Sunday, June 3, 2012

Simple shoulder help

Ok, so I was still a little mystified (albeit amazed) at how effective simply hanging from a bar for like 20 seconds multiple times a day is for my shoulder/neck pain.  One thing I've realized is that I've never really had a diagnosis for what's wrong with my shoulder.  I mean. I keep figuring out what muscles are tight (Scalenes, Sternocleidomastoid, etc.) and figured out some great stretches for them thanks to Kstar.

[Update 9/11/13: I'm not the only one who has blogged about how great this stretch is for undoing tight shoulders and rendering surgery unnecessary.  Here is the post about him coming across Dr. Kirsch, and here is a detailed explanation of his protocol that worked for him.]

[Update 4/20/14: OK so that guy who wrote those posts has since shut down his blog.  I've changed the links to the wayback machine and just for the sake of keeping the good stuff I've tacked on his protocol here at the end of my post.]

At first I thought it was simply from laxity in the supraspinatus from injuring my shoulder and then years of sleeping on it.  However, it seems like it's a little more complicated then that, or my self-diagnosis is completely wrong (nothing new in either case).  There were definitely some instability issues in my neck, which I've fixed through prolotherapy and sleeping with a soft neck brace.  However, there are still some issues, and they feel like they come from near the center of my back, like right between the shoulder blades.

Well, since hanging from a bar seems to help, I decided to investigate: 1) what shoulder issues does it treat, and 2) why does it treat said issues.

Here is the short answer, according to one website:
  1. Hanging from a bar helps with impingement syndrome and frozen shoulder.
  2.  "This exercise does a marvelous job of stretching all of the ligaments, muscles, and tendons surrounding your shoulder joints, along with many of the soft tissues that cross your shoulder joints but that travel a good distance away from your shoulders, like your biceps tendons, triceps tendons, latissimus dorsi tendons, and even the tendons of your front chest muscles"
For a much longer, in depth look at this I found a thread that is started by someone asking about Subacromial Decompression surgery.  A certain Dr. John Kirsch is a huge fan of this whole "brachiating" (You should check out his website here), and here is what he thinks:
When you hang, you are bending the acromion and stretching the coracoacromial ligament (CA arch). Then, when you do the full side lift weight lifting, the RC tendon will become thicker, more robust and healthier. Most hardly ever use their rotator cuff muscles and the tendons become thin and fragile.
After remodelling your own CA arch, there will be more room beneath the arch for the rotator cuff, bursa, etc.

I've never heard about the coracoacromial ligament before, but it seems to be fairly important, at least to Dr. Kirsch:
The CA arch is responsible for most of our shoulder troubles. It presses on the subacromial structures (rotator cuff, bursa, biceps tendon) and when contracted due to time and disuse, produces degenerative damage in these structures. By hanging from an overhead bar or similar support; and then doing forward, side and extension dumbbell weight lifting (palms forward or down) you can restore the health of the rotator cuff tendon and muscles. Each time you stretch the CA arch by hanging, you are making more room for the RC. Over time, the deformity of the acromion will remodel (Wolff's law), and the coracoacromial ligament will stretch becoming more compliant.

Dr. Kirch actually has a book out on this, "Shoulder Pain? The Solution & Prevention, Revised & Expanded".  I plan on buying it and giving it a look over, I don't think it's too long of a read.

I'm very, very interested to see how this plays out, if I actually do have shoulder impingement and if remodeling my CA arch will help out.  So far so good, my shoulder is feeling markedly better, and I'm really, really surprised.

Here's the guy who wrote the fight4inches blog:

Brachiating  which is essentially hanging from a pull-up bar like a monkey. Not my idea (see Part 1 of this blog). I try to hang daily for 3x rounds of max duration from a pull-up bar. I often start off w/ a supported hang to warm up the joint because it is painful with a cold start. The purpose of this activity is primarily focused on re-shaping your acromion (or re-flatten it) to create space in your shoulder capsule per your original design. What happened over time is that your bone (acromion) literally got bent out of shape, so you have to straighten it out. 
Shoulder Capsule Mobility – to really understand this, you’ll have to purchase the ultimate guide to resolving pain, preventing injury, and optimizing athletic performance and look up how to specifically do this. I’m a fan of the band assisted approach (not the Kettlebell). Basically, this protocol entails pushing the ball joint of your humerus way back into the shoulder capsule to it’s designed position. I do this after I brachiate – open up the physical joint and then shove the joint back, deep where it belongs. You have to do this for over 2-minutes to get the best results. 
Strength Training – finally, do exercise elements to build up your upper back and anterior deltoids. If you buy the references I outlined in these two blogs, then you have all you need to know. An additional exercise I do that is not prescribed is elevated feet ring rows w/ knuckles up. You can do ring rows w/out elevating your feet – but you won’t juice up your back to the same extent. So where is my Prescribed Shoulder Mobility Recovery WOD (one day I’ll post a video blog on this if there is demand): 
1. Warm-Up – Mobility – look up mobility WOD activities for your thoracic region of your back, lats, pecks, etc. You want to prep the muscles on your chest, back, sides that limit the full mobility of the shoulder joint. This takes about 10-mins to do properly. 
2. Warm-Up – literally Warm UP – do forward and backward small shoulder circles w/ arms fully extended to the side, palms up. I like to try to make my arms rotate behind my frontal plan. I do these in both directions until my shoulders are burning. Then do larger circles both direction until you feel your arms are ready to fall off. This is like 4-5 mins of work. Now your shoulder joint is properly juiced up for some good physical therapy. 
3. Shoulder Mobility Recovery WOD: 3 x Rounds for effort of:
Brachiate (max duration)
Shoulder Capsule Mobility (both Arms) – 2mins each arm
Strength Training Elements 
I recommend doing this a minimum of 4x a week. To date, I keep experience gradual improvements and went from not being able to do near anything upper body to now being able to row, deadlift (full effort), front squat (full effort), power cleans (lighter weights), OH Squat (lighter weights), etc. and continue to improve. I make a point of taking fish oil to help w/ the inflammation, but my shoulder continues to get healthy.  Once I’m 100% healthly – I’ll outline a detailed post on a very specific approach.  I feel comfortable that I’m on azimuth – we’ll see how it goes and I hope it helps any other weenie in pain.  Even if you aren’t in pain, assess your shoulders and make sure you have full mobility – otherwise, if you strength train, you are an injury waiting to happen.


Jennifer Lynch said...

Hi Adam -- I stumbled upon your blog while doing research for my own shoulder. I've been reading about hanging to help alleviate shoulder pain. I'm on day 3 of hanging. I'm wondering what kind of success you've had...


Adam said...

It helped out a lot, for the first week or so I felt some pretty intense burning going on in my neck as the adhesions in my muscles were being stretched apart. Also, what used to take my massage therapist 30+ min now only takes like five, thanks to the fact my muscles are no longer wound up really tight. After the first week I stopped getting that burning, everything seems to be put back to rights. I still stretch out like once a week, but I seemed to have fixed whatever it was that was causing the tightness.

Jennifer Lynch said...

Thanks for the response. I'm glad you're doing better. I am hopeful -- Dr. Kirsch seems to swear by this treatment. I've tried many many things over the past 4 months, and have had no improvement. Maybe this will be the solution...


Adam said...

Hope it helps! Just wondering do you feel anything going on when you are on he bar? It took about 20 seconds until things started to unwind for me, then another 30 or so before the pain went away.

Jennifer Lynch said...

No, I don't feel shoulder discomfort while hanging. However it's not exactly comfortable otherwise -- it's kind of hard to breathe! I can already hang much longer on day 3 than I could on day 1...