Updated November 2017
If this is the first time you’ve read been reading this article series I recommend going back to part 1 and starting there. A lot of the topics build on top of each other. I don’t want anyone to be confused if they start here!
As discussed in part 1 of the series, acromion type is associated with excessive shoulder impingement and rotator cuff tears (1,2). This is a boney structural problem. Unfortunately this can’t be changed without surgery. (Also keep in mind that many people actually have rotator cuff tears and are asymptomatic)
However, we do have a great deal of control over the amount of impingement we have at the shoulder. The elements we have control over are called functional causes of impingement. We’ve systematically broken down each of these elements in prior articles. In the upcoming articles we’ll address specifics treatment ideas for these issues.
Remember: Always consult a qualified medical professional before you begin any type of exercise program ipod musik kostenlosen. Getting a professional to do a thorough evaluation of your shoulder and creating a program specific to your needs will always be the best option.
Before we start addressing these aspects of rehabilitation we need to address where you are with your injury. Everyone is an individual and should be treated according to their specific needs. This means that certain individuals may need more of some treatment and less of another. It also means we’ll have to figure out how bad the injury is and where you are along your journey of healing.
If we jump into the wrong phase of rehabilitation we’ll be setting ourselves up for failure.
Shoulder impingement is a vicious cycle. Exercise is the cure but also the culprit. If we add too much exercise or the wrong exercises at the start of a rehabilitation program it creates more impingement and can make your shoulder worse. Our goal is to start adding exercises slowly and progressively while carefully monitoring for symptoms over time.
I realize that most meatheads and fitness buffs out there (myself included) have a really difficult time cutting back on their current activities. Getting your shoulder better will absolutely require us to scale back on our program with the removal of offending activities and exercises amazon music herunterladen stoppen.
Common offenders (ooh, it hurts to hear this):
“You may take my pride but you’ll never take my bench presss!!”
The ideas is to set yourself up for healing. We need to take out the offensive exercises in order to do this. On top of that we also have to be careful with our rehab exercises. Just because they are therapy exercises doesn’t mean we can go willy-nilly with them.
I had a professor that used to say that prescribing physical therapy exercises is like making soup. If you add too much spice to the soup all at once, you ruin the soup. Ideally you want to add a small bit of spice at a time and taste it frequently.
The same goes for shoulder exercises. Too much exercise increases pain and impingement, worsening your condition easy soft herunterladen. In the beginning keep in mind that less is more. Enough exercise and we progress forward, too much we go back. We’re trying to make delicious soup, not a rotator cuff tear.
It’s vital to have patience. You won’t be able to rush your body. It’s going to heal on its own terms.
Food for thought: If you’ve been having shoulder impingement for some time now (especially if you’re an older individual) you might have some tendon degeneration or what we like to call in the medical world a tendinopathy. This is a condition where the tendon becomes enlarged, weakened and more likely to tear. This takes a significant period of time to fix and up to 4-6 months to really start feeling better (5).
Now that we’ve got that underway, let’s get down to business. The next step is to classify what phase of rehabilitation we’re in at the moment. An excellent resource is the chapter on non-operative treatment of shoulder impingement in the text, “The Athlete’s Shoulder.” Keirns and Whitman have outlined clear cut phases of rehab for subacromial impingement to help guide us through the rehab process (4) how to download itunes.
Note: The authors concluded that approximately 70% of people will fit the categories of the upcoming phases. 15% of patients will need to be progressed faster, and 15% slowed down (4). Don’t rush this process, no matter how tempted you might be.
1. Phase I – Acute Inflammatory Phase (4) – How do we know if this is the phase we’re in?
What is the purpose of this phase?
What do we need to do in this Phase hörbücher kinder herunterladen?
How long will I be in this phase? You can progress to stage II when you:
Food for thought: Cortisone shots are commonly used in patients with subacromial impingement syndrome. Although effective for reducing inflammation and subsequently pain, these injections can produce tendon atrophy and decrease the ability of the tendon to heal itself (The opposite of what we want). Also, several control studies have shown minimal effectiveness of cortisone injections to the shoulder in the absense of therapy (4). On top of that the use of NSAIDs such as ibu profen have been shown to slow the tissue healing process of a tendon (3).
2. Phase II – Subacute Stage (4):
What is the purpose of this phase 194 länder mp3 download kostenlos?
What do we need to do in this phase?
How long will I be in this phase? You can progress to stage III when you:
Food for thought: Impingement leads to tendinopathy of the rotator cuff tendons. When rehabbing a shoulder we’ll have to think about not only decreasing impingement but treating a pathological (diseased) tissue. In a healthy tendon the collagen fibers that make up the tissue run parallel to each other and line up in an efficient position to help transmit force. In tendinopathy the fibers don’t line up properly and do not transmit forces normally. A pathological tendon is more likely to tear. Also keep in mind that a resolution of pain does not equate to a completely healed tendon (3,4).
3 klassische klingeltöne kostenlos downloaden. Phase 3 – Progressive Exercise Stage (4): Finally the good stuff!
What is the purpose of this phase?
What do we need to do in this phase?
Here are some of my favorite closed chain exercise progressions to help return to exercises like pushups, pull-ups and handstand work
Here are some of my favorite open chain exercise progressions to progress back to dumbbell and barbell work like push press, push jerk and split jerk herunterladen.
How long will I be in this phase? You can progress to stage IV (Return to Activity) when you have:
4. Phase IV – Return to sport or activity (4): Get back at it!
Just a few things covered in the course…
Dan Pope DPT, OCS, CSCS
The Ultimate Guide to Squat Mobility
4 Reasons Why You Can’t Do Kipping Pull-ups and Muscle-ups
The Best Mobility Exercises for the Front Rack
The Complete Guide to Patellar Tendinopathy
The Complete Guide to Patellofemoral Pain Syndrome
The Best Exercises To Get Out of Shoulder Pain and Back to Training
5 Pro Tips For Reducing Shoulder Pain During Bench Press
The Ultimate Guide to Getting Out of Shoulder Pain and Back to Bench Press, Overhead Press and Olympic Lifts