Acromioclavicular Joint Injury

acromioclavicular joint injury

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.

Acromioclavicular joint is a joint between the clavicle and the scapula. Acromion is a continuation of the scapular spine and hooks over anteriorly. It articulate with the clavicle (collar bone ) to form the acromioclavicular joint.

Problems types

The most common problems are arthritis, fracture and separation. Arthritis is characterized by a loss of joint’s cartilage. Arthritis of acromioclavicular joint is common with weight lifter, especially with bench press and a little less with shoulder press. When there is a problem with the rotator cuff, it’s possible that there is also acromioclavicular joint’s arthritis.

Acromioclavicular separation

acromioclavicular joint injury type grade

When there is an acromioclavicular joint separation, it means that the ligament that connects the acromion and clavicle is damaged and that the 2 structures don’t align properly. Separation’s state can be weak or severe, that is why there is a system of « grade » according to which ligament is torn and the severity of the tear.

Grade I Injury – This is the weakest damage and the acromioclavicular joint is still aligned.

Grade II Injury – This is an average damage. Ligaments are only stretched but not fully torn. In case of stress (physical effort), the acromioclavicular joint becomes painful and unstable.

Grade III Inury – This is a serious damage. Ligaments are completely torn and the collar bone is no longer attached to the scapula, which creates a visible deformity.

Treatment of acromioclavicular joint arthritis

If the rest, ice, medications and change of the training program (changing the exercises) don’t work, the next step is a shot of cortisone. A shot of cortisone in the joint may have calmed the pain and may be permanently swollen. As each individual is unique, the effects may vary and it’s possible that it doesn’t swell permanently.

If non-surgical methods fail, it’s possible to perform a surgical operation. The pain is localized at the bones end that make contact with each other and the goal of the operation is to remove some of the end of the clavicle. This ambulatory surgery can be done with a small incision of 1 inch (2.5 cm) long or with the arthroscopy technique with 2-3 incisions. The results and recovery of these 2 surgical techniques are about the same. Most patients have a full movement by 6 weeks and can return to do sport by 12 weeks.

Treatment for acromioclavicular separation

Separation can create very painful injuries, so the first thing to do is to decrease the pain. Hold the arm in a sling, put ice and pack the shoulder for 20-30 minutes every 2 hours as needed. Acetaminophen and non-steroidal anti-inflammatory medications can also help calm the pain.

When the pain begins to subside, it’s important to move the fingers, wrists and elbow (and eventually the shoulders) in order to avoid having stiff or « frozen » shoulder. The length of time needed to regain complete movement and function depends on the severity or injury’s grade.

Recovery from Grade I acromioclavicular separation usually takes 10-14 days while Grade III takes 6-8 weeks.

When surgery

Grade I and II separations require very rarely surgery. With a Grade III injury, after surgery, it’s possible to have full body physical activity with some restrictions.

Statistics

  • More males than females suffer acromioclavicular joint injuries

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-Steph

Squat Correctly (Part 2)

sqaut

I read a Nerd Fitness article  and I learned good stuff.

Click here to read the Part 1 

Barbell Squat

I know 3 types of squat and this is the best known : the high bar back (also named « Olympic Squat » or « Oly Squat »), the low bar back squat and the front squat. Maybe there are others but I’ll talk about the best known.

The difference is how you place the barbell.

Depending on how you place the barbell on your body, this will modify the squat’s mechanism and geometry. Which means that you will use your muscles slightly differently depending on how you place the barbell.

  • The Low Bar Back is a posterior chain dominant squat

    posterior chain muscle

  • The High Bar Back and Front Squat are a quad dominant squat.

Here a diagram form the book « Starting Strength » to better visualize the barbell’s placement.

diagram barbell placement squat strating strenght

Don’t worry, these 3 squat’s type work the same basic muscles. As you know each exercise has its variants. Now, you know the 3 variants of squat.

Go, find in your gym a squat rack,  a power cage or a squat stand  and place the barbell at the height of your clavicle. If you can’t do this and the height is too low or too high, choose the too low. I have never seen anyone lift on toe and with heavyweight, the accident is guaranteed.

power rack squat rack squat stands

As you read in my articles « Know how much weight to lift (Part 1 et Part 2) » [url link], it’s important to do a warm up with the barbell without weight. I don’t want to know how much you want to lift, do some sets with the barbell without weight to prepare your muscles and joints.

Low bar back squat

It’s the most popular squat’s type for beginners, general lifters and powerlifters. It’s also the squat’s type taught in the book « Starting Strength », one of the best book for beginners.

Once you have adjusted the barbell’s height, be in front of the barbell. Take a step to be under the barbell and grab it with your hands. For this squat’s type, you’ll use a thumbless grip so that your wrists aligned with your forearms.

Usually the grip’s width is near of the shoulders to create a meaty shelf to place the barbell on the muscles in our upper back (deltoid posterior). If you aren’t comfortable, you can have a wider grip. And with time, when you have more flexibility, you can have a grip near of your shoulders.

Here is the difference between a « wrapped grip » (left) and « thumbless grip » (right) : 

barbell wrapped grip thumbless grip

Once the barbell is on your back, stand up, contract your core (squeeze butt and abs) and step back. Normally, if you followed instructions well, you can only step backward. If you can take a step forward, you’re in the wrong direction.

This squat’s type is a posterior chain dominant squat and you’ll be able to lift heavier that the 2 others squat’s type.

High bar back squat

For this type of squat, you’ll start the same way but you’ll put your thumble around the barbell. This isn’t a thumbless grip.

The grip’s width is near of the shoulders to create a meaty shelf to place the barbell on the muscles in our upper back (deltoid posterior) like for the low bar back squat.

If you lack of flexibility to have a narrow grip, you can place the barbell 5cm (2inches) higher on your trapezius instead on your posterior deltoid. Which means that the barbell is placed almost on your shoulders.

Look the difference between a high bar back squat (left) and a low bar back squat (right) :

high bar back squat low bar back squat

Attention : the barbell placed almost on your shoulders and not on your spine. If you feel the barbell touching your spine, it’s too high and this can cause serious damage.

Place the barbell on your back and take a step back. Stabilize and tighten your core and squat down.

To do this squat version well, you need to keep your torso more upright. If you had difficulties to keep your torso upright with the bodyweight squat, it will be a little be more difficult here.

You can try, there is no problem but lift lightweight until you do it well to correct yourself. It would be a pity if your torso collapses and the barbell rolls on your neck (avoid this pain, really).

Front squat

For this squat’s type, you need to place the barbell in front of your shoulders. This squat’s type is quad dominant so you have to be able to keep your torso even higher than the high bar back squat.

Instead of stepping under the barbell, you place the barbell in font of you on your shoulder. To grip the barbell, it’s a little bit more complicated because you need to have mobility and flexibility in your wrists.

Front squat is done with a full grip around the barbell like the other 2 squat types but most people let the barbell roll on their fingertips (a three finger grip is enough). If you like’re me, you don’t manage to have 3 finders around the barbell, there are 2 variants :

Keep your hands to hold the barbell (if not the 3 fingertips is enough) and keep your shoulders high so that your upper arms are parallel to the floor. And squat down.

It’s important that you keep your shoulder as high as possible during the front squat. When you’re gonna squat down, you’re gonna feel the weight on your arms and it will probably correct your position, drop the weight otherwise you will hurt yourself.

What squat do ?

This is an excellent question. You’ll meet 2 clans that clash in the gyms : high bar back squat VS low bar back squat. Both clans have good arguments but that doesn’t help you make a choice.

The truth, test the 3 types and look with which you feel most comfortable, which you have the best technique and with which you can squat down the lowest (your hips joints lower than your knees). Once you have well studied and tested the 3 types of squat, you’ll find your type of squat.

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

-Steph

Back To The Source Of Equipment (Part 2)

source water river

I read a Nerd Fitness articles  and I learned good stuff.

If you didn’t read the part 1, click here

Racks Et Machines

To do squat, there are differents equipements, we name it « racks ». Let’s go.

Squat stands

squat stands

It’s 2 pieces standing, next to each other to hold the Olympic bar. It’s handy because it’s portable and you can do squat outside. But in a gym, it’s not great because you can’t put heavy weights, it’s too fragile.

Squat rack

squat rack

It’s 2 bars that are standing tied with horizontal bars. With the Squat racks, you can put heavy weights.

Power rack

power rack

It’s my favorite. It looks like a large rectangle with poles in vertical and horizontal. The Power racks have holes for placing J-hooks to adjust the height of Olympic bar. What is cool is that you can do several exercices with like pull-up, bench press, overhead press and dips.

Smith machine

smith machine

Smith machine looks like Squat racks except that the bar is guided.

Gym staff will tell you that it’s a machine to do squat safe. I don’t advise to use this machine because it forces your body to make unnatural movements. This scientific study (https://www.ncbi.nlm.nih.gov/pubmed/19855308 ) shows that you have better results with a squat with free weights.

The difference between Squat racks and Smith machine is that the bar where you put weights is fixed on Smith machine.

Weight machine

plate loaded machine weight pin loaded stack machine weight

Weight machines are in 2 categories : Pin loaded (stack machine) and Plate loaded. Pin machines have a rectangular weight stack with a hole to put the pin. More the pin is low, more the weight is heavy to lift. What is cool with this machines is that you don’t need to look for weights anywhere in the gym.

With Plate loaded, there is no weights attached to the machine. You put weights on the machine yourself. Plate loaded machines have a wider range of motion than Pin loaded.

Cable machine

cable machine

No matter the size or design of the cable machie, it will always be a pin loaded (stack machine). A handle is at the end of the cable and you can pull or push in different directions. Cable machine can be an alternative for some exercices you do with dumbbells or barbells. Cable machine has a wider range of motion.

Pull-up Bar

pull up bar

You know in most gyms, there is no real pullup bar (like in my gym). If you don’t find a freestanding bar, there are several alternatives like power rack, smith machine or the top of the cable machine.

Dips station

dips station

Usually dips station is integrated into the power rack or the cable machine. You can find some that are freestanding.

Assisted Pullup /Dip station

assisted pull up

It’s a Pin loaded (stack machine). You choose a weight and you put yourself on the platform. The weight you choose will help you to do pullups or dips. For pullups, I advise you to do Lat pulldown and the day where you can lift your bodyweight, you do freestanding pullup.

Bench

adjustable bench

Ajustables benches and standard flat benches are types of benches you will see in a gym. To do incline and decline exercices, ajustable bench is perfect. Benches are the equipement the most use in a gym, especially on Monday. I don’t know why but Monday is the international chest’s day and it’s hard to find a bench that day.

Bench press

bench press

Squat stand and Squat rack are use to do bench press in small gyms and Crossfit. In big gyms, there are special bench press with a stand attached.

Equipement items

Now you know the main gym’s equipment, I will show you small equipement items.

Collars/Clips

collar clip

There are several collars/clips designs but they have the same purpose that is to keep weights safe on the bar.


Weight plates

weight plate

There are several type of plates :

  • Standard metal plates/ rubber encased weight plates

    They’re made of metal and they shouldn’t be thrown to the ground. There are circle with the denomination of weight on. Depending on the weight, they have different diameters.

  • Bumper plates

    They’re made of rubber and can be thrown to the ground for above your head (clean and jerk).

Plates can have a denomination in kilograms or pounds :

Kilogramme : 1, 1.5, 2, 2.5, 5, 10, 15, 20 et 25kg

Pound : 2.5, 5, 10, 25 ou 45lbs.

You can also find plates with a combination of metal and rubber that can be thrown to the ground but not from aboe you head.

Kettelbells

kettelbell

This is looks like a cannon balls with handles. Most gym don’t have the same weight repertoire than dumbells but it’s possible to find kettelbells of 24kg (53lbs) and 31.75 (70lbs) and more.

GHR/GHD Machine

ghr ghd machine glute ham raise developer

The translation is « Glute Ham Raise » or « Glute Ham Developer ». With this you can do glute ham raise, back extension or sit ups.

Prowler/Dragging sled

prowler dragging sled

Put weights on a prowler and push or pull while you run.

Strongman equipment

strongman kegs yokes hammers tires atlas stone

If you don’t intend to make a strongman competition, kegs, yokes, hammers, tires and atlas stones are good to do from time to time.

Plyo Boxes

plyo Boxe

These boxes have several size. You jump on and off of.

Bands

band

Those are big rubber bans to work mobility and speed lifts.

Gear

It’s funny because people ask me often : « What do I wear ? ». I noticed in gyms, it’s often a fashion show. It’s for this reason beginners are impressed. Unless you have an injury, clothes don’t matter. When I started, I took some clothes that I rarely used and I always do that. Sometimes I see people with cool clothes and I say to myself : « Wow, I have to buy it » and when I see theirs performances I say to myself : « Pffff, show-off ! ».

Clothing

Gym isn’t a fashion show. You’re not going to win a prize because you’re well dressed. We’re here to sweat so wearing comfortable clothes. You know, my clothes and shoes are torn and the funny thing is that people ask me, if they can train with me because they see my body evolve.

Shoes

squat deadlift shoes classic converse chuck taylor all star

It’s important to have a good pair of shoes to do deadlift and squat. A good pair of shoes allows you to put your weight on your heels to be as stable as possible. Running shoes don’t allow you to do this because their soft soles. If you don’t have the budget for this type of shoes, the classic Converse Chuck Taylor All Star works well and is what many top powerlifters still wear.

Personally I use my Converse Chuck Taylor All Star for my strenght training and my Puma to run.

Gloves

Gloves are used to protect hands from callouses. At the beginning, I wore gloves and I still had callouses and sometimes my hands slipped inside gloves because of the sweat. I notices that gloves could also mess up your grip and technique. I don’t use gloves and I don’t recommand to have gloves.

Knee/Wrist wraps

knee wrist wraps

Wraps allow you to have support and stability when you lift heavy weights (squat/deadlift).

Straps

straps

Straps allow you to hold the bar longer in your hands. Straps are wrapped around the bar which relives your grip. It’s excellent for intermediate and advanced lifters. Beginners don’t need to use it.

Weightlifting Belt

weightlifting belt leather weightlifting belt velcro

There are 2 type of weightlifting belt : leather or velcro. It’s very usefull for intermediate and advanced lifters. I use my weightlifting belt only for deadlift and squat.

Stop, stop, stop, I see you start to worry about buyiing all this. Don’t panic, the most important thing to have is a good pair of shoes to get started. It’s simple, let’s go my friend.

Whats’s the biggest mistake you made when you started lifting ?

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

-Steph