Watch these new videos from Joint Mechanix, (see right), inventors and makers of the the Rotater. Demonstrated by Eric Beard, a very experienced physical therapist and trainer, these newly issued videos thoroughly explain the background to rotator cuff prehab and rehab, how to set up the Rotater and how to make the most from this unique device.
There is an old saying that suggests that there are many ways to skin a cat. Just so, and there are also many ways to stretch and rehab any joint, including the shoulder.
I sometimes feel that there is a gap in the way that we as therapists and trainers handle the recovery and rehabilitation phase of shoulder injury; that the categories are sub-divided too starkly into black and white, passive and active, low-stress mobilising and strength building. It seems to me that we should more often look at what the individual needs and build in an intermediate phase, where act as guide but let the injured individual be inventive and therefore participatory in their own recovery. They improve faster as a result. Encourage them to clean windows, polish floors, bounce balls against a wall – all low, (or at least controllable), effort activities that help to distract from the discomfort but also gives a sense of achievement.
This is not revolutionary thinking by any means as business management techniques are always telling us that if the employee ‘buys in’, then productivity and contentment rise! Why should patients and sports people be any different?
Each individual is just that, individual, and has different physical structure, varying levels of physical activity, abilities, age, expectations and needs. It seems intuitive, therefore, that while those who are professionals endeavour to tailor recovery regimes, that they should, in part at least, be led by the recipient.
I am a great fan of The Rotater and, increasingly, of Kettlebell workouts, but they have very different ‘points of entry’ in the timeline of recovery – the Rotater can be used fairly early in the recovery phase – gently at first, ramping up the intensity as pain reduces and range of motion increases and until it becomes an integral part of any workout, prehab or sporting event. Kettlebell is fantastic as a total body workout that is low impact and wonderful as shoulder mobiliser, BUT is only appropriate rather further down the recovery road!
The following video tries to outline a fairly ‘loose’ approach to mobilising the shoulder – be inventive, work within your means to start with, gradually increasing range and intensity, trust your therapist or trainer, but trust yourself as well.
As with all advice on medical conditions, check with your doctor, osteopath, physiotherapist, chiropractor or trainer before embarking on any new regime.
What is a dislocation? Everyone knows, right? A true dislocation of a joint requires the complete separation of the two sides of a joint. What is often called a dislocation is actually a sub-luxation, or partial separation – they still hurt and do damage, but tend to recover faster.
This is an example of a shoulder dislocation. It is of a rare type, inferior, (or downwards into the armpit), and is caused by hyperabduction and makes up only 1% to 2% of all dislocations. This is a Luxatio erecta type.
So, if it is so rare, why does it matter? Well, it is rare overall, but is relatively common in sporting people who fall! Mountain biking, moto-X, soccer goalkeeping, equestrian sports and skateboarding.
If YOU end up in the emergency room with your arm stuck above your head, the chances are that they will not have seen it. The key to relocating this joint is to dislocate it again first…..FORWARD, creating an ANTERIOR dislocation, then a more normal reduction to its proper position.
As well as the usual problems associated with dislocations, (AC joint, nerve and blood vessel damage), the inferior type causes damage to the floor of the armpit and can lead to concurrent fractures of the upper arm, AC joint, as well as injury to the nerves, (brachial plexus), or specifically to the axillary artery.
Recovery can be slow, even with conventional physical therapies, medication and exercises. You will probably have to start with PASSIVE movements, such as pendulum swinging which you can see if you run the video. Remember that passive means just that – let someone else make the movements for you, (physio,osteopath), or use the weight of a tin of beans or can of coke and your body movements to generate the impetus.
Repeat these exercises several times a day and at every opportunity. If you don’t use the range of motion, you may well lose it! Repeat each direction on movement about 30 to 40 times. ie, 30-40 clockwise, anticlockwise, front-to-back, etc.
Good luck with your rehab and make use of all the tools available to you; information, professional advice, devices like the Rotater and, most of all, use your imagination.
© 2010 ShoulderCentric · Proudly powered by WordPress & Green Park 2 by Cordobo.
Valid XHTML 1.0 Transitional | Valid CSS 3
MIDDLE AGE: TRAINERS & TRAINEES
July 23rd, 2010I am 52 years old. Recently, I have asked myself, what do I want from exercise? My history of sport, physical exerci
se, competition, health and health needs are probably quite typical!
Tall and strong at a young age, I was good at contact sports, particularly rugby and field athletics – running at someone, throwing anything and jumping were all fun for me. It was all about strength, condition and being bullet proof.
Dislocated left shoulder – shrug it off! Torn right knee cartilage – move on! Concussion – shake your head and get back up again.
Then, work and career started to get in the way. I married. We started a family. Professional training. Change of career. More qualifications. Walking with the kids and dog don’t really count, do they? Sport and exercise got put aside.
Twenty years pass. Sporadic attempts at gym, squash, circuits, and the rest. The kids grow up. Then, “40 years old” arrives and passes. Time to get rid of the growing belly. Back to the gym in earnest.
Boring, boring, boring! Too many ‘beautiful people’ who put me off and seemed so judgemental at my lack of focus and progress. Looking back, the problem was me not knowing what I wanted.
Next? A chance conversation and I was introduced to mountain biking. Now, this presses the right buttons! Wonderful and refreshing in its freedom and variability. Expensive, mind you! Great for aerobic fitness, balance and stamina – but ultimately, you get fit for what you are doing.
The activity doesn’t matter; tennis, running, rugby, and the rest – all wonderful but something was missing – I could bike a steep hill with the best and the rest, but couldn’t run up the street without puffing. The fitness was too specific, too focused.
It took another injury, severe this time, to make, no, force me to think about what I was doing. In my case, I came across kettlebell and body weight training and this works for me, physically and, more importantly, mentally. I enjoyed it and continue to enjoy it. Total body workout, flexible, aerobic and balanced. You can go heavy or light, hard or gentle.
Frankly,what works for me doesn’t matter – at my age so many people are searching for a specific or magical regime or principle that they can work to, a set of rules that they can follow. Well, let me spell it out – THERE IS NO SUCH THING! Human beings are just too variable, we all have the baggage of our particular genetics, history, fears and wants.
This means that even when we exercise in a group, there is a huge range of variability and you have a responsibility to look at what is both good and safe for you to engage in. If this wasn’t true we wouldn’t have specialist participants, (who ‘play to their strength’), in every team sport that I can think of! Why, then do we imagine that synchronised mass step aerobics, for example, is suiting everyone and yet you don’t see anyone doing their own thing. Peer pressure – think for yourselves!
Most, if not all of this more mature age group, carry injuries. Most will have arthritic changes. The fast, twitch muscle fibres are fast disappearing. Recovery times are longer even just after each training session, let alone injuries!
Then, if that is not enough, even those who manage to get to a class, (of whatever type), are so often greeted by these lovely specimens of male and female beauty and physical perfection!
It’s enough to make you run a mile.
BUT DON’T, please don’t. Don’t blame the trainers for your lack of success in class or even for putting you off from taking up a class.
As an Osteopath, I mostly deal with illness and the effects of injury. Personal Trainers deal with wellness and do their best to avoid injury during training. This is an important distinction, especially as we age and I believe we should keep this in mind when we are choosing our direction.
What I think we should do is to ask, “WHERE ARE ALL THE MIDDLE AGED TRAINERS?” Why aren’t trainers staying in the business into their middle years? Why aren’t people of my age taking up training as physical trainers?
Plenty are training as therapists. Why? Perhaps because there are so many people who need treatment and therapy! Why not try and prevent rather than treat?
Let’s face it, these skilled but youthful trainers are wonderful. I have absolutely no criticism other than one that they simply cannot help, and that is their lack of experience in FEELING what I feel.
Most are sympathetic to the middle aged groaning, but aren’t generally empathetic. How can they be?
So, where do trainers go when they get to 35? Why does there seem to be a gap until the emergence of the 65 year old yoga teacher who leads sit-down, ‘aerobics’ in a Care Home?
OK, so I’m going over the top a bit, but I believe that most 40-60 year olds will recognise what I am saying. I try, in my professional life, to encourage exercise, movements, stretching and flexibility to my clients.
Within reason, clinically speaking, I don’t care what they do – If you hate swimming, don’t do it – very good for you but you won’t keep it up. Find your level, use advisors of course, but do what you are going to continue.
Squats or lunges while brushing your teeth. Sumo squats when you stand at the sink. Pull up your pelvic floor and lower abs when weeding the flower bed. Whatever works. Now, this chimes with me with the philosophy that Rannoch Donald is espousing with the 100 Rep Challenge. I strongly recommend you take a little of your valuable time and look at the site and Face Book page and you will see loads of examples of 100 rep sequences. Sure, the macho, the hardened, ‘no pain, no gainers’, the fab abs lot and many more are represented. But you will also find something for you. It’s not how hard you are or even how hard you do it, but that you do it.
Whatever it is!
Find something that fits your life, health state, age and desires. Your motivation doesn’t really matter to anyone other than you, better health, flatter belly, serenity, a better sex life – No one else’s business, but your own – my advice, if anyone cares, is to get your starting premise right and then design your own regime.
Rannoch Donald, Jonathan Lewis, Christian Vila, Steve Cotter, Mark Stroud and many others have great ideas about fitness and can give you a fantastic programme, but, (and I think they would all agree), they will all tell you to be clear about your objectives, don’t just follow the latest trends – think about how their method and advice will fit for you and your lifestyle.
So, what do I want from my exercise regime? None of your business. You have to work out what suits you and do what it takes to achieve it, (with a bit of professional help and guidance, of course).
Good luck.
SHOULDER EXERCISE – MOBILIZATION USING FIT BALL
References;
Wikipedia defines the general population that use personal/physical trainers “as an age range of 18 to about 50 (45 and younger for males, 55 and younger for females)”. One internet thread I found asked, ‘what is the average age of trainers?’ and was full of well intentioned individuals with great mission statements, but not one of them was over 31!
There are a few certification courses for older trainers and for those training older individuals, but they seem mainly to be in the US.
Interesting article on STRENGTH TRAINING FOR THE OVER FIFTIES
2 comments »
Posted in Fitness, General Comments, Golf Related, Personal Training, Rotater Cuff Injuries, dislocation