Shoulder Impingement

shoulder impingement

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Impingement is the fact of having mechanical compression and/or tendon wear of the rotator cuff. Rotator cuff is composed of a serie of 4 muscles connected to the shoulder blade at the humeral head (upper part of the shoulder joint). The function of the rotator cuff is to maintain the humeral head within the glenoid (socket) during normal shoulder function and to participate in shoulder strength during activity. Normally, the rotator cuff glides gently between the inferior surface of the acromion, the bone at the point of the shoulder and the humeral head.

Causes

Any process that can interfere with rotator cuff being able to glide normally can cause impingement. The causes are :

  • Weakening

  • Degeneration of the tendon due to aging

  • Formation of the bone spurs

  • Inflammation of tissues on the space above the rotator cuff

  • Injury due to overuse

Overuse activities that can lead to impingement are most commonly seen in tennis players, pitchers and swimmers.

Diagnosis

shoulder impingement

Diagnosis can be made with the patient’s history and physical examination. Patients suffering impingement often complain of pain in the shoulder. This pain worsens with overhead activity and can be so strong that it causes an awakening during the night. Manipulation of the shoulder in a specific way by a doctor will usually reproduce the symptoms and confirm the diagnosis. X-rays are also useful for the evaluation of the presence of bone spurs and/or the narrowing of the subacromial space.

Treatment

The first thing to do is to eliminate identifiable causes or factor that contribute to the pain. This means temporarily avoiding activities like tennis, pitching or swimming. A non steroidal anti-inflammatory medication may also be recommended by your doctor. The treatment is based on exercises aimed at restoring flexibility and normal strength to the shoulder girdle, especially by strengthening the muscles of the rotator cuff and the muscles responsible for the normal movements of the scapula (shoulder blade). This program may be performed by a doctor, a certified athletic trainer or a qualified physiotherapist. Sometimes a cortisone injection may be helpful in the treatment.

Surgery

Surgery isn’t necessary in most case of shoulder impingement. But if the symptoms persist despite non-surgical treatment, surgical intervention may be beneficial. Surgery involves deriding or surgically removing, tissue that is irritating the rotator cuff. This can be done with open or arthroscopic technique. The result is favorable in about 90% of cases.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Ankle Sprain

ankle sprain inversion lateral

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A sprain is a stretch injury of the ligament that supports the ankle. This sprain often happens to the ligament outside the ankle when the foot is twisted inward (inverted). It’s a « lateral » ankle sprain that localized to the ligaments in the outer/lower part of the ankle.

A « high » ankle sprain (or syndesmosis injury) is a ligament stretch injury that holds the tibia and fibula together in the lower leg. This type of sprain happens when the ankle is twisted outward, it’s an eversion injury.

ankle sprain inversion eversion syndesmatic lateral medial high

When there is a sprain, the ankle is tender and swollen on the outside, above and at the front of the ankle bone, but the pain doesn’t come from the ankle bone. A sprain can create moderate or severe pain that can prevent the foot from supporting the body weight.

ankle sprain stretch injury grade

Treatment of sprained ankle

ankle sprain rice rest ice compression elevation

The basic treatment is what we call RICE (rest, ice, compression and elevation). During a severe sprain, it’s advisable to use a walking boot to help support the ankle.

Recovery time for a « lateral » sprain is usually 1-3 weeks and for a « high » sprain is usually 3-6 weeks.

Rehabilitation can begin a few days after the sprain when swelling decreases. The rheabilitation has 3 goals :

  1. Restore movement and flexibility

  2. Restore strength

  3. Restore balance

How to avoid a ankle sprain

It’s possible to use a brace to help prevent sprains. There are several types of neoprene or elastic materials. Here are some models on Amazon, click here .

Statistics

  • Ankle sprains are more common in all sport that involve cutting and pivoting

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-Steph

How To Do Box Squat

box squat

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Box squat is often used by powerlifters to gain strength to do squat.

This exercise involves doing a squat sitting on a bench for 1-2 seconds and returning to the standing position .

In classic squat the tension accumulated in the muscles during the negative phase when you get down (as a stretched elastic ) and this tension restored during the positive phase when you get up. With box squat, sitting on the bench relaxed thighs muscle, there is not tension accumulated when you get down to be used when you get up.

For the same weight, quadriceps should provide more effort for box squat than classic squat. It’s a great exercise to target work on thighs.

This exercise can be included in a training program for people who have long legs and don’t feel their quadriceps work with classic squat.

box squat

Starting squat in sitting position allows push automatisms for the classic squat which has the effect of having the positive phase to get up faster and more powerful.

Attention : It’s necessary to be careful for this exercise in controlling the movement to get down to sit gently on the bench. If get down too fast, the butt crash on the bench and this can create serious trauma due to shock and excessive compression of spinal joints.

Note: There are special benches adaptable for different morphologies with a very padded seat to limit the risk of spinal injuries and the possibility of adjusting the height. To have a good execution of the movement, it’s necessary to have your back slightly incline. If your back is too vertical at start of the bench, the exercise will be impossible to do.

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-Steph

Neck Position

neck

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

In bodybuilding, having a bad neck’s position during an exercise can create neuralgia.

These neuralgias are numbness of the arm with tingling.

These sensations arrive a few days after doing exercise like dips, pec deck rear deltoid lateral, squat and deadlift. The cause is that the exercises were done with the neck extension, head back.

dips bad neck position

The truth is that the head back’s position triggers spasms and contractions of the deep muscles of the neck, which creates compression of the spinal nerves at their exit from the cervical vertebrae.

This compression creates a neuralgia that usually affects the brachia plexus around the vertebrae C4, C5, C6, C7, C8 et T1 (C for cervical and T for thoracic).

plexus brachial

Solution

Do dips or pec deck rear deltoid lateal with head forward by bringing your chin to your chest. This avoids these neuralgias.

neck position

Do deadlift or squat with your head straight (neutral position) looking forward. This avoids these neuralgias.

If the neuralgia installed, it’s important to stop any exercise with the head back (neck extension).

Share this article if you think it can help someone you know. Thank you.

-Steph