Shoulder Press Pain and Thoracic Outlet Syndrome: What You NEED to Know.
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- Опубліковано 5 лип 2024
- Shoulder pressing is painful for many lifters, and they may experience symptoms of thoracic outlet syndrome. The reasons are:
🔹their thorax is tight
🔹they can't diaphragmatically breathe
🔹they are using their neck too much due to forward head posture
Through a Postural Restoration Institute perspective, to overhead press safely, one must have the ability to expand their thorax with air to promote diaphragmatic breathing, stabilize the pelvis, and get out of a forward head posture. Otherwise the neck will stay tight and you won't have full control of your shoulder muscles.
Hey there, my name is Neal Hallinan.
The purpose of this channel is to help people understand and resolve chronic muscular and joint pain, primarily through the discipline of Postural Restoration.
As someone who lived with chronic pain for many years of my life, I know how debilitating and isolating it can be. But I also know it can be resolved.
I hold the following credentials:
Postural Restoration Trained (PRT)
Strength and Conditioning Coach (CSCS)
Licensed Massage Therapist (LMT)
Amateur Historian (AH, my own self-designation)
I live and work in the great state of New Jersey, USA.
I offer one-on-one training as well as online consultations via Zoom. The information can be found here:
pritrainer.com/on-line-consul...
/ neal_hallinan
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Subscribe to my channel here: / @nealhallinan
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For an example of typical exercises for a beginner program, you can look here:
pritrainer.com/pri-left-aic-r...
Please note, this is quite generic and not sufficient for everybody!
It was such a pleasure talking to you about this Neal!
One other consideration that viewers need to be aware of is congenital variants of anatomy. Some people are born with accessory cervical ribs. This can be unilateral or sometimes bilateral. These accessory ribs can also be a source of obstruction in the thoracic outlet in anyone and particularly when coupled with muscular hypertrophy. Vascular ( venous and arterial) causes also exist but were beyond the scope of our chat.
Thank you for the follow-up!
Wow! Just checking those channel again after being obsessed with PRI a while back and the channel has grown so much Neil! Great job finding the right titles /clickbait Neil!🎉
This is me right now and your videos have been a great help. Just knowing the name of this symptom is helping me a lot.
Love this! So informative. The doc puts things in such easy to understand terms. Thank you Neal and Dr Kremel
Terrific video Neil, extremely informative.
Thank you.
So good!
My TOS is on my left side and, while I don’t do traditional weight lifting, I list students with severe physical and cognitive impairments in and out of wheelchairs with their trunk on my left arm. I’ve been doing this for 28 years and it’s definitely taking its toll on my body. However, I don’t have rib cage extension due to kyphosis, I have rib cage compression.
Hello, I've seen your video explaining the correlation between pelvic tilt and jaw structure.
I want to ask about APT (anterior pelvic tilt). I have an APT that makes me lose about 2 inches. Will any kind of surgery fix this? If so, will it also make me "gain" my 2 inches of height back? I have a pretty decent jawline and facial structure so I don't think there's a real correlation.
Please let me know and thank you for your time :)
This is what I have and it makes me afraid to do push-ups and bench press because I don’t want to injure myself
Hey Neal, I have asymmetric face. One side of the face is more prominent and forwardly grown (jaw and cheekbones. My left side jaw seems like it lacks bone mass compared to right). I have scoliosis and i think my asymmetry is cause by it, so my question is can face asymmetry due to scoliosis be fixed? And with what it could be fixed?
Hi, I’m 15 years old and I’ve been watching your videos and I really need help. So I have had an extra tooth in the left side of my mouth for 4 years. It led to an asymetry in my face.I got it out of there today and here is what I have now. Left eye higher than le right, restricted breathing in the right ribs, my right shoulder higher than the left one and the nerves in my arms etc. are all tight. I had to take a break from basketball until I Get that fixed and my right hip feels uncomfortable sometimes. Its been 7 months since this breathing problem and I stopped working out because of it. My collarbone on the left side seems like its pulled down and I have neck tightness too. Also, I have a left rib flare and not much in the pelvic I think except a right leg externally rotated most of the time. I really want to get back to my sport even if I have learned a lot from this injury. can you help? Thanks for Your time
Which exercise should I do in left AIC right BC right TMCC pattern.
I am left hander!
Neal, can you help me? I watched the video about neyrology where you showed the picture of the brain and said your left eye. Can someone help me find it?
What is the best area to get an MRI for suspect TOS?
My left shoulder feel pretty silly when I try to do incline bench..
Well, while it is not mentioned here - You can also get severely injured in your posterior neck/ scalenes /brachial plexus/pec minor while doing dumbell shoulder press (for whatever reason, it might be inevitable). It happened to me in an early morning workout session (6am), perhaps I did some neck hyperextension when lowering the dumbells or was not in focus, I'm using a standing position. It did cause me chronic damage (Almost 4 years have passed since then) which could be described as TOS.
7.7.1 Post-Traumatic Onset
The large majority of NTOS patients give a history
of some type of hyper-extension neck injury
preceding the onset of symptoms. Whiplash injuries
in motor vehicle accidents is the most common
cause, but other causes include falls on ice,
slippery floors, down stairs, and athletic injuries.
In these patients the usual sequence of symptom
development is neck pain within the first 24 hour
followed within a few days by headaches and
pain over the trapezius muscles. Anywhere from
a few days to a several weeks later pain moves
into the upper extremities and paresthesia develops
in the fingers and hands. The microscopic
pathology as noted in Fig. 7.7, is a significant
increase in scar tissue spread diffusely throughout
the scalene muscles. Putting together the history
of an injury along with the pattern of
symptom development and subsequent muscle
pathology gives a plausible explanation for the
pathophysiology: Following a neck injury the initial
neck pain is due to two things: Cervical spine
neck strain and tearing of the scalene muscle
fibers. There is probably some muscle hemorrhage
in the scalenes which causes muscle swelling
and increased neck pain over the first few
days. The symptoms of arm pain and paresthesia
that develop in the first few days are due to swelling
of the injured scalene muscles. If the muscle
injury is mild so there is not much swelling, arm
pain and paresthesia may not appear for a few
weeks. This is because the later arm and hand
symptoms are due to the healing process in the
scalene muscles by which the intramuscular
blood is absorbed and replaced by fibroblasts
which later are replaced by collagen. This normal
healing process results in scarred, tight muscles.
Since normally the nerves roots of the brachial
plexus are in contact with the scalenes, when the
muscles become scarred they compress the nerve
roots causing the arm and hand symptoms, usually
with activity of the arm and neck, but also in
some patients at rest as well. Even though these
muscles appear normal when viewed during
supraclavicular surgery, the microscopic picture
(with special stains) is far from normal as seen in
Fig. 7.7 (old Fig. 7.2). The predominance of type
I muscle fibers and the reduction in type II fibers
in addition to the significant muscle fibroses further
confirms that there has been significant
structural changes in the muscles.
In addition to the pathology noted in the scalene
muscles, other pieces of evidence are available
to incriminate the scalenes as the primary
pathology in most cases of NTOS. These are the
scalene muscle block with local anesthetic and the
response to surgical scalenotomy and scalenectomy;
that scalene muscle blocks can temporarily
relieve symptoms and reverse physical findings
within a few minutes supports the scalenes as the
primary source of pathology in NTOS; finally,
that dividing or removing the scalene muscles surgically
gives good long-term relief in the majority
of patients is more support for this theory.
Such great information. Thank you Neal. Could a tight thorax cause costochondritis?
Thanks, Thomas. I’m really not too familiar with costochondritis to be honest.
Thank you Neal. I couldn’t have done it without your videos to be where l am now. My biomechanics still ‘suffers’, but lots of my pains have gone away. And l couldn’t have done it without watching your channel. At 48, with scoliosis and discs degeneration in my spine, l am back to playing football and jogging again. So far, l haven’t found anyone who would explain it all better than you. Thank you for allowing me to access all that information for free Neal. You are a life saver.
@@thomas2081 I’m very happy for you and it makes me feel good that I was able to help.
I need to look more into this PRI thing!
So what's the alternative to overhead barbell press? Alternating single-arm dumbbell press?
Yes, I have a card for it during the video and a link to it at the end of the video.
@@NealHallinanThanks for taking the time to respond! Some of the most common workouts we do seem to reinforce bad compensations. It seems like there are 2 extra steps to do before any PRI technique can stick. And none of them can work on its own. Would you agree?
1. Don't do any exercise or have any daily habit that reinforce bad compensations.
2. Release any compensatory or overactive muscle.
3. Relearn how to use the side of your muscles (with proper breathing) that have been dormant via PRI techniques.
don't depress your shoulder blades and elevate your scapula a little, watch msk neurology for more information on this.
Neal do I get internal obliques in all on fours technique by strenghtening more left serratus and rounding?
You could lift your left arm from the ground while focusing on keeping the right glute max engaged. This may help you to remain more grounded and flexed on the left in a less compensatory way.
The goal would be to maintain spinal flexion while reaching, using more L obliques and serratus instead of your back and neck (extension).
@@heal2hair517 I cant feel left serratus If I lift my left arm. Didnt you mean to lift right arm?
@adamchmelovsky9941 the left serratus helps to retract your left side of the ribcage, reaching with your left arm maintaining your L serratus engaged is more difficult but helps you keeping the ribcage retracted and the thoracic spine more flexed.
While reaching with the right arm is less challenging in keeping the L serratus active, it's harder to maintain R scapular compression.
Speaking of a traditional L AIC R BC pattern.
@@heal2hair517 Yeah I remember now that Neal said something about feeling conpression in right scapula but I didnt achieved it.
Im so weak in Left serratus that I barely can lift right arm so thats why.
What’s the story behind that framed quote :)
I think you are referring to the Bob Dylan song? It’s just in the room. It’s not actually mine.
Escape the matrix he is a part of it.
jeps,Trapezius,first Rib(Scalenis)b,SCM-Muscle,Masseter Muscle,Pectoralis Minor & not forget the hole Arm-lines & wrists ! greetings from Germany :) PS: after 2 Years of TOS, i fixed the hole Body. My ears,my nose,my Skull are totally in Re-Balanced!
I’m glad you are fixed!👍
What type of TOS did you have?