Slap Lesion Physical Therapy Treatment Before and After Surgery

SLAP is short for Superior Labrum from Anterior to Posterior, or from front to back. The labrum is the rim of cartilage found in the shoulder socket. An injury or tear to this part of the body is a SLAP lesion, which typically results from overuse, trauma and accidents such as falling onto your outstretched hand.

What are the symptoms of a SLAP lesion?

A person with a SLAP lesion or injury has shoulder pain, which becomes worse with throwing activities or when reaching overhead. The person may also experience some pain and soreness in the shoulder front when bending the elbow or turning the wrist. The person?s shoulder may also click or snap with movement and may feel like being dislocated. Diagnosis of this injury involves a physical examination of the shoulder and a contrast MRI scan.

What are the treatments for SLAP lesion?

Most cases of SLAP injuries respond well to non-invasive or non-surgical treatment so this would be the first option for any patient. After your injury, your doctor would first recommend some rest to help ease symptoms. Your doctor may also prescribe medication to alleviate inflammation and pain.

Next, you will have to undergo a SLAP lesion physical therapy, which mostly involves stretching and muscle strengthening exercises targeting the muscles around the rotator cuff and scapula. It is also important at this point to limit or make adjustments in the activity that caused the injury, which could be a sport or work-related activity.

Cold therapy is also a part of SLAP lesion physical therapy. Therapists make use of ice packs or ice massage to reduce pain and swelling by applying these agents four to six times in an hour for three hours. Therapists may also apply ice if pain or any other symptoms worsen after an activity.

Certain patients, especially athletes, who play sports or do activities that involve a lot of throwing may continue to experience pain despite undergoing proper SLAP lesion physical therapy program. When symptoms do not go away after 6 weeks of conservative treatment or SLAP lesion physical therapy, your doctor will then recommend surgery to treat your shoulder. In surgery, the doctor may remove torn cartilages or attach them back in place.

After surgery, you will need complete bed rest and you must avoid activities involving the treated area. After a period of rest, your doctor may then recommend SLAP lesion physical therapy to help you restore your shoulder?s strength and full range of motion.

Milos Pesic is a successful webmaster and owner of popular and comprehensive Physical Therapy information site. For more articles and resources on Physical Therapy related topics, Physical Therapy exercises and much more visit his site at:

=>http://physical-therapy.need-to-know.net/

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Save Your Shoulders With This Exercise

A lot of clients need to prioritize exercises for their upper back muscles. Because so many of us sit at a desk and computer all day, our posture becomes compromised. One of the key weight exercises to reduce shoulder problems that train the upper back is the Wide-grip Seated Row. This exercise trains the posterior deltoids, the rhomboids, and the lats, while putting relatively little stress on the shoulder joint.

When you do the exercise, make sure to keep your shoulders down so that you don't strengthen the already overstressed upper-traps. How do you know if you have stressed upper-traps? Stand up, and take a look in the mirror. Do you look like you are permanently shrugging your shoulders? If so, you need to work on your posture (both seated and standing). I encourage practicing perfect posture at every opportunity (whenever you can remind yourself - such as sitting at a desk, standing in line, driving, etc.).

In general, the wide-grip seated row strengthens a lot of otherwise neglected muscles, including the muscles of the rotator cuff. Because so many self-prescribed training programs focus on the front of the body (i.e. upper body pressing muscles), many people are weak in upper body pulling muscles. If this is your case, it will probably help to reduce the amount of pressing and increase the amount of rowing.

When I had an irritated teres minor muscle (a small muscle in the rotator cuff), I dropped all pressing for one month and focused on wide-grip seated rows, underhand grip seated rows, band pulls, and similar exercises to train the upper back and posterior deltoids. I have been problem free ever since. Of course, if you have any injuries, make sure to talk to your doctor and get the proper referral to a health care professional.

Craig Ballantyne is a Certified Strength & Conditioning Specialist and writes for Men's Health, Men's Fitness, Maximum Fitness, Muscle and Fitness Hers, and Oxygen magazines. His trademarked Turbulence Training fat loss workouts have been featured multiple times in Men?s Fitness and Maximum Fitness magazines, and have helped thousands of men and women around the world lose fat, gain muscle, and get lean in less than 45 minutes three times per week. For more information on the Turbulence Training workouts that will help you burn fat without long, slow cardio sessions or fancy equipment, visit www.TurbulenceTraining.com

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Fitness Tips That Can Help Your Golf Game

If you're really looking for more consistancy in your golf swing then stretching exercises that are "golf specific" will help your shoulders a lot! These types of fitness stretch exercises are designed to specifically help your back and rotator cuff area.

By stretching these muscle groups on a regular basis you can make big strides in improving your swing.Some of the most common injuries to golfer's occur because of a lack of flexibility in their back. This usually affects the area of the rotator cuff. Injury prevention is another reason why it's so important for you to start some type of golf specific exercise routine right away, if you don't already have one.

Have you ever stood in front of a full length mirror and watched yourself going through your swing motion? It may sound a bit silly, but by going through the motion slowly you can actually feel the muscles that you use while performing this movement. When you get to the top of your rotation try going just a bit further and holding it for ten seconds. Don't hurt yourself or bounce, but hold it just enough to feel a slight discomfort.

Once you've done this on one side, switch sides and do it again. Do both sides twice the same way. You should notice that it's a little bit easier the second time. You should also be able to go a little bit further now that you've warmed up your muscles a bit.

Next, try stretching directly overhead. Get all the way up on the tips of your toes and reach for the sky, holding it for a few seconds. When you come down go ahead and spread your feet more than shoulder width apart and simply bend over and "hang there" loosely.

Do NOT bounce as you could possibly tear a muscle. All that you want to do is hang there and breath deeply while counting to ten by one thousands. One thousand one, one thousand two, ect. Do this a second time. Reach for the sky as far as you can, hold it for a few seconds and relax.

Spread your feet again and bend over forward and hang there while counting. You can go farther the second time, can't you? Now try it with your feet together. This is a bit more rough if you're just starting out, but remember not to bounce, but to just hang there, count to ten and repeat. If you continue this regularly there will come a point in the near future where you'll be able to easily touch your toes without bending your knees. Can you imagine the flexibilty that you'll have when you've achieved this?

Once you've done this you'll feel like a million bucks. I've had some days where my spine will just pop right back into place. It's simply a wonderful feeling and will help your golf swing a lot. If you do this on a regular basis, you'll soon see a marked improvement in your game.

There are many different exercises that are specifically for golf fitness that you might find helpful. I recommend that you either invest in a good book on golf fitness, get with a fitness coach that specializes in golf fitness or, if you have the time and the money, do both.

Joe Stewart is a sports fanatic that writes articles on different topics that interest him. Would you like to get a 30 minute consultation with one of the countries best known trainers for golf improvement exercises if he was willing to skip his $150.00 an hour fee? You can get more Golf tips by going to http://www.GolfFitnessTips.net or by simply clicking on Exercises Golf Illustrations

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Bodybuilding Periodization: Bodybuilding Workouts without Bodybuilding Pain

Periodization is a very popular word in the bodybuilding and powerlifting worlds. It seems that every day we see an article promising us great gains through the use of this or that periodization scheme. We have old school linear periodization. We have new school Russian waved periodization, for example, by Boris Sheiko or Pavel Tsatsouline. We have Westside Barbell?s conjugate periodization. Well, get ready, because now we have yet another form of periodization: Pain Periodization.

What is Pain Periodization? Is it some new hardcore bodybuilding method? Is it the latest fitness fad? Is it some leftover practice of the Marquis de Sade? Is it a new reality game show? That would be three nos. It is simply a common sense way to schedule productive bodybuilding exercises that might otherwise be discarded. Read on and I?ll explain, but first let me illustrate the problem we are trying to overcome.

We all know that there are exercises that we both love and hate. For example, skullcrushers are one of the best triceps moves for getting those huge guns. Unfortunately, some of us also get nasty elbow pain after a few weeks of skullcrushers. It?s the same with presses behind the neck. Some of us swear by them for their ability to build cannonball delts. Some of us swear at them for their ability to produce rotator cuff pain. We all love the bench press, but not all of us can handle the shoulder strain the bench press can produce. Luckily, there is an answer. It?s called Pain Periodization. Let?s break it down.

Pain Periodization is a method of planning our workouts so that we can use our favorite exercises without letting the pain get out of hand. We use the exercise for a certain preplanned period, and then move on to something else. As James Brown would say, we ?hit it and quit it.? Let?s look at some examples.

For shoulder size, we might like the behind neck press. But after four or five weeks, the rotator cuff is so sore that it takes a month to heal. We have forsaken the behind neck press altogether and instead used machine shoulder presses. We?d like to do behind neck presses, but we can?t afford the pain and possible down time. By using Pain Periodization, we can have our cake and eat it too. We can start using our favorite shoulder exercise again and still retain shoulder health.

Here is an example 8-week workout plan using Pain Periodization.

? Weeks 1-2 Behind Neck Press

? Weeks 3-4 Machine Press

? Weeks 5-6 Behind Neck Press

? Week 7 Machine Press

? Week 8 Prehab/Rehab

In the above example, we used the behind neck press for 2 weeks only, then went to the machine press which we find easier on the rotator cuff. We don?t just keep using the behind neck press until our shoulder health is wrecked. In effect, we ?hit it and quit it.? In the second 4-week period, again we use the behind neck press for 2 weeks followed by the machine press. Also shown is an optional week of rehab or ?prehab? during which time we drop all heavy overhead pressing and focus on rotator cuff work and stretching. This one-week rehab phase can work wonders for our shoulder health.

Let?s look at another example using the bench press. We all want that big bench press, but we don?t want a blown rotator cuff. We can use Pain Periodization to allow us to work the bench press without wrecking our delts. Like this:

? Weeks 1-3 Bench Press

? Week 4 Machine Bench

? Weeks 4-6 Bench Press

? Week 7 Machine Bench

? Week 8 Rehab/Prehab

Are we getting the picture here? In both of these examples, the ?painful? exercise was alternated with an exercise that we find to be easier on the body. The examples were slightly different, but the main idea is the same. The pain producing exercises were used only for a short period, and then we switched exercises before the pain had a chance to accumulate. In essence, we ?hit it and quit it.? Try Pain Periodization. It may be just what you need to resurrect some of those forsaken exercises.

Randy Williams is an online personal trainer with 24 years of weightlifting experience. Please visit my blog at http://massactionheroes.com/ and sign up for my free newsletter and receive a 2-part free report on bread and butter bodybuilding set methods. Inquire about online personal training by emailing me at Randy@massactionheroes.com

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Achieving the Dream Quest for 90 MPH

The objectives of this program:

1.To achieve a velocity reading of 90 MPH or greater on the JUGS Radar Gun.

2.To apply all available linear force to the back of the baseball.

3.To maintain a healthy and strong arm, while being able to pitch 2-3 times per week.

Variables that effect throwing velocity in baseball pitchers:

1.Applying direct force to the back of the baseball.

2.Flexibility in pelvis during balance/acceleration phase of pitching motion.

3.Lead leg stability after foot plant.

4.Torso rotation during acceleration.

5.Use of scapular muscle used during pitching motion.

6.Elbow/bicep extension during the pitching motion

7.Break/release to plate.

8.Rotator cuff strength and durability

9.Use of forearm during pitching motion.

10.Use of available force from wrist during pitching motion.

The Program:Achieving the Dream:Quest for 90 MPH

In this section, each velocity variable will be addressed and discussed. Exercises will be provided to improve strength and precision in each domain. Data from previous research will be documented to provide creditability to the exercises listed. At the end of this section, the program?s schedule will be clearly illustrated to inform coaches on the specific time commitment required to successfully complete this program.

Velocity Variable #1Applying direct force to the back of the baseball with correct arm action
The application of direct force to the baseball is illustrated with elbow circle break of the pitching hand right before acceleration. With the elbow circle break, the ball never travels out of a straight line with the plate. The pitcher?s fingers should always stay behind the ball. Pitchers need to fire their relaxed pitching elbow down and around toward 1st base. This may come into conflict with many pitching coaches mythology of the high cocked arm position during the balance phase of the pitching motion. But by evaluating action photos of many elite pitchers like Kerry Wood, Mark Prior, Nolan Ryan, and Roger Clemens it is clear to see that these throwers consistently stay behind the ball through the throwing process. Also, these pitchers achieve full extension in front of their body through an elbow angle of less than 90 degrees as their hand travels pass the ear during the acceleration phase. The following exercises promote staying behind the ball and increasing straight-line strength:

A.Weighted Baseballs(Set of three: 4oz, 5oz, and 6oz)
B.Stretch Cord

Velocity Variable #2Flexibility and strength in the pelvis during balance/acceleration phase of pitching motion
Through research it has been documented that the pelvis is one of the most important body parts in promoting velocity. In fact, during a 2003 study by T. Inohiza he incorporated the ?Matawari? stretch routine to his daily exercise schedule. During a three-month period he was able to gain 12.42 MPH on his fastball. Moreover, the stretching also helped his bat speed. Stodden and colleagues (2001) also studied the effects of the pelvis on velocity and concluded that with a higher pelvic velocity a pitcher could throw harder during his delivery.

A.Groin Stretch
B.Hip Flexor Machine
C.Hamstring Curl

Velocity Variable #3Push and Lead leg Stability
The strength and stability of pitchers lower body has been proven to be very important for throwing velocity. In 1998, Bruce MacWillams conducted a study that examined ground reaction forces during the pitching motion. The study?s results indicated that leg drive is a significant factor in pitcher?s throwing velocity. The push motion in the delivery is not the only important action of the lower body. The lead leg that blocks forward movement is also an essential element in a pitcher?s throwing velocity. In a 2001 study, Matsuo found that high velocity throwers were able to plant and extend the lead knee to provide stability to the pitching motion. In addition, the Lexington Clinic was provided an outline evaluating kinetic movements. They included a .89 correlation between throwing velocity and lower body strength. The following exercises promote strength and extension of the lower body:

A.Lunge
B.Squat
C.Clean and Jerk
D.Calf Raises
E.Leg Press
F.Leg Curl

Velocity Variable #4Torso rotation during acceleration
The speed and strength of a pitcher?s torso is another key element in throwing velocity during the pitching delivery. In the September 2003 edition of Coaching Management magazine, former White Sox Strength and Conditioning Director Vern Gambetta, acknowledged that the torso plays a key role in getting the arm in the proper throwing position. In addition to Gambetta, Arnel Aguinaldo, from Children?s Hospital San Diego, conducted a study, which proposed that larger body segments create most of the velocity in throwing. Speed of the trunk is not the only aspect of torso that needs to be developed. Late trunk rotation is a movement that can help increase force applied to the ball along with keeping the arm healthy and safe. Jordana Bieze reported in the June 2004 issue of Biomechanics that collegiate, high school, and youth pitchers rotate less than 15% of their way through the pitching motion. Rotating too early can produce added strain to the arm and shoulder. The following exercises promote strength, increase speed, and delayed rotation of the torso during the pitching delivery:

A.Medicine Ball
B.Total Abdominal Work
C.Leg Lifts

Velocity Variable #5Use of scapular muscle used during pitching motion
The scapular muscle is an under utilized muscle by developing pitchers. The muscle is not developed because many pitching coaches believe weight training, specifically upper body resistance training, tends to promote injuries and will not produce higher pitch velocity. Robert U. Newton and Kerry I McEvory, from the Centre for Exercise Science at Southern Cross University conducted a study, which compared an upper body resistance-training group to a group that performed medicine ball exercises. The 8-week study found that the upper body resistance-training group was able to produce a higher pitch velocity than the medicine ball group. In 2000, Donatelli published a study in the Journal of Orthopedic and Sport Physical Therapy. The study suggested that the strength of the scapular muscle could play a vital role in preventing injury. The following exercises promote strength in the scapular muscle and provide general upper body resistance training:

A.Bench Press
B.Seated Row
C.Lat Pull Down
D.Push Up
E.Dumbbell Flys

Velocity Variable #6Elbow/bicep extension during the pitching motion
According to a 2001 Fleisig and Andrews?s study, elbow extension is one of the four key elements found in high velocity pitchers. Elbow extension occurs during the acceleration phase of the delivery right before release. High velocity pitchers like shot putters, typically pronating their pitching arm and extending through release. The following exercises promote strength and increase speed of extension:

A.Use of the Shot Put(4lbs)
B.Shoulder Press
C.Tricep Pulldown (Standing/Sitting)

Velocity Variable #7Break/release to plate
While examining a Major League pitcher?s delivery it is easy to see the smooth and ease of their motion. Although, each pitcher has different styles, they all possess a certain rhythm that makes their movements look natural. This is not a born characteristic. It is learned throughout their career by constant practice and repetition. In 2001, Stodden found that pitchers who practiced consistent mechanics created higher throwing velocity in their pitches. Moreover, the pitching mound resides 60?6 from home plate. If a pitcher can cut that distance down and release the ball closer to home, a pitcher can gain added pitching velocity. Moreover, to improve mechanics pitchers need to produce the same throwing action during the delivery, but not create undue stress on the pitching arm. During an ASMI study, they concluded that throwing at 50-75% can be beneficial to pitchers because they are able to reproduce actually delivery, but not game ?like stress on their throwing arm. Dry mechanical and towel drills let pitchers recreate the pitching motion to improve techniques. Stamina is another variable this domain works to improve. According to an article by Medco Sports discussing Elbow and Shoulder Problems in Youth Baseball Players, using the kinetic chain can help pitcher use less energy. The kinetic chain is the proper sequencing of body movements in the pitching delivery. The chain includes seven body segments: legs, pelvis, spine, shoulder girdle, upper arm, forearm, and hand. Using dry or towel mechanic drills can only encourage the proper sequencing of the kinetic chain. The following exercises promote consistent mechanics, while helping pitchers release the ball closer to home plate:

A.Towel Drills:Total Delivery, Stretch, Bounce, Bounce, Reach, Grab/Circle Drills
B.Dry Mechanical Drills:Cross Arm, Stretch/Pull, and 3 Point Line Up Drills

Velocity Variable #8Rotator cuff strength and durability
The rotator cuff is a key contributor to the overhand throw. Pitchers must maintain a strong and healthy rotator cuff if they want to be successful on the mound. In fact, in an outline of kinetic movements by the Lexington Clinic, they found that the shoulder is responsible for 21% of the force placed on the ball. If a pitcher can strengthen this muscle, it is easy to see how pitch velocity can be added. A University of Hawaii review of literature can back up this claim. It was reported that Toyoshima conducted a study and concluded that 53.1 % of an overhand throw velocity was due to the action of the arm. In another 2001 study by Galloway and Koshland, their worked focused on finding a pattern in shoulder or elbow centered activities. Their findings suggested that shoulder-centered activities were illustrated with straight or curved finger paths. Since the pitching motion requires straight and curved finger action, strengthening the shoulder and corresponding tendons should provide optimal velocity results. Furthermore, in a 1996 comparison performed by Fleising and colleagues, he found that quarterbacks and pitchers perform many of the same movements. In was concluded that cross training between throwing activities can be beneficial to players in both sports.

A.Arm Swings
B.Jobe Exercises with 2lb dumbbells
C.Football Throws from 20 yards

Velocity Variable #9Use of forearm during pitching motion
The forearm is vital to achieve high velocity in the pitching delivery. In Will Carroll?s 2004 book Saving the Pitcher; he discussed the use of the forearm in the pitching motion. During the acceleration stage, the pitcher?s forearm will pronate, giving the ball its last bit of energy. Dr. Joshua Dubin explained in his #13 Injury Management Update on Pitcher?s Elbow, how a flexed wrist will activate the forearm flexors during the release of the baseball. Even the most inexperienced pitcher can tell that the forearm lends to force during the pitch. By keeping a hand on the throwing forearm and moving the throwing fingers, a pitcher can feel the movement inside the forearm. By developing the forearm muscle, pitchers will be able to powerfully pronate their arms during this stage in the delivery. The following exercises promote muscle development in the forearm muscle:

A.Forearm Curls with Bar
B.Reverse Forearm Curls with Bar
C.Hammer Curls with Dumbbell

Velocity Variable #10Use of available force from wrist during pitching motion
The wrist is a very important lever in the pitching motion. In fact, Norihisa Fujii from the University of Tsukuba concluded after a 2002 study that wrist flexion and strength are major contributors for increasing throwing velocity. In addition, many pitching coaches have incorporated a ?wrist flick? during their throwing warm up progression. The Lexington Clinic reported that the wrist accounted for 10% of the force applied to the baseball during the pitching delivery. Force is not the only function the wrist may perform. Many pitching instructors agree that proper wrist movement can help a pitcher?s control and command of pitches to their target. The following exercises promote strength and increase speed of wrist motion:

A.Weighted Balls(12oz)
B.Hand Grip/Tennis Ball
C.Shot Put Flips(4lbs)
D.Wrist Rolls

Council Bluffs (IA) Abraham Lincoln High School

9-Week Schedule

Monday
Groin Stretch(Morning/Night)Shot Put Flips
Hip Flexor Machine Hamstring Curl
Squat Clean and Jerk
Bench PressShoulder Press
Tricep PulldownLat Pulldown
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Tuesday
Groin Stretch(Morning/Night)Vertical Jumps (5 X 10)
Side Jumps(5 X 10)Weighted Ball Workout (Arm and Wrist)
Stretch CordLunges
Tennis Ball Squeeze (100)Calf Raises
Medicine Ball (Weight Transfer)Leg Curls

Wednesday Groin Stretch (Morning/Night)Shot Put Flips
Hip Flexor MachineLeg Lifts
Hamstring CurlWrist Rolls
Reverse Forearm CurlsHammer Curls
Medicine Ball (Rotation)Push Ups
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Thursday
Groin Stretch(Morning/Night)Vertical Jumps(5 X 10)
Side Jumps(5 X 10)Weighted Ball Workout (Arm and Wrist)
Stretch CordLunges
Tennis Ball Squeeze(100)Calf Raises
Medicine Ball (Weight Transfer)Leg Curls

Friday
Groin Stretch(Morning/Night)Shot Put Flips
Hip Flexor MachineHamstring Curl
Forearm Curls with BarDumbbell Flys
Bench PressSquats
Clean and JerkLeg Press
Arm Swings with Baseball (20/20)Jobe Exercises (Frontal, Lateral, Elbow Ex.)

Saturday
Dry Mechanical Drills
Towel Drills
35 Mini Football Throws (20 Yards)

Sunday
OFF

Exercise Series
?Three sets of ten on each exercise
?Three sets of ten seconds each during the Groin Stretch Activity hold for 20 seconds each
?Weighted Ball Workout Below

Weighted Ball Workout

Week 1-2TTHTotal ThrowsSequence of Throws

549-18-18-9 (5oz-6oz-4oz-5oz)

Week 3-4TTHTotal ThrowsSequence of Throws

6010-20-20-10 (5oz-6oz-4oz-5oz)

Week 5-6TTHTotal ThrowsSequence of Throws

6611-22-22-11 (5oz-6oz-4oz-5oz)

Week 7-8TTHTotal ThrowsSequence of Throws

72 12-24-24-12 (R-O-U-R)

Week 9TTHTotal ThrowsSequence of Throws

78 13-26-26-13 (R-O-U-R)
Replication of Decker Sports Training Manual

*Optional

*Week 10TTHTotal ThrowsSequence of Throws

549-18-18-9 (6oz-7oz-5oz-6oz)

*Week 11TTHTotal ThrowsSequence of Throws

6010-20-20-10 (6oz-7oz-5oz-6oz)

Materials

1.Stretch Cord3ft or comfortable length
2.Weight room AccessSchool or Local Weight room
3.Medicine Ball8lbs
4.Mini FootballSmaller size than standard
5.Weighted Balls 4oz, 5oz, 6oz
6.TowelKitchen or Bath
7.Shot Put4lbs

Methods

The purpose of this workout is to help developing players achieve maximum throwing velocity. Each daily workout isolates the body parts that function during the delivery of a pitch. All of the exercises listed needs to be performed at 100% intensity. The only way a player can gain strength is to push themselves beyond their current level of resistance. For motivation, coaches should test players throwing velocity with a radar gun every three weeks. Players should view the results and analyze their dedication and commitment to the program. A majority of players should receive positive feedback from testing if they are fulfilling the program?s requirements at a high intensity level. Also, this testing gives players the opportunity to create short-term goals. To maintain muscle memory, players should try and play 10-15 minutes of regular long toss twice a week. An emphasis should be placed on a circular elbow path, front side shoulder tilt, and pull down. If a player experiences shoulder pain during their workouts, they should stop the exercise immediately. If the player?s shoulder pain persists, they should seek medical attention.

References

Bieze, Jordana. Early trunk rotation may affect shoulder load in young pitchers. Biomechanics, 6:04, 2004.

Carroll, Will. Saving the Pitcher: Preventing Pitching Injuries in Modern Baseball, Ivan R. Dees, 2004.

Donatelli, R., Ellenbecker, T., Ekedahl, S., Wilkes, J., Kocher, K., and Adam, J. Assessment of Shoulder Strength in Professional Baseball Pitchers. Journal of Orthopedic Sports Physical Therapy, 30(9) 544-551, 2000.

Dubin, Joshua. Medial Epicondylitis. Injury Management Update. Information obtained from http://www.dubinchiro.com

Fujii, N, Hubbard, M. Validation of a three-dimensional baseball pitching model. Journal of Applied Biomechanics, 18:135-154, 2002.

Galloway, JC, Koshland, GF. General Coordination of Shoulder, Elbow, and Wrist Dynamics during Multijoint Arm Movements. Physiological Sciences Program, University of Arizona, 142(2) 163-180, 2002.

Gambetta, Vern. Mound Muscle. Coaching Management, 11:06, 2003.

Information on Toyoshima?s report obtained from http://www.drkochno.com/pitching.htm

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The Mass Builders

The Mass Builders

[Courtesy of www.Mind-MuscleSupplements.com




If you could only do one exercise for mass per body part, what would it be? The formula for mass is maximum overload in minimum time. Overload consists of taxing a muscle to the point of getting a pump without the burn. The burn you get from maxing out a muscle group is called muscle fatigue and for mass it isn't as beneficial as muscle overload.

Now that we know how to tax the muscle, we still need to know how much it takes to tax that muscle and what motions are most successful in taxing the muscle the right way. First, many people think that the more sets and reps that are done, the more growth that will occur. The problem is that if these reps are not done with maximum intensity, growth will be limited. The best combination of reps and sets for maximum overload is 4-6 reps and 1-3 sets. At this rep range, you can focus on delivering maximum intensity to the muscles for all the reps. It is best to pick a weight that is light enough to do 4 times, but heavy enough so that you can not do more than 6 reps for the 1-3 sets. Each set should be done to positive failure with total focus on maximum intensity for maximum overload. Positive Failure is where you cannot do another rep, but no negatives or help from a spotter. This helps with the intensity for the next set. Which brings me to my next point. If you have the time during the week, I recommend doing 1 muscle group per workout per day. This way you overload the whole muscle group and then give it a whole week to recover. Recovery is very important to building mass, it is better to get in the weight room, overload the muscles (most of the time in under an hour) and then grab a shake (within 15 minutes of completion of your workout). The whole mass building process is clean and compact and yields proven results. While throwing around big weight in the gym feels like it is building the muscles, recovering with 1-2 grams of protein per pound bodyweight throughout 6-8 meals with shakes and getting 8 hours sleep is where the real muscle repair and transformation occur.

It is very important to warm up before you even think about lifting with intensity. And I don't mean running for 10 minutes either. You could either do 5-10 light sets of a supplemental exercise OR do a warm up routine that has been proven to add pounds and reps to your core sets. Start with a comfortable weight that you can do 12 reps of your mass building exercise with, do those slow and deliberate. Next up the weight to do 10 reps with, again slow and controlled. Next do 8 reps with more weight and start to explode out of the bottom. These are the warm up sets, now time for weight acclimation sets. These let you feel the heavy weight and how you need to handle it. Do a heavier set with 3 reps, that's it , just enough to feel the stress. Then for the last set before show time, do a set of 1 with either the weight you will do 4-6 reps with or a little more to get you accustomed. This warm up routine will not get you tired ( if you do it properly), and will warm your muscles up enough to handle your real weight (maybe even more).

So you know how to warm up and you have your game plan ready ,but if you are only going to do one muscle group per day, what are the best exercises for each muscle group that will yield the highest overload and results? Get a Pen--

Legs - Ugghh...Leg day. While most people don't even bother to jump under a squat rack or load up a leg press, the few troopers that do put themselves through the hell of leg exercises can expect great results with the use of the FULL SQUAT as their #1 mass builder. That shouldn't be a surprise to anyone that has ever researched this subject. The full squat has been proven to stimulate just about every major muscle group in the upper and lower body. I know because when I come out of my leg workout, I feel sore from head to toe. And who doesn't want massive legs with diamond-shaped calves. Now don't think that doing parallel or partial squats, like the old man with 500 pounds on the bar, is going to even compare to the full squat. Remember the lower you go, the more stimulation of the glutes, hamstrings and quads. Enough said, so go grab your weight belt.

Chest - So what do most people do instead of legs? You got it--chest. Next to biceps, this body part is done more in a week than legs are done in a lifetime...except for us. We know what is important and that is why we do chest the day after legs, after the hard stuff. And the best mass builder for the chest...bench press, of course. Bench is pretty straight forward, but there is a right way and a wrong way for extracting the most out of it. There are 4 parts of the body that should never leave contact with either the bench or the floor. Your head, your shoulders, your butt and your feet. All should be planted firmly, but this doesn't mean to arch your back to gain leverage and have your feet on the bench, contact your chest to push the weight up, not your back. Some people of taller, lankier body types like to do incline bench, and feel it works better for them. This may be true for different people, but for incline try to make the angle no more than 20 degrees...or else you will be using your shoulders, and I have a great exercise for that.

Back- No shoulders yet. The back is a very overlooked muscle group, and if fully developed, can yield a very impressive hourglass physique. The best mass builders for back is split between pull-ups and bent-over rows. I like pull-ups, because I can feel my lats pushing on my triceps after a good couple sets. I have learned not to use the wide angled grip. It is an unnatural movement and can put stress on the rotator cuff. Just grab the bar at the end of the straight part. Also, I don't use any weight when I do them, but I don't do them first either. I do bent-over row first. This is a great exercise for widening the back and getting noticed. You can go up in weight fairly quickly and there are many different ways to do them also. Mixing up you grip on a row machine or barbell can surprise your back muscles into serious growth. I prefer barbell rows.

Shoulders - Now if you are not sore from the incline press, grab a barbell and a comfortable 90 degree seat. It is time for military press. Do these in the front, not behind the neck. Behind the neck puts unnecessary stress on the shoulder joint, and you are going to need all the help you can get with these. I use a smith machine, or else get a spotter, because you can overload shoulders fairly quick and hit positive failure without expecting it. A variation of this front military press is Arnold press, where you start a set of dumbbells with you palms facing you and then rotate them out as you push the weight up. These are good for full shoulder development, but man do they hurt and also demand strict form and execution.

Calves - Even though not usually done on a separate day from legs, calves demand high intensity and hold true to the saying, You get out what you put in I like the seated calf raise. Don't be afraid to pile on the 45 lb. cookies. Make sure you squeeze at the top and stretch at the bottom. Calves respond well to overload and are a great complement to well shaped upper legs.

Biceps - The proven king of bicep exercises is the barbell curl. Nothing more, nothing less. Strap on some weight and start pumping, It is ok while doing these to lean into them to get an extra rep. This kind of cheating is beneficial because it maintains the stimulation on the muscle and increases leverage, arching your back on the bench is not beneficial and can cause injury. Barbell curl is the best exercise for overloading the bicep for those hard to find each muscles.

Triceps - For triceps, there are two good exercises. Close-grip bench and skull-crushers (a.k.a.- nose-breakers, don't laugh I've seen it happen). If you are going to do close-grip, grab a spotter. Never do an exercise with less weight than you should and you know you should do, because you don't have a spotter and failing with the weight could put you in a potential injury-prone position. Instead grab an EZ-curl bar and a flat bench. throw some weight on and lie down with your head over the end of the bench. lower the bar past your nose, your skull and your head, pretty much to the back of your head. This will cause your elbows to move back a little. This is ok, because with overload you want to use less isolative movements and more total body overloading movements. Letting the bar travel this far back will give you a good stretch and allow you to get a little momentum to force all that weight back up. Skull-Crushers offer a great pump for you tri's at the beginning of a workout.

Traps - Building thick traps start with the shrug, everyone know it. Pack some weight onto a barbell and touch your shoulders to your ears. Unless you have heavy enough dumbbells to get 4-6, stick with the barbell or machine. Make sure to let the bar sag at the bottom for a good stretch and then explode up. Also for traps, another good overall body exercise is deadlift. This rivals squat for total body stimulator of all time. It may not be the best, but use it in a trap routine or back routine for best results. Form on deadlift has to be learned, start off light and get down the basics and then rock and roll. PS...wear a belt.

Written by Jeff Harding

09-16-2006

Copyright 2006 Mind-Muscle Supplements

All content is proprietary and based on the authors personal knowledge


About the Author

An avid Health and Fitness enthusiast, Jeff Harding owns and operates www.Mind-MuscleSupplements.com; a online Health and Fitness Superstore that goes beyond an ordinary webstore by also offering an expanding Health and Fitness article database, full of tips, tutorials and expert advice. The supersite also has a message forum for health and fitness community conversation.

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Pain Shoulder Pain Causes Tests And Treatments

Painful shoulder conditions that limit movement are common, and are caused by problems with the shoulder joint and its surrounding structures. Your shoulder is more prone to injuries than other joints because of its wide range of movement.

About 13.7 million people went to the doctor's office in 2003 for a shoulder problem, including 3.7 million visits for shoulder and upper arm sprains and strains. (Source: National Center for Health Statistics; Centers for Disease Control and Prevention 2003 National Ambulatory Medical Care Survey.)

One of the best ways to avoid injury is to keep physically fit, with a balanced program of aerobic exercise, stretching and strengthening exercises for your whole body. There is a range of exercise programs available from local fitness centers, to online services and even downloads for your MP3 or iPod players.

Here are some of the common causes of shoulder pain.

There are several reasons that cause pain and limit movement of your shoulder joint, including:

1. Rotator cuff disorders

Inflammation can be caused by general wear and tear that occurs with age, activities that require constant or repetitive shoulder motion (especially above shoulder level), heavy lifting, trauma, or poor posture. Serious injuries and untreated inflammation of the tendons can cause the rotator cuff to tear.

The pain associated with rotator cuff problems is normally felt at the front or on the outside of your shoulder, particularly when you raise your arm or lift something above your head. You may also notice the pain more when lying in bed. Severe injuries can cause weakness of the shoulder muscles, restricted shoulder movement and continuous pain.

2. Rotator cuff tears

It is usually the rotator cuff tendons (the thick bands of tissue that connect the muscles to the bones) that tear, but sometimes the tear occurs in the muscle. Severe injuries can cause several of the tendons and muscles to tear. There are special movement tests that your doctor can use to help determine which of the muscles or tendons has been torn.

3. Frozen shoulder

Frozen shoulder, is characterized by progressive pain and stiffness in the shoulder. The pain is felt deep in the shoulder joint and may become worse at night due to inactivity.

The exact cause of this condition is not known, but it sometimes develops following other shoulder injuries. Resting a painful, injured shoulder for too long can cause the shoulder muscles and connective structures to stiffen up, so when a shoulder injury occurs make an effort to keep it loose without putting to much strain on it.

Frozen shoulder can develop spontaneously, particularly if you have thyroid problems or diabetes seem to be at increased risk. Most people with frozen shoulder tend to improve within 2 years, with or without treatment. In the interim, however it can be quite painful.

4. Dislocated shoulder and shoulder instability

A dislocated shoulder is visibly deformed or out of place, and there may be swelling or bruising around the joint. Your shoulder movement will be severely restricted. Your Doctor can usually put the shoulder bone back into place using gentle maneuvers.

If you suffer a dislocation, keep in mind that the shoulder joint sometimes becomes unstable and susceptible to repeated dislocations. This causes pain and unsteadiness when you raise your arm or move it away from your body. Your shoulder may feel as if it is slipping out of place when you lift your arm over your head.

5. Arthritis

Arthritis causes progressive joint pain, tenderness, swelling and stiffness. Both rheumatoid arthritis and osteoarthritis will affect the shoulder joint.

Sometimes shoulder pain can be due to problems in your neck or a mixture of several different problems. A visit to your doctor is almost always necessary when it comes to a shoulder problem because in rare instances, shoulder pain may be caused by infection, problems with the nerves, or a tumor located somewhere else in your body.

What tests are needed to determine the cause of your shoulder pain?

As with any medical issue, a shoulder problem is generally diagnosed using a three-part process:

? Medical History ? You tell your doctor about any injury or other condition that might be causing the pain.
? Physical Examination ? Your doctor examines you by feeling for injury and to discover the limits of movement, location of pain, and extent of joint instability.
? Tests ? Your doctor may order one or more of the tests for you listed below to make a specific diagnosis.

Your doctor will determine the cause of your pain based on your symptoms and a physical examination. Where the pain is felt, both at rest and when moving the shoulder, is a clue to the cause of the shoulder pain. Your doctor will also test your shoulder strength and the range of movement in your shoulder joint.

You may need an X-ray, or other scans, such as an ultrasound scan or MRI. Sometimes, an arthroscopy is needed. In this test, your doctor can look inside the shoulder joint using a small telescopic instrument that has a camera on the end. This is not as painful as it sounds.

How your shoulder pain will be treated

In addition to relieving pain, treatment is aimed at restoring mobility in your shoulder joint. The choice of treatment depends on the extent of your shoulder problem and the level of pain.

Pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) are often used as an initial treatment for shoulder pain. Ibuprofen is the best and Aspirin should be avoided.

Another simple way of easing shoulder pain is by applying a cold pack to your shoulder for 10 minutes at a time three or four times a day. Cold packs will reduce inflammation, and are most helpful when applied for the first few days following a shoulder injury. After that, you can switch to using a heat pack; intermittent applications of heat can help relax the shoulder muscles.

A heat pad used at night when sleeping will keep the shoulder from stiffing up.

You should rest your shoulder for a couple of days after an injury, and if you have dislocated your shoulder, you may need to rest your arm in a sling or splint for several weeks after the joint has been manipulated back into place.

However, with most shoulder problems it isn?t a good idea to rest for too long. While you should avoid strenuous activities and lifting heavy objects, you should still move your shoulder to help make sure that you regain full use of the joint. By returning to your normal activities as soon as possible (within the limits of disability and pain), you can help prevent the shoulder joint from stiffening up.

Physiotherapy can help treat you shoulder pain.

Physiotherapy can help improve your shoulder strength and flexibility as well as relieve the pain associated with most shoulder problems. Physiotherapists use a variety of different therapies, including massage, ultrasound therapy, laser therapy and electrical nerve stimulation (TENS) ? a therapy that uses mild electrical currents to treat pain.

Taping the shoulder joint can also help stabilize it and reduce pain during activities. Your doctor will refer you to a good Physiotherapist is he feels the extent of your injury warrants Physiotherapy.

Physiotherapists can also teach you special rehabilitation exercises to stretch and strengthen the rotator cuff muscles of the shoulder. Exercises that improve your shoulder?s range of movement help reduce the pain and stiffness that occurs after a period of immobility. Range of motion exercises may be followed by resistance exercises and weight training to strengthen the muscles.

Steroid injections can be effective but proceed with caution.

Depending on the cause of your shoulder problem, corticosteroid injections may be given to relieve the pain in the short term. The corticosteroid, which is often mixed with a local anesthetic, reduces inflammation and allows you to move the shoulder more comfortably. Make sure you understand what is involved in this kind of treatment to include the long term effect on your body. The jury is still out on the impact of this type of treatment.

Surgery may be necessary to treat your shoulder problem.

Because most people improve with the above treatments, only about 10 per cent of people with shoulder problems will need to be treated with surgery. People with shoulder instability or rotator cuff problems that are not responding to less invasive treatments may benefit from an operation, and shoulder joint replacement may be considered for people with degenerative arthritis.

There are also some conditions that need to be treated initially with an operation, including some rotator cuff tears and dislocated shoulders that cannot be reduced (put back in) with simple manual maneuvers. Sometimes frozen shoulder is treated with what?s known as manipulation under anesthesia. In this therapy, your shoulder is gently moved while you are under a general anesthetic to help improve its range of motion and of course avoid the treatment pain.

So make sure you do not self-diagnosis your shoulder problem, see your doctor. Keep in mind that it isn?t a good idea to rest it for too long or it will stiffen up. Use Cold and Heat intermittingly to speed up the healing process. Avoid strenuous activities and lifting heavy objects, but remember to move your shoulder to help make sure that you regain full use of the joint by returning to your normal activities as soon as possible and you will regain full use of your shoulder in a reasonable period of time.

But, if you are still experiencing pain, listen to it, it is a signal trying to tell you something is still wrong with your shoulder.

About the Author:

Ray is Managing Dir. for Daily Health Updates,a breaking health news service for the broadcast industry and also President for The Center for Pain Relief in New York City.Click On:http://www.painreliefforpain.com, The Centre for Pain Relief and alsohttp://www.forshoulderpain.com, Shoulder Pain

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Using Exercises For Rotator Cuff Treatment Effectively

One of the most important parts of physical therapy for the shoulder are exercises for rotator cuff muscles. This is the first treatment for shoulder problems related to injury to the rotator cuff. Stiffness, pain and weakness in the shoulder or arm are good indicators of injuries to the rotator cuff.The R.I.C.E. treatment is used in conjunction with exercises for rotator cuff. The meaning of R.I.C.E. is rest, ice, compression and elevation. These four treatments are used to reduce swelling and inflammation that can happen due to the injury and also from rotator cuff physical therapy.The first choice for treatment of rotator cuff injuries are exercises for rotator cuff. If physical therapy has not been effective, surgery will be recommended. This is usually a last resort.The doctor will recommend that you avoid exercises that require you to stretch the shoulder extensively. This includes reaching backwards or turning with the injured arm. Exercises for rotator cuff begin with easy stretching that will be closely watched by a physical therapist. Strenuous exercises will not be started till some range of motion is restored. Strengthening exercises are only added to the daily workout after extensive physical therapy has been done.

Even though exercises for rotator cuff are very effective, it will come slowly in order for the proper healing to take place. If physical therapy is post-surgical, this is especially true. Rehabilitation of the shoulder muscles always includes therapy after rotator cuff surgery. Range of motion may not be completely 100%, but physical therapy is very effective in restoring the amount of use that is regained in the arm and shoulder. The physical therapist or the physician will monitor the physical therapy very closely.

By Bob Downe

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Types of Rotator Cuff Exercise

People who have injured their shoulder, along with people who are having problems with normal wear and tear and deterioration in their muscles and tendons in the shoulder, which can develop into rotator cuff tendonitis, can all benefit from rotator cuff exercise.There are many different types of rotator cuff exercise. However, they are grouped into two different categories: stretching and strengthening. You must have made significant progress with the stretching exercises and have restored mobility before considering the strengthening exercises.You should be doing some stretching exercises at least eight times per day. The Posterior Stretch is good for stretching the back of the shoulder. Pull on the elbow of the injured arm and pull it across your body until you can feel the stretch in your upper back. Once you can, hold this position for about five seconds, then repeat twice.The Overhead Stretch will work both shoulders equally. Bend your body at the waist to a 90 degree angle and stretch the shoulders. Hold the position for about 15 seconds and repeat. The Forward Wall Climb is done facing a wall and extending the arm by walking the fingers up and down the wall. Each time your fingers climb the wall you should be attempting to go just a little higher. Only go as far as you can stand, pain wise.

The strength of the area both in and around the rotator cuff is very important as well. A good rotator cuff exercise for the rotator cuff is the Wall Push Up. This is done in the same way that you would normally do one on the floor, except that you are vertical instead of horizontal. As your shoulder strength improves, you may graduate to more difficult positions, like a countertop, a couch arm, and lastly, the floor.While there are many other rotator cuff exercise routines available, it is important to consult with a physical therapist before starting any strength training following an injury.

By Bob Downe

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Rotator Cuff Exercises That Will Get You Pain Free

Are you looking for rotator cuff exercises? Have you ever experienced a dull ache or sharp pain in your shoulder or upper arm?Do you have trouble sleeping at night on one side because of the pain in your shoulder?What about reaching behind your back when getting your billfold or tucking in your shirt or putting on a belt? If so, you may be suffering from a rotator cuff injury.Did you know that nearly 30% of the population has some form of rotator cuff injury, like bursitis, tendonitis and various tears?Whether you suffer from an acute injury or chronic pain, tendonitis, or even a rotator cuff tear, one thing is certain, you need to reduce the inflammation in your shoulder if you want to eliminate the pain.Steps to Reduce InflammationImmediately apply a cold compress to the painful shoulder. The inflammation is the culprit that is causing the pain, therefore if you can get that reduced, then of course the pain will lessen too. Swelling in the bursa is common, as well as inflammation around the tendons of the rotator cuff itself. Icing these areas will help decrease your pain and swelling.

In addition, the element of compression will aid in the healing process and help prevent recurrences of inflammation moving forward.Applying cold therapy immediately after exercise or increased activity is effective in minimizing inflammation and speeding recovery. It is also beneficial to utilize cold treatment prior to sleep in order to reduce nocturnal pain disturbances.Rotator Cuff Exercises For Strength and Range of MotionAs pain and inflammation subside, you must begin performing effective range of motion and strengthening exercises to rehabilitate the injured area. You can return to pre-injury functioning levels and do away with muscle weakness and imbalances with the right rotator cuff exercises.A typical strengthening program may last 4-6 weeks. Of course the degree of your injury, the length of time you have been suffering with it, how active you are all determine how long it will take for you to recover.Remember the first thing that has to happen is the inflammation has to be reduced...so get started with your ice therapy immediately. So, go ahead a buy a quality cold compress wrap, don't do silly repetitive or too strenuous shoulder activities, and find a certified medical professional to guide you on effective safe rehabilitation rotator cuff exercises.
By Lynn West

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Rotator Cuff Exercises For Pitchers - Avoid Being Thrown a Curve Ball

Rotator cuff exercises for pitchers are necessary. A baseball pitcher can easily be booted out of the lineup and into the dugout by a rotator cuff injury or worse, end their career. Pitchers are not alone in this. Swimmers, golfers, weightlifters or any athlete that stresses the shoulder must consider rotator cuff exercises.Keeping the Arm WarmShoulder exercises are necessary to keep the arm warm during the off-season and help prevent injuries like muscle tear and inflammation. Tubing exercises as well as light dumbbell lifting will help prevent rotator cuff injuries.Developing and Maintaining StrengthPlaying baseball hastens the wear and tear of the rotator cuff making it vulnerable to swelling and other related injuries. Rotator cuff exercises for pitchers cultivate muscle strength and aides in maintaining the strength during the season.Exercise Using DumbbellsGrasping a five-pound dumbbell in each hand, stand perpendicular to the ground with both arms stretched sideways forming a 'T'. Sustain the position for a few seconds then guide your arms back to its place. Repeat fifteen times. If this exercise proves painful, you may either use a lighter dumbbell or diminish the number of repetitions. Perform this for a maximum of three times a week.

Exercise Using Resistance Band or TubingRotator cuff exercises for pitchers may involve a resistance band. The process is straightforward. Obtain a resistance tube that is 2 1/2 or 3 yards long. Then at a standing position, step on one end of the tubing and gently grab the other end with you hand. While grasping the band, lift your arm sideways forming a 90-degree angle. Maintain the position for a few seconds then lower it back. Do three sets of ten repetitions twice a week.
By Steven Jay

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Rotator Cuff Exercises and Strategies to Prevent Injury

Have you ever experienced a dull ache or sharp pain in your shoulder or upper arm? Maybe you are unable to sleep on one side because your shoulder wakes you up at night. Perhaps, you have discomfort reaching behind your back to tuck in your shirt or grab your wallet. If so, you may be suffering from a rotator cuff injury.Rotator cuff injuries, such as tendonitis, bursitis and tears plague several people in our population. The rotator cuff consists of four small muscles, which form a sleeve around the shoulder and allow us to raise our arm overhead effectively. These muscles, consisting of the supraspinatus, infraspinatus, teres minor and subscapularis, oppose the action of the deltoid and depress the head of the humerus (upper arm) during shoulder elevation to prevent impingement.The most commonly injured muscle is the supraspinatus. It is responsible for initiating and aiding in elevation of the arm. If torn, the individual typically experiences persistent pain in the upper lateral arm and significant difficulty raising the arm without compensatory motion from the scapula (shrug sign). The hallmark signs of a tear are nocturnal pain, loss of strength, and inability to raise the arm overhead.However, acute tendonitis may also present with similar signs and symptoms, as pain can inhibit motion and strength. Yet, symptoms associated with tendonitis normally respond to rest, ice, anti-inflammatory medication and therapeutic exercise.

Rotator cuff tears are most common in men age 65 and older. Tears and/or injury are typically related to degeneration, instability, bone spurs, trauma, overuse and diminished strength/flexibility related to the aging process. However, youth are also at risk for injury if they are involved in repetitive overhead sports, including swimming, volleyball, baseball, softball, tennis, gymnastics, etc.Many people can function adequately with a torn rotator cuff provided they have a low to moderate pain level. The primary reason for performing rotator cuff surgery is to alleviate pain rather than to restore function. It is common for post surgical patients to lose some mobility/range of motion. Strength recovery is dictated by the size of tear, quality of the torn tissue at the time of surgery, time elapsed between injury and repair, and the surgeon’s ability to recreate the proper anatomical relationship.It may take up to 18 months following surgery to completely recover, although most people return to normal activities of daily living in 3-6 months. On the contrary, tendonitis usually resolves within 4-6 weeks, depending on the management of the injury.The key to avoiding rotator cuff injury is performing adequate conditioning prior to stressing it with vigorous activities. Many weekend warriors try to pick up the softball, baseball, football, etc. and begin throwing repetitively and forcefully without properly warming up. In addition, they are not likely to condition before the season like competitive athletes.This often leads to excessive strain on the rotator cuff and swelling. The inevitable result is soreness, especially with overhead movement or reaching behind the back. The act of throwing is the most stressful motion on the shoulder. The rotator cuff is forced to decelerate the humerus during follow through at speeds up to 7000 degrees/second.Without proper strength and conditioning, the shoulder easily becomes inflamed. Since the rotator cuff muscles are small, it is best to utilize lower resistance and higher repetitions to sufficiently strengthen them. Sample exercises include theraband or light dumbbell external and internal rotation exercises, which can be performed at various degrees of abduction.Other common exercises include forward elevation to shoulder height in the plane of the scapula (scaption), press-ups, prone dumbbell horizontal abduction with external rotation, and diagonal arm patterns with bands, weights or medicine balls. In addition to cuff specific exercises, it is also important to strengthen the muscles around the shoulder blade. These exercises include wall push-ups with a plus (rounding shoulder blades), shrugs, rows and lower trapezius exercises.Finally, it is important to note some precautions with general exercises routinely performed in health clubs. I recommend the following suggestions to prevent rotator cuff problems:• Avoid lat pull downs and military presses behind the head, as they place the shoulder in a poor biomechanical position encouraging impingement.• Do not lower the bar or dumbbells below parallel with incline/flat bench press for the aforementioned reason.• Refrain from using too much weight with lateral shoulder raises. This exercise increases the load on the shoulder to 90% of the body weight, so there is no need to use heavy weight. It is best to maintain an arc of movement slightly in front of the body with lateral raises to decrease stress on the rotator cuff, while avoiding elevation above 90 degrees.• Specific rotator cuff exercises can be incorporated into upper body workouts. Perform 2 sets of 15-25 repetitions for each exercise. These exercises should be done no more than three times per week to avoid overtraining.Brian Schiff, PT, CSCS, is a respected author, physical therapist and fitness expert. For more information on his e-book on resolving rotator cuff pain, visit http://www.rotatorcufftraining.com. This article was originally published in Business First Columbus, Ohio in 2004.


By Brian Schiff

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Rotator Cuff Exercises For the Shoulder

If you have injured your shoulder and seen a physician about it, he/she will probably recommend a prescribed plan of exercise to see if it relieves the symptoms. This is almost always the first course of action before surgery. You will be instructed to rest the shoulder, apply ice and/or heat, take an over the counter anti-inflammatory such as ibuprofen, and follow the exercise plan set forth by a physical therapist. This exercise plan will work to help to relieve any stiffness, pain, or weakness caused by your injury. If, after working the exercise program for a while, your symptoms have not improved, then you may be faced with making the decision to have surgery to repair your shoulder. After surgery, you will again need to see a physical therapist for more exercise to strengthen the shoulder. During your rehabilitation period, you will need to refrain from reaching behind you or pulling your shoulder in any way that will strain the rotator cuff. Also, when you first start the rotator cuff exercises, especially if you have had surgery, you will need to start out very slow and ease into more intense exercise. You will need to consult with your physician or physical therapist before stepping up your exercise program to be sure that the added strain will not cause you to re-injure your shoulder in any way. Under no circumstances should you return to normal activities without first consulting your physician. The last thing you want to do is risk a re-injury.

Examples of rotator cuff exercises that are often used to rehabilitate a shoulder after injury or surgery include those that are designed to restore strength to the shoulder and those that will help you to restore range of motion and flexibility. If any of your exercises causes you pain in your shoulder then you need to stop that exercise immediately and talk to your physical therapist before continuing. You may have re-injured your shoulder or you may need to modify your exercises somewhat. As you are doing the rotator cuff exercises that have been prescribed for your rehabilitation, you need to remember to take them seriously. They are something that you will need to do every day for the rest of your life. This is because a torn rotator cuff is very easy to re-injure and if you do not keep the shoulder strong and flexible the chances of a new injury are very great. You will need to continue your strength and stretching exercises long after your shoulder has healed. By Bob Downe

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Rotator Cuff Exercises - Prevent Injuries Before They Happen

Many people who engage in various sports activities do not do any rotator cuff exercises or any other warm up exercises. Of course, the warm up has to be done before you start your main workout or any kind of sports games (golf, football, tennis etc.). The reasons for not doing any warn up are usually laziness or ignorance, but the out can very well be severe. Take Golfers for example. Many people believe that Golf is a game for people who are too lazy to do any other, more intensive sports. That may be so, but will you be surprised to learn that thousands of golfers each year suffer form rotator cuff injuries, and seek medical help accordingly? These folks could have treated themselves better, and would have saved themselves a world of pain, and medical bills. Same story applies for people who do other sorts of sports, work out in the gum, swim in the pool etc. Please don't get me wrong. I'm all for sports - it still has more advantages than dis advantages. And I do work out in the gum 3 times a week. The thing is - you need to acquire a few useful habits that will help you avid these kind of problems. So, how could you make the best of your workout, and still have the best chance of avoiding rotator-cuff problems.

Let's look at some tips: 1. You need to warm up. Even 2 minutes of warm up before hitting the golf course, to the swimming pool will go a long way to help you stay on the safe side. There is a great verity of rotator cuff exercises aimed at loosening the area and making it lees vulnerable to stress and pain. 2. Stay fit and strengthen your muscles and tendons. The rotator cuff is a group of four muscles and their tendons that are responsible for the connection of the upper arm and the shoulder blade. Indeed, a very important group. Take good care of them by regularly doing exercises to strengthen the area. This will help you cope with all the strain and effort that area observes while doing an activity like swimming or golfing. Thus, reduce the chances of injury. 3. Consult your doctor. Especially if you had problems before, Consult your doctor regularly. This just might save you from and potential problems. 4. Listen to your body. If your rotator cuff is in pain, don't push it. Take a rest, and see a doctor. Most problems are easy to fix if you attend them at the beginning and don't wait till it gets worse. The best way to deal with a problem is to avid creating it. Regular rotator cuff exercises will help you to build strength and endurance to the area, and will lessen the risk of getting hurt along the way. By: Dave Green

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Rotator Cuff Exercises - Exercises You Can Do With Rotator Cuff Injury

Rotator cuff exercises will restore strength and mobility in the shoulder, eliminate pain and help strengthen the shoulder to prevent future rotator cuff injuries. None of the following rotator cuff injury exercises should cause pain. If they do, stop and talk to your medical professional for advice. Exercise 1. This exercise will help loosen up the shoulder before getting into the other rotator cuff exercises. Stand with your feet shoulder wide and bend over so you are horizontal to the floor. Slowly rotate your bad arm in small circle motions gradually increasing the width of the circles. Do fifteen rotations and 3 sets. Exercise 2. Using your injured arm, reach up and across the chest and put the arm behind the shoulder. Now place your other hand behind the elbow and apply gentle pushing. Hold the stretch for about 10 seconds and repeat 3 or 4 times. Exercise 3. Grab a towel and using your good arm, sling it across your good shoulder. Reach behind your back with your injured arm and grasp the towel. Smoothly pull on the towel so it pulls the injured arm upward. Hold for at least 10 seconds and do 3 to 4 sets. This exercise can be difficult to do in the initial stages of a rotator cuff injury so if it causes to much pain don't do it.

Exercise 4. Find a door frame or use the corner of a room. Place both hands on the edge of the frame and gently lean forward. Hold the stretch for ten seconds and repeat 3-4 times. Exercise 5. For this and the following rotator cuff exercises you will need a piece of rubber tubing about 2 to 3 feet long. Grip the tubing with both hands horizontal to the floor (you can do this exercise either sitting or standing). Now, tuck the elbow of the injured arm into your side and rotate the hand outwards. Hold for 10 seconds and do 3 or 4 sets. Exercise 6. Side raises. Grab your rubber tubing. Let one end dangle on the floor and stand on it. Gently lift your injured arm out from your side. Hold for ten seconds and repeat 3-4 times. Exercise 7. Front raises. This is similar to the previous rotator cuff exercises except you will lift your arm to the front rather than the side. Again, stand on the end of the tubing and then slowly raise your injured arm up to the front of your body as far as it will go. Hold for 10 seconds and repeat 3-4 times. These are just a few basic rotator cuff exercises to get you started before starting a more advanced rotator cuff strengthening program which will help prevent future injuries. Stretching however, is the best way to start conditioning muscles and tendons of the shoulders. Stretching improves flexibility and mobility. Do them every day and avoid exercises and movements that will make you reach up. This will further impinge the tendons and talk to your doctor or physio about other rotator cuff exercises and the correct form for each. Good luck with your dodgy shoulders! By: Steven Jay

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