Back to doing research reviews.  This is fun.  It is great to go into the research to see what is new when it comes to exercise and injuries.  In this round of research reviews I found some great research on scapular stabilization exercises, jumper’s knee and osteoarthritis.

Let’s get into the research.

Should I be Wasting My Time with Scapular Stabilization Exercises if I have Shoulder Impingement?

What They Looked At:

The effectiveness of an exercise program on the shoulder with people who have subacromial impingement syndrome.

How Did They Do It:

They divided 40 subjects into two groups.

Group 1 did stretching and strengthening exercises while group 2 did stretching, strengthening and scapular stabilization exercises.

What They Found:

Both groups showed improvement but the second group had greater improvement in muscle strength, joint position sense and scapular dyskinesis.

Take Home Message:

If you or your client has subacromial impingement, make sure to add scapular stabilization exercises to your program, along with stretching and strengthening.

Let me take a minute to explain a little more on why you should do this.

The results above all make sense because in shoulder impingement clients you often see:

• increased upper trapezius activity
• decrease in middle and lower serratus anterior activity
• reduced rotator cuff activity
• delay in middle and lower trapezius activity with sudden perturbation

To get more information, check out: Başkurt Z, Başkurt F, Gelecek N, Özkan MH. (2011). The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2011;24(3):173-9.

Also have a look at this one:  Phadke V, Camargo P, Ludewig P. (2009). Scapular and rotator cuff muscle activity during arm elevation: A review of normal function and alterations with shoulder impingement. Rev Bras Fisioter. 2009 Feb 1;13(1):1-9.

For the program that I use for scapular stabilization exercises, click here.

Want to Improve Osteoarthritis pain? Then Losing Some Weight is the Key.

What They Looked At:

They looked at 111 obese adults.   The researchers performed a baseline MRI and a 12-month follow up MRI to look at cartilage thickness.

Neat Stuff in the Introduction:

• Obesity is a major health problem
• The World Health Organization estimates more than one billion people are overweight and 300 million are obese
• Osteoarthritis is the most common form of arthritis and the leading cause for chronic disability among older adults
• Weight loss has been shown to decrease knee pain and to improve knee stiffness, function and disability

What They Found:

The average age was 52 years old, a BMI of 37 and average weight loss was 9%.

A decrease in weight led to an improvement in quality and quantity of medial articular cartilage but this was not observed in the lateral compartment.

This improvement in cartilage could lead to a reduction in the need for total joint replacements and decreased the impact on the health system.

Take Home Message:

We don’t talk about it often but with so many conditions in the lower body, an emphasis on decreasing weight will help overweight and obese clients recover from some injuries and prevent future ones.

Thinking beyond just exercise to lifestyle, nutrition and activity – even when injured – is key.

To get more information, check out: Anandacoomarasamy A, Leibman S, Smith G, Caterson I, Giuffre B, Fransen M, Sambrook PN, March L. (2012). Weight loss in obese people has structure-modifying effects on medial but not on lateral knee articular cartilage. Ann Rheum Dis. 2012 Jan;71(1):26-32.

I go through more stuff on knee osteoarthritis in the course:

What is the Best Treatment for Jumper’s Knee?

What They Looked At:

The effectiveness of an exercise program, ultrasound and transverse friction for the treatment of chronic patellar tendinopathy.

Neat Stuff in the Introduction:

• Jumper’s knee or patellar tendinopathy
• common in sports involving jumping and landing, rapid acceleration and deceleration, cutting moves and kicking (basketball, volleyball, soccer, tennis, high jump, long jump, fencing, track)
• No correlation between intrinsic factors leading to jumper’s knee (malalignment, Q-angle, biomechanics).
• Principal cause of jumper’s knee is hard playing surfaces, increase in training involving repetitive eccentric movement and tight hamstrings and quads

How Did They Do It:

They had 30 subjects with chronic patellar tendinopathy and divided them up into three groups (exercise, ultrasound and friction). Each group received treatment three times a week for four weeks.

Then they looked at the pain level of each of the subjects at 4, 8 and 16 weeks.

What They Found:

They found the exercise program had better results than the ultrasound and friction.

Yay, exercise.

If you do get treatment for jumper’s knee and have ultrasound and friction performed, don’t discount the exercise. It may be the missing piece that will help you out the most with your jumper’s knee.

What the focus needs to be on is an eccentric exercise program.  I go through that in Achilles Tendinitis Exercise Solution for the Achilles tendon.  In a few weeks, I will be finishing up this month’s, Injury of the Month, which will be Jumper’s Knee.  Watch for it before the end of December.

To get more information, check out:  Stasinopoulos D, Stasinopoulos I. (2004). Comparison of effects of exercise programme, pulsed ultrasound and transverse friction in the treatment of chronic patellar tendinopathy. Clin Rehabil. 2004 Jun;18(4):347-52.

Hope you enjoyed the research review.

Let me know what you think. Please feel free to share a recent article that you have read in the comment area.

Rick Kaselj, MS

.

Today let’s talk about winging scapula.

As you know I am a big shoulder guy.

No, I don’t have big shoulders, but I am passionate about shoulder injuries and what exercises to do about it.  One thing I see in people with shoulder injuries and people with a potential shoulder injury is winging scapula.  Let me explain a little further in what I observed last week.

Last Week’s Assessments

One of the cool things I am lucky to do is assessments for a major utility company.  They get me to come in and test prospective employees to see if they have the physical ability to do the job. Over the last two weeks, I have tested about 40 of them.  Mostly men ranging from 20 to 40.

The tests are not a typical fitness assessment but it more tailored to the type of work they do.

There is a cardiovascular and flexibility testing but many of the strength tests involve carrying, lifting, pulling and squeezing tasks.

Kids These Days

When you test 40 people, you see all kinds of shoulders and you notice a difference between people in their 30′s and those in their 20′s.

From observation, you can see that those in their 20′s have greater winging in their scapula.  I think there are a lot of reasons for it.  Let me explain a few of the reason why I think they have it.

Here are some reasons why people in their 20′s are more liking to have a winging scapula:

• Not Very Physical After Work - They may be doing a physical job but often times outside of that physical job, a lot of what they do outside is not very physical.  There is more TV watching, computer work and less active recreational activities compared to those 30 plus.  I know looking at my parents, on their days off or after work they were working on the garden, building stuff, fixing stuff or heading to see their friends to help them out.
• Looking Lean – With men these days, there is a movement to look lean and thin.  More and more are tying not to look big and bulky.  This affects how much muscle mass their is in the shoulders and the scapula.  Leading to more winging scapulae.
• Not Much Time Crawling – My guess is there was less time spent crawling when they were kids.  When you have kids, there is an obsession to get them walking.  The grandparents are the worst with this.  People want to get their kids walking but all of the stages of movement in a baby (from head lifting, head stability, rolling to their stomach, fulling rolling, etc.) are essential and affect things later in life.  I know with our second child, it took a longer time to get him to walk.  He crawled around and was a crawling machine.  He also went through a phase where he dragged himself around the floor.  I was okay with this as is part of the development process.  It drove the grandparents crazy but that is what their children do.  Now our son is walking and has good shoulders and this will help him in the long run.

These are some reasons why but let me move to some other observations that I saw.

Overhead Work Makes it Worse

The guys do two tests where they lift something to waist height and then to head height.

All of them did great when it came to waist height.  You may see some scapular lifting but there are so many other muscles that help out (biceps, pectoralis major, rhomboids, rotator cuff, wrist flexors), that it is minor.

When we go from waist height to head height lift, things get worse.

Some of the guys could not do the test because they did not have the stability in their scapula to allow their shoulder to do the work.  With the winging scapula, this put more stress on the other muscle groups in the shoulder and they just could not do the test safely.

Another interesting thing was they may be fine for repetition 1 to 9 but when we get to repetition 19 to 27, all hell breaks loose.  Interesting.  That leads to the next point.

This is lifting to waist height.  You can see he had not problem doing it but you can see inferior angle of the scapula winging.  From the shine on his neck, you can see he is sweating and working during the test.

Now when we get him to lift to shoulder height, we had an increase in scapular winging.  You can see the scapula has protracted and now there is great lift in the medial aspect of the scapula.

Endurance Makes it Worse

As we moved through the tests, you could see the winging scapula get worse.

We would go from pulling, lifting and then to overhead work.

You could see from the start to the end of the test, which was between 45 minutes to 75 minutes, that the scapula would get worse.

Planes of Movement Makes it Worse

We do a strange test overhead where we get them to move a weighted stick across a wall.

You could see that winging of the scapula changed depending on what type of movement they did.

They maybe fine in the sagittal plane, but when they moved into the transverse or frontal, things got worse.

Wrapping it Up

Thanks so much for reading and I hope this article helped you out and got you thinking about winging scapula differently.

If you want more info on what to do about winging scapula, you can attend the live course, Core Stability of the Shoulder or download the Scapular Stabilization Exercise Program.

That is it.

Well kind of.  Let me summarize.

Summarizing scapular winging:

1. When it comes to winging scapula, endurance places a huge role.  This can be during the exercise or over the whole workout.
2. The more overhead the exercise, the more the scapular muscle are needed to do the exercise.  Remember this.  You can see with single arm reverse wood choppers.
3. Movement and planes of movement play a big role.  People might be great in the forward and back movement (sagittal plane) but may be poor in the side-to-side (frontal plane) or twisting planes (transverse).  Consider this in your exercise selection.

Okay, now I am done.

Thank you so much for reading and hey, if you like it, share it.

Have  a great day.

Rick Kaselj, MS

I can waste hours looking at new research that has come out.

I am so glad I have this blog so I can share what I find because so much great research dies in journals and never makes it out into practice.

Last week the focus was on low back pain. Today let’s focus on the shoulder even though when I was digging, I came across some great stuff for the lower body. I will leave that for another day.

What Effect Does Range of Motion Have on Shoulder Muscles During a Military Press Exercise?

What they Looked At:

The researchers looked to see if a change in elbow range of motion during a dumbbell Military press exercise can lead to specific muscle isolation during 3 intensities (0, 30% and 70% 1-RM).

They called it elbow range of motion but I think that is confusing.

They looked at three different Military press techniques:

• Incomplete ROM – Elbows at the side of the body and pressing up until the elbows are at shoulder height.
• Intermediate ROM – Elbows at the side of the body and pressing up until the shoulder range of motion is at 125 degrees of shoulder abduction.
• Complete ROM – Elbows at the side of the body and pressing up until the elbows are straight and arms are overhead.

What They Found:

• The greatest muscle activation was during the Complete ROM exercise where the range of motion of the shoulder is full.
• With the intermediate range of motion there was isolation of medial deltoid with respect to trapezius at high loads (70% 1-RM)

Rick’s Comment:

I know someone out there is going say the military press is not functional and can injure people. I look at exercises like I do cooking. Every ingredient (ie exercise) has a purpose, function, time, amount and place. I will leave it at that for now.

With the Military press you get a fair bit of serratus anterior activation which people with shoulder issues need to work on.  So I like doing it.  I may modify it by having the movement done in the scaption plane or sagittal plane.

Plus those with neck issues need to work on overhead movements as well. For those with neck issues, performing the Intermediate ROM may be an idea option, especially if they are performing the exercises at a high 1-RM.

There was good muscle activation for all three techniques so going from incomplete, intermediate to complete would be a nice progression to consider.

Where to get more information – Paoli A, Marcolin G, Petrone N. (2010). Influence of different ranges of motion on selective recruitment of shoulder muscles in the sitting military press: an electromyographic study. J Strength Cond Res. 2010 Jun;24(6):1578-83.

What is a Good Test for Upper Body Power in the Older Adult?

What They Looked At:

The researchers were looking for a low-cost, easy-to-administer field test of upper body power for the older adult.

They looked at the validity and reliability of the seated medicine ball throw.

Interesting Stuff in the Discussion:

Most of the research out there has looked at muscular strength level when it comes to functional ability of the older adult.

The researchers propose that power may be something more important to look at.  Examples of daily tasks that represent power are lifting something, correcting balance after a bump, opening a door and getting out of a chair.

In the older adult, sarcopenia occurs, which leads to a loss of muscle size and strength, which affects power.  This all leads to a decrease in functional ability and independence.

How the Test Was Done:

The 33 male and female subject that had a mean age of 72 started off with a 5 minute warm up (walking or biking).

The subjects sat in a chair placed against a wall with a tape measure placed on the ground and stretched for 10 meters.

Subjects sat in the chair with their backs up against the chair and feet flat on the floor.

They adjusted for arm length by getting them to straighten their arms with the medicine ball between their hands and drop it on the measuring tape.  This distance was subtracted from the throwing distance.

Then the subjects pressed the 1.5 kg or 3.0 kg medicine ball away from their chest like they were performing a basketball chest pass.

Where the front of the medicine ball hit was the throw distance.

Subjects performed 3 trials with a 90 second break between trials.

What the Researchers Found:

The seated medicine ball throw was a good test for muscular strength and power in older adults.

Rick’s Comments:

This is great.  I am going to use this as a test for muscular strength and power in my older clients.

One other note, I know you are thinking about injuries.  The researchers reported in 400 medicine ball throws there were no injuries or complaints of discomfort, plus the subjects enjoyed the test.  More reason to do it.

Where to get more information – Harris C, Wattles AP, Debeliso M, Sevene-Adams PG, Berning JM, Adams KJ. (2011). The seated medicine ball throw as a test of upper body power in older adults. J Strength Cond Res. 2011 Aug;25(8):2344-8.

Rick Kaselj, MS

P.S. – If you are looking for more great information, resources, assessments and exercises for the upper body, do check out Muscle Imbalances Revealed – Upper Body Edition –

.

Today I have a great guest blog post on Shoulder Pain and Anterior Humeral Glide.

The excellent info is from Zach Moore.

Take it away, Zach.

How can Anterior Humeral Glide Lead to Shoulder Pain?

Anterior humeral glide (AHG) is a common problem among many individuals and occurs when there is excessive or abnormal anterior movement of the humeral head during shoulder motions. AHG can occur during any movement where the humerus moves into extension or horizontal abduction.

It is important to spot and correct this mistake because AHG can eventually lead to, or further aggravate, anterior shoulder pain, AC joint problems, pec and lat strains, as well as impingements. Therefore, today I want to look at some common exercises where this often occurs and then go over possible solutions to help address it.

Again, this problem can occur during any exercise where the humerus moves into extension or horizontal abduction, but I am only going to cover a few popular exercises.

The fixes and mistakes for each will usually be similar, so you can apply them to other exercises as needed.

Horizontal Row

Video Demonstration of Anterior Humeral Glide during a horizontal row along with cues to help correct this:

Cues and Possible Fixes:

• Place your hand medial to their scapula and cue them to squeeze back.
• Point to the anterior part of their humeral head and tell them to pull that back.
• Help guide them into the proper position. Place one hand on the anterior part of their humeral head and the other on their scapula. As the person begins to row, guide their scapula into retraction and apply posterior pressure to their humeral head.
• Lastly, have them try rowing with both arms. Sometimes their inability to retract is just a coordination problem and this will better allow them to feel their shoulder blades being squeezed together.

Dumbbell Row

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):

Cues and Possible Fixes:

• Same cues and fixes as described with the horizontal row above.
• Make sure spine is neutral. If upper back is not flat then you are more likely to see a faulty rowing pattern.

Push-Up

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):

Cues and Possible Fixes:

• Make sure spine is neutral. This will help to better position the scapula on the rib cage, which will help facilitate proper retraction on the eccentric (lowering) phase.
• Cue them to squeeze their shoulder blades together in order to activate their scapular muscles as they lower their body.
• Use an incline or raise the incline to make the exercise less challenging.
• Shorten the range of motion (i.e. do not have them lower as far).

Chin-Up

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):

Cues and Possible Fixes:

• Tell them to think about putting their shoulder blades into their back pocket.
• Have them demonstrate to you how to squeeze shoulder blades down and back before they perform the movement. This will ensure they know what you mean.
• Use a band or increase the band tension to make it easier.
• Try a Chin-Up ISO. This is an exercise we will usually give to clients at IFAST before progressing them to a full chin-up. You basically get into the top position of a chin-up with chest to the bar and scaps depressed. You then hold this position for max time. It is very effective for teaching people the final portion of this exercise.
• Lastly, if the above strategies do not work then I would take them to a Lat Pulldown where the stability requirements are less demanding.

Bench Press

Cues and Possible Fixes:

• First, I would make sure the person could perform a push-up properly without AHG before giving him or her a bench press.
• If AHG is occurring during this exercise, then you know they are not keeping their shoulder blades retracted, which is desirable when performing a bench press.
• Make sure the client knows that he or she should not protract (i.e. make arms long) at the end range. This will better allow him or her to keep shoulder blades together.

Final Points

Never be afraid to lighten the load or decrease the stability requirements. Performing an exercise over and over with incorrect form (in this case, anterior humeral glide) will not fix the problem/form.

If the cueing and loading strategies above do not work, then you may need to resort to other corrective strategies such as soft tissue treatment and/or rotator cuff exercises.  For soft tissue treatment, I would first examine the posterior shoulder capsule as it can often be stiff and restricted, which will not allow the humerus to glide posteriorly as it is flexed.  Next, examine the pecs as they can become dominant and pull the humeral head anterior.

For the rotator cuff, I would examine the subscapularis.  If the subscap is too long or weak, then its downward and posterior pull will not be able to offset strong muscles, such as the pec major, that pull the humeral head anterior. Therefore, strengthening exercises for this muscle may be appropriate.

Summary:

Learn to retract/depress properly by squeezing the scapula back/down without allowing the humeral head to glide anteriorly.

Common Cues and Fixes:

1. Make sure person is in a good spinal position.
2. Put hand back by shoulder blade and tell person to squeeze shoulder blade back to touch hand.
3. Point to anterior part of humerus and tell person to pull it back.
4. If performing a unilateral pulling exercise try to pull with the other arm at the same time, which may allow for better proprioception.
5. Lighten the load.
6. Reduce stability requirements
7. Make sure the problem is not due to soft tissue restrictions and/or a weak cuff.

Read the rest of this entry »

One of my most popular programs is the scapular stabilisation exercises program.

I really like it when I get emails from people that are working on the program so I can help tailor the program for them, so they get the results they are looking for.

This is an email I got a few days back and thought it would be best if I shared my answer with you:

Hi,

My name is Ron and I ordered your scapula stabilisation program and had questions about doing exercises in my current situation.

I have a shoulder impingement and also a winged scapula, and my posture has always been poor, which I’ve been working on.

I went through PT twice, the first time they worked on my rotator cuff strength and it got better so I went back to work but three months later I was back out again. I went back to PT they worked on rotator cuff and lots of pulling and pushing exercises for my scapula.

I’m back to work which requires a lot of pushing pulling motions. I work 3-4 12 hour days a week. My problem is I don’t know if I should be doing rotator cuff exercises and scapula stabilization exercises together, or don’t do rotator cuff exercises and with me working I don’t want to overwork my muscles but at the same time I don’t want to not do enough.

I haven’t tried doing the exercises you provided as I know if I try to do them myself without coaching at first I probably won’t do them correctly.

Thank You.  Ron

Thank you so much for the questions Ron.

#1 – Should You Be Doing Rotator Cuff and Scapular Stabilization Exercises at the Same Time

Yes, do both of them at the same time.

Start with the scapular stabilisation exercises as they will improve the scapular muscles but also help with the rotator cuff muscles.

The specific rotator cuff exercises will help target the rotator cuff muscles.

#2 – Not Wanting to Overwork Your Scapular and Rotator Cuff Muscles

You are on the right track with this.

Recent research came out on this:

Chopp JN, O’Neill JM, Hurley K, Dickerson CR. (2010). Superior humeral head migration occurs after a protocol designed to fatigue the rotator cuff: a radiographic analysis. J Shoulder Elbow Surg. 2010 Dec;19(8):1137-44. Epub 2010 Jul 3.

If you fatigue the rotator cuff, it decreases the effect the rotator cuff has on the shoulder and increases the risk of injury. Especially with clients with shoulder impingement.

What I suggest is:

• Perform under 12 repetitions of rotator cuff exercises.  You can do 3 sets of the exercise but just perform under 12 repetitions to minimize fatigue.
• Perform your rotator cuff and scapular exercises at the end of the day because if you fatigue both of the muscles prior to work, you increase the risk of shoulder injury.

#3 – I am Not Sure if I am Doing the Scapular Stabilization Exercise Correctly

Print out the manual that comes with the program and bring it to your next physical therapy session and ask if they can help you will these exercises or see a personal trainer that specializes in post injury rehabilitation and have them take you through the exercises.

They will make sure you are doing the exercises correctly and you will feel better knowing you are doing them right which will lead to the results you are looking for.

I think that is it.

I hope this helped answer your questions about scapular stabilisation exercises.

Ron, if you have any more questions email me at support(at)ExercisesForInjuries.com .

Take care and have a great day.

Rick Kaselj, MS

P.S. – If you have a shoulder injury are are interested in my scapular stabilization exercise program, CLICK HERE.

.

I have had a question about what the scapular muscles are so let me take a minute to explain what they are.

What are the scapular muscles?

These are all the muscles that connect and attach to the scapula (shoulder blade).

These muscle are very important for shoulder health and often ignored when it comes to an exercise program or the recovery of a shoulder injury.

What are the names of the scapular muscles?

There are 16 primary scapular muscles that connect to the shoulder blade:

1. Pectoralis minor
2. Coracobrachialis
3. Serratus anterior
4. Triceps brachii
5. Biceps brachii
6. Subscapularis
7. Rhomboids major
8. Rhomboids minor
9. Levator scapulae
10. Trapezius
11. Deltoid
12. Supraspinatus
13. Infraspinatus
14. Teres Minor
15. Teres Major
16. Latissimus Dorsi

As you can see there are a lot of muscles that have an effect on the scapula.

What do these scapular muscles do to the scapula?

Read the rest of this entry »

I have a guest blog post for you today on suspension training and the shoulder.  It is from Zita Alves.

Enjoy the post and make sure to try out some of the exercises.

Take it away Zita…

I love to do bodyweight exercises but there comes a time when you know that something is missing – the pulls.

There are not many people, especially women, who can just hop up onto a bar and bang out a set of pull ups, particularly if they are overweight.

It can be really hard to achieve muscle balance without using any gym equipment/dumbells etc as pulling movements using the lats, rhomboids, trapezius and biceps cannot  always be overloaded enough by gravity alone – they need an external force.

How many people do you see who have internally rotated shoulders and an overdeveloped chest.

Not only from a postural point of view but also from a sports specific standpoint should we be looking at working the back musculature in equal measure. Given where the lats insert, isolated lat exercises or overtrained lat muscles can exacerbate this internal rotation which is why “rowing” movements are so beneficial in order to hit the rhomboids,mid/lower traps, serratus and posterior deltoids.

By using a suspension trainer you are able to do both horizontal and vertical pulling movements to target different muscles and the great thing is that by tiny adjustments in hand, elbow or body position you are able to hit the whole back from every angle.

Be sure to set the scapula, shoulders down away from ears, neck long for every movement.  Here are some great exercises to try include:

REVERSE FLYES

Start

• Arms out in “T” Position in line with shoulders
• Hands facing forward
• Standing almost upright

Movement

• Lean back as arms come forward in front of chest, hands facing each other
• Lift arms back to start position keeping arms slightly bent, leading with top of hand
• Wrists strong, core braced, keep chest up, squeeze shoulder blades down

HIGH/WIDE ROW

Start

• Arms out in-line with shoulder
• Bent elbows , hands face down in-line with elbows
• Lean back slightly

Movement

Lean back more as arms straighten in-front of body, hands facing down chest up, core braced, back straight, wrists strong

LOW ROW

Start

• Arms by side, elbows bent
• Hands facing each other, inline with elbows
• Lean back slightly

Movement

• Lean back more as arms straighten in front of body, hands facing each other, chest up, core braced, back straight
• Pull leading with elbows, keeping shoulder blades down to bring arms and body back to start position
• Pull leading with elbows, keeping shoulder blades down to bring arms and body back to start position

ROTATIONAL SINGLE ARM ROW & SQUAT

Start

• Hold 1 handle only
• Feet hip width apart, slightly in-front of hands
• Bend knees to sit back, bottom towards floor
• Arm straight and rotate body to let other hand touch floor  Hands facing forward

Movement

• Push into legs at same time as pulling handle to bend arm and row body up to standing position, other hand can cross over strap
• Straighten the arm and bend the legs to return to start position

Y OVERHEAD RAISE

Start

• Arms in “Y” position
• Hands facing forward
• Standing almost upright

Movement

• Lean back as arms come forward in front of chest, hands facing each other
• Lift arms back to start position keeping arms slightly bent, leading with top of hand
• Wrists strong, core braced, keep chest up, squeeze shoulder blades down

Once the exerciser has mastered  the basic movements with good form they can work on some great combinations such as the following:

• Low and high row combi
• Low row, reverse flye combi
• High row to Y raise combi

One of my favourite combinations is :-Y raise, high row, low row to bicep curl. Perform 1 rep of each after the other in a continuous movement aiming for approx 5 reps in total, or more reps depending on the foot positioning. The advantage of suspension training is that during a set if form deteriorates the feet can be very slightly moved to make the exercise easier and maintain the time under tension.

One of the coolest ways to use the Ztrainer is for MYOFASCIAL STRETCHES. The body has lines that run through the it and tightness in these lines is very common and can lead to dysfunction. For example one of the lines that I love to stretch for both myself and my clients is the anterior lines that runs from the head down the front of the body through the hips down the legs into the feet. A great way to prepare the body ready for activity is by incorporating the following movements.

Lunge and chest openings

Facing away from the anchor point, holding the handles lightly, arms straight and wide in T position step forward into lunge, tucking pelvis under. Make sure fingers pointing back to add a slight nerve stretch.

Alternate feet and repeat with arms in more of a Y position

Developing this further you can get an even deeper stretch. Step right foot forward into lunge position, tuck pelvis under and lift left arm. Keep right arm down by side and rotate upper body slightly to right to get a great stretch down the left side of the body. There are not many people who won’t feel this one!

Curtsey lunge and lat stretch

Facing the anchor point standing back with arms straight, take 1 leg behind into a curtsey lunge and drop chest to feel the lats stretch.

Side Stretch

Standing sideways to anchor point, grab both handles with arms straight, feet under handles and drop hip slightly to side, eg if anchor point is on left, drop left hip out to side to feel left side of body stretching

Do as many of the above as you feel your body needs.

Zita Alves has been a Personal Trainer for 13 years after a career change in 1998. As a non-exercising, overweight asthmatic she has found her true passion in helping others. In 2009 Zita set up Bath Bootcamp in Somerset, UK which currently runs 15 classes a week. In 2010 she launched the Ztrainer Suspension Fitness Training System which already has customers around the world and is being used by some of the UK’s leading Fitness Professionals.
For more information go to www.ztrainer.co.uk

Thank you so much Zita.

Thank you for reading, until next time.

Rick Kaselj, MS

.

I just got an email from an online training client.

She is testing out my upcoming shoulder pain program.

It is so cool getting emails like this:

Dear Rick,

Thank you for your email. Sorry for not replying to your email earlier. I had a friend in crisis staying at my house, I was helping her all week and she just left on Friday.

Today I have completed the first day of your program ( Sunday 1st May ) and I am very happy with the result.

Both shoulders are getting a bit more movement and I look forward to doing these exercises each day to see how much improvement I can get by next Sunday.

I will be going on my 3 month camping trip around Australia next Tuesday and I will have my computer with me. I might not be able to email you when I am at a remote location. My plan is to report to you at the end of each week, however depends on when I can get a signal to send emails.

Thank you for your help and I look forward to talking to you next week.

All the best,
DF

It is great to get great feedback like this and also to be able to help people around the world.  Plus I love the fact she is doing the exercises where ever she is, even on her camping trip.  Camping in Australia would be fun, I have yet to do that.  Soon enough.

One other thing she said in her email was she was having difficulty with some of the stretches for the shoulder and was wondering what she could do.  I will do another blog post on what you can do if the typical shoulder stretches cause you pain.

Back to today’s post.

This past weekend at the Exercise Rehabilitation of the Lower Body course, a fitness professional asked me about the tricep dip exercise.

She had been giving it to a client and it had been causing her shoulder pain.  She wondered why it would be causing her pain and if she should be doing it.

I cringe when I see someone doing a tricep dip.  It is not a great exercise for the shoulder.  Let me explain why:

Few Thought from Rick on Tricep Dips:

I Used To Do It

This was an exercise that I was taught when I started out doing personal training.

I thought it was good for the triceps but I always did not feel right doing the exercises as I felt a lot of stress in my shoulder.

Now that I have trained a few people and have a better understanding of the biomechanics of the shoulder, I have put this exercise in the museum of exercises.  Right beside ballistic toe touching in leg warmers and spandex.

Rotator Cuff and AC Joint Injuries

Just like leg extensions are not the best exercises for a client with a knee injury, tricep dips are not the best for someone with a rotator cuff or AC joint injury.

Great Way of Sawing Your Rotator Cuff

I know we are all fans of Jillian Michael’s kettlebell technique.

How about Bob:

Can you hear her rotator cuff being sawed?

Way to go Bob!  100 reps!  CrAzY.

Can you image a client who is overweight and needs to lose 50 pounds doing Bob’s challenge?

With every repetition her scapula anterior tilts and digs into her rotator cuff.

I shake my head.

Why would anyone do 100 reps of a small muscle group?

Whatever.

Read the rest of this entry »

Lets talk about trigger points today.

I want to share with you a tool that I use for my trigger points and for self myofascial release (SMR) while I am traveling.

Quick Traveling Tool for Trigger Points

In the video, I am coming to you from Orlando, Florida.

I share with you in the video:

1. A tool that I travel with.
2. Why I am a huge fan of foam rollers.
3. Why a 1 foot foam roller is useless to travel with.
4. Something a foam roller can’t do, but helps.

Sitting on the plane for hours does not help the body out.  So it is nice to land and take a few minutes in the hotel room to relax. I find if I roll out for a minute are two, it makes the stretching more effective.

Take 128 seconds to watch the video on:

==>  Travel Tool for Trigger Points

If you are looking for a trigger point course, make sure to check out the upcoming course on the topic in April.

Muscle Imbalances Revealed Review

Muscle Imbalances Revealed 2.0 has been out for 4 months and the kind words about the program keep coming in.

I just got another great review for MIR2.

“Product Muscle Imbalances Revealed by Rick Kaselj is complete and is an important tool in my repertoire of works in practice. It is easy to use and understand. The various presentations allow us to touch a wide variety of muscle imbalances that may apply to both a general sports population. Its content will be definitely very helpful to me to optimize the training of my clients.”

Xavier Roy
Montreal, Quebec
Performance Specialist

Xavier did a detailed review of the MIR2 resource.  To read the full review from Xavier, click here.

The cool thing was Xavier’s review was all in French.  I am from Western Canada and did learn French in grade school but it has been some time since I have had to use it.  I used an online translator to help me translate things.

Thank you for the kind words, Xavier!

Helping People with Shoulder Pain

As you know, I am very passionate about helping people with their shoulder injuries and pain.  It is great to hear when those with shoulder pain follow my Scapular Stabilization Exercise Program and get the results they are looking for.

“I used Scapular Stabilization Exercise Program on myself and it was very helpful. My right serratus anterior is a lot bigger than my left, probably because I kept training while I had problems with my supraspinatus.  My right scapula used to move really bad, I would feel a tingle around the medial border when I would abduct my arm. I used the program and no more tingling anymore. My right shoulder complex still isnt 100%, but it’s a lot better.”

Thanks again,
Nick Mudaliar

Few Kind Words for the Exercise Rehabilitation Courses

I have a little break from courses but here are a few kind words from a Pilates instructor who attended my Exercise Rehabilitation of the Lower Back and Shoulder.

If you are looking for upcoming courses:

==>  Upcoming Fitness Education Courses

That is it.

If you have any feedback, positive or negative, make sure to send it to me at support(at)exercisesforinjuries.com .

Take care.

Rick Kaselj, MS

Today was the day to dig into what is new in the research world.

To be honest, I started it in yesterday’s blog post.

In yesterday’s blog post I talked about new research in muscle imbalances.

Yes, there is research about it. More and more keeps coming out.

Now to today’s research.

Harrington S, Padua D, Battaglini C, Michener LA, Giuliani C, Myers J, Groff D. (2011). Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants. J Cancer Surviv. 2011 Jan 12. [Epub ahead of print]

I know this is a little new for me, to be talking about breast cancer and exercise.

I have been having more questions about this of late, plus it reminds me of the group of breast cancer survivors that I trained while working in Penticton, BC, Canada.

The ladies were a group from a local Dragon boating team that were all cancer survivors.  It was amazing to train these ladies and they were so much fun.

Here we go into the research.

What They Looked At:

Read the rest of this entry »

Now continuing on with my predictions when it comes to exercise and injury trends we will see in 2011.

PREDICTION 3

Focus on Scapular Muscle

I love the shoulder.

From training thousands of clients and helping thousands of fitness professionals, when it comes to injuries, one of the areas that most people ask for my help in is the shoulder.

A big issue I have been seeing in more clients and fitness professionals has to do with the scapular muscles.

Let me go through an observation.

Common Scapular Issue

I have done a variety of testing for companies.

They have asked me to come in and test to see if their new employees have the physical ability to do their job. I will design, assess, and test the new employees. This is fun work, as it is different than training clients with injuries.

When I test 50 to 60 year olds compared to 20 to 30 year olds, there is a big difference when it comes to their scapular muscles.

The older adult has better activation, strength, and endurance when it comes to their scapular muscles when they are pushing, pulling, carrying, and lifting.

In the younger adult, you see a drastic difference.

Problem with Scapular Muscles Today

Read the rest of this entry »

I have been doing research this week.

A colleague, Brenda Adams, emailed me and asked if I had any reference on what muscle is being used during the bench press.

I know what muscle works, but I did not know if what I knew was right; so I hit the books.

I found the answer but also some information on grip and bench press; plus which is better  – machines or free weights – when it comes to the bench press.

Enjoy!

What Muscles Are Working during Different Bench Presses?

What They Looked at

This experiment investigated the effects of varying bench inclination and hand spacing on the EMG activity of five muscles acting at the shoulder joint.

What They Did

Six male weight trainers performed bench presses under four conditions of trunk inclination and two of hand spacing at 80% of their predetermined maximum.

What They Found

- The sternocostal head of the pectoralis major was more active during the press from a horizontal bench than from a decline bench.

- The clavicular head of the pectoralis major was no more active during the incline bench press than during the horizontal one, but it was less active during the decline bench press.

- The clavicular head of the pectoralis major was more active with a narrow hand spacing.

- Anterior deltoid activity tended to increase as trunk inclination increased.

- The long head of the triceps brachii was more active during the decline and flat bench presses than the other two conditions, and was also more active with a narrow hand spacing.

- Latissimus dorsi exhibited low activity in all conditions.

Where to get more information – Barnett C. (1995). Effects of variations of the bench press exercise on the EMG activity of five shoulder muscles. 1995 Nov;9(4):10-14. (Yes, it is an oldie but a goodie.  Let me know if you have something more recent.)

If the research above interested you, make sure to get my free seminar that I did on exercise and shoulder injuries, you can get it here.

Read the rest of this entry »

I just finished off my review of last weeks journals.  I have chatted about what I do in a previous post.  I talk about it in my 6 Must Read Journals for Exercise and Injuries .

I came across two articles that are great and will be helpful when it comes to neck pain, shoulder pain, scapular stabilization and poor posture.

Lets get to the two articles.

Can Head Posture Affects Neck Pain, Shoulder Pain and Scapular Muscles?

In this research they assessed the effects of forward head posture in a sitting position on the activity of the scapular upward rotators during loaded isometric shoulder flexion in the sagittal plane.

Three Keys I Got Out of This Articles:

#1 – With forward head posture there increase in EMG (muscle activity) activity in the upper trapezius and lower trapezius and a decrease EMG activity in the serratus anterior during loaded isometric shoulder flexion.

#2 – Forward head posture may contribute to neck and shoulder pain during loaded shoulder flexion in sitting.  This can be an issue for all of us.  Poor head posture could be lead to neck pain and shoulder pain when driving, working and being at our computers.

#3 – Neutral head position is advantageous in reducing upper and lower trapezius activity and enhancing serratus anterior activity as compared with forward head posture during loaded shoulder flexion

Read the rest of this entry »

Hey, it is Friday, lets ramble.

Well, let me ramble.

More Rambles about Facebook

It is very cool to get comments like this on my Facebook account:

Read the rest of this entry »

Foundations of Upper Body Conditioning

DESCRIPTION:

OBJECTIVES:

Getting the Most From Scapular Exercises

I want to share with you a story about a client that came to see me looking for help with his shoulder impingement.

Like most of my client, he has seen a lot of different people for his shoulder impingement.  Some of them include doctor, chiropractor, massage therapist, acupuncturist and physical therapist.

He has had minimum success with the above, he saw my blog and thought he would give me a go.  He has tried the rest, why not try me.

I do like the shoulder and the challenge of figuring out what is going wrong when it comes to what is going on in a muscle imbalance perspective.

Within two session, we have got to a point where he can abduct his shoulder to 180 degrees compared to 90 degrees when he first saw me.

I can’t take all the credit, the big thing is he did the scapular exercises I gave him.

Let me share with you why this client had such great results with his shoulder impingement in just two session.

3 Steps to Scapular Exercise Success

Read the rest of this entry »

What is Shoulder Impingement?

As you know, I am really big into scapular exercises and teaching an effective rotator cuff exercise program.

I have another perspective on the shoulder for you.  It is a guest blog post from Tara Keller.  It is the third part of her series.  Enjoy!

Addressing Shoulder Dysfunction Beyond the Shoulder Itself

By Tara Keller, BSc.(KIN), MES

Part III: The Silent Triggers

Leading into this final segment of this article we have discussed the kinetic chain response and how cueing can play an integral role in the retraining of functional movement. This week we are looking beyond the shoulder to the silent triggers of shoulder dysfunction.

Read the rest of this entry »

What’s My Cue? (Part 2)

The lats pulldown is a great exercise for the scapular muscles.

It is also important in working shoulder adduction and abduction plus working the latissimus dorsi and rhomboids muscles.

There are a couple of key things to remember when performing the lats pulldown machine in order for it to work your scapular muscle better.

Don’t Move Your Shoulder Blades Down and Together at the Start

Read the rest of this entry »