Needles, Needles, Needles!!!

Ok so yesterday I had an arthogram on my shoulder. Right now, my shoulder is feeling… different, and not in a good way. Maybe a little looser in the socket? It’s like the arthogram awoke something wrong in my shoulder, now it clicks every once in a while when it didn’t before. The joint is super sore in the back area near the lat, completely opposite of where the injection site was. I cannot wait to see what the results will tell.

So I got a big injection yesterday, and today for my groin I tried dry needling for the first time.  Dry needling is similar to acupuncture, except they just stick the needles where the knots are.  Going in my hip/groin was feeling better than it ever has, so I was a little worried I was just wasting my time.  That turned out to be a needless concern.  When he worked on my groin it caused all kinds of… sensations. Like it felt kind of like a cramp, kind of like a shock of electricity. It was also an extremely specific like it was just a single strand of pain, the diameter of a iPhone connector cable, shooting up from my knee to my hip.  Highly foreign, and highly uncomfortable.  The PT told me that the sensations indicate that the procedure is being effective.  If that's the case I really needed this.

Afterwards it still felt like there were needles in me, but when the PT tested my range of motion it was pretty ridiculous how much more I could open my leg.  It still feels... strange, but I am to keep stretching it and hopefully it will get a whole lot better.

I also got my allergy injections today, so there’s another case of me being stuck by a needle.

Also, if this shoulder thing proves to be a torn labrum, I’m probably going to go the route of prolotherapy again.  That, as you know, means even more needles.  I wish I were more comfortable around them, but even if you’ve been stuck as often as I have, it’s still no fun. But if it makes the pain go away, then I’m all for it.

Another Labral tear????

Well, I finally saw someone to figure out what is wrong with my shoulder.  …I don’t know why, but I feel like I’ve seen many, many Dr.’s about my shoulder. But as I sit here and think about it, I am not so sure.  So I saw a PA today and we did all kinds of tests.  After passing quite a few, he then gave me one where I had to resist pressure with both arms.  My right arm resisted, and my left arm went straight down. Like, I couldn’t muster any strength at all.  “Now we’re getting somewhere.” He tried a couple more tests, all of which I failed.

He told me these all point to having some damage to the labrum in the shoulder.

Really?  Really? Another laberal tear???

We are going to confirm with an MRI with arthogram.  It was funny, having the PA explain to me what the labrum is as well as an arthogram. …Sometimes I wish I wasn’t so familiar with this stuff.

I have no idea if this comes from my time with crossfit and its dangerous kipping pull ups, or it could have come from wrestling or whatever. This kind of damage can happen slowly over time, and I think that is what happened to me. Whatever the case, I am looking forward to getting the MRI and following that a real diagnosis.

Interestingly enough, I might decide to go back to Dr. Hauser for more prolo, this time on the shoulder. I’m pretty darn sure the situation isn’t dire enough to warrant surgery, at least not surgery without trying prolotherapy first. We’ll see how this works out.

I just want to know what is going on, so I can start fixing it.

Starting Strength Update.

Not much to report, all is quiet on the home front.  I’m still doing starting strength, and so far I’m still seeing gains, except for the press.  It’s been eight  weeks, and here were my first work set numbers:

Squat: 135

Press: 70
Bench: 115

Deadlift: 185

And here are they now:

Squat: 235

Press: 110 (kind of, can only get three reps of this)

Bench: 160

Deadlift: 235 (as of tomorrow, I’m pretty damn sure I’ve got this one)

So in two months my Squat has gone up 100#s, Press is 40#, and Bench has gone up 45#.  I’ve stalled twice with the press, so I think it’s time to switch it up to 5/3/1 for the press while I continue to see linear gains with everything else.  I was originally only upping my deadlift weight by 5#s, but as soon as I realized that’s only 5#s a week I went to 10#s.  Still, I’m going to start squatting more than I’m deadlifting, and that just doesn’t feel right.

...Honestly, from this experience, I think it would be wise for one to do Starting strength and then do crossfit, get the strength first, then do the conditioning.

I’m thinking of abandoning the intermittent fasting for now.  I’ve only gained 6 pounds since the beginning of all of this, and I think most of that was from this past weekend when I was in dallas and just pigged out all the time.  However, I just got some protein powder in the mail and will add that to the mix.  If I don’t gain weight while on IF and the shakes, I’ll just drop IF all together and then when I’ve put on some pounds (not sure what my goal is right now) I’ll get back onto IF and lose the fat.  Most of the IF testimonials show guys getting ripped, but none of them really look bigger (although they are stronger).

My hip is doing ok with all of this.  When I was testing out the front squat over two months ago I felt something… disagree with the movement.  Now I’m feeling tightness/pain in my psoas and adductors.  Although this is a bit of a step back, the discomfort/pain has not continued to get worse so I don’t think I should back off of squatting.  After all, I was back squatting back in Barrington and everything was fine.  I am also really, really looking forward to seeing Dr. Hauser with the intention of checking out my hip with regards to internal rotation.  I really believe that will be fixed, and I will eventually have a completely healed labrum.  It will be awesome.

However, I know that for probably about two weeks after I see Dr. Hauser I shouldn’t really push the hip to let it heal.  So during the Christmas holidays I will be doing leg curls/extensions and bench and pull ups, maaaaybe deadlifts.  We’ll see how I respond.

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): 

Pre-game:
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.

Tweet

Adam's Gym, Part Two

Here's a real quick thing to add to the client intake procedure for my imaginary gym.  I think it's something that all gyms, especially crossfit gyms, should do when they get a new client.  It's simple, easy to do, and can prevent a potentially disastrous result.  All it is, is a blood pressure test.  That's it.

If you take someone with hypertension or pre-hypertension and make them try a crossfit workout, you're just asking for trouble.  Let's say that you have high blood pressure, and then show up for your first free/demo WOD.  You start hammering through it, and your already high blood pressure is going to go up even further, not something you want.

The thing that makes hypertension so dangerous is that it's so hard to spot without a blood pressure test.

Thus, when you have your new clients filling out forms, give them a blood pressure test as well.  It very well may save a life.

For more about the dangers of strenuous exercise with hypertension check out these links:
http://www.livestrong.com/article/384446-is-it-safe-to-exercise-with-high-blood-pressure/
http://www.sparkpeople.com/resource/health_articles.asp?id=701

And an article from Crossfit Santa Cruz:
http://www.crossfitsantacruz.com/crossfit_santa_cruz/feeling-faint.html

Adam's Gym, part one

So while I’m waiting for the day when I can get back to Crossfitting (which is starting to feel like waiting for the rapture), I’ve been using all this free time to start dreaming of my own box.  I don’t think I’ll ever open one up, it’s just not for me. But it’s a cool thought experiment and it keeps me entertained.  So what is Adam’s Dream Crossfit Gym like?  Well, I can tell you that I don’t really think about the equipment or the space, but I think about what the programming is like.  Programming is really what separates the boxes where people get hurt from the boxes where people get stronger.

So what’s in my programming?  I think it’s best to start off with what isn’t in it.  These moves will never show up in my WODs.  I’ll make special exceptions for those looking to compete, but even then the clients will be exposed to them like skill work and will rarely have them incorporated in conditioners.

1. Kipping pull ups: Essentially, they're nothing but trouble. If you really want to get better at kipping pullups try working on strict pull ups, like beast modal did.  Hell, kipping is one of the last things Drywall makes fun of.  You don't need it. Period. Unless you want your clients to get SLAP tears.
2. Sumo Deadlift High Pull (SDHP): Perhaps the second most dangerous exercise in crossfit.  It's ok if done with perfect form, but as soon as you get tired and form goes to crap (which it will), then you are asking for a supraspinatus impingement.  It's not needed, there are a lot better exercises out there.
3. High Rep Box Jumps: Again, there's a high risk of injury here.  Beast Modal brought it to my attention here. If you want to work the plyometric part of the box jump, just do double unders correctly.
4. High rep Oly lifts:  I probably won't have them at all in the conditioning section of a workout.  When you're doing a conditioner, form will degrade and when you do oly lifts with poor form you're asking for an injury.
5. Muscle ups: I'm kind of eh about keeping these out.  I do like them as a goal, Lord knows when I got my first one it was the happiest day of my life.

Another thing is introducing people to new movements, it will be gradual.  I see a lot of boxes just throw new client into the deep end and see if they swim.  Thing is, they’re definitely being set up to drown, so I’ve been coming up with ways to ease them into the water.

1. For one, I would follow nicki violetti’s on ramp program.  I’ve read over some of her stuff and philosophically we’re pretty much the same.  In a nut shell, the emphasis is on technique and not speed or weight.
2. For one, I’m not going to automatically sub in 3 or 4 reps of low-skill exercise for 1 rep of high skill exercise.. I’ve talked about this earlier, but when a new client comes in you don’t need to do even more stuff to kick their ass.  If they can’t do 10 single rope jumps in a row I’m sure as hell not making them do 150 of them when the WOD “Rx’d” prescribes 50 double unders.  In my gym you won’t even be allowed to even start doing double unders in WODs until you’re able to hit 100 single unders.  Boring?  Possibly, but I want to set up nice little attainable goals before you go for the big stuff.
3. Ring work is not going to be happen until you can show that you’ve mastered bar work.  I got this idea from this Grayskull’s post, I don’t care if we have bands to make you lighter, if you’re not used to doing dips of any sort I’m not going to overwork those shoulder stabilizers and get yourself hurt.  First thing’s first.  If you want to start doing ring dips, then you’re going to have to show me you can do 20 dips on the bars before you can try.

There are other things that I’ve been thinking about, but I think I’ll just keep this a running segment of “Adam’s Gym”.

An Omnivore's Morals

Today the family guinea pig, Larry, died.  This morning he wasn’t eating, and when he tried to move around it was apparent he had suffered a stroke of some sort.  Although he wasn’t making any noise like he was in pain, he had lost the ability to eat.  We were going to take him to the vet to be put to sleep, but before that happened he died.

Santa Larry for Xmas

This has been hard for me.  When I first met Larry I thought very little of the rat.  He always bit my finger mistaking it for some fruit or something.  Even drew blood once.  But in his twilight years he settled down some, and suddenly, like a switch went off, I liked him.  I liked him a lot.  Multiple times a day I would take him out of his cage to hold him and pet his little head, hearing him purr and squeak.  I found it calming.

I knew his time was fast approaching, he had lost a lot of weight and like I said he was a lot less energetic.  Knowing my time with him was short, I tried to make an effort to make sure his last months were good months, giving him a cherry tomato or a blueberry every day.

Anyways, right after I was told Larry was on his way I really didn’t know what to do, so I decided to make lunch before heading to the vet.  I made chicken salad, my specialty. It’s paleo awesomeness, canned chicken, homemade paleo mayo, even has bacon.  After breaking up the bacon into crumbles I licked my fingers and, while staring at Larry’s cage, tearing up because I’m thinking about how much he meant to me, I thought to myself, ‘damn this bacon is delicious.’

That, in a nutshell, is the conundrum I faced.  How can I mourn the life lost of one animal while simultaneously enjoying the tasty rendered fat of another?

“Am I a hypocrite?”

“Am I an uncaring predator?”

“Am I supposed to be, gasp, a vegan?”

I think, nay hope, that the answer to all three is “no”.

I’ve always thought that it is my duty to myself and the world to be the happiest I could be.  This world doesn’t have enough people who are self-actualized.  And for me to reach self-attainment, for me, is to be as healthy as can be.  That means strong and fast.  And I simply cannot do that on a vegan diet.  The human body was designed for meat consumption. This is just the way things have to be.  Tigers need to kill gazelles to survive, Pythons need capybaras to live. And so do humans.  That’s just how I feel (feel free to enlighten me in the comments section if you disagree).

Death is a part of life, and I owe it from all those animals I have depended upon for sustenance to live the best life I can possibly live.  And while I believe meat eating is necessary, I don’t think animal suffering is.  That is one thing that I know we as humans have control over.  That is one reason why I always try to buy my meat from local places where I know the animal has led a good life and was humanely killed.  It is also another reason why I try to avoid Dairy and eggs.  Look, Larry would viciously grab a cherry tomato out of my hand and run back to his little house to snack on it. That’s just who he was.  And if he were capable of it, I think he would understand my need to eat meat.  That’s just who I am.  And to deny myself what makes me happy/healthy wouldn’t really change the world, I think it would just make it a sadder place.

Forgive me writing about this stuff is not easy, these subject matters are very murky to me.  But I don’t think I’m a hypocrite, I’m just a person who accepts for me to truly live other animals must die, yet I am still allowed to form bonds with creatures that I don’t deem a food source.  I also don’t think I’m uncaring, I just accept the fact that all life must come to an end one way or another, and an omnivore eating meat is about as natural as can be.  And I really don’t think I’m supposed to be a vegan.  It just seems way to unhealthy for me to be happy.

I do not write this as an article condemning others who have chosen different paths, this is just how I, personally, see life.  Larry, you will be missed.

hip is getting better!

Met with Bobby yesterday, and he had some pretty awesome news

1.       The pectineus did not feel damaged.  It’s a stabilizer that is being made super tight, like the psoas was, to protect the hip joint.  I think I’ve always felt pain there, there have been occasions when I thought there was something wrong with a hip adductor.  I just didn’t really pay attention to it because my psoas was stealing the show being insanely tight.  Which leads me to my next point…
2.       My psoas was tight, but nothing like what it was three weeks ago.  When he worked on the muscle it didn’t put up a fight, it released fairly easily.  This is fantastic news, progress is being made!

I see Dr. Hauser this Monday for another treatment, and I have to say I’m super excited.  I never thought I’d look forward to having 60cc of sodium morrhuate injected into my hip through 60 injections at once, but that is the case.  The pain is temporary, which is way better then experiencing pain ALL THE TIME.

The next step is my shoulder.  I still have a lot of tightness in my scalenes that I work on constantly.  Bobby worked on them and there were a good ten or so knots in my neck that he had to work through.  On the ride home I felt more comfortable than I had in a long, long time.  My neck and tricep muscles are tightening up in order to protect my shoulder joint (specifically the Acromioclavicular joint, otherwise known as the AC joint).  I believe what is wrong with my shoulder joint is that rotator cuff injury I had four years ago when I just started crossfit, combined with sleeping on my side for years, which may have caused some weakness and laxity. 

How am I guessing this?  Back in June last year Bobby figured out that it was sleeping on my side that was causing all of my shoulder pain.  So I already know that sleeping on my side helped cause this situation and I have an injury to my supraspinatus.  Then I read this paragraph on Dr. Hauser’s website (excerpt from here):

The supraspinatus tendon often refers pain to the back of the shoulder. Sleeping on the shoulder causes a pinching of the rotator cuff muscles and can lead to rotator cuff weakness. There are cases where the cause of the rotator cuff tendon laxity was due to years of sleeping on the shoulder.

…This is exactly my situation, and Dr. Hauser seems to be once again promising a cure.  I told myself that I would wait until after prolotherapy proves to cure my hip to start working on my shoulder, but now that I’m seeing results I’m itching to end this shoulder pain as well.

FAI/labrum tear does not have to equal surgery!

So I just got a question from a follower from Denmark asking how I'm coping post surgery.  Maybe there's a bit of a language barrier, but maybe not and I haven't been that clear.

So let me clarify the record.

Two years ago I was diagnosed with FAI (cam and pincer type) and was told I may have a small tear in my labrum as well.

Incidentally I learned I had tight hip capsules.

I started seeing a massage therapist while doing exercises to treat the hip on a regular basis to release the hip muscles, and it starts to render me pain free.

Fast forward to August last year and I seemed to make the hip worse in an Olympic lifting competition.

I go get another MRI to see what's going on.  In the report it comments that my femur heads are nice an smooth, nowhere does it mention that there is an impingement.  It seems that my impingement has gone away.

I still have a laberal tear though (which seems to be the root cause of the pain), so I start seeing a Dr Hauser, a prolotherpist, and I seem to be progressing nicely.

Nowhere in there did I get surgery.  For me, surgery is not the answer for a hip impingement.  An impingement is the result of poor mobility, if you fix the impingement it will just come back because you still have the mobility issues.  Moreover, even if the surgery fixes the underlying issues it may not leave you pain free.  I'm willing to bet good money that the large majority of people who have pain and impingement actually have muscular pain and not joint pain.  If you fix the impingement, the muscles are still going to be too tight.  After months or years of learning how to be tight (and painful), the muscle is going to take a lot of attention to make it release and stop hurting.  If you go online and read people's blogs who just have the surgery, it just doesn't seem to work.  Even if you have multiple surgeries (like five of them).  Surgery is at best an incomplete solution.

First fix the mobility issue, the body will take care of the extra bone growth on its own (mine did).  If you already have a tear in the labrum, then try prolotherpy before surgery.  Prolo seems to be largely dependent on the skill of the administrator.  For example, the "expert" in Alexandria said he couldn't help me, but lo and behold I'm getting help from Dr. Hauser and it seems to be working.

My point with all of this is surgery is not the only answer.  Orthopods think it's the only answer because that's all they know.  They don't know anything about massage therapy or PRP treatments or anything else.  They just do surgery, and that's it.  So if you ask an Orthopedic surgeon for help of course all they are going to recommend is surgery.  But there are other ways, I'm a prime example.

[Edit 7/8/13: I am now seeing a PT who does dry needling, and it is doing wonders for the last remaining bits of pain. I highly recommend you find someone who does dry needling early on in your search for pain relief.]

Has my FAI gone away???

The fact that Dr. Hauser couldn't detect any impingement has really got me thinking, is it actually gone?  I really need to check with the results from the MRI I had a couple of months ago to see if my cam and pincer impingements are gone.  If this is the case, then I'm proof positive of the importance of mobility work.  I always wondered if the extra bone growth would go away on its own.  I mean, it's no longer needed because the femur is no longer banging into the hip socket, so it could go away.  On the other hand, it would seem odd that the extra bone would realize it's no longer needed and would go away.

...I will call the doctor's office later today and see if they could help me out on this one, since I don't have the images for myself.

Met with Dr. Hauser

The meeting was... interesting, to say the least.  He did a few, quick tests and felt that I really didn't have an impingement of the hip (this would kind of make sense since I've been working on my stretching my hip capsules for almost two years to the day now.), but he definitely felt some instability in the hip joint as well as that laberal tear.  This is almost completely opposite of what the PRP Dr Wager diagnosed like two years ago (no laberal tear, but FAI). Perhaps all the stretching and stuff has made the impingement a non-issue, that would definitely be ideal as well as the hope of getting all those massages. 

He told me that he felt he could help, and if I wanted to he could do a procedure in like 30 minutes.  ...He gave me the option of taking some painkillers before the procedure, as I will get poked by a needle 30+ times.  That is a ridiculous amount of needle, so I felt I would be best served by some vicodin.  However, I have a lot of work to do, and I can't really afford to take today off so instead I scheduled an appointemnt for the 23rd.

There is one thing that really, really bummed me out though, and that's the recovery.  One of the main reasons why I wanted to try prolotherapy before surgery was because of the recovery.  In the clip of Dr. Hauser getting an injection of stem cells (the stem cells come from the marrow in his own tibia) for treating his knee he talks about how he was running three days later.  Well, appearently with a labral tear I would have to be inactive to let the labrum knit together.  I can swim and walk,but anything that causes my hip to snap would be bad (so no more than 20 degree movement), and I wouldn't be able to do any external rotation as well.  ...That last part may mean I might have to hold off on dance lessons (have been learning how to dance with Kristin in preperation for our wedding). 

It's that last part that kills me.  I've really been enjoying dancing with Kristin, and that I would have to hold off on dancing for like eight weeks is sad news.  The recovery time for prolo is almost the same as surgery, so it makes the idea of prolo less appealing.  However, I know that surgery is not always the answer, in various forums there are people who are months post-op and are still expereincing pain just walking.

So I think I've decided to try at least one prolo treatment, but I swear I'm not as near as excited about this as I was when I thought I could immediately get back into squatting and stuff.

I will keep posting about this, as well as some other things.  I apologize for the lack of posts, but since I've become more inactive there hasn't been too much to write about.

Another possible diagnosis, and possible PRP treatment

So I've kept researching what could be causing this pain, and there is a very similar injury to Athletic pubalgia (aka sports hernia), and that is an injury to the pubic symphysis.  The pubic symphysis is a cartilige joint, and it has some ligaments keeping it in place, and according to wikipedia:

Two such ligaments are the superior and inferior, these being the ligaments that provide the most stability... The strong and thicker superior ligament is reinforced by the tendons of the rectus abdominis... and thigh adductors muscles.

So I'm thinking when I pulled my groin (aka thigh adductor) I might have aslo damaged the ligament up in there as well.  It definitely feels like a precise pain in the pubic area, so this is a possibility, although it could be "just" a sports hernia.  If it is damage to superior ligament in the pubic symphysis then prolotherapy should prove to be really helpful.  If it's a sports hernia then perhaps not so much.  Either way, I think Dr. Hauser will be able to figure out if it is either.

Even though I have been very inactive this past two weeks, when I saw my massage therapist my psoas was once again "insanely tight".  We talked about why this could be when I've rested for the past two weeks and the only conclusion we could come up with is that there must be some type of soft tissue damage that the psoas is compensating for.

I feel like I am so God Damn close to figuring out this hip pain once and for all that I'm experiencing all kinds of emotions.  I've been dealing with my hip for years now, and the idea that I could finally figure the underlying reason for pain is honestly an idea that I'm a little scared to believe.  I want to hope for this, but I've been burned already and it makes me hesitant.  But it makes sense that I have some type of soft tissue damage in my hip, and that this is why I still experience hip pain.

If there is damage to the Pubic symphysis I am not going to look forward to the prolotherapy treatment,  I've seen this video of the treatment and the idea of getting like 7 injections right above my junk is not my idea of a good time.  However, this should tell you how much I'm ready for this pain to be gone.

I'm hoping the symphysis is the only issue, but if there is something else going on I surely hope Dr. Hauser can figure it out. 

Oly Competition: Epilogue

My Badge

I had a great time at the competition, hard to believe it's over.  I've competed in three or four crossfit competitions, and I have to say this one was a lot different, and all was pretty much in a good way.  First, I knew exactly what to train for.  This allowed a focus and a specialization that was pretty awesome.  Crossfit competitions, being what Crossfit is, is all about testing your weaknesses on an off day.  You don't know what's coming so you have to train for everything, but even if you train for everything you can think of, the competition may come up with something you've never seen before.  This is exciting, but it tends to make it all about pure athleticism rather than skill.  At least, that is my own take on it.  Now there's nothing wrong with that, it's just that I'm a person that likes a test of skill.

...That's probably why I prefer Oly lifting to Power lifting, because the Olympic Lifts are about coordination and technique in addition to strength, where power lifting is more about sheer strength.  I liked the fact that I knew exactly what to expect, and that this competition would catch me when I'm peaking.  It's testing me when I'm at my best, rather then testing me on an average day.  Two different goals, but I prefer the former, but that's just my humble opinion.

Guys warming up

Secondly, these competitions are different than crossfit competitions in that all eyes are on you.  Instead of working out side by side other competitions, it's just you, on the platform, with three judges and that light box behind you.  It's a pretty awesome feeling.  I love performing in front of people, whether is singing or dancing solo in front of thousands of people at SMU's sing song contest or playing the upright bass in Orchestra, I enjoy the rush of all the attention.  You don't have to worry about what others are doing around you. You just approach the bar, lift, and then turn around and see if the judges decided whether it was a good lift or not.
 

A guy in his 40s who is way strong

And third, the sport just places so much more emphasis on technique than just gutting it out and letting slop happen.  I've always been big on perfect technique, quite the opposite of the stopwatch whore who will do anything for a faster time.  And lo and behold here in the Oly world technique is something you want to have all the time, since in the competition you only lift six times, with at least 2 minutes in between lifts.

Oh, and one more thing, Oly competitions have weight classes.  To me, that's huge.  Although, Olympic Lifting, like crossfit, favor the shorter competitor, at least the guy that weighs 60 kilos isn't competing with the guy who weighs 120 kilos.  At least not directly (the lifter that lifts the most weight with respect to body weight wins an award. This also favors the smaller, lighter guy).

The Platform, made of Japanese hardwood

...There were 12 lifters in my weight class (94 kg), by far the most popular weigh class.  I manages to lift more than one guy, the only guy who was taller than me.  So I got second to last, but I didn't do this competition to beat other people, I did this all for myself.  And I am pretty damn happy with myself.

Gyms don't get the idea behind Subbing out exercises

Back in the day, when crossfit was done by pretty much only people who were already in really good shape, Glassman (I think) came up with the idea of subbing out 4 pull ups and 4 dips for every 1 muscle up. The idea behind this was to provide incentive to work on getting a muscle up, which was a pretty tricky movement at the time. This 4-for-1 model was designed for people who have no problem with dips or pull ups, the only thing that was stopping them from getting a muscle up was technique, not strength.

Sadly, the crossfit community seems to be unaware of this notion. Instead, they just see the 4 to 1 ratio for subbing in excercises you can for those that you can't. Can't do 10 pull ups? Then do 30 jumping pull ups! Can't do 50 double unders? Do 150 singles!!! Just blind substitution without really thinking about the context of the client will lead to frustration, pain, and possibly injury, like one girl who's first wod involved a large amount of jumping pull ups and it lead to a slap tear.

When the client is new to exercise don't sub out a 4:1, 3:1 or even a 2:1 without considering what effect it will have on the client. If they can't do a double under because singles are a challenge, just do a 1-1 substitution, or even assign half the number so you don't push them painfully past their limits. If the client can't do a double under but that's because they don't put in the time to practice and can do ten minutes of singles straight then sure make them do 5 singles for every double. My point is every client is unique, and thus the programming should be unique as well. But people see the 4 -1 muscle up sub and just figure it's a good idea to do it to everything and everyone. This really saddens me because trainers have the posibillity of hurting their clients or at least make them miserable. "Punish" those that are capable of handling it, help those that can't.

Second most dangerous crossfit exercise

So earlier this month I talked about how the kipping motion (in both pull ups and toes to bar) is dangerous and can lead to a SLAP (or shoulder labrum) tear. Well, apparently there is another exercise that can lead to a shoulder injury is the sumo deadlift high pull, or SDHP. Basically, the SDHP is safe if you're not using your arms to lift the weight, but as soon as you get tired (and if you're trying to do this at 100% intensity then form will degrade rather quickly) you'll start to use your arms and it will cause an impingement and you'll hurt your supraspinatus. This is all explained beautifully here from Whole9. I highly recommend reading it. Makes me wonder about this years FGB and what I'll do.


Tweet
Follow @AdamDHouston

The need for a stregnth bias in crossfit (aka, beware the sexy metcon)

Came across an interesting thread on the crossfit message boards talking about how all the game competitors train with a strength bias, and it got me to thinking about crossfit programming. Programming a good strength and conditioning program, in my opinion, is one of the top three things you should look at in a crossfit gym (Programming, emphasis on technique, and personality).

And when you think about crossfit sans a strength bias, which looks like a bunch of random met-cons that have to be done at maximum intensity, it becomes appearent that you need something more. That something more, if you want to get much faster times and bigger lifts, is a strength bias. Sure Met-cons are cool, but as Whole9 says, beware of the sexy metcon.

I've heard of the 5/3/1 program, and because Jerry always has us finding our 5, 3, and 1 rep max I think that's what we do here at CFOT. For anyone who wants to know what it is exactly, I reccomend checking out this awesome article summerizing the program here.

It seems to me that a problem with crossfit.com programming is two fold: 1) a lack of periodization and 2) high intensity all the time for every workout.

First, you need to have programming with a plan, you just can't vomit up a triplet of random movements and do it for time. However, as far as I can tell the .com workouts seem to be exactly that, there's no rhyme or reason, no repetition. It's exciting, but you actually need to repeat movements periodically if you want to get better at them. Muscle confusion is great and all, but you actually want muscle adaptation to occur, you need it to occur to actually be stronger. If you squat every week, your squat will get stronger. Proper programming is cyclical with goals in mind, a beginning, middle, and an end. Because .com is suppose to be for everyone all the time, it has no beginning, middle or end. It's just a continuous stream of workouts that leave people in a puddle. Which leads me to my second point, intensity doesn't always have to be 100%.

"Simple answer is you can't go balls to the wall all the time. Well you can but then it becomes raisins against the wall."

One of the hallmarks of Crossfit.com is that you're suppose to do each workout as fast and as intense as possible, but as Crossfit One World says, intensity isn't always the answer. You'll open yourself up to injury and won't see much long term gains.

Point is, you need a stregnth bias in crossfit if you really want to see any real gains in you lifts as well as see improvement on your Fran time.

Danger of doing kipping pull ups without sufficient strength

(UPDATE: if you've hurt your shoulder I've found something that can really help out.  It's simple and cheap, and it's hanging from a bar multiple times a day. Won't heal the labrum, but it can help out with a lot of other shoulder ailments.)

If you peruse the injury threads on the crossfit.com board you'll find a lot of shoulder injuries, specifically SLAP tears (tears in the labrum). A lot of them seem to come from kipping pull ups, and I've come across a possible explanation. There is an article explaining what a SLAP tear is and how it comes about, most notably:

In theory, SLAP lesions most likely occur in overhead athletes from a combination of these 2 previously described forces. The eccentric biceps activity during deceleration may serve to weaken the biceps-labrum complex, while the torsional peel back force may result in the posterosuperior detachment of the labral anchor.

As some one else pointed out, when you look at the kipping pull up with this knowledge you'll see:

Eccentric bicep loading = the negative part of the pull-up, the arms straightening at the bottom

Arm deceleration = the swing into the kip

Abduction and external rotation = the position of the arms at the apex/reversal point of the kip

Just imagine the "peel-back" force in the shoulders when they are forcefully wrenched back at the apex/reversal point of the kip. If you really think about it, the head of the humerus is trying to push out the front of the glenohumeral (shoulder) joint, the kipper is trying to RELAX their muscles at the bottom to get the most out of their kip, leaving all the strain on the LABRUM (think of it as a suction cup on the scapula that holds the humerus on the body, with the greatest forces on the top/superior and the front/anterior parts), and the resultant forces--over time (repetition)--TEAR the TOP part of the labrum from the FRONT to the BACK...this is therefore a SUPERIOR LABRUM ANTERIOR-POSTERIOR injury mechanism, almost perfectly designed (as evidenced by the orthopedic doctors making a ton of money off of people who do them).

Steven Low, writer of an awesome exercise blog, has chimed in on this subject matter as well. I have much respect for the man. Not only do I have a link to his blog in the margins, but his posts have really helped me in the past with my injuries (led me to find a DO for my hip, helped realize massage would fix the tendonitis, etc.). Concerning SLAP tears, he says:

The reason why you don't seen the top CF athletes getting slap lesions is because their shoulder mobility sucks. If your shoulder mobility sucks when you relax your shoulder muscles at the bottom of the pullup you have your muscles contracting against opening the shoulder all the way thus mitigating any forces on the biceps long head tendon. In addition, the muscles do help bar forces from the shoulder.

However, when you get people who are weak (e.g. women in general, or those with good shoulder mobility) they're the ones getting the primary forces distributed through the muscles into the other soft tissues such as the long head of the biceps. This is especially the case with learning the kipping pullups where there's going to be a lot of jerking down into the motion while learning it.

I would never ever ever ever recommending learning kipping before you at least have 3+ deadhang pullups. It's not just not a good idea putting trauma on the shoulder especially when it's easy to not do it right and jerking down into the movement which is much more dangerous than a smooth movement.

Jerking down from toes to bar can do the same thing for reference.

There's also another article here by Whole 9 that basically sends the same message of do dead hangs before working on the kip. Crossfit Virtuosity also recently mentions how important it is to have strict pull ups before you start kipping (and provides a great program to get strict pull ups).

This kind of concerns me because my shoulder mobility is pretty darn good, however I have a very smooth swing, without a jerk. I also wonder if butterfly exposes the shoulder in the same way (don't think so). But from now I will definitely make sure I'm keeping my shoulders engaged at the bottom of a kip, I already have a tear in my hip labrum, and I really don't want to add a shoulder one to the mix.

...I should also point out that, as far as I know, no one at CFOT has suffered a SLAP tear. This is further testament to the training and programming that Jerry lays out for us. The man knows his stuff.

(UPDATE #2: Turns out I have a tear in the back of my shoulder's labrum, not a slap tear, but a tear nontheless. I've decided to forego surgery and try prolotherapy to repair the damage naturally. For more about prolotherapy check out these two videos here and here.  I've started a vlog where I document what recovering from prolo is like:



Tweet
Follow @AdamDHouston

Possibly a light at the end of the tunnel of hip pain

Finding a way to relieve the pain pain in my hip has been been quite the journey, one that almost sounds like an episode of House, MD (although I was never dieing at any point). Because I'm not sure if I've been very clear on my plight for a cure, I've decided to write up a summary of my dealings with this problem:

Part One: Hip feels like it's on fire.

June 27, 2008: Started crossfitting, and soon after my right hip started to feel pain, like it was on fire.

July: Saw Dr. Bruno, an Orthopod, for my hip, and he wasn't sure what was going on but had some physical therapists work with me. This involved stretching and weight exercises as well as TEMS and ultrasound therapy. Nothing was really working though.

August: After researching the crossfit forums, I realize I need to see a DO, and I have the therapist confirm that my pelvis and hip are twisted, causing the illiopsoas to stretch unnaturally resulting in severe inflammation. This inflammation is what is causing the sensation of my hip being on fire. Dr. Craddock also tells me the twisting of the pelvic muscles is why my hip clicks when I raise and lower my knee (a problem I've had since I can remember).

August 26: I meet a DO, Dr. Craddock, for the first time, he resets my hip and the pain goes away almost immediately.

August '08 - June '09: I receive regular treatments from Dr. Craddock, but after two months of no longer experiencing the inflammation of the illiopsoas I notice there is still a lingering, deep throbbing pain. This pain doesn't feel like fire, and is much easier to ignore. I figure it's still the illiopsoas, that it just needs some time to get used to being un stretched. However, this pain doesn't really go away.

February '09: I see a massage therapist and tell her about all of my various ailments, although I find her massage relaxing I do not find it therapeutic.

Part two: Maybe it's a torn labrum?

July '09 part 1: I casually mention to Dr. Craddock that my hip still clicks when I raise and lower my right knee. For a brief moment he seems a little confused by this because all the muscles are in the right place. After a second he then says I may have a torn labrum in my hip, and this might be causing the clicking and the residual pain.

July '09 part 2: I see Dr. Bruno again and he reccomends an MRI, but without contrast. He gets the results and tells me I have a torn laburm, but he's not sure since he deals mostly with old people. He then sends me to another Orthopod, Dr. Johnson, who deals with sports medicine.

July '09 part 3: Dr. Johnson determines I have fermoral acetabular impingement (FAI), but is unsure about the labrum because the MRI does not have contrast. I believe the pain I am experiencing is in my hip joint, as it feels incredibly deep. It's around this time when I come across prolotherapy for torn labrums. Dr. Johnson says that if theses treatments don't work there is arthroscopic surgery for this condition.

August: I meet up with the prolotherapist Dr. Wagner, and he says he needs an MRI with contrast in order to do anything.

September: I see Dr. Wagner again, and after the MRI he tells me that I do not have a torn labrum, only FAI and that he can not do anything for me. So I'm back to square one. Or is it two? I'm confused now with all these doctors and procedures.

Part three: No, it's tight hip capsules.

September: I go back to Dr. Johnson, preparing myself to have surgery. He comments that there probably is a small, small tear in my hip labrum, but it is the FAI that is causing the pain. He suggests trying Euflexxa injections to lubricate the hip joint and render me asymptomatic.

November part 1: The meds finally arrive and I get my first injection of Euflexxa, where they take a needle, pierce the hip capsule, and then inject the viscous solution. During the procedure I find out that I have extremely tight hip capsules, which Dr. Johnson notes may be the cause for my FAI. After the procedure, thanks to the numbing agents I receive during the procedure I do not feel any pain in my hip, and Dr. Johnson takes this, as well as my description of the pain, as a sign that the pain is indeed in the joint and not muscular. However, as the meds wear off the pain returns. ...I have a feeling that this new piece of the puzzle is important.

November part 2: I meet up with the chiropractor Dr. Bills for back and shoulder pain, but then mention the tight hip capsules, he then works on them and they suddenly feel a whole lot better. This indicates it is muscular and not a joint problem. This gives me a lot of hope.

November part 3: second Euflexxa injection. Still have pain in the hip.

November part 4: I talk to Dr. Craddock, and he recommends Rolfing, a deep tissue massage. I find one and book three appointments.

November part 5: I mention this to Andrea and she recommends Olga, her massage therapist. I cancel my appointments with the Rolfer and make one with Olga.

Conclusion: There is hope still

So yesterday I saw Olga, and she worked me over thoroughly, and unlike the previous time I got a massage I felt like this was extremely therapeutic. She worked extensively on my hip/leg muscles, and it was an incredible sensation. I told her to go as hard as she could, and the pain was indescribable. It was like my muscles were bubble wrap, and she was a rolling pin. As she slowly dragged her elbow up and down my muscles, I had this sensation like some combination of popping or sparking in muscles I never even knew existed. She commented that my muscles were extremely tight, but they were releasing quite nicely. She worked both my right and left hip.

While she was able to get my left hip to release, she said she was unable to get my right hip to release. She also commented that because this is a chronic problem it will take a while to fix it. I've scheduled an appointment with her next week, and I really hope that next week will be the week the muscles learn to relax. Unfortunately, she told me not to workout after the massage, so I had to forgo the wod.

Today I saw Dr. Bills again, this time exclusively for the hip. As he worked on them, I asked if he noticed any difference, and he said they felt a LOT better, that he couldn't feel as much "gristle" in them as he did last time.

This makes me very happy. It has been a long, long journey, but it seems like I've finally figure it out: Tight hip capsules twisted my pelvis causing the inflammation of the illiopsoas, but the tight muscles also jam my femur into the hip socket, creating the FAI.

I know I've said this before, but I'm very excited by the thought of no longer being in pain. Hopefully there will be no more curveballs, and this will finally kill the throbbing ache that I experience everyday. I write this so that others out there who may have hip pain or any other type of ailment may have hope and learn from my experiences. If I help at least one person out there, then I am a happy man.

Tweet

Dealing with inequality and jealousy of others

My hip is still full of fluid and feels unstable, so I made today a rest day (that and this is the last biweek of the fiscal year). So today I’m only working on my push ups.

However, I'd like to talk about something I’ve noticed in workout blogs (including my own): frustration and jealousy. Now, usually I don't experience these feelings, as I keep a pretty good focus on not where I'm at, but where I'm going (e.g. my increase in the deadlift). But I would be lying if I didn't say that I never felt frustrated in almost always being at the back to the pack in met-cons, or that I'm just not as genetically gifted as some. I hope to write about these feelings so that others may relate.

When I started Crossfit a little over a year ago I was definitely one of the weakest and slowest in the class. Because of my difficulty attending morning sessions, I went to the 5pm class, which was comprised of the Capital Jujitsu students. They were already in shape in a met-con sense to some degree, whereas I was only lifting weights and running by myself (and not that effectively). I simply accepted this and figured if I didn't like it than I just have to zone, attend class, get stronger and get faster until I could compete with everyone.

And I've continued to keep this focus, albeit I feel like I should be making better strides in my met-con performance. There are people who are still stronger and faster than me, but I can see the progress (mostly thanks to my blog) and am encouraged to keep going.

But recent events have come up where I feel jealousy and frustration, and I'm quite surprised at my response.

The reason why I joined crossfit was to attain the body of a Greek God, a la 300. Now that I'm in crossfit my goals have shifted more towards performance (sub 5 Fran?), but attaining a great physique is still one of my motivations. I've seen some great changes with crossfit, and I'm as close to a six pack as I've ever been, but something happened, and it has caused a bit of frustration (at least at first).

What happened? Quinton happened, that's what. Who's Quinton, you ask? Well, he's a roommate of mine, and for a while he was pissing me off. For exercise, he would occasionally run. For diet, he doesn't really have breakfast or lunch, but for dinner will have either something like Five Guys or snack on something like pineapple with sugar (he eats mostly carbs). If I did the things he did, I would not be in very good shape, at all. And yet, he has pretty much the physique I'm going for, and the inequity was starting to bother me. I would mollify myself by pointing out that it's not what you're given but what you do with what you've got, that the discipline and dedication I have to my diet and crossfit mattered more than just lying around and looking like I a professional athelete. This argument worked for a while, but then he had to go and start working out. This pic to the right is what he looks like, after one week of working out.

He asked me for help with his diet, because he was “trying to lose some body fat.” And it was at this precise moment when I felt a jolt of jealousy and frustration run through my body. I thought to myself ‘Body fat? Trying to lose body fat?!?!?! You don’t have any body fat Quinton!!! What has he done to deserve his six pack?’ I asked myself, ‘Nothing! Here he is looking all ripped and unhappy while my BF% is a good 8-10% higher and I’m working my ass off.’ I quickly calmed down and told him I would be happy to help (which I was, after the initial shock of negativity). As I walked away, I was surprised and puzzled by my initial reaction.

After processing my feelings, I keep coming back to the original idea that has kept me motivated throughout crossfit: we are not all created equal, there will always be others out there who have an easier time hitting a 400# deadlift, or their first muscle up, or getting a six pack. There is nothing I can do about other’s performances; I only have control over my own actions. Therefore, to worry about how I perform relative to others is useless (although there’s nothing wrong with competing, you hear me Sean?). If I want to be able to deadlift 450# while having a sub 4 Fran and a fgb score of 350, the only way will be to stick to the plan: stay loyal to my diet, attend crossfit, and give each session all that I have. I’m also starting to supplement crossfit with Yoga and possibly swimming.

I should be (and am) happy for Quinton in that he’s wanting to improve, and I will do everything I can to help him. Life is too short to spend time focusing on other people’s accomplishments to the detriment of your own morale. I also recognize that while he might have the physique of an athelete, right now I would probably dominate him in any crossfit WOD (except for one that's push up intensive). Instead of resenting Quinton, I will think of it as inspiration as to where I want to be in a year. I intend to keep up the great work that I’ve done, and will eventually accomplish all of my goals.

Now if you excuse me, I have some push ups that need to be done.

Weighted Chin ups, and an MRI/Arthogram of the hip

So today I had my second MRI of my hip, this time with contrast. This time before the MRI they injected liquid into my hip joint. First they shot me up with lidocaine to numb out the area, then they took this very large and faint-inducing syringe and injected it into my hip, guided by fluoroscopy. There was some pain, but it was very brief and the whole process took less then five minutes.

I'm meeting the newest doc, Dr. Wagner, on Wednesday to go over this, and we'll be able to finally have a definite diagnosis and form a game plan. Hopefully it will only take a few treatments of prolotherapy to get me right, I don't want to have to deal with surgery.

I'm also excited about the idea that Dr. Wagner will also be able to help me with my shoulder. However, right now my shoulder is feeling no pain, and every time I push it it responds well. I will continue to be conservative in returning to working out, but I can now add weighted chins to the mix. And with that, today's WOD:

Weighted Chins: 1, 1, 1, 1, 1, 1, 1

I only got up to 58#, I can't find it but I think my max is 63#, but given that I'm just starting to get the shoulder back in the game I'll take it.

It was a good thing that we did chins today, as the doc told me I can't do any hip-related workout like running for 2-3 days. Right now my joint is filled with fluid, and is thus unstable. After I was done with the chins I did some push ups and light hang cleans. Andrea helped me with my push up form. Apparently I let my back bend, and this arch causes all kinds of problems. I think this arch is related to problems I have with my posture, as well as push press. My shoulder is doing so well, I'm going to start re-instituting my grease the groove, and will try to do at least 5 sets of 10 push ups throughout the day.