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Kettlebell No overhead work...What to do now?

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Tom0Blom0

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So I've had a pretty long injury journey that has been documented in various spots here, but I'll save you the hassle and summarize quickly. I had been doing S&S since september 2018 and doing well until April of this year when I had some pain in my left arm/elbow. Basically what I have found is I have Thoracic Outlet Syndrome (TOS) that led to some Ulnar Nerve Compression in my left arm. I had an MRI that revealed no issues with my neck, thankfully. Problem is, I have no idea what to do now regarding fitness. I asked both my ortho and my OT what I could do/avoid and they were both a little less than helpful. The ortho said to avoid "overhead work", which I took to mean TGUs being out and my OT said "if it hurts, don't do it." Wonderful. I had been really doing well with S&S. I was a fairly inactive fella before I started (33 at the time, now 34. I was about 230, very sedentary, ate crappy, 5'11, ) now I'm 34, 208, eating mostly a kinda whole 30-ish kinda thing (maybe Paleo?) I was working out at least 4-5 days a week up until last week when I saw the doctor again for my MRI results(at least doing yoga after the injury), still 5'11.

I guess I'm just looking for some additional guidance. I did not feel like I was getting a lot of support from the professionals I saw. Clearly overhead work is out and I have OT stuff to work on to improve things to avoid issues in the future. I'm wondering though what I can do instead of S&S, or to supplement S&S now that the TGU are out? Should I be doing chest and back work to strengthen those areas? Are my shoulders going to suffer significantly as a result of no overhead work? Anyone else have experience with TOS? Should I not be doing anything with weights? I plan to push a little more when I see by OT on Friday but in the meantime I'm hoping the folks here can provide some additional insight.
 
I avoid overhead work for different reasons (degenerative cervical disks) but have been able to work around it with good results.

You're on the right track:
Tom0Blom0 said:
Should I be doing chest and back work to strengthen those areas? Are my shoulders going to suffer significantly as a result of no overhead work?
Click to expand...

Horizontal push/pull will go a long way toward keeping your shoulders in good shape along with everything else. Supplement it with some lateral shoulder work if not contraindicated and you'll be covered pretty well.

You may find it helpful to branch out from KBs and include some bodyweight pushups and rows (1H or 2H) with whatever weight is appropriate. One arm PUs are a great core/upper body exercise, and there are tons of lunge and squat variations to choose from.

I would still test overhead work from time to time unless you are certain it is causing symptoms.
 
Hey Tom, I had this years ago, the most useful thing I did was shoulder dislocates with a band or with a strap. The other thing was to take a break from sleeping on that shoulder. Overhead work was not limited and in fact my bet (disclaimer: I am not your ortho under a false name trying to trick you) is that passive hangs would probably help.
 
Were you referred to the OT because of the ulnar nerve compression? If so, that would mean you could also have issues with either the elbow or even the wrist. working with heavier loads will aggravate this. TOS can sometimes be a broad diagnosis that generally means compression of the neuro-vascular bundle (your nerves and blood vessels) that causes radiating symptoms down the arm. Typically in a PT setting, we will see an elevated and hypomobile 1st rib, restrictions in the pectoral muscles, poor thoracic extension mobility, limited scapular mobility...etc. Generally these can all result in aggravated symptoms with overhead work.

I'd be very interested to hear what the OT is thinking, but I would definitely heed the advice by the ortho and the OT.
 
Steve A said:
Hey Tom, I had this years ago, the most useful thing I did was shoulder dislocates with a band or with a strap. The other thing was to take a break from sleeping on that shoulder. Overhead work was not limited and in fact my bet (disclaimer: I am not your ortho under a false name trying to trick you) is that passive hangs would probably help.
Click to expand...
I actually did these for a while when I first got injured before I had the MRI. Just trying to stretch things out. It did feel like it was helping. When I was younger I did more pull-ups and did not recall having a lot of issues, but I have had ulnar nerve fare ups in the past, so who knows. I also play guitar and have generally crappy posture so it is hard to say what is causal factor here. I appreciate the post!
 
JamesPTA said:
Were you referred to the OT because of the ulnar nerve compression? If so, that would mean you could also have issues with either the elbow or even the wrist. working with heavier loads will aggravate this. TOS can sometimes be a broad diagnosis that generally means compression of the neuro-vascular bundle (your nerves and blood vessels) that causes radiating symptoms down the arm. Typically in a PT setting, we will see an elevated and hypomobile 1st rib, restrictions in the pectoral muscles, poor thoracic extension mobility, limited scapular mobility...etc. Generally these can all result in aggravated symptoms with overhead work.

I'd be very interested to hear what the OT is thinking, but I would definitely heed the advice by the ortho and the OT.
Click to expand...
Initially it was for hand/elbow/nerve stuff (that was really where I noticed it the most first), now it is for more scapular/thoracic stuff (the pain/discomfort persists more so in my shoulder, though I still occasionally have discomfort in my elbow/upper arm - but that suggests the problem is upstream they say). She said my 1st rib seemed fine. She has me doing a w-stretch with a band, and some other stretch with a towel under my butt that goes over my shoulder and I do some stuff with my head looking up and down. I can look at the handout she provided and give you the name when I get home. I also have been doing corner stretches per her recommendations pretty regularly.

I'm honestly not trying to get into extremely heavy load stuff. I'm not looking to get ripped. I just want to be healthy, ya know? Strong would be great, but I've never been a competitive athlete and I don't know that starting at 34 is the time to do it, lol. I have a 24kg kettlebell I'd like to be able to swing again. 1-arm swings would be great but I'm not trying to push it. Push ups and pull ups would be great as well, but I have a feeling that my ortho would frown upon the pull ups for sure. Primarily just looking for resources that can help with the limitations I have given the issues related to TOS. I appreciate your input!
 
North Coast Miller said:
I avoid overhead work for different reasons (degenerative cervical disks) but have been able to work around it with good results.

You're on the right track:


Horizontal push/pull will go a long way toward keeping your shoulders in good shape along with everything else. Supplement it with some lateral shoulder work if not contraindicated and you'll be covered pretty well.

You may find it helpful to branch out from KBs and include some bodyweight pushups and rows (1H or 2H) with whatever weight is appropriate. One arm PUs are a great core/upper body exercise, and there are tons of lunge and squat variations to choose from.

I would still test overhead work from time to time unless you are certain it is causing symptoms.
Click to expand...
Thanks very much! This is extremely helpful. I'll look into this stuff. I was definitely looking into adding pushups into some swings to get going and knock the rust off a bit. Start going from there. I think I might also keep going with some squats using the KBs I have.
 
I’m just an average Joe with no professional knowledge. I once had been told by one specialist not to ever go beyond 90 degree with my knee bend due to knee problems that kept me from doing any sport for two years. I had wasted a decade not challenging that. Thanks to SF I’m know now it’s ridiculous and now I comfortably squat to bottom.

I think you should:
- find a SFG with medical background and rehabbing experience to help you dig into the details and explore potential solutions,
- then take the time to further study that with comfortable light weights
- try bottom up presses
- try lightweight TGU ‘Resilient’ style (search topic on the forum)
- read PTTPP about Valentin Dikul for inspiration

Good luck and don’t give up on overhead work just yet! Keep us updated.
 
@Tom0Blom0
Good advice given thus far. Your Ortho.... are they Sports Medicine specialists? Many are not. My council to you would be to find the best Sports Medicine doctor you can find along with the best physiotherapist you can find. (again a PT that specializes in athletes)
 
Tom0Blom0 said:
Initially it was for hand/elbow/nerve stuff (that was really where I noticed it the most first), now it is for more scapular/thoracic stuff (the pain/discomfort persists more so in my shoulder, though I still occasionally have discomfort in my elbow/upper arm - but that suggests the problem is upstream they say). She said my 1st rib seemed fine. She has me doing a w-stretch with a band, and some other stretch with a towel under my butt that goes over my shoulder and I do some stuff with my head looking up and down. I can look at the handout she provided and give you the name when I get home. I also have been doing corner stretches per her recommendations pretty regularly.

I'm honestly not trying to get into extremely heavy load stuff. I'm not looking to get ripped. I just want to be healthy, ya know? Strong would be great, but I've never been a competitive athlete and I don't know that starting at 34 is the time to do it, lol. I have a 24kg kettlebell I'd like to be able to swing again. 1-arm swings would be great but I'm not trying to push it. Push ups and pull ups would be great as well, but I have a feeling that my ortho would frown upon the pull ups for sure. Primarily just looking for resources that can help with the limitations I have given the issues related to TOS. I appreciate your input!
Click to expand...

34 you old man...I'll be 45 next month
 
I get ulnar nerve issues as well when doing tgu or things like pullups, for whatever reason clean and jerk or military press doesn’t bother me. For that reason i have given up s&s for now, but i will point you to check out pavels new book you can read about here New Book

It says its swings and pushups so this may be something that you could do.
 
offwidth said:
@Tom0Blom0
Good advice given thus far. Your Ortho.... are they Sports Medicine specialists? Many are not. My council to you would be to find the best Sports Medicine doctor you can find along with the best physiotherapist you can find. (again a PT that specializes in athletes)
Click to expand...

The ortho is definitely a sports medicine guy. The OT I think is as well. The PT i previously worked with was not at all. I'm not currently working with a PT but when I saw the OT last week they had a PT stick some needles in my trapezius before doing some work and shock them for about 5 minutes. I'm not sure it was helpful.
 
A
Provx said:
I get ulnar nerve issues as well when doing tgu or things like pullups, for whatever reason clean and jerk or military press doesn’t bother me. For that reason i have given up s&s for now, but i will point you to check out pavels new book you can read about here New Book

It says its swings and pushups so this may be something that you could do.
Click to expand...
Awesome, that might be perfect. And it comes out in just a few days. Thanks for the heads up!
 
Tom0Blom0 said:
The ortho is definitely a sports medicine guy. The OT I think is as well. The PT i previously worked with was not at all. I'm not currently working with a PT but when I saw the OT last week they had a PT stick some needles in my trapezius before doing some work and shock them for about 5 minutes. I'm not sure it was helpful.
Click to expand...


That's too bad to hear. I like all the suggestions so far especially with the new book release and the Swing/Push up program. One of the suggestions I was going to make if you're keeping with S&S is attempt partial get ups. I would certainly think that if you keep your grip loose enough with the swings, that you will be just fine!
 
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Tom0Blom0 said:
So I've had a pretty long injury journey that has been documented in various spots here, but I'll save you the hassle and summarize quickly. I had been doing S&S since september 2018 and doing well until April of this year when I had some pain in my left arm/elbow. Basically what I have found is I have Thoracic Outlet Syndrome (TOS) that led to some Ulnar Nerve Compression in my left arm. I had an MRI that revealed no issues with my neck, thankfully. Problem is, I have no idea what to do now regarding fitness. I asked both my ortho and my OT what I could do/avoid and they were both a little less than helpful. The ortho said to avoid "overhead work", which I took to mean TGUs being out and my OT said "if it hurts, don't do it." Wonderful. I had been really doing well with S&S. I was a fairly inactive fella before I started (33 at the time, now 34. I was about 230, very sedentary, ate crappy, 5'11, ) now I'm 34, 208, eating mostly a kinda whole 30-ish kinda thing (maybe Paleo?) I was working out at least 4-5 days a week up until last week when I saw the doctor again for my MRI results(at least doing yoga after the injury), still 5'11.

I guess I'm just looking for some additional guidance. I did not feel like I was getting a lot of support from the professionals I saw. Clearly overhead work is out and I have OT stuff to work on to improve things to avoid issues in the future. I'm wondering though what I can do instead of S&S, or to supplement S&S now that the TGU are out? Should I be doing chest and back work to strengthen those areas? Are my shoulders going to suffer significantly as a result of no overhead work? Anyone else have experience with TOS? Should I not be doing anything with weights? I plan to push a little more when I see by OT on Friday but in the meantime I'm hoping the folks here can provide some additional insight.
Click to expand...
I'm not your doctor so check with him/her first, but dips, pushups, bodyweight rows (need gymnastics rings or TRX straps for these) are all good. If you buy the little pushup handles these keep you training the kind of pushing grip you need for TGUs. I take it you can still do the swings. TGUs have an element of squatting too, so it would be good to do more goblet squats to compensate.

  • dips
  • pushups
  • bodyweight rows
  • N-sits and L-sits on the parallell bars
  • goblet squats

If you have no equipment whatsoever, do plenty of pushups, and work towards the 1 arm pushup and ideally one arm one leg pushup.
 
When I dislocated my shoulder, I avoided any overhead work for 4 months. For pushing my main moves were pushups and banded pushups, for pulls rows and band rows. I could do swings (1 hand) relatively briefly after the injury and it thought me to really drive with the hips and use the arms only as a hook (otherwise it would have gotten painful). I did lots of crawling also. In fact I took one week completely off after the injury and then started crawling, it was the first exercise I did.
This might not work for everyone but maybe gives you an idea. Just start light and see what you can take.
 
My shoulders are both very sore, probably from embarking on my new bodyweight training emphasis - most of the moves put pressure on the shoulder from various angles. I'm considering taking this week off training entirely and just walking.
 
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