Discussion in 'Everything Else' started by Tirofijo, Feb 19, 2018.
How are things now?
Hey guys, In 2010 I injured my right shoulder. The initial diagnosis was a suspected tear in my right bicep tendon. From then until 2017 I was unable to train for more than a few months at a time before having to take time off due to pain. I’m a Rodman so I throw steel all day and had to put training aside for work when the pain got too intense. I went to a new sports physician early 2017 to see if maybe it was time for surgery and found out that it wasn’t a tear in my bicep but a severe impingement that was supposed to be the problem. I’ve done extensive rehab since then and have got the pain management part taken care of but since seeing a 0% gain in my strength I sought out another doc who finally suggested looking at the nerves to see if that was the problem. Last month they finally figured it out and found that I have chronic nerve damage to my right bicep, deltoids, and tricep and acute ongoing damage to my right forearm. From the test they figure it is Degenerative disc disease with the worst being my C6and c7. I suspect I have this through my spine as I’ve noticed the same strength loss in my deadlifts as well as pain in my lower back from time to time.
I never had a super strong bench but at 5’6 and generally sitting between 165-175lbs my best lift was 275 for 6. I did have great strength in my shoulders being able to do push presses for sets of 5-6 with 275. Now I can’t bench 135 for more than 4 or 5 on a good day and my overheads stay below the 100lbs mark. Is there any coming back from this or did it take too long for them to get to the root of the problem and the damage is now done? I’m fine with not being as strong as I was in my 20s and early 30s but I generally do powerlifting training and it it’s a huge ego killer, lol. I’ve switched up my training To try to limit the stress on my spine until I get the mri and see how bad it is. Any therapies or anything I should be pursuing through my doctor? Any help would be greatly appreciated.
@Jesse Shields, welcome to the StrongFirst forum.
I think your next step is the doctor - let us know what he/she has to say.
@ Jesse Shields, a couple of thoughts:
First and foremost stick with Dr's advice.
Common first steps are to avoid all loaded overhead work, dips and other shrugging movements. If recommended use some form of cervical traction/decompression to see what sort of relief if any it gets you. This did nothing for me, but some folks get a lot of relief.
NSAIDs are useless for the most part, don't bother.
The pain in your lower back is probably unrelated to the cervical issues, and some of your other symptoms might be unrelated as well.
Is there significant shrinkage of the muscle compared to the non-symptomatic side?
Whatever conclusion your Dr comes to once you get the MRI, if possible get a second opinion from a neurologist, even if your current doc is also a neurologist.
Explore the possibility your posture is part of the problem and if so address it. Almost certainly there are positive changes you can make if you can ID questionable posture habits. This includes how you sleep.
Rotational stretching helped me the most, consult w/ your Dr or PT to see this if this is contraindicated in your case. Loosening up the muscles around the neck and traps can make a big difference over time.
Whatever exercises you are cleared to do, get right on it. There is not a ton of research on this but exercise does appear to help restore function in partially impinged nerves. In my case I bumped it up a bit and followed more of a BB protocol with a lot of training to failure using submax loads, something I hadn't done for quite a few years prior.
Nobody can say what your final level of function might be restored to, assume it will be nearly 100% and train optimistically. I went from being in excruciating pain to 90+% restored, although I'm sure I could jack myself up very quickly if I stopped applying all the little correctives I've learned.
Listen to what your body is telling you - when my symptoms subsided enough to get back to training I still had to avoid some postures without taking additional steps - bent rows, pushups, other lifts where my head was tipped over unsupported I had to keep my chin up. Working a lot of overhead pressing back in led to more pain and stalled progress and had to be discontinued.
Be aware that some localized muscle pain that feels just like DOMS but persists for days or shows up unexpectedly could easily be from the impinged nerve. Again, posture and exercise selection are very important pieces of the puzzle. Be careful reintroducing exercises and keep tabs on how they are tolerated.
Really nice video that doesn't address specific exercises but gives a great run-down on the condition:
I don’t have any pain really just a ton of strength loss. I wouldn’t say my more damaged size is noticeably smaller either. I have good posture but have got to correct my sleeping posture for sure. I’ve been working at that and my neck does feel a bit better already. As far as the lower back pain, I don’t think that it’s got anything to do with the cerbical problems but I do think that if I have Degenerative disc disease in my neck I’ll have it elsewhere in my spine as well. I’ve been training and working as an reinforcing ironworker for 20 years plus so I know I’ve got issues all throughout my back. I think that because I have such a strong core I don’t feel how bad it is. Right now I’m still playing the waiting game so won’t know how bad it is for a few months I’m guessing. I don’t play any sports anymore so my life outside of my familly is the gym, fishing and hunting. Only one of those I can do 5-6 day a week year round so I hope I can get some strength back. I guess my main concern is that I will be told no more deadlifting or squatting because they’re my favorite lifts. I love cleans and anything overhead but I’ve taken. A huge step back and have only been doing seated overhead barbell with weight I can keep between a 10-15 rep range. Which with the strength loss is between 65-80lbs. For dumbbells I’ve just been doing light Arnold presses with 25lbs DBs. I appreciate the help and I will watch that video right away. Thanks
Every case is different to be sure. I have degenerative disks at C5/C6 and C6/C7 that actually shed bits, all the rest of my disks look great. I blame it on too much bench work doing fabrication by hand, but the Doc just shrugged - it could be from anything or just genetic - most often researching it, posture is a huge factor. I also do cutlery sharpening as a side job and had to correct my posture from that as well - way too much craning my head over detail work for many hours of the years.
When the symptoms subsided I went right back to pressing, trying to improve on the 4-5 repmax I could do pressing the 32kg. Made no progress and eventually swapped out for a totally different suite of exercises that eliminated overhead work entirely.
Went back after a few months of that and hit the 32 for 8 and maybe could have done more, and that on a day I'd already trained pretty hard. I actually hit the 36 for 2, a PR and that with absolutely no loaded overhead work for months. In my case, more direct overhead work was 100% making me weaker. YMMV
I'd be very surprised if they told you no more DL or Squat forever, maybe a layoff for a few weeks to establish some sort of baseline and reintroduce lifts gradually. I know it sucks, but you have to figure out for yourself what works and what doesn't. Using lifts that aggravate the impingement will make you weaker, so the first thing to do is find out what lifts are totally benign, which ones are borderline, and which ones need to be eliminated at least for the time being.
You might have to adopt more of a low bar backsquat, and with DL make extra effort to really keep those shoulders back, have to puzzle it out.
I wrote that a month or two ago.
I'll add this. I kind of keep track of how my left side is doing by testing my grip strength.
There's one thing I've noticed that is somewhat concerning. I seem to have good and bad days. Some days my left hand is almost equal to my right, but other days I'll get noticeably fewer reps on a gripper (maybe a 20-40% decrease, so not nearly as bad as when I was at my worst.) My left grip seems to fatigue faster than my right, as well.
I do know that the grip is a biomarker and can be an indicator of accumulated fatigue. But it also hints that my recovery is tenuous and some days my disc may be pinching my nerve and giving me short term loss of strength. I do not know if that's true. That's just my hypothesis.
I do my MacKenzie neck tuck thing regularly which I think helps.
I'm about 7 weeks in to recovery from a pinched nerve affecting my right arm. Index finger still numb but all pain has gone and I tentatively returned to the gym this week. As everyone on this thread has said, the loss of strength is alarming and I'm wondering how best to handle things now one arm is so much weaker than the other?
I was never a heavy lifter but for DB or machine press exercises for example, should my lifting weight with both arms be dictated by whatever my weak arm can handle and build weight slowly over months as the arm recovers? Or should I be lifting whatever each arm can handle individually?
For example: Hex press - left arm 20kg but right arm can only manage 8kg. Or should I just lift 8kg with both arms and feel unbalanced, look weird and not give the good arm any real workout?
I worked to my weak side for most stuff. Many pulling exercises the imbalance wasn't too bad, pushups about 15% difference. Overhead pressing by the time I took it back up was off about 15-20% on reps.
If the imbalance were larger I probably would have either avoided unilateral work entirely or trained them to capability.
Everyone should read this article. Good info on nerve regeneration. Peripheral Nerve Trauma: Mechanisms of Injury and Recovery
Sounds like we are in the same boat. I have a double herniation c5/6 c6/c7. It started with overhead dumbell press. 1 week later I rolled up a towel under my neck and fell asleep and hell broke lose the next day. Practically 2 weeks in bed. I had to keep my left arm overhead to keep the pressure off the root nerve which was radiating into shoulder, tricep and forearms. I am on my 5th week and in therapy gaining strength very slowly. Before the injury i could do 80 pushups and bench 335lbs. I have worked back from 0 pushups to maybe 10 but I stopped doing them and following my therapy instructions. I am doing tons of tricep and shoulder work bit the weakness freaks me out even though I have made some progress. I am just happy not to be in pain but now I want more and it is hard to be patient. I started doing dumbell bench presses and I am up to 30lbs with my left side. Most of the pain has left my arm and was told it should centralize back to the spine before going away. I do see that happening which is a good sign. I am also doing traction and trigger massages as well. I am encouraged my some of the posts here and would be happy with 90% recovery. Whatever that tricep muscle on the very top back is seems fried. Fried meaning very weak. 5 weeks in and from all the research I have read on some .gov site regarding nerve injuries level one such as pinched nerve takes 3 to 4 months and level 2 pinched nerve up to 1 year recovery. Nerves heal very slowly. Everyone should read this.
Peripheral Nerve Trauma: Mechanisms of Injury and Recovery
Please let me know how tou are progressing as it seems your injury was before mine.
I had my first episode Nov.2018. Zero pain but went to warm up on bench and could not lift the bar with my right arm. Freaked out and thought I had torn rotator. MRI showed bulging C6-C7. Went from 75 push-ups and 20 strict pull-ups to zero for each. Worked on stability and strength unilaterally. Focused on maintaining strength on left side and regaining on right. I’d say within 2 months all strength had returned.
Two weeks ago (~8 months later) I developed pain in the scapula, lat, and tricep. Visited my chiropractor and he adjusted my neck. I developed severe vertigo the next day and spent 2 days in bed. When i could finally walk around again, my level 6 pain was now a 9-10. Its finally lessened. Noticed today I had also lost about 50% strength again in my right arm. I feel like the neck adjustment worsened my symptoms but not sure.
I have a 2nd MRI scheduled to see what has changed in past 8 months. Doc telling me fusion is an option but I never seem to hear about full recovery. Getting a 2nd and 3rd opinion.
“Fortunately” now that I experience pain, I can tell what movements aggravate the issue. Here’s my takeaways so far...
My sleep posture seems to significantly affect pain.
Arm overhead seems to lessen pain.
Arm extended such as in a DB row increases if I don’t maintain neutral scapula position.
I think I may be whipping my neck back on jerk presses and snatches. Moving my head back (looking up) is painful.
Beginning to incorporate chin tuck exercises and gonna research McKenzie stretches.
I’m looking on the bright side that one week of rest has helped reduce pain to a tolerable level and I’m going to resume stability and mild strength training in a few days.
I want to beat this without surgery.
Forgot to mention...with my first episode, neck traction made an immediate improvement in strength. My PT tested with grip strength and arm extension as traction was applied. I bought a used Saunders traction off EBay and now use it nightly.
Sleep posture is a biggie, took a bit of experimentation to find what worked best for me - in my case on my side or on stomach w/ right arm over my head (posture that the chiro told me would make my neck worse). After that, my posture at work is huge.
I also found that when doing shrug movements I need to do them unilaterally, if I do conventional dips I have to use a real short ROM. I can do some overhead pressing, but a steady diet of it actually weakens me over time - ironically a strict OHP with packed scapula makes it worse. Overhead sandbag work with a bit of lumbar extension is much better tolerated.
I tried the Saunders unit when I first went symptomatic but it didn't do much for me. My mother in law has had cervical disk issues for many years, she used to use an upright traction unit, and slept w/ cervical collar but pretty sure she doesn't use any of those currently. I used to use a homemade cervical brace that was nothing more than a shaped piece of Kydex backed with some closed cell foam that I wrapped in a bandana and tied around my neck - braced from my jaw to my collarbone. I stopped using it, but it was a big help in realigning/staying aware of my posture at work.
Best of luck! I wouldn't want surgery either, but would get it if I were symptomatic enough to warrant it and prognosis was poor enough. They are slowly improving treatment for spinal complications all the time.
2nd and 3rd opinions and current MRI are important, the recurrence of symptoms could be from a piece of disk broken off which like as not will be reabsorbed over time. Hard to say as everyone's condition is a little different.
I am exactlty 2 months post peripheral nerve injury from a c5/c6 and c6/c7 pinched nerve.
The level 9 pain is all gone. I did traction, trigger massages and therapy which introdiced me back to light weights. Even though the pain is gone the muscle weakness on the injuried side is obvious. I finally started to go to the gym 1 week ago and my first time benching got up to 115lbs. Before the injury my max was about 330lbs. Pushups before injury was about 80. After injury it was 0. Currently I am up to 15. So I am making slow recovery but I know it is very early as nerve recovery and strength takes up to 4 months to 1 year. My mri showed 14mm herniations which is very large. No pain after 8 weeks ill take it for now.
I looked like a retard for weeks as my injuried side was compensation and the shoulder was 2 inches higher with my neck leaning to that side. All that has corrected itself as well. I will post updates on my strength recovery as i am sure others who.find this thread will want to know.
Last couple of weeks have been experiencing increasing discomfort in middle delt and bicep of right arm, and decreasing sensation in right index and middle finger, with measurable loss of strength in at-rest bicep. Once warmed up the right bicep feels pretty good and everything is functional, but symptoms have been increasing overall to point where pain is now spreading across right trap and neck as well. Probably another small piece of disk has come lose and will take some time to reabsorb.
Took a single 4mg tab of dexamethasone, prescribed to me last Summer while on vacation. I didn't take any at the time as I didn't want to use the full course and was unfamiliar with the side effects. Was on the road and didn't get very clear instructions for usage, and is a drug that has wide application for everything from skin issues to inflammation, to MS symptoms, so dosing and frequency seem to vary quite a bit depending.
Was pleasantly surprised to find it could be taken as needed and not in a full course dosing, so gave it a try. Aside from giving me a little bit of a headache it worked beautifully. Woke up symptom free.
Wouldn't want to be popping these on a regular, but is nice to have something in the bag that actually works. Stuff has a long list of nasty potential side-effects, but is a very potent anti-inflammatory for acute flare-ups.
Update on my pinched nerver. 2 herniations 14mm c/5-c6 and c6-c7.
I am 9 weeks post original injury. Was in bed or on the floor for first 3 weeks. Pain scale an 8-9 on 1-10. No pain free. I am going to gym every day and slowly increasing the weight. My fried triceps, shoulder and chest is showing some life. I can finally flex them. I massive loss of chest and triceps during the injury. I can now bench 140. My top bench on amy given day was 315 before injury and was able to do 80 pushups. I can do.about 20 pushups now. Keep on mind my pushups went to 0 with my arm almost useless. My biceps took no hits as my left biceps seems to be compensation some for the triceps and has increased in size. So its a slow process and its only 9 weeks post injury. I am only increasing my bench 2.5lbs every visit and still I think i am trying to progress too fast. However, I feel like a human being finally. No surgery here just traction, trigger massages, needling and time.
I will continue to update my progress.
My dog took me out at the top of a small flight of steps and I did a face plant on the concrete slab below and popped a vertebra in my neck and chewed up a disk a bit. I got over the initial pain in a few weeks but it left me with tingling hands on both sides.
I still can't sleep on my back or both my hands go numb and if I move my head forward too fast I get a jolt to both hands. I backed off the exercise for a few weeks because I struggled even getting my arms above my head but when the inflammation settled down it recovered quite well.
I can't do pullups with a neutral head position now or flares it up again, now I have to initiate the movement looking up at the bar and roll my head down to a neutral position as I move towards the bar. Other than that it's fine most of the time unless we get a sudden cold snap and then it flares up a bit.
Sleeping was a real problem for over year and I tried all sorts of pillows with mixed success. Now I just use a regular pillow and jam a wheat pack beneath the pillow in the space where your neck normally sags down and I sleep on my side with no problems.
Boy, am I glad I found this thread. I felt totally alone. My name is Ilya, I am from Israel, living in Europe.
So I am 30 years old, had a pinched nerve occurrence 8 weeks ago. Felt sudden neck pain one morning which I thought was just a pulled muscle and didn't put much importance on this, continued with weakness and tingling down the arm, pain along the arm, as well as spontaneous muscle contractions. Then when I arrived at the gym I realised my left side isn't nearly as strong as the right.
MRI showed herniation, specifically disc-osteophyte complex pressing left spinal nerve, C6-C7. All exercises involving triceps / pecs, went down by 50% of previous weights and reps. Doctors said that this is usually seen with older patients as part of degenerative processes, which made me feel even worse. As my loss of strength was not complete and pain manageable, surgery was not considered yet.
- 4 weeks in, after some PT, Chiropractor and rest, I was pain free. Went to the gym for the first time, and after the first short (40-50% of my weights) workout, I woke up next morning with the symptoms present all over again, like 4 weeks ago or worse.
I was so frustrated I didn't know what to do with myself.
- Went to another PT, which said that in my case chiropractor should not be contacted at all and that they will accept you in order to earn their money, but the manual manipulation with the condition may hurt more than help, especially with possible osteophyte/spurs. He gave me new PT exercises to do at home and 10 consecutive days of electro therapy + laser + ultrasound at his clinic.
- another 4 weeks in, Now again pain free and feel much better, with slight occasional discomfort in neck. Went to the gym a few times, psychologically unable to do Bench / isolated triceps exercises yet as I am afraid of a flare and those muscles feel extremely weak, I think I even am imagining non existent pain when training them. Can do around 30-35 push ups (was at about 80 before).
Every time after a gym session I feel a little discomfort, and once in a few days some tingling, but feel slowly more and more confident and trying to keep on with the PT exercises, and step-by-step practice of gym return, hope to get back to (nearly) my former self.
What helped me the most with my symptoms and confidence in gym exercises, was direct & indirect daily exercises of the small muscles of the neck. Stronger support and neck strength (small ones, not Trapezius) seem to highly alleviate the stress from the vertebrae and remove the pressure on the nerve, allowing it to stay un-pinched.
Hope you guys are doing better.
Only 4 weeks after an injury you should be doing very light weights. This is the best article I have come across regarding this.
Injuries to peripheral nerves are common in the general population. This includes prevalent conditions such as “pinched nerves” in the neck or back, caused by disc herniations, bone spurs or thickened ligaments, and carpal tunnel syndrome. When a nerve has been compressed of sufficient magnitude and duration, the usual transport up and down the nerve of various proteins and other substances may be blocked or slowed down, increasing the irritability of the nerve. Even slight nerve compression also reduces the blood flow to the nerve, which makes it more sensitive. Greater nerve compression can lead to cell death in the nerve, and subsequent re-growth, or regeneration of the nerve, after the nerve compression has been sufficiently relieved.
In cases of mild nerve injuries, function of the nerve may return within a few months, at which point the nerve irritability typically resolves, whereas in more severe cases, the regeneration process can take over a year.
Significant stress put on a paralyzed muscle through e.g. stretching or strengthening delays, and may even prevent full nerve recovery, and such treatment should not be started until the late stage of nerve regeneration, when progressive strength return can be seen. As a general rule, a muscle which has been weakened due to nerve compression should not be exercised until there is measurable return of muscle strength due to nerve regeneration, and there is minimal pain associated with the nerve injury.
A severely injured nerve may require many months before initiating any resistive exercise to the involved muscle, in order to allow for sufficient nerve healing. A less traumatized nerve may be able to tolerate light exercise within the first month.
If a nerve cannot handle the task of exercise, there may be increased pain, tingling or numbness, or even increased muscle weakness during or after the exercise. Therefore, such signs must be watched for when starting and progressing an exercise program.
When rehabilitating the neck and back, and there is remaining arm or leg tingling/numbness or residual arm or leg weakness, the muscles in the arm or leg that have been affected by the nerve injury should typically not be exercised with resistance or stretching early on. Focus should instead be put on exercising stabilizing muscles in the neck and back, in positions which provide plenty of room for the affected nerve, and to gently promote nerve mobility. With back injuries, even exercise in standing may be too much for the nerve to handle at first, whereas lying exercises can be tolerated well.
The recovering nerve can also handle lower intensity exercise better than with high intensity, so that exercises are performed with 25-30 repetitions or more, rather than 10-15 repetitions or less prior to onset of much fatigue. This can even apply to old severe nerve injuries, e.g. more than 1-2 years after the trauma, or decompressive surgery. Therefore, symptoms and muscle strength must always be measured, as the rehabilitation exercises are initiated and progressed.
This topic of how to proceed with appropriate exercise after spinal nerve roots or other peripheral nerves have been compressed or traumatized is in general poorly understood by many physical therapists and even physicians, and many clinicians fail to recognize that such nerves often need considerable time to regenerate.
If you know of anybody who has had these types of nerve injuries, it may be helpful if you forward this information to them.
Finally, I would like to wish you an enjoyable holiday season and good health into the New Year.
With best wishes,
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