How to Deal with Shoulder Injuries: The Infraspinatus
Feb 12th, 2008 by Mehdi
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Posted by Sandbender in StrongLifts.com Forum:
I’ve been doing Stronglifts 5×5 since November 2007. I injured my right shoulder while lifting 3 weeks ago. Pain between spine & shoulder-blade, shooting into biceps.
Prior to that, I’ve had persistent pain in my right shoulder. I think the pain was from holding my right hand out for the mouse plus bad sitting posture. I’m working to address the ergonomics of my desk.
The injury required me to drop 10 lbs off my Overhead Press and Bench Press. I’ve continued lifting through the injury. Not increasing the weight for presses but focusing on technique.
Daily I’ve been doing:
- 20x Shoulder Dislocations
- 2×10 Scap Push-ups
- 3×10 Face Pulls
- 3X10 Behind The Neck Pulldowns
Should I take a break from pressing to allow the shoulder time to heal? Are there other exercises that would assist in strengthening the shoulder girdle?
The Infraspinatus. One of your 4 rotator cuff muscles. The Infraspinatus is a dynamic stabilizer & assists in outward arm rotation. It’s located behind your shoulder & covers your shoulder-blade.
Image credit: A.D.A.M.
How Do You Get Infraspinatus Injuries? Habitual overload or repetitive strain related to outward arm rotation can injure your Infraspinatus. Examples:
- Keeping Arm in Front/Overhead. Driving car with your hands on top of wheel, working on computer without elbow support, etc
- Reaching Back Repeatedly. Controlling computer mouse, forehands in tennis, smash in volleyball, etc
Symptoms of Infraspinatus Injuries. Although the infraspinatus is located behind your shoulder, pain is usually felt in your front shoulder.
- Front Shoulder Pain. Pain down into biceps. Pain feels as if it’s deep in the joint. Side shoulder, neck & shoulder-blade can also hurt.
- Stiff/Weak Shoulder. Shoulder & arm tire out more easily on one side than the other. Muscle imbalances. Stiffness. Arm going numb.
- Restricted Mobility. Reaching back – like when putting on your jacket – is difficult. Lying on your shoulder when sleeping hurts.
How to Treat Infraspinatus Injuries. Other rotator cuff muscle will compensate the weak/injured infraspinatus. This can cause problems in your whole shoulder – like frozen shoulders. Don’t let this get out of hand.
1. Fix Posture. Correct posture when sitting & doing exercises like Barbell Rows or Bench Press is shoulder-blades back & down. Hanging shoulders & flaring shoulder-blades is bad posture. Exercises you can do:
- Shoulder Dislocations. Improve upper-body mobility. 3×10 reps as warmup / on recovery days. Start with a wide grip.
- Doorway Chest Stretch. Tight chest muscles will pull your shoulders down. 3 sets of 10 seconds post workout/ on recovery days.
- Bike Face Pulls. Strengthen your upper-back & traps. Squeeze your shoulder-blades when pulling back. 3×10 reps post workout.
- Pelvis Realignment. Problems with your shoulders often means problems with your hips. Check for symptoms of lordosis.
2. Trigger Point Therapy. Trigger points are knots in your muscles caused by overstimulation. These can shorten & stiffen your muscles. Movement stresses muscle attachments, which can damage connective tissue & distort joints.
Popping shoulder joints are evidence of joint stress caused by trigger points. Stretches & rehability exercises can irritate trigger points and aggravate your pain. To remove the knots:
- Infraspinatus Massage. Massage your shoulder-blade using a tennis ball against a wall. 20 strokes several times a day.
- Rhomboid Massage. Between shoulder-blade & spine lies the Rhomboid which can also be overworked. Massage it using a ball or Thera Cane like in this video.
3. Prevention. Posture realignment exercises & trigger point therapy won’t do much if you have bad posture the other 20 hours of the day.
- Sit Correctly. Build the habit of sitting with your shoulder-blades back & down. Put a post it on your computer “shoulder-blades back & down“.
- Drink More. The best way to move more when you have a desk job. You’ll be forced to get out of your chair to go to the toilet.
- Switch Sides. Use your left hand for a while so your right hand gets a break. It takes 2 days to build dexterity in your other hand. Persist.
- Quality Chair. Adjustable chair with elbow support so your shoulders stay relaxed. Aeron Chairs or Steelcase Chairs are worth the money.
- Balanced Program. As much pulling (Rows, Pull-ups) as pushing (Bench & Overhead Press). 1 overhead session for each Bench Press session.
Stay away from painkillers. Pain is your body telling you something is wrong. Find out what. Educate yourself. Ask your doctor’s advice. But make sure you treat the causes, not the symptoms.
Take it slowly with weight lifting in the meanwhile. Lower the weight, spend time improving technique & slowly build back up. Don’t worry about strength loss, getting rid of injuries is more important in the long run.
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Awesome tips Mehdi. Anyone working at a desk has probably felt this pain from time to time. A big thing regarding seated posture as you mentioned is that your shoulder is supported. For example, if your elbow is up off the desk, you tend to put a lot of strain through your infraspinatus, and rotator cuff in general. Even now my computer posture is leaving lot to be desired. Elbow off the desk and arm too much forward. I need a better chair!
I like the point you make about the rest of the day being the big problem. You can do as much rehab as you like, but if you don’t fix the cause, there is no hope.
Cheers.
@Lauren
Thanks Lauren. Computer posture over here is also not optimal. Desk is too high, chair is too low. Quality desk/chair cost money, but really worth the investment in the long run.
This post caused me to do a search on the Infraspinatus muscle, and I found a site that is absolutely amazing (at least to me). This site has flash animations and diagrams of a large percentage of the muscles in the human body….you can check it out at…
http://www.getbodysmart.com/index.htm
…and then click on the Muscular System to get started.
Congrats on passing 6000 subscribers, Mehdi! It’s posts like this one that make your site so valuable. Keep up the inspiring work!
@Michael
That’s a great site indeed.
@Trev
Thanks Trev. All of this is thanks to you, the readers. You read, subscribe, participate on the forum, provide ideas, etc. Without you & the other 6k readers, no StrongLifts.com. Thanks!
Mehdi,
very informative post. I think I may have had such an injury back in the spring from doing heavy dips. I dropped them for a few months to heal the muscles.
I didn’t expect my post to make the feed! Thanks for the excellent tips, Mehdi, the face pull clip is great - doing the scapular retraction before the pull is a great idea. I did the trigger therapy with the tennis ball and I did thoracic spine stretches using foam roller today and it’s really been helping the shoulder. The doorway stretches are great too.
I actually was able to bump up the weight on my overhead press by 5 pounds last workout, so the shoulder work has really been paying off. Forced me to improve my press technique, too.
@Sandbender
Great to read the exercises work. Be sure to work on your ergonomics at work to avoid the problem to come back.
Thanks for giving me the idea for the post
I thought it was a great post.
The other thing I’ve found that can contribute to infraspinatous problems is the posterior deltoid. The posterior deltoid can become the dominate shoulder external rotator if over developed.
Thanks again for the info.
nice article Mehdi, I actually tried using my other hand for using mouse.
This is an excellent, informative blog you have here. I was wondering if you had tips for fixing subscapularis/ upper humerus muscle attachment injuries and strains. I have a habit of sleeping on my side with my arm under the pillow and my head in an overhead position. That’s resulted in pain the inner attachment area to my upper humerus, I think at the subscapularis attachment or inner upper bicep attachment and really derailed my workouts. I can perform flat bench OK but my inner shoulder/upper arm hurts when I do incline bench presses or military presses. I’m pretty sure it’s that inner shoulder, under my armpit area that’s injured because that’s a little tender when I massage my shoulders and inner biceps area. Any suggestions would be greatly appreciated.