Training with an injury

[APL76]

Back in November I was in a collision with a car. I was on my bicycle; person didn't give way when they should have and now my left shoulder AC joint is &*%$ed (I basically caved in the side of their car).

In February tried training again, just one night with my sifu, exclusively stance/footwork, it still aggravated my shoulder no end. Presently Wing Chun training is not a viable option. I have gone from 200 Ks + on the bike per week, Wing Chun 6 days a week, and 2 gym sessions per week, to absolutely NO physical activity. And in addition to turning into a tubby bastard, I'm starting to go a bit crazy.

Has anyone else dealt with something similar? and if so, how did you deal with it? Did you figure out alternative training options that didn't aggravate your injury?

 

[Gyakuto103]

Shoulder injuries…my perennial issue! Frozen shoulder, rotator cuff injuries (no tears so far ). One shoulder gets better and then the other kicks off with something that limits my movements and causes me pain. The my gym workouts are limited and I often have to modify my exercise regime to accommodate my painful shoulder. Without knowing the nature of your injury, (&*%$ed is too complex for me) it’s hard to know how to help although I suspect the headroom in the joint is reduced due to crushing. You’re probably aware that your shoulder will never be normal again and you’re always going to have an issue with it.

The shoulder is susceptible to injury because it’s evolved to be highly mobile in all directions. The glenoid fossa (socket) is very shallow, encapsulating only about a third of the numeral head which is thus held in place by four weak rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres minor). The supraspinatus tendon, that runs under the acromioclavicular joint, is usually the bit that gets inflamed due to friction against the roof of the shoulder joint. Also, as we age, the blood supply to the joint diminishes which slows healing considerably (diabetes makes that even worse!). Physiotherapy has been very hit and miss and I have very little faith in them as practitioners. A couple of books have been helpful, one for understanding the shoulder joint and injury diagnosis (it’s written for health professionals so very specialised)

The other is interesting, written by a shoulder surgeon, because it simply recommends passive hanging from a monkey bar the rational being that in doing so and over time, the acromion is bent back and straightened, increasing the space in the joint which allows the supraspinatus tendon to move unencumbered. Most of the book is devoted to convincing the reader that the author has discovered a new joint and is a bit tiresome. The advice on how to, hang safely is just one page (71 if memory serves!)

I hope you find some of this useful; I’m aware that I haven’t answered your question directly, but hopefully this will prevent you having to reinvent the wheel as I had to

Best of luck!

 

[drop bear103]

You need to find an activity that meets your injury requirements and do that untill you are not injured.

 

[Xue Sheng96]

Back in November I was in a collision with a car. I was on my bicycle; person didn't give way when they should have and now my left shoulder AC joint is &*%$ed (I basically caved in the side of their car).

In February tried training again, just one night with my sifu, exclusively stance/footwork, it still aggravated my shoulder no end. Presently Wing Chun training is not a viable option. I have gone from 200 Ks + on the bike per week, Wing Chun 6 days a week, and 2 gym sessions per week, to absolutely NO physical activity. And in addition to turning into a tubby bastard, I'm starting to go a bit crazy.

Has anyone else dealt with something similar? and if so, how did you deal with it? Did you figure out alternative training options that didn't aggravate your injury?

Had a minot rotator cuff tear and arthritis in my right shoulder that made Bong sau impossible and most other things painful. I had to stop Wing Chun and just abot everything else. Went to my Orhtopedic MD and he sent me to PT. It helped but then winter hit and running the snowblower and shoveling and I was in constant pain, sitting, standing and it woke me up more than once. Went back to my MD and decided I needed to get a cortisone shot. Got the shot, he sent me to PT and so far so good, Went back to Wing Chun for the forst time in months, was able to do Siu lum tao and work with the mook jong. And I can even start exercising again, and do my taijiquan forms pain free.. I too gained weight, 13 lbs.

But all I can say now is so far so good and i am just careful. Will be in PT through April

 

[HighKick1]

Back in November I was in a collision with a car. I was on my bicycle; person didn't give way when they should have and now my left shoulder AC joint is &*%$ed (I basically caved in the side of their car).

In February tried training again, just one night with my sifu, exclusively stance/footwork, it still aggravated my shoulder no end. Presently Wing Chun training is not a viable option. I have gone from 200 Ks + on the bike per week, Wing Chun 6 days a week, and 2 gym sessions per week, to absolutely NO physical activity. And in addition to turning into a tubby bastard, I'm starting to go a bit crazy.

Has anyone else dealt with something similar? and if so, how did you deal with it? Did you figure out alternative training options that didn't aggravate your injury?

Have you had a medical diagnosis? Do you really know what injury you are dealing with? Not certain how you would rehab what you do not know.

 

[APL76]

Thanks for the response, basically my AC joint is separated, just trying to find out if anyone had experienced similar and found exercise they could do without aggravating the injury.

I'll look out for those books.

 

[APL76]

You need to find an activity that meets your injury requirements and do that untill you are not injured.

Thanks for the reply. Yep, was just wondering if anyone had any experience of similar and specifically what exercises they did, like hydrotherapy, or whatever.

 

[APL76]

Have you had a medical diagnosis? Do you really know what injury you are dealing with? Not certain how you would rehab what you do not know.

Yep, separated AC joint, have physio rehab plan and possible escalation to surgical options pending progress of physiotherapy.

What I'm after is something a little more intense than yanking on a rubber band, that won't make it worse.

 

[APL76]

Had a minot rotator cuff tear and arthritis in my right shoulder that made Bong sau impossible and most other things painful. I had to stop Wing Chun and just abot everything else. Went to my Orhtopedic MD and he sent me to PT. It helped but then winter hit and running the snowblower and shoveling and I was in constant pain, sitting, standing and it woke me up more than once. Went back to my MD and decided I needed to get a cortisone shot. Got the shot, he sent me to PT and so far so good, Went back to Wing Chun for the forst time in months, was able to do Siu lum tao and work with the mook jong. And I can even start exercising again, and do my taijiquan forms pain free.. I too gained weight, 13 lbs.

But all I can say now is so far so good and i am just careful. Will be in PT through April

Thanks for the response.

Yeah injuries suck, I'm off for the cortisone shot next week, I'll keep up the physio.

I'm glad you are able to get back into training, hopefully I won't be too far behind.

 

[Gyakuto103]

Yep, separated AC joint, have physio rehab plan and possible escalation to surgical options pending progress of physiotherapy.

Do you know what type?

What I'm after is something a little more intense than yanking on a rubber band, that won't make it worse.

Physios tell me this attitude of wanting something more intense in the belief it’ll progress things faster/more efficiently is an error and can potentially be counterproductive. They suggested a yellow band for me, I wanted to use a strip of steel. 1kg dumbbells? I wanted to use 5kg! It’s the macho attitude we tend to develop when subject to testosterone

From what you’re reporting, I’d be very cautious about doing anything beyond what you orthopedic surgeon et al. is recommending. You essentially have some degree of an unsupported joint. Don’t do any repetitive, sudden movements beyond your prescribed band work and since Wing Chun is very ‘upper limb’ orientated including jarring percussive impacts, I wouldn’t engage with it at all until things have repaired substantially. How about trying something that’s all kicks and getting really good at that until things improve with your shoulder?

You could try applying heat to increase blood flow and hence the bringing of nutrients and flushing away of metabolites. I have a home ultrasound device that is supposed to do the same, but it’s sh*te since it’s low powered, so a good ol’ hot water bottle three times a day might hasten things along.

 

[Xue Sheng96]

Thanks for the response.

Yeah injuries suck, I'm off for the cortisone shot next week, I'll keep up the physio.

I'm glad you are able to get back into training, hopefully I won't be too far behind.

See if your MD will send you to physical therapy, It’s helping me.

 

[APL76]

Do you know what type?
View attachment 33946

Physios tell me this attitude of wanting something more intense in the belief it’ll progress things faster/more efficiently is an error and can potentially be counterproductive. They suggested a yellow band for me, I wanted to use a strip of steel. 1kg dumbbells? I wanted to use 5kg! It’s the macho attitude we tend to develop when subject to testosterone

From what you’re reporting, I’d be very cautious about doing anything beyond what you orthopedic surgeon et al. is recommending. You essentially have some degree of an unsupported joint. Don’t do any repetitive, sudden movements beyond your prescribed band work and since Wing Chun is very ‘upper limb’ orientated including jarring percussive impacts, I wouldn’t engage with it at all until things have repaired substantially. How about trying something that’s all kicks and getting really good at that until things improve with your shoulder?

You could try applying heat to increase blood flow and hence the bringing of nutrients and flushing away of metabolites. I have a home ultrasound device that is supposed to do the same, but it’s sh*te since it’s low powered, so a good ol’ hot water bottle three times a day might hasten things along.

Thanks for replying again.
Type 2.

I can also see how what I wrote could have been misinterpreted. I'm pretty cautious to only push the rehab exercises to what the physiotherapist has told me to do, so doing the band exercises. But just in general, I feel I'm not getting enough exercises, so only the band stuff is inadequate from that respect, not meaning I want to ramp up the rehab exercises, but rather find non-shoulder-rehab related exercises that don't exacerbate things.

The little bit of lower body training I have done, has proven to be entirely unfeasible, it aggravated things no end, even though I was cradling my arm the whole time, so whing chun is off the agenda for the moment. I'll give the hot water bottle a go, thanks for the suggestion.

 

[Gyakuto103]

Thanks for replying again.
Type 2.

Ouchy!

But just in general, I feel I'm not getting enough exercises, so only the band stuff is inadequate from that respect,

And you’re basing that opinion on the fact you’re a physiotherapist? More isn’t always better as I remind myself when confronted with cake! I really think you should listen to your healthcare professional’s opinions. Ask other ones if you doubt them but they are the experts.

You’re probably aware that therapy is often instigated with the most conservative first and when that is explored and found to be lacking, it’s ramped up. If you can avoid surgery then you really should since complications such as infection, bleeding, adhesions can make things worse.

Do your exercises diligently, allow adequate rest and maintain good nutrition and I’m sure things will improve…slowly

Have you heard of the Japanese term, mitori geiko? Neuroscience shows just how powerful, rich internal visualisation is in improving motor skills. Virtually the same neural pathways are activated when imagining doing a movement as actually doing it! Try it!

not meaning I want to ramp up the rehab exercises, but rather find non-shoulder-rehab related exercises that don't exacerbate things.

I think the nature of rehabilitation exercises is that they aggravate injuries, but the trick is to ensure it doesn’t do that too much!

The little bit of lower body training I have done, has proven to be entirely unfeasible, it aggravated things no end, even though I was cradling my arm the whole time, so whing chun is off the agenda for the moment. I'll give the hot water bottle a go, thanks for the suggestion.

I really sympathise with you, it must be so frustrating for you. It does show how connected body movements are; if you’ve ever had lower back pain, this is explicitly demonstrated

How about working on ancillary martial arts skills? Balance -standing on one leg, wobble boards, eyes close (that’s really hard!), footwork, isometric leg exercises etc. As martial artists we tend to ignore those foundational aspects in favour of the flashy stuff. This is your opportunity to become so incredibly solid it will frighten your opponents and small dogs etc

 

[HighKick1]

Yep, separated AC joint, have physio rehab plan and possible escalation to surgical options pending progress of physiotherapy.

What I'm after is something a little more intense than yanking on a rubber band, that won't make it worse.

I had my right shoulder dislocated in an open tournament around '90. My GM, who is qualified, put it back in place in the ring. Hurt like a b***h. It was like most soft tissue injuries, they hurt worse than a broken bone and take longer to heal. I was young and inpatient and never really let mine heal like I should have. Not certain if this is where it all began but now the ball & socket, clavicle, and scapula are really messed. I am scheduled for a shoulder replacement this year.
As far as intensity, listen to the PT folks. Soft tissue really takes time and you are risking the actual joint and structure if you rush it. I know this from my many, many leg injuries & surgeries. I straight up caused two surgeries because I rushed things and kept tearing the same tendon. And I tell you, nothing can be more nagging than a soft tissue injury. I can remember broken ribs/tissue that stopped me in my tracks a year after the injury just by moving a certain way.
I hope the physio and rehab takes care of the injury.

 

[Haruhiko]

Has anyone else dealt with something similar? and if so, how did you deal with it? Did you figure out alternative training options that didn't aggravate your injury?

I'm currently recovering from moderate bursitis in my left shoulder and mild in my right. I see a physio weekly, and my exercise physiologist twice weekly.

For about the last month I've been out of action, and my physio has told me what to do, as have the EPs. I follow medical advice, that gets to my sensei, and my sensei told me to do "mitori geiko" — essentially, observational (both internal and external) training.

In the meantime, I've been doing shoulder rehab and last weekend I was finally back in action for Musō Shinden-ryū iai.

So while I sympathise with your situation I can't empathise, because from your OP, it doesn't sound like you've sought out medical advice or rehabilitation?

EDIT:

Get your physio to refer you to a radiologist. This shouldn't last that long. You might need keyhole surgery.

How's your posture? Are you ever working or spending long times with weight on your shoulder joints?

In the meantime, so it's clear, the chain of medical authority here should be:

Surgeon > radiologist > physiotherapist > exercise physiologist.

Personal trainers know how to send invoices, that's about as far as they're qualified as far as I'm concerned.

Avoid ice, use heat sparingly, and if you feel any pain at all cease whatever you're doing immediately and take note.

And walk. Isometrics are good, but it really depends on injury.

 

[Haruhiko]

Neuroscience shows just how powerful, rich internal visualisation is in improving motor skills. Virtually the same neural pathways are activated when imagining doing a movement as actually doing it! Try it!

There's been studies on groups of people who visualise going to the gym and lifting weights, and they gained greater muscle growth and memory than than control group and slightly less than the group who physically went.

It's a fascinating new frontier.

 

[APL76]

Ouchy!

And you’re basing that opinion on the fact you’re a physiotherapist? More isn’t always better as I remind myself when confronted with cake! I really think you should listen to your healthcare professional’s opinions. Ask other ones if you doubt them but they are the experts.

You’re probably aware that therapy is often instigated with the most conservative first and when that is explored and found to be lacking, it’s ramped up. If you can avoid surgery then you really should since complications such as infection, bleeding, adhesions can make things worse.

Do your exercises diligently, allow adequate rest and maintain good nutrition and I’m sure things will improve…slowly

Have you heard of the Japanese term, mitori geiko? Neuroscience shows just how powerful, rich internal visualisation is in improving motor skills. Virtually the same neural pathways are activated when imagining doing a movement as actually doing it! Try it!

I think the nature of rehabilitation exercises is that they aggravate injuries, but the trick is to ensure it doesn’t do that too much!

I really sympathise with you, it must be so frustrating for you. It does show how connected body movements are; if you’ve ever had lower back pain, this is explicitly demonstrated

How about working on ancillary martial arts skills? Balance -standing on one leg, wobble boards, eyes close (that’s really hard!), footwork, isometric leg exercises etc. As martial artists we tend to ignore those foundational aspects in favour of the flashy stuff. This is your opportunity to become so incredibly solid it will frighten your opponents and small dogs etc

Yeah, Thanks., I appreciate the advice. Interesting you mention lower back pain. I actually had a bacterial infection that went undiagnosed for about 5 years and took about 7 years in total to get past. I think that's part of my frustration that I was beginning to return to full capacity after years of mediocrity, and then this...Anyway.

But yes, I understand the foundational stuff well, And I think you are right, I'll be back to isometric stance training for a while.

 

[APL76]

I had my right shoulder dislocated in an open tournament around '90. My GM, who is qualified, put it back in place in the ring. Hurt like a b***h. It was like most soft tissue injuries, they hurt worse than a broken bone and take longer to heal. I was young and inpatient and never really let mine heal like I should have. Not certain if this is where it all began but now the ball & socket, clavicle, and scapula are really messed. I am scheduled for a shoulder replacement this year.
As far as intensity, listen to the PT folks. Soft tissue really takes time and you are risking the actual joint and structure if you rush it. I know this from my many, many leg injuries & surgeries. I straight up caused two surgeries because I rushed things and kept tearing the same tendon. And I tell you, nothing can be more nagging than a soft tissue injury. I can remember broken ribs/tissue that stopped me in my tracks a year after the injury just by moving a certain way.
I hope the physio and rehab takes care of the injury.

Thanks for the advice. sorry your shoulder is messed up, hope the surgery helps.

 

[APL76]

I'm currently recovering from moderate bursitis in my left shoulder and mild in my right. I see a physio weekly, and my exercise physiologist twice weekly.

For about the last month I've been out of action, and my physio has told me what to do, as have the EPs. I follow medical advice, that gets to my sensei, and my sensei told me to do "mitori geiko" — essentially, observational (both internal and external) training.

In the meantime, I've been doing shoulder rehab and last weekend I was finally back in action for Musō Shinden-ryū iai.

So while I sympathise with your situation I can't empathise, because from your OP, it doesn't sound like you've sought out medical advice or rehabilitation?

EDIT:

Get your physio to refer you to a radiologist. This shouldn't last that long. You might need keyhole surgery.

How's your posture? Are you ever working or spending long times with weight on your shoulder joints?

In the meantime, so it's clear, the chain of medical authority here should be:

Surgeon > radiologist > physiotherapist > exercise physiologist.

Personal trainers know how to send invoices, that's about as far as they're qualified as far as I'm concerned.

Avoid ice, use heat sparingly, and if you feel any pain at all cease whatever you're doing immediately and take note.

And walk. Isometrics are good, but it really depends on injury.

"I can't empathise, because from your OP, it doesn't sound like you've sought out medical advice or rehabilitation?"

No, no, I have certainly got the medical advice and rehab well underway, what I'm frustrated by is my current level of inactivity and was just wondering if others had had similar experience and if they were able to find some way to remain active but, in a way, compatible with their recovery. Appreciate the suggestions. Thanks.

 

[Haruhiko]

"I can't empathise, because from your OP, it doesn't sound like you've sought out medical advice or rehabilitation?"

No, no, I have certainly got the medical advice and rehab well underway, what I'm frustrated by is my current level of inactivity and was just wondering if others had had similar experience and if they were able to find some way to remain active but, in a way, compatible with their recovery. Appreciate the suggestions. Thanks.

Walks, mitori geiko, and rehab. It sucks. But it's better a few months out than never again.

Any luck with the radiologist?