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Old 03-15-2008, 06:02 AM   #11
Garrett Smith
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Eric,
Glad you agree.

I could also do the 6-8" elbow bend variation. I felt like a newbie who didn't know how to do a push-up. You know, using all sorts of muscles (the wrong ones) to try to do a movement.

You'll do great with your rehab. Make sure to keep some serratus exercises in your warm-up routine after you have this issue licked. When I was in high school and college, I had a winging scapula on the left side. Back then, I fixed it with a lot of conscious attention on retraction/depression during all the push-up-type movements in Ashtanga/power yoga class.

I was also thinking that clap push-ups would require some darn good activation of the serratus, especially during the lift-off (and the eccentric on the landing).
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Old 03-15-2008, 05:09 PM   #12
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Planche work is extremely good for serratus anterior strength.. if you wanted alternative exercises.
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Old 03-18-2008, 10:35 AM   #13
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[quote=Garrett Smith;27937]Eric,
Glad you agree.

I felt like a newbie who didn't know how to do a push-up. You know, using all sorts of muscles (the wrong ones) to try to do a movement.

[quote]


Exactly.

From doing outer cap stretches I can already tell that there is a slightly increase in mobility and the push-up pluses with the 6-8" elbow bend get are getting easier to manage with good protraction.

I will endeavor to include some pre-hab exercises in my warm-up.

Steven, I would love to manage a planche. I will put that on my list of things to work towards. And oh lookie, Beast Skills has a progession routine. Snice.

Thanks,
Eric
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Old 03-18-2008, 11:04 AM   #14
Garrett Smith
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Steven,
Great suggestion as usual. As my routine will now be including pushups plus with added resistance AND planche progressions, I think I'll be dropping the protraction work from my prehab (gotta cut something out sometime or the workouts become unmanageable time-wise).
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Old 03-24-2008, 07:51 PM   #15
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Come to think of it there's protraction in the front lever as well (although retraction in front lever pullups).

Interestingly enough I figured out planche was awesome for protraction when basically my weighted muscle ability went down after doing push heavy work with planches. Not enough retraction and long rhomboids significantly weakened them to the point where I was just less strong.
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Old 01-21-2010, 08:38 AM   #16
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Trying to fix my cronic muscle spasms in my upper back, (seperated left shoulder and winging scapula right) and as I was reviewing this thread I found a full link to the study Dr G posted with pictures and explanations of all the exercises.

http://scottsevinsky.com/pt/referenc..._exercises.pdf
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Old 01-26-2010, 11:53 AM   #17
Mark Fenner
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Default SA Re-Programming

Hi folks, long time, no post ... but this is an issue near and dear to me.

In about June of 2008, I developed some severe shoulder pain that, of all things, completely destroyed me while squatting. I got bad enough that I did some squatting and then attempted to bench press and ..... presto, I had to limp home holding my arm as if it were in a sling. Not good. One note, my downhill slide with the shoulder issue was accelerated by a transition from hi-bar to low-bar squatting. That is neither here nor there for this discussion. One other note, I was a "overhead athlete" for sometime: LOTS of volleyball in my history and some of my soccer career was spent as a goalie. My shoulders have also been dinged up from judo.

My pain was primarily on the posterior side of the left deltoid: sometimes coming at the top left of the scapular triangle, sometimes at the delt-tricep intersection. For the summer of 2008 I did a bit of this, that, and the other thing to rehab it. Mostly, I rested it. It healed up enough to let me do two rounds of Sheiko in the Fall of 2008. In spring 2009, I followed Cressey's Maximum Strength programs, partially b/c of the lack of direct back squatting. I really enjoyed it (great program! my wife is doing for her second time now), but at the end my back squat was in sorry shape and my shoulder pain while back squatting was substantially worse. Now to the point.

In May, 2009, I was fed up with my back squat being interferred with by a "stupid" shoulder problem. So, I found a great PT (Joe Grant, Warren, VT) and we went to work. His main comment on assessing me went something like this: "Holy Crap! I've (almost) never seen someone that trap dominant". In other words, thanks to lots of heavy pulling (especially rack pulls), my traps were doing all the raising (literal lifting) of my scapular shelf and I wasn't getting any raise out of upward rotation of the scaps. Now, you can get height at the shoulder in two ways: either shrug (duh) or rotate your scaps so they "face the heavens". I was doing all of the former.

So, my PT prescribed some exercises. Here are the two "raises" that were most useful:

(1) DB in right hand, standing tall, shoulders pushed away from my ears, palm facing forward (supine position): do a "front raise" but move from the hip across in front of your LEFT eye/ear and continue up ... as long as you don't get into a shrug. Lower and repeat. Eventually, I did this in a staggered stance (right leg slightly back) which emphasized the cross-body movement a bit.

(2) DB in right hand, slightly bent forward and rotated right shoulder towards left hip, palm to the back: basically do the cocking motion for a volleyball spike but keep it in slightly tilted plane ... when you get to the top, reach back but also allow your body to open up (don't isolate). As you get the feel for your serratus anterior, make sure it is locking your scap to the ribs as you reach back.

A comment on raise (1). Thing about the action of the SA: it anchors the scaps to the ribs. If you reach across your body (particularly with your palm like a mirror coming up to your face), you almost have to staple the scaps to the ribs to make it happen. Bingo! Hello, Mr. SA, pleased to meet you! Raise (2) is more of a "make the whole body open up so you don't overstress your rear delts and friends" when you reach behind you.

I consider raise (1) my money exercise to wake up my SA. I do it almost every workout. When I "forget" it ... I pay. My setup for my squat now includes actively raising my chest (includes upward scap rotation), shrugging my shoulders DOWN, and then reinforcing the upward rotation. All of a sudden, I have tons of room for my arms AND I'm not hyperextending in the rear delt compartment.

3 other exercises that were surprisingly helpful:
(1) Full body version of raise (2) progressing to one foot. Right hand starts near your left foot. Open up and reach back behind you to your right-rear corner. Make sure everything contributes to opening-closing. If you do it very forcefully, you might want to review your judo forward rolls.

(2) Full body reach up. While standing, dip low and then reach up as if you are trying to do a layup. Focus on the shoulder mechanics in raise (1) and using all your muscle to extend up and absorb the force of coming back down.

(3) Kung fu power punch (sorry folks, this are my mental images ). Standing in about a 45 degree stance: coil back on your right leg with your right hand chambered at your hip. Twist your feet, rotate your hips, shoulders, and extend your right arm forward (a knife hand or cupping hand works well, palm facing your left) ... and keep extending and extending and extending. Possibly try to take the base of your hand (the side under the pinkie) and show it to a person in front of you [that last bit I found helpful to get more SA involved].

In all three of these "stupid human tricks" as my PT names them for some of his clients, the goal is to look like an athlete. When I was learning them, an older lady on a bike in the office said: "He looks like a Greek statue". Let me assure you, it was not b/c of my physique!!! It was b/c of the full extension/movement of my whole body.

A few other notes that I learned on my journey:

(1) If you are compensating for lack of scapular mobility with overuse of your posterior delts and friends, then doing more posterior delt/upper back work may make your shoulder worse! Seriously! I look at it like this: my humerus should be in line with my scap. If the humerus goes back significantly further than my scap, there is going to be a "pinch" in the area of the delt.

(2) Pushup-pluses are good ... if you know how to work your SA. If you don't, you are just grooving the wrong pattern. If you are in the position of re-educating your SA, then make sure you have a mind-body connection to your SA and make sure you can feel it before going pushup-plus crazy. Don't be ashamed to do pushup-pluses from your knees.

(3) Raised feet pushups can activate the SA more (if you are using the right movements ... if you pike up and shrug your shoulders, guess what ... you lose).

(4) I found that pushups with either my hands (fingers) pointing to 10 and 2 o'clock (or even 6 o'clock on both like a reverse grip bench press) made feeling my SA easier. Using a medicine ball with the fingers at 9 and 3 o'clock has the benefits of being unstable (more muscle activation with less weight) AND the great benefit of requiring some compression (i.e., pulling the arms to the chest ... and the scaps to the ribs).

I didn't pursue it alot, but raised feet, medicine ball pushups definitely bring out the SA.

(5) Be careful of pull ups and friends. If you do a "chest heavy" pull up (i.e., at the top squeeze, you pull your shoulders together with your pecs to get the last inch), you might be making things worse. If so, make sure that your are opening your chest at the top (i.e., pulling your shoulder blades together for the top squeeze).

My PT also recommended DB presses from seated and incline. He wanted me using the "reverse bench press" grip orientation and taking them in front of the opposite eye. These were low weights. Again the cross-body action forces the SA to get in on the act.

Hope your find one or two useful pieces of advice in here.

Best,
Mark

Last edited by Mark Fenner : 01-27-2010 at 07:37 AM. Reason: Typos
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Old 01-26-2010, 05:56 PM   #18
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Interesting stuff mark. I'll keep it in mind
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Old 01-27-2010, 04:31 AM   #19
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Nice post Mark.
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Old 01-27-2010, 05:39 AM   #20
Garrett Smith
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Please post that in the Prehab/Rehab sticky thread.
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