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Handstand Pressing - Shoulder and Forearm Pain Riddle


Mike Twem
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Mike Twem

Hi all, 

 

Longtime viewer and reader, first time poster. Greetings from Aus. 

I understand the complexities about diagnosing pain via a forum post and the amount of posts on pain here, but I've seen three separate physio's now who have all told me different diagnosis, and research online isn't coming up with anything that I can relate to personally. So, i thought i'd try here in case there is experience, wisdom, or advice that could be imparted. 

I'm currently experiencing an odd pain/tightness in my left trap area (between upper and mid) that occurs particularly after a straight-arm strength session where i accumulate a lot of pressing reps. This could be in the form of straddle press, pike press, or stalder eccentrics. 

The interesting/complex part of it all as that there often isn't any pain in the movement itself, rather than the pain/tightness onsets the more i press throughout the session, and particularly in the evenings after a session where i have a very dull ache/tightness in the trap region. This also occurs in the ulnar side of the mid forearm as well, with a dull ache showing up after a press session, and if i continue to train throughout the week with general handstand practice, and other bent arm work (hs pushups etc.), it stays tight. Similarly, with acrobatic style training, capoeira etc, the trap and forearm particularly flare up in comparison to a standard handstand practice, or bent arm session. Nothing onsets te tightness/dull pain more than pressing work and acrobatic training. 

I got an MRI on the forearm last year as there was concerns it might be pommel arm, but the MRI showed no such signs of that, and nothing other than normal musculature and bone. 

It's incredibly frustrating, as its halted my progression in HS, presswork, and acrobatic style training. Interestingly, I can still do 2x bent arm sessions a week with no issues, and can still deadlift heavy etc... 

I have been spending a significant time on shoulder mobility, scap stabilisation, and rotator strength and yet have not seen any symptoms disappear. I have tried some rest (4-6 weeks of very minimal overhead training) to no avail. My int/ext rotator strength is well above average in all tests completed by the physio. 

The first physio diagnosed it as a form of tendonosis, which my second and third physio both agreed strongly against. The latest diagnosis is this: 

'the key is to improve your ability to stabilize your scapular with more serratus strength, keeping the inferior angle against your ribcage, even when your are in a planche or pressing to handstand. The pain however is likely caused by your bodies attempts to offset this deficit. That is over-activation of your mid traps/rhomboids which is turn is stiffening your cervicothoracic junction, making it progressively harder for you to stabilize your scapula when your arms are overhead.'

 

After about 4 months of physio work with this diagnosis, and a lot of time spent increasing scap stabilisation strength and shoulder mobility, i'm still no better than i was 4 months prior. I'm increasingly returning to the physio to get the areas released and my lats, but getting a bit frustrated as its just repetition and not much improvement each month. 

So, I thought i'd reach out and see if anyone had any thoughts, experiences, or perhaps exercise recommendations related to the above that may help me in my quest to get back to normal operating! Any thoughts are welcome. 

 

Cheers! 

 

 

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Alessandro Mainente

hI Mike, well first i'm not a physio but lot of students come toe me with forearm pain. what do they have in common? bad scapular stabilization during straight arms press WORK specifically when the hips move under or at shoulder lever for example:

- planche

- planche press

- pseudo planche pushup

- the first part of the stalder press

the main problem is that the lats were never engaged and they finish to work primarily with forearms , traps and supraspinatus and no one of them are make to support high level of load or freqency if training.

the fact that you can sustain twice x week of bent arm work simply means that probably you do not have to counter balance a decent amount of leverage like in a planche.

so with high probability the main problem is the pressing amount of load with straight elbows on a support joint that are not enough edapted to this load and probably unilateral trigger point are typical of asymmetrical work.

i do not know if tou have a coach of something similar but probably i wuld check for the exercises technical execution first, then volume and intensity in the program.

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Mike Twem
15 hours ago, Alessandro Mainente said:

hI Mike, well first i'm not a physio but lot of students come toe me with forearm pain. what do they have in common? bad scapular stabilization during straight arms press WORK specifically when the hips move under or at shoulder lever for example:

- planche

- planche press

- pseudo planche pushup

- the first part of the stalder press

the main problem is that the lats were never engaged and they finish to work primarily with forearms , traps and supraspinatus and no one of them are make to support high level of load or freqency if training.

the fact that you can sustain twice x week of bent arm work simply means that probably you do not have to counter balance a decent amount of leverage like in a planche.

so with high probability the main problem is the pressing amount of load with straight elbows on a support joint that are not enough edapted to this load and probably unilateral trigger point are typical of asymmetrical work.

i do not know if tou have a coach of something similar but probably i wuld check for the exercises technical execution first, then volume and intensity in the program.

Hi Allessandro, 

Thank you for your detailed response! 

That's fascinating and very relevant to me, as the intial forearm pain i was experencing initially came from planche related work (particularly at the end of the hold coming out of the position) and then continued to show up in handstand pressing. 

The fact that both the forearm pain and the trap pain are on the left hand side would indicate there is a deficit in my stabilisation in straight arm pressing work (similarly for acrobatic style movement where is it all straight arm work, cartwheeling, etc...). 

I have currently paused with my online coach as i'm looking for a new one, and have not wanted to start with one until I had resolved this issue and discomfort. 

My technical execution is likely off, but perhaps I need to also try and build up my lat utilisation in straight arm movement in general. The shoulder is such a complex puzzle particularly in these movements and the activation thats required! 

I will pass your experience and thoughts onto my physiotherapist for reference. If you have any other thoughts i'd love to hear them. 

 

Cheers! 

 

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Alessandro Mainente
5 hours ago, Mike Twem said:

Hi Allessandro, 

Thank you for your detailed response! 

That's fascinating and very relevant to me, as the intial forearm pain i was experencing initially came from planche related work (particularly at the end of the hold coming out of the position) and then continued to show up in handstand pressing. 

The fact that both the forearm pain and the trap pain are on the left hand side would indicate there is a deficit in my stabilisation in straight arm pressing work (similarly for acrobatic style movement where is it all straight arm work, cartwheeling, etc...). 

I have currently paused with my online coach as i'm looking for a new one, and have not wanted to start with one until I had resolved this issue and discomfort. 

My technical execution is likely off, but perhaps I need to also try and build up my lat utilisation in straight arm movement in general. The shoulder is such a complex puzzle particularly in these movements and the activation thats required! 

I will pass your experience and thoughts onto my physiotherapist for reference. If you have any other thoughts i'd love to hear them. 

 

Cheers! 

 

so my suspects were right at 100% and this is what i call EXPERIENCE, I coach calisthenics athletes since 2013 (and you can see what they do from my IG profile) so sometime i make the correct assumptions.....when shulders does not work properly the body will find a situation soon or after. the fact tha t we have synergist muscles leads to the possibility to peform the movement also with bad technique, BUT what's the price in the long terms...?

 

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Mike Twem
18 hours ago, Alessandro Mainente said:

so my suspects were right at 100% and this is what i call EXPERIENCE, I coach calisthenics athletes since 2013 (and you can see what they do from my IG profile) so sometime i make the correct assumptions.....when shulders does not work properly the body will find a situation soon or after. the fact tha t we have synergist muscles leads to the possibility to peform the movement also with bad technique, BUT what's the price in the long terms...?

 

Thanks man, agreed! I'm feeling that price. If you have any recommendations for improved scap/lat stabilisation in overhead , would love to hear them, otherwise i'll wait to see what my physio can advise. Cheers

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Alessandro Mainente
5 hours ago, Mike Twem said:

Thanks man, agreed! I'm feeling that price. If you have any recommendations for improved scap/lat stabilisation in overhead , would love to hear them, otherwise i'll wait to see what my physio can advise. Cheers

well the main poblem is to see if you really need them..i mean that if the shoulder rythm is fine during flexion and abdution and you did not have previous clavicle injuries it is hard to have bad stabilization...

 

 

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Bill Marr

Mike: Sounds like you found your new online coach. Alessandro is terrific!

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Alessandro Mainente
7 hours ago, Bill Marr said:

Mike: Sounds like you found your new online coach. Alessandro is terrific!

:D

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Mike Twem

Thanks Allessandro! 

I've unfortunately already planned to start with another coach here in Aus (Harry Williams), but wanted to sort this out first. 

I'll message you separately. 

 

If anyone else has any experience here in meantime, feel free to add any thoughts ! 

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