Rotator Cuff Tears

rotator cuff tear anatomy shoulder

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.

Rotator cuff is a group of 4 muscles and their tendons that together form a « cuff » around the head of the humerus (upper end of the arm). The 4 muscle, originate from the scapula (shoulder blade), are upraspinatus, infraspinatus, subscapularis and teres minor. Tendons of each muscle fit on the humerus tuberosity.

Rotator cuff’s functions :

  • Lift the arm

  • Turn the arm

  • Stabilize the humerus in the joint

Causes

rotator cuff tear anatomy

The causes of a rotator cuff tear can be an acute injury such as a fall or because of chronic wear with tendon degeneration. For people over 40 years old, the pinching of the tendon on the underside of the scapula may participate in tearing.

Diagnosis

Diagnosis of rotator cuff tears is based on an examination and/or diagnosis study such as a MRI (magnetic resonance imaging) to confirm the diagnosis. Diagnosis early on in the first symptoms and rotator cuff’s treatment can help to boost the treatment’s results.

Treatment

Goals treatment are to relieve pain and restore strength to the injured shoulder. Several tears in rotator cuff can be treated without surgery. Anti-inflammatory drugs, steroid injections and physical therapy can all be beneficial in treating the symptoms of a tear in the cuff.

Even though a full-thickness tear needs to be cured with surgery, it’s possible to use non-surgical treatments to have a satisfactory function in some cases.

Surgery

rotator cuff tear anatomy surgery

Surgery is recommended if there is persistent pain or shoulder weakness that doesn’t improve with non-surgical treatment. Often patients who have surgery indicate nocturnal pain and difficulty using the arm for lifting and reaching. Many will indicate persistent symptoms despite several months of treatment and limited use of the arm.

Surgery is also recommended for active people who use the arm for overhead work or sports.

Surgical options

The type of repair performed is based on the findings at surgery. A partial tear my necessarily only a trimming or smoothing procedure called a debridment. A full-thickness tear with the tendon torn from its insertion on the humerus is repaired directly on the bone.

3 techniques are used for rotator cuff repair :

  • Open repair (through a traditional incision)

  • Mini-open repair (partially assisted by a camera view, with a smaller incision)

  • Arthroscopic (performed with only a small camera inserted through multiple small puncture wounds)

Recovery and rehabilitation process

Whether for the treatment of non-surgical and surgical rotator cuff tear, rehabilitation has a very important role. Usually recovery is at least 6 months or more depending on the extent of the tear.

When there is a tear, there is frequently a loss of shoulder movement. An exercise or physical therapy program is needed to restore strength and improve shoulder function.

Although surgery repairs the defect of the tendon, the muscles around the arm remain weak and an important effort is necessary in the rehabilitation so that the procedure is a success. After surgery, a complete re-education can last several months.

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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 .

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Adapt Your Training To Your Morphology (Part 1)

morphology

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

In bodybuilding, it’s really important to take into account individual morphological differences. Especially for squat and deadlift.

Squat and deadlift have a different muscular work for a brevilineal person and a rangy person

A brevilineal person has a proportionally long torso and short limbs. An rangy person has a proportionally short torso and long limbs. This has nothing to do with height, muscle development or adiposity. Which means that a person can be a small fat rangy or a tall skinny brevilineal.

A brevilineal person have facility for squat because their short femurs makes that the torso is little inclined. This limits lower back and hamstring tension. As a result, the movement can be done in relative safety and the brevilineal person can almost exclusively focus on quadriceps work. It’s for this reason that almost all squat champions are brevilineal. An impressive example is that usually dwarves monopolize podiums of small categories in powerlifting.

Rangy people have more difficulty to do squat because their long femurs makes that the torso is very inclined forward. This puts hamstrings, adductors and gracilis in a dangerous position. Rangy people must fight constantly to not be out of balance forward.

It’s also important to pay attention to the back’s position to avoid rounding the back. Having the round back causes serious spinal injuries like the famous herniated disc.

Rangy people doing this type of squat leaning forward works much muscles of gluteus maximus which have the function of straightening the pelvis, torso and all erectors spinae muscles that try their best to avoid the rounding of the back.

As a result, the squat for long limbs is excellent for developing powerful glutes and lumbar spine. On the other hand it requires a lot of concentration for the positioning of the body during the movement. It should be noted that more weights are heavy, the more dangerous the movement’s execution.

For rangy people who really want to work quadriceps, it’s advisable to use incline machine like « hack squat ».

Difficulties change side

change side

For brevilineal people who are the kings of squat, there is a reverse medal. They have a lot of trouble to do deadlift.

Brevilineal people with short legs should bend their legs to take the barbell. Sometimes their femurs are almost horizontal and this position requires a lot of energy to start the movement.

On the other hand, rangy people can take the barbell with their legs half bent. With this position, quadriceps can us the maximum energy to start the movement. The morphology of the rangy people allows them to lift heavier weights than brevilineal people despite a tilt of the gluteus and erectors spinae muscles

It’s for this reason that almost all of the deadlift champions are rangy people.

morphology brevilineal rangy

morphology deadlift

Ankles flexibility

ankle morphology

The ankles flexibility has a great influence on the squat’s execution.

Ankles flexibility may be influenced by musculotendinous limitation (such as significant calves retractions) or bone limitation. For example, if the dorsal flexion (the fact of raising forefoot) is limited, the squat technique is completely modified.

The lack of ankles flexibility limits the shifting of the shins forward and the advanced knees. This makes it necessary to squat with the buttocks very back and the back leaning forward, which has the effect of working intensely the gluteus maximus and the spine erectors muscles.

Squat with an excessive inclinaison of the torso put dangerously tension on the back muscles of the thighs, adductors magnus, gracilis and increase the risk of muscle tearing.

It should be added that the positioning of the femurs below the horizontal has the effect of rounding the back, which increases the risk of vertebral damage. This squat requires a lot of concentration for the positioning of the body during the movement because the more the weigh is heavy and more the movement’s execution is dangerous.

Be careful, whether for the squat or the deadlift, having stiff ankles make it difficult to flex our legs even if the femurs are horizontal.

morphology deadlift

Finally, the cantilevered that is more important for deadlift than squat, this is requires quadriceps to provide more strength to extend thighs on the legs.

To read Part 2, click here.

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

-Steph

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New Record Daily

record breaker

I read a Nerd Fitness article  and there is good stuff.

In training, the key of success is to have constantly better results and improve challenges level.

If you repeat the same training everydays, every months, your body will adapt et it will learn to burn less calories and make less progress.

To continue to make progress our body to become stronger, we must constantly add little challenges everydays.

Always do the same thing again and again doesn’t work

same thing

Normaly, if you want to lose weight, you need to increase your energy expenditure. You need to move more, right ?

In summary to lose weight, you must move more and eat less. But move more is a little bit more complex than that.

Exercices don’t always lead to an expenditure of energy. There is a little explanation the New York Times .

Professor Pontzer for Hunter College followed a hunter-gatherers tribe and he learned they burn the same amount of calories than an average american. Mainly, their bodies adapted to the stress and learned to burn less calories in other ways to increase efficiency :

« Energy expenditure is consistent across a broad range of lifestyles and cultures. Of course, if we push our bodies hard enough, we can increase our energy expenditure, at least in the short term. But our bodies are complex, dynamic machines, shaped over millions of years of evolution in environments where resources were usually limited; our bodies adapt to our daily routines and find ways to keep overall energy expenditure in check ».

If you do 3 sets of 10 push-ups everydays, your body will be really good to do 3 sets of 10 push-ups, it will be more efficient but not necessarily stronger each time.

Look :

  • To increase your level in a video game, you need to fight against enemies stronger than you.

  • To increase your level training, you need to do harder challenges in your training.

Progressive overload

progressive overload

We know we can’t do the same thing forever to have huge progress. We need to do challenges.

« Progressive overload », this is our chanllenge’s name. We overload ours current capacities, slowly but surely.

NSCA’s Performance Training Journal  explains :

« Without overload there is no adaptation by the body. Neuromuscular adaption occurs first, followed by increases in muscle and connective tissue, and bone mass. Proper conditioning methods will lead to physiological advancement as well. Depending on the training goals, improvements in lactic acid tolerance, lactate threshold, maximum aerobic power, and a variety of cardiovascular functions could be the appropriate responses ».

Our body will improve in all sorts of ways form stronger muscles to a better performance of the central nervous system. All of this is possible with a stimulus or simply « a challenge ».

We apply a stimulus to our body and our body responds, this improve all these areas mentioned above.

The solution is simple, right ? Just increase the challenge to each exercice, everydays and forever. Just to reach the level 99.

A record everydays

I wrote an article to break a plateau  and the better thing to break a plateau is to avoid it. A plateau can drain mentally, depress and can demotivate the most rebel.

When a linear progression is no longer possible, it’s the time to make little progress each week. This allows to progress without injuries.

Here are the benefits of this approach :

  • You don’t overload too much your body but you learn to lift more weight each week then your body begin to adapt to become stronger and repairing properly.

  • You don’t have these days where you feel blocked. You proves to yourself constantly than you’re better than yesterday.

The goal is to increase the total weight you lift in each training somehow. There are several ways :

  • Lift more weight per reps than the last time

  • Do more reps with the same weight than the last time

  • Lift more tota weight than the last training

  • Do the same number of reps, same number of sets and the same weight, but with less rest time between sets.

  • Lift in a better form with more range of motion or a harder variation.

As long as one of these metrics is higher than your previous training, you’re improve your level et you are stronger.

Example :

  • Training 1 : 5/5/5 x 43kg (95lbs)

  • Training 2 : 6/5/5 x 43kg (95lbs)

  • Training 3 : 6/6/5 x 43kg (95lbs)

  • Training 4 : 6/6/6 x 43kg (95lbs)

Each weak ONE rep was added in the training. Then for the Training 5 and 6, the processus restart with a heavier weight.

  • Training 5 : 5/5/5 x 45kg (100lbs)

  • Training 6 : 6/5/5 x 45kg (100lbs)

The total weight lifted in Training 4 is 3x6x43kg = 774kg (1706lbs) and the total weight lifted in Training 5 is 3x5x45kg = 675kg (1488lbs). There is more weight per reps, there is progress, it’s cool.

Slow, stable, constant progress. Little by little, we become less little !

You ? How you progress ?

-Steph

P.S. : Do you want a free training program ? Click here 

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Muscle Mass Mystery

muscle mass

I watched a JamCore DZ’s video  about muscle mass secret and I wanted to share this with you.

You have trouble to gain muscle mass ? You tried and you were disappointed with the results ? Then this article will interest you.

When you begin to train you, you are very motivated and very excited. The first training’s year, you gain between 5kg (11lbs) and 8 kg (17lbs) of muscle. This is because you lift weights that shock your muscles and even if you eat anything, your body will respond.

Consistency and coherence

constitency coherence

When you gonna evolve, you will stagnate. This is normal, this is the nature. But what will help you is consistency and coherence. No matter that you to take supplements or steroids ! We must stay consistent and coherent all year, every day, all week, all month.

The problem is that when the body evolve well the first year, the second year we start doing bullshit. We’re no longer coherent and consistent and it affects our muscle mass. Even if we train well, eat anything slowed our muscle mass development. When we eat anything, we create wrong muscle mass based on water and fat.

Training and nutrition should be at 100%. You focus on them and recovery, therefore sleep as much as possible, for 3 years and you will get the body to do a competition.

In summary, you must be coherent and consistent with training, nutrition and recovery. You must also continue to learn how to evolve your body and you need to have discipline.

Become your own coach

Continue to learn how to change your body with valuable information. Stop looking bullshit, stop to watch people who only want to attract attention with scandals. Select a program with a good coach and keep it. Don’t look other stuff on Internet that can cause you injuries. Follow your program and become your own coach because results come with time.

JamCore DZ’s evolution :

jamcore dz jamcore dz

  • 1987 he weighs 69kg (152lbs)

  • 1994 he weighs 102kg (224lbs) (it took 7 years)

  • 1995 he weighs 104kg (229lbs)

  • 1996 he weighs 108kg (238lbs))

  • 1997 he didn’t train throughout the year. He was with girls in Australia

  • 1998 he weighs 102kg (224lbs)

  • 1999 he weighs 110-112kg (242-246lbs) through existing muscle tissue. muscle memory.

When we start this sport we want to have results as soon as possible but it’s the opposite is happening. You have to stay focused every day and see results every 6 months. More you will learn and more you will understand this science, that’s the muscle mass mystery. Science to have a mind and a healthy body.

You thought you had to do what to have muscle mass ?

-Steph

PS: Do you want a free training program? Click 

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Why Fitness In First And Being Selfish

fitness smile

Imagine what you can do if you put fitness first ?

Like famous actors and actresses who become SUPER shape for their movies. What does it take to get there ? Focus on healthy food, several hours to sleep and exercise, right ?

You could look like King Leonidas in 300 or Jennifer Lawrence in The Hunger Games ? Do you still confuse about Chirs Evans in Captain America ?

It’s fun to think about « what would happen if ». What you would be able to do if you put your training and your nutrition before everything else ?

Most people have an answer to this question: « I would like to have the best physique of my life but this is not possible because … »

a wife / husband / girlfriend / boyfriend / OS

Children / pets / dragons

Job

No money

Friends / obligations, etc.

You can ask anyone and they’ll give you a reason why fitness can’t come first. They’re too busy ! But busy doing what ?

Since I put my physical condition before any other aspectes of my life (at first it was boring), I accomplished much more things in all domains of my life.

It’s like my mind was opened as Neo in The Matrix !

Let’s go ?

fitness smile

Fitness should be in terms of months and years, not days and weeks. I learned that a friend personal trainer. Most fitness programs are based on 90 or 30 days. I stopped to think about short-term programs and I was interested in long term. Now I know I would have a better physique in end 2016, 2017, etc and results are sustainable.

Have slow and steady results. Being injured is a huge brake ! At first I lifted too heavy and I didn’t stretch me enough. The consequence ? I needed to take 1 month off because of my pain and I lost what I had gained. If you’re looking to improve every week, it’s better to have about 50 weeks of small progressives improvements than big improvements that will cause you injuries Go slowly and let your ego in the locker room. Remind yourself that you are in the gym to develop your strength, not for show.

Put your faith in the process. I stopped worrying about « what level I would be in a few months ? » Or «  How my body will change in a few months ? » And I just put my faith in the process with this state of mind « how to place the next brick ? ». I knew that if I slept well, if I ate healthily and enough, if I pushed myself a little in training every time, I was building my body. Appearance is a consequence of fitness. I stopped worrying about the scale and I concentrated all my efforts in training and recovery.

Not all progress is seen on the outside. I don’t feel that my transformation is spectacular but I know I have changed physically and mentally.

I used to feel fragile. Now I feel like a Wolverine.

I used to say « I don’t have time ». Now I realized that it was an excuse.

I used to wish that I was able to do somethings. Now I do these things.

I used to think it was either the fitness or the life. Now I know that fitness improves every aspect of my life.

I’m always excited to go to my next workout and I want it to be the same for you.

Begins today, I challenge you to take a few weeks to build your life around your body, don’t neglect your personal well-being.

Can you put fitness first for 1 month and see what happens ?

fitness smile

Training – For me it’s weight training or bodyweight. I never even miss a workout when I travel.

Healthy eating – Fuel your body properly is 80-90% of the battle. Get enough protein, carbohydrates and fat for the results you want to have.

Sleep – No excuse, turn off the TV, turn off the computer and go to bed on time to sleep 7 hours !

What kind of challenges are you trying to overcome ?

-Steph

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Cardio Or Training

cardio weight

I usually do 45 minutes of cardio every Sunday, it’s just 4 times a week. It’s true that in March, I made 1 time of cardio, that’s why I went back to serious cardio. I think it’s important to do the combination training and cardio to have an athletic physique and improve it.

In the gym, it’s funny, there are those who do only cardio and those who do only training. If they do this for years, it’s easy to recognize. There are those who have volume, biceps fill T-shirt’s sleeves and skinny people with a physical of marathon athlete.

When I ask people who have volume if they do cardio, they tell me « no » because they don’t want to lose their muscles. When I ask marathon athletes if they train with weights, they tell me « no » because they didn’t want to be bodybuilders.

marathon athletic

I think there is a bad interpretation of the info. A person who has volume will not lose all his muscles but it will make them more visible, it just need a good fit with time and intensity. Cardio will also help to improve heart health, increase metabolism (improving the various processes in the human body), increase the type of hormone « I feel good », improves recovery and for diabetics that helps manage diabetes.

A person who makes marathon will not become a bodybuilder but it will avoid to have injuries, it just need a good fit with time and intensity. Weight training strengthens hips and glutes to protect knees, have good abs and a good back to have a better posture while running and to impart more force into the ground to run faster.

You see the combination cardio and training works for all types of athletes, you just need to adjust to achieve your goals. I find it unfortunate that people with potential stagnated because of myths or stupid lies. It’s too stupid !

Do you want have an athletic body ? Free fitness program (selecting a program and click on « Log in as Guest ») or on my eBook.

-Steph

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Why impress others ?

 impress gym

Now that I have changed my training program for 1 week, I am aware that the technique is really important if we want progress without serious injury. I must admit that I still had a little afraid to lift heavy because I have two friends who were wounded in the shoulder by lifting heavy really really anyhow.

Show off in the gym trying to lift heavier than its neighbor or scream like pig to say: “I make a sick perf, I’m too strong”, it’s useless. It’s clear, I’m not gonna lie, I’ve done this 2-3 times but when you feel an ongoing shoulder pain for 2-3 days, that makes scare.

Wait wait, man, I must tell you the time I wanted to show off with a friend who is a rugby player (I will not say his name because otherwise he’s going to laugh at me). Well, he invited me in his gym, my friend is strong and his team is 3rd or 4th in the championship, he’s a good player. I following training program and he told me that I’m doing well. He pushes me to my limits, it was crazy, dude, it was crazy, people in the gym looked us like we were barbarians.

After training, we eat, I promise, man, to raise my glass to my mouth, oh damn dude, it was hard, I had sore arms, shoulders, it burned. Each time I raised my arms, I had a crazy pain. And I was like everything is okay, I had to, we had trained at noon, the day wasn’t over. Ouch…ouch….ouch….oooouuuucccchhhh, it was long this day.

injuries

In the evening I go home and I tell myself that it isn’t possible that I became so weak because I have too forced. Let’s go some pushups, then 1…..1…. 1…..1. There, I start freaking, not even 1 pushup, I CAN’T DO 1 PUSHUP. I begin to imagine that I got injured and I couldn’t make sports, in less than two seconds I was already in depressed mode. Before going to bed, I make a prayer to keep training. The next day it was better, little pain but I could lifted as usual.

I have been lucky compared to my 2 friends because them is that their shoulders dislocated. It means that all chest and shoulders are limited to a light weight. I saw with my eyes while I was helping one of my buddies at press bench, it lifts and POP! The shoulder was dislocated and he can’t finish the movement. It’s violent because it can’t develop their chest and shoulders, it is a plateau for life, it sucks.

So from these stories, I often seeks perfect technique, but nothing is perfect, you just do things the best way you can do. When you increase weights, there are new requirements and if you are used to doing bad moves, you feel the pain right away. And heavier, it’s more radical as happened to my friends.

That’s why it’s important to REALLY listen to your body, not your head !

hurt

You train for yourself, to be a better version of yourself, not to impress someone who look cool. Look, you’re impressed someone, it will last how long ? A few minutes. But if you improve yourself, it will last all your life. Imagine that you don’t see this person that you’re impressed for years and you continue to train without hurt. You see again this person and he/she didn’t look cool now, he/she has even become unbearable and ugly. You know what you’re going to tell yourself ? It’ll be something like: “Oh my God, I wanted to impress that person because I thought he/she was cool, now it’s a real shit.”

You really gonna hurt you to impress someone who just looks cool?

Betting happiness in the long term rather than short-term pleasure. You have a choice: train yourself by paying attention and your progress will be slow but steady OR you train like a barbarian and your progress will be fast and get injuries. You can’t train yourself as before, forget your progress as my 2 buddies.

impress yourself

The only person I want to impress is myself. You, you want to impress yourself or others ?

-Steph

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