Reddit mentions of Shoulder Pain? The Solution & Prevention, Revised & Expanded

Via [1, bottom], this is an excerpt from what seems to be a well-regarded book on shoulder anatomy. The acromion apparently has a bit of flex (emphasis mine):

> More recent investigations have pointed to the importance of contact and load transfer between the rotator cuff and the coracoacromial arch in the function of normal shoulders, including the provision of superior stability. Because there is normally no gap between the superior cuff and the coracoacromial arch, the slightest amount of superior translation compresses the cuff tendon between the humeral head and the arch. Superior displacement is opposed by the countervailing force exerted by the coracoacromial arch through the cuff tendon to the humeral head. Ziegler and collaborators demonstrated this “passive resistance “effect in cadavers by showing that [t]he acromion bent upward when a superiorly directed force was applied to the humerus in the neutral position. The amount of acromial deformation was directly related to the amount superior force applied to the humerus, the load being transmitted through the intact superior cuff tendon.

Rockwood CA Jr, Matsen FA III, Wirth MA, Lippett SB. The Shoulder. 3rd ed Philadelphia: WB Saunders; 2004

So it's plausible that repeated application will cause the structures to adapt. The thing is, I can't find any studies that say anything about it (y'all're welcome to flex your Google Scholar Fu).

The "Dr Kirsch" turns out to be John M Kirsch, MD, an orthopedic surgeon (book) so he ought to know what he's talking about. However, this dismissal makes me nervous (in response to a query on scientific rigor) [1, top]:

> Thanks, Suspender. I understand the limitations of protocols to "scientific" outcomes etc.

The book also refers to a "Kauai Study" in which the protocol is tested on 92 patients (with positive results for 90), but I can't find the study.

So as far as I can tell, it's in the realm of theoretically possible, little hard evidence that I can find. I also can't find anyone saying that dead hangs caused them shoulder pain, so it's probably safe. At the very least you'll improve your grip, and it does feel good...

[1] http://physicaltherapy.rehabedge.com/printable.aspx?m=3879&mpage=3

Hang.

https://www.amazon.com/dp/1589096428/ref=cm_sw_r_cp_awdb_j9sszbEJ7JJHT

I back the foam roller/lacrosse ball recommendations, and some focused area yoga. Also look up some of Christopher Somers' Gymnastic Bodies programs, they have a lot of exercises for shoulder strength and mobility.

Another thing that might help you are deadhangs from a pull up bar. Dr. John Kirsch wrote a book about his studies treating shoulder pain, and as I understand it, the crux of it was that he found that doing consistent dead hangs (with the thumbs disengaged) helped alleviate a lot of the issues over time. I have rotator cuff syndrome in my left shoulder and doing the hangs has definitely been helping the pain from it https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

There is a book by Dr. John Kirsch, M.D. Shoulder Pain? The Solution & Prevention

https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

Basically, the point is there are some tendons in the shoulders and due to the bone deformations with age they start to touch the bone and you get shoulder pains and crackling. The remedy is to hang for 15 minutes a day.

Here is a video on youtube and there are more where this came from: https://www.youtube.com/watch?v=ae9nW7acekk

Its called Brachial hanging.
It was on one of the steve maxwell episodes (probably the latest one.) He tells Joe about a book he read on the subject of shoulder pain.

John M. kirsch book:

https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

its good shit. also check out John E. Sarnos book for chronic pain issues:

https://www.amazon.com/Healing-Back-Pain-Mind-Body-Connection/dp/0446557684

If you have the money I’ve heard of people having great results from stem cell injections. Also like FDLife said, hanging is great for your shoulders and I’ve personally gotten good results from this for shoulder pain. The book “Shoulder Pain? The Solution & Prevention” by John M. Kirsch, MD is worth checking out.

have you tried yoga? I am not recommending this instead of, but in addition to, seeking professional help.

Previously i had a back and rotator cuff injury from a car accident. the doctor has done multiple rounds of imaging, and i've tried many things to relieve this pain Rx naproxen, celecoxib, indomethecin, also physio, chiro, etc. I've had coughing spasms violent enough to pull back muscles, and was given codeine for this. i have gone through the mattress replacement, and pillow replacement ritual.

i found the basic chiro stuff - stretches etc. were not enough. the drugs did not stop acute, breakthrough pain that would keep me up at night, and in the evenings my back muscles were so sore from being sore, they were twitching. I remember crawling to the bathroom some nights because it was too painful to roll out of the bed and stand up and walk. I felt i was lost in physical therapy and at times the therapist was just chasing symptoms, and had even forgotten about the car accident that got me there in the first place. with two physios and a chiro, i felt i reached the point where they were just milking me for repeat visits with no improvements. After faking politeness at my last physiotherapy/acupuncture session with no relief, I decided to take a more active role in decision making re: physical therapy.

i started doing a yoga routine of just child's pose, sphinx, upward-facing dog. i didn't go to classes but looked at poses and gradually learned from youtube videos for me it took weeks to get to the third pose; my back was in too much pain for me to even curl up into a ball, and my knees also had to get their flexibility back over time. i started trying to hold a pose for 30 seconds, and then build up from there. i also did intermediate poses until i could get my flexibility back in my joints.

One thing i noticed doing this solo was i could finally start targeting specific areas based on how painful or sore they were. i mainly picked positions to try, using my back pain as a diagnostic tool. i gradually noticed there were different kinds of pain - the kind of soreness that could disappear after about 30-60 sec. in a pose, and the ones that lasted longer. i worked on the pain i could make go away with stretching poses, and it felt so empowering to be able to see some of my pain could be managed with stretching, and to see improvement over a few days or a week. The more i did yoga, the less i relied on the NSAIDS for pain management.

for my shoulder, i did the pectoral stretches and arm stretches, posture exercises i learned from my physiotherapist. i also read the John Kirsch book on Shoulder Pain: The Solution and the Prevention, which recommends hanging by your arms from a tree, and simple exercises, to slightly remodel the spine and shoulder over months through the normal stresses of statically hanging from a bar. i'd highly recommend this book if you have shoulder trouble; all of the treatments/exercises are free so he it's not like he's selling you on Zumba. When i started seeing improvements in my shoulder, i started sleeping much better.

i think what helped me the most was a good night's sleep. i went from about 3-4 hours of sleep to 8+ hours every day. I think this helps me as much as the stretches. I think once i started getting more sleep every night, i felt i got more benefits from the yoga stretches and hanging from a tree. it took me about a year and a half to get to this point.

n.b re: mattress: i still get a sore back every fucking night, but i am too poor to buy another. but i get out of bed and do my yoga poses, shoulder stretches, and by then the coffee is ready. I still need to figure out how to get less painful sleeps, but otoh i am actually sleeping now, albeit bit sore.

I encourage in addition to the tests, try to explore and restore the flexibility in your back with stretches and exercises. They are free and can be learned on youtube. i also want to encourage you to keep trying things until you can start getting quality sleep. Chronic back pain is a discouraging thing to go through and it has almost broken me many times.

So, I heard about this from Joe Rogan's Podcast after experiencing the same thing. i put a pullup bar in my office just a few inches from the ceiling so at full extension my feet do not touch the floor. Twice a day i hang from the bar. try to disengage your shoulder muscles as much as possible. This is the clip from the podcast. Good luck!

What a shitty system, they should have done an MRI a long time ago. Please push for an x-ray, if they don't find anything there ask what other imaging methods could help. Paying out of pocket for one would set you back around 200-250 euro.

Not a doctor so that sounds like it could be anything to me, but you could try dead hangs as per this book: https://www.amazon.co.uk/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

Here ya go
Shoulder Pain? The Solution & Prevention, Revised & Expanded 1st Edition
by John M. Kirsch M.D.

Had a grade 2 to both shoulders, one from surfing, one from Jiu Jitsu (a beautiful but vicious spider guard sweep).

The advice sounds about right. Good news is, two other guys (that I know of) in the same situation at my gym and all of us are still training. One is an active MMA fighter, the other won black belt worlds masters in 2014.

I went to a physiotherapist for massage and rehab exercise. This was good, but not cheap. It was OK to roll after six weeks, but took a few months to totally settle down. Or maybe I learned to move around it better.

One of my collarbones sticks up further than it should at the shoulder. Slight hunchback of Notre Dame effect. If I sleep on that side, I get pins and needles in that hand after a few hours.

Occasionally get mild tweaks when rolling, especially on my side in half guard with a big guy trying to crush me, but they usually go away after some icing and a day or two's rest.

I found this book useful once I had recovered, as recommended by Steve Maxwell:

https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

You might be able to find a free digital copy somewhere.

On the rotator cuff issue, what you do about it may come down the specific nature of the injury. Generally speaking, though, I would pay attention to exercise selection. I have issues with my supraspinatus tendon (the one that passes over the top of the shoulder). I tend to floor press more often than I bench press, because it keeps my elbows from passing behind my back; I've injured my shoulder that way on heavy lifts. I also use a landmine, single or double arm, for shoulder presses more often than pure overhead pressing. I am 39 years old and I want to keeping getting strong, but I recognized that I may have to do things a little differently than if I were in my 20s. I am not advocating abandoning all potentially risky exercises, but you may want to reconsider how frequently you do them.

Also, this will sound weird, but I spend some time each day just hanging from a bar. Just a relaxed hang, as long as I can hang on, for a few sets over 10 minutes. An orthopedic surgeon named John Kirsch wrote a book called Shoulder Pain? The Solution and Prevention that advocates this approach. It's not a very long book, and it basically tells you to do the hangs and explains the mechanism as to why it works. In a nutshell, in a fully overhead hang the head of the humerus comes into contact with the acromion and, over time, reshapes the space between the acromion and the humerus to make more room for tendons, tissues, etc. Also, it's just a good stretch; you can feel it stretch out your pecs if you're tight there. Combine this with some accessory exercises that work the rotator cuff.

Yes, thanks.

One thing about the comment about the RC muscles getting smashed up. I read this book on shoulder pain a while ago and the author actually recommends dead hangs for shoulder pain. While I'm not sure that's the best recommendation for everyone, one thing he does address is RC impingement in the overhead position and he claims it's not possible as the RC will have completely cleared the acromion by the time the arm is straight up. So I assume something else must be getting pinched here like the bursa or bicipital tendon.

Personally I do get some pain in my left bicipital groove with some overhead presses and occassionally with a hang. Would that be remedied by the same thing, more external rotation?

You could try reading this book, Shoulder Pain? The Solution & Prevention, Revised & Expanded https://www.amazon.com/dp/1589096428/ref=cm_sw_r_cp_apa_DmGkybTFSYDFW , if money is the issue. But if it hurts a lot I would stop doing exercises that hurt. Don't want to permanently injure yourself.

I'm no doctor but can highly recommend the approach laid out in the following book https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428 The program basically involves hanging from a pull up bar to help remodel your shoulder.

I heard this episode as well and I am still very sceptical. The guess is the author of this book: John M. Kirsch M.D. Shoulder Pain? The Solution & Prevention, Revised & Expanded https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428?SubscriptionId=AKIAILSHYYTFIVPWUY6Q&tag=duckduckgo-fpas-20&linkCode=xm2&camp=2025&creative=165953&creativeASIN=1589096428

I haven't read the book myself. There are reviews online, but I haven't read them either. So you can find a lot of information on this stuff.

I personally don't find hanging to be effective at all.

> Every business person has to figure out where the point is that money gets you the rest of the information. We all have to eat, sleep, and save for rainy days/retirement/children, etc.

Absolutely, but if injury is to come from it... that is a dishonorable method. This is all conjecture though, right? I mean, Ido sincerely believes (from Dr. Kirsch's book) that hanging is the way to go toward improving shoulder health. So, maybe the people who are getting hurt are anomalies? I sure hope so!

Are you doing a shoulder health routine for preventative reasons or do you currently have an issue with your shoulder? There's an orthopedic surgeon that wrote this book stating that he treats many of his patients by telling them to do dead hangs every day. It's good for preventative care and recovery. I've started doing deadhangs about 2 weeks ago and I've noticed an improvement in my weak rotator cuffs already. Sorry that I didn't really answer your original question, but I figured this would be worth mentioning.

Hey man, haven't seen the doc yet (plan to next month) but I've changed something that seemed to make a lot of difference.

Every time I introduced extra work to my external rotators I felt my teres minor really really tight to the point where it would bother me way too much.

Two things that have helped were:

1-) Hanging from a bar. Just seriously hanging form a bar. Shoulders completely relaxed and loose up to my ears. At first you wont feel it, but after getting used to it you'll be able to stretch further and you'll feel (or at least I did) your teres minor stretch so fucking good (the one on my left side, with the shoulder issue). It feels searing hot but without pain (as opposed to normal stretches) and my shoulder has been crackling a lot less and feeling a lot better since incorporating this and #2 which I'm about to tell you.

I encourage you to read this blog post. He talks about this book towards the end. I'm just doing a regular bar hang anywhere from 30 to 40 seconds to a total of 6 minutes a day. I started about 10 days ago doing 15 to 25s of hanging and around 3 minutes a day and was able to improve very fast.

2-) Snatch grip BTN presses (klokov press). Fuck these feel really good and I really feel like they've taught my body how to proper position and recruit my scapular stabilizers. I don't really know and at this point I'm just guessing but fuck me this has been really helping me. I feel like this guy properly communicates what I'm saying and well, u/gzcl advocates these for shoulder health as well so I'd say go for it if you can do them without pain.
I did these before but never in combination with the hanging work and I'd just end up with an extremely tight and painful left teres minor. Now shit just feels good. I honestly thought I'd need some sort of surgery or shit.

Also, don't forget to do rear delt work. I've been doing a shitload of band pull-aparts and band bilateral external rotations and I feel these really help as well (albeit not as much as the other two).

So there's a great book and rehab protocol for shoulder rehab called "hanging therapy". I competed many years in brazilian jiu jitsu and have used it successfully for shoulder pain and issues of myself and friends. I first saw it on the Joe Rogan podcast.

You can read up on the protocol or get the book that it originates from. Here's a link to it: https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428

It's written by a doctor who was a shoulder specialist. It has a very high success rate for rehabilitating shoulders.