Acromioclavicular Joint Injury

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I started to get this problem about six months ago now in my acromioclavicular joint in my right shoulder. Flat bench seems to be the culprit. After training it is sore to the touch but putting my right forearm behind my back is what makes it sting the most. During the exercise there is some discomfort and I am aware that it doesn't feel right compared to my left shoulder but I can usually get to the end of my set and just ignore it. It has improved over the six months but now it's staying pretty constant. Over SD it just stays sore and this cycle, 15s haven't helped so far.

Am I right in thinking that if it's going to take about 100 days for my body to sort out the repair (through collagen replacement) that I should just lay-off bench completely for that time? Or, will it gradually improve as it has done at a very slow rate? I don't want to cause a chronic condition so my guess is that I should probably stop.
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I can only do inclines in a Smith machine which I hate (and they are still uncomfortable).

Dips don't seem to hurt it as much so I could still do them. I could also give db inclines a try to see if that reduces the discomfort. I know Sci likes those.

Are there any specific supps I should take to speed up healing? Maybe lots of jelly for the gelatin? Or will I get enough in a balanced diet and just have to sit it out?

Any similar experiences and how you sorted it would be nice to hear. TIA.
 
have you seen a doctor or therapist about this?
if not, i would think that might be the best way to find out what the problem is.
 
I only have pain in my right shoulder too. I finally discovered why!
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It is caused by muscle imbalances. I am very right-hand dominant and over the years I have developed right-shoulder muscle imbalances. Before it gets too serious I am doing some rehabilitation. What I have noticed is my left shoulder is very healthy, and I have noticed very specific differences in my left and right shoulder flexibility. On exrx.net I found out that the tightness/ imbalance is caused by a very inflexible infraspinitus/teres minor (external rotators). The way I found out about it is by looking at the different stretches, the infraspinitus broomstick stretch tells the whole story for me, my left shoulder has no problem with this stretch, but my right shoulder is very inflexible in this position. The particular problem for me is called "internal rotation inflexibility". I have had this problem for years and never knew what to do about it, the tightness in my external rotators is so bad that it pulls my upper-back out of whack, and I can't afford to go to a chiropractor regularly. I am so relieved to have found the cause of my right-shoulder problem before it got too serious. I plan on doing pretty intensive therapy. Basically focusing on stretching the external rotators of my right shoulder many times/day, but to be safe I am going to stretch all muscles of both shoulders and also make sure to do some strengthening of the rotator cuffs to balance this issue.

Most degenerative shoulder diseases are caused by specific shoulder muscle weaknesses/inflexibilties that were left untreated and exacerbated by heavy lifting, imbalanced exercise, etc. Make sure to stretch and strengthen your shoulders!
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Thanks Blue and Sci. I'd like to see a good sports physio to see what they say but I'm going to check out right shoulder flexibility, as Sci suggests, first. I like to have plenty of ammo before I go to see anyone so that I am able to raise "intelligent" questions and better understand their responses.
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Off the top of my head, I'd say to be sure to get your flax and fish oil in; which can help a lot of things. Next, since I have the same thing to a lesser degree, as suggested, you should not do the exersize that exacerbates the pain the most (bench for you and me) but I do d/b presses with palms facing and can go heavy as heck with no problem.
Oftentimes a shift of merely two degrees in angle of attack can alleviate you of a pain in a movement. Try all the other presses and pick the two that hurt the least and stay with them for 6 months. (just advice)
As for imbalances as SF spoke of, most of these sort themselves out as you grow, just like differences in arms, unless you're Jay Cutler or Ronnie. It looks like naturals get things evened out and 'roiders end up back with imbalance on some guys. Just an observation. If something doesn't hurt; I tend to ignore it and lift.
Next, as having a new, hyper wife has shown me, hard massage is good. Painful, but recuperative. The stretches are a must. I have this black orthopedic specialist at my church who asked me if I wanted to be young again. (well...DUH!) He said to stretch everything at least four times a day and watch the difference. I've yet to take that much time from my day, but it sounds good. He's about 60 and limber as spaghetti.
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<div>
(Lol @ Nov. 01 2006,21:46)</div><div id="QUOTEHEAD">QUOTE</div><div id="QUOTE">I started to get this problem about six months ago now in my acromioclavicular joint in my right shoulder. Flat

Am I right in thinking that if it's going to take about 100 days for my body to sort out the repair (through collagen replacement) that I should just lay-off bench completely for that time? Or, will it gradually improve as it has done at a very slow rate? I don't want to cause a chronic condition so my guess is that I should probably stop.  
sad.gif
 I can only do inclines in a Smith machine which I hate (and they are still uncomfortable).

Dips don't seem to hurt it as much so I could still do them. I could also give db inclines a try to see if that reduces the discomfort. I know Sci likes those.

Are there any specific supps I should take to speed up healing? Maybe lots of jelly for the gelatin? Or will I get enough in a balanced diet and just have to sit it out?

Any similar experiences and how you sorted it would be nice to hear. TIA.</div>
1.  Quit doing flat bench presses
2.  Go here http://www.t-nation.com/readTopic.do?id=459454 and see if your 8 rep external rotation SA is 9% of your bench
3.  If it is at least 9%, then work on your RC's without doing any bench work for at least 8 weeks.  If it is not 9%, then work on your RC until it meets that strength level even if it takes more than 8 weeks.
4.  For the next 3 months,
 a. Don't go below chin level on shoulder barbell     presses
 b.  Don't go below chin level on pullups or chin ups

5.  Also incorporate exercsises such as these -- http://familydoctor.org/265.xml for 8 weeks, done at the end of your workouts while abstaining from flat bench presses
 
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(Lol @ Nov. 02 2006,05:09)</div><div id="QUOTEHEAD">QUOTE</div><div id="QUOTE">. I like to have plenty of ammo before I go to see anyone so that I am able to raise &quot;intelligent&quot; questions and better understand their responses.  
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this is a good way of looking at things.
i know a lot of folks here have had similar problems and their advice is &quot;spot on&quot; if you have the same problem, but if you dont.....

the reason i mention this is....
a few yrs ago i had shoulder trouble and spent 4-6 months diagnosing and attempting to heal it with all sorts of advice that made sense at the time. bottom line i eventually saw someone about it, tried rehabing it, eventually needed surgery. the real kicker was i spent 4-6 months working around it and also not gaining when if i had seen someone to start with i would have been recovered from the surgery and already back in the gym. as it was i was only just  going into surgery, basically 1/2 of a yr wasted and a 2-3 month recovery to look forward to.

im not saying youll need surgery and if you do ALWAYS get a second (or 3rd)opinion . just arm yourself with as much info as possible AND see a professional. if you can find someone you like and trust it will be a huge asset for now and the future. if you dont have (or cant find) a doc you trust and who understands your lifestyle/goals/interests then its time to find one who does, it can make a huge difference.

good luck with the shoulder.
 
Thanks Steve. As I haven't been doing close-grip bench (and I'm certainly not thinking of testing it right now) I'm not sure how it compares to my usual 'a-bit-wider-than-shoulder-width' grip bench?

If I took my 5RM flat bench as 250lbs that would give me an estimated 1RM of 280lbs. If I take 9% of that I get about 25lb. So, 9% of close-grip bench would be a bit less than that.

It would be helpful if any of you know how your flat bench regular-grip 1RM compares to your close-grip 1RM. TIA.
 
Bluejacket: I think that's very sound advice and thank you for relating your experience. It is early days for me yet but I would really like to know (if you don't mind my asking) how your surgery went just in case it is a road down which I will have to travel. Do you feel like it was a great success or the best of a bad deal? The shoulder is such a complicated joint that I think I would be very nervous if a doc suggested that surgery might be required to sort out my problem.
 
Quad: thanks for your thoughts too. I am indeed taking all my EFAs in the form of flax (a blended mix of Omega 3,6,and 9), olive oil and fish oils. My joints have been brilliant since taking these supps. I can carry on with 5s for much longer now.

I do think that muscle imbalances around the rotator cuff are probably the root cause so I will attempt to strengthen them and ensure that I have a good range of motion once I have seen a good sports physio and been given the OK to do so.
 
lol
shoulder surgery was a success for me. but i resorted to it only after attempting rehab with strengthening exer. to no benefit. it took some time to find a specialist i felt comfortable with as well as a 2nd opinion i also was comfortable with. the shoulder is a complicated place and even an MRI doesnt give a clear picture of everything due to its proximity to the lungs (cant stop breathing during the 20 min MRI).

bottom line was he was expecting to find a bone spur (which he did) but prepared me for a number of possibilities from tears to detachments ( not likely in my case but like i said its apparently quite complicated in there). the pain really isnt that bad (never took the pills) and just the piece of mind knowing the problem had been fixed and i would be able to lift again in a few months was worth it.

imo surgery should be a last resort but seeking advice of a professional (doc or therapist, physcio, etc) once your sure your got a real problem (not just soreness etc.) should be a first step. youve got a lot of info already, couple that with a good docs expertise and exper. and youll be on top of it in no time. chances are you may just need to lay off the bench for awhile and do some strength exer.

its funny, many think if they go in to a doc they will be signed up for surgery tommorrow....not unless you play pro ball. by the time you see you gp doc and he refers you to a specialist who finally fits you in in a few weeks. then you try rehab for a month then back to the specialist then the time for a second opinion etc etc...

as you can see even if you want it to go fast it wont.
i wish you the best...i hope it all works out for you.
 
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(Lol @ Nov. 01 2006,21:46)</div><div id="QUOTEHEAD">QUOTE</div><div id="QUOTE">I started to get this problem about six months ago now in my acromioclavicular joint in my right shoulder. Flat bench seems to be the culprit. After training it is sore to the touch but putting my right forearm behind my back is what makes it sting the most.</div>
Am I the only guy here who can't really get his arms behind his back anymore? Ever since I went to narrow pullups and my lats expanded, I can't pop my own back anymore, because I can't reach my other elbow with my hand!
(sorry for getting off-topic, but I was wondering about it all year)
 
New info. regarding shoulder problems...

I recently switched from flat bench to dips + incline bench, to better develop my pectorals. I also thought it would help the weird pull I get in my right shoulder when flat benching. It turns out the angle of benching has little to do with it, as THE PULL IS EVEN WORSE IN INCLINE PRESS!

I recently discovered I have an inflexible infraspinitus (external rotator) on my right shoulder, which I am currently rehabilitating with stretching. Well, I noticed that an inflexible infraspinitus is not supposed to affect benching, but a weak infraspinitus will! I thought there could be no way my right infraspinitus could be weak also, since the reason I developed it to be so inflexible was due to being right-hand dominant. I figured with all the extra use my right-hand gets I should have an extra strong (yet inflexible) infraspinitus. NOPE, I tested my strength today, lying on my right side I grabbed a 15 lb. dumbell with my left hand and did 12 lying external rotations no problem, then I switched sides and I only did about 6 with my right-shoulder and fatigue set in!
I have no idea how a right-hand dominant person could have WEAK AND INFLEXIBLE muscles in their right-shoulder, when the left is fine? But it happened somehow and so now I have to do stretches and strengthening of my f*&amp;@$#d up right external rotators! oh well at least I know the problem AND the solution now.

Also if anyone else has this problem (weak external rotators), exrx.net suggested to do bench presses with a narrower grip and keep the elbows closer to the body, and the bar lower down on the chest (further from the neck). I tried this and was happy to find the pain was gone! Apparently keeping the elbows down and close to the body does not involve as much pressure on the internal rotators so a weak external rotator will not imbalance the shoulder as much in this position.

Hope this info. helps someone as it certainly is helping me tremendously!
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That's a powerlifter's bench press.  You will see very few powerlifters who use a wide grip with elbows flared in competition.  Wide grip with elbows flared works the chest MUCH more than a powerlifter's bench press, but that's also a great way to get a pec tear if you go heavy.  If you're a bodybuilder, the problem with bench pressing the powerlifter's way is that it takes a LOT of pressure off the chest and moves more onto the shoulders and triceps, which defeats the purpose if you're doing the movement for chest.
 
I agree Steve, once I have fixed my external rotator problem , I can go back to a wider-grip to hit the pecs better. For now I either have to do the power-lifter bench or do no benching at all. I might switch to dumbells at least until my shoulder is better. They seem to hit my pecs strongly without affecting my shoulder-problem.
 
I just tested my external rotators with the seated, single-arm external rotations (as in the Polyquin article on the T-Nation site)

I decided to try a 25lb db as that worked out to be about 9% of my estimated 1RM for normal grip flat bench (280lbs) as I don't know what my close grip RMs are. Anyway, 25lbs is exactly equal to 10% of my 5RM @ 250lbs.

So, 1st set I managed 12 reps with my right arm and 15 with my left. Then 2nd set, 9 reps with right, 15 with left again! So there is an imbalance. No pain from doing these so that's good and I also managed more than 8 reps with both arms.

Do you folks think I should just focus on the right arm and do these three times weekly HST style until it has caught up? I obviously don't need to work on the left right now.

I have only done dips this week (no bench) and my AC joint is much less sore already so I am very hopeful that this will be fixable without too much of a disruption to my training. Thankfully, standing shoulder presses don't seem to be a problem. I got a pb for my 15RM on Friday with 16 reps@115lbs. I lower the bar to my upper chest too for each rep without any shoulder pain. It doesn't sound much but a year ago I could only manage 70lbs so I've added nearly 65% to this lift in that time.
 
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(Lol @ Nov. 05 2006,11:09)</div><div id="QUOTEHEAD">QUOTE</div><div id="QUOTE">I just tested my external rotators with the seated, single-arm external rotations (as in the Polyquin article on the T-Nation site)</div>
Despite having an imbalance between your left and right, your external rotators seem to be fine, since both shoulders seem to be able to get enough reps with the 9% minimum of your max.

I think it's time to find out exactly what part of your shoulder is giving you pain, and do the exercises or therapy that will work on that specific part of the shoulder.
 
Lol, I did this test a few weeks back and didn't notice much problem either, I noticed a problem when I tried it lying on my side.  Try lying exernal rotations, too.  Lie on your left side and keeping your right elbow on your right hip, try to do external rotations, this is when I noticed a weakness.  Also have you done the shoulder flexibility tests yet?  exrx.net has a list of stretches for the shoulder and the rotators (internal and external) should be tested.  I have been doing intensive external rotator stretches, but no improvement yet, these things take awhile.  When I am sitting in a car or at home, I put my right hand behind my lower back and sit back so my elbow sticks forward, it hurts like hell on my right shoulder as it stretches the inflexible infraspinitus/teres minor.  When I stretch my left shoulder like this I feel the stretch, but it is mild.  Definite imbalance!  Also I noticed that this stretching pain in my shoudler when I do these is very similar to the sensation I get when benching, so for me I know this is the problem for sure.  Hopefully with daily stretching and the rotator exercises, my shoulder will be healthy in a few weeks/(months?
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).

I hyper-linked the stretches here:

Infraspinitus stretch

Subscapularis stretch
 
I'm going to try to get to the bottom of this this week if poss, although I have a lot on. Thanks for the links Sci. I will be doing the exrx.net stretches among others.

I actually think I should be doing a regular stretching/flexibility program for all my muscles and joints on off-days. It is almost amazing to me now that I used to be able to get close to doing the splits many moons ago. Sadly, that flexibility has now gone. I expect it is possible to get it back (not that I want to go that far again) with a concerted effort over time but I do recall that all improvements were slow and uncomfortable.

I've found a few more T-Nation shoulder health related articles which are really worth a read. There are lots of useful tips to work out shoulder issues. They are here:

Shoulders pt I
Shoulders pt II
Shoulders pt III
 
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