Author Topic: I Failed the Empty Can Test  (Read 3109 times)

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Offline Kavik

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I Failed the Empty Can Test
« on: Thu, 18 February 2021, 10:53:42 »
My right shoulder has periodically felt some pain when getting the bar on my back when setting up for low bar squats. This occasionally cropped up during curls too. However, it's been rather persistent the last few months, causing pain during all arm exercises, and has started affecting everyday life, not just lifting.

Yesterday, I saw an orthopedist, and I failed the Empty Can Test or Jobe Test. With my arm raised to the side and thumb pointed down, I couldn't resist even slight downward pressure. It hurt a little bit, but it was really just extreme weakness. When he did the same to my left arm, it was trivial to resist the downward pressure.

Since I don't remember a traumatic event to suggest a rotator cuff tear, he prescribed physical therapy and a follow-up in two months, at which time I'll get an MRI if it's not fixed. I wish I could get the MRI now, but I understand why he didn't want to. Sometimes things show up on imaging that aren't relevant, so one ends up treating the wrong thing. Conservative treatment is best at first, but I hate the waiting.

I did get a cortisone shot which made it feel about 10 times worse until this morning.

So I may have a torn or partially torn rotator cuff or just bursitis.
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline alertArchitect

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Re: I Failed the Empty Can Test
« Reply #1 on: Thu, 18 February 2021, 11:15:21 »
Good luck with all of that! I've never had that type of injury myself, so I don't know the extent of what that can do to you, but I hope that it all works out for you in the end. Hopefully it's something less serious than a muscle tear, but either way I hope it gets remedied properly.

Offline kurplop

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Re: I Failed the Empty Can Test
« Reply #2 on: Thu, 18 February 2021, 12:30:51 »
There are specific  PT exercises which can help with certain rotator cuff injuries. Specifically ones which strengthen some of the lesser known and lesser worked muscles on the back side of the shoulder. Look them up on YouTube. They are probably the ones that the Physical Therapist will recommend.

Offline alertArchitect

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Re: I Failed the Empty Can Test
« Reply #3 on: Thu, 18 February 2021, 13:03:01 »
There are specific  PT exercises which can help with certain rotator cuff injuries. Specifically ones which strengthen some of the lesser known and lesser worked muscles on the back side of the shoulder. Look them up on YouTube. They are probably the ones that the Physical Therapist will recommend.

This might help, but I would say only do things recommended by the physical therapist. Some exercises could be meant for specific kinds of injuries you may not necessarily have, and doing the wrong ones or doing them improperly could result in further damage. I would say you should only do exercises recommended and, hopefully, taught to you by the therapist so that you don't accidentally do them in a way that could cause further damage and issues later down the line.

Yes, these YouTube exercises could work, and could help, but when it comes to medical issues I always go with what the professionals say and recommend first and foremost.

Offline iri

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Re: I Failed the Empty Can Test
« Reply #4 on: Sun, 21 February 2021, 14:07:22 »
Get well, Kavik!
(...)Whereas back then I wrote about the tyranny of the majority, today I'd combine that with the tyranny of the minorities. These days, you have to be careful of both. They both want to control you. The first group, by making you do the same thing over and over again. The second group is indicated by the letters I get from the Vassar girls who want me to put more women's lib in The Martian Chronicles, or from blacks who want more black people in Dandelion Wine.
I say to both bunches, Whether you're a majority or minority, bug off! To hell with anybody who wants to tell me what to write. Their society breaks down into subsections of minorities who then, in effect, burn books by banning them. All this political correctness that's rampant on campuses is b.s.

-Ray Bradbury

Offline funkmon

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Re: I Failed the Empty Can Test
« Reply #5 on: Mon, 22 February 2021, 09:44:44 »
There are specific  PT exercises which can help with certain rotator cuff injuries. Specifically ones which strengthen some of the lesser known and lesser worked muscles on the back side of the shoulder. Look them up on YouTube. They are probably the ones that the Physical Therapist will recommend.

This might help, but I would say only do things recommended by the physical therapist.

Nah dude register for an ironman.

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #6 on: Mon, 22 February 2021, 09:49:46 »
Get well, Kavik!

Thank you.

There are specific  PT exercises which can help with certain rotator cuff injuries. Specifically ones which strengthen some of the lesser known and lesser worked muscles on the back side of the shoulder. Look them up on YouTube. They are probably the ones that the Physical Therapist will recommend.

This might help, but I would say only do things recommended by the physical therapist. Some exercises could be meant for specific kinds of injuries you may not necessarily have, and doing the wrong ones or doing them improperly could result in further damage. I would say you should only do exercises recommended and, hopefully, taught to you by the therapist so that you don't accidentally do them in a way that could cause further damage and issues later down the line.

Yes, these YouTube exercises could work, and could help, but when it comes to medical issues I always go with what the professionals say and recommend first and foremost.

I saw a PT on Friday, did some exercises, and then did them again the next day. My shoulder hurt so much over the weekend it was basically useless. I hope if I keep doing them they'll improve the pain instead of making it worse!
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #7 on: Thu, 06 May 2021, 14:18:42 »
I forgot to update this. Basically, the physical therapy exercises made my shoulder feel at least 10x worse. I ended up doing them for only two or three weeks instead of the prescribed eight weeks. It went from being an annoying pain in certain positions and weakness when throwing to waking up in the middle of the night with the feeling that someone had been repeatedly punching me in the shoulders. It also got so bad that just using my computer mouse while playing games would hurt. Sometimes when just sitting and doing nothing, terrible pain would occur. This kept happening even weeks after discontinuing the PT. I'm not sure if those PT exercises really irritated it or if that useless cortisone injection irritated it. The only lucky thing about the pain is that it has been very responsive to over the counter NSAIDs despite how intense it is. Of concern is that both shoulders hurt, but the doctor only wants to deal with the one that hurts worse.

Anyway, I finally got an MRI done yesterday, so we'll see if structural damage is the cause or if it's just an inflamed bursa.

Just for kicks, I tried to put a barbell on my back today and could hardly tolerate it. I definitely feel it in my left shoulder too, but not as intensely.

I'm not sure what I'm hoping for. If there's a definite issue, surgery would at least be a clear path forward. If it's something indefinite like inflammation or nothing perceptible on the image, then it'll probably be a lot of trial and error.

EDIT: I just read the notes on the MRI, and it looks like some weirdness with my labrum. The muscles and tendons look fine apparently.
« Last Edit: Thu, 06 May 2021, 15:23:39 by Kavik »
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline jamster

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Re: I Failed the Empty Can Test
« Reply #8 on: Thu, 06 May 2021, 21:44:30 »
I was kind of stunned reading your original post where they didn't want to give you an MRI, but were perfectly happy giving you a cortisone shot! Where I am from, that is the opposite way things would happen.

Hope you get to the bottom of this- I can empathise as I went through something similar several years ago, turned out to be tendonosis in the rotator cuff. Remarkably painful.

Hmm... can you work around it for the time being with front squats, or that doesn't work either?

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #9 on: Thu, 06 May 2021, 22:19:40 »
I was kind of stunned reading your original post where they didn't want to give you an MRI, but were perfectly happy giving you a cortisone shot! Where I am from, that is the opposite way things would happen.

Hope you get to the bottom of this- I can empathise as I went through something similar several years ago, turned out to be tendonosis in the rotator cuff. Remarkably painful.

Hmm... can you work around it for the time being with front squats, or that doesn't work either?

I'm not sure why the cortisone shot is the first line of treatment either. Maybe it's something they can easily bill insurance for. When I had an issue with my other shoulder several years ago, a different doctor did the same thing: gave me a shot and a prescription for PT, and that was it. It didn't hurt as much that time; it just felt tingly and numb for a day or two, but it didn't actually help. I will refuse a cortisone shot in the future if offered one. That problem ended up resolving itself after several months of rest.

I hate to say it, but I have just stopped lifting entirely since January. I've never been able to do front squats because my forearms are too long and my wrists are very sensitive to extension under load (I'm pretty sure I have a scapholunate ligament tear in my right wrist). I might be able to do high bar back squats, but even that position was a bit painful in my shoulders when I tried it today. I may have to suck it up and just do machines, like leg press, for a little while. I suppose I could also buy a safety squat bar, but those are pretty expensive.
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline jamster

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Re: I Failed the Empty Can Test
« Reply #10 on: Thu, 06 May 2021, 22:56:09 »
I was kind of stunned reading your original post where they didn't want to give you an MRI, but were perfectly happy giving you a cortisone shot! Where I am from, that is the opposite way things would happen.

Hope you get to the bottom of this- I can empathise as I went through something similar several years ago, turned out to be tendonosis in the rotator cuff. Remarkably painful.

Hmm... can you work around it for the time being with front squats, or that doesn't work either?

I'm not sure why the cortisone shot is the first line of treatment either. Maybe it's something they can easily bill insurance for. When I had an issue with my other shoulder several years ago, a different doctor did the same thing: gave me a shot and a prescription for PT, and that was it. It didn't hurt as much that time; it just felt tingly and numb for a day or two, but it didn't actually help. I will refuse a cortisone shot in the future if offered one. That problem ended up resolving itself after several months of rest.

I hate to say it, but I have just stopped lifting entirely since January. I've never been able to do front squats because my forearms are too long and my wrists are very sensitive to extension under load (I'm pretty sure I have a scapholunate ligament tear in my right wrist). I might be able to do high bar back squats, but even that position was a bit painful in my shoulders when I tried it today. I may have to suck it up and just do machines, like leg press, for a little while. I suppose I could also buy a safety squat bar, but those are pretty expensive.

I'm guessing you're in the US, land of weird healthcare options :)

Over here and back in my home country, it's never done on the spot, it's a "get some tests done, have it brought up as a possibility with some warnings, go and think about it as one of several options but try a load of PT first." I have no medical understanding of this at all, but it's always been raised as a non-trivial option.

I stopped lifting and am only now getting back into it. Too many covid-induced gym closures were hugely demotivating, then covid-WFH-induced back problems. Wish that people here would come to their senses and get vaccinated already.

Leg press... found that really odd, the movement is so restricting. Remember not to hyperextend, the Youtube videos are horrific :/

Offline Sintpinty

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Re: I Failed the Empty Can Test
« Reply #11 on: Sat, 08 May 2021, 08:16:25 »
My right shoulder has periodically felt some pain when getting the bar on my back when setting up for low bar squats. This occasionally cropped up during curls too. However, it's been rather persistent the last few months, causing pain during all arm exercises, and has started affecting everyday life, not just lifting.

Yesterday, I saw an orthopedist, and I failed the Empty Can Test or Jobe Test. With my arm raised to the side and thumb pointed down, I couldn't resist even slight downward pressure. It hurt a little bit, but it was really just extreme weakness. When he did the same to my left arm, it was trivial to resist the downward pressure.

Since I don't remember a traumatic event to suggest a rotator cuff tear, he prescribed physical therapy and a follow-up in two months, at which time I'll get an MRI if it's not fixed. I wish I could get the MRI now, but I understand why he didn't want to. Sometimes things show up on imaging that aren't relevant, so one ends up treating the wrong thing. Conservative treatment is best at first, but I hate the waiting.

I did get a cortisone shot which made it feel about 10 times worse until this morning.

So I may have a torn or partially torn rotator cuff or just bursitis.

Hope ya recover well

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #12 on: Sun, 09 May 2021, 01:19:40 »
My right shoulder has periodically felt some pain when getting the bar on my back when setting up for low bar squats. This occasionally cropped up during curls too. However, it's been rather persistent the last few months, causing pain during all arm exercises, and has started affecting everyday life, not just lifting.

Yesterday, I saw an orthopedist, and I failed the Empty Can Test or Jobe Test. With my arm raised to the side and thumb pointed down, I couldn't resist even slight downward pressure. It hurt a little bit, but it was really just extreme weakness. When he did the same to my left arm, it was trivial to resist the downward pressure.

Since I don't remember a traumatic event to suggest a rotator cuff tear, he prescribed physical therapy and a follow-up in two months, at which time I'll get an MRI if it's not fixed. I wish I could get the MRI now, but I understand why he didn't want to. Sometimes things show up on imaging that aren't relevant, so one ends up treating the wrong thing. Conservative treatment is best at first, but I hate the waiting.

I did get a cortisone shot which made it feel about 10 times worse until this morning.

So I may have a torn or partially torn rotator cuff or just bursitis.

Hope ya recover well

Thanks, it'll definitely take some sort of intervention since rest isn't helping. I made the mistake of trying to throw a football today, and holy cow did that hurt.
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #13 on: Tue, 28 September 2021, 14:14:50 »
After an MRI and more physical therapy, the doctor just said to go back to lifting weights to see if it starts hurting severely again (it still hurts; it's just not nearly as bad since resting for *months*. The physical therapy didn't improve it any more than resting did). If it does, then I can have surgery. I'm glad it took nine months to come to that conclusion... not.

Now I have an appointment with him in a couple weeks to discuss my suspected scapholunate ligament tear in my wrist.
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.

Offline jamster

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Re: I Failed the Empty Can Test
« Reply #14 on: Tue, 28 September 2021, 20:49:49 »
I am not sure what a "physical therapist" is... I am assuming that they are the same as "physiotherapists" which is what I am familiar with. Have you seen more than one?

There's a huge range in the physios I have seen, dependent on what country, where they were trained (Australian physios tend to be good), and what they specialise in. I would not trust the average, run of the mill, physio for anything that seemed important. That you mentioned earlier that some of the exercises proscribed made your injury a lot worse- I have literally never had this happen. Any physio who has given me exercises has figured out what movements caused pain, and given me things to do that do not exacerbate this.

Several years ago I finally started seeing physios who specialise in sports rehab for athletes. Besides being of a generally higher calibre, their objective is quite obviously to get you back into exercise as quickly as possible. I've had doctors or general physios just tell me to stop exercising, the sports ones are different- most recently I've a knee injury that stops me from squatting, but the physio was "you can keep deadlifting, just keep it below 100 kilos for now, in a couple of weeks try squatting to test ROM and you should keep doing it anyway to make sure replacement tissue forms correctly."

So, I guess this is my long-winded way of asking- have you seen more than one physio, and have they been skilled and oriented towards sporting recovery?

Offline Kavik

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Re: I Failed the Empty Can Test
« Reply #15 on: Mon, 04 October 2021, 11:12:14 »
I am not sure what a "physical therapist" is... I am assuming that they are the same as "physiotherapists" which is what I am familiar with. Have you seen more than one?

There's a huge range in the physios I have seen, dependent on what country, where they were trained (Australian physios tend to be good), and what they specialise in. I would not trust the average, run of the mill, physio for anything that seemed important. That you mentioned earlier that some of the exercises proscribed made your injury a lot worse- I have literally never had this happen. Any physio who has given me exercises has figured out what movements caused pain, and given me things to do that do not exacerbate this.

Several years ago I finally started seeing physios who specialise in sports rehab for athletes. Besides being of a generally higher calibre, their objective is quite obviously to get you back into exercise as quickly as possible. I've had doctors or general physios just tell me to stop exercising, the sports ones are different- most recently I've a knee injury that stops me from squatting, but the physio was "you can keep deadlifting, just keep it below 100 kilos for now, in a couple of weeks try squatting to test ROM and you should keep doing it anyway to make sure replacement tissue forms correctly."

So, I guess this is my long-winded way of asking- have you seen more than one physio, and have they been skilled and oriented towards sporting recovery?

"Physical Therapist" is the American term for a physiotherapist; although, there is some dispute that "physical therapy" is for below the waist, and "occupational therapy" is for above the waist. Some people care about the distinction, but most don't.

I'm not sure if it was the therapy that caused the pain the first go-around or if it was the cortisone shot, or the combination of the two. I did mostly the same exercises the second time without nearly the same level of pain. It was an out-patient setting the first time, so there wasn't a good way to give feedback to the therapist(s) (I could've called).

I didn't shop around for therapists since this clinic is where both my wife and her father rehabbed their wrists. I was encouraged to test my shoulder with my normal exercise routine a couple times, but it's not really that easy to get back into a routine that one has given up for several months. I definitely could have continued deadlifting this whole time and probably found other things to do, but I felt discouraged, and it seems weird to do one lift out of four I normally do. I am also very paranoid about exacerbating injuries since I've pushed myself through pain a few times before and made things a lot worse. I'll see how it goes.
Maybe they're waiting for gasmasks and latex to get sexy again.

The world has become a weird place.