Ask Coach E
Episode 12

0. Coach E: Intro [0:00]

Welcome message from Coach E 

1. Cindy Wood: I have moderate glenohumeral osteoarthritis with chronic shoulder pain and have been advised I may need a shoulder replacement—can the Shoulder Pain Solution help reduce my pain and potentially help me avoid or delay surgery? [06:09]

Right shouler MRI result: moderate glenohumeral joint OA with accompanying small-moderate-sized joint space effusion with accompanying synovitis; there is a osteophtye arsing from the inferior aspect of the humeral head.

I was a diaysis nurse for over 25 years and this pain started when I was over-exerting myself during "burpies" in April of this year. I have done physio since, mostly 3-4 times per week as per my athletic trainer?masseuse. I am told I will need a shoulder replacement but will try cortisone injection to help aleviate the pain so I can do more muscle building exercises and hopefully help with recovery post surgery (if and when I have it). I am 56 in January.

What can the Shoulder Pain Solution do for me? Will it help my avoid surgery?

2. Carla: I recently broke my wrist and am doing the Low Back Pain Solution—can you suggest wrist-free modifications, and can you also help clarify why my email says I have premium access but the ROM app does not, even though I paid for a year of premium? [08:24]

I recently broke my wrist. I'm trying to do the low back pain solution. Can you suggest modifications that don't put any weight on the wrist.

Also the email says that I have premium but the rom app says I don't. I supposedly paid for something that gave me a year of premium. Can you help with this?

3. Mufazzil Waris: After completing the Pain Solution programs, what should my next steps be to address my ongoing knee, shoulder, and foot issues so I can return to boxing confidently, and can you recommend specific exercises for finger/thumb strength and boxing or MMA-focused conditioning? [13:16]

Dear coach E,

I’ve been struggling to get back to 100% and a few niggles have been troubling me. In general I’ve never had any major injury, I was an athletic and sporty kid/teen. However, I was inactive for a few years before jumping back into boxing training full time. Over the last few months I have completed 3 pain solution programs (knee, neck and foot and ankle) and have nearly finished all the other pain solution programs too.

Right knee pain: It’s hard to pinpoint the exact location but it’s definitely the lateral side of my knee and it’s more internal, mostly towards the back and sometimes towards the front. I can recreate the pain/discomfort when standing on my right leg with a slight bend in my knee and leaning backwards with my body (leaning forwards recreates the pain as well but not as much). I can also recreate it by doing a deep squat all the way down and leaning/shifting weight to my right or leaning back. Knee pain started in February, no sudden impact or fall. Probably due to some imbalance that I had and then lots of boxing training (running, jumping, pivoting). The pain was really bad at first and for a while I used to wake up with a stiff knee and struggle to walk up and down the stairs. I’ve had two MRIs, first one showed “minimal joint effusion” and second one showed nothing. I have finished the knee pain solution program and it definitely reduced the pain and strengthened my knee but it’s still not 100%. I don’t feel confident when shifting weight as I feel a bit of that pain/discomfort. I’d like to note that for many years I’ve felt that my right leg is “shorter” than my left and my right torso is “shorter” than my left. Also my right glute, quad and hamstring are smaller than my left, even though I am right footed. My right calf is also smaller than my left. I’m thinking my right knee pain is related to my hamstrings or popliteus or even an imbalance in my hips but I’m not sure. The doctors are also not sure lol.

Left shoulder: I get left shoulder pain when throwing certain punches on the heavy bag like a high left hook. I have previously been diagnosed with bicep tendinopathy after a weight lifting injury 2 years ago. Before that I never had any injury but I’ve always had a weak left bicep which is prone to cramping when flexing my arm and also an unstable left shoulder. My left bicep is significantly smaller and weaker than my right. My left scapula muscles are definitely smaller/weaker than my right ones, I also get a nasty cramp under my left shoulder blade when doing scapula depression and I feel I have less control/range of motion of my left scapula. An MRI of my left shoulder in March this year said “suggestive of infraspinatus tendinosis”. I have weaker external rotation of my left shoulder. I’ve nearly finished the shoulder pain solution program and it has helped but not 100%.

Left foot: I have bad balance on my left foot, when trying to balance my left big toe joint/inner foot keeps lifting off the ground/moving excessively causing me to wobble. I have had multiple left ankle sprains over the years. The last one was quite bad but it was 3 years ago. My left foot seems like it sits slanted and the arch is more flat than my right one. I also have pain in my left big toe joint. An MRI showed I have arthritis and sclerosis in the big toe joint. I have completed the foot and ankle pain solution program and it has helped but not 100%.

I’ve not been able to train and it’s really affecting my mental health. I just want to be able to move and box freely again with confidence and without feeling pain. What do you think my next steps should be after completing the remaining pain solution programs? Also, can you recommend exercises for strengthening the thumb and fingers and exercises/routines for boxing/MMA?

Thank you

Kind regards,
Mufazzil

PS I want to thank coach E and everyone at precision movement, I’ve really learnt a lot about anatomy and exercises that actually work. I always recommend ROM coach to my friends and family and they love it. Most recently I’ve been getting my mum to do the 5 minute lower back pain routine as she suffers from arthritis, hopefully she moves onto the back pain solution program.

4. Elaine Sparrow: I have a history of a rotator cuff tear (2021) and struggle with rotating planks despite being able to do side planks and standard planks easily—are there modifications or additional exercises you recommend to improve my rotation strength and stability? [15:54]

I have an old rotator cuff tear- September, 2021 after a fall - that was healed using laser treatments. I keep trying to do rotating plank. I can't get past 1 rotation without falling out of position. Any suggestion besides keep trying? Do I need to add other exercises to strengthen my core? (I do side plank and plank from your DMT often & pretty easily)

Thank you for your kind assistance.

5. Nayib Suz: I have structural kyphosis and although the Neck Pain Solution and Acute Neck Pain routine help, why do exercises in the Fix Forward Head Posture routine (like supine chin tuck, wall lean, and 6-way neck isometrics) trigger headaches instead of relief, and how should I adjust them to safely strengthen my neck? [18:48]

Hello Coach E.

I'm a 59y/y man whith Kyphosis (structural). As I mentioned in an old Ask Coach E, I already did the Neck Pain Solution with great success some months ago. All that being said, my neck pain is always coming back specially after waking up in the morning, and you gave me some tips like using a better pillow (working on that now) and improving my posture while using my cellphone; also, I'm doing the Acute Neck Pain routine almost daily and it helps.

I want to strengthen my neck and surrounding musclés and for that I recently started your new routine Fix Forward Head Posture My question is why some of the exercises like the Supine chink tuck, the Wall lean and the 6-way neck ISO instead of giving me relief are causing head aches after doing them? Thanks in advance.

6. A Mukherjee: I have severe intermittent pins and needles starting in my left big toe and radiating through the outer foot, ankle, and up the outside of the calf to the knee—given my known left-sided L4/5 disc herniation and no diabetes, is this more likely coming from the spine or a localized nerve entrapment (e.g., peroneal/ankle), and what should my next steps be? [24:44]

Severe pins and needles starting from big toe under foot radiating into the outer foot into ankle and outside of calf all the way to the knee. not present all the time but every time i get up after sitting. i do have severe L4/5 herniation on left side and the affected foot is on left. no diabetes. could it be localized nerve entrapment stemming from the ankle area, peroneal nerve area or could it be stemming from the L4/5? I do walk about 3 miles a day and have been for the last couple of years.

7. Stephen Grewe: I’ve had plantar fasciitis for about six weeks and recently received a steroid injection and orthotics—are there specific stretches or exercises you recommend to support recovery and prevent recurrence? [29:54]

I have had a problem with plantar facts for about six weeks. I went to a podiatrist this week a confirmed that diagnosis and got a steroid injection and ordered an orthotic. Have you any suggestion of stretches/exercises to help ?

Stephen

8. Rajbir Dhillon: I’ve been experiencing reduced left arm extension strength, tightness along my medial scapula, and occasional radicular triceps symptoms, possibly related to the dorsal scapular nerve—can you recommend specific exercises to help relieve this and safely strengthen my scapula and triceps? [33:28]

Hi Coach E,

Sorry the last question i sent was incomplete and by mistake as the details weren't complete and the submit icon was pressed accidently.

RAJBIR here 40/M from India.

I'm going through a rather tricky condition, which I feel is on the mend but still not there.
It all started a month back with me noticing that my left arm extension power was going down and i felt it specially doing push ups, bench press and overhead triceps extensions.

I'm quite active and do yoga everyday and started with gym work out around 4 months back. It Was into 3rd month of working out in the gym when the symptoms began, gradually. It was around that time, 3rd month, that i also started learning how to swim.
During these 4 months, everything was

Fine except my neck at Times would get still and tight, and there were a few occasions where i could feel my neck kind of blocked on both sides. Left more than the right but it would ease off at Times and many a times just a feeling of tightness as if it's under spasm.
Once the power in extension started to reduce, i found it difficult to do chest exercises on machine so i would do with reduced weights.

I met an orthopedic surgeon, did an mri and interpreting it we saw the rhomboids are fine, we were suspecting a tear or injury, and there were few disc bulges at the thoracic level d1-2, d2-3 .. the surgeon thought may be it's the bulge that's irritating the nerve.

But somehow i feel it's not the bulge but it's something to do with the dorsal scapular nerve that's causing tiredness around the rhomboids, feels like a trigger point there and occasionally cause radicular nerve symptom along the triceps, like a travelling ache.

I have been continuously working on scapula stabilisation, specially posterior tipping which you have mentioned in so many exercises. The symptoms are better and extension had improved but still i feel the tightness and tenderness along the medial border of scapula. Retraction helps a lot and when not aware and slouch or the scapula protracts i can feel the symptom along the triceps.

Hope my explanation is clear enough, if not please let me know and i will try again🙂.

If you can suggest some unique exercises i can do to nurse my injury and heal it.

Regards.
Raj

9. James Rivet: I experience severe quad and hamstring cramps after intense endurance training when getting up from rest—what exercises or activations could I do post-training or before bed to prevent this? [37:52]

Hi Coach E, I have done hip and shoulder programs from PM, among others. I appreciate your approach and follow it closely. I have long had trouble with leg cramping, quads and hamstring, following intense endurance training, ie cycling running. It is not as bad doing strength stuff like squat and lunge. It occurs after I finish and rest/ lie down then get up suddenly to use the restroom. What advice could you give to perhaps stop this from happening? It is extremely painful. I wonder if there is some activations I should do after my training but before bed?

10. Conclusion / Update : [39:16]


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