Shoulder Mend

I'm not a great athlete or anything, but I do have something important to say. Something that can
change your life, something that can set you free.

Sometimes you want to take a certain path in life, but it really just doesn't work out that way. For
instance, I am a nerd that always wanted to be a jock. I started playing baseball at 8 and got good at it
pretty quick. In grade school I was always the leader of the made up team on the playground, but
always of the team of the misfits and the not quite cool kids, and I really liked being the underdog. I
begged my dad for a few years to let me play football, but he said it was ridiculous to have kids
playing football that young. He said you should start in high school, when your body can take it. It
took a few years, but I started playing football in 6th grade.

Football was hard, but I was tough. I was pretty good size for my age, and naturally strong, so I caught
on. My coach was a no nonsense type of guy, he knew exactly what kids need to get good at football,
and that's old school. We ran hard, we drilled hard, and we did leg lifts until you thought it would be
less painful to fly into the sun, but I'll be damned if that stuff didn't work.

When it came to hitting drills, which were full contact all of the time, I was a little slow on technique. I
still remember the first time very clearly. Ben was carrying the ball and he ran me right over, the
coach laughed and told me to try again. So we did it again, and he ran me over again, and we did it
again, and he ran me over again. Finally the coach said, Alright, back of the line, but a couple of
minutes later I was up again. When you are drilled this way you figure it out sooner, rather than later.
My first year I only hit with my right side, and at one point I got a couple of medical opinions on my
arm because it was pure black from shoulder to elbow and the muscle was lumpy and hard, but I
pulled through, kids are tough and stupid. By the way, that kid went on to start on an undefeated Ivy
League team on the defensive line, tough guy.

Two major things changed in my life while I was thirteen, and one of them has to do with you. In
eighth grade we are still under the same coach, and we are still doing the same drills. By this time I am
one of the best, I run fast, I hit hard, and I am aggressive. One day, a couple of games into the season,
I line up for a one on one hitting drill against Corey. He has the ball, I slam into him to tackle him, and
something goes horribly wrong. There is a shooting pain in my arm, a tremendous pain. I start walking
back to the end of the line and Im tearing up. One of the guys says, hey coach, I think Jeff is really
hurt. So Jim says Jeff, you alright, and I respond yeah, Ill be fine. Next time around in line my
arm couldnt support itself, so in my stance I had to cradle it against my leg, and I had to take the
football with one arm, and standing in line again I had to hold it up in place with my other arm. I
thought I would be fine, I was tough, it would heal, I was wrong.

I played the rest of the season with that injury, without ever really mentioning it to anyone, and my
performance was still good, amazingly. Then I went through a wrestling season in which I won no
matches, but was only pinned once, and that was by the state champ. The pain of that wrestling
season was tremendous, but I couldnt quit, because if you quit while you are losing everyone thinks
that is why you quit, so I took the pain and trudged through. Like I said, tough and stupid.
Now came baseball, the sport I was the best in. We are practicing at a church field a little ways down
the street from the high school. I play pitcher and third base, because I have a strong arm. So we are
just doing a light batting practice because it is the beginning of the year and I am pitching. My
shoulder hurts and feels weird, but at this point it is really nothing new and I can handle a lot of pain
on a constant basis now. I am actually throwing as hard as I can, but its really odd, the ball is coming
out of my hand slow. No one says anything, everyone assumes I am throwing slow on purpose
because it is the first practice. Then Ben gets up, same Ben from earlier, and he is just winging heaters
in there. Bill, the coach and Bens dad, says Ben take it easy, throw slow like Jeff was, and thats
when it hit me, my shoulder is really messed up. My shoulder has not healed like I thought it would,
my shoulder is not getting better, and I cant play this sport without being able to throw a ball, it hit
me just like someone punched me in the face.

I talked to Bill that practice and told him that I was throwing as hard as I could, that my shoulder
hurts, and there is something wrong with it. We talked to my parents when they came to pick me up
and that is when the doctors started.

I cant remember what the first doctor said, but I do remember the first test, to see if my shoulder
really hurt. He says he is going to have me lay down on the table with my arm raised at my side, then
he is going to bend it back and I am going to tell him where it starts hurting. I tell him that my arm is
hurting now, he ignores me and does the test, he has my arm a long ways back and its throbbing, he
asks if it hurts and I say yes it effing hurts, I told you it hurt before we started. So I guess he finally
realizes it is actually serious and that gets us to more tests.

So next I get an x-ray. In the x-ray room the nurse takes the x-rays and and she is looking at them to
make sure they are clear and she says oh, when did you break your collarbone, and I say I didnt
know I did, and because I believe that statement could get her in trouble she looked worried and left
the room rather quickly. From that we were able to tell that I had broken my collarbone and that it
had healed back together on its own already, but not what would still be causing pain.

Next we do an MRI. For this they put a radioactive liquid into your shoulder with a huge needle.
Unluckily they have the new guy doing it and he is horrible, he has to stab me five whole times to get
the needle into the correct position. Finally we are talking to the guy that actually knows what he is
talking about, the best one for this type of thing in west Michigan. He tells me that I have some very
small tears in my rotator cuff, but that shouldnt be causing this type of problem and that he can do
exploratory surgery but that he isnt sure what he will find or if he will be able to fix it. Either way he
figures I wont ever really be able to play sports again and that I will have severe arthritis in my right
shoulder by the time I am twenty years old.

So I go to physical therapy and they have me do a bunch of stuff with bands and balls. They give me
exercises to do at home that I do religiously, they do not work and are even uncomfortable. Jim, the
baseball coach, asks me to just hit for baseball, but I dont want to play half of a sport. I practice and
help with the football team, but I cant hit and I cant play. I pick up and get really into mountain
biking for a while because it is exciting and it is something I can do. It was right in here to that

I still did powerlifting with a focus on squats, because I did have some pain from both bench pressing
and deadlifts. Competition style raw I got up to a 265 bench, a 415 deadlift, and a 500lb squat,
although the most I think I ever did in competition is 485. My legs were actually ridiculously strong
and enduring because it was the only thing I could really focus on. The one summer I literally would
ride my bike 10 miles to powerlifting, do squats for an hour, run reps for an hour, then bike 10 miles
back home.

That same year in the winter, riding my snowmobile back from powerlifting, I forgot that a new
driveway had been put in and hit it going full blast. I was flipped off of the snowmobile and landed
next to it on my back with my hand still on the throttle. To be in that position my right shoulder had
to come out of the socket, which is very painful, but since my shoulder subluxed all of the time
anyways I was able to hit it against a tree and put it back in, which is also very painful. Oddly enough
the pain after that wasnt much worse than it had been almost constantly for the last few years.

Unfortunately I still cant find a golden key to my shoulder problems even though I have sought out
information from everyone and at this point I start to think that the doctor was right, I am basically
just screwed.

My junior year Shane, my football coach, locates an arm brace. Really this thing is a restraint, it
attaches to the front of the shoulder pads and around my upper arm so I cant move my arm too far
back or up. I cant do everything with the brace on, but at this point I am pretty much ready to do
anything, and all of the rotator cuff exercises in the world are really getting me nowhere fast. I am
able to play my last two years of football, with pain, but painkillers help dull it a little.

Finally in 2007, five years after I was first injured, I get my first breakthrough. This is the summer after
my high school graduation and I hear about this 400 year old exercise that wrestlers and strongmen
used to do called the turkish get-up. I started out slow, but I was already pretty strong, so I just kept
moving up in weight. Now I must admit that the exercise did feel a little odd, especially at the
shoulder, but my shoulder felt odd all the time so that wasnt really a reason to stop doing it. I think
around sixty pounds, maybe less, I am halfway up and my shoulder makes a pop sound and shifts in
an odd way. I drop the weight and cradle my right arm in the left like I have become so used to doing.
This is in my parents basement and my dad comes from the garage, sees me holding my arm and asks
if Im alright, I let my arm drop and say, yeah, it actually kind of feels a little better.

That event in 2007 is really the beginning of the odyssey that I have traversed in finding out what
exactly is needed to fix a shoulder that was in such disarray as mine was. Before that I had tried all of
the normal stuff, after that I tried all of the not normal stuff. Little by little my shoulder held me back
less and less. After that I found muscle control, feed-forward tension, bodyweight exercise
progression, joint mobility, incremental progression, biofeedback testing, and everything else that has
gone into both mending my shoulder and into the creation of ShoulderMend. By 2012 I didnt even
have to think about my shoulder anymore, which means I could throw a ball as hard as I wanted,
swim overhand, and a bunch of other stuff that you wouldnt normally think about until you cant do
them anymore. Now, I can do these things, and soon you will be able to as well.

With that, I would like to welcome you to the ShoulderMend community.

To begin with, if you have a shoulder injury or discomfort, you are not alone. Around 40 million
Americans suffer from some type of arthritis in their shoulder and between 4 and 7 million people
visit the doctor for shoulder problems each year, of which 1.5 million see the orthopedic surgeon.
Almost two-thirds of the population will have a bout with shoulder pain at some point in their life.
What is more disturbing though are the cure and help rates, because only a little over half of those
people ever really feel 100 percent again.

The doctors are very good at working with acute injuries, when you break or dislocate something, go
to the doctor immediately, do not wait, that was a huge mistake I made. After the initial injury is
when the real work begins though, and this is what the doctors are not good at, the chronic pain. Sure
they have their painkillers, their injections, and their surgeries, but I have found these all to be
lacking, even physical therapy is sorely lacking.

In that last section I mentioned a lot of numbers, but in the end it just doesnt really matter, what
matters is your problem. Maybe you want to reach something up high, like a cabinet, maybe you want
to pick something heavy up, like a baby or groceries, maybe you want to be able to throw a ball or
swim, whatever it is you should be able to do it and you cant. I like the way the International
Association for the Study of Pain breaks down shoulder problems into four areas, and Ill explain each
in relation to my situation, I am sure many of you can relate.

Your shoulder can be inflamed, mine stayed inflamed for a prolonged time because I continued to use
and injure it repeatedly. You can have excessive motion like subluxation and easy dislocation. You can
have limited motion, I couldnt fully reach up or back, and this was at the same time that I had
problems with subluxation. You can also have a muscle weakness or imbalance like my rotator cuff
muscles were compared to my primary movers.

So the real question becomes, how do we fix these things? First of all, muscle weakness and
imbalance will resolve with proper training, which I will be showing you for the other problems so we
can eliminate this as a focus. Second, if inflammation is still present from the injury or repeated injury
you have to heal, if it is from some kind of inflammatory reaction to a substance you have to avoid
that, but this should be rare. The inflammation will slowly decrease over time if you do not continue
to injure your shoulder and you are able to accelerate the removal of waste and expedite the delivery
of nutrients, which I will also be showing you. That brings us to the two that we are going to be using
as a focus, instability and immobility.

The most common problem with immobility in the shoulder is impingement, basically nerves and
tissue are pinched by the bones of the shoulder. This reduces the nutrients in and wastes out
equation, creates inflammation and pain, and reduces your range of motion. The most common
problem with instability is subluxation, where the shoulder moves out of place but isnt fully
dislocated. This is extremely painful and the more it happens the easier it becomes, at one point if I
made a full throwing motion, at the far back motion my shoulder would slip out of place and I
couldnt bring the arm forward. Unfortunately for anyone with a shoulder problem, formerly me and
currently you, any one of the problems can create the other problems. For instance, subluxation can
cause inflammation which will cause immobility and that will cause an imbalance. Once you have
multiple problems it is very hard to know what to do, and the doctors will have a hard time advising
you as well, luckily for you I have already paved the trail.

I made a lot of mistakes in rehabilitating my shoulder, and the biggest one is that I did the whole
process backwards, that is why it took so long for me. First I learned external resistance based on
feedback, then I learned to incorporate feedforward tension, then internal self resistance, and finally
resistance free motion. Basically I tried to regain my mobility by increasing my stability, unfortunately
for me and my shoulder this simply does not work. What does work is regaining stability through
mobility, which is how you are going to do it.

The first thing is resistance free motion, commonly called joint mobility. This does a couple of things
for us. It opens up the joint bringing in nutrients and removing waste, it begins to rebalance the
tissues, and of course it increases your ability to move your shoulder, which is what it is all about.
There are a couple of important things to remember with resistance free motion, and really these
apply to all of training.

Start low and go slow. Start at the beginning. Start with simple movements at slow speeds in small
ranges of motion and progress slowly and incrementally at the optimal rate at which your body can
handle the stimulus. I will show you how to make consistent incremental gains later.

Never go into pain. We are trying to get out of pain, not into it. Dont try to pop or crack the joint, it
will happen and is no big deal, but dont pursue it, just let it happen. The pain is probably alerting you
to inflammation or something that will cause inflammation so pushing through will actually be
contributing to the problem not the solution.

So, with those in mind we are going to start with shoulder rolls. First shrug your shoulder up as far as
they will go, then down, now forward, and finally back. These are your limits of motion to start with.
For the rolls you are just going to combine them. Go up, forward, down, back, up. Also do them in the
opposite direction: up, back, down, forward, up. Now smooth it out and let it flow. Slowly, over weeks
or however long it takes for you, increase your speed and range of motion, one at a time, and do what
feels good.

Next we are going to do arm circles. Sometimes some of the arm circles will not really be possible
without pain, usually the up and back motions. If this is true for you have no fear, by doing the circles
in the planes of motion that you can, you will facilitate the recovery of your other planes of motion.

So, to start with your right arm, we are going to begin with down. Since your arm is usually hanging
down, basically everyone will be able to do this with no problem. With your arm hanging, you may
bend forward just slightly for room, begin to circle your arm. The direction of the circle is no big deal
because you will be doing the circles in both directions anyways. Remember to begin slow and easy,
even with the easy ones.

Next you are going to be doing the same circling motion, but this time it will be across your body. The
usual sticking point that you will have to work on is coming into your body, or back in general.

Then you will do the circles out to the side. The resistance here will also be to the back, so take it
easy.

The next circle is both a difficult and important one. Many people with shoulder problems have a
difficult time reaching up, so the next circle is up. I caution you to take it very easy on this one,
especially at first.
Directly forward may seem like an easy direction, but still pay attention when you are doing it. The
rotator cuff muscles inside of your shoulder have a lot of work to do in all of these shoulder circles, so
really there is more happening than you initially realize.

Back is probably the most difficult over all, you dont even have to begin with it if it is painful to even
try. I do suggest that you eventually work up to and incorporate it, but soon you are dealing with
normal human limits anyways.

Circles are the ideal place to begin to mend your shoulder, and after you progress with them you can
link them into figure eights and do both shoulders at once. This makes the exercise extremely simple
and fast to do, once you get there.

The last motion we are going to do for now is the shoulder screw. With your arms out to your sides
you are basically going to twist one arm forward while you twist the other arm back, but there is
something more. When you twist your arm forward first raise the shoulder and then try to bring it
over the top and forward, this little motion makes all of the difference in this exercise.

These resistance free motion exercises are just amazing for mending your shoulder. They will begin
the healing and rejuvenation process and you will start to feel life coming back into your shoulder,
which is just an amazing feeling, especially if this has been an ongoing problem for you.
The next thing we are going to do is called internal self resistance. A lot of the old time strongmen did
this type of thing back when it was called muscle control. This is the next most powerful thing for
mending your shoulder and it also requires no equipment or apparatus. There are really just two
things that I am going to teach you, but they do require some patience and a little getting used to. I
dont really know what to call these so I am going to call them the back motion and the front motion
for simplicities sake. The back motion will really help with anyone that is dealing with impingement in
their shoulder. I must stress in both of these exercises that you do not go into pain and that you
progress slowly, really try to coax rather than force your body to do what you want it to do.

The back motion is a little easier to describe so we will start there. Put your hands behind you and
clasp them with the palms facing each other. Now pull your shoulders back, your chest should seem
to stick out, and try not to bend your neck or hips. As you are pulling back there should be a tendency
to pull down in your shoulders as well, this is good. Now keeping tension, especially in your triceps,
push your arms up behind you and try not to bend forward, just move your shoulders and arms. This
is an incredible exercise. When I first found this exercise, my shoulders, both of them, made horrible
sounding cracking noises. It didnt hurt, and it actually felt really good, but be careful, there is a lot of
power there. To really juice up this exercise you can do the motion and then do a squatting motion, or
even do it in a squat. Many times you do not have to emphasize the rising motion in back either, just
the pulling back of the shoulders will do the trick.

Next we have the front motion. With your arms in front of you and down put your palms together and
interlace your fingers. Now while keeping your arms straight pull out on your hands and slowly begin
to raise your arms. Remember to only go as far as you can and not farther. When you are all of the
way over your head bend at the elbows and bring the arms down behind your head while still
maintaining tension. Then go back up and slowly lower your arms in the front. This exercise has an
incredible range of motion and puts a lot of controlled tension through the shoulder. Both of these
internal self resistance exercises are meant to be done slowly while in tension, the point is to slowly
increase the amount of tension through the shoulder joint over time.
You can go a long ways and for a long time with just resistance free motion and internal self
resistance, but usually once people realize that they can use their shoulder again they want more, I
know I did. Really it just makes sense as well, now you can lift your arm up and get stuff out of the
cupboard or pick up a heavy bag of groceries or throw a ball, but you want to be able to do more. This
is very good as well because continuing to progress in your training will help keep your shoulder
healthy and strong.

This is where we are going to introduce equipment, apparatus, and all manner of stuff, but we are
going to keep it simple and do it slow. I am not too worried about exactly what you are pursuing, but I
do prefer forms of exercise that allow for free motion and are not fixed into an exact path, basically
anything except machines.

A little story here. A few years ago now I was at a fitness seminar with an amazing group of
instructors. I bought the seminar early and was really looking forward to it. I had been working on
endurance bodyweight exercises pretty extensively and was really feeling confident about the
progress I had been making. I had a pull-up bar installed in a doorway and I would play on it when I
went through sometimes. One of those times I happened to jump through the door and catch the
handle with just my right hand and twisted through the door and let go, kind of winging myself
through the door. By this point I had a great amount of confidence in my shoulder and hadnt really
had a problem with it in a couple of years, but that day was difference. When I landed I knew
something was wrong immediately, my shoulder hurt, just a couple of days before the seminar, oh
no!

I called immediately and asked all of what physical activity would be involved in the seminar, and I
was reassured that I could go as far as I wanted to but that I could also stop at anytime. Luckily I had
absolutely no problem doing everything at the seminar and learned a lot there. The most important
conversation I had though was about my shoulder. I shared with one of the instructors the problem I
had with my shoulder and my fears before the seminar and he shared that he has always had
shoulder problems as well. Over the years we both found that we steered away from the upper body
exercises a little too much and focused on the lower body a little too much. Talking about this more
he pointed out that really someone with shoulder problems should focus on major motions that
include the shoulder rather than avoiding them. We specifically talked about the fact that we had
both avoided overhead motions, now that is my main focus.

This conversation really helped propel me to focus on overhead pressing motions and also helped me
to realize that even though I had made a ton of progress I still had a few things to learn about
mending my shoulder. After this I really focused on the basics like resistance free motion and internal
self resistance and I knew that this would help propel me to progress in all other aspects of training.
There is a gap between internal self resistance and external feedback resistance, and something is
needed to bridge this gap. To do this we will use feedforward tension. This is really a mix between the
two. With feedforward tension you are going to use a much lighter weight than you can actually do
and you are going to add in tension above and beyond what is needed.

This sounds a little more complicated than it actually is, in reality it is very simple. Basically you are
going to tense your muscles as hard as you can while you lift a light weight. For instance, start with a
simple shoulder press with a kettlebell. For feedforward tension you are going to move slowly,
deliberately and purposefully. Start with the kettlebell in the rack position, now tense your muscles
and slowly start to press the kettlebell. Keep the tension all of the way up and all of the way down,
and thats it. You can do this with basically any exercise. For example, pushups are perfect. Just keep
all of your muscles tense, down and up, really focus.

Feedforward tension puts a lot of tension through the shoulder joint, through a large range of motion
and one that you specifically want to train. This is an amazing tool, especially use it when you are first
beginning to train a specific motion. After you do this for a little while you will move onto external
feedback resistance.

External feedback tension is really where you want to be, these are your sports movements. These
are the more explosive and athletic movements. This is where you are thinking about making the
movement and your body automatically uses the correct amount of tension, not too much not too
little. This is efficient motion rather than the purposefully inefficient feedforward tension. You do not
want to be using feedforward tension in a sport, that is for sure.

External feedback tension is easily demonstrated by comparing it to our feedforward pressing. Instead
of a slow press we are going to use a quick jerk. Starting in the rack position again, you slightly dip
down with your legs, you explode up driving with your legs and hips which pushes your arm up. As the
arm ascends you dip down with your legs again and catch the full weight of the bell again with a fully
locked out arm and stand up straight. As you can tell this is a much more athletic movement and it is
not slow, it is in fact very fast. To do this type of movement your shoulder has to be able to move
quickly through a range of motion while being supple at times and stabile at times. At this point you
will know very quickly if your shoulder is ready, remember not to push into pain.
Now a huge issue, programming. When do you do what? Intuition is a great way to do it honestly.
Many trainers will give you a million different programs of what days to do what exercises. This
doesnt work because people are not the same and their lives are not the same. Your program has to
be based on you and your lifestyle, not someone else and definitely not their lifestyle. So the
traditional way to do this is by intuition, you can even design a program yourself and adjust it for
yourself and your lifestyle as you go. The most important part about this is that if your program is too
aggressive you need to be able to back yourself off so that you avoid any type of injury or irritation
from your training.

It is really important to keep in mind to never go into pain and to start low and go slow. A good way to
do this, especially with resistance free motion and internal self resistance, is to do the exercises
intuitively and intermittently. For instance, lets say you do your joint mobility work when you wake
up. Part of the way through the work day you do one of the muscle control exercises. Then a little
while later you do the other one. When you get out of work you do a few shoulder rolls on the way
out to the car. You are just doing what you feel like doing when you feel like doing it. As simple as this
is it can work great, especially for the busy person, do not let that be an excuse, it isnt.

The other great way to program your exercise for yourself is biofeedback training. With biofeedback
training you will literally know exactly what to do for your specific body and when to do it. It is a test,
a self test, basically a way for your body to talk to you, to tell you what it wants. It is really simple but
it definitely takes a little bit to get it. There are different ways to do it, but I am going to show you
what I use and what I think is the best way to do it.

The toe reach is a range of motion test. It tests the residual tension in the posterior chain. If you do a
movement that is good for your body you will hold less residual tension, this is immediate. If you do
something bad for your body you will hold more tension, this is sometimes called bracing. Make sure
you are ready to do your exercise directly after you do the test with nothing in between.

So first of all you are going to slowly reach down toward your toes with your feet together. You want
to make sure that you are doing this the same each time. You are going to stop when you feel tension,
when you first feel tension. You are not going to go as far as you can, and you are not going to stretch,
that is not what we are doing. Stop when you first feel tension and remember that spot, you can mark
it if you really want. Now do the exercise that you will be doing for a couple of reps.
Stop doing the exercise, resume the position, and test again. If you cannot reach as far, definitely do
not do that exercise, it is bad for you at this time. If the reach is the same, then you dont need to do
it. If it is good for you, you will feel it and you will gain a couple of inches in reach, it will just seem to
give way. If this is the case, then do the exercise. If you go through testing a few things and nothing
tests good, then do nothing at that time, test the next day, for now maybe you just need to rest.

Biofeedback training allows you to make continual improvement without having to second guess
yourself. I have found it to be a godsend myself and use it every time that I do external resistance
training, although for joint mobility and muscle control I just do what feels good when it feels good,
and that has worked great for me for several years now.

Now you know my story, and now you have the power. Fixing your shoulder is possible and you can
do it, and it is pretty simple really. That is not the end however, your story has to be written, your
comeback, so really this is just the beginning.