-“Shoulder Injury Facts & Rehabilitation Ideas”
-“Leg Training for Athletes: The lunge”




For acute shoulder injuries the immediate treatment is extremely simple: ice the area and avoid any motion that causes further pain, but complete rehabilitation will most likely involve the strengthening of the external shoulder rotators and posterior deltoid. Ice should always be applied after a rehabilitation session to reduce the inflammation from activity.


Shoulder pain can occur from strength imbalances between the deltoids and the external shoulder rotators. The internal rotator muscles and the anterior deltoid muscle are very strong, therefore it is important to train the external shoulder rotators, the posterior deltoids, and muscles of the upper back in order to achieve balanced strength in this area.


When training the external shoulder rotators, ensure a time-under-tension (TUT) of at least 40-seconds using a light- to moderate-load (6-8 repetitions) at a 3- 2 –1 tempo (see ISSUE #53). Also, limit your use of the Smith machine apparatus because it locks your movement pattern into an unnatural fixed plane. See an injury rehab professional (therapist) to overcome these problems.


Inflammations from impingement (bursitis, tendinitis)

The rotator cuff consists of four small muscles that help the pectoral muscles to hold the precarious shoulder joint together. The large range of motion (ROM) permitted by the design of the shoulder joint is a benefit to performance, BUT/ is offset by the ease with which impingement of the shoulder structures occur. Impingement can lead to inflammation (specifically of the bursa and rotator cuff tendons), tissue degeneration, pain, swelling, and weakness.


Impingement occurs when the head of the humerus (upper arm) pushes upward against the underside of acromion process of the scapula (shoulder blade) and pinches one of the many structures associated with the shoulder joint (i.e. a tendon or bursa). Compression of the structures leads to inflammation such as bursitis or tendinitis. A bursa is a fluid sac found in large joints and serves to assist normal joint mechanics. Bursitis (inflammation of the bursa) accompanies 90% of rotator cuff tears and can occur along with shoulder impingement (i.e. from poor exercise technique, such as narrow-grip upright rows).


The chief causes of rotator cuff tendinitis are repetitive overhead movements (i.e. poor throwing technique, swimming, volleyball spiking, etc.). Avoid all behind-the-neck movements because these movements may cause the rotator cuff tendons to become impinged between the humerus and acromion process. To reduce impingement from the lateral raise, keep the arm at OR below parallel to the shoulder to avoid impinging the subscapularis muscle.


In summary, the shoulder joint is fragile, BUT/ its anatomical design permits an extensive ROM. The benefits are often outweighed by the risks of having such an easily injured joint. Train smart and you will help protect this area, BUT/ train improperly and you may injure yourself without even participating in your chosen sport!


Shoulder injuries often occur due to chronic misuse, so correct your form as soon as possible and avoid unnecessary exercises (front pulldowns and presses are likely safer and just as effective as those performed behind-the-neck). You may also want to reduce the amount of direct training you do for the shoulders. The shoulders are extremely active in many chest and back exercises and will receive an adequate amount of exercise stress from these movements.





-          Muscles trained

: same as squats (quadriceps, hamstrings, & gluteus maximus), plus the iliopsoas

  (hip flexor) of the trailing leg & the calf muscles (soleus & gastrocnemius) of the

  leading leg


-          Positioning

: can be done using either a barbell OR a dumbbell (DB)

: bar – place on the trapezius muscle (similar to squat)


: DB – hold the DB’s in hands at sides


-          Forward step movement

: take an “exaggerated” step forward with the “lead” leg

: inhale as you step forward

: keep torso erect and toes pointing straight ahead

: plant the lead foot in line with the lead knee

: flex the lead knee and lower the trailing knee towards floor with the torso erect

: balance on the ball of the trailing foot and flex the trailing knee

: bring the trailing knee 2 inches from the floor with lead knee flexed 90 degrees


-          Backward movement

: exhale as you return to the starting position

: push off the lead foot with the quadriceps & hip extensors (hamstrings & glutes)

: allow the trailing heel to contact the ground

: place the lead foot back in the starting position


-          Summary

: step forward and plant lead foot

: perform a one-legged squat then push off and stand up

: finish in original position


The lunge is an excellent exercise for complete leg strength development. It is very efficient (trains many muscles in little time) and is excellent for athletic training (movement is very sport-specific). Try it, BUT/ start easy (1-2 sets of 12-15 reps), or you will have an extreme pain in the butt the next day!





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