Trying to restart serious training, how to handle 6+ year old shoulder injury?

I’m 36, 5’9", 212lbs. About 6 years ago or so I was doing a half-assed version of the SS Novice Program. My shoulder started to hurt, first noticeable during OHP, subsequently during bench press. I tried to rest, ice, and NSAID it for a couple weeks and resume training. In short, I did everything wrong (up to and probably including my form that may have caused the issue in the first place). Training fell off, I’ve been doing an off-and-on half-assed approach to the gym for a while as I slowly grew fatter and weaker.

I’m reading/listening to the Blue Book now and trying to piece things together so I can start over properly; exercises and form, diet, and this old injury. In time it faded into the background so that I all but forgot about it. “Normal” activity hasn’t bothered it. Active stuff–loading/unloading and stacking 60+ square bales of hay–would leave it aching and sore for a couple of days. Mostly it complained infrequently and I ignored it. Low to moderate (for me) Bench Press doesn’t seem to make it act up. I tried to do some dips once a couple of years ago and it was very painful. Last week I did 4 sets of OHP with light weights (40-50-70 lbs) and low reps (6-8) and it hurt the next day, then sore for a couple more. Now it’s back to being “fine.”

I want to dive into the SS Novice Program properly, as I said, but I’m concerned that as soon as I start trying to OHP it’s going to flare up. I called and made an appointment with an Ortho, but I’m concerned that the age of the injury might make it difficult to actually diagnose. I also read a couple of The Shoulder articles at Barbell Medicine, which make me skeptical about surgical intervention unless there is a very clear smoking gun. So, some questions:

  1. Should I keep the appointment just to rule out something more serious that would require surgical intervention?
  2. If the diagnostics don’t reveal anything, is there a good way to proceed with rehabbing an injury that has had years to heal poorly so that I can get back to getting good?
  3. If not, what is the best way to work around the problem to mitigate the impact?

Thanks very much for your help.

Hey man, thanks for reaching out. I’ll do my best to get you on the right path. When working through issues like this it sometimes comes down to when we need to work through versus work around. I would advocate you look into the Beginner Prescription versus the Novice Program for returning back into training. If you are slinging hay bales I don’t know that I would be overly concerned about a specific diagnosis as it relates to symptoms. If you have read through the shoulder articles you know there isn’t any strong correlation between pathology and symptoms. If you’ve lead an active life (which it sounds like you have) odds are they are going to find some things on imaging.

Odds are we can find some ways to start working on increasing capacity for pressing without doing anything too drastic from changing programs. I would probably first recommend you get a consult with Mike or I and we can talk through what your current programming is as well as develop a program to get you back into training. There are some specific shoulder exercises that we can use as a workaround with which to get you ready for pressing. Sometimes this involves some specific cuff work or pressing variants with which to start reintroducing the movement, sometimes it is more approaching it as a biceps tendinopathy as starting a specific loading protocol.

Derek