Comments on: 3 Keys to Remember when Training a Client with Chronic Shoulder Subluxations http://exercisesforinjuries.com/shoulder-subluxation-rehabilitation/ Rick Kaselj specializes in helping clients use exercise to overcome their injuries. Rick shares his knowledge and experience with other fitness professionals across North America through live courses, webinars and books. This podcast is made up of audio clips featuring some tips and information for fitness professionals on the topic of exercises and injuries. To learn more about Rick Kaselj you can exercise and injury blog at ExercisesForInjuries.com . Sat, 04 Feb 2012 02:25:38 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Rick Kaselj http://exercisesforinjuries.com/shoulder-subluxation-rehabilitation/comment-page-1/#comment-254 Rick Kaselj Mon, 17 Aug 2009 16:15:04 +0000 http://exercisesforinjuries.com/?p=581#comment-254 Dr. Jones, Excellent information, thank you very much for adding so much to the post. Rick Kaselj www.ExercisesForInjuries.com .<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('254','Rick Kaselj'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('254','Rick Kaselj','Dr. Jones,\n\nExcellent information, thank you very much for adding so much to the post.\n\nRick Kaselj\nwww.ExercisesForInjuries.com\n.'); return false;">Quote</a></div> Dr. Jones,

Excellent information, thank you very much for adding so much to the post.

Rick Kaselj
http://www.ExercisesForInjuries.com
.

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]]> By: Michael K. Jones, PhD, PT http://exercisesforinjuries.com/shoulder-subluxation-rehabilitation/comment-page-1/#comment-252 Michael K. Jones, PhD, PT Mon, 17 Aug 2009 15:49:09 +0000 http://exercisesforinjuries.com/?p=581#comment-252 Yes, a posterior subluxation is medically documented but so seldom do they occur that the management is limited for the non-surgical candidate. I would imagine in this scenario the client is deemed non-surgical for medical reasons and not due to complications with the shoulder. If the shoulder complications are the primary reason for the removal of the surgical option, I would bet the client has significant humeral head involvement or has such poor connective tissue the surgeon feels the outcome has less than a 50% chance of success. For the non-surgical client, work on strengthening of the posterior shoulder girdle but the emphasis is on stability and eccentric work. You will find a common area of instability is the seam between the infraspinatus and the teres group. Try to use any form of manual stimulation such as tapping, light touch or muscle activation to recruit these muscles. In many instances we think strengthening rather than increased muscle fiber recruitment with instability. In this situation, increase recruitment first, second increase stablity and the third component, strength comes along well. Rhythmic stabilization, eccentric scapula protraction and retraction as well as serratus activities will help in this scenario. My final questions with this client are 1) how did the injury occur and 2) what are the complications that are eliminating surgical management as an option. You have a lifetime of stabilization to keep this client functional.<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('252','Michael K. Jones, PhD, PT'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('252','Michael K. Jones, PhD, PT','Yes, a posterior subluxation is medically documented but so seldom do they occur that the management is limited for the non-surgical candidate. I would imagine in this scenario the client is deemed non-surgical for medical reasons and not due to complications with the shoulder. If the shoulder complications are the primary reason for the removal of the surgical option, I would bet the client has significant humeral head involvement or has such poor connective tissue the surgeon feels the outcome has less than a 50% chance of success. For the non-surgical client, work on strengthening of the posterior shoulder girdle but the emphasis is on stability and eccentric work. You will find a common area of instability is the seam between the infraspinatus and the teres group. Try to use any form of manual stimulation such as tapping, light touch or muscle activation to recruit these muscles. In many instances we think strengthening rather than increased muscle fiber recruitment with instability. In this situation, increase recruitment first, second increase stablity and the third component, strength comes along well. Rhythmic stabilization, eccentric scapula protraction and retraction as well as serratus activities will help in this scenario. \r\n\r\nMy final questions with this client are 1) how did the injury occur and 2) what are the complications that are eliminating surgical management as an option. You have a lifetime of stabilization to keep this client functional.'); return false;">Quote</a></div> Yes, a posterior subluxation is medically documented but so seldom do they occur that the management is limited for the non-surgical candidate. I would imagine in this scenario the client is deemed non-surgical for medical reasons and not due to complications with the shoulder. If the shoulder complications are the primary reason for the removal of the surgical option, I would bet the client has significant humeral head involvement or has such poor connective tissue the surgeon feels the outcome has less than a 50% chance of success. For the non-surgical client, work on strengthening of the posterior shoulder girdle but the emphasis is on stability and eccentric work. You will find a common area of instability is the seam between the infraspinatus and the teres group. Try to use any form of manual stimulation such as tapping, light touch or muscle activation to recruit these muscles. In many instances we think strengthening rather than increased muscle fiber recruitment with instability. In this situation, increase recruitment first, second increase stablity and the third component, strength comes along well. Rhythmic stabilization, eccentric scapula protraction and retraction as well as serratus activities will help in this scenario.

My final questions with this client are 1) how did the injury occur and 2) what are the complications that are eliminating surgical management as an option. You have a lifetime of stabilization to keep this client functional.

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]]> By: Rick Kaselj http://exercisesforinjuries.com/shoulder-subluxation-rehabilitation/comment-page-1/#comment-250 Rick Kaselj Mon, 17 Aug 2009 15:34:40 +0000 http://exercisesforinjuries.com/?p=581#comment-250 Dr. Jones, What do you do with a client that has instability in the posterior direction in the shoulder. (They have been medically investigated, they are not a surgical candidate and have been cleared to begin an exercise program.). Rick Kaselj www.ExercisesForInjuries.com .<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('250','Rick Kaselj'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('250','Rick Kaselj','Dr. Jones, \n\nWhat do you do with a client that has instability in the posterior direction in the shoulder. (They have been medically investigated, they are not a surgical candidate and have been cleared to begin an exercise program.).\n\nRick Kaselj\nwww.ExercisesForInjuries.com\n.'); return false;">Quote</a></div> Dr. Jones,

What do you do with a client that has instability in the posterior direction in the shoulder. (They have been medically investigated, they are not a surgical candidate and have been cleared to begin an exercise program.).

Rick Kaselj
http://www.ExercisesForInjuries.com
.

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]]> By: Michael K. Jones, PhD, PT http://exercisesforinjuries.com/shoulder-subluxation-rehabilitation/comment-page-1/#comment-245 Michael K. Jones, PhD, PT Fri, 14 Aug 2009 04:43:57 +0000 http://exercisesforinjuries.com/?p=581#comment-245 Posterior instability. If you got posterior instabilty you got more than an issue with a subluxation. This client might need surgery. Posterior instability is usually associated with a boney anomaly of the scapula and/or a ruptured capsule. You arent going to manage a posterior instability with exercise. In 24 years of practice I have seen 3 of these and all three needed surgery.<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('245','Michael K. Jones, PhD, PT'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('245','Michael K. Jones, PhD, PT','Posterior instability. If you got posterior instabilty you got more than an issue with a subluxation. This client might need surgery. Posterior instability is usually associated with a boney anomaly of the scapula and\/or a ruptured capsule. You arent going to manage a posterior instability with exercise. In 24 years of practice I have seen 3 of these and all three needed surgery.'); return false;">Quote</a></div> Posterior instability. If you got posterior instabilty you got more than an issue with a subluxation. This client might need surgery. Posterior instability is usually associated with a boney anomaly of the scapula and/or a ruptured capsule. You arent going to manage a posterior instability with exercise. In 24 years of practice I have seen 3 of these and all three needed surgery.
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