Hello Derek and Michael (and possibly Charlie or Austin)!
I have been having some pain/discomfort in my serratus antertior on both sides but more pronounced on my right side (probably because I am right hand dominant) over the last couple weeks since starting doing construction work. I know it could end up be something else but based on the specific localization of the discomfort and the activities that seem to cause increase in discomfort seem to involve the movement that requires it to work.
No catastrophizing going on, no decrease in strength on things like bench or OHP so no injury seems likely. I realize it is most likely a spike in the work load for a reasonably small muscle causing fatigue which is essentially causing them to be whiny all the time to my brain. On week 4 of the Bridge after two round of the legacy Endurance template while going through a few months of cutting weight and proceeding as normal.
My question is, should I be adding anything like movements that would work the muscle group more directly to try and strengthen it in a more structured manner? Or do I just need to deal with the discomfort until my body adapts to the fun of move lots of oddly shaped reasonably heavy things around for 8 hours a day?
Hey Bobby! Hope you don’t mind a different Michael chiming in. My initial thoughts are that if your performance hasn’t decreased and you can tolerate the construction work, then I would carry on and monitor symptoms from there. That being said, I do have some questions that might help give a clearer picture of what you’re experiencing and if I can give more specific advice: Can you explain more about the specific localization of the symptoms? Do you have examples of the activities or movements that seem to increase the symptoms? Thanks!
You are pretty official considering you were on the PT Podcast recently though your BBM picture seems to be after a haircut compared to your Boston Wellness photo.
The symptoms are localized to what I would describe as the outer mid back. I can palpitate the area which seems to be mostly localized around my middle ribs (probably 4-8) and seems to line up with where you can visually see the serratus anterior on people that are sufficiently lean with enough development of the group. Additionally, it seems to be aggravated/fatigued when I do activities that require me to grab things in awkward positions that seem to require scapular extension like carrying large sheets of drywall, plywood or other objects that are large and unwieldy that I usually have to carry rather far away from my body. The fatigue does seem to persist to a lesser extent even on days that I am less active and is best alleviated by lying on my back in a slightly elevated position.
Hopefully that is sufficiently specific and, if not, I am happy to give you more details.
Haha, you can say I’ve been through some hairstyle changes over the last year.
No, that helps and makes sense. It may very well be some soreness in the serratus anterior, or possibly the intercostals, but hard to say with a large degree of certainty, not that we need an exact diagnosis in most cases. So going back to your original questions:
“Should I be adding anything like movements that would work the muscle group more directly to try and strengthen it in a more structured manner?”
Probably not. If you’re able to bench and OHP within tolerance, without any decrease in performance, then that should be fine. And if you’re keeping up with some general accessories, i.e. rows, pull downs, then I don’t see a need for anything more specific.
“Do I just need to deal with the discomfort until my body adapts to the fun of move lots of oddly shaped reasonably heavy things around for 8 hours a day?”
You will likely adapt to this., but I have a follow up question: Is this something you will be doing long term, or is this just a project that will be ending in the near future?
Sorry for the slight delay Mike, very busy last few days.
I think in the spirit of Barbell Medicine this is an answer that requires some nuance. I am transitioning from a career in corporate sales to the construction industry. As such, I would predict my day to day will permanently have more physical demands but probably not quite to the current level. I am currently working as a General Laborer to build some industry experience while I work on getting into an IBEW Apprenticeship to become an Electrician which should require more skill and less moving rocks and other heavy things from one place to another.
Sooo, I will be working at this level of demand for an undetermined amount of time until I get into the apprenticeship which will hopefully only be a couple months but could be longer.
As an aside, I do seem to see a slight decrease in performance on my Bench and Press over the most recent two weeks but I’m not sure if that is just poor luck with performance cycles, something related to this or even just some small drop related to my extended cut and weight loss because it’s only a drop of around 5% or so.
Thank you again for all your time and knowledge!
P.S. I was listening to the second Rehab Podcast and want to thank you for the awesome philosophical insights! Also, I know you mention something about reading fiction at one point so if you want a book series recommendation I cannot recommend Pierce Brown’s Red Rising trilogy highly enough. Absolutely brilliant!