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  • Shoulder pain at night

    Hi there,

    For the past several weeks, I'm waking up every night in the middle of the night with shoulder pain in both shoulders. I'm currently on week 10 of the 12 week strength template just to give you an idea of Bench and press volume. The strange part is that my shoulders don't hurt in the day or at the gym but they wake me up hurting EVERY night. Any thoughts on what to do?
    Last edited by FortuneA; 10-02-2018, 02:27 AM.

  • #2
    reposting in hopes of a reply

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    • #3
      Waking night pain in any joint, but especially the shoulders, is a sign of connective tissue inflammation/injury. It happens at night due to the wacky and/or sustained positions while asleep. Push your index finger into a stretch and leave it there you and will have a good idea what's happening. They don't hurt during the day because they can be kept in a reasonably neutral position...and the injury is not bad, yet. Your rotator cuffs are really warning you to back off. Pretty soon pain at night will lead to pain during the day and then your lifting is majorly derailed. I'd back off on the bench press for a while and do something less provocative. NSAIDS can help, I'd give it at least 4 weeks to subside.

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      • #4
        Originally posted by FortuneA View Post
        Hi there,

        For the past several weeks, I'm waking up every night in the middle of the night with shoulder pain in both shoulders. I'm currently on week 10 of the 12 week strength template just to give you an idea of Bench and press volume. The strange part is that my shoulders don't hurt in the day or at the gym but they wake me up hurting EVERY night. Any thoughts on what to do?
        Sorry to hear about the shoulder pain and for the delay of my response.

        Can you provide some background - How old are you? Any relevant medical information/history? When did this start? Can you describe what you are experiencing? How long do the symptoms last?

        Sounds like you aren't having any issues completing training or activities of daily living?

        Vance - out of curiosity, can you provide evidence for your stance regarding inflammation at night, neutral positioning, and the identification this is a rotator cuff "issue". Finally this last statement - "Pretty soon pain at night will lead to pain during the day and then your lifting is majorly derailed." can be fear-mongering and elicit a nocebo response - I caution against making such statements.

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        • FortuneA
          FortuneA commented
          Editing a comment
          Hi Michael, Thanks for your reply. I'm 46 years old. For the past 3 weeks, the pain set in while sleeping at night and is in both shoulders equally. It didn't both me in the day or at the gym the first 2 weeks but woke me up several times during the night every night. This past week it has affected me a night and at the gym and I've had to massively back off my bench and pressing volume and intensity due to pain (I'm in the middle of weak 11 of 12 week BBM strength program...which has me super bummed out since I've had to basically stop pressing this week). But I'm still progress on CB an CS....I'm not going to stop training. FYI, I've had this issue come and go over the past couple of years. It seems that when I back off pressing, get weekly trigger point acupuncture treatments (probably placebo - but seems to help) and get deep tissue massage (probably placebo - but seems to help)....that it eventually goes away....and I ramp back up my pressing....then 6 months later this issue creeps back up.....super frustrating!!!

      • #5
        Hi Michael Ray, based on his limited history sounds like bench press induced rotator cuff tendonitis that has been described over decades by legions of lifters. Is it precisely what's going on? Maybe not, the poster can further elucidate. Far from fear mongering (nocebo is now my favorite $10 word), just giving the logical worse case scenario, which happens all the time.

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        • #6
          Originally posted by Vance View Post
          Far from fear mongering (nocebo is now my favorite $10 word), just giving the logical worse case scenario, which happens all the time.
          This is literally fear mongering. Additionally, descriptions by "legions of lifters" is not particularly reliable evidence.

          We appreciate your interest in helping others in the community, but we'd also request that you not give rehab advice like this here, as we disagree with the majority of what you're saying.
          IG / YT

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          • #7
            Originally posted by Vance View Post
            Hi Michael Ray, based on his limited history sounds like bench press induced rotator cuff tendonitis that has been described over decades by legions of lifters. Is it precisely what's going on? Maybe not, the poster can further elucidate. Far from fear mongering (nocebo is now my favorite $10 word), just giving the logical worse case scenario, which happens all the time.
            I'm in agreement with Austin. The anecdotes you are presenting are not beneficial and have a high likelihood to instill unnecessary fear into readers. The 'legions of lifters' you are referencing is often how fear-mongering false narratives are spread, we wish to minimize the spread of such misinformation via Barbell Medicine.

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            • #8
              Ah jeez.... FortuneA, let me apologize if I scared you. Hope you are feeling better soon.

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              • #9
                Hi Michael, Thanks for your reply. I'm 46 years old. For the past 3 weeks, the pain set in while sleeping at night and is in both shoulders equally. It didn't both me in the day or at the gym the first 2 weeks but woke me up several times during the night every night. This past week it has affected me a night and at the gym and I've had to massively back off my bench and pressing volume and intensity due to pain (I'm in the middle of weak 11 of 12 week BBM strength program...which has me super bummed out since I've had to basically stop pressing this week). But I'm still progress on CB an CS....I'm not going to stop training. FYI, I've had this issue come and go over the past couple of years. It seems that when I back off pressing, get weekly trigger point acupuncture treatments (probably placebo - but seems to help) and get deep tissue massage (probably placebo - but seems to help)....that it eventually goes away....and I ramp back up my pressing....then 6 months later this issue creeps back up.....super frustrating!!

                Comment


                • #10
                  Originally posted by FortuneA View Post
                  Hi Michael, Thanks for your reply. I'm 46 years old. For the past 3 weeks, the pain set in while sleeping at night and is in both shoulders equally. It didn't both me in the day or at the gym the first 2 weeks but woke me up several times during the night every night. This past week it has affected me a night and at the gym and I've had to massively back off my bench and pressing volume and intensity due to pain (I'm in the middle of weak 11 of 12 week BBM strength program...which has me super bummed out since I've had to basically stop pressing this week). But I'm still progress on CB an CS....I'm not going to stop training. FYI, I've had this issue come and go over the past couple of years. It seems that when I back off pressing, get weekly trigger point acupuncture treatments (probably placebo - but seems to help) and get deep tissue massage (probably placebo - but seems to help)....that it eventually goes away....and I ramp back up my pressing....then 6 months later this issue creeps back up.....super frustrating!!
                  Thanks for the information. I'd recommend a consult with us: https://www.barbellmedicine.com/consults-and-contact/.

                  It's likely this is a load management issue given the prior history. What you are describing is also fairly standard regression to the mean (https://www.ncbi.nlm.nih.gov/pubmed/1280801).

                  So what does the graph mean?
                  In a nutshell, we tend to encounter an event which may provoke symptoms (like pain). When pain spikes there’s usually a subjective tolerance level where we seek out treatment for fear of something being wrong or thinking we need a treatment to alleviate symptoms. In most cases, the pain will regress back to baseline levels. The unfortunate reality, interventions are utilized that appear to be effective in reducing symptoms but are erroneously assigned success when in fact the pain perception would have decreased with time.
                  Understanding this talking point allows the “tools” in the magical toolbox to be minimized and thus mitigating dependency by a patient. More importantly, this time can be used to set patient expectations, reassure, and a teaching point how one can take care of themselves (building self-efficacy).

                  Regarding dry-needling, yes it is highly likely to be theatrical placebo - https://journals.lww.com/anesthesia-...lacebo.25.aspx

                  We'd also need to discuss the existence of trigger points, which research continues to demonstrate we don't have diagnostic criteria for as an actual issue: https://www.ncbi.nlm.nih.gov/pubmed/28098584

                  Same story with massage and manual therapy in general (Placebo Mechanisms of Manual Therapy: A sheep in Wolf's Clothing? http://www.jospt.org/doi/abs/10.2519...ode=jospt-site).
                  These implements may feel good and "work" because your belief is that is what's necessary to "fix" the perceived issue and have conditioned yourself to these modalities. At the end of the day I tell people, it's your choice, time, and money - but I do my best to educate what we have evidence to support, what evidence is contradictory to, and what is likely perpetuating the persistence of the issue and our learned responses. Happy to discuss.
                  Last edited by Michael Ray; 10-12-2018, 01:14 PM.

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                  • #11
                    Let's separate the "treatment" discussion for a moment. I like getting a massage and will continue to do so. I don't know if it actually helps or not ....but I will do it because I like it. Now.....let's discus the cause of the pain.

                    it's episodic pain and it goes away once I back off on loading and time passes (and I detrain as a result). Assuming that I'm using correct form in benching and pressing, and following a reasonable training program such as BBM 12 Strength template ......i.e. I'm working within the prescribed set, reps, RPEs in the program.....WHY am I experiencing this pain in the first place?

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                    • #12
                      Originally posted by FortuneA View Post
                      Let's separate the "treatment" discussion for a moment. I like getting a massage and will continue to do so. I don't know if it actually helps or not ....but I will do it because I like it. Now.....let's discus the cause of the pain.

                      it's episodic pain and it goes away once I back off on loading and time passes (and I detrain as a result). Assuming that I'm using correct form in benching and pressing, and following a reasonable training program such as BBM 12 Strength template ......i.e. I'm working within the prescribed set, reps, RPEs in the program.....WHY am I experiencing this pain in the first place?
                      FortuneA, it is quite difficult to state anything is the "cause" of pain. Regarding the why is also difficult to state. However, if you are noticing symptoms at night and with training, then it is possible you aren't tolerating loading regardless of what is programmed. There could potentially be other "triggers" that are going on in life as well that may need addressing.

                      We also can not link pain to technique or form very well either. Rather than expending time and energy to attempt to reduce pain to a single cause, our time is typically better spent addressing the current occurrence and then attempting to set you up for the future with the understanding pain is a part of life and what matters most is how we deal with it.

                      EDIT: We could give better advise with a consultation but if this continues to worsen then I'd recommend seeking consult with someone.
                      Last edited by Michael Ray; 10-12-2018, 10:32 PM.

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