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

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Anterior Cruciate Ligament Injuries

anterior cruciate ligament injury tear

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.

Knee is the largest and most complex joint of the body. There are 4 primary ligaments (with their muscles and tendons) and secondary ligaments for the knee to function properly. Here are the ligaments of the knee : there are 2 ligaments on the side the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) and two crossed ligaments in the center of the knee, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).

Anterior cruciate ligament connects the front top part of the shine bone to the back bottom part of the thigh bone and keeps the shin bone from sliding forward.

anterior cruciate ligament

Injury

anterior cruciate ligament injury tear

There are several ways to have an injury to the anterior cruciate ligament :

  • The injury can be done because of a direct hit on the knee, which often happens in team sport.

  • The injury can be done without contact with an object in a situation where the knee forced to be in a abnormal position, which causes a tear in one or more ligaments of the knee. Or when an athlete in the race change direction. Or when an athlete make a hyperextend of the knee when landing a jump, which often happends in agility sports.

Diagnostic

In the majority of cases, the doctor is able to identify what is the injured ligament. But the knee can also be injured at the joint on the surface and in this situation, it’s more difficult to diagnose because of knee swelling. To make an accurate diagnosis, it will be necessary to use a MRI scan or arthroscopy.

Prevent

There are several fast, powerful movements that lengthen (eccentric phase) and shorten (concentric phase) a muscle. These prevention programs are for injuries without contact. These exercises are to improve the nerves/muscle control of the knee. These prevention programs use plymetrics, balance and strength/stability exercises.

Plymetrics

It’s a fast, powerful movement that lengthens (eccentric phase) and shortens (concentric phase) a muscle. The concentric phase increases the muscle power. Here is an example, an athlete who jumps from a box and immediately jumps into the air after touching the floor.

Balance

Balance exercices are done with the wobble or balance board. It’s also possible to perfom exercices by throwing a ball with a partner while balancing on one leg.

Strength/stability

To improve single-leg core strength and stability, there are excellent exercices such as jumping and landing on one leg with the knee flexed and momentarily maintaining this position.

Surgical treatment

In the past, there was a technique that consisted of stitching the ligament together but it was rarely successful. Currently, the technique involves reconstructing the anterior cruciate ligament by building a new ligament from tissue taken from one of the other tendons around the knee or from on organ donation. This tissue passed through drill holes in the thigh bone and the shin bone, and then ancored in place to create a new anterior cruciate ligament. Over time, this transplant becomes mature and becomes a new living ligament in your knee.

Recovery

recovery

Rheabilitation of the knee after the reconstruction of the anterior cruciate ligament requires time and work. To have a complete function, this can last between 6 weeks and 6 months depending on the severity and level of activity. Rehabilitation rate may take time depending on the specific requirements of the sport/physical activity of the individual.

The overall success rate of the anterior cruciate ligament surgery is very good. A lot of study show that more than 90% of patients are able to return to sport without symptoms of knee instability. It’s true that some patients complain of stiffness and pain after surgery, that is why it’s necessary to make an aggressive rehabilitation until the new surgical technique to reduce these problems.

Statistics

  • One of the most commonly injured ligament in the knee

  • Female athletes participating in basketball and soccer are 2-8 times more likely to suffer anterior cruciate ligament injury.

  • Athlete who suffer anterior cruciate ligament injury at increased risk of arthritis development later in life.

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-Steph

Broomstick Twists

broomstick twist

What’s up ? This is THE stephane ANDRE ! I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Standing with your legs apart and the stick placed on your trapezius above your posterior deltoids. Your hands are on the stick but don’t press on it :

Make a torso rotation on one side then the other, keeping your pelvis motionless with an isometric contraction of your glutes.

This exercise works when your right shoulder is forward : the right external oblique, left internal oblique and a little bit rectus abdominis, quadratus lumborum and extensor spinae on the left side.

For more intensity, it’s possible to slightly round your back. A variant is to do this movement sitting on a bench, which will block your pelvis and focus the effort on your abs.

seated broomstick twist

It’s with sets of several minutes that you get the best results.

Attention

Torso rotations are prohibited for people suffering from low back or having had a herniated disc as this may aggravate or resurgence of this lumbar pathology.

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-Steph

Calf Stretching

calf stretching

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

Standing with your hands on your hips. One leg forward with your knees stretched and your feet in the knee axis :

  • Flex the knee of the front leg while advancing your pelvis. Be careful to keep your back leg straight and keep your heels on the floor.

  • Keep this position to feel the stretch of the back leg.

This exercise mainly stretches triceps surae (composed of 2 gastrocnemius and soleus), flexor muscles of the toes and tibialis posterior. This exercise stretches a little bit long and short fibular.

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-Steph

Standing Calf Raises

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

Stand with the front of your feet on a step. Put your hand on a wall or a support to have more stability :

  • Slowly flex your feet to stretch your calves.

  • Extend your feet with your knees extended or slightly bent.

It’s a movement to be done slowly and with high reps until the burning sensation.

This exercise has an action of stretching and muscle contraction. It’s for this reason that this exercice can be used as a warm up before a calf exercise with heavyweights, to avoid injuries, or at the end of the session to feel the pump.

This exercise works triceps surae composed of 2 gastrocnemus and soleus and also flexor hallucis longus, tibialis posterior and flexor digitorum longus.

Note

This movement is excellent for stretching the muscles of the plantar surface of the feet like flexor digitorum brevis and quadratus plantae and soften plantar faschiitis.

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-Steph

Good Morning

good morning leg exercise

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

Standing with your feet slightly apart. The barbell put on your trapezius or lower on your posterior deltoids :

  1. Inhale and bend you torso forward to the horizontal with your back straight, the axis of flexion passing through coxofemoral joint.

  2. Back to the start position and exhale.

It’s possible to make the movement easier by bending your knees.

This exercise works glutes (gluteus maximus), all spinal muscles and hamstrings (except the biceps femoris short head). Besides the knees flexion, hamstrings have the function of retroversion of the pelvis, which allows to straighten the torso. This action performed when the torso bound by isometic contraction to abs and sacro-lumbar muscles.

To have better feeling on hamstrings, it’s advisable never to work with heavy weight. In negative phase, « good morning » is excellent for stretching the back of the thighs. Work regularly the negative phase of the « good morining » helps prevent injuries to hamstrings during the squat with heavy weight.

good morning leg exercise method straight bent leg

  1. Legs stretched while your torso leans forward, extends hamstrings. This make is easier to feel sensations of hamstrings when you straighten up your torso.

  2. Legs bent while your torso leans forward, relax hamstrings. This facilitates flexion of hip.

good morning leg exercise method straight bent leg

good morning leg exercise pelvis stabilization

good morning leg exercise glutes gluteux maximus hamstings

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-Steph

Spinal Disc Herniation

disc herniation

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

First we can say : « disc herniation » or « herniated disc » but I prefer use « disc herniation » in my article.

Disc herniation is a common pathology in bodybuilding. This often occurs because of poor back placement during exercises such as squat, deadlift and rows (barbell bent row, seated row, etc).

During the execution of theses exercises, the main defect observed is the rounding of the back or a flexion of the spine. Because of that discs are pinched forward and loosened backward.

disc herniation

If an intervertebral disc cracked or aged, the gelatinous fluid of the nucleus pulposus moves backwards and can compress the spinal cord or roots of the spinal nerves. The symptoms of a disc herniation depends on the nature of the lesion, the amount of nucleus displaced and the surface that nucleus compresses.

The disc may have a bump or even worse, the nucleus may explode through the surrounding annulus fibrosus. It’s also possible that the posterior ligament that joins the vertebrae to each other is broken. The compressions caused by the rupture of the annulus fibrosus are always painful and incapacitating.

In bodybuilding, disc herniation are mainly at the lumbar level. Often between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae. The pain is dull and deep and sometimes with numbness and tingling. Often the pain is in the middle of the back or on one side. The pain extends onto the glutes, pelvis and pubis. Sometimes pain can be felt throughout the leg following the path of the sciatic nerve because the sciatic nerve is compressed at the root (hence the name of sciatic to define this type of pain).

disc herniation sciatic nerve

Usually disc herniation resolve spontaneously and the pain gradually disappears. But in some cases the bump on a vertebral disc doesn’t disappear and can continue to painfully pres on the nerves or it’s a loose piece of intervertebral cartilage that compresses the nervous elements.

In these 2 cases, the doctor will think of doing a surgical operation to remove the part that compresses the nerves.

To avoid having a disc herniation, it’s essential to do squat, deadlift, « good morning » and rows (rows, barbell bent row, seated row) with excellent positioning technique.

Attention

For all exercises done with very heavy weight, it’s necessary to perform a « blocking » :

  1. Take a deep breath and block the breathing to fill the lungs like a balloon. This stiffens the ribcage and prevents the top of the torso form tilting forward.

  2. Squeeze abs stiffens the belly, This increases the intra-abdominal pressure and prevents the torso from sagging forward.

  3. By slightly arching the lower back with lumbar squeeze, this allows to have the spine’s bottom in extension.

These 3 simultaneous actions is what we call « blocking ». This « blocking » has the function of avoiding the rounding or bending of the spine because with very heavy weights, it can create disc herniations .

Note

After a training session with very heavy weights, it’s advisable to do stretching for the spine. There is an excellent exercise to relax the back muscles and rebalance the pressure inside the intervertebral discs. Click here .

Bad position

disc herniation bad positon squat deadlift

For exercises such as deadlift or squat, it’s important not to round your back to avoid lower back injuries.

Disc herniation

disc herniation

Flexion of the spine with heavy weights can create disc herniations at the level of the lumbar vertebrae.

These disc herniations are common at squat and deadlift. This is caused by a bad back position during exercise. That’s why it’s important to work the technique for these exercises.

Disc herniation according to the age

disc herniation intervertebral

From the age of 30 years old, intervertebral discs degenerate and don’t worry, it’s normal, The annulus can crack and the nucleus pulposus dries progressively.

Vertebral discs of people over 30 years old are more rigid, less elastic and the mobility of the spine is more limited. But as the viscous gel of the nucleus pulposus deacreases due to drying, the risk of the vertebral discs moving and compressing the nerves diminished.

Vertebral discs of people under 30 years old are more flexible, more elastic and there is more mobility with the spine. There is a greater amount of viscous gel in the nucleus pulposus which increases the risk that vertebral discs will move and compress the nerves. Disc herniation is very common among young athletes.

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-Steph