train right: shoulders terry kane, physiotherapist
TRANSCRIPT
train right = results & referrals.
Appropriate Exercise for client
“X”
Inappropriate Exercise for client
“X”
Appropriate Dose for client “X”
Results & Referrals
Injury
Inappropriate Dose for client “X” (too much)
Injury Injury
Inappropriate Dose for client “X”(too little)
No change No change / Injury
What’s appropriate for one client may not be appropriate for another
train right
Hippocratic Oath
If in doubt, first do no harm.
Personal Training Oath
If in doubt, first do no harm.
Clients expect you share the same oath as healthcare professionals.
They expect that every exercise that you give them is safe for them...that’s why they pay you.
5
What we know
Mechanisms of Injury
Mechanisms of Injury
1. Acute
2. Overuse
3. Acute on Vulnerable Genetics Age Fatigued tissue Old injury Recent injury
6
there is no such thing as a ‘bad’ exercise….
But there are exercises that are;
1. Inappropriate for the client
2. Inappropriately executed
3. Inappropriate dose
a. Past medical history
b. Current medical conditions
c. Neuromotor Skills
d. Experience
e. Flexibility
f. Strength
g. Endurance
7
there is no such thing as a ‘bad’ exercise….
But there are exercises that are:
1. Inappropriate for the client
2. Inappropriately executed
3. Inappropriate dose
a. Poor technique
b. Inexperience
c. Inadequate instruction
d. Incorrect instruction
8
there is no such thing as a ‘bad’ exercise….
But there are exercises that are;
1. Inappropriate for the client
2. Inappropriately executed
3. Inappropriate dose
a. Too much too soon
b. Sudden increase in frequency
c. Sudden increase in intensity
d. Sudden increase in volume of exercise.
review
Anatomy
Scapula
Coracoid process
Acromion
Glenoid fossa
Glenoid labrum
Subacromial space
Clavicle
Humerus
Bicipital groove
Greater tuberosity
Lesser tuberosity
review
Muscles
Rotator Cuff
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
Biceps
Long head
Short head
Scapular stabilizers
Serratus Anterior
Trapezius
Rhomboids
Levator scapulae
Latissimus Dorsi
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
review
Biomechanics
Scapular plane
Scapulohumeral rhythm
Subacromial impingement
Painful arc
Winging scapula
Apprehension sign
Stress-Strain Curve
If in doubt, first do no harm.
Jury of Your Peers
Would another personal trainer agree that a given shoulder exercise you prescribed is safe and appropriate for the same client?
Medical / Health profile
Technique Dose
If in Doubt
1. Elbows below 60 d of abduction (impingement)
2. Hands and elbows visible throughout entire motion (scapular plane)
3. Slow and controlled (stress-strain curve)
4. Appropriate load (stress-strain curve)