Six ways to prevent and rehabilitate shoulder pain

Are you hunched over all day? Do you have rounded shoulders? Suffering from neck and shoulder pain?

Most of the population spend their days internally rotated, going to the gym to work chest and back, neglecting the small but essential rotator cuff muscles that keep their shoulder girdle in balance. When the external rotators are neglected, shoulder problems can arise and the prime movers will shut down when under high tension, and you may experience a sharp pain in the front of your shoulder.

Your rotator cuff muscles should be able to lift at least 10% of your bench press. The good news is, once your external rotators are able to perform under high loads, you will directly improve your larger pressing and pulling movements.

 

Six ways to prevent and rehabilitate shoulder injuries

  1. Emphasise a full range of motion. Pay attention to the eccentric motion (lowering of the resistance) to a completely stretched position.
  2. Improve internal rotation. By increasing the range of motion of the antagonist muscles between sets, you increase motor unit activation of the prime movers. An effective method is PNF.
  3. Apply gradual overload. Start with low weight to improve motor patterns, but eventually you will want to use a challenging weight.
  4. Maintain proper head and wrist position. Keep the wrist in a neutral position to minimize the stress on the elbows. Proper head position reduces strain on the neck.
  5. Always train the non-dominant arm first. The number of repetitions done by your weaker arm will determine how many reps you do for your dominant arm. Performing extra reps on the weaker side can allow it to catch up.
  6. Use soft tissue techniques, such as ART. A qualified practitioner who will release the muscles around the shoulder girdle and forearm will help improve your movement. The deep and superficial forearm flexors, infraspinatus, latissimus dorsi, long head of the triceps, subscapularis, teres major and teres minor can all contribute to imbalance of your shoulder girdle.

 

A strong, functional shoulder girdle translates to better performance in sports and daily activities. Unsure where to start? Find a trainer and a therapist to help you improve your shoulder girdle balance.

Toronto Body Transformation – Case Study 1

Somehow, people are led to believe that chronic neck and lower back pain are a normal part of life and that your genetic predisposition determines your hamstring flexibility. You do not have to live with chronic pain and muscular tightness. We design every training program to correct structural imbalances to avoid potential injury.

 

Improving posture through structural balance

Six weeks ago, KX client Neil was suffering from chronic neck, mid back and lower back pain. Posturally, on the left, you can see that his rib cage was anteriorly (forward) shifted and posteriorly (backward) tilted, compressing his mid-back, causing pain. His mid and lower back muscles were underactive, and left arm was very internally rotated.

 

Postural and movement assessment

Like majority of the population, Neil’s career forces him to be seated all day. Slumping forward  over a computer creates increased muscular tension in the upper trapezius, pecs, hamstrings and hip flexors. Consequently, the opposing muscles such as the lower trapezius, scapular stabilizers, transverse abdominus and obliques become weak. Tight hamstrings tilts the pelvis posteriorly in an attempt to correct the anterior tilt imposed by tight hip flexors. This “tug of war” when not protected with a strong abdominal core,  can induce lower back pain during lifting movements.

 

Correcting imbalances through strength training

By targeting these imbalances using strength training and effective myofascial stretches, Neil can better externally rotate his left arm and stabilize his scapula during pushing and pulling movements. By stabilizing his rib cage relative to his pelvis, he can activate his core and reduce back pain, enabling him to deadlift without pain.

 

You don’t have to live with back pain

If you’re looking to improve your posture, get rid of nagging chronic pain, perhaps put on some lean mass in the process, book a complimentary consultation with the KX Team. KX Therapists are an asset for diagnosing these postural issues and our KX Coach will be help you every step of the way to correct movement patterns, giving KX the edge as a multidisciplinary team to optimize the results of the training.

 

Train smarter, and harder.

Oh, and he also gained 5.5lb of lean muscle mass. Good job, Neil.

Posterior pelvic tilt – the “no ass syndrome”

The general sitting population suffers from the  “no ass syndrome” (NAS). The NAS is unflatteringly but commonly paired with thoracic flexion (slouching of the upper back). This position increases the risk of herniation during lifting heavy (as well as light) objects.

How do we go about fixing this?

As usual, we assess and determine which muscles are locked long and weak and short and tight. We’ve written about structural balance here. The most commonly tight muscles in posterior pelvic tilt are the external obliques, rectus abdominis, glutes and hamstrings. Most importantly, the hamstrings insert above the pelvis and below the knee. The tension in the hamstring between the glutes and the calves, contributes to the “back sway” appearance.

How to fix posterior pelvic tilt, “no ass syndrome”

The hip flexors, notably the psoas and rectus femoris, tensor fasciae latae, spinal erectors will need to be strengthened and activated. Here are some exercises to lengthen and strengthen the corresponding muscles.

Piriformis stretching –  tight piriformis associated with posterior pelvic tilt can elicit sciatica-like symptoms.
Hamstring stretching – tight hamstrings are responsible for pulling the hips posterior.
Quadricep strengthening – strengthening the quadriceps will reinforce anterior pelvic tilt
Lower back strengthening with back extension and side planks. Read more about it at how to overcome low back pain here.
Thoracic spine mobilization – using foam roller. NAS is commonly paired with thoracic flexion. Mobilizing the thoracic spine will help take the thoracic spine out of flexion.

If any of this sounds familiar to you, get a professional functional movement assessment and appropriate Chiropractic treatment. Performing exercises which induce pain will only make the injury worse.

Train smarter, not harder.

What you need to know before starting a program

Most people we see want to drop x% of body fat and look good naked. Guess what? Your posture is half the battle.

A good trainer will be able to help you achieve your goal, but should also be able to identify, as well as modify exercises and correct structural imbalances to avoid potential injury. When a muscle becomes locked short and tight, the antagonist (opposite) muscle often becomes locked long and weak. For example, in the common slouching in front of the computer posture, the trapezius is ‘locked long’, eccentrically loaded and strained, while the pectoralis minor will be ‘locked short’, concentrically loaded and bunched. This creates imbalance in the body and increases fascial bonding and thixotropy of the surrounding intercellular matrix. In layman’s terms, the body often will reinforce these faulty recruitment patterns and lay down more collagen fibers around the awful position you sit in.

 

What is the danger of neglecting structural balance?

Now, imagine putting muscle on a structurally imbalanced person, lets say, with typical forward head posture from tight anterior chain, and weak, under active posterior chain. You will start building muscle on the imbalanced foundation, displacing the spine more anteriorly, and putting pressure on the joints and ligaments. The long and weak muscles will be weaker and the short and tight muscles will become tighter. poor desk posture

No one should be doing plyometrics if they are not structurally balanced or able to squat 1.5x their body weight. Maybe you’ll see it performed by Instagram “fitness enthusiasts”, but that typically does not work for the general structurally imbalanced population who are doing jump squats with underactive gluteuses who slouch in front of their desk 8 hours a day, 5 days a week.

 

Our team of exercise coaches and therapists, we will help you reach your goals faster.

Do you experience nagging shoulder pain? Weak upper back? Tight neck or hips? We’ll fix that first. Before an exercise program is created, we first assess your structural balance with functional movement patterns and static posture. Then we send you off to our Chiropractor for an orthopedic assessment and spinal analysis. Using all the given information and your goals in mind, we then create a customized training program tailored for you.

 

So, will it take longer to reach my goal?

Absolutely not. Our clients typically drop 1-2% body fat every 2 weeks, demonstrate better posture, energy and lower their risk of injuries. If you want to experience it for yourself, come in for a complimentary consultation and a training session, on us. Limited spots available.

 

You’re only as strong as your weakest link. Train smarter, not harder.

 

Suffering from knee pain?

Build a VMO.

Are you an avid runner suffering from back and knee pain? Does your knee feel “achy” walking up and down the stairs? If you do, then you probably suffer from lack of VMO (vastus medialis oblique) development. This teardrop-shaped quadricep muscle has horizontal fibres on the lower portion and is responsible for stabilizing your knee medially.

 

Causes of knee pain

Imbalance between vastus lateralis (VL) and vastus medialis oblique (VMO), may be an aetiological factor in the development of patellofemoral pain syndrome. Preferential atrophy or inhibition of the VMO may contribute to patellar instability, by permitting VL to exert a relatively greater lateral force, displacing the patella from its normal position within the knee. Other common causes include muscle imbalances in the hip and thigh, arthritis or a tight iliotibial band—a tendon that runs along the outside of your thigh.

 

 

How to build a VMO

Our favourite exercise to strengthen the VMO is the Poliquin Step Up, Petersen Step Up, and Side Step Up. Focus on activating lower medial quadrant of your thigh muscles. Perform high reps of these exercises.

 

 

Unsure where to start? Find a trainer and a therapist to help you get rid of your aches and pains here.

Overcoming Back Pain

Causes of Low Back Pain

The most common cause of low back pain is postural stress. Poor posture, prolonged bending in a working position, heavy lifting, standing or lying down for a long time in a suboptimal position can lead to back pain. Weakness in the core may cause spinal pain as well as increase chance of injury. 

 

Loss of integrity in lower back

Most people suffer from a flattened lower back over a long period of time causing long and weak posterior muscles and short and tight anterior muscles. Without care and training, people will eventually lose their lordosis and experience back pain.

 

Overcoming back pain

  1. Sit properly, or better yet, sit in a squat. Sit in position where your chest is open with maximal lordosis, knees above hips. Sitting in a bodyweight squat allows you decompression the spine.
  2. Recognize muscle imbalances. When a muscle becomes short and tight, the antagonist (opposite) muscle becomes long and weak. This creates structural imbalances, leading to pain.
  3. Recruit the proper muscles for specific movement. This could be a result of muscle imbalances. The short and tight muscles will compensate for the long and weak muscles, leading to excessive compression, torsion and shear in the joint. This can lead to inflammation, pain and eventually injury.

 

Most common mistake for back pain

One of the most poorly executed exercise for low back and glutes is the back extension (this includes the horizontal, 45* or on a ball). As you are at the bottom position, you should INITIATE the movement from your glutes! Not just at the top! By engaging your glutes throughout concentric, isometric, and eccentric motion while engaging the low back isometrically, you take the compression off your lumbar spine and activate your glutes. DO. NOT. EXTEND. WITH. YOUR. LOW. BACK! I cannot stress this enough!

 

Your body is brilliant at compensating for injuries. When one muscle becomes hypotonic, surrounding muscle will compensate for being hypertonic. If any of this sounds familiar to you, get a professional functional movement assessment. Performing exercises which induce pain will only make the injury worse.

 

Train smarter, not harder.

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