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.
YOU are your body and mind
I just wanted to point you towards a brilliant post by in-house nerd, Scott Wood, on how we deal with our pain.
This post is a great little insight into some of our typical reactions, and could apply to how we respond to so many areas of our life! Understanding that ‘pain’ is the way our brain interprets a multitude of factors is a key step to start dealing with each of those factors to change the way we feel and hence what we experience. Obviously this will give you some very useful tools to be able to coach your clients through their rehab process.
I definitely recommend a read of it! – it was posted in our iNform blog and facebook page, so click on the links to read it!
Enjoy!
Max
Flexibility – achieving great movement
Sunday February 26, 2012 – Sunday February 26, 2012
9 Kensington Rd
Description:
Workshop from 9:30 am – 4pm (please arrive at 9:15am for registration)
Registrations close on Wednesday February 22nd, 2011.
Tight hamstrings in horse-riding client!
Ok, so you you might not have a lot of horse-riding clients perhaps, but I was asked by a PT what I would do with such a client with chronically tight hamstrings. The answer actually fits for tight hamstrings in general, so I thought it would be worth while posting. hope it helps!
“Now in regards to your horse riding client (I’ve had a couple of these too!), as a general rule of thumb, a tightness is a compensation/protection due to a weakness somewhere else, and we find that in hamstrings this is related to glut (max and med) weakness > which is often due to poor core function. Especially in a horse riding position, where they are often holding a half squat position, where the core and hips have to absorb a lot of forces. So if they are weak in this chain/pattern, then the hamstrings tend to overwork and end up getting tight as a result. So I would ensure good core and glut function, and then progress adequately into positions that create a similar demand (eg. Bent over cable rows, deadlifts, etc) – but ensure you have good function first, otherwise you risk feeding the problem!”
