Shoulder Instability Or Dislocations

shoulder instability anatomy

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.

Shoulder is the most mobile joint of the body. This allows you to lift your arm, rotate your arm and lift your arm over your head. It’s possible to have a greater range of motion with less stability.

How

Shoulder instability

This happens when the humerus head (the upper arm bone) is forced out of the shoulder’s cavity. Usually this happens as a result of a sudden traumatic injury.

Once the shoulder is dislocated, the shoulder is vulnerable to repeat. When the shoulder is loose and slips several times, it’s called a chronic shoulder instability.

The shoulder is made of 3 bones : humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone).

Dislocation shoulder

shoulder dislocation anatomy

This may be partial, which means that the arm’s ball partially comes out from the cavity. This is called a subluxation. This can be complete which means that the arm’s ball comes out completely from the cavity.

Symptoms

Symptoms of chronic shoulder instability are :

  • Pain caused by the shoulder injury

  • Repeated shoulder’s dislocation

  • Repeated instance of the shoulder giving out

  • A persistent sensation of the shoulder that is loose, slipping out of the joint or hanging.

Diagnosis

Specific tests help assess shoulder instability (including general relaxation of ligaments). A doctor may prescribe imaging tests such as X-rays, CT Scan or MRI to confirm the diagnosis and identify other problems.

Treatment

First, chronic shoulder instability treated with nonsurgical options. If these options don’t relieve pain and instability, surgery may be needed.

Nonsurgical treatment

shoulder dislocation treatment non surgical

Generally, it often takes several months of nonsurgical treatment before success can be assessed. Nonsurgical treatments includes :

  • Activity modification

  • Non-steroidal anti-inflammatory medication

  • Physical therapy

Surgical treatment

shoulder dislocation treatment surgery bankart repair

Often, surgery is often required to repair torn or stretched ligaments so that they can maintain the shoulder joint in place.

Bankart lesions (tearing of the front labrum from the cavity) can be repaired surgically using suture anchors to reattach the ligaments to the bone.

Arthroscopy => Soft tissues of the shoulder can be repaired using tiny instruments and small incisions. It’s a procedure that is done the same day or outpatient. Arthroscopy is a minimally invasive surgery. The surgeon examines the inside of the shoulder with a small camera and performs the operation with special instruments.

Open surgery => These are patients who require open surgical intervention. This involves making a wider incision on the shoulder and performing the repair under direct visualization.

Rehabilitation

After surgery, the shoulder can be temporarily immobilized with a sling. When the sling is removed, it’s essential to do ligament rehabilitation exercises. These exercises improve the range of motion of the shoulder and avoid scarring during ligament healing. Thereafter, exercises for strengthening the shoulder will be added in the rehabilitation program.

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-Steph

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Variant To Avoid Dumbbell Bench Press Shoulder Pain

shoulder pain

What’s up ? This is THE stephane ANDRE ! I watched an Athlean-x’s video  and I learned some good stuff.

I wrote an article about to avoid pain when you do dumbbell press or overhead shoulder press because I have a pain when I do it. Click here to read the article  . I have the same problem with the dumbbell bench press. I have pain when I do it, so I write this article to continue this exercise without pain.

Bench press is one of the fundamental exercises to build muscles but with this pain, I wondered if I should continue doing this exercise because it hurt.

Problem

The reason for this pain may be a biceps tendonitis, a torn labrum, an inflammation or shoulder impingement (inflammation in rotator cuff). All these problem create instability during this exercise while we know that stability (body’s stability and dumbbell’s stability) is very important to perform the movement properly.

In the case of a torn labrum, labrum is tied to the biceps tendon or rather the biceps tendon is attached to the labrum. During the movement, it’s the tension of the biceps tendon that pulls on the torn labrum.

Solution

The solution is to change the elbows position. To do the classic bench press, the elbows are at between 45° and 90°, dumbbell held horizontally in the hands and you press up. To calm the pain, we’ll change the position. The technique is to tilt the dumbbells so that the dumbbell’s back are facing the ceiling.

Classic dumbbell bench press

dumbbell bench press

dumbbell bench press

dumbbell bench press

Variant dumbbell bench press

variant dumbbell bench press

variant dumbbell bench press

variant dumbbell bench press

Tilting the dumbbell’s back does 2 things :

  • This brings your arms closer to your body because you use a semi pronated grip. With this position your hands and arms make your shoulders have a neutral position. It’s the equivalent of barbell corner press which helps to reduce the pain caused by dumbbell press .

  • You use your triceps more than your biceps during the movement. With the classic position, you use your biceps to stabilize dumbbells than your triceps. With this position, you flex your elbows so you use more triceps to stabilize dumbbells than your biceps.

 

 

dumbbell bench press
Classic dumbbell bench press

 

variant dumbbell bench press
Variant dumbbell bench press

Using more triceps than your biceps will seriously reduce the pain or make it disappear because there is less tension through the biceps and it will less pull on the torn labrum. If you have biceps tendonitis or inflammation, this will seriously decrease the pain. Try this technique and you’ll see that it will be the first time you’ve been doing pain-free bench press for a long time.

When I had this pain during this exercise, I thought of 2 options :

  • Stop doing bench press because you can’t support the pain anymore

  • Use lightweight

Now that I know this technique :

  • I can continue to do bench press

  • I can keep the same weights and increase them

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

Exercise To Avoid Overhead Shoulder Press Pain

shoulder pain

What’s up ? This is THE stephane ANDRE. I watched an Athlean-X’s video  and I learned some good stuff.

I have a little pain when I do dumbbell press  or overhead shoulder press, maybe you have that pain too ? As I want to avoid having surgery like the majority of professional athletes, I tried to find out if I could find an alternative exercise to work the same muscles without pain.

This shoulder pain during this exercise is a real problem, because it’s a movement that is so advised to do to develop shoulders that the majority of people continue to do despite the pain. The longer a person continues to do this exercise with the pain and the more the person, several years later, will need to do a surgery to the damaged shoulder. It’s sad because people keep doing this exercise because they don’t know (like me at the beginning) that there are alternative exercises.

Pain

For me, I felt the pain at the starting position, it means with a dumbbell in each hand, dumbbells at the level of my ears or a little above my shoulders and my elbow at the outside. It was impossible for me to keep this position for more than 5 seconds and after a few reps, I felt less pain. A few months later, I changed the starting position. I started with my arms outstretched but the pain was still there. The feeling of pain is really bizarre because sometimes, I felt that my shoulders could be dislocated with heavyweight.

Solution

barbell corner press

The idea is to do this exercise with the elbows forward because the pain is due to instability of the rotator cuff. In fact, this pain appears on the weakest shoulder.

This exercise has no official name and has a lot of variation but the best known name is barbell corner press. You need to use a barbell and put it in a corner of the gym. If you do this at home, I advise you to put a blanket in the corner of the wall to not damage the wall. Put a plate of 10kg (22lbs) or 20kg (45lbs) on the opposite side :

  • Lift the barbell with your 2 hands with a squat position to protect your back. Stand up with your torso leaning forward, your back straight, one leg forward and your hands almost on your torso with your elbows forward.

  • Press straight up overhead and exhale

  • Back to the start position and inhale

You can also do this exercise with one hand. Barbell corner press is an alternative exercise to dumbbell press or overhead shoulder press to continue developing your shoulders without pain and without sacrificing your shoulders.

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-Steph

Knee Instability

knee anatomy

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

When the knee extended, external and internal lateral ligaments stretched and prevent rotation of the joint. Standing on one foot, knee wedged in extension, which means that there is no need for muscle action to stabilize the joint.

knee anatomy extension flexion

When the knee flexed, external and internal lateral ligaments relaxed. In this position, the joint only stabilized by the action of the muscles.

knee anatomy meniscus

In flexion-rotation of knee, meniscus moves forward on the side of rotation If the extension of the articulation which follow is poorly controlled, it may happen that meniscus doesn’t back in its place quickly enough. In this case, meniscus pinched between condyles and there may be a meniscal lesion. If during pinching, a small piece of meniscus has been cut, a surgical operation may be necessary to remove it.

knee anatomy meniscus ligament

During asymmetical exercise such as lunges (lunges and dumbbell lunges), it’s important to preserve the knee joint to control movement in speed and straightness to avoid any injuries.

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

-Steph