Sternoclavicular joint injuries and rehabilitaion training.
I hope ya’ll are doing well. The subject for this post entry is going to be injury rehabilitation for a sternoclavicular joint injury. It’s been a while since I posted something and this subject seemed appr. considering, I have been out of action for a while. It’s called the sternoclavicular joint. It’s one of those injuries only a few doctors see. Add to that the mentality that the doctors have here in DK and you better start looking into things on your own ( personal experience! ). Looking at what I can do today and how bad it was after the accident I feel very lucky. Old dogs can learn new tricks.
Before we get too far into it. This entry is based on what I went through / am going through with my sc-joint injury. Find a good therapist to help you with your needs if you are in my shoes. Many are just not good enough. :( look at this post as food for thought and do some real research into the complications, variations of the injury, treatments, and rehabilitation tactics. In my case, they said give it time. The problem was that there were joints in the general area that were out of alignment which made healing up a problem. An example is how the 1 rib being out puts pressure on the sc joint. now think of a t-spine joint, a c-spine joint and three ribs out of place along with the sc-joint injury. We are getting into osteopathy and chiropractics here. Imagine a doctor letting a bone heal up without making sure it is straight. That’s what I was facing.
I could do a lot of complaining about the way we are looked at as a number and so on but I’ll just throw a few pointed remarks in as part of this blog entry. Getting back to how many people have seen this injury, you’ll need to do some research if you are so unlucky to abuse your body like I have. It’s well worth the time when talking with the doctors. I learned that several were not prepared and just said ” give it time.” To be honest there are a few angry doctors because I would not accept that. I wanted scans and more. Ultra sound scan, MR scan and more to see what was wrong. The doctors did not understand that I knew something was wrong based on the way it felt. Most people don’t have great control of their bodies and that makes it easy to just say “give it time,” it’s your imagination.
To start with you’ll have to just be real careful with your arm and shoulder for a long time. Tendons and joints tissue heal a lot slower than muscle. So if you are like me, no more super man for longer than you will like. When your arm is ok to move you’ll need to keep it mobile without putting a strain on the joint. Remember that the arm hangs from this joint if we are talking about the skeletal system. That means everything pulls on that very sore unstable joint. Good luck with using your arm without hurting the sc-joint from time time to time.
Getting back to the mobility issue, there is something called atrophy. That’s one reason old folks can’t get their arm over their head. Muscles shorten and become smaller and weaker while joint become stiff. Be real careful with your arm/shoulder so this doesn’t happen to you. In order to take the burden off the stiff shoulder joints you will end up with it’s worth the energy to work on t-spine mobility. Here’s one version of t-spine mobility. We are meant to have a mobile thoracic section of the spine. We lose that, way too often, because of our modern lifestyle. That can be a subject for another day. The physical therapist I go to works with the joint alignment as well as nerve issues. I am very happy that I found a good physical therapist. You can find him here. Ask for Niklas. I was and am still very thankful for his knowledge of how the body works. In my case several joints needed to be set straight because it was more than just the sc-joint that went out.
Once you are ready to train, the fun starts. I started with 1 kg hand weights. Just think I went from jerking 150 kgs. around to lifting 1 kg weights. Watch your ego if you want to get back to what you were doing. The weights will get heavier with time. You need to remember that the joint strength improves MUCH slower than muscle strength. It’s a baby step affaire from this point on. I can say That I am well past the baby weights with the current program. Not rushing is the reason.
I started with static/ isometric strength. I had to learn to use back and shoulder muscle to stabilize my arm before being able to push and pull. When doing lunges my arms hanged at my side. A lot of energy went into holding the arm in with the back and shoulder muscles. Most modern people don’t have the isometric strength, that they should, just like shoulder, t-spine and hip mobility. Once again … another post and another time. The shoulder program I did and still do grew/is growing. It’s an issue of not putting too mush strain on the joint. Front raises, lateral raises and reverse fly’s are but some of the exercises. I don’t push it to the limit to avoid making the joint too weak. That means a superset of one shoulder exercise after another. At the moment I am doing 6 exercises in the superset. I started with 1 exercise. My shoulder are tired when I’m finished but I avoid feeling pain in the joint. Push until you have pain in the joint, and you will be knocked back a few weeks like I was after forgetting the baby steps. If I had to put a number on it, I am doing a 15-20 rm weight no more than 10 reps before going to the next in the superset.
Having the nerdy background in personal training, kettlebell training and other functional training as well as martial arts means that I have a good list of exercises in my head. The logical pushing exercise was and is the floor press. The shoulder is not pushed to an extreme like laying on a bench. You’ll need to pack the shoulder blades in and down for stability in most of the exercises you do. The floor stops the backwards movement of the arm at a safe angle. I started with baby weight so I could work on stability and proprioception. My advice is to not take this for granted. Many people have very poor proprioception. Commonly called balance in many cases, that’s an incorrect use of the word balance.
The other half of this superset is a bend-over-row. Once again baby weights and isometric focus for the shoulder. With time you can let your shoulder drop towards the floor a little and pull it back into place as part of the exercise. As always, when stability is gone… DON’T PUSH IT. Stop there for the day. My natural progression was to rotate my body with the light weights while working on holding my arm in place with tension in the shoulder and back muscles. Once again … baby steps! In the beginning I noticed how my arm just was not attacked to my chest plate like it should be if I was not careful.This version of the bend over row has helped greatly. Look at this experience as a reboot of the system in which you are going to have to learn to use your body in new ways.
My advise is to work on some extra core strength while you have the time. I do legs one day and body and shoulders the next with a thirds day’s break to heal up. On the leg days, my lunges and so on are controlled by the static shoulder strength/stability that I have for that exercise. When there is no stability , I stop right there! You can alway use a machine to lift more with your legs. Saying that really hurt :( The next day I’ll do my shoulder superset and floor press/ BOR superset. I end both days with a lat-pull based on stability not lat. muscle strength. We are talking baby steps again. I hope to start working again soon. I can feel this exercise helping a lot and am looking forward to heavier weights. It’s all about controlling every second of the lat-pull. That means reprogramming the other muscles to hold and not just let go. It can be done simply by taking it slow and teaching your body to do it. Overhead press is the next frontier so to speak. This movemnet pattern will take a little while to build up. We all need a project, the overhead press will be mine.
If you are like me, it’s pure heaven to do frontal and lateral t-spine mobility while using the lat-pull machine. You will get the joint decompression that makes you smile. It can be weird in the beginning, because you are holding tension in some muscle to avoid stressing the sc-joint, while trying to relax and do mobility drills for other parts of your back/body. Forget the rotational stuff if you are like me.
A final note could be about escrima training. I have started training escrima a little bit and I am still testing what I can and can not do. I will not be swinging big heavy axe handles around for a while. I’ll be using light rattan sticks. Short power strikes are also out for a while to come. The “reboot” or reprogramming my body to hold the shoulder stable will effect my training for a while to come as well as the short power techniques used when that time comes. Who says old dogs can’t learn new tricks … when they have to. ;)
We have to look at the dynamic stresses we put on our bodies when doing fma. Knowing my body like I do, will get me up and running so most people would say that I don’t show signs but there will be limitations and a rebooting of the system. Things will have to be changed. New ways of developing power are just some of them. I am looking forward to escrima training. I feel like a kid looking through the window of a candy store. The challenge will continue to be baby steps.
My advice to anyone with the same injury is to do the same. Make sure the rest of your body works like it should to take the stress off the sc-joint. And most importantly do the research. All doctors, therapist and personal trainers are not equal. If you live in the Copenhagen area and you need a good physical therapist contact Niklas at Nivå Fysioterapi. The other therapist there are very good as well. Don’t be afraid to piss some doctors off. I was just a number and I am where I am in my rehab because I will not be a number. As in all things in life, take charge and responsibility for your life.
Stay Proactive in Life and Training