# Rotator Cuff



## Aevolve (Mar 21, 2012)

So Monday I did my usual chest routine which consists of:

3x4-6 Flat Bench
3x4-6 Incline DB Bench
3x4-6 Decline DB Bench
3x4-6 Cable Crossovers

Followed by back routine shortly thereafter:

3x4-6 Wide-Grip Lat Pulldowns
3x4-6 Seated Cable Rows
3x4-6 Lawnmower DB Pulls

I felt fine the next day, the usual soreness. However, I work at a grocery store and long story short I had to bring in ALL of the carts outside in a hurry, which involved frenzied pulling and pushing of huge lines of carts.
This morning I wake up and my shoulder is in way more pain than it was yesterday. The pain is focused right in the center of my shoulder joint and, although I have full-range of motion in my shoulder, it hurts to move. Not crippling-ly bad, just twinges of pain that shouldn't be there. A bit of searching around on the internet and I'm pretty positive that I hurt my rotator cuff in some way.
Thinking back to Monday I can remember being confused as to why my right arm was failing before my left while doing DB Bench. I read today that loss of strength in the arm is a symptom of rotator cuff injury.

So- my question being: Anyone had any experience with rotator-cuff injuries? Any tips, pointers, or general information that may be helpful? I won't be lifting again until I'm sure it's healed, and I'm going to get someone to double-check my form when I start again. 
It pisses me off that I may have done this to myself  and hopefully it won't progress any farther. I'm being very careful with it.


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## Winspear (Mar 21, 2012)

That sucks  Sorry I don't know about healing or anything - just wanted to say that as well as getting somebody to check your form, make sure to be doing rotator warmups and exercises to strengthen them.


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## Aevolve (Mar 21, 2012)

EtherealEntity said:


> That sucks  Sorry I don't know about healing or anything - just wanted to say that as well as getting somebody to check your form, make sure to be doing rotator warmups and exercises to strengthen them.



I think the worst part is knowing I could have prevented it. I've known about rotator cuff exercises and neglected to do them. 


So to anyone reading this: Do the rotator cuff and shoulder warm-up exercises. Do them. This shit sucks.


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## TRENCHLORD (Mar 21, 2012)

I doubt it's really injured, just strained.
Usually if it's an injury you'd feel it happen on the spot.
Do a shit ton of arm circles these next few days.
Pretend you're flying (not literally lol), but instead of just flapping your extended arms out to the side, start with mild small circles and play around with it trying to work through the area of discomfort.
Go until you get a good burn, rest and repeat.
It might take a couple minutes to get a burn going as you speed it up.

Really you should do this and some other specific rotator warmups before benching.
Also I'd seriously consider stream-lining the workouts to reduce total volume.


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## Aevolve (Mar 21, 2012)

TRENCHLORD said:


> I doubt it's really injured, just strained.
> Usually if it's an injury you'd feel it happen on the spot.
> Do a shit ton of arm circles these next few days.
> Pretend you're flying (not literally lol), but instead of just flapping your extended arms out to the side, start with mild small circles and play around with it trying to work through the area of discomfort.
> ...



This is exactly what I had planned once the pain dissipates. 

And what would you suggest? (not being a dick, actually asking- I'm not the most experienced as far as lifting goes)


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## TRENCHLORD (Mar 21, 2012)

Many people like them, but I never got along with the declines.
Maybe one week do flat-bench and incline dumbells,
and the next week do incline barbell followed by flat-bench dumbells (these can be a bitch though without a helper to assist with getting into position and dismount, if using anything heavy that is).
You could substitute dips (weighted dips if strong enough) in place of the flat dumbells.

As far as set numbers go, some guys actually do better doing only one or two all out sets (if you have a good spotter or can do them inside of a squat rack for safety).
One set to failure followed by a forced rep or two always has done me better than doing multiple sets to a pre-determined rep count.
But that's not possible without a very trusted spotter.
Even better is doing all barbell benches inside the squat rack with the safety rods set perfectly so you can go all the way down,
and then when you reach failure you just exhale and the bar will rest right on the safety bars to avoid cruchage.
Spotter assisted forced reps are 100x safer like this as well.


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## Aevolve (Mar 21, 2012)

TRENCHLORD said:


> ...



I'll keep this in mind for when I get back started, thanks man.


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## Uncreative123 (Mar 22, 2012)

TRENCHLORD said:


> Usually if it's an injury you'd feel it happen on the spot.


This is not true- in fact when it comes to most gym injuries they accrue over a period of time and you will never actually "feel" the injury until it becomes very serious.



> Do a shit ton of arm circles these next few days.
> Pretend you're flying (not literally lol), but instead of just flapping your extended arms out to the side, start with mild small circles and play around with it trying to work through the area of discomfort.
> Go until you get a good burn, rest and repeat.
> It might take a couple minutes to get a burn going as you speed it up.



*DO NOT DO THIS. * For the love of God, do not do this. It can exacerbate the situation or at best, do nothing. 

If you are having a serious shoulder issue the first thing you need to do is see a physiotherapist. Not a doctor. Do not self-diagnose over the internet. Even trained physiotherapists cannot diagnose you online- it is something that needs to be done in person. Many people struggle with shoulder injuries. I can tell from your prognosis that you don't know what your specific issue is or how to treat it. I have suffered from a shoulder issue and have put a lot of time into researching shoulder issues. My issue too was a result from benching. At first I thought it had something to do with my rotator cuff. Then I was convinced it was a shoulder impingement. Then it was an impingement due to weak rear delts, then due to over-active traps. The point is it could be one thing or many things. I did a lot of corrective exercises and it stopped the issue from not only getting worse, but it even managed to get better. My shoulder strength in my right arm is still not 100%. 

Again, I am not here to diagnose you, but I would suspect the issue stems from your bench form- most likely elbows going below your chest plane. If you touch your chest with the bar this is almost certainly the cause. The reason I avoided my problem for such a long time was because I had a really wide grip on the bench- which too can be rough on the shoulders, especially when going below parallel. If you do dips and go to low, this can also contribute. And one of the biggest, most destructive shoulder exercises: upright rows. If you're doing them- stop. Look at the anatomy of the shoulder and it will be quite clear why this exercise is so bad, especially for people who suffer from shoulder problems. 

All I can say is get it diagnosed as soon as you can or you are in for a world of hell. Immediately look into buying a foam roller for myofascial release (everybody should do this). Any good physio will have you do this anyway. Look up Eric Cressey's foam rolling shit on youtube. Invest in a tennis or lacrosse ball to further assist in myofascial release. Those are the things that have helped me. It took a very long time to put it all together. One issue will in turn cause others and unwinding them all is a bitch. It will take TIME. Most people get upset when they don't see results after foam rolling for 5 weeks- but then you need to remind yourself- how long had you been lifting with shitty form and destroying your shoulder? A hell of a lot longer than five weeks I'm sure. 

I haven't flat barbell benched or done dips in over a year. I continue to decline and incline bench, and flat bench with DB's, but it's not the same. I have increased my bench by doing rotator cuff exercises but you need to make sure you are doing the RIGHT ones as well as A LOT of rear delt work. Weak rear delts can also contribute to these issues as they cause other muscles to take over and do more work than they should. This post has become quite long so I'll save that for another time.


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## TRENCHLORD (Mar 22, 2012)

I call that wear and tear, but yes technically you are right.
I don't think that's the case here, I think we have a strained shoulder and if he works it's motion a bit everyday to get some blood flowing (slight pump and burn) that it'll be just fine in a few days - a week.

Just take some days off lifting and get a pump going everyday with no weight or just 5-15 pound dumbells doing some basic shoulder shaping moves and a couple of the rotator specific motions.


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## TheBigGroove (Mar 22, 2012)

I would suggest 2 things *when you do get back* to your workout from my own personal experience:

1) switch up your decline bench and flat bench - try doing heavy flat bench with dumbells and a bit of a lighter decline bench on a smith machine or something like it.

2) avoid doing lat pull downs on your bench day - in MY experience this workout is hard on the tater'cuffs and when I follow my heavy press workouts with this I would get hurt (about once every 2 months it felt like). However, I think the other two back exercises won't hurt....I also do really heavy seated rows on my bench day to move some of the lactic acid out of my chest before I do cable flys. If you're doing the last 2 back exercises you mentioned with 'proper' form you shouldn't really be putting much, if any, strain on your rotator cuffs.

As for rehab style workouts, I would try doing a variation of a front-raise style workout with light'ish dumbells (I use 20's). Basically start doing a front raise until you clear the height of your collar bone, then extend your arms out laterally to the point where you would be doing lat-raises...then bring your arms back down to your sides and repeat. This helped me build up some much needed resilience in my rotator cuffs. 

Hope this helped out!


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## Aevolve (Mar 22, 2012)

I'll see if I can make an appointment with somebody  I was planning on doing this if it didn't improve by the end of the week anyway.

And I don't touch the bar to my chest- I'm trying to think. It could be because of a wide grip perhaps. I haven't been lifting in a gym for very long. I have done some DB bench on and off at my house for over a year, but I've never suffered shoulder issues.


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## TheBigGroove (Mar 22, 2012)

PeachesMcKenzie said:


> And I don't touch the bar to my chest- I'm trying to think. It could be because of a wide grip perhaps. I haven't been lifting in a gym for very long. I have done some DB bench on and off at my house for over a year, but I've never suffered shoulder issues.



Once I got to the point where I was repping 200+ lbs on the bench, I decided to move to dumbells to save my shoulders. I'm not sure what your build is, but I'm quick long and lanky - 6'4" tall, 205-210 lbs, and a 6'8" wingspan. While I DO believe having a full range of motion is always good with lifting (especially at heavier weights) I just haven't ever seen the need to touch my damn chest with the bar when I'm doing barbell bench. Why? because it hurts my shoulders! I would say for the purposes of general strength and fitness there's really no clear and defined benefit from touching the bar to your chest....as you said you're already doing cable flys anyways. Flys are a much more effective way of opening your pecs up and really hitting the middle of your chest. Unless you're planning on being a competitive powerlifter (they have to touch their chest with the bar) then going down 1-3 inches from your chest, depending on your build, is the right way to go if you want to lift in years to come.

As far as form goes, make sure you're not sticking your arms out perpendicular to your body. this is another reason why DB press is so much more effective IMHO. It naturally encourages you to keep your arms at about 45-60 degrees from your body (i.e. in between parallel and perpendicular). AND btw I'm talking about the bicep portion of your arm. Also, you want to bring the bar down towards your 'nipple line' rather than higher up towards your collar bone....that single-handedly will destroy your rotator cuffs!


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## Aevolve (Mar 22, 2012)

TheBigGroove said:


> As far as form goes, make sure you're not sticking your arms out perpendicular to your body. this is another reason why DB press is so much more effective IMHO. It naturally encourages you to keep your arms at about 45-60 degrees from your body (i.e. in between parallel and perpendicular). AND btw I'm talking about the bicep portion of your arm. Also, you want to bring the bar down towards your 'nipple line' rather than higher up towards your collar bone....that single-handedly will destroy your rotator cuffs!



Yeah, I've been careful to keep it at the nipple-line, so I'm really not sure what happened. I suppose my elbows may have been a bit too perpendicular. Hmm.


And for anyone's reference- I've got an athletic build. I'm about 5'9 or 5'10 and 150-155lbs. Most of my weight is in my upper body, I'm just starting to work on my legs.


EDIT: Also- a little update today: my shoulder is much less sore than it was yesterday, still being careful with it. Pain when moving is so slight it's barely apparent. I'm not sure if a doctor's visit is necessary at this point.


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## TheBigGroove (Mar 23, 2012)

Glad you're doing better dude! Shoulder injuries can be scary...the thought of not being able to do upper body workouts for a few months is terrifying to me to say the least. And sorry if I came off as one of 'those guys' when I was going into basics on form...mostly just throwing stuff out there that took me entirely too long to figure out.


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## Uncreative123 (Mar 23, 2012)

TRENCHLORD said:


> I call that wear and tear, but yes technically you are right.
> I don't think that's the case here, I think we have a strained shoulder and if he works it's motion a bit everyday to get some blood flowing (slight pump and burn) that it'll be just fine in a few days - a week.
> 
> Just take some days off lifting and get a pump going everyday with no weight or just 5-15 pound dumbells doing some basic shoulder shaping moves and a couple of the rotator specific motions.



You're not in a position to diagnose him. You have no idea what the issue is and therefore you shouldn't be offering any advice other than telling him to seek out a professional who can diagnose him. "Wear and Tear" leads to impingement, which leads to surgery if you don't know how to fix it. It's not something to be written-off as "it'll heal on it's own if you just rest it". 




PeachesMcKenzie said:


> EDIT: Also- a little update today: my shoulder is much less sore than it was yesterday, still being careful with it. Pain when moving is so slight it's barely apparent. I'm not sure if a doctor's visit is necessary at this point.




lol, I said DON'T see a doctor- they will do nothing for you. I said see a physiotherapist- someone who is specifically trained for recognizing and treating these symptoms. 
Just because it didn't hurt today doesn't mean it won't next week. You think I went to see a doctor at the first sign of pain? Of course not. It would hurt and then get better. Hurt then get better. I waited until I physically could not bench and left the gym on the verge of tears. I was in so much pain I couldn't even lift my gym bag- and that was after my first two sets of bench. I started off completely pain-free. If you want to ignore it, that is your choice. I'm just trying to relate my own experience to you of how much hell it is going to be for you if it is a serious problem. I have always been of the mantra 'better safe than sorry.' 
But do whatever you want. When you're back here two months from now in more pain feel free to read my first post again.


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## TRENCHLORD (Mar 23, 2012)

Uncreative123 said:


> You're not in a position to diagnose him. You have no idea what the issue is and therefore you shouldn't be offering any advice other than telling him to seek out a professional who can diagnose him. "Wear and Tear" leads to impingement, which leads to surgery if you don't know how to fix it. It's not something to be written-off as "it'll heal on it's own if you just rest it"


 
I actually said it'll heal on it's own if you just gently work it out.

It seems you are always assuming that we all have brittle old man bones, joints made of jelly, and very little common sense.
I've tugged on loaded pallet jacks many of day, I know what a worked shoulder feels like, dragging around sheet metal, bailing hay for that matter.

Why run to the physiowhatever every time you have a little strain or pain?
Around here they call that making mountains out of mole hills.


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## UnderTheSign (Mar 23, 2012)

I won't tell you what to do but I'll vouch for the effectivity of seeing a physiotherapist. Without him, I'd probably still not be able to move my back.


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## TRENCHLORD (Mar 23, 2012)

UnderTheSign said:


> I won't tell you what to do but I'll vouch for the effectivity of seeing a physiotherapist. Without him, I'd probably still not be able to move my back.


 
Yes. Anyone who has a truely painful or persistant nagging ailment should certainly go in.


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## Aevolve (Mar 23, 2012)

Uncreative123 said:


> lol, I said DON'T see a doctor- they will do nothing for you. I said see a physiotherapist- someone who is specifically trained for recognizing and treating these symptoms.
> Just because it didn't hurt today doesn't mean it won't next week. You think I went to see a doctor at the first sign of pain? Of course not. It would hurt and then get better. Hurt then get better. I waited until I physically could not bench and left the gym on the verge of tears. I was in so much pain I couldn't even lift my gym bag- and that was after my first two sets of bench. I started off completely pain-free. If you want to ignore it, that is your choice. I'm just trying to relate my own experience to you of how much hell it is going to be for you if it is a serious problem. I have always been of the mantra 'better safe than sorry.'
> But do whatever you want. When you're back here two months from now in more pain feel free to read my first post again.


Alright.. When I said "doctor" I was referring to a physiotherapist or orthopedic specialist. It was just a generalized term, trust me I listened to what you said.

I understand trying to get me to realize the gravity of what this injury may be, but that doesn't merit being a dick about it. I appreciate the advice, honestly.


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## Uncreative123 (Mar 23, 2012)

TRENCHLORD said:


> Yes. Anyone who has a truely painful or persistant nagging ailment should certainly go in.




....unless they're the OP.


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## TRENCHLORD (Mar 23, 2012)

Uncreative123 said:


> ....unless they're the OP.


 
You might be some one who considers a day or two of having a little work strain to be a truely painful or nagging persistant ailment.
That's fine and great because that's what keeps the doctors busy and rich.

By that thinking then every time you wake up with a kinked neck or stiff back you'll be running to get help .

It's quite often the best idea to give it a few days and use common sense to evaluate how it feels. But there again, you just assume that none of us have any common sense.


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## snowblind56 (Mar 23, 2012)

I messed up my shoulder weight lifting last summer. Went to the doctor and it was a minor labrum tear or SLAP tear or whatever the doctor wants to call it. I chose to not go the surgery route, and it still isn't right. It just plateaued. I finally started back with weights about 6 weeks ago, but I still can't bench press or shoulder press or really do any major weights for that matter. It sucks, but what can you do? Now I focus more on cardio, which I should have been doing more of anyways.


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## Aevolve (Mar 23, 2012)

Uncreative123 said:


> ....unless they're the OP.



This just started this Wednesday. I'm not exactly ignoring it. I've been extremely careful with it, and I'm seeing how it fares by the end of the week. There's no problem in waiting until the end of the week when I'm not lifting with it or exacerbating it in any way. Doctor visits cost money, I need to make sure it's necessary.


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## Aevolve (Mar 24, 2012)

Additional update today: Feel almost no pain in my shoulder, maintaining full range of motion, still being very careful with it. Taking Ibuprofen every once in a while to make sure there's no inflammation.


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## Murmel (Mar 25, 2012)

I have some troubles with my shoulder, generally only when benching. It usually stays sore several days after benching and hurts during too.
Only did dumbbell presses yesterday and I don't feel my shoulder at all today .
Will probably ditch bench altogether, because no matter how I adjust my technique it fucks with my shoulder.


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## Aevolve (Mar 25, 2012)

Murmel said:


> I have some troubles with my shoulder, generally only when benching. It usually stays sore several days after benching and hurts during too.
> Only did dumbbell presses yesterday and I don't feel my shoulder at all today .
> Will probably ditch bench altogether, because no matter how I adjust my technique it fucks with my shoulder.



Phil Heath (Mr.Olympia) has done away with any sort of flat bench exercises because of the risk of injury. He exclusively does incline DB bench, hammer bench, etc.


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## Captain Shoggoth (Mar 25, 2012)

Same thing happened to me in September (albeit less severe) I found an exercise that isn't a solution, but is an excellent preventative measure. For the love of God do not start doing these immediately-but when your rotator cuff has healed, implement shoulder dislocations.



Use a broom (anything shorter will be agonisingly painful, regardless of existing injury), 3 sets of 10 as part of your warm-up (on your chest/shoulder days I guess, I train powerlifter-style (all compound lifts, no split) so I just do them every time I train. Has worked beautifully and I've not experienced any rotator cuff problems or soreness since, not even DOMS).


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## Aevolve (Mar 27, 2012)

Additional good news: went to the Orthopedic MD today, they examined me and took x-rays. Nothing's torn, he believes I sprained my rotator cuff. He says I've been taking good care of it, and it seems to be healing well. Just gotta stay on some steady Ibuprofen and I can even start lifting again  (granted, I need to start low-weight and work my way back up)
Looks like it won't be a problem for me as long as I stay careful with it.


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## Harry (Mar 27, 2012)

^Good to hear man.
I had pretty bad shoulder problems myself, which consequently left me with a way undeveloped chest/tri/shoulder region because I couldn't work out those areas for about 8 months of last year.
I've made external rotation exercises (my favorite being the Cuban Press) a regular part of my workout regime and they definitely help to keep stuff stable.
Shoulder dislocations are fantastic too. 
I still shy away from barbell flat bench though. Hoping one day to be able to do it though.
Always best to go with the 'powerlifter' form on flat bench if you're gonna do it. I've never understood why it was the 'powerlifter' form anyway, it should be THE way to flat bench IMO and you don't necessarily need a crazy back arch, just enough that it decreases the stress on the rotator cuff. 
Some people can get away with a totally flat back on bench, but I've noticed it's mostly guys with T-rex arms that don't have much natural range of motion or guys with fairly regular length arms that don't use full ROM anyway.
If you've got long arms like me, definitely best to get that back arch happening, because the range of motion on a flat back bench is just way too much for the shoulders to take.


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## TRENCHLORD (Mar 27, 2012)

Yeah with all benching motions IMO it's crucial to hold that leveraged position throughout.

To start with you must be on a bench of proper height relavent to your leg length/positioning, which sometimes means placing plates or mats or even both under your foot rest positions.
Experimenting is key here.

Also make sure and suck your gut in and expand your chest.

I also recomend lowering the weight at a normal but controled speed (not super-slow), and holding it at the bottom position (wheather brushing against shirt or at the couple inches from chest mark) for a full one or two count.

I always explode the weight up and freeze at the top for a good squeeze and hold for a 1/2 second or so.

When exploding from the bottom it's hyper-crucial to not use any sort of bucking motion or shoulder hitching to gain momentum or elastic bounce. 

Takes some practice, but it'll make a world of difference in safety and development.


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## Uncreative123 (Mar 28, 2012)

PeachesMcKenzie said:


> Additional good news: went to the Orthopedic MD today, they examined me and took x-rays. Nothing's torn, he believes I sprained my rotator cuff. He says I've been taking good care of it, and it seems to be healing well. Just gotta stay on some steady Ibuprofen and I can even start lifting again  (granted, I need to start low-weight and work my way back up)
> Looks like it won't be a problem for me as long as I stay careful with it.




Same thing happened to me, less the 'sprained RC'. X-rays showed no scar tissue build up or anything torn. Basically the doctor told me nothing was wrong with me and I should stop benching for 6-8 weeks. Really one of the most insightful diagnosis' I've ever received. I mean I nearly cried from how much pain my shoulder was in, but he told me nothing was wrong, so obviously nothing was wrong and it was all in my head. 
And that's exactly why I'll never go to a Ortho MD again.

I don't even think it was an issue with my RC, but rather with the AC joint being completely fucked. Though that was never acknowledged or looked at.

Shoulder dislocators are pretty good. I stopped doing them because they would cause wrist problems for me. Wall slides work tremendously as a substitution.


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## Aevolve (Mar 28, 2012)

Uncreative123 said:


> Same thing happened to me, less the 'sprained RC'. X-rays showed no scar tissue build up or anything torn. Basically the doctor told me nothing was wrong with me and I should stop benching for 6-8 weeks. Really one of the most insightful diagnosis' I've ever received. I mean I nearly cried from how much pain my shoulder was in, but he told me nothing was wrong, so obviously nothing was wrong and it was all in my head.
> And that's exactly why I'll never go to a Ortho MD again.
> 
> I don't even think it was an issue with my RC, but rather with the AC joint being completely fucked. Though that was never acknowledged or looked at.
> ...



Well contrary to your experience, I am experiencing nearly zero pain in my shoulder anymore. I trust my MD as he has treated me before for a broken ankle and leg with ligament tears, and I recuperated fantastically with no problems whatsoever. I'll take his advice and continue to be careful, but thank you for your insight.


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