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5 Tweaks to Make Shoulder Exercises More Effective

The latest Inner Circle webinar recording on 5 Tweaks to Make Shoulder Exercises More Effective is now available.

 

5 Tweaks to Make Shoulder Exercises More Effective

5 Tweaks to Make Shoulder Exercises More EffectiveThis month’s Inner Circle webinar is on 5 Tweaks to Make Shoulder Exercises More Effective.  Over the years, you tend to pick up on the little things that can make a big difference.  I’m always reading the latest research to find simple little tweaks that I can make to an exercise to change the desired result.  Maybe I’m trying to optimize the mechanics of the scapula, or trying to enhance EMG activity of a certain muscle, or even change the ratio of activity between two muscles.

In this webinar, we discuss:

  • Why little tweaks can make a big difference
  • Why integrating the kinetic chain into a shoulder exercise may be effective
  • How altering hip and trunk movement during exercises change the muscle activity
  • How you can put this all together and make your own functional exercises specific to each person

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A Better Way to Perform Shoulder Exercises?

It’s pretty obvious that the shoulder is linked to the scapula, which is linked to the trunk.  So why do we so often perform isolated arm movement exercises without incorporating the trunk?  It’s a good question.  The body works as a kinetic chain that requires a precise interaction of joints and muscles throughout the body.

 

The Effect of Trunk Rotation During Shoulder Exercises

A recent study was published in the Journal of Shoulder and Elbow Surgery that examined the impact of adding trunk rotational movements to common shoulder exercises.

The authors chose overhead elevation, external rotation by the side, external rotation in the 90/90 position similar to throwing, and 3 positions of scapular retraction while lying prone (45 degrees, 90 degrees, and 145 degrees) that were similar to prone T’s and Y’s.  The essentially had subjects perform the exercise with and without rotating their trunk towards the moving arm.

A Better Way to Perform Shoulder Exercises?

EMG of the the upper trapezius, middle trapezius, lower trapezius, and serratus anterior were recorded, as well as 3D scapular biomechanics.

There were a few really interesting results.

  • Adding trunk rotation to arm elevation, external rotation at 0 degrees, and external rotation at 90 degrees significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation
  • During overhead elevation, posterior tilt was 23% increased and lower trap EMG improve 67%, which in turn reduced the upper trap/lower trap ratio.
  • Adding rotation to the prone exercises reduced upper trapezius activity, and therefore enhanced the upper trap/lower trap ratio as well.

 

What Does This All Mean?

I would say these results are interesting.  While the EMG activity was fairly low throughout the study, the biggest implication is that involving the trunk during arm movements does have a significant impact on both muscle activity and scapular mechanics.  Past studies have shown that including hip movement with shoulder exercises also change muscle activity.

This makes sense.  If you think about it, traditional exercises like elevation and external rotation involve moving the shoulder on the trunk.  By adding trunk movement during the exercises you are also involving moving the trunk on the shoulder.

This is how the body works, anyway.  Most people don’t robotically just move their arm during activities, the move their entire body to position the arm in space to accomplish their goal.

It’s also been long speculated that injuries during sports like throwing and baseball pitching may be at least partially responsible for not positioning or stabilizing the scapula optimally.  I think this study supports this theory, showing that trunk movement alters shoulder function.

Isolated exercises like elevation and external rotation are always going to be important, especially when trying to enhance the strength of a weak or injured muscle.  However, adding tweaks like trunk rotation to these exercises as people advance may be advantageous when trying to work on using the body with specific scapular positions or ratio of trapezius muscle activity.

 

5 Tweaks to Make Shoulder Exercises Even More Effective

I’m a big fan of understanding how little tweaks can make a big difference on your exercise selection.  If you are interested in learning more, this month’s Inner Circle webinar will discuss 5 Tweaks to Make Shoulder Exercises Even More Effective.  The webinar will be Tuesday August 25th at 8:00 PM EST, but a recording will be up soon after.

 

 

 

How to Assess Shoulder Capsular Mobility

The latest Inner Circle webinar recording on Assessing Shoulder Capsular Mobility is now available.

 

Assessing Shoulder Capsular Mobility

Assessing Shoulder Capsular Mobility - Social MediaThis month’s Inner Circle webinar is on Assessing Shoulder Capsular Mobility.  This is a recording of an actual inservice we performed with the students and interns at Champion this week.  I’m super excited to be able to record and share things like this with my Inner Circle.  It’s like having a front row seat at our inservices!  I think this offers many benefits over the traditional webinar/lecture format, as you can watch the interaction and also see some of the clinical techniques better.

In this webinar, we discuss:

  • The anatomy of the shoulder capsule and glenohumeral ligaments
  • How different arm positions stress different aspects of the capsule
  • How to determine which ligament and aspect of the capsule is tight
  • How to assess range of motion at different positions to assess different portions of the capsule
  • How to perform range of motion and capsular mobility assessment of the shoulder
  • Clinical tips on the assessment technique

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Anterior Pelvic Tilt Influence on Squat Mechanics

anterior pelvic tilt influences squat mechanicsI feel like we’ve been discussing anterior pelvic tilt lately in several articles and an Inner Circle webinar on my strategies for fixing anterior pelvic tilt.  I wanted to show a video of a great example of how a simple assessment really tells you a lot about how pelvic positioning should influence how we coach exercises such as squats and deadlifts.

If you haven’t had a chance to read my past article on how anterior pelvic tilt influences hip range of motion, you should definitely start there.

In this video, I have a great example of a client that has limited knee to chest mobility and with boney impingement.  However, if we abduct the leg a bit, it clears the rim of the hip and has full mobility with no impingement.

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As you can see, because he is in anterior pelvic tilt, he is prepositioned to start the motion in hip flexion, so therefor looks like he has limited mobility.  I have a past article on how anterior pelvic tilt influence hip flexion mobility, which discusses this a little more.

While you are working on their anterior pelvic tilt, you can work around some of their limitations.  I hate when people say there is only one way to squat or deadlift.

Our anatomy is so different for each individual.

Some need a wider stance while others need more narrow.  Some need toes out while some need more neutral.  Do what works best for your body, not what the text book says you are supposed to look like.

 

 

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the Lunge

One thing I talk about a lot when it comes to training and rehabilitation is the need to train the body in all three planes.  This often requires moving in one plane of motion and stabilizing in the other two.   We are often very good at moving in the sagittal plane, and poor at stabilizing in the transverse and frontal planes.  This is a big topic of discussion in my program Functional Stability Training of the Lower Body.

To enhance this triplanar stability, we often attempt to facilitate greater contraction of the gluteus medius muscle during sagittal plane exercises.  The lunge in particular is a great exercise for triplanar stability as the narrow stance challenges strength in the sagittal plane and stability in the transverse and frontal planes.

 

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the Lunge

The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the LungeA recent study was published in the Journal of Strength and Conditioning Research that investigated the effect of holding a dumbbell in either the contralateral or ipsilateral hand during a split squat and forward lunge.  (Note: they called it a “walking lunge” but I am 99% certain it was a forward lunge, so I’m just going to say forward lunger in this article…  probably just semantics.)

The study found that:

  • Holding the dumbbell on the ipsilateral side had no effect on glute med activity.
  • Holding the dumbbell on the contralateral side resulted in a significant increase in glute med activity, but only during the forward lunge, not the split squat.

I was a bit surprised that glute med activity was not impacted during the split squat, but perhaps the static nature of the position inherently requires less transverse and frontal plane stability.

There was one other finding from this study that I thought was interesting.  Kinematic differences during the forward lunge were found between a group of trained individuals in comparison to a group without training experience.

This makes sense as the forward lunge is a complex movement pattern that requires an understanding of how to control the pattern.  It requires both mobility and stability, but also the ability to control the eccentric deceleration phase.

contralateral lungeHowever, there were no kinematic differences between training age during the split squat, meaning that both novice and experienced trainees performed the split squat in a similar fashion.  This make split squats a great exercise to incorporate in the early phases of training for those with limited training experience, eventually progressing to forward lunge as they get better at moving and stabilizing the pattern.

This helps solidify the use of split squats in our lunge regression system.

 

Implications

I like simple studies like this.  Having the rationale to make small tweaks to your program is what sets you apart.  It’s the small things that may not be obvious at first but will produce better results over time.

Based on these results, I would recommend using the split squat with bilateral dumbbells to maximize strength gains since a unilateral load did not alter glute med activity.  The split squat is more of a basic exercise, so why not just use it to work on strength gains in the novice trainee.  As the person progresses, you can add the forward lunge variation with a contralateral load to enhance triplanar stability.

 

 

 

How to Improve Overhead Shoulder Mobility

The latest Inner Circle webinar recording on my How to Improve Overhead Shoulder Mobility is now available.

 

How to Improve Overhead Shoulder Mobility

Improving Overhead Shoulder MobilityThis month’s Inner Circle webinar is on how to improve overhead shoulder mobility.  In this webinar I’ll discuss:

  • We we are losing overhead shoulder mobility
  • Why it matters
  • The 4 main reasons why we lose overhead mobility
  • How the body compensates when we lose overhead mobility
  • How to assess for a loss of overhead shoulder mobility
  • What you MUST stop doing immediately with people that have lost overhead mobility – you are making them worse!
  • Corrective exercises to enhance overhead position
  • Manual therapy techniques to improve mobility

 

To access this webinar:

4 Ways to Improve Overhead Shoulder Mobility

4 Ways to Improve Overhead Shoulder MobilityOne of the most common areas we attempt to improve in clients at Champion PT and Performance is overhead shoulder mobility.  If you really think about it, we don’t need full overhead shoulder mobility much during our daily lives.  So our bodies adapt and this seems to be an movement that is lost in many people over time if not nourished.

I’m often amazed at how many people have a significant loss of overhead mobility and really had no idea!

That’s not really the issue.  The problem occurs when we start to use overhead mobility again, especially when doing it during our workouts and training.  Exercises like a press, thruster, snatch, overhead squat, kipping pull up, toes to bar, handstand push up, wall ball, and many more all use the shoulder at end range of movement.  But here are the real issues:

  • Add using the shoulder to max end range of overhead mobility and we can run into trouble
  • Add loading during a resisted exercise and we can run into trouble
  • Add repetitions of this at end range and we can run into trouble
  • Add speed (and thus force) to the exercise and we can run into trouble

 

4 Ways to Improve Overhead Shoulder Mobility

In this video I explain the 4 most common reasons why you lose overhead shoulder mobility and can work on to improve this movement:

  1. The shoulder
  2. The scapula
  3. The thoracic spine
  4. The lumbopelvic area

The first three are commonly address, but not so for the lumbopelvic area, which is often neglected.  I’m going to expand on this even more in this month’s Inner Circle webinar.  More info is below the video:

 

Improving Overhead Shoulder Mobility

This month’s Inner Circle webinar is going to expand on this topic and discuss how and why you want to improve overhead shoulder mobility.  In this webinar I’ll discuss the importance of overhead mobility, how to assess the 4 most common causes of loss of mobility we discussed above, what corrective exercises to perform, and tips for manual therapy.  The live webinar will be on Monday April 20th at 8:00 PM EST, however will be recorded for those that can not attend live.

 

 

 

Scalene Hypertrophy

I recently evaluated yet another Major League baseball player with the “yips,” or what I like to call thoracic outlet syndrome.  I really don’t believe in the yips at all and feel that thoracic outlet syndrome is almost always to blame.  Telling a professional athlete it’s all in their head or some mysterious mechanical flaw is just insulting.

One of the major reasons that thoracic outlet syndrome occurs in baseball pitchers is from hypertrophy of the scalene muscles (and sternocleidomastoid).  Throwing a baseball causes many adaptations to the body, including this increase in scalene size.

Here is a video of the athlete inhaling with his head turned to each side.  Notice the significantly larger scalene and sternocleidomastoid on his right side.

scalene hypertrophy

I wish I had a magic trick to help in this situation.  I will perform manual therapy on the scalene muscles, surround musculature, 1st rib, and thoracic cage, however, it’s hard to combat the hypertrophy associated with throwing.

Understanding what to look for is the first step, though.  Scalene hypertrophy is a subtle finding to detect on examination.