Other/Mixed Summer training project; help me fix my scapula (so I can do plain old pushups again)

[Don Fairbanks]

Hi SF community,

As many of you might know, I have done extensive self-research into the shoulder. This stemmed out of an injury and subsequent surgery on my right shoulder in 2017. Fast forward and now that shoulder is perfectly fine; it is now the left one that gives me trouble.

In short, it doesn't want to stick to my back when I do horizontal movements, and it tends to overly downwardly rotate below something like 90 degrees of flexion. Overhead is better because I can push in a more aB-ducted position, but as soon as I try regular old pushups, it refuses to cooperate. Doing a plank or something where I just pin it down in full protraction seems okay; it's when I try to bend at the elbows, or even just do scapular shrugs in a plank, that it misbehaves.

What I can do without much trouble:
-Overhead work, strangely enough. If I am careful, the upward rotation in overhead work feels okay. It's not always perfect or great, but it's good enough to do some overhead pushing.

-Pullups/chin ups: chin ups feel better. Pullups feel pretty good but if I try strict hollow pullups, there is something about the angle that seems to bother the shoulder.

Symptoms are:
-tight left neck and upper traps
-occasional aches on the anterior portion of the left shoulder
-left shoulder wants to "hike" or shrug up without my asking it too
-"winging" and excessive downward rotation below about 90 degress shoulder flexion. It also seems to have a funky resting position that you might be able to see it in some of the below videos.

What I have tried:
-everything, it seems like. I have been dealing with this since 2019. It has improved tremendously, to the point where I only get the above issues if I do much horizontal pressing, or get stressed out. Stress seems to aggravate the "hiking up" issue.
Specifically, I have tried:
-lots of PRI and breathing drills, ribcage expansion, postual changes to my hips and feet. All of this stuff has helped the most, but something just isn't clicking to get it all the way there. All of this stuff, in theory, is supposed to help with the resting position, but either I've taken it as far as it will go or I am not doing the right drills.

-band work: I have done Ido Portal's routine, which helped. It feels good and helped with the acute issues, but now (as you will see below) the scapula still does it's own thing. I have tried so many different band drills. A lot feel good, but, there's a recurring theme here....

-serratus slides: these feel great and seem to alleviate the neck tension, but don't seem to carry over to pushups

-Original Strength: many rocking and crawling drills feel good, and have helped a little, but again....don't carry over to pushups.

-Turkish Get ups: I know someone will mention this. I tried them multiple times and in some cases left with a tighter neck than before.

Physical therapy: the elephant in the room. I have seen a PT many times. The trouble is that I don't have money to see one consistently. Mine got me on the track of doing PRI-type stuff. I like her, however, I have no money for it at the moment.

I am just throwing this out there (again) in the hopes that some of the PTs/physios on the forum might have some suggestions. It could be that I have tried things that will help but just haven't done them long enough. I'm willing to try most anything at this point. I would like to be able to just do regular pushups again. Every time I do sets of regular pushups, I have plenty of general strength for the movement, but I pay for it with neck tension afterwards, and occasionally anterior shoulder pain. I also am 90% sure this issue part of what is holding me back from making strength gains with pressing in general.

Pushups. You can see the left shoulder blade stick out way more than the right.


Scapular pushups and plank position


Viking Press: keeping weight back on feet/heels, keeping tension out of face/neck. These feel good and "seem" to help, but if you have a close look, you can see the scap do its thing when I am in the bottom position


Pushups from above. This was taken last year. The symptoms you see are a little better, but not by much.


Thanks for taking the time to read/watch all that, if you did. And thanks in advance for any input.

SFB cert. in Denver the weekend after next.

 

[bluejeff]

heavy overhead loading. doing TGUs, once i got up to 32k, i unexpectedly discovered that they helped to push the scap back into place, and that after a heavy session, that scap would "remember" that position for awhile.

Thanks for the input. I have found something similar. I can now get into a handstand (against the wall) and get everything locked into place. Most of the time I can do handstand pushups (again, on the wall) without much issue, as long as I do them wide. If I do them shoulder width, forcing me to bring hands more in front of my chest at the bottom, the problem rears its head. But overall, overhead loading with arms locked straight seems fine. It's bending them that brings the issue into play.

have you tried something simple like the cue "don't sag" on pushups?

Oh yes. I have tried to protract at the top, all the way through the motion (which feels totally unnatural and weird)...

 

[Training for Life]

One more thing…

Have you tried any version of the Y raise? One variation I might try would be to do it like in this video, by rotating the arm and lifting it more up than to the side. I would do the same motion but bent over, with a light weight and slower.

 

[Bill Lets]

I'd forget about pressing for a while and work on getting your upper back built up.

My presses almost always improve, both mechanically and in terms of force production, after I do a a few cycles of serious back work.

And I don't mean pull ups.

Rows, face pulls, scaption, trap work, etc.

Get a yoke.

Put some meat on that shoulder girdle.

Get thick and 3D.

Well, PT exercises are nice but I'd focus on some real meat-makers.

I'd want to put 3-4 good size 16 oz steaks on that back, so call it 5 lbs of muscle to allow for some buffer.

“Meat makers . . . 3-4 good size 16 oz steaks” Back slapping and motivational.

Could you give an example of scaption exercises beginner or advanced?


Rows- One arm chest supported full range of motion rows, Yates rows?, Dumbbell rows to arm pits
Carries- Farmer, Racked kettlebell, Sandbag on shoulders,
Shrugs- barbell/machine,
Wide grip pull-downs w/tension to bottom of neck,

 

[watchnerd]

“Meat makers . . . 3-4 good size 16 oz steaks” Back slapping and motivational.

Could you give an example of scaption exercises beginner or advanced?


Rows- One arm chest supported full range of motion rows, Yates rows?, Dumbbell rows to arm pits
Carries- Farmer, Racked kettlebell, Sandbag on shoulders,
Shrugs- barbell/machine,
Wide grip pull-downs w/tension to bottom of neck,

 

[Antti]

In an exercise like that, do we want to load it horizontally, vertically, or both?

Like many examples of band scaption show a typical resistance band below the feet. Is this because of convenience? Or is the crossover symmetry video with the band coming from behind because of their setup and not it being preferable?

How would simple dumbbell raises compare?

 

[watchnerd]

In an exercise like that, do we want to load it horizontally, vertically, or both?

Like many examples of band scaption show a typical resistance band below the feet. Is this because of convenience? Or is the crossover symmetry video with the band coming from behind because of their setup and not it being preferable?

How would simple dumbbell raises compare?

The lower positioning is intentional because the angle of resistance desired.

Other Crossover Symmetry exercises use a high anchor.

 

[Antti]

The lower positioning is intentional because the angle of resistance desired.

Other Crossover Symmetry exercises use a high anchor.

Do any CS exercises use an anchor right below the trainee?

 

[watchnerd]

Do any CS exercises use an anchor right below the trainee?

You mean right at the feet?

You'd need shorter bands than they provide. There would be too much slack in the bands at such a close distance.

 

[JamesPTA]

@bluejeff

so I'm at work and enlarged your videos with the push ups (especially your first video you shared), and aligned my goniometer from your shoulder joints to your elbows. your elbow on the left is 10 degrees more in abduction than your right at the bottom (35 degrees Right, 45 degrees left). Also, both arms are in slight external rotation prior to at rest. A few things you could try is get your hands place more neutral or very slight inward. While they are planted on the ground, apply an external rotation contraction prior to the movement (you should feel your armpits tighten). Secondly, try drawing both elbows in toward your rib cages as your lower yourself down.

 

[bluejeff]

@bluejeff

so I'm at work and enlarged your videos with the push ups (especially your first video you shared), and aligned my goniometer from your shoulder joints to your elbows. your elbow on the left is 10 degrees more in abduction than your right at the bottom (35 degrees Right, 45 degrees left). Also, both arms are in slight external rotation prior to at rest. A few things you could try is get your hands place more neutral or very slight inward. While they are planted on the ground, apply an external rotation contraction prior to the movement (you should feel your armpits tighten). Secondly, try drawing both elbows in toward your rib cages as your lower yourself down.

Thanks so much! Based on self tests for external and internal rotation (just lying prone and having the humerus and elbow at 90 degrees), I have less ER on the left and less IR on the right. Also, if I try to do those popular dumbell external rotations (with the elbow propped up on your knee), it's typically much harder and often uncomfortable on the left side.

It's not easy for me to picture, but I think the scap doing what it does is possibly tied to a lack of ER at the left glenohumeral joint. Additionally, all of the PRI-based breathing drills really affect the left side. They open up a lot and relax my neck a lot if it's tight. So there's something there, in some form.

So just to make sure I understand you correctly:
Are you suggesting turning my hands more inward and then applying ER contraction? And then keeping the elbows close to the ribs as I descend?

 

[JamesPTA]

So just to make sure I understand you correctly:
Are you suggesting turning my hands more inward and then applying ER contraction? And then keeping the elbows close to the ribs as I descend?

Basically, yes! Try placing your wrist without any radial or ulnar deviation (so for you, that is inward). While you have weight through your hands, apply a ER force through your hands that will tighten your arm pits.

And yes to the elbows staying closer. Try those out just to see if it helps with the winging.

 

[Boris Bachmann]

Well, PT exercises are nice but I'd focus on some real meat-makers.

I'd want to put 3-4 good size 16 oz steaks on that back, so call it 5 lbs of muscle to allow for some buffer.

I'm circling back to this now - I agree w. this.

To the OP - it sounds like you've thrown a lot of different things at it already and nothing seems to (in your words) "click". With some exercises and issues, I believe the reason for excess tension is quite simply not enough of a "strength reserve" (watchnerd just called it a buffer). If I don't do a lot of overhead work or presses, and then do a lot, guess what? I might have a stiff neck. After I've re-acclimated, it's generally not an issue - the shoulder girdle and supporting structures can now "shoulder" the work without a problem.

I don't think there's any reason NOT to do some shoulder rotation work, scaptions, shrug variations, "shoulder cams", etc too, but maybe you just need to get stronger and beef up. Just my 2 cents but here's some more stuff to throw at it if you need more options: Episode 178: Scapula Strength and Mobility

 

[bluejeff]

Basically, yes! Try placing your wrist without any radial or ulnar deviation (so for you, that is inward). While you have weight through your hands, apply a ER force through your hands that will tighten your arm pits.

And yes to the elbows staying closer. Try those out just to see if it helps with the winging.

I will try it out, thank you. In the past, when I would try to go narrow, it was worse. But maybe some of the cues you provided will be helpful. I will report back.

I'm circling back to this now - I agree w. this.

To the OP - it sounds like you've thrown a lot of different things at it already and nothing seems to (in your words) "click". With some exercises and issues, I believe the reason for excess tension is quite simply not enough of a "strength reserve" (watchnerd just called it a buffer). If I don't do a lot of overhead work or presses, and then do a lot, guess what? I might have a stiff neck. After I've re-acclimated, it's generally not an issue - the shoulder girdle and supporting structures can now "shoulder" the work without a problem.

I don't think there's any reason NOT to do some shoulder rotation work, scaptions, shrug variations, "shoulder cams", etc too, but maybe you just need to get stronger and beef up. Just my 2 cents but here's some more stuff to throw at it if you need more options: Episode 178: Scapula Strength and Mobility

I will check the link out, thanks! I can agree that it may be possible I simply don't have strength in certain areas, although I have mostly worked on overhead stuff for the past few years. Perhaps it's the result of neglecting other parts, as was suggested to me by @watchnerd . I do recall (though it's hard to separate causation and correlation for me being n=1) things going well when I was doing LOTS of upper back work after recovering from a shoulder surgery in 2017.

It makes me wonder a bit whether trying to "go minimalist" and neglecting that stuff sent me down this road. No disrespect to minimalism.

 

[Oscar]

@bluejeff have you tried light bench press for high reps?

Whenever I have an ungry joint or movement, I do slow, light, high rep movement targeting that painful movement. I don't know why but it helps. Maybe it is the blood flow.

 

[bluejeff]

@bluejeff have you tried light bench press for high reps?

Whenever I have an ungry joint or movement, I do slow, light, high rep movement targeting that painful movement. I don't know why but it helps. Maybe it is the blood flow.

Not bench press, specifically. I don't have access to one. But I think I know the phenomenon you're talking about; I've found the same in other ways. My trouble has been that I can't really find much that gets the scap in the right position, unless I'm in humeral abduction or overhead. I do recall using a bench once and thinking that I didnt' feel the neck tension as much, and felt my chest and delt working more instead. The only thing is that I don't have regular access to a bench (unless I buy one), so I don't know if doing that move specifically would help in the long term.

 

[Oscar]

Not bench press, specifically. I don't have access to one. But I think I know the phenomenon you're talking about; I've found the same in other ways. My trouble has been that I can't really find much that gets the scap in the right position, unless I'm in humeral abduction or overhead. I do recall using a bench once and thinking that I didnt' feel the neck tension as much, and felt my chest and delt working more instead. The only thing is that I don't have regular access to a bench (unless I buy one), so I don't know if doing that move specifically would help in the long term.

I mean any movement that targets what you want to target. Maybe kettlebell floor press, if you have. Or kettlebell bridge floor press. I also bought a stepper to use as a bench for kettlebell bridge floor press.

Anything you can load light in the movement you want to do.

 

[Brett Jones]

Just a couple of thoughts:
Does your neck have normal range of motion and is it pain free?

Have you checked and worked on t-spine mobility?
T-Spine Rotation with Rib Grab | Functional Movement Systems

Have you tried a basic scap stability drill: https://www.functionalmovement.com/Exercises/31/trunk_stability_rotation_knees_flexed

 

[bluejeff]

Just a couple of thoughts:
Does your neck have normal range of motion and is it pain free?

Have you checked and worked on t-spine mobility?
T-Spine Rotation with Rib Grab | Functional Movement Systems

Have you tried a basic scap stability drill: https://www.functionalmovement.com/Exercises/31/trunk_stability_rotation_knees_flexed

Thanks Brett!

Regarding my neck:
I have slightly less range of motion turning to the left, and other than the aforementioned tightness that can result from horizontal pushing, it’s pain free. I would say pain free but not always “comfortable.”

Regarding t-spine: the drills you linked seem pretty easy to me, unless I’m “cheating” them somehow. I can try and film them when I get more time.

 

[Zwuckel]

I had similar problems 10 years ago. For me personally it was a wrong learned movement pattern of the scapula I got from bouldering. So I tend towards "not enough control and / or activation of some muscles".

What I see on the first two videos is winged scapulae which come from a weak serratus anterior muscle. (easy to google) I did controlled movements like assisted pull up and always feeling where my scapula is during the movement. It´s frustrating work in my opinion. A "gorilla chest" helped me to ease into it.

Some already wrote about posture. Additional to my not activated, weak or not controlled serratus I had a more severe case of thoraic outlet syndrom. (Yes, office worker here.) So it might be that those things influence each other as a not optimal posture in the neck let the neck musscles put pressure on the nerves in it. Pain and different movement patterns could be the result.

I spend about 800 Euro (~800USD) in Germany for two different Osteopath, Personal trainer, Physical Therapist, Chiropractor and was, of course, talking to orthopedist and went under the MRI. No one, just no one of those people could help me, let alone give me a proper diagnosis. Don´t know where you´re from but I only go to guys who are certified by the German Olympic Sports Club. My guy went with the national team to Tokyo. He diagnosed my thoraic outlet syndrom, got rid of blockages and showed me the specific exercises I should do within 45 minutes and I paid 67 Euro. So he was no amount more expensive than other people who probably are focusing more on the elderly...

That said, I ditched those exercises. Why? There never has been anything better for me than the P3 protocol by Geoff Nupert. Period. (It also involves a lot of neck training and fixed a lot if things there) I don´t get it, it´s magic and it helped me to get rid of the rest of my shoulder girdle problems. (3 weeks in.) I cannot guarantee it fixes the scapula but in my opinion it´s worth over the typical therapists.