A strongman athlete came in complaining about left shoulder pain. They were worried as they had about 10 days until their next comp. After discussion and some ROM assessment, we decided to use some NKT testing to assess the shoulder. This client had mentioned that their shoulder started to hurt after doing bench press last session. One of the first muscles I test when I am working with shoulder pain is the Latissimus Dorsi as its quite often dysfunctional. I tested the left lat, it was weak. I will usually immediately test the other side to check if its a unilateral or bilateral weakness. I tested the R lat and it was also weak. Having bilateral (both sides) weakness or pain generally means we are looking for a central interrelated cause that mightn’t necessarily be close to the source of pain.
I decided to continue to assess the shoulder before going too deep into looking for the REAL cause of pain.
After further testing, I found the that the Left pec minor and triceps for facilitated for an inhibited Lat. Basically, this was a compensation pattern that had developed for this athlete to continue to train. If the lat wasn’t weak the likelihood of this dysfunction occurring would be minimal.
I still had some work to do as I needed to find out WHY the lats were weak.
After further discussion, we found a scar on the client's stomach. I tested the lats against the scar on the stomach and sure enough, there was a relationship. The scar was facilitated for bilateral Lat weakness.
We released the scar, released the left pec minor and tricep and then activated both lats.
We retested the shoulder. Full Rom was restored and the pain was gone!.
This client had some specific scar work to do but they should be fine to compete in 10 days time as long as their diligent with their dysfunction management.