Chronic Injury/Overhead Pressing

[jtmb]

Over the last four to five years, I have had a chronic injury to the levator scapulae on my left side. It is particularly prone to strain while pressing, especially overhead. Massage therapy helps alleviate the short term symptoms, but it doesn't seem to decrease the likelihood of re-injury.

I've both gone to physiotherapy and looked up re/pre-hab movements to help strengthen and stretch the muscle. Face-oulls, overhead shrugs, isometric holds, stretching the levator scap/scalenes, using a theracane/lacrosse ball/myofascial release; nothing seems to be helping though. The issue will clear up after a work or so, but I have probably strained it over 100 times in the last five years. I have left overhead pressing and deadlifting alone (also seems to exacerbate the problem) for stretches, but it doesn't seem to have much effect.

Anyone experience similar issues? Any suggestions for what could help? I'm at the point where I am considering dropping overhead pressing, but it seems like its not really addressing the underlying problem. I should also mention that I grapple somewhat frequently, as much as 5-6 times a week, which is also a huge contributor to the stress on my neck. It is usually only during lifting that I experience a strain.

 

[Disco]

Go to a shoulder sports specialist doctor

 

[bad seed]

I bet you didnt do a lot of pullups/rows. When I started doing pullups between every OHP set, my chronic shoulder problems vastly improved.

 

[Revok]

What's your thoracic/cervical posture like? A lot of grapplers have excessive kyphosis and forward-head posture, aka upper crossed syndrome. If this is the case then going at the lev scap with stretching & massage is only treating the symptoms: the fix comes with targeted strengthening of those muscles that are keeping the injury-prone tissues chronically overworked.

 

[Real LoveGun]

revok that's a great point. I've always heard this you didn't pull enough argument. I have always done lots of volume row/pulling and it never helped. I finally found the right therapist who basically had me address all/most of the problems. Strengthen the rotator cuff, graSton method and other more painful deep tissue work, and really emphasized the weak areas such as lower trap muscles. It help my shoulders a ton. TS I'd first find a good shoulder doc and if the recommend therapy find a sports specific therapist someone who specializes in working with athletes and weightlifters. A good therapist is probably close to as important as a good surgeon.

 

[jtmb]

Hmm, this grabbed my attention. Sternocleidomastoids are always tight, as are scalenes. I've had trouble getting to them myself as they are areas where self-massage and myofascial release isn't exactly the easiest. What types of exercises are optimal to correct this? I'll try and look into it, just wondering if you had some more info.

As for the pull-up/rowing comment, I do my fair share of both. I've run 5x5 madcow, 5/3/1 and a variation of starting strength for athletes training in mma. I don't really think this issue is related to a lack of pulling or back work, as I also laid paving stones for a few summer which would certainly have accounted for any lack of programming.

Most of the pain experienced is localized to the levator scapulae attachment at around C5-C6 and under the trap above the rhomboids. I would say it is more of a neck issue than a shoulder/rotator cuff problem.

 

[Revok]

First off, assess your posture. Get a trained eye to take a look at your alignment or, short of that, take a side-on photo and post it up. It's not hard to spot: basically, if your earlobes are forward of your acromions, you're likely in forward head carriage. It's frequently accompanied by excessive thoracic spine kyphosis & scapular protraction to some degree, but not always.

That you've been doing plenty of lifting and hard work isn't necessarily a guarantee against having misalignments: it's all about relative strengths of the muscles involved. Also, habituation (i.e. your brain's default postural setting which you naturally fall into throughout the day) is arguably a greater determinant than what you do the hour or two you're in the gym. So you may well be a hell of a deadlifter, rower and paving flagger, but if you've spent even more time strengthening your anterior musculature, you'll still be in misalignment. George Sotiropolous can probably out-pull us all, but with all that time on the mats working his anterior musculature, his head is still a good 4 inches forward off his spine (which put it that much closer to Ross Pearson's fist).

Check to see if you're lacking thoracic mobility - if so then what you're probably dealing with is just 'computer guy posture' which is easy to fix. tl;dr: stretch the front, strengthen the back.

Some info on the possible neck symptoms...

http://robertsontrainingsystems.com/blog/category/neck-pain-2/


Of course all of this could be completely off-base and what you actually have is cancer. See a sports physio and get a full assessment for responsible advice.