pig's dimensions, and not in good physical shape. As a result, a little bit (and sometimes a lot) of pain in my shoulder (and elsewhere) is something I've learned to expect. Last year, though the pain became so severe it was waking me up at night. At one point, I couldn't move my right arm, at least from the shoulder -- I was actually using my left hand to place my right hand on my keyboard at the office so I could work. I bring this all up to emphasize that I had similar, but severe, symptoms.

Thankfully, the advice of my trainer and instruction from my best friend (a physical therapist and martial-arts enthusiast) resulted in a full recovery. Perhaps it'll help you too:

1. Relax your shoulders when punching. My trainer emphasized this to me over and over, and it was an extremely difficult thing to do. For defense, I keep my chin tucked and slightly hunch my shoulders, so a little tension is unavoidable, but good body mechanics reduces its potentially harmful effects. Most important is probably keeping your arm relatively relaxed during punches and ensuring power comes from twisting into them, from the body, rather than from only the arm. In my case, "sitting down" into the right cross helped me rotate into it... Might be more tricky with the left, assuming you're right-handed and using your left to jab. Try turning into the jab a bit and stepping forward, making sure your shoulder and body are behind it, if punching hard is a concern (and why wouldn't it be?)

Also, I was shown a kungfu stance that helped me stretch and relax my shoulders quite a bit, as well as just become aware of the shoulder muscles I was keeping tense. (I've noticed when working with others that "finding" these muscles can be a bit tricky.) Anyway, if I need to stretch those bad boys out, I'll put my feet a little wider than shoulder-width, ben my knees a bit, keep my lower back straight,and just put my arms out in front of me with my elbows slightly bent and my palms facing down -- everything relaxed. Think resting your arms on an imaginary fence a foot or two in front of you. A variation is to face your palms inward and bring your hands a bit closer together, perhaps like you're hugging a delicious keg of beer.

Mmmm, beer.

Anyway, in my experience, you'll know immediately when you've hit that sweet spot and are stretching out all those crazy, tense, complicated shoulder dealies.

2. Exercises: Arms straight out at your sides, shoulder-height. Rotate forward 100 times. Rotate backward 100 times. Very small circles.

Arms at your sides, elbows flush against your ribs. Make fists and stick your forearms straight out in front of you, like you're a rock 'em sock 'em robot. Next, while keeping your elbows against your body, spread out your arms as far as they'll comfortably go. Do this 100 times. It should look like you're flapping a pair of stupid, ineffective little wings. Eventually, try doing it with 1-pound weights, if you have 'em. Keep flapping, little bird.

Also, push-ups. 100-200 a day, sets of 20-25. Just whenever. Do some in the morning, do some in between rounds (if you train with rounds), whatever you can do.

Good luck. I hope this helps.