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Exercise Hacks Ep. 7 - Core Stability for Shoulder Mobility

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In this video we discuss a very relevant truth when it comes to the shoulder - sometimes your shoulder pain is not a shoulder problem.

The inability to properly stabilize the rib cage and pelvis as well as having adequate movement in the thoracic spine can result in problems associated with the shoulder blade or shoulder joint itself. As a general rule, reduced mobility or stability in one area of the body will result in compensations in other areas. These compensations often take the look of reduced movement quality, joint/muscle stiffness, or poor movement control.

To correct the problem you must first identify the true cause.

This video demonstrates an exercise progression that can help improve core and scapular stability as they relate to shoulder motion. The plank variation utilizes single elbow support on one arm and a slider with a reach on the opposite arm all while being performed from support on either the knees or toes.

Some tips and pointers to keep in mind during the set-up and execution of this exercise:

  • Choose a support position (knees or toes) that enable you to maintain proper posture and support without compensation during the exercise.
  • Brace the core with proper intrabdominal pressure (IAP), maintain a neutral spine and pelvis
  • Shoulders, rib cage, and hips shoulder remain parallel to each other. Think about maintaining a 'table top' position from shoulders to hips.
  • Keep the chin tucked and maintain a neutral head and neck position.
  • The only movement that occurs is from the hand/shoulder on the slider. Perform a reach straight ahead and return to the starting position with hand next to the shoulder.
  • Perform 2-3 sets of 5-8 reps per arm and switch sides. Be sure to give yourself adequate rest between sets and allow for enough recovery.
Dealing with shoulder pain? Give our office a call and set up an appointment so we can customize a rehab program tailored to you.

 
 
More related reading:

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/beginners-guide-injury-recovery/

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/solving-movement-problems-entertainment-vs-effective/

Exercise Hacks Ep. 5 - Shoulder External Rotation

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In this video, we discuss shoulder external rotation commonly performed on a cable column machine. This exercise is also frequently performed with the use of bands. Regardless of whether you use the cable column or bands, these pointers will still apply.

The quality of shoulder external rotation one can achieve plays a big role in overall shoulder health and upper body strength. Shoulder external rotation is dependent upon the quality of scapular stabilization one can achieve. That said, in order to improve shoulder external rotation, we can apply a hack to reflexively improve scapular stabilization.

By placing an object such as a yoga block, small exercise ball, or folded up towel or sweatshirt between your torso and elbow, we creating a fixed point to improve scapular stabilization. In doing this, it forces pure shoulder external rotation when the movement is performed well - making it very difficult to cheat!

Some key points discussed in this video:

  • The traditional cable column external rotation can be improved to heighten scapular stabilization and the demand on the external rotators/rotator cuff of the shoulder.
  • How to create a fixed point at the elbow to improve scapular stabilization by increased activation of the serrates anterior.
  • Avoiding ulnar deviation and maintaining a neutral wrist.
  • Increased global stabilization and muscular activation by setting the feet, hips, pelvis and spine into correct posture and utilize intra-abdominal pressure (IAP).
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/exercise-hacks-ep-4-dumbbell-press/

https://gallagherperformance.com/exercise-hacks-ep-3-hand-support/

https://gallagherperformance.com/exercise-hacks-ep-2-scapular-upward-rotation/

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

Exercise Hacks Ep. 4 - The Dumbbell Press

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In this video, we discuss the dumbbell press and how the position of the wrist impacts pressing strength and shoulder stability.

Wrist position is often overlooked during the dumbbell press but is a critical part of ideal mechanics. The wrist should maintain a neutral position during the entirety of the lift. Often you'll see wrist extension and/or ulnar deviation as a compensation when the wrist falls out of neutral position. We discuss ulnar deviation and making sure to avoid this position as it can place too much stress on the wrist and feed into reducing pressing power.

As usual, the key is finding and maintaining optimal stabilization of the shoulder and upper extremity. Avoiding wrist extension and ulnar deviation will keep the wrist and shoulders more stable, healthier and stronger. The goal is to improve performance while reducing the risk of injury and pain developing in the shoulders, elbows or wrists.

Some key points discussed in this video:

  • What ulnar deviation looks like and how to avoid it while holding dumbbells.
  • How to press through the dumbbell with correct hand and wrist position.
  • How ulnar deviation will cause the shoulder to destabilize and fall into internal rotation. This isn't ideal for shoulder health and pressing mechanics.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/dns-solves-pain-improves-performance/

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

https://gallagherperformance.com/exercise-hacks-ep-2-scapular-upward-rotation/

https://gallagherperformance.com/exercise-hacks-ep-3-hand-support/

Exercise Hacks Ep. 3 - Hand support

[embed]https://www.instagram.com/p/BcaN02NDlZg/?taken-by=gallagherperformance[/embed]

In this video, we discuss the proper way to create ideal hand support during exercises which require you to have contact with the ground. When it comes to creating ideal scapular stabilization during hand supported exercise, how well someone loads the hand or supports from the hand will directly impact their shoulder.

By creating a stable hand, the scapular stabilizers can work more efficiently at holding your shoulder blade in the proper position during exercise. This applies to exercises such as push-ups, plank variations, hand walks or row variations that involve support from the hands.

Poor hand loading is often a reason for poor scapular stabilization, shoulder pain and poor shoulder function. Learn to properly load the hand and make improvement.

Some key points discussed in this video:

  • What proper hand loading looks and feels like. More importantly what improper hand loading looks and feels like.
  • How to create an awareness of proper hand loading and make sure you are maintaining it during your exercises.
  • How the hand and elbow positioning will influence your shoulder positioning. This is important as the position of these joints can destabilize the shoulder if they aren't position correctly.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/exercise-hacks-ep-2-scapular-upward-rotation/

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

 
 

Exercise Hacks Ep. 2 - Scapular Upward Rotation

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In this video, we build off our previous video on the dumbbell row and discuss scapular upward rotation. Scapular upward rotation is a critical component in overhead activities performed regularly in daily life, the gym or sport.

If your scapula cannot rotate properly as you reached overhead, it will play a role in shoulder pain and problems such as tendinitis, bursitis, or impingement syndromes. This exercise variation would be a great inclusion in the strengthening of the rotator cuff musculature and scapular stabilizers.

Some key points discussed in this video:

  • Most rehab exercises for scapular upward rotation will address bilateral movement at the same time. Training support on one limb while training movement on the other will enhance the quality expressed in stabilization.
  • Performed correctly, this exercise targets scapular stability on the support side and scapular upward rotation on the movement side while training proper core stabilization.
  • To heighten the global effect on the body, focus on creating a tripod with the support foot as well as hip external rotation to get the glutes involved.
  • This variation respects reflexive patterns of stabilization in order to improve movement quality and performance.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

https://gallagherperformance.com/beginners-guide-injury-recovery/

https://gallagherperformance.com/3-exercises-athletic-mobile-hips/

https://gallagherperformance.com/improved-approach-chronic-pain-management/

 

Exercise Hacks Ep. 1 - The Dumbbell Row

[embed]https://www.instagram.com/p/BcSuHV9jXz4/?taken-by=gallagherperformance[/embed]

In this video, we discuss the dumbbell row and how to improve both scapular stabilization and thoracic spine rotation during the exercise.

The dumbbell row is a fantastic exercise for building mass and strength in the upper back and arms. When done for reps (and no straps), it will build a solid grip. However, an often overlooked and undervalued aspect of the exercise is how awesome it can be in developing scapular, core and hip stability in the supporting limbs.

Some key points discussed in this video:

  • The traditional bench supported DB row utilizes hand support on the bench, which can be problematic for those with poor scapular stabilization.
  • Scapular stabilization on the support arm and be improved by elevating the bench to an incline position and supporting from the elbow instead of the hand.
  • With proper attention to posture during the support from the elbow will also improve thoracic spine rotation and mobilize the rib articulations during the exercise because of the increased spinal musculature involvement.
  • This can be a great variation of the DB row for those with shoulder pain, poor scapular stability or stiff upper back.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/why-therapists-should-understand-strength/

https://gallagherperformance.com/the-truth-about-functional-exercise/

https://gallagherperformance.com/dns-solves-pain-improves-performance/

 

The Most Effective Treatment for Shoulder Pain

Our approach to working with shoulder pain or injuries is very unique in that we really don’t work around shoulder injuries when properly indicated. The majority of the time, we don’t force someone to rest for several days while inflammation quiets down. Yes, it can be necessary in rare circumstances. However, rest and traditional methods of ice and anti-inflammatory meds are often over utilized when properly prescribed movement (i.e. exercise) is probably the better bet for improved recovery. At Gallagher Performance, we have a nasty habit of getting our athletes, clients and patients to work through pain and injuries by strategically incorporating exercise with specialized approaches tailored to find “the hardest thing they do well”. We want to find what they can be successful with while not posing any undue risk. And the best part? The system works.

When it comes to the shoulder, pain and injury is most commonly associated with poor shoulder function and faulty mechanics. And when I say most commonly, it’s not a stretch to say over 50% of shoulder injuries are due to these underlying problems. If muscles are unable to fire properly to provide ideal amounts of support (stability) and motion (mobility), then injury will occur regardless of how strong or flexible one is.
I have written extensively on the subject of the “hidden cause of injury” since the root cause of the overwhelming major of musculoskeletal injury is dysfunctional movement. Most doctors and trainers do not have the training or eye to look for dysfunctional movement and no amount of rest, ice, and Advil will ever provide the solution. No amount of passive modalities, taping, cupping, mobility drills, or stretching will correct dysfunctional movement. When it comes to shoulders, the solution to reducing shoulder pain and preventing injury is all about restoring proper rhythm and mechanics of the shoulder joint. This includes all it’s associated articulations – the glenohumeral and scapulothoracic. Basically we have to improve how both the “ball and socket” joint or “shoulder joint” (as most of us know it) and “shoulder blade” function together.

When it comes to improving the function of the shoulder, we’ll take an athlete or patient and have them perform variations of rows, pulls, presses, and ground-based movements with adequate loads to reinforce ideal body mechanics and correct dysfunctional movement or stability patterns. This is done through a combination of exercises, tempos, external stimuli, and progressions to essentially re-educate the nervous system. This is why it’s called neuromuscular re-education. We must teach the nervous system to do things better and break bad habits. Yes bad habits can be very challenging to break. Most people would rather pop a pill or rest until their pain disappears rather than break bad habits because breaking bad habits sounds like hard work. Popping pills and rest are great because they are easy and effective. But those who deal with chronic recurrences may want to think about a different strategy once their patience wears thin.
For example, some lifters have such poor thoracic spine posture and scapular dyskinesis that they may need 6 months+ of rehab and corrective work. But they have no interest in that. They have no interest in stepping back a little and refocusing their training for long-term development. They prefer to band-aid symptoms while they push their training and perpetuate the pain cycle.

The funny thing is breaking bad habits isn't as hard as most people think. If you work with the right person you’d be surprised what proper coaching, cueing, and exercise can do in a relatively short period of time. The reality is most people are highly resistant to breaking bad habits because of either ego or the unwillingness to take a step backward. Typically after a number of training or therapy sessions, the individual is able to perform any and all movements without pain and with improved shoulder mechanics. For those dealing with shoulder pain, improving their mechanics through sensory-motor training enables their nervous system to be re-educated. This re-education process is the most effective form of therapy and healing available. It cannot be understated that a critical component of this process is proper coaching and cueing. This is the responsibility of the coach or therapist. As much as proper coaching and cueing can be beneficial, improper coaching and cueing can prove to be very damaging. It is my opinion that many injuries occur because the athlete or patient had previously received very poor coaching or instruction.

This is exactly why performing exercise with proper technique is proving to be the single most effective form of therapy as it promotes almost immediate healing. If someone is having pain during a movement, they are doing something wrong. Correct them into the proper movement and watch their pain disappear. The key is re-educating the nervous system so movement becomes both therapeutic and performance-enhancing to one’s body rather than promoting pain and destroying joints. This is truth when it comes to the shoulder joint as well as any joint within the human body.

Tired of pain? Want to reach your full potential? Visit gallagherperf.wpengine.com
EXPERIENCE THE DIFFERENCE.

More related reading:

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

Finding a Solution to Your Shoulder Pain


 
"He who treats the site of pain is often lost."
- Karel Lewit

The purpose of this article is to provide some basic information about the importance of understanding the role posture and function have in pain and movement dysfunction. The hope is that you will gain an understanding of why your chiropractor or therapist must evaluate and bring into consideration issues that may not seem related to your pain.
When it comes to dealing with chronic musculoskeletal pain, the site of the pain is rarely the actual source of the pain. This concept is often missing or ignored in traditional North American treatment. Let's look at shoulder pain as an example. All too frequently the shoulder pain patient is provided an evaluation and treatment that is solely focused on the shoulder. Depending on the professional you see, the shoulder is typically treated with any combination of adjustments, passive modalities (ultrasound, electrical stimulation, laser), manual therapy, or shoulder exercises. If those fail, you may be referred for shoulder injections or you may become a potential candidate for shoulder surgery.

Notice the pattern? Everything is focused around the shoulder. That's where the pain is, so that's where my problem has to be, right? The same pattern can be seen with low back pain, neck pain, knee pain, etc. This seems like rational thought, but what if you, as the patient, do not respond? Does this mean that conservative treatment failed? Does it mean you need surgery? What if only focusing on the site of pain caused something very critical to a positive outcome to be missed?

Looking Beyond the Shoulder
Czech physician Vladimir Janda likened musculoskeletal pain and dysfunction as a chain reaction, thus stressing the importance of looking beyond the site of pain for the source of pain. Janda observed that due to the interactions of the skeletal system, muscular system, and Central Nervous System (CNS), dysfunction at any one joint or muscle is reflected in the quality and function of joints/muscles throughout the entire body. This opens the door to the possibility that the source of pain may be distant from the site of pain.

Janda also recognized that muscle and connective tissue are common to several joint segments; therefore, movement and pain are never isolated to a single joint. He often spoke of "muscular slings" or groups of functionally interrelated muscles. Muscles must disperse load among joints and provide stabilization for movement, making no movement truly isolated. Meaning shoulder movement does not occur only at the shoulder, but is dependent upon the function of the spine, rib cage, pelvis, and even the ankles. For example, trunk muscle stabilizers are activated before movement of the upper extremities begin; therefore, shoulder pain can be caused by poor core stabilization.

Hopefully you are coming to realize that while you may have pain in a specific area, it's not always the cause of the pain. Going back to the shoulder, a 2006 study that reported 49% of athletes with arthroscopically diagnosed posterior superior labral tears (SLAP lesions) also have a hip range of motion deficit or abduction weakness. This illustrates a key point. How often do you see shoulder pain/dysfunction treated by correcting hip mobility and stabilization patterns?

Outside of glenohumeral joint range of motion and rotator cuff endurance/strength, has your shoulder evaluation included any of the following items:

#1 - Breathing Pattern
The average person will take close to 20,000 breaths per day but until recently the impact breathing has on movement and dysfunction has been largely ignored. Proper breathing certainly provides great benefit to athletes and individuals who display a variety of movement dysfunction. Neurologist Karel Lewit said, “If breathing is not normalized, no other movement pattern can be.” Understanding the impact proper breathing has on the body and how to restore ideal breathing patterns is critical in both athletic development and rehabilitation.

#2 - Thoracic and Cervical Spine Function
Spinal posture lays the foundation for shoulder function. Improper function of the thoracic (mid-back) and cervical (neck) areas of the spine will compromise the function of your shoulders. Imagine the spine as a series of cog wheels, movement in one area will impact all areas. This is visualized in the picture below:



Regardless of whether they are sitting or standing, the majority of people tend to fall into a posture very similar to what is seen on the left. Increased kyphosis of the thoracic spine (rounded mid-back) is a major reason for forward head posture and rounded shoulders. There are seventeen muscles that attach to the shoulder, many of them influencing the position and movement of not just the shoulders, but spine as well. Shoulder function is dependent on proper spinal posture and without correction of spinal posture, the shoulders don't have a fighting chance to stay healthy.

#3 - Mobility of the Opposite Hip and Ankle
The importance of looking at hip mobility was emphasized previously, but let's also consider the ankle. This ankle becomes of particular importance when dealing with overhead throwing athletes. Dysfunction at the ankle will alter mechanics up the kinetic chain and place undue stress on the shoulder and elbow. Correcting any muscular tightness or poor joint movement of the ankle sets the stage for ideal throwing mechanics and the prevention of shoulder injuries.

Closing Thoughts
Despite focusing on shoulder pain, many of these concepts hold true for any type of chronic musculoskeletal pain. Before abandoning all hope or 'learning to live with the pain', consider that being evaluated by a professional who will look beyond your site of pain could be the solution you have been looking for. That's why these concepts form the foundation of the examination and treatment process at Gallagher Performance.

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  • Murrysville, PA 15668

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    Friday: 9am-1pm, 3pm-5pm
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