Glute Imbalance and Scapular Winging

darreneatschicken

Workout A:

BB bench press: 5x5 (75 lbs)
Pendlay rows: 5x5 (85 lbs)
Assisted dips: 3x8 (55 lbs assistance)
DB close-grip bench press: 3x10 (17.5 lbs)

darreneatschicken

Workout B:

Chin-ups: 5x7
DB bicep curls: 3x8 (22.5 lbs)
Lat-pulldown: 3x8 (75 lbs)
DB front raises: 3x8 (20 lbs)
DB hammer curls: 3x10 (15 lbs)

I've only been strengthening my serratus anterior for about a week, but my left scap is already feeling much more stable.

darreneatschicken

Workout A:

Squat: 3x15 (heavy resistance)
BB bench press: 5x5 (75 lbs)
Pendlay rows: 3x10 (75 lbs)
Assisted dips: 3x8 (50 lbs assistance)
DB close-grip bench press: 3x8 (20 lbs)

Getting back into squatting after a long break.

darreneatschicken

Was sick for the past few days, but I don't think it set me back too much.

Workout B:

Chin-ups: 5x7
DB bicep curls: 3x8 (22.5 lbs)
Lat-pulldown: 3x8 (75 lbs)
DB front raises: 3x8 (20 lbs)
DB hammer curls: 3x8 (17.5 lbs)

justinejacksonm

asianambition wrote: »

weak gluteus medius and gluteus maximus (left is weaker than right) .

So... she told you you have a weak a@$ !? 😁

darreneatschicken

Workout A:

BB bench press: 5x5 (75 lbs)
Pendlay rows: 3x8 (85 lbs)
Assisted dips: 3x8 (45 lbs assistance)
DB close-grip bench press: 3x8 (22.5 lbs)
Planks: 3 sets

darreneatschicken

I was reading the "how to fix a winged scapula" article by posturedirect, and the author said you shouldn't be working out as you fix your scapula.

I don't care though. I'm tired of taking time off to rehab.

darreneatschicken

Seated rows: 3x8 (42.5 lbs)

darreneatschicken

A snipet of the email that I sent to my osteopath:

Scapular Winging / Shoulder Dyskinesis

My left scap and arm still feels disconnected from my body. If I lift heavy, a slight tinge of pain runs through my left bicep.

Piriformis Syndrome

I'm no longer experiencing pain down the back of my left leg, but my left glute is usually very tight. I have to constantly be thinking about how I walk, sit, and sleep. And I constantly have to be doing your exercises.

A Possible Solution?

Anyways, I was scanning the internet and I came across this physiotherapist named Mark Wong. He has written some very informative articles on my problems and I feel that his advice is very sound:

http://posturedirect.com/how-to-fix-a-winged-scapula/

http://posturedirect.com/how-to-fix-a-rotated-pelvis/

I've been doing his serratus anterior exercises for a couple of weeks now and my left side already feels a lot stronger and stable.

He said that you shouldn't be working out as you fix your scapular winging, but I've been working out all this time, so I don't know whether I should stop or keep going.

His rotated pelvis article is very similar to your advice, but he offers more exercises.

What do you think about all this? I think these two articles may be the only hope I have left."

darreneatschicken

I think I may have to take some time off to do more rehab...

darreneatschicken

Man, those serratus anterior exercises that Mark Wong posted are a god-send. I'm actually starting to feel a lot my symmetrical when I pinch my scaps.

This past week has been so boring in regards to fitness. Absolutely no working out, just been rehabing.

Hopefully, this doesn't drag on for too much longer...

darreneatschicken

http://posturedirect.com/how-to-fix-a-winged-scapula/

I've been doing level 1 for a month now and I actually feel my left scap retracting more now. My left scap and pecs get sore and I feel uncomfortable if I don't stand/sit up straight. Whenever I do the exercises though, I still feel "impingement" in the area underneath my left armpit. Should I stay on level 1, or progress to level 2 regardless?

darreneatschicken

So my left scap and pecs have been sore for the last couple of days.

I guess this is a good sign; an indication that I'm actually improving.

I feel hopeful about the future.

wanderingrat

I haven't read all of the pages here, so I'm sorry if it is redundant. But specifically your scapular winging that you keep feeling.
Did the physio ever check or tell you if they think the cause is a lack of muscle strength or neuromuscular control (or both)? Lack of strength of the serratus anterior and trap ascendens is the most usual cause for winging. But if it's an issue with the neurological pattern that you may have changed and is now 'saved' wrongly in your brain, that is going to make a major difference in how you have to train. Also neuromotoric learning is going to take long, you have give your brain time to relearn and resave the movement pattern anew.

darreneatschicken

wanderingrat wrote: »

I haven't read all of the pages here, so I'm sorry if it is redundant. But specifically your scapular winging that you keep feeling.
Did the physio ever check or tell you if they think the cause is a lack of muscle strength or neuromuscular control (or both)? Lack of strength of the serratus anterior and trap ascendens is the most usual cause for winging. But if it's an issue with the neurological pattern that you may have changed and is now 'saved' wrongly in your brain, that is going to make a major difference in how you have to train. Also neuromotoric learning is going to take long, you have give your brain time to relearn and resave the movement pattern anew.

I dunno. It just feels like my left scap doesn't retract freely like my right one. Like I have a frozen scap or something.

salbean78

I also am not taking the time to read all your new postings right now either (sorry). I found a couple articles related to gluteal amnesia that seem to have helpful information on re-training muscles.
Best to you.
https://www.backfitpro.com/pdf/selecting_back_exercises.pdf
https://bretcontreras.com/how-to-fix-glute-imbalances/

darreneatschicken

Been trying to strengthen my serratus anterior since the new year, but my scaps still feel asymmetrical.

I googled "I can't feel my left scap retract and it came up with this: https://uprighthealth.com/exercises-improve-scapular-retraction/

Hopefully these scapular retraction exercises can help.

kdsjlkdjasjdlkjaslkdj

Hey man. I do not have the ailments or any real advice but i notice you are posting very detailed information about what you are going through and your successes. I learned a lot just reading it and i just wanted to say thanks.
This is the type of stuff that makes the internet so great.

I made a post about my issue in hopes if i ever figure it out it can help some people.

Keep it up and good luck.
Your going to be a PT by the time your done. Actually i think its only 3 years. Pays 80k or so.

darreneatschicken

Emailed my osteopath and his answers are in bold below:

Hi Ian,

Long time no talk. I hope you've been doing well.

Anyways, I remember you telling me that I should put a towel behind my back whenever I'm sitting as a way to remind me to shift my right hip forward.

But rather than using a towel, should I use something like this?

This device only increase lordosis, not side to side weight shifting.

http://www.chairlines.com/product/obus-forme-side-side-massage/

Back Support | ObusForme Side to Side with Massage | Vancouver, BC - Chairlines - Office Chairs | Ergonomic Office Furniture - Vancouver
The ObusForme Side to Side cushion now comes standard with massage setting to relax the lower back. Gently supports the natural curvature of your lower back, preventing the tendency to slouch and helping to enhance overall sitting posture.
www.chairlines.com

The reason I ask is because I'm still feeling pain after I squat, so I feel like I'm not being disciplined enough in regards to my pelvis position.

I can’t say for sure why this is Darren. If you have been diligent with the exercises then you should start to see some improvement. The other thing to note is that sometimes a patient needs to stop the aggravating movement (ie squat in your case) in order to fix the issue. Adding weights to an exercise reinforces that movement pattern. If it’s bad/dysfunctional to start with, adding weight only aggravates the issue.

Also, I'm still having a hard time feeling my left scap retract, despite releasing my infraspinatus and my thoracic spine.

This is to be expected as releasing those structures doesn’t fix the scapular issue. Improving mobility prior to stabilizing the scap is essential ground work before doing so.

I've been trying to strengthen my serratus anterior in hopes that it will correct this imbalance in my body: http://posturedirect.com/how-to-fix-a-winged-scapula/

How to fix a Winged Scapula - Posture Direct
The Serratus anterior is the primary muscle that anchors the scapula flat on the rib cage.. It attaches onto the under surface of the shoulder blade and to the side of the rib cage. If you do not have strength or control of this very important muscle, it can lead to scapular winging.
posturedirect.com

Lastly, do you think I should make an appointment to see you, or have we exhausted all options? I don't want to spend another $100 if it's not going to help.

You would be best to go see a good kinesiologist at this point to work on more scapular retraining as opposed to coming to see me.

Thanks Darren and best of luck

Ian

darreneatschicken

Hi Ian,

Thanks so much for your response. I really appreciate all the help and support you've given me during this tough time in my life.

Although you haven't "cured" my problem, you've given me a lot of insight into my body, such as my rotated pelvis. You've given me some exercises that temporarily take away the pain and you've told me how I should be sitting and standing in my daily life.

With that being said, I do have some final questions for you before I find another health professional:

If I don't use a towel, is there anything else I could use? I feel like if I spend money on something, I'll be more likely to use it. A towel is sort of flimsy and very hard to notice. Maybe I should just use a thicker, bigger towel? I dunno. Links or pics would be greatly appreciated.

I can’t remember specifically asking you to use a towel to sit on Darren? But if it’s to correct an up slip of the pelvis, there aren’t any specific devices that I know of that are available to purchase.


I haven't been squatting at all. I just tried randomly the other day in hopes I would've improved, but it still led to pain running down my left leg. I might make a followup appointment to see the chiropractor who prescribed me the orthotics that are meant to compensate for my leg length discrepancy to see what he says about the pain. The fact is that I have an overactive left hamstring and left hip, underactive left glutes.

Before making that assumption, get the chiropractor or kinesiologist to manually test this Darren!! Our subjective feeling of tightness, weakness etc etc are not in any way accurate! I have patients on a daily basis who think the opposite of what is actually happening.


I also Googled "rotated pelvis Vancouver" and it came up with this article, written by a chiropractor at Vitality Clinic: https://vitalityclinic.ca/short-leg-syndrome-sls/

Short Leg Syndrome (SLS) | Vitality Clinic - Chiropractic and Sports Therapy, Yaletown, Vancouver
Many individuals develop imbalance and pain as a result of a leg-length discrepancy.. If one leg is longer, it is similar to driving around with one car tire slightly larger than the others.
vitalityclinic.ca
It seems like she knows what she's talking about, so I may go see her as well.

Yeah that sounds like a good resource for sure!


Lastly, in regards to scapular retraining, I Googled "shoulder kinesiologist Vancouver" and it came up with this article, written by a personal trainer at Le Physique: https://www.lephysique.com/shoulder-rehabilitation-exercises/

Le Physique | Vancouver Personal Training | Shoulder Rehabilitation Exercises
Got shoulder pain? Don’t worry – you aren’t the only one! Shoulder injuries are common amongst athletes and older individuals. I am a competitive dragon boater and experience shoulder pain regularly. It is often associated with poor technique and over training. An effective shoulder conditioning…
www.lephysique.com
Le Physique is a rehabilitation centre in False Creek run by kinesiologists and personal trainers. They also offer a type of treatment there called Muscle Activation Techniques (MAT), so I just sent them an email about my problem to see what they think.

Before I saw you, I was seeing Cameron Bennett at West Point Grey Physiotherapy. He's a physiotherapist who specializes in shoulder issues. However, the exercises he prescribed me just led to pain in my left scap (push-ups, bent-over rows, etc.). He said visually, there was nothing wrong with the way my scaps moved, but if I'm still having issues after doing his exercises, he would start to treat my neck. I'm unsure whether or not I should book a followup appointment with him.

I wouldn’t Darren. Those exercises sound very rudimentary for someone who is supposed to be a shoulder specialist.

What are your thoughts on all this? I know this was a really long email and I really appreciate everything you've done for me so far. I promise I'll stop bothering you after this. I'm just really determined to fix my problem, but am feeling a bit lost as usual.

My thoughts are quite simple at this point.. you should see someone who is going to manually muscle test the strength and length of muscles of the pelvic and shoulder girdle, accurately determine what is weak and start rehabilitating that.

Thanks Darren and best of luck!!

Ian

darreneatschicken

Followed my osteopath's advice and saw a kinesiologist the other day for a free consultation.

She said that she agrees with my osteopath: my rotated pelvis is causing problems throughout my entire body, so once we fix my rotated pelvis, my scapular dyskinesis should be fixed as well.

So I'm just going to be doing the exercises in this article now: http://posturedirect.com/how-to-fix-a-rotated-pelvis/

I also taped a note on my work desk to remind myself to shift my right hip forward when sitting.

Must keep remembering to stand with my left leg behind my right and to put all the pressure on my left.

Because my custom orthotics are meant to prevent the pain that I get from my rotated pelvis and my overpronation, I'm going to slowly wean myself off the orthotics by fixing my pelvis and strengthening my feet.

This is a good article that shows how you can strengthen your feet: http://posturedirect.com/how-to-fix-flat-feet/

I'm seeing my chiropractor on Monday to tell him my plan.

I doubt he's going to agree with me because he's the one who prescribed me the custom orthotics. I honestly just want to look him in the face and tell him that he's just treating the symptom, not the root cause.

Seriously, chiropractors are evil...

Theoldguy1

kdsjlkdjasjdlkjaslkdj wrote: »

Hey man. I do not have the ailments or any real advice but i notice you are posting very detailed information about what you are going through and your successes. I learned a lot just reading it and i just wanted to say thanks.
This is the type of stuff that makes the internet so great.

I made a post about my issue in hopes if i ever figure it out it can help some people.

Keep it up and good luck.
Your going to be a PT by the time your done. Actually i think its only 3 years. Pays 80k or so.

Actually a Doctor of Physical Therapy is generally a Bachelors degree plus 3 years. You can be a PT assistant with usually a couple years of junior college.

darreneatschicken

Theoldguy1 wrote: »

kdsjlkdjasjdlkjaslkdj wrote: »

Hey man. I do not have the ailments or any real advice but i notice you are posting very detailed information about what you are going through and your successes. I learned a lot just reading it and i just wanted to say thanks.
This is the type of stuff that makes the internet so great.

I made a post about my issue in hopes if i ever figure it out it can help some people.

Keep it up and good luck.
Your going to be a PT by the time your done. Actually i think its only 3 years. Pays 80k or so.

Actually a Doctor of Physical Therapy is generally a Bachelors degree plus 3 years. You can be a PT assistant with usually a couple years of junior college.

I'm so stupid. I should've majored in kinesiology instead of psychology. If I go back to school, I may be able to get my bachelor's in kinesiology in 2 years because I've already completed all of my electives. Don't know if it's worth it though...

darreneatschicken

So I just saw my chiropractor today and he disagrees with my osteopath: he says that my problem is structural, not functional.

For example, he adjusted my pelvis and showed me that my leg length discrepancy still existed.

He said that I was born that way and because my left foot is also flatter than my right, my left glute will always be tighter than my right.

There is no way to fix a flat foot.

There is no way to fix my rotated pelvis.

My problem is structural, not functional.

I just don't know who or what to believe anymore...

darreneatschicken

I saw my osteopath and he disagrees with my chiropractor: he showed me that when I'm lying down, my left leg is shorter, but as soon as I sit up, the leg length discrepancy disappears. This is how he knows my problem is functional.

He said that the only way to truly test for a leg length discrepancy is either by measuring with tape, or by getting an x-ray done. My chiropractor has done neither. Therefore, he wants my chiro to modify my orthotics to remove the heel lift, but to keep the arch lift. I told my chiro what happened and he said he will measure my legs again the next time I see him.

My osteopath did some more testing and says that I am still stuck in a left AIC pattern (although my hamstrings have greatly improved).

To get out of this pattern, I have to keep stretching my left glute ligaments, strengthening my right glute, and doing the 90/90 hip shift along with this new exercise he taught me, called the right side-lying abductor pullback:

https://www.youtube.com/watch?v=EK9PcFsIOfE

I've also spent $300 on a laptop stand, wireless keyboard and trackpad to make my work station as ergonomic as possible. I put a note saying "SIT RIGHT" on my desk so that I always remember to sit up straight and shift my right pelvis forward.

darreneatschicken

After doing the PRI exercises, I am no longer stuck in the left AIC pattern.

These 3 exercises allowed me to get out of the left AIC pattern:

1. 90/90 hip shift
2. right sidelying adductor respiratory pullback
3. right clamshells + single leg glute bridge

Now, I am doing a modified clamshell exercise on my left glute to try to get it firing. However, I am worried that it will not work.

Also, I am still experiencing dyskinesis in my left scapula. I don't know what else to do. My osteopath said my scapula was uneven, but I fixed it by doing his exercises. Still, I am experiencing pain in my left arm after exercising.

I may have to get an MRI or a CT scan to see if there's something going on inside of me that we can't see. I'll talk to my osteopath the next time I see him.

ThoughtsRus

hey man, don't believe the *kitten* doctors. i essentially have the same problem as you except my right side fires properly. look up the spiral line, what i've noticed is that so long as the glute max isn't active and doesn't fire properly the upperhalf of your body will never settle in. try all the stretches and releases you want. what i recommend is since you mention your right side fires properly; lay down, put your hands under your butt and get the contraction on your right side and try to imitate it, you might see that the side of your butt activates and that's not what you want. don't let the hammys or quads turn on either, you might find you get some twitching that goes up to your lat, back,thighs, foot. once you can properly fire/activate the glute max strengthen it

ohene_af

Hey dude! Just wondering I'd you've found any solutions to your problem? I might have an idea as I've got exactly the same problem.