Shoulder Trouble...Interesting Diagnosis

[Mr. Bloom]

For several weeks I've been having shoulder pain:mad:

I went to the chiro (a former bodybuilder) and he suggested that my rotator cup is loose because my anterior deltoid is developing more (from cycling) than the posterior deltoid. Hmmm...talk about the cause/effect of kinesiology;)

The prescription: Inverted Fly (http://en.wikipedia.org/wiki/Fly_(exercise)#Inverted_fly) exercises to develop the posterior.

I read all these things that talk about the need to exercise "off the bike", but this is my first tangible brush with the reality.

Does anyone know of other "balance" exercises that are needed to compensate for what the bike doesn't develop?

[Crankin]

Ah, well, the older we get, the more important the "other" exercises are. I'm not a PT or MD, but I have a series of stretching and core exercises I do 5-7 days a week. They involve using a roller and a stability ball. I also do upper body lifting 2x a week and yoga 1-2x a week. Too much to explain here, but if you want more explanation, PM me.
I don't always feel like doing this stuff, but if I don't, I feel it. As you said, cycling can cause a lot of muscular imbalances. I also make myself walk or hike at least once a week during the cycling season and I'm beginning to actually look forward to the cold weather sports season, so my other muscles get some use.

[OakLeaf]

It's a truism that people work harder on the muscles they can see in the mirror than the ones they can't. ;) So those types of imbalances are pretty common.

In my classes, I like to emphasize the muscles you can't see, because I know the participants get plenty of work on the front muscles in other instructors' classes and on their own. Rear delt flyes, bent-over rows, seated rows with a stretchy tube, back extensions. Rotator cuff work (in both directions of rotation) with a light dumbbell or with a stretchy band. Opposite arm/opposite leg in any of the three positions - bird-dog, supine, plank position. T-pushups to work just about everything! - but the rear muscles are working especially to bring yourself into T position and keep you stable there.

Just be sure if you're doing those rear delt flyes in an unsupported stoop, be VERY careful about using your abdominal muscles to support your low back. Neutral spine or flat, no lumbar flexion. Bend at the hip joint, NOT the waist. Put one foot forward, the other foot back, and switch feet between sets. Keep your neck in line with the rest of your spine, no hyperextension - look at the floor when you're not checking your form in the mirror. You can also do them supine on a bench or stability ball, or your gym may have a machine.

[Zen]

Does anyone know of other "balance" exercises that are needed to compensate for what the bike doesn't develop?

Yes.

[redrhodie]

Boy, do I know what you mean. The other day I worked at the CSA farm, and I was toast withing 5 minutes of picking beets. The posterior muscles were firing up in ways that surprised me, since I thought I was pretty fit in that area from cycling.

Yesterday, I thought I'd be too sore to ride, but I got on the bike, and strangely enough, nothing hurt. Makes me think I need to add some squats (or volunteer at the farm more) to my current regimen of cycling, walking and Pilates. Evidently, I'm not working all the muscles I thought I was.

[bounceswoosh]

I think another common one is that the inner quad doesn't develop as well as the outer quad, because you don't straighten your leg out fully when cycling. That can lead to funky knee problems. You can do exercises like standing on one foot, bend the standing leg as far as you can balance, then straighten it all the way, focusing on flexing that inner quad at the top.

Or ... you can do lots of different stuff =) I don't ride my mountain bike as much as I used to, but in a typical week I will ride either my road or mountain bike, play soccer, and climb at the gym. I seem to have fewer joint problems than when I was just riding. I don't stretch enough, though, and I'm sure that'll come around to bite me. Oh, which brings up another great cross-training activity, yoga. Yoga is great stuff; unfortunately, I tend to avoid it because a lot of the positions involve putting weight on your palms, which is a problem for my bad wrist.

[BethG]

I agree with bounce, and I've also heard that imbalances between your hammies and quads are very common for a lot of sports.

Did you talk to your chiro about other potential trouble spots?

[Mr. Bloom]

Yes.
Good.


I think another common one is that the inner quad doesn't develop as well as the outer quad,
Funny you said that...I also had tibular torsion which was causing me sharp knee pain. When straightening it, my leg was so tight that I realized that, despite incredible muscle tone, I could really use some regular stretching exercises.



Just be sure if you're doing those rear delt flyes in an unsupported stoop, be VERY careful about using your abdominal muscles to support your low back.

I think that I'm going to do them in a seating position leaning my torso forward.

Oakleaf: Requesting that you ignore Zen's response to my other closed end question:p:rolleyes:, do you have a favorite book/website that demonstrates these exercises?



Did you talk to your chiro about other potential trouble spots?
I should have...but I was too busy wiping the tears from my eyes after the adjustment;)

[Zen]

do you have a favorite book/website that demonstrates these exercises?



No. Google is your friend.

[Mr. Bloom]

No. Google is your friend.

Google is not real...oakleaf is;)

[malkin]

I've found the book, Bicycling Bliss by Portia Masterson has lots and lots of info, but I wish she'd hired me to edit and organize it before it got published.

[BethG]

Google is not real...oakleaf is;)

No offense to oakleaf, but I would research any suggestion you get - there's a lot of snake oil out there being passed on by even well-meaning people.

[VeloVT]

I dunno, everything Oakleaf says there (and generally otherwise, FWIW) seems pretty reasonable to me.

I do these reverse flyes. You do have to be very careful to use your abs to stabilize your back muscles. I do them bent over, with no support. I actually do them with feet parallel, shoulder width apart, since it feels strange to me to do a symmetrical exercise with one foot forward and one back (I will put the opposite foot out to support a one-sided exercise though).

One other thing... Start with a MUCH, MUCH lighter weight than you think you should be using. I have a super-weakling upper body, but to give you an example, I can do bent over rows (also both sides simultaneously) with 60 lbs in each hand, but for the reverse flyes I'm using 12-15 lb weights in each hand -- the "girl dumbells." It's not because I'm "afraid of bulking up", it's because with heavier weights I can't maintain good form throughout the entire motion for more than a rep or two. So yeah, I'm weak... You're probably much stronger, but take that general idea to the gym...

Good luck!

[Wahine]

OK, I spent about 20 min this AM typing up a response to this and it got lost in the ether and I got frustrated. Now I'm going to try again but please realize that if the tone of the response seems terse, it's not my intention... just happens that way because of what happened this AM.

Rear delt exercises have to be done with caution, the elbow whould not go past the line of the torso, this adds stress to the shoulder and may actually make the pain worse. Here's (http://www.youtube.com/watch?v=4AylxDSSP_Q&feature=related)a visual example of that form mistake. Here's (http://www.youtube.com/watch?v=jelaPFT25eY) an example of a rear deltoid exercise where the person doing the exercise is not mving his arm too far back. I really like exercises that use your own body weight like this one (http://www.youtube.com/watch?v=9QT3NVCHSkA). What I like about this is that the weight is effectively less as you get into the form danger zone. You can easily do this with webbing or rope, you don't need anything fancy. This (http://www.youtube.com/watch?v=c3uiaGcVvBg) is also a good option using cables.

The other things to keep in mind is that you need to do pec stretches and specific rotator cuff strengthening is also important.

Hope that helps.

[salsabike]

Hey, thanks for posting that, Wahine. Ever since I overdid the swimming thing, I have been doing light-weight shoulder strengthening exercises. That is one of them, and I didn't know about the alignment thing. Think I am going to go consult with a triathlete PT here in Seattle to get a complete program of training/exercises that take into account the fibromyagia-related issues as well. Anyway, I appreciate this post of yours.

[Zen]

Google is not real...

For something imaginary, the shareholder dividends aren't bad :)

[salsabike]

Hey, thanks for posting that, Wahine. Ever since I overdid the swimming thing, I have been doing light-weight shoulder strengthening exercises. That is one of them, and I didn't know about the alignment thing. Think I am going to go consult with a triathlete PT here in Seattle to get a complete program of training/exercises that take into account the fibromyagia-related issues as well. Anyway, I appreciate this post of yours.

Jeez--sorry, I only posted half of my thought. What I MEANT also to say was: I got those shoulder strengthening exercise on the internet--but they did not make clear that pulling back beyond your torso was not okay. Point being that internet is a great resource for damn near anything BUT that it's also probably good to check in person with a PT or someone with similar knowledge to ensure you are doing the exercises correctly.

[Wahine]

Pulling beyond the torso is often OK if you don't already have shouder pain but it's not good for people with rotator cuff problems.

[BethG]

I dunno, everything Oakleaf says there (and generally otherwise, FWIW) seems pretty reasonable to me.


I didn't mean to disparage oakleaf or her suggestions, and fwiw, I don't think MY advice should be swallowed whole without chewing, either.

My point is only that advice from knowledgeable people on a message board is a great place to start, but a) we can't know all the particulars of the person asking the question and b) even reasonable best practices can get outdated.

[beccaB]

My right rotator cuff has a frayed edge on it and there is tendonitis in the left rotator cuff. I've been going to Curves for about 5 years. the problem started before that with my job, and Rotator cuff is a common problem there. So far I've been able to avoid surgery. I had a second round of physical therapy, 2 years after the first time. It focused more on flexibility this time, which motivates me more to do the home exercises. Cortisone is a wonderful thing too!
I would be VERY careful doing any exercise that makes me push my elbows past the plane of my torso. On one machine at curves one of the ladies keeps trying to get me to go too far. I know my own limitations. It's easier to do that now that I'm closer to 50 than 40.

[OakLeaf]

Aw, shucks, I'm real (said the Velveteen Rabbit). :D

Seriously, I hope everyone does take my advice here with a grain of salt!

Wahine, on the other hand, really knows her stuff.

Books/websites - exrx.net (http://www.exrx.net) has descriptions of a wide range of strength and flexibility exercises, anatomy illustrations (apparently lifted from Gray's Anatomy but with their own copyright bug on them :rolleyes:), discussions of muscular weaknesses and imbalances, etc. Their exercises tend to be pretty traditional gym work, but useful.

Lately I'm a big fan of Stott Pilates (http://www.stottpilates.com/). Their Comprehensive Matwork Manual is incredibly detailed. (Way too detailed to simultaneously read and do the exercises.) They have a number of good DVDs also.

Yeah, funny people should mention the inner thigh, because I kind of came the other direction. Before I came back to cycling and learned Chi Running (which happened about the same time), I was mostly doing a lot of step aerobics, with a little bit of running. My adductors were way overdeveloped and my vastus medialis were underdeveloped. Since taking up Chi Running and cycling, my thighs are visibly MUCH more balanced.

[BethG]

Forgive my ignorance, but what's "Chi running"?

[OakLeaf]

Chi Running (http://www.chirunning.com/shop/home.php)

[TahoeDirtGirl]

There are two things that are going on. Muscle groups become tight while others become ..well...lazy. I'm a good example. My pecs are over developed and tend to round my shoulders forward while my back muscles are stretched due to the pecs being over tight. So when you look at muscle imbalances you have to address the tight muscles as well as the weak muscles. The only way to do this is with dynamic assessments.

There is a whole way of approaching it but what what it comes down to is that cyclists need to spend time hitting the weights (or doing some type of strength training that includes core and balance training) to help keep everything in check.

I'm a good example. I thought that mtn biking and commuting would be enough. I should know better. It's not. I now have a muscle imbalance that came to light after an injury and won't heal right. Guess what I'm now doing? Yep, calf strengthening. I was pretty surprised but then I compared what my calves look like now compared to last year and it's pretty obvious. I have much less defined calves and last year I weight trained twice per week.

Balance is really important too, I was pretty surprised how much I was lacking in that area as well. I am spending alot of time on the bike but I need to take my own advice at some point and spend some time training off of it too.