Sunday 18 September 2011

Shoulder Dislocation and Rugby Injuries

An increase in the occurrence and severity of shoulder injuries in rugby has been noted and this realisation has prompted guidelines such as these to be drawn up as a specifically for coaches, physiotherapists and sport physicians caring for players on and off the field. Younger players are playing more competitively and aggressively and it is important to note the specific injury patterns in these players with immature skeletal structures.

BASIC ANATOMY

The most pertinent structures of the shoulder to recognise as far as injuries are concerned are:

• The trapezius, which is the large muscle running from the neck to the shoulder and back .
• The acromio-clavicular (AC) joint, which is the joint between the collar bone and shoulder bone.
• The Deltoid muscle: The large muscle at the upper and outer aspect of the arm which is the main muscle used to lift the arm.
• The clavicle (collar bone) which supports the shoulder and can be felt under the skin.




STRUCTURES MOST OFTEN INJURED

• Soft tissue around the shoulder: In the game of rugby, direct blows are common and soft tissue bruising of the trapezius muscle, the deltoid, the pec major and other soft tissue around the shoulder usually has long-term effects for the player.

• Rotator cuff: The rotator cuff tendon (mostly the supraspinatus tendon), deep to the deltoid, is usually injured when the abducted or extended arm is forced downwards or backwards especially during a fall or a tackle. The injury may be a simple sprain or a frank tear of the tendon. The latter is rare in young players and usually a sprain of the tendon is more common.

MECHANISMS OF INJURY MOST COMMONLY SEEN IN RUGBY
The most common mechanism of injuries includes:
• A direct blow to the shoulder: This may happen when a player falls or is hit on the shoulder from either the front or the back. This may result in a simple bruising of the shoulder or even dislocation.
• Falls directly onto the shoulder with the arm by the side: AC joint injuries often occur due to this mechanism - direct falls onto the shoulder often result in AC joint sprain or dislocation. In some instances rotator cuff injuries may also occur due to this mechanism.
• Rotator cuff injuries: These usually occur when the arm is forced downward when it is held up forwards or to the side or even from a fall onto the shoulder.

Obvious bruising or deformity:
• Swelling or deformity over the AC joint may indicate an AC joint injury / dislocation
• Bruising or swelling over the trapezius or deltoid may be the result of soft tissue bruising of these muscles
• Pain inside the joint could be linked to a labral or rotator cuff injury




GUIDELINES CONCERING WHEN TO REMOVE THE PLAYER FROM THE FIELD IN THE EVENT OF A SHOULDER INJURY:
If the shoulder is obviously dislocated the player should be taken off the field and managed by the medical practitioner on the side of the field or referred to a hospital for reduction of the shoulder displacement.

A deformity over the AC joint is a crucial area and pain can be the determining factor. Should the player be able to continue, he may do so without any serious results. On the other hand, should his pain be of such a nature that he is not able to play competently, he should be removed. Trying to play on does not have any serious or harmful effect though, but the pain and associated loss of function may limit his/her rugby playing performance from a team perspective.

In conclusion, with the appropriate management of shoulder injuries in rugby players most of the players should be able to return to the sport and not suffer long term consequences to the function of this important joint.


I have been considering surgery for his rotator cuff impingement and came across some interesting websites focusing on shoulder replacement surgeries.



For more information click here

Rotator Cuff Therapy Fixed My Shoulder Without Surgery

Rotator cuff problems come in a variety of shapes and sizes. You can Get anything from a mild sprain to a full thickness tear or a shoulder impingement, all of them are caused by problems with the rotator cuff to some extent and all of them will involve rotator cuff therapy exercises as part of the rehabilitation.

Most rotator cuff problems can be fixed without resorting to surgery. If you have managed to snap one of the tendons completely or have a severe shoulder impingement then you are probably looking at corrective surgery. Surprisingly, I managed to fix a pretty nasty shoulder impingement with rotator cuff therapy.

At the end of last year I managed to tear my rotator cuff. Around a third of us will do this at some point in our lives. I managed to do it by lifting something that was too heavy. Felt a pop in my left shoulder and woke up the next day to restricted movement and shoulder pain that just got worse as the days went by.

I went to the doctor who diagnosed a rotator cuff problem and made an appointment for me to see a specialist. Being stubborn and somewhat pig headed I decided to carry on using my shoulder as normal, despite my doctor's advice. What I didn't know at the time was that each bout of pain I suffered as I moved was an indication that I was doing more damage.

I had a shoulder impingement which is where an inflamed tendon gets pinched against part of my shoulder blade, gradually fraying as I continued to use my shoulder as normal. Fortunately for me, the pain eventually got so bad that I had no choice but to stop using my arm.

Because of the extra damage that I had managed to do, I was booked for surgery to shave away a piece of bone to free up the trapped tendon.

With ten weeks to go until the operation date I began researching rotator cuffs on the internet and discovered just how lucky I had been. Had I continued to use my shoulder I could easily have snapped the tendon completely.

Having a second chance made me rest the arm properly this time. I took to wearing a sling during the day, gave up driving and avoided any movement that gave me any pain. At the same time I was treating the inflammation with anti-inflammatory drugs and gradually the pain subsided.

Once it had I was able to start some Pilates based exercises to gently get my shoulder moving again, starting with gentle stretches and moving on to strengthening exercises. As these exercises focus on control and flexibility they avoid putting any great strain on the muscles.

Gradually over the next few weeks I regained full movement in my shoulder and have now been able to cancel the planned operation. Even though my shoulder is now better I still do shoulder exercises every day just to make sure that I don't suffer another shoulder problem. After all prevention is definitely better than cure.

If you found this article useful and would like more information on rotator cuff therapy check out my blog at

http://www.strongershoulders.com

For more information click here

Rotator Cuff Rehabilitation - Heal Shoulder Pain Naturally With Home Rehab

You've been living with the shoulder pain for a while. Maybe you thought the pain would go away after a few weeks but it didn't. Your doctor discovers a tear. So what should you do? There's really only a couple ways to go: surgery or rotator cuff rehabilitation. Is it possible to heal without surgery? The good news is that many people have healed their injured rotator cuffs through proper and progressive rotator rehab.

An intricate series of smaller muscles and tendons make up the rotator cuff. If rest isn't taken, a tear may happen. A sudden fall where you catch yourself with an outstretched hand is also a common cause.

These small muscles are endurance oriented, so any rotator cuff rehabilitation must be approached with light weight and high reps. When first starting out, stay around 12-14 reps per set and gradually build up to around 20-30 reps as you get stronger.

Besides resistance training, stretching should also be included in any complete physical therapy approach. Greater range of motion, more mobility, increased circulation and decreased shoulder pain are some of the benefits of stretching. The small muscles and tendons of the rotator cuff don't receive a lot of blood flow, so improving circulation with stretching, massage and applying heat is important to the overall healing process.

Any exercises should mimic the movements of the rotator cuff, progressively strengthening and healing the injury. Not all physical therapy programs are created equal... be sure to do the proper research before jumping in.

Random, inconsistent efforts won't cut it here. You must work consistently if you want your rehab program to work for you. Depending on the severity of your injury, it could take many months or even a year to fully recover. Properly done rotator cuff therapy has the potential to help you regain full use of your shoulder.

Use common sense and avoid the temptation to start performing exercises without the proper guidance. If this type of rehab is not done in a very specific and progressive way, more injury and shoulder pain is the likely result. A physical therapist who specializes in rotator cuff rehabilitation is the only one qualified to advise you. With professional guidance it is very possible to heal your rotator cuff and hopefully avoid intrusive surgery.


Yes, a torn rotator cuff can heal naturally. Check out Rotator Cuff Health for a free report, "7 Tips To Immediately Reduce Rotator Cuff Pain" and more articles on solving rotator cuff injuries and shoulder stiffness... without surgery or intrusive methods.

Original Article Source:
Rotator Cuff Rehabilitation

For more information click here

Can You Repair Rotator Cuff Tendonitis Simply With Just Physical Therapy?

The last thing on your mind when you have rotator cuff tendonitis is exercise but surprisingly that is precisely what you need to do to sort ot out. But, before you reach for the gym bag and rush off to lift some weights, stop and read the rest of this article.

The right sort of exercise can help sort out rotator cuff tendonitis. Doing the wrong sort of exercise will almost certainly make it worse, probably much worse. In fact if you exercise an inflamed shoulder incorrectly you will almost certainly end up making it worse or even snapping the tendon completely which would put you on a waiting list for corrective surgery.

Shoulder tendonitis or rotator cuff tendonitis is simply the irritation or swelling of the rotator cuff tendons. How severe it is will depend on what the initial cause was but is generally the result of either wear and tear caused by getting older or a repetitive overhead action such as painting. It is an injury that is common to certain sports people and is sometimes known as pitcher's shoulder or swimmer's shoulder.

So what do you do if you have rotator cuff tendonitis. Firstly, don't despair. It is a common problem with roughly thirty percent of people experiencing this at some time in their lives. It is also relatively easy to sort out with the right treatment.

To begin with the treatment will involve giving the muscles a rest and avoiding any of the movements that causes pain. These will almost certainly be any sort of overhead movement or reaching action. You might need to think about the way that you work for a few weeks in order to allow the muscles to rest but it is essential if you want to avoid making things worse.

The irritation needs to be treated with ice packs and non-steroidal anti-inflammatory drugs such as Ibuprofen. If the pain persists it might be worthwhile having a cortisone injection to reduce the inflammation. Your doctor can do this for you.



As soon as the muscle has settled down you need to start some exercises specifically for the rotator cuff designed to strengthen the rotator cuff muscles. These will be resistance exercises that isolate this group of muscles and can easily be done at home. Going to the gym and lifting weights will not do anything for the rotator cuff muscles. These are small but very important muscles that effectively hold the humerus in place in the socket of the shoulder joint and they are vital to the general health of the joint. Weak rotator cuff muscles equal a weak shoulder no matter how strong the other muscles of the shoulder are.

Rotator cuff therapy exercises are essential to regaining a healthy pain free shoulder and should really be mandatory for anyone over forty just to keep our shoulders healthy. Unfortunately most of us aren't even aware of the existence of the rotator cuff until we get an injury and find out to our cost that we have been neglecting them.

I personally now do five or ten minutes of rotator cuff exercises every day simply to make sure that I never suffer from shoulder problems in the future.

Exercise is the quickest way to fix rotator cuff tendonitis. I know because that's what stopped me needing surgery.

Read my story here

www..myrotatorcuffcure.blogspot.com

For more information click here

Shoulder Dislocation and Rugby Injuries

An increase in the occurrence and severity of shoulder injuries in rugby has been noted and this realisation has prompted guidelines such as these to be drawn up as a specifically for coaches, physiotherapists and sport physicians caring for players on and off the field. Younger players are playing more competitively and aggressively and it is important to note the specific injury patterns in these players with immature skeletal structures.

BASIC ANATOMY

The most pertinent structures of the shoulder to recognise as far as injuries are concerned are:

• The trapezius, which is the large muscle running from the neck to the shoulder and back .
• The acromio-clavicular (AC) joint, which is the joint between the collar bone and shoulder bone.
• The Deltoid muscle: The large muscle at the upper and outer aspect of the arm which is the main muscle used to lift the arm.
• The clavicle (collar bone) which supports the shoulder and can be felt under the skin.




STRUCTURES MOST OFTEN INJURED

• Soft tissue around the shoulder: In the game of rugby, direct blows are common and soft tissue bruising of the trapezius muscle, the deltoid, the pec major and other soft tissue around the shoulder usually has long-term effects for the player.

• Rotator cuff: The rotator cuff tendon (mostly the supraspinatus tendon), deep to the deltoid, is usually injured when the abducted or extended arm is forced downwards or backwards especially during a fall or a tackle. The injury may be a simple sprain or a frank tear of the tendon. The latter is rare in young players and usually a sprain of the tendon is more common.

MECHANISMS OF INJURY MOST COMMONLY SEEN IN RUGBY
The most common mechanism of injuries includes:
• A direct blow to the shoulder: This may happen when a player falls or is hit on the shoulder from either the front or the back. This may result in a simple bruising of the shoulder or even dislocation.
• Falls directly onto the shoulder with the arm by the side: AC joint injuries often occur due to this mechanism - direct falls onto the shoulder often result in AC joint sprain or dislocation. In some instances rotator cuff injuries may also occur due to this mechanism.
• Rotator cuff injuries: These usually occur when the arm is forced downward when it is held up forwards or to the side or even from a fall onto the shoulder.

Obvious bruising or deformity:
• Swelling or deformity over the AC joint may indicate an AC joint injury / dislocation
• Bruising or swelling over the trapezius or deltoid may be the result of soft tissue bruising of these muscles
• Pain inside the joint could be linked to a labral or rotator cuff injury




GUIDELINES CONCERING WHEN TO REMOVE THE PLAYER FROM THE FIELD IN THE EVENT OF A SHOULDER INJURY:
If the shoulder is obviously dislocated the player should be taken off the field and managed by the medical practitioner on the side of the field or referred to a hospital for reduction of the shoulder displacement.

A deformity over the AC joint is a crucial area and pain can be the determining factor. Should the player be able to continue, he may do so without any serious results. On the other hand, should his pain be of such a nature that he is not able to play competently, he should be removed. Trying to play on does not have any serious or harmful effect though, but the pain and associated loss of function may limit his/her rugby playing performance from a team perspective.

In conclusion, with the appropriate management of shoulder injuries in rugby players most of the players should be able to return to the sport and not suffer long term consequences to the function of this important joint.


I have been considering surgery for his rotator cuff impingement and came across some interesting websites focusing on shoulder replacement surgeries.



For more information click here

Avoiding A Bench Press Blowout - Rotator Cuff Training

Another article about the bench press you ask? Whether you agree or not the barbell bench press is one of the most highly regarded weight room exercises period. Have you heard this conversation in the gym lately?

"So how much weight can you use for preacher curls?"

"I'm moving some heavy weight, how much can you use for kickbacks?"

"I've been struggling on those and I have a kickback meet coming up in a few months!"

I'll take a wild guess and say this conversation has never and will never take place. The truth is the vast majority of individuals measure their strength and even their manhood based on how much they can bench. You could be at the gym, or even at a bar having a beer but when the topic of working out comes up people are almost certain to ask the infamous question, "How much you bench?" If you don't care how strong you are then I don't know why you're lifting weights anyway. The bench press is a benchmark of your strength plain and simple.

Back to the conversation we didn't hear at the gym. What our friends above should have been asking each other isn't how much weight they use when doing kickbacks but rather how much weight they use when they're performing a lower pulley external rotation exercise. Did I lose you there? I know, I know we declared the bench press is the true measure of our strength not all these isolation and stabilizer exercises right?

This is true, but have you ever heard the expression, you're only as strong as your weakest link? When you bench press there are four tiny muscles that play a major role in whether your bench press takes off or if you're going to suffer from a bench press blowout. Build these muscles up and you can dramatically decrease the chance of blowing out your shoulder. If you're benching heavy weight and not paying attention to these muscles you run the risk of muscular imbalances, shoulder pain, and getting stuck in a serious plateau.

When bench pressing it essential to have stability and strength in the shoulder. The four relatively small muscles predominantly responsible for stabilizing the shoulder - teres minor, infraspinatous, supraspinatous and sucscapularous - are known collectively as the 'rotator cuff'. When these muscles contract they pull on the rotator cuff tendon, causing the shoulder to rotate. While bench pressing you may experience some rotator or shoulder pain, during part of the movement. This is likely due to weak muscles in this area. Weak muscles are often but not always the cause of rotator cuff impingement syndrome and associated rotator cuff tears. If you have the rotator cuff strength of a little girl, your body has no choice but to limit the amount of weight you can stabilize and move to prevent injury. It's not uncommon to see an individual break through a bench press sticking point simply by incorporating direct rotator cuff training.

OK maybe now I have your attention. So how do you make sure your rotator cuff isn't the weak link in your bench press? Or even more importantly how will you prevent a bench press blowout where you damage the rotator cuff? Like we discussed you need to strengthen the muscles, so let's take a look at this workout routine. Remember if you already have an injury you should not use this routine as a rehab program but rather visit a sports medicine physician. If you want to prevent a future injury and break past a bench press sticking point then follow this routine twice a week. If you're not in pain now, that's an even better reason to follow my advice. Trust me if you have a nagging injury you're not going to be growing or getting any stronger. Train smart, so that you can hit the weight hard when you do bench.

The first thing you need to do is stretch the muscles you are about to train. Make sure you have warmed up for a good five minutes on the bike or treadmill before you start stretching. This will help you acquire greater flexibility. You already know stretching is important so just do it. You don't need any equipment for this stretch. You can do it one arm at a time or with both arms at the same time. Extend your arms out from the torso at a right angle. Now bend your elbows at a 90-degree angle. Place your forearms on the frame of the doorway and lean forward. You will feel the stretch in your pecs and the back of your shoulders. Hold the stretch for 20-30 seconds. Next I want you to hang from a pull up bar for 20-30 seconds. This isn't a grip strength test so no you don't have to hang on for the full 30 seconds.

Cuban Press Rotation

Grab an EZ Curl bar and perform a wide grip upright row until the bar is a few inches below your collar bone. Now keep your elbows stationary while you externally rotate the bar as if you were trying to tap your forehead. Next you will press the bar overhead. Lower the weight along the same plane and repeat for ten reps. You will not be able to use the same weight you use for standard overhead presses due to the external rotation. This exercise won't build your ego right now, but you'll be thanking me when your bench press increases.



Cable External Rotation

Raise the pulley until it is even with your elbow. You'll be standing sideways next to the weight stack so if your right hand is holding the handle, your left foot should be closest to the weight stack. Grasp the cable attachment with your far arm while keeping your elbow close to your side and forearm across your stomach. Your palm should be facing in. Pull cable attachment away from body by externally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm.

Cable Internal Rotation

Again raise the pulley until it is even with elbow. You'll be standing sideways next to the weight stack but this time if your right hand is holding the handle your right foot should be closest to the weight stack. Grasp the cable attachment with the closest arm. Keep your elbow close to your side with your palm facing in. Pull the cable attachment across your body by internally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm.

90-Degree Dumbbell External Rotation

To finish off the infraspinatus, hold a dumbbell in each hand, and perform a lateral raise to 90-degrees while keeping the elbows bent at 90-degrees. Once your upper arms are parallel to the floor, externally rotate your arm so that your forearms are perpendicular to the floor. It will look like starting point of a dumbbell military press. Now lower and repeat. Remember to use light weight. The infraspinatus is a tiny muscle so it can't handle a heavy load. The shoulder horn is a great piece of equipment that keeps your arms in place while you perform this motion.

Do three sets of ten repetitions for each exercise. Perform the routine once a week in conjunction with your current workout. This is important so listen up. The last thing you want to do is pre-exhaust your rotator cuff before training the bench press. Never do this workout prior to a heavy bench press or shoulders session or you run an even greater risk of aggravating the area. You can give these exercises a try at the end of your workout, but be sure you always give your rotator cuff muscles 48-hours rest after a workout before training chest or shoulders.

Points To Remember:

The muscles of the rotator cuff are very small. Even if you're pushing five bills on the bench press you'll still be using five-pound dumbbells for many rotator cuff exercises. So leave your ego at the door!

Avoid lat pulldowns and military presses behind the head as they place the shoulder in a poor biomechanical position which enourages impingement.

Training your rotator cuff muscles can help you avoid pain, prevent future injuries, and fix muscular imbalances.

It's not uncommon for a trainee to add 20+ pounds to their bench press simply by strengthening the rotator cuff muscles.

Never perform a rotator cuff routine prior to bench pressing or overhead pressing movements.

If you feel serious pain in your shoulder it may be too late. Go see a sports medicine physician.

We all know people who were really into bodybuilding/powerlifting and looked forward to bench pressing only to eventually drop out after a few years of hardcore training. Why? In many cases nagging injuries especially those of the shoulder, simply took the fun out of it. This doesn't have to happen to you so you're ahead of the game. The best thing you can do to keep your shoulders healthy, and make sure your bench press continues to improve is strengthen your rotator cuff muscles so that they will never be your weakest link! After all your bench press will be going nowhere fast if you're injured. Pick up the girlie weights for a few sets once a week so you'll experience a bench press blastoff instead of a bench press blowout.

For more information click here

Posture and Frozen Shoulder Exercise

Treating a frozen shoulder with proper exercise early in the diagnosis is the single most effective action a person can take to assure quicker recovery from this condition. While there are many different exercises and programs available to restore range of motion and regain function, this article will focus on the effects of correct posture on stretching and strengthening the upper quarter. Performing exercise improperly with poor posture will delay return of motion and function and in some cases cause impingement of the rotator cuff which further contributes to pain and stiffness.

To begin with, if you observe your posture in a mirror from the side you should take notice of your shoulders . Are they rounded forward? If so then this will limit the amount of forward elevation (raising your arm overhead from the front) you will be able to effectively achieve because the shoulder joint is at a mechanical disadvantage from the start. Simply by rolling your shoulders backwards you place the shoulder joint in a better position for stretching.

Next, look at the amount of forward curve you have in your upper spine. If there is an excessive "hump" in your upper back (called kyphosis) any range of motion exercise or stretching will also be limited as the shoulder joint is now placed outside of the plane of the scapulae (shoulder blades). One should focus on extending the spine in this situation each day to enable a more natural curve of the upper spine. This can be done sitting in a chair with a rolled towel place just below the apex (greatest point of curve) and then leaning backwards until a mild to medium stretch is felt in the upper spine. This should be held for up to 30 seconds to allow proper stretching of the soft and connective tissues and repeated several times each day. There should be no pain felt with this exercise and if so it should be stopped immediately.

Lastly, look at your head position in the mirror. Is your chin protruding forward excessively? If it is then a more natural head position can be achieved by retracting your chin slightly to put the head more in line with the shoulders. Again, this exercise should be done several times during the day as long as no pain is felt.

Putting this altogether, when you are sitting or standing, your ears should line up with your shoulders and hips. You can have a friend tell you if you are assuming good posture by looking at your posture from the side. These simple observations will place the shoulder joint in a more effective position for maximum motion gains and increase the amount of range you will be able to achieve in during your stretching efforts. Always make sure you have consulted with your physician prior to beginning any frozen shoulder exercise program.

Frozen Shoulder Exercise programs are reviewed by Rex Taylor who specializes in treatments of the upper extremity such as frozen shoulder. This article originally published on EzineArticles as Posture And Frozen Shoulder Exercise.


For more information click here

Avoiding A Bench Press Blowout - Rotator Cuff Training

Another article about the bench press you ask? Whether you agree or not the barbell bench press is one of the most highly regarded weight room exercises period. Have you heard this conversation in the gym lately?

"So how much weight can you use for preacher curls?"

"I'm moving some heavy weight, how much can you use for kickbacks?"

"I've been struggling on those and I have a kickback meet coming up in a few months!"

I'll take a wild guess and say this conversation has never and will never take place. The truth is the vast majority of individuals measure their strength and even their manhood based on how much they can bench. You could be at the gym, or even at a bar having a beer but when the topic of working out comes up people are almost certain to ask the infamous question, "How much you bench?" If you don't care how strong you are then I don't know why you're lifting weights anyway. The bench press is a benchmark of your strength plain and simple.

Back to the conversation we didn't hear at the gym. What our friends above should have been asking each other isn't how much weight they use when doing kickbacks but rather how much weight they use when they're performing a lower pulley external rotation exercise. Did I lose you there? I know, I know we declared the bench press is the true measure of our strength not all these isolation and stabilizer exercises right?

This is true, but have you ever heard the expression, you're only as strong as your weakest link? When you bench press there are four tiny muscles that play a major role in whether your bench press takes off or if you're going to suffer from a bench press blowout. Build these muscles up and you can dramatically decrease the chance of blowing out your shoulder. If you're benching heavy weight and not paying attention to these muscles you run the risk of muscular imbalances, shoulder pain, and getting stuck in a serious plateau.

When bench pressing it essential to have stability and strength in the shoulder. The four relatively small muscles predominantly responsible for stabilizing the shoulder - teres minor, infraspinatous, supraspinatous and sucscapularous - are known collectively as the 'rotator cuff'. When these muscles contract they pull on the rotator cuff tendon, causing the shoulder to rotate. While bench pressing you may experience some rotator or shoulder pain, during part of the movement. This is likely due to weak muscles in this area. Weak muscles are often but not always the cause of rotator cuff impingement syndrome and associated rotator cuff tears. If you have the rotator cuff strength of a little girl, your body has no choice but to limit the amount of weight you can stabilize and move to prevent injury. It's not uncommon to see an individual break through a bench press sticking point simply by incorporating direct rotator cuff training.

OK maybe now I have your attention. So how do you make sure your rotator cuff isn't the weak link in your bench press? Or even more importantly how will you prevent a bench press blowout where you damage the rotator cuff? Like we discussed you need to strengthen the muscles, so let's take a look at this workout routine. Remember if you already have an injury you should not use this routine as a rehab program but rather visit a sports medicine physician. If you want to prevent a future injury and break past a bench press sticking point then follow this routine twice a week. If you're not in pain now, that's an even better reason to follow my advice. Trust me if you have a nagging injury you're not going to be growing or getting any stronger. Train smart, so that you can hit the weight hard when you do bench.

The first thing you need to do is stretch the muscles you are about to train. Make sure you have warmed up for a good five minutes on the bike or treadmill before you start stretching. This will help you acquire greater flexibility. You already know stretching is important so just do it. You don't need any equipment for this stretch. You can do it one arm at a time or with both arms at the same time. Extend your arms out from the torso at a right angle. Now bend your elbows at a 90-degree angle. Place your forearms on the frame of the doorway and lean forward. You will feel the stretch in your pecs and the back of your shoulders. Hold the stretch for 20-30 seconds. Next I want you to hang from a pull up bar for 20-30 seconds. This isn't a grip strength test so no you don't have to hang on for the full 30 seconds.

Cuban Press Rotation

Grab an EZ Curl bar and perform a wide grip upright row until the bar is a few inches below your collar bone. Now keep your elbows stationary while you externally rotate the bar as if you were trying to tap your forehead. Next you will press the bar overhead. Lower the weight along the same plane and repeat for ten reps. You will not be able to use the same weight you use for standard overhead presses due to the external rotation. This exercise won't build your ego right now, but you'll be thanking me when your bench press increases.



Cable External Rotation

Raise the pulley until it is even with your elbow. You'll be standing sideways next to the weight stack so if your right hand is holding the handle, your left foot should be closest to the weight stack. Grasp the cable attachment with your far arm while keeping your elbow close to your side and forearm across your stomach. Your palm should be facing in. Pull cable attachment away from body by externally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm.

Cable Internal Rotation

Again raise the pulley until it is even with elbow. You'll be standing sideways next to the weight stack but this time if your right hand is holding the handle your right foot should be closest to the weight stack. Grasp the cable attachment with the closest arm. Keep your elbow close to your side with your palm facing in. Pull the cable attachment across your body by internally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm.

90-Degree Dumbbell External Rotation

To finish off the infraspinatus, hold a dumbbell in each hand, and perform a lateral raise to 90-degrees while keeping the elbows bent at 90-degrees. Once your upper arms are parallel to the floor, externally rotate your arm so that your forearms are perpendicular to the floor. It will look like starting point of a dumbbell military press. Now lower and repeat. Remember to use light weight. The infraspinatus is a tiny muscle so it can't handle a heavy load. The shoulder horn is a great piece of equipment that keeps your arms in place while you perform this motion.

Do three sets of ten repetitions for each exercise. Perform the routine once a week in conjunction with your current workout. This is important so listen up. The last thing you want to do is pre-exhaust your rotator cuff before training the bench press. Never do this workout prior to a heavy bench press or shoulders session or you run an even greater risk of aggravating the area. You can give these exercises a try at the end of your workout, but be sure you always give your rotator cuff muscles 48-hours rest after a workout before training chest or shoulders.

Points To Remember:

The muscles of the rotator cuff are very small. Even if you're pushing five bills on the bench press you'll still be using five-pound dumbbells for many rotator cuff exercises. So leave your ego at the door!

Avoid lat pulldowns and military presses behind the head as they place the shoulder in a poor biomechanical position which enourages impingement.

Training your rotator cuff muscles can help you avoid pain, prevent future injuries, and fix muscular imbalances.

It's not uncommon for a trainee to add 20+ pounds to their bench press simply by strengthening the rotator cuff muscles.

Never perform a rotator cuff routine prior to bench pressing or overhead pressing movements.

If you feel serious pain in your shoulder it may be too late. Go see a sports medicine physician.

We all know people who were really into bodybuilding/powerlifting and looked forward to bench pressing only to eventually drop out after a few years of hardcore training. Why? In many cases nagging injuries especially those of the shoulder, simply took the fun out of it. This doesn't have to happen to you so you're ahead of the game. The best thing you can do to keep your shoulders healthy, and make sure your bench press continues to improve is strengthen your rotator cuff muscles so that they will never be your weakest link! After all your bench press will be going nowhere fast if you're injured. Pick up the girlie weights for a few sets once a week so you'll experience a bench press blastoff instead of a bench press blowout.

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Rotator Cuff Therapy Fixed My Shoulder Without Surgery

Rotator cuff problems come in a variety of shapes and sizes. You can Get anything from a mild sprain to a full thickness tear or a shoulder impingement, all of them are caused by problems with the rotator cuff to some extent and all of them will involve rotator cuff therapy exercises as part of the rehabilitation.

Most rotator cuff problems can be fixed without resorting to surgery. If you have managed to snap one of the tendons completely or have a severe shoulder impingement then you are probably looking at corrective surgery. Surprisingly, I managed to fix a pretty nasty shoulder impingement with rotator cuff therapy.

At the end of last year I managed to tear my rotator cuff. Around a third of us will do this at some point in our lives. I managed to do it by lifting something that was too heavy. Felt a pop in my left shoulder and woke up the next day to restricted movement and shoulder pain that just got worse as the days went by.

I went to the doctor who diagnosed a rotator cuff problem and made an appointment for me to see a specialist. Being stubborn and somewhat pig headed I decided to carry on using my shoulder as normal, despite my doctor's advice. What I didn't know at the time was that each bout of pain I suffered as I moved was an indication that I was doing more damage.

I had a shoulder impingement which is where an inflamed tendon gets pinched against part of my shoulder blade, gradually fraying as I continued to use my shoulder as normal. Fortunately for me, the pain eventually got so bad that I had no choice but to stop using my arm.

Because of the extra damage that I had managed to do, I was booked for surgery to shave away a piece of bone to free up the trapped tendon.

With ten weeks to go until the operation date I began researching rotator cuffs on the internet and discovered just how lucky I had been. Had I continued to use my shoulder I could easily have snapped the tendon completely.

Having a second chance made me rest the arm properly this time. I took to wearing a sling during the day, gave up driving and avoided any movement that gave me any pain. At the same time I was treating the inflammation with anti-inflammatory drugs and gradually the pain subsided.

Once it had I was able to start some Pilates based exercises to gently get my shoulder moving again, starting with gentle stretches and moving on to strengthening exercises. As these exercises focus on control and flexibility they avoid putting any great strain on the muscles.

Gradually over the next few weeks I regained full movement in my shoulder and have now been able to cancel the planned operation. Even though my shoulder is now better I still do shoulder exercises every day just to make sure that I don't suffer another shoulder problem. After all prevention is definitely better than cure.

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