Dave Asks: I am 45. I have been participating in Olympic weight training for around 4 years. I have been recently diagnosed with a torn supraspinatus muscle. It is a complete tear. I am wondering if a person at my age can recover and continue lifting. I also wonder if I even need to have it repaired. I really only hurts during certain movements, such as the eccentric contraction of a press. I can still snatch around 70KG and Jerk around 95KG. I am around 80-85KG. I am wondering if continuing lifting will make my shoulder worse or if I need to have the surgery.

Greg Says: First of all, I’m not a doctor, physical therapist or any other kind of medical professional, so you need to consult someone like that before you make any decisions. That said, I’m currently recovering from a complete supraspinatus tear myself, so I can at least share my recommendations based on that experience.

My injury was quite a bit more extensive, as it included a 270-degree tear of the labrum as well, so I had no choice but to get surgery. The supraspinatus tear itself required two anchors to be repaired. If you have a complete tear, I would recommend surgery to repair it—if it were partial, I might say you could try getting away without it. I think you’re in a position to simply do more damage.

Without surgery, you could try to stabilize the shoulder by strengthening everything else, but I would argue that the supraspinatus is there for a good reason and no matter how much you strengthen the rest of the muscles that stabilize the shoulder, it’s always going to be less stable and more prone to further injury, damage to surrounding tissues and structures, and chronic pain. The fact that you can lower a press without pain is a problem.

Ultimately it’s up to you to decide what you’re willing to put up with in terms of discomfort and limited function, but I would suggest at least consulting with a surgeon to get his/her opinion and prognosis with and without surgery.

Cam Asks: Preface: Love the site, your vids, photos and content. Very helpful. My question revolves around the second pull and transition in both the clean and the snatch. I've noticed (from videos) that as I'm getting into that full extension my left knee internally rotates. I think about it before every lift and it still seems to happen. What supplementary drills would you suggest to "correct" something like this? I've tried doing Clean DLs, SLDL and I don't seem to do it then.

Greg Says: The obvious thought is that it’s a glute strength and activation issue. I would continue with the snatch and clean deadlifts, SLDL and RDL, and add good mornings with a fair amount of knee bend, along with lunge variations (focusing on keeping the knee out in line with the foot and not allowing it to move inward at all) and single leg RDLs (with a dumbbell or kettlebell). Things like glute bridge variations, unweighted single-leg RDLs, bird-dogs, clamshells and similar can also be thrown in during your warm-up.

However, the other thing that comes to mind is that there is likely a reduction in the pressure against the floor momentarily during the transition in the pull that’s allowing the knee to move. Usually this presents as the foot or feet rotating on the balls of the foot during the pull, but I suspect something similar could be happening here (and your feet may be spinning and you just didn’t mention it).

The goal is to keep continuous pressure against the floor through the entire pull. Start working on this consciously rather than thinking about keeping your knee from moving inward. Also try doing snatch and clean pulls with a slower movement to mid-thigh, such as a 2-3 count, and then focusing on accelerating at mid-thigh without letting up on the pressure you’re placing against the ground at that point. You can also do this with actual snatches and cleans—that is, slow the first pull down and focus on never letting up on the pressure.