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 .

Overuse Injuries

overuse injuries sport 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.

There are 2 types of injuries : Acute injuries and overuse injuries. Acute injuries are usually caused by a single traumatic event. Here are some examples :

  • Wrist fractures

  • Ankle sprains

  • Shoulder dislocations

Acute injuries are less common in sport than overuse injuries. Overuse injuries are usually subtle and appear over time, making them difficult to diagnose and treat. Here is some example :

  • Tennis elbows

  • Swimmer’s shoulder

  • Pitcher’s elbow

  • Runner’s knee

  • Achilles tendinitis

  • Shin splints

Why

Human body is extraordinary to adapt to physical stress. We’re used of thinking that « stress » is bad for our emotional well-being, but physical stress is simply doing an exercise or activity. This is beneficial for our muscles, tendons, ligaments and bones. This physical stress causes an internal process called remodeling. Remodeling process involves both the breakdown and the build up of tissue. It’s necessary to have a good balance between 2, if breakdown occurs more rapidly than buildup, an overuse injury occurs.

Causes

overuse injuries sport injury gym fail

Usually, it’s training errors that cause overuse injuries. These errors are too fast acceleration of intensity or duration or activity frequency. These injuries can also happen to people who return to the sport/activity after an injury. They try to make up for lost time as quickly as possible to reach the level they had before the injury. Doing an exercise with a good technique is important to avoid overuse injuries. When the exercise’s technique is bad, it creates overuse injuries. It’s for this reason that coaches, athletic trainers and teachers can play a preventive role so that athletes avoid overuse injures.

There are people who more easily have overuse injuries. An unbalance between strength and flexibility around certain joints predisposes some people to have this type of injury. Body alignment, such as knock-knees, bowlegs, unequal leg lengths and flat or high arched feet, also impact overuse injuries. There are also people who have weak links because of old wounds, incomplete rehabilitation of wounds or others anatomy factors.

Other factors must also be taken into account as equipment such as the type of running shoe or ballet shoe and terrain (hard versus soft surface in aerobic dance or running).

Diagnosis

Generally the diagnosis is based on the athlete’s history and physical examination. It’s recommended to make a diagnosis with a sports medicine specialist with a specific interest and knowledge of your sport. In some situations X-rays, bone scan and MRI may be necessary.

Treatment

overuse injuries sport injury ice

Here are some recommendations for treating an overuse injuries :

  • Cutting back the intensity, duration and frequency of an activity

  • Adopting a hard/easy workout schedule and crosstraining with other activities to maintain fitness levels

  • Learning about proper training and technique from a coach or athletic trainer

  • Performing proper warm-up activities before and cool down after

  • Using ice after an activity for minor aches and pain

  • Using anti-inflammatory medications as necessary

If symptoms persist, a sport medicine specialist may create a more detailed treatment plan for your specific condition. This may involve an exam of your training program and an evaluation of predisposing factors.

Prevention

Majority of overuse injuries can be avoided with a proper training program, common sense and learning to listen your own body. The quote : « No pain, no gain » doesn’t apply here. The 10% rule helps a lot to get things to the next level.

In general, you should increase the training’s intensity to a maximum of 10% per week. This allows your body to have enough time for recovery and response. This rule should be used to increase pace or milestone for walkers or runners. Or for the weights amount to increase for strength training programs. In strength training, add flexibility exercises and core stability exercises help tremendously to minimize overuse injuries.

It’s recommended to seek advice from sports medicine specialist or athletic trainer to prevent chronic or recurring problems. Your training program can also be modified to maintain fitness levels safety while you recover from your injuries. You must return to the sport only if an authorization is granted by a health professional.

Remember, it’s very important to warm-up before training and cool down after training.

Stats

3.5 millions of children are treated for overuse injures every year.

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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 .

Stretching Of Trapezius And Neck

stretching trapezius neck

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

A hand on your head, you pull slowly to tilt your head to the side. This exercise stretches the sternocleidomastoid, all (anterior, middle and posterior) scalenes muscles, the upper part of the trapezius, splenius capitis , splenius cervicis , semispinalis and small spine muscles like longus colli, rectus capitis posterior minor, rectus capitis lateralis and rectus capitis posterior major muscle.

Attention

Pull your head slowly with caution. Stretching should be done gradually.

Note

While you pull your head, lower your shoulders to feel the stretch of your trapezius.

Concerning the neck

stretching trapezius neck stretching trapezius neck

Quadrupeds and anthropoids (such as the gorilla) have very powerful neck muscles to prevent the head from tipping forward.

For the human being, it’s different. When the human being is fully biped depleted thus a vertical position with the head at the top of the spine , the muscles neck have become less powerful because the muscle’s neck have solely as a function of balancing the head.

  1. When the human being became biped, the morphology changed. The face‘s size decreased, the brain’s size increased and the occipital hole moved to the center of the skull. As the head is at the top of the spine, the neck’s muscles have the function of stabilizing the head

  2. Gorilla which is partially a quadruped has a larger face, a smaller brain and the occipital hole is towards the back. To prevent that head tits forward, the neck’s muscles are very powerful and developed.

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-Steph

How To Do Trap Bar Shrugs

trap bar shrugs

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

Standing with your legs slightly apart. You’re in front of the trap bar on the floor or on a support :

  • Take the trap bar, paying attention to centering your grip (attention : with heavy weight, a poorly adjusted grip will rock the bar backwards or forwards).

  • You have your head straight or a little bent forwards and your abs squeezed. Do shoulder shrugs.

This exercise works the upper trapezius which is inserted on the clavicle, the acromion and the scapular spine and which goes up to the superior nuchal line the the skull.

The rhomboid major / minor muscles and levator scapulae muscle work a little bit.

The trap bar created to work trapezius by lifting heavy weights without rubbing against the thighs like dumbbells or barbell.

la barbell.

Note

People with long clavicles will always have more difficulty doing shoulder shrugs than people with short clavicles.

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-Steph

How To Do Seated Rows With A Bar

seated rows with a bar

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

Podcast:

Sitting on the machine with your feet on the feet stop. Your torso is bent and you hold the bar with a pronation grip (thumbs inside). Your hands are more apart than the width of your shoulders:

  • Inhale, pull the bar towards your chest by straightening your back with your elbows rise.

  • Exhale at the end of the movement and returns to the starting position by controlling the movement.

This exercise works latissimus dorsi, teres major, posterior deltoid, infraspinatus and teres minor and a little bit the biceps, brachialis, and brachioradialis.

When the shoulders blades get closer, the rhomboids and the middle part the trapezius also work.

During straightening your torso, the spinal erectors also work.

Hands position

  1. With a supinated grip (thumbs outside), you work especially the lower trapezius, rhomboids, and brachialis.

  2. With a pronated grip (thumbs inside), you work particularly posterior deltoid and the middle part of the trapezius.

Attention

Stay focus to keep your back straight because if you round your back, you can have injuries.

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-Steph

Barbell Pullovers

barbell pullovers

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

Arms stretched with the barbell with a pronated grip. Your arms spread to your shoulders width:

  • Inhale as much as possible and lower the barbell behind your head by slightly bend your elbows.

  • Exhale returning to the starting position

This exercise work pectoralis major, triceps long head, teres major, lats and a little bit serratus anterior, rhomboids and pectoralis minor.

This exercise is to be done with light weights and it’s necessary to pay attention to positioning and breathing. This movement is excellent for thoracic expansion.

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-Steph

Dumbbell Pullovers

dumbbell pullovers

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

Lying on a bench with your feet on the ground. You take a dumbbell with both hands and your arms outstretched. The dumbbell is on your palms and your thumbs and forefingers encircling the handle:

  • Inhale and lower the dumbbell behind your head by slightly bending your elbows

  • Exhale returning to the starting position

This exercise work pectoralis major, triceps long head, teres major, lats and a little bit serratus anterior, rhomboids and pectoralis minor. The serratus anterior, rhomboids and pectoralis minor have the function to stabilize the scapulae (shoulder blades) and to allow the humerus to tilt over a stable support.

It’s possible to do this exercise only to open the rib cage. To do this, work with lightweights and be careful to not bend your elbows too much. And it’s necessary to use a bench in a transverse position so that your pelvis is lower than your shoulder girdles. It’s important to inhale as much as possible at the beginning of the movement and to exhale only at the end of the movement.

dumbbell pullovers

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

-Steph