Shoulderpain for one year

Pain & Rehab Forum [Moderated]
1

First of all thank you Barbell medicine for all the great content you made.

In the summer of 2022 I was following the powerlift II template and the intensity (lots of @8/@9 press work) might have been too much for me. I noticed my left shoulder starting to trouble me with a bit of pain and as a tactic I changed my competition grip to a close grip and I could bench pain free. For a few weeks this went great and I was even hitting a PR with that grip (so no all Time bench pr, but a close grip bench pr). My best 1RM bench around that time was 140 kilo to give an idea of my strength level. Anyway after a few weeks the close grip started to hurt too and I figures I would just keep my volume about the same, dial back in kilo’s and built back up. I was familiar with barbell medicine content and of course the ‘famous’ article pain in training what to do. Unfortunately building up in a few weeks did not help. In the meantime I have tried a lot of excreties that I could tolerate better and dialed back volume.

I can find entry points on exercises so a weight that does not cause any pain and I try to build from there, but every time I get to a certain amount of kilo’s its ‘too much’ and my shoulder hurts again. Then my shoulder hurts during training and the days after including extra stiffness that I do not feel in the other shoulder.

For example the last month I had removed flat bench and only did incline bench because I can tolerate it better. But I could bench around 60-75 kilo’s pain free, 75-90 kilo’s with a bit of pain and above 90 kilo’s the more weight the more it hurts. And the more it hurts the longer my shoulder is painful and stiff after the session. It’s been months since I last benched 100 kilo’s.

My main press is currently the incline dumbell press. I can do this excersise complete tpainfree with 20 kilo’s, and 30’s is going fine as wel. Above 35 kilo’s kinda hurts. This week I tried 40 kilo’s for 7 reps at like an RPE4, but I could feel during the excersise the strength was there but my shoulder did not like it. I dropped the back off sets because it felt painful again and moved on.

At this moment I press 3 times per week.
Day 1 Incline press 1-3 work sets, low RPE
Day 2 dumbell shoulder press (strongly with a barbell its really painful, with dumbells I feel nothing), this is the only excursive that goes well and I train with RPE 7-9
Day 3 Incline barbell benchpress, extreme low RPE and just pumping.

This is what I did the last 5 weeks and not getting frustrated on the flat bench was nice for a few weeks, but I dont really feel that my shoulder is recovering. I could not incline press 35+ kg pain free 5 weeks ago and I still can’t do it.

My conclusion is that I can find an entry point (I could even go back to flat bench and find an entry point without pain) but I have trouble progressing the right way. It’s hard to imagine I already have this injury for 12 months and maybe I have not been progressing the right way. Also important to notice I did visit a physical therapist a few times, but he said there was not really a problem and it would get better if I would just decrease training enough.

I hope to find a bit of guidance and feedback how I should move forward from here. Would be awesome if I am injury free and benching heavy weights again before the end of the year : )
Thanks in advance.

Edit:
While I have written this I think my problem is I find it very hard to decide how to progress and how much ‘pain’ is acceptable. Ofcourse I had injuries in the past, for example about 6 month ago I hurt my back while warming up for the deadlift. I followed the BBM method, so deadlifting very low weight the next session and I could add weight every week and in 3 weeks I was training with normal weights again. But in this case with my shoulder it did not work that way at all…

2

Have you considered doing the upper body work from the shoulder rehab template and the lower body work from your current template?

3

I have not considered it. I have multiple BBM programs including the knee rehab program. If the shoulder rehab follows the same guidelines I can take the reps/tempo’s/intensity and built up from the knee rehab program. Would that be an idea?

4

I’m not a rehab clinician, but sure, why not try it? Principles like movement variability, increased rep range, tempo components, lower RPE are all basic principles of rehab. Although with shoulders there do seem to be some specific rehab motions included here and there like side-lying rotations and whatnot, but these aren’t magical exercises.

5

I could indeed give it a try. Still I have an open question unanswered:

‘how should I decide how to progress and how much ‘pain’ is acceptable’

6

See the section titled " Step 2: Progression and Expectation management"

7

Sorry, slow reply from my end. So I dialed back all weight and added tempo variations.

Even after reading ‘step 2’ I am trying to grasp what exactly is the best way to progress.

For example this week I did:

Day 1
tempo spoto press, 10x 40, 10x60, 10x65kg
tempo Incline db press 2x16x20kg

Day 2
Tempo incline bench 12x40, 12x50, 12x60kg

During set 3 on spoto press I felt increased tension in my shoulder. The extra incline dumbell press volume made it worse. In the evening my shoulder felt stiff. 24 hours later a bit painful and stiff, 48 hours later is was almost gone.

On day 2 I felt no pain during the excercise and no pain the day later. I was happy with day 2.

My conclusion would be that I should not yet increase volume or weight on day 1. And my conclusion about day 2 is that I can increase the weight a little bit next week.

Would you agree Austin?

8

You may have even overshot a little bit on day 1, in terms of your tolerance. So you may need to dial that day back, or re-distribute some of the training stress (for example, move the tempo incline DB press to a third session).

It seems you’re good to go on day 2.

9

Thanks for your feedback.

incline bench is a bit more tolerable for me then flat bench at the moment.

If we zoom in on day 1 again, I might dial it back a bit. But how much pain/stiffness is acceptable? I understand that we not expect to train pain free, so I guess 24 hours and 48 hours after training are important indicators if you overshoot.
Any thoughts about this, mr Baraki?

10

How are u now?

11

So nice of you to ask.

About 8 weeks ago I dialed everything back a lot in terms of weight and volume. I still press 4 days a week but really low volume and I am slowly building back up.

On bench and variations I do only 1 set and have a bit of assistance like high rep push ups. Right after the pressing sets or during I still feel a little bit of pain but important for me how it feels 24hours and 48 hours later. Most of the time I feel no pain 24 hours later, I take that as information that I can add a bit of weight or volume. Incline bench is going well and building up towards old working weights and also the dumbell shoulder press is going well.
Flat bench is the most sensitive for my shoulder so I built it up extra slow. I have benched 95 kilo this week and after the set I could feel my shoulder but no pain a day later so that’s good news. Hopefully 100+ kg again soon.