Designing a Pilates Program For A Client With Shoulder Impingement Syndrome

Size: px
Start display at page:

Download "Designing a Pilates Program For A Client With Shoulder Impingement Syndrome"

Transcription

1 Designing a Pilates Program For A Client With Shoulder Impingement Syndrome Kyuyoung Nicole Huh- Limousi, CPT Body Art and Science International Comprehensive Teacher Training Program July 2013 Paris, France

2 Abstract The many structural problems slouching causes include forward migration of head and rounding of shoulders. The migration of head and rounding of shoulders is then found to cause muscle imbalances between force couples, manifesting through pain and dysfunction of the shoulder. Whether imbalances in other part of the body may have caused the symptom or vice versa, conventional exercise programs and therapies often overlook the importance of conditioning the body as a whole, only focusing on the muscles responsible; rotator cuff muscles. This paper discusses the structure of shoulder girdle and the spine on a functional continuum and how BASI Pilates block system, when applied as a holistic exercise system, can contribute to achieving neck and shoulder girdle stabilization, and improving functional strength for a client diagnosed with functional shoulder impingement. 2

3 Table of contents 1. Abstract 2. Shoulder Anatomy 3. Shoulder pathology 4. Rationale for holistic approach 5. Case study a. Assessment and goal setting b. Exercise Plan c. The program d. Phase 1 - releasing tension and core stabilization e. Phase 2 - addressing the shoulder mechanism 6. Conclusion 3

4 Figure 1 Bones of shoulder joint Anatomy of shoulder Shoulder joint is made up of the clavicle, the scapula, and the humerus (fig.1) and complex layers of muscles and ligaments across the entire upper body. (fig.2) Of the 4 joints of shoulder, Glenohumeral joint, commonly referred to as shoulder joint, has the ball shaped superior head of humerus, the arm bone, loosely fitted into the shallow socket-shaped lateral edge of scapula, the shoulder blade. The glenohumeral joint is held in place by surrounding ligaments and muscles (fig.2). Scapula can slide along the posterior ribcage to further facilitate the arm Figure 2 muscles of Upper extremity (source : 4

5 movement. Among the muscles of shoulder complex, a group of four muscles called rotator cuffs, Supraspinatus, infraspinatus, teres minor, and subscapularis is identified as being responsible for the stability and movement in shoulder (fig.3). Figure 3 Rotator cuff muscles (source : shoulderdoc.co.uk) Shoulder pathology Shoulder impingement is the irritation or compression of one or more of the rotator cuff muscles in between the socket and the ball, creating inflammation, pain, and decreased function of shoulder. Primary impingement is structural and due to overcrowding of subacromial space due to bony abnormality or thickening of tendon through repeated injuries. Secondary, or functional impingements results from uncoordinated manner of arm bone movement or due to overuse when arm bone slides forward during abduction and external rotation of the shoulder. Rationale for holistic approach While rotator cuff muscles are often singled out as being responsible for shoulder health, shoulder is a complicated structure requiring an advanced sense of proprioceptive capacity due to its multiple joint mechanism and the dependence of its stability on the supporting muscles. These muscles, in turn, have their origins and insertions spanning the 5

6 entire torso, front and back. For example, pectoralis minor connects upper ribs of chest to coracoid process, and overactive pectoralis minor draws scapula forward which then pulls the shoulder into forward and rounded position. In a controlled study, Borstad and Ludewig found that «short pectoralis minor demonstrated scapular kinematics similar to the kinematics exhibited in earlier studies by subjects with shoulder impingement, support the theory that an adaptively short pectoralis minor may influence scapular kinematics and is therefore a potential mechanism for subacromial impingement. Similarly, overactive muscles of elevation and flexion such as upper trapezius and levator scapulae may pull the pectoral girdle superiorly, then anteriorly, leaving the antagonist muscles of depression and extension deconditioned. Contrary to popular belief, Latissimus dorsi is another dominant player in multiple shoulder and arm movements, due to its position covering the entire lower vertebrae from T6, as well as the iliac crest of hip bone and the lower three to four ribs, which then has impact or are affected by the mechanisms of lower extremities. When we consider that scapula glides against the ribcage which are attached to thoracic vertebrae, study results showing a significant relationship between thoracic spine and scapula kinematics are not surprising either (figure 4; Kebaetse M, McClure P, Pratt NA, 1999). Holding the pelvis in fatigue posture, as well as excessive foot pronation may all contribute to shoulder health as these maybe cause compensating effect on the entire structure s integrity. This maybe a reason behind the persisting pathologies even after localized approach to repetitive rehabilitation efforts. As such, clients with pathology more global addressing the posture and imbalances, working locally pain. conditioning shoulder must take approach whole body muscular instead of around the 6

7 Figure 4 Thoracic kyphosis and scapula kinematics demonstrating reduced shoulder ROM on thoracic kyphosis (source : dynamicchiropractice.com) 7

8 8

9 Case study Dominique, 45 years old, is a corporate marketing professional who has always been tall and slim. He is a long time runner and cyclist, with love for motorcycle and photography. He was diagnosed with shoulder impingement in his 30 s and has followed through shoulder re-education in several occasions. He never changed his life style except during his recurring episodes of shoulder tendinitis, which would force him to limit his activities. In the past 2 years, however, he has completely stopped his running and cycling due to worsening shoulder condition. His short-term goal is to rectify his shoulder problem, and long-term goal is to regain strength and improve general health and energy level. Posture assessment and goal setting Static posture assessment reveals forward head position, hyper extended neck, protracted and upwardly rotated scapulae, internally rotated arms with hands facing back, ribs showing exaggerated curvature and thoracic spine in exaggerated posterior curve. The entire body from his chest down simply hangs from his shoulder girdle, in a fatigue or sway back position; the anterior curve of lumbar spine is flattened, pelvis jutted forward with a posterior tilt, hip joints are extended, knee joints hyperextended, and feet turned out. From the assessment, upper trapezius, pectoralis major and minor erector spinae, and hamstrings are identified as shortened or tight but not necessarily strong. These are the muscles that will need stretching before strengthening. The rest of the body was deconditioned in general and needed strengthening. During forward flexion, the client showed exaggerated thoracic spine flexion, limited hip flexion and bent knees early on towards the end of forward bending, suggesting inflexible gluteal, hamstrings and or calf muscles, confirming the result of static posture assessment. Exercise plan 9

10 Although his ultimate goal is to build back overall strength as quickly as possible, we came to agree that ignoring his shoulder issue will in the long run only set him back more than go forward. During the first phase, the attention will be on improving breathing, and cervical and thoracic spine alignment and function. While the focus is working on opening up the rib cage to give more space to the lungs and other internal organs, the exercise program in phase 1 also introduces truck and pelvic stabilization as well as foot and knee awareness. As soon as Dominique can dynamically stabilize and control the lumbopelvic complex, or the core, the exercise will gradually add on strengthening the deep mid and lower back muscles and re-activating proper scapula rotation rhythm. Also, more exercises for abdominal strength will be incorporated into the daily program. Phase 1 tension release and corrective stretches Stretch (administered independantly everyday and before each session) Ladder barrel shoulder stretch 1 and 2 Breathing with chest opening on pilates ball Warm-up - emphasis on pelvic curl to encourage lower abdominals and gluteal activation, and to introduce the client to spine articulation. Traditional chest lift is modified with the Step barrel in order to encourage opening of the chest muscles and isolation of abdominals, discouraging upper back flexion o Pelvic curl o Side twist supine o Negative chest lift on step barrel Foot work series on reformer- giving closed chain feedback to activate the posterior trunk proprioceptive receptors to re-adjust the thoracic curvature. Ideally, conscious supine position will provide the mind a chance to work on releasing the neuromuscular hold on neck and shoulder tension, and bringing awareness to TA and Latissimus dorsi, to balance out the natural spine curvature. Having a flat surface on his 10

11 back (closed chain) to refer to facilitates the mind to focus on conveying information regarding alignment to the body. Hundred prep on reformer encourage dynamically controlling shoulder extensors and build up abdominal strength Cadillac basic leg spring series while the leg spring series will increase mobility of hip joint and strengthen the quadriceps and hamstrings, the main focus will be on stabilizing the pelvis while legs are in motion. The client will also work on knee and foot alignment in relation to femur positioning parallel or external rotation. The client is gently yet consistently encouraged to let go of the tension in his neck and shoulder. Arm series supine on reformer - continue giving the support for back chain while working to stabilize the shoulder girdle, focus on lengthening of the movement to work on crowded articulation and to engage intrinsic muscles of shoulder girdle including serratus anterior Standing lunge stretch while still getting an effective stretch on his hip flexors and hamstring, by placing hands on the foot bar and actively pressing down with the entire arm, an upright closed chain position is created. Dominique is encouraged to imagine his shoulder girdle expanding 3 dimensionally and upper trapezius melting away, and to experiment with his body in relation to the space. Lateral Flexion and rotation - Side over leaning on to the Step barrel gives support to pelvis for stabilization and keeping the spine neutral while oblique muscles go through full ROM Leg work Gluteals Kneeling series and Adductor Lift are chosen to activate and strengthen the hip extensors and adductors which are weakened from holding the sway position for too long. Kneeling with elbows on the box also reduces the intensity of gravity on upper girdle, allowing us to work on weakened neck flexors by keeping the head lifted 11

12 Back extension by focusing on keeping the abdominals engaged and reaching the arms and the legs towards the back of the room, Dominique is strengthening his entire posterior chain while eccentrically working the shoulder depressors including serratus anterior and teres major. The adductor muscles are encouraged to stay active in order to aid in pelvic floor muscle activation The client is also given as homework pectorals stretches and a simple fundamental Mat routine with emphasis on back extension and shoulder girdle stabilization. Phase 2 - addressing the shoulder mechanism After a month of training with 2 private sessions per week and keeping up 20minutes routine everyday, Spine articulation and Full body Integration blocks are added to previous exercise blocks. Avalon is introduced to add more strength training. More abdominal work is added with careful emphasis on avoiding excessive flexion. Strict priority is given to movement quality over the amount of resistance or flexibility. Progress from Supine arm work to Sitting arm work on Avalon - Arms sitting side series are introduced with focus on rotator cuff muscles while stabilizing the trunk Sitting side on Cadillac scapula protraction and retraction is explored before combining the recruiting of shoulder depressor muscles Shrug on chair Dominique is encouraged to take as much time resisting the way up as well as the way down, thus to be in control of the movement the complete repetition. Arm work - Triceps Press sitting, Side Kneeling Arm press, Side Kneeling stretch on Wunda chair: more movements to combine stabilization of the trunk, and the activation and strengthening of shoulder depressor muscles. The movements balances out tight antagonist muscles, namely the upper trapezius. 12

13 Full body Integration on reformer Up stretches with emphasis on scapula stabilization. Down stretch with emphasis on mid back strength and scapula stabilization Hip extension and back extension on Avalon in addition to providing challenges to mind by putting the body in a unfamiliar position, the back chain exercises on Avalon challenges the client by freeing up the ROM, allowing supine movements to go from negative to neutral to positive. Conclusion A carefully thought out Pilates exercise program can safely and successfully improve general fitness of clients with shoulder issues because its approach is global. Incorporating well-executed Pilates movements can reverse the faulty movement pattern that causes pain and deconditioning in other parts of body. While each movement has different muscle focus and objectives, the underlying principle of holistic care is constantly present to reinforce the motor learning and adaptation, and reinforcement of healthy and efficient use of our body be it static or dynamic. The client should be reminded that good habits form the same way bad habits form. Even after the pain is gone, tight muscles relieved and weak muscles strengthened, and the general balance is brought back to the body, in order to maintained the balance and the good posture, the client should be encouraged to continue Pilates or include some form of mindful and holistic exercise in her life. 13

14 Bibliography Borstad J. D., Ludewig P. M. (2005 April). The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. Retrieved 23 July, from Clark, M. A., Lucett, S. C., & Sutton, B. G. (2012). NASM Essentials of personal Fitness Training. Fourth edition. Piladelphia, PA:Lippincott Williams & Wilkins Feil, C. & Morgan, W. E. (2010 May 6). The Importance of the Thoracic Spine in Shoulder Mechanics. Retrieved 20 July 2013, from Franklin, E. (2012). Dynamic alignement through imagery. Champaign, IL:Human Kinetics. From FDA reports: Depression and Kyphosis n.d. Retrieved 20 July 2013, from Isacowitz, R. & Klippinger, K (2011). Pilates Anatomy. Champaign, IL:Human Kinetics. Isacowitz, R. (2013). Study Guide. Comprehensive Course. Costa Mesa CA: Body Arts and Science International Kebaetse M. & McClure, P. & Pratt N. A. (1999 August) Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics. Retrieved 20 July 2013, from Paterson, J. (2009). Teaching Pilates for Postural faults, Illness & Injury. A practical guide. Kidlington, Oxford:Butterworth-Heinemann Elsevier 14

15 15

Pilates for Kyphosis A BASI Pilates program designed to help correct thoracic kyphosis

Pilates for Kyphosis A BASI Pilates program designed to help correct thoracic kyphosis Pilates for Kyphosis A BASI Pilates program designed to help correct thoracic kyphosis 1 Lucy Penrose 19/01/2014 Wimbledon UK, April 2013 Abstract Kyphosis refers to an exaggerated curve in the thoracic

More information

PILATES Fatigue Posture and the Medical Technology Field

PILATES Fatigue Posture and the Medical Technology Field PILATES Fatigue Posture and the Medical Technology Field Marybeth Kane May 2014 Course: 2014, Pacific Palisades, CA 1 ABSTRACT A medical laboratory scientist (MLS) (also referred to as a medical technologist

More information

HYPERLORDOSIS & PILATES TREATMENT

HYPERLORDOSIS & PILATES TREATMENT HYPERLORDOSIS & PILATES TREATMENT Grace Tiangco 3/18/15 2012-2013 Abstract Sacramento/Mountain View Lordosis or Hyperlordosis is defined as a postural type in which the natural curves of the spine are

More information

DSM Spine+Sport - Mobility

DSM Spine+Sport - Mobility To set yourself up for success, practice keeping a neutral spine throughout all of these movements. This will ensure the tissue mobilization is being applied to the correct area, and make the techniques

More information

Flexibility Assessment and Improvement Compiled and Adapted by Josh Thompson

Flexibility Assessment and Improvement Compiled and Adapted by Josh Thompson Flexibility Assessment and Improvement Compiled and Adapted by Josh Thompson Muscles must have a full and normal range of motion in order for joints and skeletal structure to function properly. Flexibility

More information

Ken Ross BSc ST, Nat Dip ST

Ken Ross BSc ST, Nat Dip ST Ken Ross BSc ST, Nat Dip ST Trunk Most people will suffer from back pain at some point in their lives. Good spinal posture places minimal strain on the muscles which maintain the natural curve of the spine

More information

Pilates Based Treatment For Low Back Pain with Contradicting Precautions : A Case Study

Pilates Based Treatment For Low Back Pain with Contradicting Precautions : A Case Study Pilates Based Treatment For Low Back Pain with Contradicting Precautions : A Case Study Kerry Susser, DPT January 27, 2013 Body Arts and Science International Comprehensive Teacher Training Program 2013

More information

Don t. Hamstrings. Calf Muscles. both legs 2-3 times. stretch is felt in the back of the calf. Repeat with both legs 2-3 times.

Don t. Hamstrings. Calf Muscles. both legs 2-3 times. stretch is felt in the back of the calf. Repeat with both legs 2-3 times. Remember to: Warm-up your muscles first before stretching (e.g. stretch after walking). Stretch until you feel mild discomfort, not pain. Never bounce or force a stretch. Hold the stretch for 10-30 seconds

More information

Pilates for Lumbar Spine Herniation

Pilates for Lumbar Spine Herniation Pilates for Lumbar Spine Herniation Michelle Hawley Date: Module 12, 10/21/2012 Course Year: July 2012- October 2012 Location: Chandler, AZ Abstract Research has demonstrated that non-surgical methods

More information

A proper warm-up is important before any athletic performance with the goal of preparing the athlete both mentally and physically for exercise and

A proper warm-up is important before any athletic performance with the goal of preparing the athlete both mentally and physically for exercise and A proper warm-up is important before any athletic performance with the goal of preparing the athlete both mentally and physically for exercise and competition. A warm-up is designed to prepare an athlete

More information

Posture. Let s look at. in the head is jutting. the norm. you know if your belt. If you belt. lower body. 2 sections, upper. pulls?

Posture. Let s look at. in the head is jutting. the norm. you know if your belt. If you belt. lower body. 2 sections, upper. pulls? Fixing the Computer Guy Posture Lower back/h hip stability Let s look at ideal posture for a minute. Look at your profile in the mirror. Chances are you re gonna find that your head is jutting forward,

More information

SAMPLE WORKOUT Full Body

SAMPLE WORKOUT Full Body SAMPLE WORKOUT Full Body Perform each exercise: 30 secs each x 2 rounds or 2-3 sets of 8-12 reps Monday & Wednesday or Tuesday & Thursday Standing Squat Muscles: glutes (butt), quadriceps (thigh) Stand

More information

Pilates to correct overactive upper trapezius muscles and prevent scapular elevation.

Pilates to correct overactive upper trapezius muscles and prevent scapular elevation. Pilates to correct overactive upper trapezius muscles and prevent scapular elevation. Stephanie Blum July 13 th, 2014 Flow Studios, Chicago, IL Page 1 of 19 Abstract It s important to recognize where your

More information

The Pilates Studio of Los Angeles / PilatesCertificationOnline.com

The Pilates Studio of Los Angeles / PilatesCertificationOnline.com Anatomy Review Part I Anatomical Terminology and Review Questions (through pg. 80) Define the following: 1. Sagittal Plane 2. Frontal or Coronal Plane 3. Horizontal Plane 4. Superior 5. Inferior 6. Anterior

More information

Clients with Lumbar Hyperlordosis

Clients with Lumbar Hyperlordosis Clients with Lumbar Hyperlordosis Andrea Sobke June 10, 2007 1 BASI Costa Mesa 2007 Abstract Lumbar hyperlodosis is a faulty posture in which the curve of the lumbar spine is increased. This can be caused

More information

McMaster Spikeyball Therapy Drills

McMaster Spikeyball Therapy Drills BODY BLOCKS In sequencing Breathing and Tempo Flexibility / Mobility and Proprioception (feel) Upper body segment Middle body segment Lower body segment Extension / Static Posture Office / Computer Travel

More information

Stretching in the Office

Stretching in the Office Stretching in the Office Legs: Quads, Hamstrings, IT band, Hip flexors, Gluts, Calves Quads: Standing @ desk maintaining upright posture, grab one leg @ a time by foot or ankle and bring it towards backside

More information

Spine Conditioning Program Purpose of Program

Spine Conditioning Program Purpose of Program Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.

More information

by Ellen Saltonstall and Dr. Loren Fishman

by Ellen Saltonstall and Dr. Loren Fishman 10 Yoga Poses for Low Back Pain Prevention by Ellen Saltonstall and Dr. Loren Fishman Introduction This series of poses is designed to prevent future back pain and also to relieve back pain that you may

More information

THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T

THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T CLARIFICATION OF TERMS Shoulder girdle = scapula and clavicle Shoulder joint (glenohumeral joint) = scapula and humerus Lippert, p115

More information

FINDING NEUTRAL SPINE POSITION

FINDING NEUTRAL SPINE POSITION FINDING NEUTRAL SPINE POSITION It seems everywhere you look people are talking about the benefits of being able to achieve and maintain a neutral spinal alignment. Most exercise regimes and especially

More information

THE BIG SIX. Six Best Volleyball Strength Training Exercises. By Dennis Jackson, CSCS www.strength-and

THE BIG SIX. Six Best Volleyball Strength Training Exercises. By Dennis Jackson, CSCS www.strength-and THE BIG SIX Six Best Volleyball Strength Training Exercises By Dennis Jackson, CSCS www.strength-and and-power power-for for-volleyball.com THE SQUAT What it is The two most common squatting exercises

More information

BASI Pilates Research Paper Pilates for Rehabilitation Alleviating Chronic Neck and Low Back Pain

BASI Pilates Research Paper Pilates for Rehabilitation Alleviating Chronic Neck and Low Back Pain BASI Pilates Research Paper Pilates for Rehabilitation Alleviating Chronic Neck and Low Back Pain By Sheela Srinath March 7, 2016 Course Year 2014-2016 Costa Mesa Studio Pilates Rehabilitation for the

More information

Fact sheet Exercises for older adults undergoing rehabilitation

Fact sheet Exercises for older adults undergoing rehabilitation Fact sheet Exercises for older adults undergoing rehabilitation Flexibility refers to the amount of movement possible around a joint and is necessary for normal activities of daily living such as stretching,

More information

Lumbar/Core Strength and Stability Exercises

Lumbar/Core Strength and Stability Exercises Athletic Medicine Lumbar/Core Strength and Stability Exercises Introduction Low back pain can be the result of many different things. Pain can be triggered by some combination of overuse, muscle strain,

More information

Pilates for the Rehabilitation of Iliopsoas Tendonitis and Low Back Pain

Pilates for the Rehabilitation of Iliopsoas Tendonitis and Low Back Pain Pilates for the Rehabilitation of Iliopsoas Tendonitis and Low Back Pain Bruce Manuel November 30, 2015 CAP Standard 2015 Pilates Denver Greenwood Village, CO Abstract Iliopsoas Tendonitis is irritation

More information

Strength Training for the Runner

Strength Training for the Runner Strength Training for the Runner Strength Training for the Runner What? The goal of resistance training for runners is not necessarily adding muscle mass but 1. improving muscular strength, 2. improving

More information

The Process of Strength and Conditioning for Golfers

The Process of Strength and Conditioning for Golfers The Process of Strength and Conditioning for Golfers The use of different sporting activities and resistance work to develop a strength and conditioning program specific to golf. Many club golfers are

More information

Basic techniques of pulmonary physical therapy (I) 100/04/24

Basic techniques of pulmonary physical therapy (I) 100/04/24 Basic techniques of pulmonary physical therapy (I) 100/04/24 Evaluation of breathing function Chart review History Chest X ray Blood test Observation/palpation Chest mobility Shape of chest wall Accessory

More information

The Pilates Method: A Conditioning Program for Clients with Acetabular Dysplasia and Charcot-Marie-Tooth Disease

The Pilates Method: A Conditioning Program for Clients with Acetabular Dysplasia and Charcot-Marie-Tooth Disease The Pilates Method: A Conditioning Program for Clients with Acetabular Dysplasia and Charcot-Marie-Tooth Disease Kara McCulloch April 13, 2008 BASI Oct 2007 Apr 2008 Herndon, VA Abstract This study applies

More information

Clarification of Terms

Clarification of Terms Shoulder Girdle Clarification of Terms Shoulder girdle = scapula and clavicle Shoulder joint (glenohumeral joint) = scapula and humerus What is the purpose (or function) of the shoulder and entire upper

More information

NETWORK FITNESS FACTS THE HIP

NETWORK FITNESS FACTS THE HIP NETWORK FITNESS FACTS THE HIP The Hip Joint ANATOMY OF THE HIP The hip bones are divided into 5 areas, which are: Image: www.health.com/health/static/hw/media/medical/hw/ hwkb17_042.jpg The hip joint is

More information

Low Back Pain Exercises Interactive Video Series Transcript July 2013

Low Back Pain Exercises Interactive Video Series Transcript July 2013 Introduction Low Back Pain Exercises Interactive Video Series Transcript July 2013 ** Note: If an exercise causes an increase in your pain, stop the exercise.** [Music introduction; Dr. John Sheehan onscreen]

More information

Flat foot and lower back pain

Flat foot and lower back pain Flat foot and lower back pain Dr James Tang, MBA, BDS, LDS RCS General Dental Practitioner, NASM Corrective Exercise Specialist with special interest in postural dysfunction & lower back problems, Level

More information

Anatomy and Physiology 121: Muscles of the Human Body

Anatomy and Physiology 121: Muscles of the Human Body Epicranius Anatomy and Physiology 121: Muscles of the Human Body Covers upper cranium Raises eyebrows, surprise, headaches Parts Frontalis Occipitalis Epicranial aponeurosis Orbicularis oculi Ring (sphincter)

More information

CHAPTER 3: BACK & ABDOMINAL STRETCHES. Standing Quad Stretch Athletic Edge - www.athleticedge.biz - (650) 815-6552

CHAPTER 3: BACK & ABDOMINAL STRETCHES. Standing Quad Stretch Athletic Edge - www.athleticedge.biz - (650) 815-6552 CHAPTER : BACK & ABDOMINAL STRETCHES Standing Quad Stretch ) Stand and grasp right ankle with same hand, use a wall or chair to Lower maintain Back balance with left hand. Maintain an upright Stretches

More information

Chapter 5. The Shoulder Joint. The Shoulder Joint. Bones. Bones. Bones

Chapter 5. The Shoulder Joint. The Shoulder Joint. Bones. Bones. Bones Copyright The McGraw-Hill Companies, Inc. Reprinted by permission. Chapter 5 The Shoulder Joint Structural Kinesiology R.T. Floyd, Ed.D, ATC, CSCS Structural Kinesiology The Shoulder Joint 5-1 The Shoulder

More information

Rotator Cuff Pathophysiology. treatment program that will effectively treat it. The tricky part about the shoulder is that it is a ball and

Rotator Cuff Pathophysiology. treatment program that will effectively treat it. The tricky part about the shoulder is that it is a ball and Rotator Cuff Pathophysiology Shoulder injuries occur to most people at least once in their life. This highly mobile and versatile joint is one of the most common reasons people visit their health care

More information

Chapter 4 The Shoulder Girdle

Chapter 4 The Shoulder Girdle Chapter 4 The Shoulder Girdle Key Manubrium Clavicle Coracoidprocess Acromionprocess bony landmarks Glenoid fossa Bones Lateral Inferior Medial border angle McGraw-Hill Higher Education. All rights reserved.

More information

are you reaching your full potential...

are you reaching your full potential... T h e r e s n o s u c h t h i n g a s b a d e x e r c i s e - j u s t e x e r c i s e d o n e b a d l y FIT for sport are you reaching your full potential... These tests are a series of exercises designed

More information

he American Physical Therapy Association would like to share a secret with you. It can help you do more with less effort breathe easier feel great.

he American Physical Therapy Association would like to share a secret with you. It can help you do more with less effort breathe easier feel great. The Secret... T he American Physical Therapy Association would like to share a secret with you. It can help you do more with less effort breathe easier feel great. The secret is about good posture, which

More information

How to Get and Keep a Healthy Back. Amy Eisenson, B.S. Exercise Physiologist

How to Get and Keep a Healthy Back. Amy Eisenson, B.S. Exercise Physiologist How to Get and Keep a Healthy Back Amy Eisenson, B.S. Exercise Physiologist Lesson Objectives Statistics of Back Pain Anatomy of the Spine Causes of Back Pain Four Work Factors Core Muscles Connection

More information

Have a ball SWISS BALL EXERCISES SWISS BALL TRAINING

Have a ball SWISS BALL EXERCISES SWISS BALL TRAINING Have a ball SWISS BALL EXERCISES SWISS BALL TRAINING 2 Swiss Ball training is an excellent way to build 'core body strength' and have some fun at the same time. Training on the Ball forces you to use muscles

More information

Exercises for Low Back Injury Prevention

Exercises for Low Back Injury Prevention DIVISION OF AGRICULTURE RESEARCH & EXTENSION University of Arkansas System Family and Consumer Sciences Increasing Physical Activity as We Age Exercises for Low Back Injury Prevention FSFCS38 Lisa Washburn,

More information

Strength Exercises for Improved Running Biomechanics

Strength Exercises for Improved Running Biomechanics 2 CHAPTER Strength Exercises for Improved Running Biomechanics ssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssdd s Many gait abnormalities seen

More information

Tennis Players And Low Back Pain - A Case Study

Tennis Players And Low Back Pain - A Case Study Tennis Players and Low Back Pain: How to deal with musculature imbalance. Jaqueline Barreto Lenhard December 4 th, 2014 CTTC March-June 2014 Costa Mesa, CA Abstract: The research to follow examines in

More information

Spinal Exercise Program/Core Stabilization Program Adapted from The Spine in Sports: Robert G. Watkins

Spinal Exercise Program/Core Stabilization Program Adapted from The Spine in Sports: Robert G. Watkins Spinal Exercise Program/Core Stabilization Program Adapted from The Spine in Sports: Robert G. Watkins Below is a description of a Core Stability Program, designed to improve the strength and coordination

More information

Cervical Exercise: How important is it? What can be done? The Backbone of Spine Treatment. North American Spine Society Public Education Series

Cervical Exercise: How important is it? What can be done? The Backbone of Spine Treatment. North American Spine Society Public Education Series Cervical Exercise: The Backbone of Spine Treatment How important is it? What can be done? North American Spine Society Public Education Series Important: If you have had an accident that started your neck

More information

KNEE EXERCISE PROGRAM

KNEE EXERCISE PROGRAM KNEE PROGRAM INTRODUCT ION Welcome to your knee exercise program. The exercises in the program are designed to improve your knee stability and strength of the muscles around your knee and hip. The strength

More information

Exercise 1: Knee to Chest. Exercise 2: Pelvic Tilt. Exercise 3: Hip Rolling. Starting Position: Lie on your back on a table or firm surface.

Exercise 1: Knee to Chest. Exercise 2: Pelvic Tilt. Exercise 3: Hip Rolling. Starting Position: Lie on your back on a table or firm surface. Exercise 1: Knee to Chest Starting Position: Lie on your back on a table or firm surface. Action: Clasp your hands behind the thigh and pull it towards your chest. Keep the opposite leg flat on the surface

More information

SHOULDER PULL DOWNS. To learn efficient use of the shoulder blades and arms while maintaining a neutral spine position.

SHOULDER PULL DOWNS. To learn efficient use of the shoulder blades and arms while maintaining a neutral spine position. SHOULDER INTRODUCT ION Welcome to your shoulder exercise program The exercises in the program are designed to improve your shoulder mobility, posture and the control of the muscles in your neck and shoulder

More information

Today s session. Common Problems in Rehab. www.physiofitness.com.au/filex.htm LOWER BODY REHAB ESSENTIALS TIM KEELEY FILEX 2012

Today s session. Common Problems in Rehab. www.physiofitness.com.au/filex.htm LOWER BODY REHAB ESSENTIALS TIM KEELEY FILEX 2012 Tim Keeley B.Phty, Cred.MDT, APA Principal Physiotherapist physiofitness.com.au facebook.com/physiofitness Today s session Essential list for the lower body Rehab starting point Focussing on activation,

More information

Rotator Cuff and Shoulder Conditioning Program. Purpose of Program

Rotator Cuff and Shoulder Conditioning Program. Purpose of Program Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.

More information

Myofit Massage Therapy Stretches for Cycling

Myofit Massage Therapy Stretches for Cycling Guidelines for Stretching Always assume the stretch start position and comfortably apply the stretch as directed. Think Yoga - gently and slowly, no ballistic actions or bouncing at joint end range. Once

More information

HIP RESURFICING CLAIRE HESLOP 25/10/13 COURSE YEAR: 2013/LONDON- WIMBLEDON

HIP RESURFICING CLAIRE HESLOP 25/10/13 COURSE YEAR: 2013/LONDON- WIMBLEDON HIP RESURFICING CLAIRE HESLOP 25/10/13 COURSE YEAR: 2013/LONDON- WIMBLEDON ABSTRACT My case study is about a client who contacted me 9 years after her hip resurfacing procedure as she was suffering with

More information

Addressing Pelvic Rotation

Addressing Pelvic Rotation 1 of 5 4/20/2008 10:31 AM http://www.strengthcoach.com Addressing Pelvic Rotation Aaron Brooks of Perfect Postures When trying to address your athlete's or client's limitations due to pain or joint restriction,

More information

COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES

COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES Listed are a few of the most common overuse injuries associated with cycling long distances. 1. Cervical and upper back

More information

Range of Motion. A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program

Range of Motion. A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program Range of Motion A guide for you after spinal cord injury Spinal Cord Injury Rehabilitation Program This booklet has been written by the health care providers who provide care to people who have a spinal

More information

Muscular System. Student Learning Objectives: Identify the major muscles of the body Identify the action of major muscles of the body

Muscular System. Student Learning Objectives: Identify the major muscles of the body Identify the action of major muscles of the body Muscular System Student Learning Objectives: Identify the major muscles of the body Identify the action of major muscles of the body Structures to be identified: Muscle actions: Extension Flexion Abduction

More information

No Equipment Agility/Core/Strength Program for Full Body No Equip Trainer: Rick Coe

No Equipment Agility/Core/Strength Program for Full Body No Equip Trainer: Rick Coe No Equipment Agility/Core/Strength Program for Full Body No Equip Trainer: Rick Coe Introduction Program designed to be performed in a circuit. Perform exercises in sequence without rest 2-3 times. Increase

More information

Coaching the Injury Prone Athlete. www.englandathletics.org www.englandathletics.org/east

Coaching the Injury Prone Athlete. www.englandathletics.org www.englandathletics.org/east Coaching the Injury Prone Athlete Injury! The Causes? Frequently the consequence of poor physical preparation ( accidents excluded) Exceeding training loads the athlete can handle at that time Volume,

More information

Core stability training program

Core stability training program Core stability training program The structure of the lumbar region is inheriently unstable. In practical term this means the lumbar spine relies upon sufficent support from the muscles that actively suport

More information

Therapeutic Pilates. Introduction to Pilates. Joseph H. Pilates. Improving Core Stability, Kinesthetic Awareness and Supporting Spinal Integrity

Therapeutic Pilates. Introduction to Pilates. Joseph H. Pilates. Improving Core Stability, Kinesthetic Awareness and Supporting Spinal Integrity Therapeutic Pilates Improving Core Stability, Kinesthetic Awareness and Supporting Spinal Integrity Introduction to Pilates Pilates exercise is designed to mobilize and strengthen the body, helping to

More information

Rehabilitation after shoulder dislocation

Rehabilitation after shoulder dislocation Physiotherapy Department Rehabilitation after shoulder dislocation Information for patients This information leaflet gives you advice on rehabilitation after your shoulder dislocation. It is not a substitute

More information

This document fully describes the 30 Day Flexibility Challenge and allows you to keep a record of your improvements in flexibility.

This document fully describes the 30 Day Flexibility Challenge and allows you to keep a record of your improvements in flexibility. Welcome to the StretchTowel 30 Day Flexibility Challenge! You can Be More Flexible in 30 days by following our stretching program for 10 minutes a day. The best part is that you can stretch using the StretchTowel

More information

Hip and Trunk Exercise Program

Hip and Trunk Exercise Program Hip and Trunk Exercise Program Hip and Pelvis Exercise Program Gluteus Medius and Minimus (Hip Abductors) Page 2 Lateral Hip Rotators Page 6 Tensor Fascia Lata (TFL) and Illiotibial Band (ITB) Page 7 Lower

More information

Pilates for Plantar Fasciitis

Pilates for Plantar Fasciitis Pilates for Plantar Fasciitis Written by: Heather Light Date: August, 2011 This is a student paper, submitted to BASI Pilates by the writer as a requirement for completion of the BASI Pilates Comprehensive

More information

TOTAL BODY: POWER/EXPLOSIVE EXERCISES

TOTAL BODY: POWER/EXPLOSIVE EXERCISES Referring to Chapters 12-14 TOTAL BODY: POWER/EXPLOSIVE EXERCISES Power Snatch hip extension Muscle group/ gluteals gluteus maximis hamstrings semimembranosus semitendinosus biceps femoris knee extension

More information

BALANCED BODYWORKS LA Rejuvenate. Heal. Restore.

BALANCED BODYWORKS LA Rejuvenate. Heal. Restore. Tools For Myofascial Self Massage and Stretching Foam Roller Lacrosse Ball (Hard) Stretch Strap What is Foam Rolling? Foam Rolling or Self Myofascial Release, is a form of soft tissue massage. Similar

More information

Sciatic Nerve A Case Report of the Treatment of Piriformis Syndrome (Muscle Related)

Sciatic Nerve A Case Report of the Treatment of Piriformis Syndrome (Muscle Related) Sciatic Nerve A Case Report of the Treatment of Piriformis Syndrome (Muscle Related) Elyse Silvia West August 5, 2007 Pacific Palisades Abstract Objective: The study assessed the benefits of Pilates training

More information

What muscles do cyclists primarily use?

What muscles do cyclists primarily use? Stress & Injury The following information has been taken from freely available articles from British Cycling and other Cycling organisations. Sources are noted at the end of this document. Please note

More information

!!!!!!!!!!!!!! Pilates for Breast Cancer Patients with Frozen Shoulder

!!!!!!!!!!!!!! Pilates for Breast Cancer Patients with Frozen Shoulder Pilates for Breast Cancer Patients with Frozen Shoulder Casey Canino February 1, 2015 New York Comprehensive Global Format September 19, 2014- January 18, 2015 ABSTRACT PILATES FOR BREAST CANCER PATIENTS

More information

Muscle Energy Technique. Applied to the Shoulder

Muscle Energy Technique. Applied to the Shoulder Muscle Energy Technique Applied to the Shoulder MUSCLE ENERGY Theory Muscle energy technique is a manual therapy procedure which involves the voluntary contraction of a muscle in a precisely controlled

More information

Sheet 1A. Treating short/tight muscles using MET. Pectorals. Upper trapezius. Levator scapula

Sheet 1A. Treating short/tight muscles using MET. Pectorals. Upper trapezius. Levator scapula Sheet 1A Treating short/tight muscles using MET Pectorals Once daily lie at edge of bed holding a half-kilo can, arm out sideways. Raise arm and hold for 10 seconds, then allow arm to hang down, stretching

More information

Living Room Bodyweight Workout Week 1 March or jog in place for 1 min to increase heart rate and lubricate joints.

Living Room Bodyweight Workout Week 1 March or jog in place for 1 min to increase heart rate and lubricate joints. Warm Up- Living Room Bodyweight Workout Week 1 March or jog in place for 1 min to increase heart rate and lubricate joints. Protocol- All exercises will be done for 2 sets of 10 repetitions. After the

More information

Passive Range of Motion Exercises

Passive Range of Motion Exercises Exercise and ALS The physical or occupational therapist will make recommendations for exercise based upon each patient s specific needs and abilities. Strengthening exercises are not generally recommended

More information

Anatomy & Physiology 120. Lab #7 Muscle Tissue and Skeletal Muscles

Anatomy & Physiology 120. Lab #7 Muscle Tissue and Skeletal Muscles Anatomy & Physiology 120 Lab #7 Muscle Tissue and Skeletal Muscles What you Need to Know Look briefly at the Structure of: 1) Skeletal, 2) Smooth & 3) Cardiac Muscle Naming, Identification, Functions You

More information

Injury Prevention for the Back and Neck

Injury Prevention for the Back and Neck Injury Prevention for the Back and Neck www.csmr.org We have created this brochure to provide you with information regarding: Common Causes of Back and Neck Injuries and Pain Tips for Avoiding Neck and

More information

Psoas Syndrome. The pain is worse from continued standing and from twisting at the waist without moving the feet.

Psoas Syndrome. The pain is worse from continued standing and from twisting at the waist without moving the feet. Psoas Syndrome The iliopsoas muscle is a major body mover but seldom considered as a source of pain. Chronic lower back pain involving the hips, legs, or thoracic regions can often be traced to an iliopsoas

More information

EGOSCUE CLINIC PAIN/POSTURE STRETCHES 1. Standing Arm Circles: Helps Restore Upper Body Strength

EGOSCUE CLINIC PAIN/POSTURE STRETCHES 1. Standing Arm Circles: Helps Restore Upper Body Strength EGOSCUE CLINIC PAIN/POSTURE STRETCHES 1. Standing Arm Circles: Helps Restore Upper Body Strength Two sets of 40 repetitions each. Stand with your feet pointed straight and hip-width apart. Place your fingertips

More information

Lower Body Exercise One: Glute Bridge

Lower Body Exercise One: Glute Bridge Lower Body Exercise One: Glute Bridge Lying on your back hands by your side, head on the floor. Position your feet shoulder width apart close to your glutes, feet facing forwards. Place a theraband/mini

More information

BP MS 150 lunch and learn: Stretching and injury prevention. Dr. Bart Kennedy (Sports Chiropractor) and Josh Thompson February 04, 2015

BP MS 150 lunch and learn: Stretching and injury prevention. Dr. Bart Kennedy (Sports Chiropractor) and Josh Thompson February 04, 2015 BP MS 150 lunch and learn: Stretching and injury prevention Dr. Bart Kennedy (Sports Chiropractor) and Josh Thompson February 04, 2015 Epidemiology Overuse injuries most common, traumatic event second

More information

X-Plain Neck Exercises Reference Summary

X-Plain Neck Exercises Reference Summary X-Plain Neck Exercises Reference Summary Introduction Exercising your neck can make it stronger, more flexible and reduce neck pain that is caused by stress and fatigue. This reference summary describes

More information

Orthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX 78240 www.saspine.com Tel# 210-487-7463

Orthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX 78240 www.saspine.com Tel# 210-487-7463 Phase I Passive Range of Motion Phase (postop week 1-2) Minimize shoulder pain and inflammatory response Achieve gradual restoration of gentle active range of motion Enhance/ensure adequate scapular function

More information

PREVENTING SPINAL INJURY

PREVENTING SPINAL INJURY PREVENTING SPINAL INJURY PRESENTED BY: BYRON BAHNIUK, B.P.E., C.A.T.(C), R.M.T. UNIVERSITY OF MANITOBA BISON ATHLETIC THERAPY CENTRE INVESTORS GROUP ATHLETIC CENTRE 231-75 SIDNEY SMITH ST. 474-6956 Who

More information

Range of Motion Exercises

Range of Motion Exercises Range of Motion Exercises Range of motion (ROM) exercises are done to preserve flexibility and mobility of the joints on which they are performed. These exercises reduce stiffness and will prevent or at

More information

BEACH VOLLEYBALL TRAINING PROGRAM

BEACH VOLLEYBALL TRAINING PROGRAM 2008 ELITE PERFORMANCE ATHLETE CONDITIONING BEACH VOLLEYBALL TRAINING PROGRAM Team BC 2008 Steve Van Schubert, CAT(C), CSCS Training Schedule General Outline Phase 1 2 Weeks Phase 2 3 Weeks Phase 3 3 Weeks

More information

Exercises for the Hip

Exercises for the Hip Exercises for the Hip Gluteal Sets: Lie on your back, tighten buttocks and hold for 3-5 seconds. Repeat 20 times. Supine Hip ER/IR: Lie on your back with legs straight. Gently rotate knees out and in limited

More information

Self-Myofascial Release Foam Roller Massage

Self-Myofascial Release Foam Roller Massage How it works. Self-Myofascial Release Foam Roller Massage Traditional stretching techniques simply cause increases in muscle length and can actually increase your chances of injury. Self-myofascial release

More information

Surgical Art. Formulaic Drawing Method. DRAWING WORKSHOP Learning to sketch for patient notes

Surgical Art. Formulaic Drawing Method. DRAWING WORKSHOP Learning to sketch for patient notes DRAWING WORKSHOP Learning to sketch for patient notes Surgical Art Formulaic Drawing Method Formulaic figure drawing systems involve using abstract rhythms and interlocking shapes to construct the human

More information

Fix Your Posture, Fix Your Pain Seminar/Workshop

Fix Your Posture, Fix Your Pain Seminar/Workshop Fix Your Posture, Fix Your Pain Seminar/Workshop Hamilton Health Sciences July 2014 Jean LaFleur CAT(C), CSCS, NSCA-CPT, FMS-1, B.HK, Dip SIM www.ancasterpersonaltraining.com jean@ancasterpersonaltraining.com

More information

Massage and Movement

Massage and Movement Massage and Movement Incorporating Movement into Massage Part One: Theory and Technique in Prone With Lee Stang, LMT NCBTMB #450217-06 1850 West Street Southington, CT 06489 860.747.6388 www.bridgestohealthseminars.com

More information

Chair Exercises For Older Adults

Chair Exercises For Older Adults Chair Exercises For Older Adults Many of these exercises were adapted from these sources: National Institute on Aging, Exercise: A Guide from the National Institute on Aging, 2001, http://www.nia.nih.gov/healthinformation/publications/exerciseguide/.

More information

How To Stretch Your Body

How To Stretch Your Body Exercise Module A New Leaf Choices for Healthy Living University of North Carolina at Chapel Hill 2007 Center for Health Promotion and Disease Prevention Physical Activity Exercises for Keeping Active

More information

SPINE. Postural Malalignments 4/9/2015. Cervical Spine Evaluation. Thoracic Spine Evaluation. Observations. Assess position of head and neck

SPINE. Postural Malalignments 4/9/2015. Cervical Spine Evaluation. Thoracic Spine Evaluation. Observations. Assess position of head and neck SPINE Observations Body type Postural alignments and asymmetries should be observed from all views Assess height differences between anatomical landmarks Figure 25-9 Figure 25-10 Figure 25-11 & 12 Postural

More information

Rehabilitation with Pilates

Rehabilitation with Pilates Rehabilitation with Pilates Flat Feet Pes Planus Naiké Durel January 2016 Montreal, Canada Table of contents Title Table of contents Abstract Anatomy of the foot p.1 p.2 p.3 p.4-5- 6-7 Case of study BASI

More information

Hip Bursitis/Tendinitis

Hip Bursitis/Tendinitis Hip Bursitis/Tendinitis Anatomy and Biomechanics The hip is a ball and socket joint that occurs between the head of the femur (ball) and the acetabulum of the pelvis (socket). It is protected by several

More information

CORRECTIVE CHIROPRACTIC EXERCISES

CORRECTIVE CHIROPRACTIC EXERCISES CORRECTIVE CHIROPRACTIC EXERCISES J O W E T T & M O U L T O N C h i r o p r a c t o r s introduction This booklet, presented by Jowett and Moulton Chiropractors, is designed to provide you with a general

More information

HELPFUL HINTS FOR A HEALTHY BACK

HELPFUL HINTS FOR A HEALTHY BACK HELPFUL HINTS FOR A HEALTHY BACK 1. Standing and Walking For correct posture, balance your head above your shoulders, eyes straight ahead, everything else falls into place. Try to point toes straight ahead

More information

Do you sit at a desk all day? Does your 9 to 5 leave no time for structured exercise..?

Do you sit at a desk all day? Does your 9 to 5 leave no time for structured exercise..? Do you sit at a desk all day? Does your 9 to 5 leave no time for structured exercise..? Staying healthy at work is easier than you might think: Try building the following desk based exercises into your

More information