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 .

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 .

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.

Biceps Tendon Rupture

biceps brachiitTendon rupture

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

Rupture or tear of the biceps long head is the serious injury the most frequent in sport

This injury usually appears on a muscle weakened by tendinitis caused by a sudden movement of the arm. Sudden arm movements are usually thrown like baseball, tennis, throwing sports and also Olympic weightlifting during the snatch. At this point, all tension transferred to the biceps long head which breaks most often where the tendon passes into the intertubercular sulcus of the humerus.

In bodybuilding, this injury is a little different, especially with the deadlift.

There is a technique in deadlift which consists of having a hand with a pronated grip and the other with a supinated grip to lift heavier weights and to avoid that the barbell rolls in the hands.

This simple technique is at the origin of the rupture or the disinsertion of the lower of the biceps (where the muscle is inserted on the humerus). Fortunately, this injury rarely happens.

During the positive phase of the deadlift, the muscles that work are legs, glutes, back and abs. Arms relaxed but they stretched as cranes cables.

Unfortunately, when a hand is with a supinated grip this shortens the biceps (the biceps is extremely powerful with a supinated grip). The result is that there is tremendous tension due to the heavy weights which cause the tearing or total rupture of the tendon of the radius. The biceps with a supinated grip works more than the biceps with a pronated grip.

In the deadlift, the injury is exclusively on the distal tendon of the muscle. The arms hang along the body, which causes the tension to be distributed at the top of the muscle between the tendons of the short head and the long head. For other exercises when the tension is at the bottom of the muscle, the tension is supported on a single tendon insertion.

biceps brachiitTendon rupture

The rupture of the biceps tendon causes a pain relatively moderate compared to the severity of the injury. If we compare the rupture of the biceps tendon with the major pectoralis or the adductors of the thighs, the pain is different. With a rupture of the major pectoralis tendon or adductors of the thighs, the suffering is so strong that the athlete must stop the effort.

It often happens that during a powerlifting competition, athletes who have a rupture of the biceps tendon during the deadlift, continue until the end of the movement.

When this injury occurs, there is swelling in the forearm because of hemorrhaging. But the most surprising thing is the retraction of the biceps which forms a ball at the top of the arm near to the pectoralis major and deltoid. This biceps retraction causes the brachial muscle in the lower arm to be more exposed.

biceps brachiitTendon rupture

It’s always possible to make a flexion of the arm with the rupture of the muscle, which less powerful than before, thanks to the brachial muscle, brachioradialis, long and short radial extensor of the carpus and the pronator teres muscle. On the other hand to make a movement with a supinated grip is a problem because the end of the movement is only carried out by a single muscle, the supinator muscle.

You have to be careful because this injury should be treated quickly by surgery to restore the brachial biceps tendon to the radius. If this surgical operation is not performed in time, the ball will have a fibrous transformation and retraction will be final. The arm’s mobility will always be possible but the loss of strength in flexion and supination is inevitable.

There is a solution to avoid this type of injury with deadlift with a bicep work to have a tendinous reinforcement. This exercise is to do a flexion only with forearms with a straight barbell. This exercise reinforces the biceps distal tendon but be careful by controlling the movement.

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-Steph

Find The Gym For Your Goals (Part2)

find a gym diffrent type

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

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

Type de gyms

different type gym

You noticed there are several categories of gyms. That’s why you have to take your time to think about a gym that fits your needs.

Fitness center franchise

In the best known franchises, you will have cheap membership. It’s cheap but you have few amenities, some type of trainings are forbidden, free weight section is limited and often the staff has no experience.

Health clubs/Sport clubs/YMCA

Clubs look like franchises but they have a better service. There is more amenities, towel service, child care, pool, tennis court. Membership can reach $100, some type of training can be prohibited and free weight’s section limited.

Note : Franchises and clubs can be convenient if you travel a lot because with their membership, you can train in different cities.

Locally owned gyms

These gyms have a better equipement, a free weight’s section bigger and a better quality staff than franchises and health clubs. Membership is around $25-50 and it’s real that amenites are less good than health clubs.

Weightlifting club/barbell club/crossfit

It’s a room with bumper plates, dumbbells, barbells and pullup bar. With the membership, you have a coach and classes, that’s why it’s expensive. These gyms are open at certain hours during the day. These gyms have their own workout program, you can’t do your own workout program.

College/university gyms

it’s cheap and you need to paid upfront in full.

You can have a discount « alumini » memberships if you go to the college or university that you attended. If you don’t live near of you old college/university, some gyms offer memberships to family members of alumini or staff, local « senior » memberships or event just local resident memberships. What is great with this type of gym is you can have acces to their full facilty (pool, racquet courts, classes, etc).

Test drive the gym

test drive

The next step is to look for gyms in your city now that you know differtent types of gyms.

Do a test in gyms to see if the equipement meets your needs. Some gyms offer pass for 1-2 weeks. During the test phase, go train the same days that you plan to train after signing the contract.

Imagine that you find the perfect gym, you sign the contract and eveydays you train, it’s war. The gym is full of people and you can’t use equipement. This is a situation to avoid.

Here is what is important to see during the test phase :

  • Is there enough equipment for everyone or you have to fight to have a bench ?

  • Does the equipment work well ?

  • What is the gym’s atmosphere ?

  • Is it clean ?

  • If you go befoire school/work, is there enough shower available or you have to wait ?

You can read gym’s reviews on internet by searching with Google or DuckDuckGo. Attention, on internet people prefer to complain than to do compliments so be careful. For me the best thing to do is talk to gym members to know what is positive and negative.

Contracts

contract

A lot of people don’t want to have a membership gym because one of their friend had a bad experience to stop a gym’s membership. This for this reason it’s important to take your time to read the contract and understand clauses.

Here things to look at in a contract :

  • A membership termination clause because for exemple, you move or you lose you job. This is rare but sometimes you can stop a membership if you live near the gym. Usually there is a fee named «  early termination fee » (that’s what I have).

  • The possibility when you’re on vacation ou you have to work for several weeks in another city to freeze your membership.

  • If the gym goes bankrupt, what happens to members ?

  • Membership renewal is automatic ?

You know salespersons work with commission so if a sales person make you a promise, make sure that this promise is in writing. Taking the contract at home is the thing I advise you to read it quietly and understand clauses.

If you feel that the salesperson put pression on you or that you don’t feel comfortable for another reason, leave the gym.

Note : There are states that has specific laws. For exemple, you can cancel the contract only 2 days after signed it. It would be a shame if you signed this type of contract without being aware of this clause. This is why it’s important to take the contract at home to read it quietly.

Here different membership’s fees :

  • Activation fee

    You pay these fees when you’re a new member. You pay these fees once.

  • Monthly cost

    it’s a fee you pay every month

  • Maintenance fee

You pay these fees per year. Attention, some gyms have a special clause that says : « We don’t have this kind of fee now but later, it’s possible to add these fees without telling you ». Be sure to know this clause if it is in your contract.

When I enrolled in my gym, there was an offer for people who applied for registration on internet. Look at gym’s website to know offers but also ask always to salesperson if there are discounts.

In gyms, there is often a membership’s range of price. You need to negotiate, don’t hesitate. Don’t forget that the more you take the more expensive membership, the more the salesperson will have a larger commission. If the salesperson tell you : « No », it doesn’t matter, you tried to get the best price.

By negotiating, somethimes you can register in a gym for the first time without paying the activation fees. To do it, you need to talk to the person who has permission to do this. Sometimes they can call you 1-2 days after to offer you an exceptional offer.

You can also have a nice offer by paying an annual membership up front. Look at the price difference.

Also you can have offers with you health insurance. It’s always with a limited number of gym but look if you have this option.

Stay focus

stay focus

The difference between a workout at home and a workout in a gym is that in a workout in a gym, you can really make your potential evolve to the maximum.

For exemple, if you do a barbell’s workout, you will have always heavy weight plates to go to the next level. It’s the same thing for dumbbells. You need heavier, it’s here. No need to worry about buying new.

Of course, there are negative pointst to enroll a gym. You have to move there (bike, bus, car, etc), you to wait if you go during busy hours, the cost and do your workout around unkown people.

I repeat, you can train at home to be healthy or gain strength with a bodyweight workout program. You can buy a set of dumbbell, barbell, kettelbell or a sandbag. You can do sprints or walk (like my father) outside with any weather and it’s free.

For me the gym, it’s an important moment of my day. It’s the moment where I’m focus on myself and the society’s pressure no longer exists.

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

-Steph