Shoulder Rehab Made Easy
Shoulder rehab is hard right? There are so many things that can go wrong in there- subacromial bursitis, supraspinatus impingement, biceps impingement, rotator cuff weakness, frozen shoulders. The list goes on and on. How do we know what is what? And what do we do specifically if we don’t know what is specifically wrong? And maybe worse, what do we do when we do know what the problem actually is? Looking through a well-regarded text like Kendall’s ‘Muscles; Testing and function’, with its 100+ pages of muscle tests for the upper extremity alone can tempt even the most stoic of anatomy nerds to place shoulders into the ‘too hard basket’. It needn’t be this hard.
Suddenly our ideal ’corrective’ exercises are suddenly not only useless, they may be reinforcing dysfunctional patterns already present!
Let me give you two pieces of information that may ease your frazzled mind.
1) As an Exercise Professional, it is not your job to diagnose. In fact, as a Personal Trainer or Exercise Physiologist diagnosis exists outside of your scope of practice.
2) Regardless, diagnosis of the specific injury is superfluous to what you actually need to do for effective shoulder rehab.
For a shoulder to be happy, healthy and functioning beautifully you really only need to tick three boxes. Continue reading
Putting the ‘Allied’ into ‘Allied Health’ Part 2
I have received some interesting responses to my previous post on this topic- unfortunately most of them have been of horror stories of practioners that people know of who practice like my friend the Osteopath. I guess it was an oversight of mine not to give a specific example of a client who has been fortunate enough to be handled by true ‘Allied Health Practitioners and had a positive outcome. The truth is I could write about at least fifty of my current or past clients, but I think it would be appropriate if I detailed the experiences of the client I was referring to last time.
The brief back ground of this client is as follows:
- Woman, early fifties, 20+kg overweight, has recently torn her left tibialis posterior tendon (overuse, with flat feet and excess wieght being causative factors). She was also experiencing low back pain and SIJ pain due to compensatory gait patterns. She hopes to reduce her foot pain sufficiently within 2 months as she is travelling to Europe for 6weeks with her family.
She decided to continue see me and her Podiatrist, and upon the Pod’s advice, saw an Orthopaedic Surgeon who has a typically conservative approach. The surgeon has advised staying off her feet as much as possible, losing some weight and wear the Podiatrist’s brace religiously. He has advised surgery if no improvement is seen.
In response she has started a reduced calorie eating plan, hired an exercise bike and worn the brace day and night.
As a result she has already lost 3kg, her foot has improved dramatically and her back and SIJ’s are also feeling better. She has continued to train, and we have been able to do some pretty vigourous sessions with no risk to exacerbating her injuries. Due to the guidance of these two practitioners I have had the confidence to work her hard within safe boundaries.
This, so far has been a great situation for everybody. What would her experience have been like if she had gone to the Osteo, and removed herself from this colaborative network? Who knows.
What I do know is that in the future, I would do nothing different, my client would do the same and she will have every confidence in the advice I give in the future.
Crunches: An aptly named exercise
I don’t like abdominal crunches. I don’t prescribe them, and don’t like the fact they are still widely prescribed. I think they are, for most people, a bad exercise. There are three major reasons why. Continue reading
