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

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Meniscal Tears

meniscus

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.

Meniscus tear

meniscus tear

Meniscal tear is one of the most common knee injuries in athletes. This is caused after a contact injury or a traumatic twist. The meniscus is a wedge-shaped cartilage that provides a cushion in the medial and lateral portion of the knee joint and acts as a « shock absorber ». It’s located in the area of joints contact to prevent the bones rub between them because of the bodyweight. It’s hard and rubbery to help cushion the joints and keep the knees stable.

It’s important to also know that the meniscus helps to nourish the knee by facilitating the diffusion of joint fluid. With this injury, athletes can experience acute pain with a swelling and often a catching or locking sensation.

Diagnose

A meniscus injury can be diagnosed on the basis of the story that the patient provides and a physical examination of the knee.

An orthopedic surgeon my also use other techniques to further diagnose such as magnetic resonance imaging (MRI), which gives a 3-dimensional image of the inside of the knee joint. In some cases, a surgeon can perform an arthroscopic inspection of the articulation, this is a minimally invasive surgical procedure.

Treatment

knee brace

A small meniscus tear can be treated with rest, ice and anti-inflammatory medications. When a meniscus tear causes a significant loss of movement or catching, the appropriate treatment is often a surgical operation. Depending on the location and type of tear, the treatment may be a simple arthroscopy to remove the torn fragment. Depending on how quickly the inflammation disappears, athletes can return to a full activity after a week or months.

For athletes with a repairable tear, sutures are used to sew the meniscus. In this situation, the knee is braced for 6 weeks. These athletes take at least 3-6 months to back to their activities but maintain the full cushion in their knees.

Prevention

There is not really any way to prevent a meniscus tear apart from a conditioning program to try to prevent an acromioclavicular ligament (ACL) tear and knee instability.

Stats

Women have meniscus tears more often than men and at an earlier age. These tears are often associated with an acromioclavicular ligament injury (ACL)

There are some variables of meniscus tears can be repaired and despite repair, they aren’t always heal. But arthritis can be avoided in the majority of cases when repair is successful. One study shows that 60% of patients who undergo meniscectomy (partial elimination) had some degree of progressive arthritis.

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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 .

Incline Bench Sit-Ups

incline bench sit ups

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

Sitting on the bench with your feet under the pads and your hands behind your neck. Inhale and tilt your torso without ever exceeding 20° :

  • Move your torso back up by slightly rounding your back to better target the effort on recuts abdominis

 

  • Exhale at the end of the movement.

This exercise work the entire rectus abdominis muscles and iliopsoas, rectus femoris and tensor fasciae latae (these last 3 muscles help pelvis anteversion). This movement is to do with high sets.

Variant

incline bench sit ups

When you back up, you can do a rotation of your torso to transfer a part of the effort to the obliques.

Example

A rotation to the left work more intensely right abdominal external oblique, left abdominal internal oblique and rectus abdominis on the right. Twists can be done alternately or unilaterally. The goal is to focus on the muscular sensation and it’s unnecessary to incline the bench too much.

Diagram showing the senses of action of abdomen muscle and the system of viscera’s compression

action abdomen muscle system viscera compression

 

  1. Rectus abdominis

  2. Abdominal external oblique

  3. Abdominal internal oblique

  4. Transverse abdominal

With quadrupeds, the entire rectus abdominis muscles passively support the viscera (like a hammock ) and help a little in locomotion.

With human being in bipedal mode, the entire rectus abdominis muscles have hugely strengthened so that the torso and pelvis is upright and prevent the pelvis from tipping excessively during walking or running. They became powerful muscles of contention and they built a strong core to maintain viscera in an active way.

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-Steph

Sit-Ups

sit ups

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

Lying on your back with your knees bent. Your feet are on the floor and your hands are behind your head :

  • Inhale and lift your torso rounding your back.

  • Exhale at the end of the movement

  • Back to the starting position but your back shouldn’t touch the floor.

  • Do it again until the burning sensation in your stomack.

This exercise mainly works rectus abdominis and a little bit hip flexors and obliques.

Variants

sit ups

sit ups inclined board

  • To make it easier, you can do this exercise with your feet blocked by a partner

  • To make it easier, you can do this exercise with your arms extended forward

  • For more intensity, you can do this exercise with a inclined board

Note

Women generally have less developed bust and proportionately larger legs than men. It’s easier for them to do sit-ups and not take off the feet during the movement.

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-Steph

Cable Hip Abductions

Cable Hip Abductions anatomy

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

Cable Hip Abductions

Standing on one leg. Your other leg attached a low pulley to your ankle and your opposite hand placed on the machine to stabilize your body :

  • Raise your leg as high as possible

This exercise works mainly gluteus medius and gluteus minimus placed in more depth. For a better efficiency, it’s advisable to do set with high reps until the sensation of burns.

gluteal msucles insertions anatomy

Abductions anatomy

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-Steph

Bridge

bridge anatomy

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

bridge anatomy

Lie on your back with your hands flat on the floor. Your arms along your body with your knees bent :

  • Inhale and lift your buttocks from the floor by pushing hard on your feet

  • Maintain the position 2 seconds and go down your pelvis without touching the floor.

  • Exhale and start again.

This exercise mainly works hamstrings and gluteus maximus.

This movement is to be done with sets of high reps because the goal is to feel the contraction at the end of every repetition.

Note

Easy and effective, this exercise is very popular in aerobics classes.

Variant

Bench bridge :

bench bridge anatomy

Lie on your back with your hands flat on the floor. Your arms along your body with your thighs vertical and your feet on the bench :

  • Inhale and lift your buttocks from the floor by pushing hard on your feet

  • Maintain the position 2 seconds and go down your pelvis without touching the floor.

  • Exhale and start again.

This exercise works gluteus maximus and especially hamstrings because hamstrings works more here than bridge on the floor.

This movement is to be done slowly, the main thing is to feel the muscles contraction. Sets of 10 to 15 reps give better results.

With calves on the bench, you’ll work even more intensely your harmstings with gastrocnemius muscles.

You can also do this movement with a small amplitude without touch your buttocks on the floor and looking for the burning sensation.

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-Steph

One Leg Toe Raises

one leg raises

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

one leg raises

Standing on one leg with your forefeet on a step. One hand holds a dumbbell and the other is placed on a support to have a better balance :

  • Do an extension of the foot keeping your knee joint in extension of slightly bent.

This exercise works triceps surae (composed of 2 gastrocnemius and soleus). It’s important to do each repetition with full flexion of the feet to really stretch the triceps surae. Only high set until the burning sensation give good results.

one leg raises anatomy

Note

For some people, triceps surae don’t gain volume bit it is gaining strength. Low calves (gastrocnemius and soleus go very down) will easily gain volume. High calves will gain a little volume.

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-Steph