Filed Under (Scapular Stabilization, Shoulder Injury) by Rick Kaselj on 24-06-2009
2 Exercises to Avoid If Your Client Has Chronic Shoulder Subluxations
This is the last part of the exercise considerations for a client with chronic shoulder subluxations.
In the first part, I talked about three things that you need to consider before giving your client any exercises if they have chronic shoulder subluxations
==> CLICK HERE to view part 1 on shoulder subluxation exercises
In the second part, I talked about three exercises that your client should do if they have chronic shoulder subluxations
==> CLICK HERE to view part 2 on shoulder subluxation exercises
Enjoy the video and please do a leave a comment below on any tips you have for working with a client with shoulder subluxations or exercises that you recommend.
==> CLICK HERE for the Two Exercises to Avoid If Your Client Has Chronic Shoulder Subluxations
P.S. – If you are a fitness professionals and are looking for a great understanding of shoulder injuries, increased confidence working shoulder injuries and exercises for shoulder injuries, I would recommend attending the Exercise Rehabilitation of the Shoulder Course.
==> CLICK HERE for the full outline for the Exercise Rehabilitation of the Shoulder Course
Rick Kaselj of Exercises For Injuries
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Hey Rick,
I’m a bit confused. Yesterday you promote rowing activities for someone with chronic shoulder subluxations, and today you say not to do anything that involves a rowing type movement. So, which one is it?
Gord
[Reply]
Gord,
Excellent questions.
In the other video, I did recommend rowing movements for a clients with chronic shoulder subluxations.
When it comes to rowing movements, I would be cautious of the set up, starting position and technique of the exercises. I would get my client to use a rowing exercise machine but I would not have them set up at a starting position where they are reaching forward to maximum, I would not have them at a starting position where they are reaching forward to maximum and would not get them to enter a maximum forward reaching position during the exercises. This maximum forward reaching position provides traction in the anterior direction which could promote a chronic anterior shoulder subluxation.
I would have them in a position where they are sitting upright and start at a position of arms straight. This is more of a natural movement and allows for better activation of the scapular stabilizers plus control of exercise.
I hope this clarifies things.
Thank you for the question and comment.
Rick Kaselj
http://www.ExercisesForInjuries.com
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[Reply]
Hi Rick and yes we often see anterior subluxations but there may be an inferior component. The 90/90 position you mention is more along the lines of an “apprehension sign”. If this is a cilent with two or more subluxations (recurrent), the need to block or eliminate extreme aspects of the apprehension ROM is vital. Three key exercises for this client are 1) the seated push-up to engage all the muscles of the shoulder to promote stability; the second exercise involves activities to strengthen the rotator cuff and 3) limited ROM activities to strengthen the pect. The pect will act as the dynamic stabilizer since the gleno-humeral ligaments were damaged with the subluxation. This is true especially with recurrent subluxations. The pect will act as a buttress to prevent the humeral head from translating anteriorly. But we must be cautious to avoid moving the humerus too far into the apprehension sign ROM.
But I think there is a missing point here. Is this a post rehab client or an acute subluxation? If this client has limited ROM and significant pain, we need to allow the healing to occur. In the acute stage, we can engage the shoulder musculature with the seated push-up to the client’s tolerance. For the post rehab professional there must be a clear set of post rehab criteria to ensure the client is appropriate for entry into a post rehab program. Some clients may be too acute for post rehab. These clients may need further medical attention. With no clear cut criteria, there is possibility of exacerbation of the condition. I would certainly appreciate any feedback from other physiotherapists.
[Reply]
Rick Kaselj Reply:
August 17th, 2009 at 8:37 am
Thanks Dr. Jones,
I go through post rehab exercises in greater detail in Exercise Rehabilitation of the Shoulder and Core Stability of the Shoulder courses.
Great comment on the acute and post rehab client.
Rick Kaselj
http://www.ExercisesForInjuries.com
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[Reply]
I have had some shoulder issues myself and therefore the information here is very helpful to me. Thank you.
[Reply]