Bench Pressing and Shoulder Pain Solutions Part 3

If you just joined in the conversation here, be sure to read the posts from the start of this series below

Shoulder Pain While Doing a Bench Press Gone Part 1

Bench Pressing and Shoulder Pain Solutions Part 2

The Solution So Far

In part 1 we discused Dave coming into the Extreme Human Performance Center here in Minnesota with pain while doing a bench press without any weight on the bar (so 45 lbs) and awhile later in the same session working up to 270 lbs without any pain!

In part 2 we discussed a solution that you can try yourself and what I did to get Dave back to benching pain free in a short amount of time.

The key in part 2 was the nervous system and looking at some opposite joints.  Dave’s LEFT shoulder was the issue, so we did some very specific mobility work for his RIGHT hip.

Now in Part 3, we will discuss the other key factor to keep you moving in the right direction, setting personal records (PRs) and increasing your athletic performance both on the field and in the gym!

Biomechanics

Most of you are probably surprised that I am now discussing more biomechanics.  When I first started learning more about exercise, I was convinced that the biomechanical path had all of the answers   Heck, I even did a MS in Mechanical Engineering from Michigan Tech (say what up to the Yooopers) with a concentration in Biomechanics.  I spent years looking at the stuff and read even more for fun.  I will save you the discussion about the mathematical theory of plasticity and other fun stuff; so stick with me.

When I started doing Z-Health about 3.5 years ago, I fully realized the power of the nervous system since it was actually controlling the muscles and of course your movements. WOW!  Seems so obvious I know.
If your nervous system is out of whack, your performance is not ideal!

Most of my blog posts here are about how to deal with the nervous system and get the most out of it, primarily because

1) it works

2) almost nobody is talking about it

3) it works really fast

It will probably be a surprise to some of you that I am now talking about biomechanics again!  The reality is that optimal lifting technique is always important and almost everyone agrees on that.

Integration

The key is how to integrate the nervous system into the biomechanical model.  Many fitness experts are way too focus on biomechanics ONLY.  Do we truly know if your right glute is not working and that is your issue? Maybe, maybe not.  Is it ONLY your psoas?  What about all of the other muscles around that area?  Whatever your answer, we need to stay focused on the END RESULT.  That is what matters.

Are you lifting more weight while having less pain and becoming a better athlete?

“The Answer”

The approach that I use now is simply addressing 1) the nervous system and 2) the mechanical system (soft tissue, muscle, etc).

The nervous system answer was in part 1.

The mechanical answer is that we need to change the function of the tissue to work better.

In Dave’s case, we found that he had a very hard time with right hip internal rotation with his knee straight.  After doing that, the pain dropped dramatically.

I suspect that there is some tissue in his right hip that needs better function.   How do we get better function and then a tissue change to that area?  Exercise!  Load ‘em up.

Corrective Exercise

Truth be told, I have not done any standard “corrective exercise” work for about 3 years now.  I used to do a crap ton of it and while it worked to some degree, but I was never happy with the results.

The solution In Dave’s case he ended up doing a forward lunge to 45 degrees on the right leg with internal rotation at the hip.

How?

“Test the parts then test the whole” -Frankie Faires

We tested a forward lunge – good
Next tested a forward lunge to 45 degree – better
Then a forward lunge to 45 degree with internal hip rotation – best!

The testing was a range of motion test as discussed in the Gym Movements DVD and in the new upcoming Grip n Rip DVD (which has tons of amazing info on it, coming soon, so stay tuned here).

Car Talk

Ever listen to the Car Talk guys Click and Clack?  I have only listened to them a few times and I loved that they were so excited about cars.  I get the same way about exercise and human performance – how to get you to bust even more PRs!

If your car pulls to the right going down the road, what do you do?  You turn the steering wheel a bit to the left to get the car to go straight.

Think of this steering as changing the effects on the nervous system.  Each time you do a mobility drill targeted at the nervous system, you are turning the wheel a bit to the left.    The downside is that the car now go straight (increased performance, less pain), but you need to keep providing input by turning it a bit left.

You bring the car in and find that you had a bent tie rod (or some mechanical issue) that was causing the car to pull to the right all the time.   They drop a new one in (for way more money than you expected) and hours later your car now goes in a straight line, without you having to steer it left a bit.  Nice!

Your Body As a Car

Tissue is constantly changing, and by doing this particular lunge, it is like replacing the tie rod in your car; over time the tissue will adapt to a new and better function!  The results is more performance and less pain PERMANENTLY.    The shorter the issue, the shorter this process.

Summary

For long term change to have you hitting PRs like a crazy person in less pain, you need to
1) Address the nervous system via joint mobility work (some times eye movements too, but that is another topic)
2) Address the mechanics of the tissue via “corrective” exercise

Without addressing both of these, your results may be more short term.

I know this was something that I did NOT do for quite some time.  Athletes would come in, I would address the nervous system and get them out of pain and moving better; but long term they would have other issues or the same one would crop up again.   I knew they still had some “movement issues” but once they were out of pain it was hard to get them to come back again.

Now I incorporate some type of loading into their “homework” to get them moving in the right direction in case I don’t see them again.    I also emphasize that they need to have their lifting form evaluated to make sure it is correct and good for their body!   A perfect squat may NOT be the best exercise for them.

Don’t repeat my mistakes and be sure to address both the nervous system and the mechanical system with a customized approach.

Comments?

What do you think?  Let me know below!  I look forward to your comments as always.

Rock on
Mike T Nelson

PS
For more information on how to set up your own training program to have you hitting PRs in the gym all with less pain, you will need to pick up the new Grip n Rip DVD once it is out.   As soon as it is released, I will have the info here.  Not sure what the final price will be as Adam Glass,  Brad Nelson and friends are handling it; but I know it will not be cheap.   If you are good, you are not cheap.

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Bench Pressing and Shoulder Pain Solutions Part 2

If you just joined in the conversation here, be sure to read the post from yesterday below

Trainer Mike T Nelson Testimonial: Shoulder Pain While Doing a Bench Press Gone!

The Solution

Note, this is what worked in this case for exercise and this does not automatically mean it will work for you since everyone is individual.   This not medical advice and if you have a medical issue, talk to your doc.  It if it painful, don’t do it!

Hopefully that will keep my attorney happy, so here we go.

Shoulder Issue, Check My Hip?

The body is a huge X.  I know it goes not look like one, but trust me on this one.
As you step with your right foot, the impact force is transmitted up the back of the leg, past the right knee, into the right hip where it then moves over to the LEFT side of the body (around the SI joint), up the left scapula where it starts to split into 1) left upper trap and left side of the face and 2) left shoulder and on out to the left elbow and eventually the left wrist/hand.

The formal name for this it the “Back Force Transmission Line” and I first learned of this from Dr. Cobb of Z-Health.

It makes sense that the force would have to shift to the opposite side in order to keep the body balanced in gait (walking movement).  Look at what you do with your opposite shoulder/arm when you run!    Hopefully you will see some opposite motion going on there.   If all the force were to stay on the right side when you plant your right foot, it would be very difficult!

Don’t believe me?  Test it!   Run how you would normally run and now try these 2 drills
1) Run without moving your arms.    Get a buddy to do this and video it.
2) Run by moving your arms in the WRONG directions.  Humans are so hard wired to walk that this is VERY hard to do.   If you can do it easily, that is not a good sign.

Efficiency Is Key

The body is so amazingly designed I love it.  Looking a bit deeper, we see that the tendons, fascia and soft tissue are designed to absorb and return force; thus making movement much more efficient.

We Are All One

Many of you are familiar with Thomas Meyer’s “Anatomy Trains” and the idea of biotensegrity from Dr. Stephen Levin at http://www.biotensegrity.com/ If so, you are on the right track.

Cadavers To the Rescue!

The body is highly highly connected.  If you ever get the chance to do any cadaver work I highly highly recommend it.  When you start, you will see nice clean lines and everything looks very clean.  This is because at the lower level cadaver work, someone else has already prosected (cut, chop, cut cut, chop)  the cadaver for you!   This is not bad, as there are tons of things to be learned from this method since having undergrads hacking away on cadavers is not only expensive, but impractical.

Note: I am not implying any disrespect to those that have donated their bodies to science for use as a cadaver model, just trying to not use too many techy words so people can understand what is involved in the process.

As you do more advanced cadaver work (and the lab fee goes up to over a grand just for one class; still working on paying back many lab fees myself yet), you will soon find fat and fascia EVERYWHERE.  Trust me, you want to pick a lean cadaver if you can.  Seriously.

Perhaps you got to see the bodies exhibit, which is amazing too!

So we now that the body is all connected, and it appears that the primary path is the back force transmission line.

Serape Effect: More Evidence

The serape effect is primarily referred to as a crisscrossed connection between the lower and upper body, most commonly (maybe not so commonly as I am a big geek) used in discussing the connection from the shoulder to the opposite hip (glute).   It was first mentioned by Logan, G., & McKinney, W. 1970 (1), so there are some evidence from multiple sources for a connection between the shoulder and the opposite hip.

Cross Body Connection Here?  Yes!

No, not here!

Enter the Nervous System

So far we have made the case for the mechanical structure of the body and how it is all connected from your little toe to your pinky finger.
The nervous system is entwined in the picture too since it is actually controlling and sensing movement of the entire body.

Cross-Body Nervous System Connection?

Great question!   There does appear to be a nervous system connection that works “cross-body”.  Again, this probably goes back to a gait (walking) type motion.

In an experiment done by Kline TL et al. (3),  in stroke patients they showed quote, “rectus femoris in the impaired leg was active during finger flexion of the impaired hand in the stroke survivors and all four tested muscles in the impaired arm were active during extension of the legs ”

Note, this was done in stroke patients and in a similar study done by Ellis MD et al. used non stroke patients (um, normal people) they did not show a pattern in them (4).

Any Evidence In Non Stroke Patients?

In a very cool study from  Huang HJ,  et al. (6) published recently stated,  “We found increased muscle activation in passive lower limbs during active upper limb effort compared with passive upper limb effort. Likewise, increased muscle activation in passive upper limbs occurred during active lower limb effort compared with passive lower limb effort, suggesting a bidirectional effect”

English Please

While these neurologically intact (read = normal) people did an upper body movement, they saw increased muscle activation in a NON MOVING lower limb.    Back to our running example, try to move your arms in the wrong direction and it is really really hard.  It looks like our wiring is set to faciliate moving the opposite limb!

Can We Alter It?

Cortis C et al. (5) showed that interlimb coordination was better in soccer players, quote,  ”Regardless of age, soccer players always showed better performances (handgrip: 383 +/- 140 N; CMJ: 28.3 +/- 8.7 cm; IP: 55.2 +/- 12.9 s; and AP: 31.8 +/- 25.0 s) than sedentary individuals (handgrip: 313 +/- 124 N; CMJ: 21.0 +/- 9.4 cm; IP: 46.7 +/- 20.2 s, and AP: 21.1 +/- 23.9 s).  ”

While this is not the exact same thing, it is similar and appears to be trainable.  I know I am reaching a bit with these data here, but there is not one perfect study to directly point to any of this yet.  I think in the next 2-3 years (so someone is doing it right now) we will have a more exact study.

Enough With the Science!  Solution!

Back to our friend Dave and his bench rising from the dead from painful with the bar to 270 lbs in one session.

Note: If you have any medical issues, see your doctor.  I am not claiming to cure or fix anything that you have currently going on.  Don’t move through pain and see a professional!

For the sake of entertainment, here is the process I used for Dave to get his shoulder pain reduced.

My goal was to get him to bench heavy again in a short period of time.  It just so happens that when you get someone to move better, many many times (with acute pain) there pain levels drop dramatically.  As my buddy Frankie says “the body really cares most about FUNCTION – what can you do.”

Step 1

Find out what movement is painful.

This may take a bit of work, but you want to isolate the painful movement.  In Dave’s case, it was primarily left arm external rotation with his elbow bent.

Step 2

Do the EXACT opposite motion with the opposite joint

The opposite joint to the left shoulder is the RIGHT hip.  Heck, they even look scary similar as both are a ball and socket joint.

We know that LEFT arm EXTERNAL rotation with his elbow bent created the pain.
What is the exact opposite of that movement?

Do you have it?

Are you sure?

Correct!  Right hip internal rotation with a straight (not bent) knee (knee is the opposite to the elbow).

Step 3

Perform a joint mobility drill in the new position

So with his right hip internally rotated, knee straight, laying down, we had him create a circle at the hip joint (joint mobility) very slow, with no pain.  He did 3-5 reps in each (clockwise and counter clockwise) directions.

Step 4

Walk around for about 20 seconds, retest the painful motion

Any difference?

If they stare at you like a 2 headed purple space alien, you are on the right track.  Then yell at them “Never doubt my VooDoo”  That always helps!

I learned this method from Dr. Cobb initially in R Phase, so thanks again!

I Left Something Out

Come on back tomorrow for part 3 as we are still missing something.

Can anyone guess what it is?

The hint is in the first part of the article.    What other exercise do you think we had Dave do for his homework?  No, you can’t ask Dave directly (nice try).

Put your guesses in the comments below, and the winner gets a free 30 minute phone consult with me (valued at about $50).

Comments must be posted by tomororw Friday March 12 at midnight CST to be eligible. You may only enter once, but you can leave multiple comments and the latest comment you left will be used for your answer.  I will do my best to scan my spam folder too, but I can’t promise that if your comment ends up in there that I will find it (getting over 100 spams a day now).  Once comments are in, I will post the answer and the final installment of part 3 (so Sat AM).

Summary

Today we went on a tour of the body to show that it is all connected by both mechanical links (muscles, soft tissue, tendons, etc) and the nervous system.     We provided data to explain how it all works together, gave some demos for you to test it yourself, and provided you a possible solution to try on your own.

Your homework is

1) If you have an issue, try it out first and see if it works for you.   Do this on your own risk and if you have an issue, go see a doc!

2) Figure out what component we did not address yet and place your comment below.  Closest one get a free 30 minute phone consult from me.

I am excited to see how gets it!  Don’t worry, even if you did Z-Health training, you can still enter below too for the missing component.  In the event of a tie, the first one posted (by time stamp) gets it.

Rock on!
Mike T Nelson

REFERENCES

1) Logan, G., & McKinney, W. 1970. The serape effect. In Anatomic Kinesiology (2nd Ed., pp. 154-561). New York: William C. Brown, Co.

2) Publications for Biotensegrity at http://www.biotensegrity.com/index.php

3) Kline TL, Schmit BD, Kamper DG. Exaggerated interlimb neural coupling following stroke. Brain. 2007 Jan;130(Pt 1):159-69.

4) Ellis MD, Acosta AM, Yao J, Dewald JP. Position-dependent torque coupling and associated muscle activation in the hemiparetic upper extremity. Exp Brain Res. 2007 Feb;176(4):594-602.

5)  Cortis C, Tessitore A, Perroni F, Lupo C, Pesce C, Ammendolia A, Capranica L.    Interlimb coordination, strength, and power in soccer players across the lifespan.  J Strength Cond Res. 2009 Dec;23(9):2458-66.

6) Huang HJ, Ferris DP.  Upper and lower limb muscle activation is bidirectionally and ipsilaterally coupled.  Med Sci Sports Exerc. 2009 Sep;41(9):1778-89.

PS

Get those answers in the comment section now before the clock his midnight on tomorrow (Friday, March 11) for a chance to win a free 30 min phone consult with yours truly!

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Shoulder Issue with Kettlebell Pressing: Video Testimonial for Mike T Nelson

I have owed Mike T Nelson this video for about three months now. My Name is George Samuelson from New Jersey. This session with Mike T Nelson was at the end of 2009 last year to address some of my present press patterning issues on my left side and also work on some kettlebell military press

Basically why this video (below) took so long is for the past lets say month or two months of a hideous viral infection like many other people, just kind of  affected with low energy levels so I was trained and whatever I have to do.

However my training sessions are still included good amount of Z Health mobility work to improve my movement.   Specifically some of the drills Mike had given me. Also during the past while doing lifts or exercises, my body has given me good feed back on going ahead and what to do for that day.

I am very happy to be able to say with even with all this stuff going on I have been able to still maintain my standard 32 kilo and 36 kilo press pretty easily.

Also during this time frame, I have put on about 5 pounds of muscle and have actually going down some body fat as well.

Doctor has asked me if I have been taking anything and I just basically told some pressing and drills, they just don’t really get it.

So if you get chance, I recommend you schedule session with Mike, whether its at a workshop by going and seeing him.

If you can’t make it out to him, make sure that you do read his blog, make sure you also sign up for his newsletter.  Its a great resource to have and thanks.

—George Samuelson, RKC II, CK-FMS, NASM-CPT, Z Health

Video Testimonial for Mike T Nelson

A huge thanks to George for the great testimonial and it was a pleasure to work with him when he was here in Minnesota.  If you are in the NJ area, be sure to contact him at his website  This Feels Good.

What are you waiting for?  Email Mike T Nelson by clicking HERE today to get started on moving, feeling and performing better!  Click HERE now!

Rock on

Mike T Nelson

PS

If you are still skeptical, be sure to check out all the other testimonial at the link below.

Mike T Nelson and Extreme Human Performance Testimonials

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I see a fair amount of shoulder “issues”   A simple test is to have the athlete bring their arm out to their side and all the way up while keeping their palm down and elbow straight and stop when they hit tension.

Have them do the same thing out in front.

If they don’t have a good range of motion (ROM), overhead lifting will NOT be a good idea!  Why would I put a kettlebell in their hand if they can’t get their arm over their head withOUT weight?

How to fix it

“He who treats the site of pain is lost” —Karel Lewitt, M.D

Not everyone who has less than stellar range of motion will have pain, but most that have shoulder pain have decrease shoulder ROM.

While my goal is not to directly get rid of their pain, I know that by getting a full range of motion a vast majority of the time their pain will go away.  Better movement almost always results in less pain.

Here is a video of a pre and post Z-Health joint mobility work

What Did We Do?

While every case is different, here we did some LEFT ankle mobility work (this athlete has some extra hardware in his left ankle and a scar from the said hardware), neck mobility work, and right wrist mobility work.

In general, from all the shoulder issues I’ve work with I find the following to help a vast majority of the time.

Mobility work for the

• Opposite foot/ankle
• Opposite hip
• Thoracic spine
• Same side hand/wrist.

While it is not this easy all the time, about 70% of the time it really is if you are doing the drills correctly (I love the Z-Health R Phase and I Phase drills for this) and you can reassess the athlete after EACH drill to know if you made them move better or worse.    A gait assessment and simple shoulder ROM test (both taught in the Z-Health R Phase certification) work awesome.

Since we are targeting the nervous system directly, we should see and IMMEDIATE change to know if the athlete is better or worse.  Gone are the days of sending them home with scap wall slide, stick ups, external rotation work, etc and then they come back 2- 6 weeks later to see if they worked or not!  We can now tell in SECONDS if the drills we did were good or bad.    This is critical since every athlete is an individual.

But I Do “Prehab” Exercises and They Work!

I am not saying that those other exercises never work or are “bad”, my point is that I believe there is a much faster way to get an end result.  You can now get great results with some simple looking joint mobility work and a reassessment protocol if you target the nervous system directly.

Any comments, let me know!

Rock on!

Mike T Nelson

PS

If you are interested in more info about the Z-Health R Phase cert, drop me a line(Mike T. Nelson) by clicking HERE with the subject “Z-Health Cert Questions”

“In 15 minutes, without any equipment, Mike was able to fix a shoulder issue that I’d been dealing with for nearly 9 months.
The pain was gone. By the end of our first session, I was moving better than I had in a long time. Some

of the science he quoted was above my head, but I am not about to argue with the results I got. I left our session with a program that I have since practiced for a week on my own. I feel better and move better every day. I can’t wait until these four weeks are complete–Mike says I will be moving as well as anyone by the end of the pro

gram and so far I have no reason to doubt.”

Josh Hanagarne “Worlds Strongest Librarian”

Update,  Josh left this comment on the blog just the other day in case you were wondering what would happen after about 3 weeks.  Would the effect stay?  Many can get an acute (short term) result, but what about weeks later when the athlete goes back to their normal routine (still doing the drills though, of course).  Josh put the few minutes in a day and here are his own words.

“Thought I’d give you an update on my Z-Health progress–fantastic. I can’t believe how good I feel. It was great to meet you!”  josh

I had the distinct honor and privilege to do a movement coaching session with Josh when he was here in town for the RKC.   Josh is indeed an extreme human and is the World’s Strongest Librarian and used kettlebells to literally beat his Tourette’s Syndrome into remission.  Amazing!!  You can read all about it at this link

How To Have Tourette’s: The Singing Stone And The Space-Age Bribes

My hats off to Josh!  Josh is also a brand new RKC too!  Hell yeah!

Be sure to check out his great blog at  http://worldsstrongestlibrarian.com/

What are you waiting for? Do you want to move and feel better TODAY?

Drop me a line and get set up for you Z-Health movement coaching session today!  I am one of only 6 Z-Health Master Trainers worldwide.  Email me at michaelTnelson@yahoo.com   Subject: Z Health session.

All sessions are booked on a first come, first serve basis and the open time slots are rather limited, so hop to it today.

I am currently in Arizona right now getting ready for the first day of the Z-Health 9S Advanced Nutrition class, so I am super excited!  Further training in exercise physiology is always like a vacation to me; even after years of study.   Note: I will have intermittent email access, so if I you don’t hear back from me, don’t fret and I will get back to you soon.  I have some updates set to go out here while I am gone, but I may be late getting to all the wonderful comments.

Rock on

Mike T Nelson