SLAP Tears

slap 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.

SLAP is an acronym for superior labrum anterior to posterior. The labrum is a rim of tissue that adds depth to the bony socket of the shoulder. The superior or « top » portion or the labrum is important and frequently injured because the biceps attaches to this region.

How

SLAP tears happens because of physical activity with repetitive overhead movements or physical shock. Tears created because of overhead movements are common among athletes as basball pitchers or tennis players. Tears created due to physical shocks are often a fall on a hand stretched with the arm over the head or fall directly on the shoulder.

Diagnosis

slap tear anatomy shoulder

SLAP tears are very difficult to diagnose only with a physical exam because of different shoulder problems. Using a MRI with or without contrast helps a lot.

Treatment

The first step is to do a nonsurgical treatment. While the SLAP tear likely will not heal, a study confirmed that many have improvement of symptoms and function. If nonsurgical treatment (such as physical therapy) isn’t successful, surgery is being considered.

Surgery is usually done arthroscopically and involves reattaching the torn labrum to the top of the cavity. Generally, bone anchors loaded with sutures are inserted into the top of the cavity. The sutures are passed through the torn area of the labrum. The sutures are tied, which brings the torn labrum to the bone.

Prevention

Although it’s difficult to avoir acute SLAP tears, it’s possible to prevent chronic tears, especially with athletes who make overhead movements, maintaining balance in the shoulder.

Exercices that strengthen the muscles around the shoulder blades and exercises that stretch posterior shoulders are recommended to reduce the risk of SLAP chronic tears.

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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 .

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 .

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 .

Mature Athlete

mature athlete

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.

Physical exercises are for everyone, including the mature population. Exercises allow older people to keep a healthy body and maintain their independence. The main health problems of the mature population are arthritis, high blood pressure, heart disease, lung disease, depression and hearing and sight loss. With the exception of hearing and sight loss, all these health problems can be serious decrease with an adequate workout program.

All mature athletes should have a complete medical and musculoskeletal assessment before starting any workout program. Having a complete medical examination, medical advice and a workout program helps to avoid serious injuries and health accidents. These 3 things should meet the needs of a mature athlete to avoid disease, increase endurance, strength, body image and competitiveness.

Exercises are beneficial

It’s important that a qualified personal trainer create a specific workout program to improve strength, endurance, balance and flexibility. If the workout program includes sports such as golf or tennis, the technical knowledge of the golf/tennis instructors is helpful to avoid injury and improve performance. For results, workout programs must be consistent for at least 30-45 minutes, 3-4 days a week.

If physical conditions require correction, a cardiac or pulmonary rehabilitation program or physical therapy may be helpful before starting a workout program. These rehab programs should be taught to mature athletes at a fitness level where they could continue with their own workout program.

Exercise type for the workout program

physical exercise type

An athlete should use types of exercises based on his/her desire, pre-existing conditions and his/her ability to exercise without pain. For an athlete with lower extremity joint problems such as arthritis or instability, it’s recommended to avoid exercises with repetitive impacts like running. For athletes with an unstable shoulder, it’s recommended to avoid overhead exercises such as military press and pull-ups.

Using several types of exercise to improve strength, can allow better recovery of muscle and tendon tissue. If a mature athlete wants to make a sport that can aggravate a pre-existing problem on a muscle, tendon or bone, that athlete should be in a good condition before doing this sport. It’s recommended to decrease this sport’s frequency to reduce the painful symptoms.

What equipment to use

Having shoes that fit with the exercise and/or the sport is beneficial. If the person has a foot with significant deformity such as flat feet (fallen arches), using orthopedic shoes helps to reduce stress on the entire lower extremity. The symptoms of arthritis in the knee may be decrease by the use of specialized braces.

Prevent injury or discomfort during exercise

If there is discomfort during or after physical exercise, this should be analyzed to prevent it from starting again or getting worse. Over-the-counter painkillers and anti-inflammatory can be used in the short term if there is no interference with other medical conditions. It’s important to know that the use of ice, heat, massage and flexibility programs can decrease several symptoms caused by exercise.

There is more aggressive treatment with narcotic analgesic and/or cortisone injections but this should only be used to treat a specific lesion. This shouldn’t be used to allow an athlete to complete in the short term.

Summary

Creating a customized workout program with a medical professional and/or a qualified personal trainer helps a mature athlete to :

  • Keep independence

  • Increase physical abilities

  • Prevent injuries

  • Improve the quality of life

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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.

Break For Injuries

sport injury

What’s up ? This is THE stephane ANDRE and today I didn’t train. I will tell you why, because I feel pain to my left shoulder and my 2 knees. 6 day ago, it was my leg day and you know, I hurt my right knee during a martial art session. So I used lightweight to train my leg.

Since around 6 months, I felt pain to my shoulder (shoulder impingement) because of the dumbbell overhead shoulder press and dumbbell bench press. Since 1 months, I hurt my right knee in a martial art sparring, because I wanted to avoid a punch and my leg (my knee) was in a bad position. I had 2 injuries . I searched an alternative exercise for the dumbbell overhead shoulder press and dumbbell bench press to decrease the pain and I found out. I wrote 2 articles about it. Click here and there .

Too much injuries

sport injury

As it was a leg day, I decided to do front squat with lightweight to not hurt to much my right knee. After my front squat session, I did leg press with one leg. After my warm-up set, I felt a pain in my left knee, it was like if someone hit my left knee with a knife, I stopped my rep immediately. It was the first time I felt this pain and I didn’t like it. I tried to do an another rep to see the gravity of the pain and I stopped my leg day here.

I did the half of my leg day’s program and I thought it was a good idea to test the new way to do dumbbell bench press without pain. When I was walking with the dumbbell in my hands, I felt the pain in my left knee. I did this dumbbell bench press variant and I validate it.

Usually after my workout, I eat my meal (my post workout is solid food). While I was eating my meal, I thought it was the time to make a break. 3 injuries is too much for me and I decided quickly to make a break of 1 month to really recover, because since 2015 I train regularly 6-7 days per weeks and the longest break I make was 10 days. Yeah, 10 days. When I realized it, I thank God of Light for his gratitude. And you know what ? When I slept, I felt I a little pain in the middle of my back. It means to do my front squat, my body compensated the weakness of my right knee with others parts of my body to be able to execute the movement.

Special recovery

Now, it’s the 6th days and I continue to write article for my blog and I learned what kind of injuries I have and I want to learn deeper about sport injuries because I scare to become like Ronnie Coleman. Ronnie Coleman is the best bodybuilder for me, it’s because of him I started seriously to train like a bodybuilder when I was on the streets. And now, see this living legend who can’t walk without a crutch, it’s too sad.

I want to have the best athletic body I can until I die, I’m more focus about sport injuries. More I know about it and more I can avoid it. Every day I do my stretching session and I do 2 special movements to help my left shoulder to decrease the pain. I will see on 15th July, if my recovery session is effective.

It’s important not to take lightly the pain of your body. I know a lot of people who had pains a few years ago and they had to do some surgery. Now, they can’t use their capacity at 100%.

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-Steph

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

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-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