Category Archives: Physio/injuries

Six things I’ve learnt rehabilitating my injured shoulders


1. It will take three times as long as any of the doctors tell you.

2. No matter what the issue you start with you will pick up other problems along the way.

3. You might might have to accept less range of motion.

4. Soft tissue work is very important.

5. Stretching is very important, but take it slowly. Little and often. On a pain scale of 1-10. Never let a stretch hurt more than a 4. If you do your tendons will become inflamed again and just put you back.

6. Find out where yo are weak and build up slowly. Start with light weights (or no weights) reps of 15-20 then gradually build up to higher weight/lower reps. There will be some pain, but again on a scale of 1-10 no more than a 4.

7. Don’t give up.

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A Kinetic Chain Approach for Shoulder Rehabilitation


John McMullen, MS, ATC* and Timothy L. Uhl, PhD, ATC, PT
Lexington Sports Medicine Center, Lexington, KY
University of Kentucky, Lexington, KY

Abstract
Objective:

To introduce an approach to shoulder rehabilitation that integrates the kinetic chain throughout the rehabilitation program while providing the theoretical rationale for this program.

Background:

The focus of a typical rehabilitation program is to identify and treat the involved structures. However, in activities of sport and daily life, the body does not operate in isolated segments but rather works as a dynamic unit. Recently, rehabilitation programs have emphasized closed kinetic chain exercises, core-stabilization exercises, and functional programs. These components are implemented as distinct entities and are used toward the end of the rehabilitation program.

Description:

Kinetic chain shoulder rehabilitation incorporates the kinetic link biomechanical model and proximal-to-distal motor-activation patterns with proprioceptive neuromuscular facilitation and closed kinetic chain exercise techniques. This approach focuses on movement patterns rather than isolated muscle exercises. Patterns sequentially use the leg, trunk, and scapular musculature to activate weakened shoulder musculature, gain active range of motion, and increase strength. The paradigm of kinetic chain shoulder rehabilitation suggests that functional movement patterns and closed kinetic chain exercises should be incorporated throughout the rehabilitation process.



Arthroscopic Posterior Capsule Release


Operation number three on the left shoulder took place last Saturday. And the results are so far good with an increase in the range of motion.

The op was necessary because  now (nine months after the first operation) progress and finally ground to a halt, with range of motion limited because of Posterior Capsular Contracture. This paper by H. Gregory Bach, MD and Benjamin A. Goldberg, MD is a very good and through explanation of the procedure.


Warm up exercises prior to lifting


As mentioned in one of my previous posts a common problem faced after shoulder surgery is that the muscles no longer coordinate properly. Activation exercises can help with this.  These exercises can be done to a) help re-engage the muscles and then latter on b) as a good warm up prior to more heavy lifting involving the shoulders.


Nutrition – the last 7 days


As you can see, this is showing that I have under eaten by approx. 1,409 calories over the past 7 days. This has to be viewed with a fair amount of scepticism. Now that my shoulders are improving week on week, I have been pushing up the poundage on my weight training with a view to adding some muscle. To this end I had initially increased the calories to give me a surplus of around 3,000 – 5,000 per week. Thinking this would allow me to add 1 – 2 pounds of muscle each week. The trouble was although I was adding muscle, I was worried I was also adding too much fat, so I scaled this back.

I’ve been working towards adding some muscle bulk now for around 6 weeks and so far have added approx 9 lb of muscles and 1 lb of fat. Which I am very happy with. The trouble is that I know that this is technically not possible to do this while under eating so what’s going on? Continue reading


Shoulder porn



Shoulder rehab exercises


This is pretty much what my current shoulder rehab programme looks like.

Takes me about 45 mins. At the moment very light weights, 10 – 20 reps x 3 sets per exercise. I am hopping to build up to 3 x 8 reps with a progressively more weight over the next six weeks. At which time I’ll reduce the workouts from three times a week to twice a week to allow more recovery time to compensate for the extra load.