10 Minute Tip #24: Adductor Strains & Tears in Barbell Training - Is a tight shoulder causing it?
THE ADDUCTOR GROUP AND GROIN REGION ARE COMMONLY INJURED IN BARBELL TRAINING AND POWERLIFTING AND IT COULD BE RELATED TO SHOULDER TIGHTNESS ON THE OPPOSITE SIDE.
PRS Clinical Coaches have identified an interesting phenomenon in a handful of adductor strains and tears they have helped rehabilitate back to full powerlifting strength.
This phenomenon is the opposite shoulder and adductor relationship.
In this episode they share four cases of mild to severe shoulder tightness resulting in adductor injuries that could have been avoided to a large degree if the shoulder issue was addressed before it became a major problem.
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Dr. Rori Alter, PT, PRSCC, SSC: [00:00:00] All right, Welcome back to the Progressive Rehab & Strength podcast. This is a ten minute tip Tuesday. I haven't set the timer. Um, you know what? I'm not going to set it. This is just a Tuesday, a Tuesday episode because it's not really a tip. What we're doing is talking about an interesting phenomenon that we see in barbell training injuries. So we're just going to discuss it to give athletes, coaches and clinicians some insight into what we've seen and kind of discuss if we should address these things before we see them or not. So this episode, what we're talking about is the relationship between shoulder tightness in the squat. An injury is to the opposite adductor in or at an inner thigh or groin in the lower extremity opposite to the shoulder that someone is experiencing tightness in. Now, I've had three specific cases that were extreme of this, and they all came to me. One of them came to me very specifically after they tore their adductor. And in my evaluation of this client, I learned that on the opposite side, in their shoulder, where the bar sits, they had a grade two ulcer or maybe even grade three. I can't remember to the point where the bar had. We've all heard of bar bite. So that's when we get skin scraping or some irritation or even loss of skin under where the bar sits on our back.
Dr. Rori Alter, PT, PRSCC, SSC: [00:01:39] And this person had such a bad ulcer or abrasion. They're called ulcers at that point when you start to see like. Muscle and fascia and bone. And this person I cannot remember because it was so long ago. If this person had just muscle exposed or a little bit of bone also exposed, then this person really should have addressed that before it got to that point. But they didn't. And but they did treat it medically with the appropriate things. And that's you need a wound doctor or a wound specialist to treat it. At that point. There are special wound medications that you need. And then that person ended up having a full tear with retraction of their adductor muscle, so one of their inner thigh muscles. And so that was one incident. That was the first extreme case of this that I've seen. I helped them with that rehabilitation process for their adductor. And then another one of my clients, who was a coaching client of mine who had various injuries. And generally speaking, the clients that we have at PRS come to us because of injuries that they have and then they stick with us for coaching after that. So this person probably came to me. I can't even remember. I worked with this client for so long, don't remember what the the first reason for coming to me was, but, worked with me online most of the time, came to see me in person every so often.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:14] And I noticed that his shoulder was bleeding while we were squatting together. And I was like, Oh, that's interesting. And we were dealing at the time with an adductor strain. That's why he was coming to see me. And I was like, Dude, like, how often does this happen? He goes, Oh, you know, all the time. Just a little blood. I was like, Oh, okay. Well, why are we bleeding? Wwhat is it about that side that is leading that side to bleed and, you know, going on there? And then another one of my clients who came to me originally because of a shoulder issue trying to avoid shoulder surgery, she was training for the world championships and en route throughout that process, she ended up with a probably grade two, like early grade three adductor tear. Um, and it was, you know, related to the tightness that she was experiencing in the opposite shoulder. So this is something that I've seen quite a bit. My husband, John even deals with a very tight shoulder on one side and a chronic adductor strain on the opposite side. And Alyssa you deal with something similar. So tell us a little bit about what you deal with.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:04:32] Yeah, And I think my, you know, my situation is probably less extreme than what you've described, partly because I'm pretty aware of it and we'll get on top of it. So my, my left shoulder is a bit tighter than my right. And I can see that in, you know, my bar placement where my elbow is for squat. And just over the years I end up with these small you know, when I say adductor strains, it's like, well, you know, I strained my adductor, but usually not something that is going to interfere with what I'm doing. It typically doesn't stop me from lifting, but I'm very aware of it and it will resolve quickly. You know, I do pay a good amount of attention as to what's happening with my bar for squat where I'm placing it. But the other complication that I can run into is sometimes if I try to make sure I'm perfectly even, then my right lower back and my left anterior hip become unhappy. So I have to find that kind of middle ground of asymmetry where it's like, okay, this is the asymmetry that my body has been dealt. And this is what I, you know, I can handle to feel good, but not so much that I'm like tweaking or straining my right adductor. And it's not usually they're not typically early. Well, it's not all the time, a training related strain. But still, you know, sometimes it can happen when I'm training or I can feel it when I'm training. But it's. Sometimes I don't even know how it's happened. Um.