Another update, now another 2.5 months later.
4.5 months since I had the original push-up problem and started this thread.
I'm better... and I'm doing pain-free full push-ups.
I've done a whole lot of things... Unfortunately I don't have any clear answer on what was the cause, what was the actual problem, or what made it better. But I have been doing rotator-cuff strengthening PT (and stretches, and a few other therapies) for almost 4 months now, I did get one steroid shot in the left shoulder 4 weeks ago, I've backed off the overhead barbell work for the last 5 weeks entirely though I've continued with other training, and I've managed the overall training volume a bit better.
During this time I also had an X-ray (normal), a great conversation with
@Brett Jones about wrist position with weight overhead and shoulders in general, a pain & rehab consult with a Barbell Medicine provider that gave me good perspective on pain and rehab approaches (and convinced me I don't need further imaging or other increased medical intervention, at least now now), and continued great coaching by my coach for almost 2 years now, Randy H.
I think in Dec-Jan-Feb I was on the right track with some of the rehab, but I was doing too much -- and still weightlifting -- which was not a formula for improvement. Feb-Mar has been better and I'm definitely headed in the right direction finally. I have no more pain at night, my mobility is much better, I can do most all movements without pain, and I really don't have much deficit in external rotation or anything else anymore.
Reading back through this thread, there are so many great ideas in it from so many of you, and I have done a
ll of these things, and/or or found them to be helpful or true to some extent:
- just need to work back into them slow and easy, include a few static holds at the bottom or even just start out with static hold at the bottom, work into more dynamic movement
- Original Strength rocking
- pushup board
- assistance pulling / back work in your program
- thorough warm up
- screw hands to the outside when pushing
- did no heavy shoulder work as I recovered from what I believe were simply overuse injuries
- stretch your biceps
- Half-Push Ups from my knees
- elevating the surface by pushing off a box or bench or even try starting at the bottom of the push-up to find your ideal hand, elbow position
- Kettlebell arm bar
- reduce the work directly, scale down your exercises, stretch a great deal. Bring in complimentary exercises in a different plane and test for what induces pain and what doesn’t
- regular PU but with band assistance
- anti shrug, ie press your traps towards your hips
- bench press
- External Rotator Cuff Strength Training
- David Allen band pull-apart super series
- for the scapular to function well on the rib cage, to find a stable base, you actually need a degree of flexion
- The "camel" portion of cat-camel, for instance (hold it and take deeeeep breaths into your back while pushing into the floor)
- deltoid and pec smashing
- allow elbows out at 45 degrees, rather than straight back and close to the ribcage
- whatever upper arm angle is most comfortable. The more in your elbows are the more the anterior delt has to do initially, but the more the lats can contribute as well
- let my elbows drift out a lot further at the bottom, coming up I would then pull them in as a first step, really firing the lats
- One of the things you'll come to appreciate about using a PU board is the clearance for your face - it makes it a lot easier to get low
- looking at pushup form in particular
- around-the-worlds with a weight plate
- build some volume with regular push-ups
- break for 6 weeks from pressing and hammered my upper back/rotator cuff directly
- rest and back off, letting my shoulder heal; quit picking the scab for a few months; the shoulder takes a long time to heal
- physical therapy exercises seem to be formulated like “hypertrophy light.”
- learning as an "operator" of your body to fire the right muscles at the right time. The longer rep sets help learn the neuromuscular connection perhaps
- backing off on the aggravating activity, doing some restorative activity, and letting the body heal itself.
- consider backing off with the oly lifts completely and focus on PT only if the problem persists after three weeks
- marmot oil
- arm bar, bent arm bar, TGU, a ton of band pullaparts, and someone who knows technique to go through your lifts
So now, I'm back to doing TGUs with up to 20 kg, full 2 arm push-ups, OAPU regressions (elevated and/or band-assisted), kettlebell snatches to 16kg, windmills, and a few other misc. things I had been really having trouble with a few months back.
Up next is training for OAPU for the Dome and StrongFirst recertification. Master SFG Karen Smith is making me a program for the next 6 weeks. If I'm able to get there, I know her path is the best one to take! I found that I can use my
jerk blocks and bands for regressions and I'm looking forward to working on this.
Ideally, I get the OAPU in April, and then move back into weightlifting after that... but we'll see. If it's not meant to be, I have plenty of other training options. Being pain free and fully functional is the main win, and I'm pretty much there already.
Many thanks to everyone for your help and great advice.