Good evening Drs. Ray and Miles, and all others on the forum,
First and foremost, I deeply appreciate the valuable work you all do in promoting patient-centered, evidence-based apparoaches for management across the spectrum of care.
I myself am a huge proponent of the BPS model and have applied it to myself and others in the context of barbell training rehab.
Over the last six weeks, I have been experiencing discomfort increasing to pain in what I would describe as my right A/C joint. The pain worsens with loading. However, tucking my elbows and narrowing grip allows me to bench mostly symptom-free.
I have been happy to ignore my discomfort and continue to train productively, but since my symptoms have not resolved l figured I should address it.
Since I appear to be sensitive to my competition bench press grip width and full ROM overhead press, my plan is to pin press at forehead height and close-grip bench press to tolerance, paying attention to sRPE and symptom exacerbation over a 24-48hr period.
Does this plan seem reasonable? Is there any reason to avoid full ROM bench pressing or “leaning into my pain”?
I very sincerely appreciate your input.
Some background:
Age: 24
Sex: M
Height: 5’6”
Weight: 152lbs
Waist: 30”
Injury Hx: 1 y/o wrist fracture (not pertinent)
Trainings Goals: Powerlifitng/Hypertrophy
Training Age: 3 years of powerlifting
Hey @sooghs , thanks for starting the thread and providing pertinent information. I’d say your gameplay is reasonable. However, have you tried modifying external load (weight being lifted) first before modifying range of motion and exercise selection?
I have not yet tried lighter dumbbells, which I am more than willing to do!
I understand I’m now wading into consult territory, but I was wondering if you have any thoughts as to how to mix very light work with the provocative movements and heavier work at shorter ROMs.
Prior to this setback, I was doing bench press variations 3 times a week and overhead pressing 2 times a week,’for reference.
Yeah - I don’t necessarily see a need to alter range of motion at this time if we can accomplish loading of the area through full range of motion with lower external intensity. Often it’s easy to silo out a particular movement as not relevant to an area because it’s not provocative but this doesn’t mean we ignore total loading to the area. You can certainly try full rom with lower external intensity for provocative movements and shorter rom with heavier external intensity for non-provocative movements and see how things progress; worst case scenario you have to dial that approach back a bit.
Dr. Ray, thank you so much for guidance and reassurance. I will take your advice and decrease external load (and internal load via RPE) through a full ROM and scale based on how things are progressing.