Frozen shoulder sucks!

• No one knows what causes it – in fact – “Most often, frozen shoulder occurs with no associated injury or discernible cause”
• We do know that frozen shoulder results from inflammation, scarring, thickening and shrinkage of the capsule surrounding the shoulder joint.
• An injury to the shoulder can lead to frozen shoulder.
• No one can tell you how long it will last.

The Mayo clinic reports:

Your risk of developing frozen shoulder increases if you’ve recently had to have your arm in a sling for several weeks, or if you have had surgery in which your arm was immobilized in a specific position for a prolonged period.

How to Heal a Frozen Shoulder

That’s a million dollar statement – if you knew how to do it.  In truth, typical treatment involves:  the use of anti-inflammatory medications, cortisone injections and physical therapy.  Physcial therapy can involve several different modalities:

• Ice packs
• Electric stimulation
• Range of motion stretches
• strengthening exercises

If none of this helps, you may be a candidate for Manipulation Under Anesthesia.

Manipulation Under Anesthesia (MUA)

Sounds sanitary – doesn’t it?  What it really means is that you’re put to sleep and then your shoulder joint is forced to move in various positions:  flexion, external rotation, internal rotation.  This manipulation stretches and tears the scar tissue that has developed in the joint capsule.  Oh – they put you to sleep because of the pain involved.

Video of Shoulder Joint Manipulation Under Anestesia

Click here to view the embedded video.

Notes from MUA video

As you can see, the doctor performing the manipulation in the video is moving the patients shoulder in the same way a physical therapist does during physical therapy.  The only difference is the doctor is not inhibited by the patients pain level.

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Post tags: external rotation, frozen shoulder, internal rotation, manipulation

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If you’ve ever had shoulder pain, then you know how miserable it can be.  It’s dificult to get comfortable and often impossible to sleep.  Wouldn’t it be wonderful to get a deep tissue massage?  You bet it would – but who’s going to do it?

The Tennis Ball Solution

The problems with massages:

• they can be expensive
• sometimes difficult to find someone qualified – naturally, this depends on your location (big city vs. rural)
• amateur massages always leave you wanting more – not quite providing total relief

Please Yourself

Here’s a thought – make yourself happy.  Okay, don’t get any off-color ideas – I’m talking massage.  Deep tissue massage / trigger point therapy.  Get a tennis ball and follow along with the video.  Let me know what you think – did it help you?

Click here to view the embedded video.

My thoughts on this shoulder pain relief technique

I love a massage – who doesn’t?  But my masseuse (my wife) usually gets tired long before the knots are worked out.  With this tennis ball technique, I can put pressure directly on the problem area and then control the amount of force applied.  Give it a shot.

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Post tags: deep tissue massage, shoulder pain, trigger point therapy

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Shoulder Pain and Confusion

Frozen shoulder can be mysterious.

• How did you get it?
• How long will it last?
• What can you do?

No one has a definitive answer as to what causes frozen shoulder or as it is medically known – adhesive capsulitis.  Basically, frozen shoulder is a stiff shoulder that does not move freely.  It is characterized by:

• the inability to reach overhead
• an overall loss of motion
• decreased shoulder flexibility
• intense pain

A video explanation of frozen shoulder

Will frozen shoulder affect you?

More mysteries – though no one seems to know why, but if you have:

• diabetes
• Parkinson’s desease
• cardiac disease
• a traumatic shoulder injury / surgery

…then you are more likely to contract a frozen shoulder.

As Dr. Halpern states in this video, intense physical therapy is usually the answer.  If you are suffering the pain of frozen shoulder, then schedule a visit with your doctor so that he can refer you to a physical therapist.

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Post tags: adhesive capsulitis, frozen shoulder, shoulder pain

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…and sometimes a lot less!

Let’s get something straight – I’m not:

• a shoulder expert / guru
• a physical therapist
• an athletic trainer
• a physician

…please note the disclaimer box at the top of the far right column.  This blog is meant to provide you with sources of information that will allow you to make educated decisions about your shoulder and its’ care.

Scary Shoulder Exercise Video

Click here to view the embedded video.

This video scares me.

• notice the grimace on the face of the student / client within the first 3 seconds
• the weight used is obviously too heavy
• the instructor has to help the student / client at the end of each rep

Lack of Understanding is Dangerous

A major issue for me is the lack of understanding ( by the instructor ) that the rear delts ( used in the first stage of the exercise ) are far stronger than the rotator cuff ( used in the second stage of the exercise ).  This lack of understanding is causing the student to struggle as he attempts to perform the exercise correctly.  Imagine doing a lying dumbbell press with a heavy weight and then at the lockout position transitioning into a flye – it would feel like your chest is ripping apart – and it might.

Muscle Strength Imbalance

The rear deltoids are strong pulling muscles and the weight used in this exercise is probably appropriate for the inital movement.  However, the rotator cuff muscles are not nearly as strong as the deltoids – and it shows on the face of the student as he tries to rotate the weight in the second stage of the exercise.

This exercise should be broken into two parts:

1. a rear delt movement such as a rowing exercise – this would allow the student to use the weight shown.
2. a rotator cuff strengthening exercise – with far less weight – which is preferred.

Final Thoughts

I do like this shoulder exercise – just not as shown.  The amount of weight used should be decreased until the student can perform the exercise without pain.  Always use common sense.  If an exercise hurts you, then stop and  re-examine why and how  you’re doing it.

• are you performing the exercise correctly?
• are you using the “right” amount of resistance ( weight, band, etc. )?
• are you doing too many exercises for the same body part?

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Post tags: rotator cuff, shoulder exercises

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Sometimes, I do stupid things!

Don't do stupid things!

Like most men, I’m prone to acts of stupidity.  That’s right, testosterone induced bravado – though not as much as I grow older.  At least I’ve progressed beyond the stage where alcohol is involved.

My stupid shoulder trick

About five years ago, my two workout partners and I devised a complex contest to motivate us during our workouts.  Basically, we did several exercises and recorded our max weight and and the max number of times that we could perform that lift.

For example:

• how much can you bench press for a minimum of 15, 10 and 5 reps?
• how many chins can you perform with how much added weight for a minimum of 15, 10 and 5 reps?

We limited the exercises to multi-joint exercises – bench press, squat, leg press, seated dumbbell press, weighted chins, incline dumbbell press, etc.  We recorded our starting weights / reps and then pushed ourselves over a 60 day time period.  The winner would be determined not by who did the most weight / reps, but by who had made the largest percentage increase in weight / reps.  This put us all on a level playing field.

Contest takes its toll

Because we were monitoring so many different lifts, it took about a week to get the final results.  On chest day, we would do our chest maxes.  On shoulder day, we would do our shoulder maxes.  So, it took about a week to determine the winner.  In fact, it came down to the last day.

Weighted Chins for the Win

The last day was back day and it was close – only percentage points separated us.  In order for me to remain in contention, I had to perform 6 wide grip chins with an additional 35 lbs.  I didn’t want to waste any energy, so I did about 5 quick warmups and strapped on the necessary weight and started pulling like I was in the “World’s Strongest Man” contest.

I did the needed six reps, but not without pain.  About the time I reached four reps, I began to feel intense pain in my left shoulder – but like the guy in the picture, I just kept going.

We all win – I lose

The contest was very close.  In fact two of us tied for the win, but in reality, we all won because we had driven ourselves to the best shape of our lives.  We had also monitored our bodyweight/fat composition and it played a part in the contest.  I told you it was a complex deal.

The cost for me was huge.  I could barely lift my left arm.  Lat pulldowns with 50 lbs resulted in me “crying like a baby”.  I was out of commission.  It took months before I could begin serious training again.  But the big loss for me is that I can no longer do wide chins.  If I try to move beyond shoulder width, its agony.

Don’t be stupid – watch the video – warm-up your shoulders

This is a good video that shows you some of the basic exercises that will save you from the dangers of shoulder injury.  Do them!  Before every workout!

Click here to view the embedded video.

My thanks to Lee Hayward for an excellent video.

Photo Credit:  the mad LOLscientist

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Post tags: shoulder exercises

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Radically Different Shoulder Stretching Technique

I’ve seen most traditional shoulder stretching exercises – but this one is new to me.  New in a good way.  After watching the video several times, I went down to the basement to give it a try.

My Shoulder Feels Good

It took me a couple of minutes to get the hang of it, but then you just kind of relax and enjoy the stretch.  My suggestions:

• start with a light kettlebell, especially if you’re not working out regularly and/or you’ve never used kettlebells before
• go slow – there is no rush, in fact I felt better the longer I stretched
• watch the video before and after trying it – make adjustments and try it again

Click here to view the embedded video.

My thanks to Unbreakablefitness.

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Post tags: kettlebells, shoulder exercises, shoulder stretching

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During the holidays, we get to spend time with visiting relatives.  Often, it’s the only time we get to see them all year.  My sister always comes home to Alabama to visit our parents for Christmas.  During her stay this time, she asked me how the Rotater business was doing and was excited to hear that:

• 5 NFL teams are using the Rotater
• we just sent a large order to the US Navy SEALS
• we recently met Donald Trump

MRI Results – SLAP Tear!

Suzan (my sister) asked me what a SLAP tear was and if the Rotater would help her.  I had posted an article about SLAP tears back in September, so I pulled it up on the web and discovered the video I had posted was no longer available – it was a great video, too.  I have yet to find a suitable replacement.

SLAP Tear

Anyway, to make a long story shorter, Suzan had an MRI done just prior to coming home for Christmas and it revealed that she had a SLAP tear.  That doesn’t really surprise me.  She is a life-long athlete who went to college on a basketball scholarship, played competitive softball into her 30’s and has trained with weights for the last 20 years.

Superior Labrum from Anterior to Posterior Tear

- what does that mean?  If you’ll look at the picture to the above, you’ll see an image of a shoulder ( without the upper arm ).  The oblong structure labelled “GLENOID LIG.” is where the ball of your upper arm would be.  It is maintained in that position by the rotator cuff ( not shown ).

Notice the BICEPS ligament attaches at the top of and to the GLENOID LIG. A SLAP tear occurs when there is a separation of the GLENOID LIGAMENT in front of the BICEPS LIGAMENT (anterior) and behind the BICEPS LIGAMENT (posterior) – if you draw a line from one blue arrow to the other and imagine peeling the GLENOID LIGAMENT away from the bony structure of the GLENOID FOSSA, you would will have a SLAP tear.

Symptoms of a SLAP tear

• A dull throbbing ache in the joint.  This can be brought on by very strenuous exertion or simple household chores. Sufferers notice that they turn to ice packs more frequently for relief.
• Difficulty sleeping due to shoulder discomfort. The SLAP lesion decreases the stability of the joint which when combined with lying in bed causes the shoulder to drop. This in turn pulls on the muscles and ligaments causing discomfort.
• For an athlete involved in a throwing sport such as baseball, pain and a catching feeling are prevalent.
• Any applied force overhead or pushing directly into the shoulder can result in impingement and catching sensations.

Community of SLAP tear sufferers

slaptear.com is an interactive website that offers extensive and easy-to-understand information – usually from the patients point of view.  It’s worth a visit.

The Real Scientific Explanation of SLAP tears

Mike Reinold, PT, DPT, ATC, CSCS, is considered one of the top experts in the fields of physical rehabilitation and sports medicine.  Mike has written several very good articles about SLAP tears.  If you want the compete 411, then take a look at the following articles by Mike:

• What Exactly Is a SLAP Lesion? Top 5 Things You Need to Know About a Superior Labral Tear
• Mechanisms of Injury to the Superior Labrum

How to test for a SLAP tear – a video by Mike Reinold

Click here to view the embedded video.

Will the Rotater help if you have a SLAP tear?

The answer is a qualified no!  The tear must be surgically reattached and allowed to fuse / grow together.  However, after surgery and when you doctor releases you to begin physical therapy, then the Rotater can be instrumental in helping you to regain your range of motion.

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Post tags: physical therapy, shoulder, shoulder surgery, SLAP tear, the Rotater

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Last month I wrote an article describing how shoulder replacement is an option for dealing with chronic shoulder pain. However, this procedure is not for everyone.  If you have an irrepairable rotator cuff tear, then conventional shoulder replacement surgery will not provide the results that you hope for.

Reversing the solution

By reversing the placement of the ball and socket, the deltoid muscles are able to provide the action needed to allow shoulder mobility without compromising shoulder stability.

Reverse shoulder replacement has been done in Europe for many years, but has only become an option for patients in the U.S. since 2004.

News Video of Reverse Shoulder Replacement Experience

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Post tags: rotator cuff, shoulder replacement

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Shoulder Pain Sucks!

Photo used courtesy of Saquan Stimpson/monstershaq200 0

It drains you, mentally and physically – especially if your particular condition is long term.

• it’s difficult to get quality, restful sleep when every sleeping position is uncomfortable or becomes uncomfortable just about the time you drift into R.E.M. sleep, causing you to jerk awake
• chronic shoulder pain affects almost every movement you make – lifting carrying, reaching pushing, pulling, holding – everyday tasks ( combing your hair or reaching for your wallet ) that you took for granted become impossible or so painful that you avoid them
• this combination of a lack of sleep plus persistent pain condemns you to a lower quality of life than you deserve

Shoulder Replacement is just one option

There are many options for dealing with your persistent shoulder pain.  Consult your physician to learn about the options available to you.

Typically, shoulder replacement is performed when a person has developed Osteoarthritis in the shoulder joint.  Though not nearly as popular as knee or hip replacements, shoulder replacement surgery is performed on about 10,000 – 23,000 people per year.  The wide discrepancy depends on the source of your information

Dr. Josh Dines and Dr. Rock Positano have posted an excellent article detailing their results:  Shoulder Arthritis Doesn’t Mean The End Of Sports

Osteoarthritis – What is it?

The short, non-medical answer – the super-slick cartilage that covers the surfaces where bones meet and form a joint, has deteriorated.  This results in bone to bone contact and a great deal of pain and usually affects patients over 60.

A much more medical definition can be found here:  Osteoarthritis ( OA or Degenerative Arthritis )

Two Shoulder Replacement Videos

The following links will take you to two excellent videos that did not have an embed option, so I couldn’t post them here – just follow the links, you won’t be disappointed.

1. Shoulder Replacement Part I – Surgery performed by Orthopedic Surgeon Dr. Stephen Zabinski – This video is over 18 minutes long.  The first part describes the kind of patients who can benefit from shoulder replacement surgery.  Then, Dr. Zabinski describes the prosthesis and how it works.  Finally, the last 9 or so minutes are the actually shoulder surgery – which is very good.
2. Shoulder Replacement Part II – Interview with Orthopedic Surgeon Dr. Stephen Zabinski – This video is almost 4 minutes long and is basically an interview with Dr. Zabinski and the patient who he performed this surgery on.  It was her 2nd shoulder replacement – her recovery is remarkable.

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Post tags: osteoarthritis, shoulder pain, shoulder prosthetic, shoulder replacement, shoulder surgery

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What is a Protocol?

It is an official procedure, set of rules or method that define how something is to be done.  A good protocol is developed after extensive research and experimentation.

Therefore a shoulder rehab protocol should be:

• extensively researched
• based on repeated observations
• tested
• documented
• monitored and retested as new information and techniques arise

Rotator Cuff Rehab Protocol

Recently I came across a blog post entitled – Rehabilitation Protocol Following Arthroscopic Rotator Cuff Repair by Mike Reinold.  So, who is this guy?

Mike Reinold - Shoulder Rehab Expert

• the Rehabilitation Coordinator & Assistant Athletic Trainer of the 2007 WORLD SERIES CHAMPION Boston Red Sox Baseball Club
• the Coordinator of Rehabilitation Research and Education of the Department of Orthopedic Surgery, Sports Medicine Division, of Massachusetts General Hospital at the new MGH Sports Center in Boston, MA
• was formerly the Facility Director of Champion Sports Medicine and the Coordinator of Rehabilitative Research & Clinical Education at the American Sports Medicine Institute in Birmingham, AL – where he worked with renowned orthopedic surgeon James Andrews, M.D. and rehab guru Kevin Wilk, PT, DPT

There is much more listed on his “About Me” page, but I think this is more than enough to establish his credibility.

Rotator Cuff Surgery is Common

Shoulder injuries are common – especially those involving the rotator cuff.  Although we often associate rotator cuff damage with athletics, the fact is that most rotator cuff injuries are the result of two factors:

• repetitive motion
• age

As the baby boomers age, rotator cuff injuries become more common.  The point is – THERE ARE ESTABLISHED METHODS that have been developed to rehabilitate your shoulder following surgery.  Mike’s article deals specifically with arthroscopic rotater cuff repair.  Do you know:

• the 6 Goals of Rehabilitation Following Rotator Cuff Repair?
• the 3 Most Important Keys to Rotator Cuff Repair Rehabilitation?

Be proactive, become involved in your shoulder rehabilitation – read Mikes article and discover the answer to these questions and much more.

Note to Subscribers and Regular Readers

It has been some time since my last posting and I apologize about that.  My PC crashed for the last time.  That’s right – I’m now a Mac convert.  The learning curve has not been nearly as steep as I expected, but I lost everything on two hard drives – yes, one was the back up.

Anyway, I’m rebuilding as many of my files as I can.  A lot of stuff was stored online, some on zip drives and some on my external hard drive.  It’s good to return to a regular posting schedule.

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Post tags: arthroscopic surgery, protocol, rotator cuff, shoulder injury, shoulder rehab

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