вторник, 15 января 2013 г.

Shoulder Savers: Part III






Shoulder Saver #17: Poor Man's Soft-Tissue Work
In Part I, I touched on the value of soft-tissue work for keeping your shoulder girdles healthy, recommending Active Release Techniques® (ART) as one of several options along these lines.
Now, I'll be the first to admit that my palpation skills leave a lot to be desired; it takes years of practice to get really good at finding the tiniest intricacies of the body's soft tissues through the skin. I do, however, understand functional anatomy and the premise behind ART — and I have a thumb.
As such, I experimented on a few training partners and found a few rudimentary patterns that yield appreciable benefit immediately. Keep in mind that these pale in comparison to what you're getting with a true ART practitioner, but they'll fill in the gaps between your "real" sessions. These aren't intended to be a substitute for work with a qualified professional; they're just some casual observations that ought to make your wife, girlfriend, or training partner's freebies a little more effective.
The pectoralis major and levator scapulae/upper trapezius are among the most "balled-up" regions in the shoulder girdle; it really helps to get them loosened up. We know that with ART, we're going from a shortened state to a lengthened state with each pass, so as long as we understand functional anatomy, we can go to town.
For the pectoralis major, a shortened state (our starting position for each pass) will be one where the humerus is internally rotated, flexed, and horizontally adducted (and scapular protraction will help the cause as well). Notice the pronation that occurs below the elbow in order to encourage the humerus into internal rotation.
If you can't find the pec with your thumb, you need to stop mixing paint chips into your Surge. Dig in (as hard as your buddy can tolerate) at any of several points along the muscle belly and tendon, and bring the humerus into external rotation and horizontal abduction (directly out to the side).
However, you'll find that most people get more bang for their buck from moving the arm to a point between overhead and directly out to the side:
For the levator scapulae, our shortened position is one where the scapula is hiked up and the head is turned to the same side. Sit the lifter down and stand behind him. Dig your thumb into the levator scapulae/upper trap region (it doesn't need to be perfect) and gradually move the person's head down toward the opposite foot as you push the shoulder blade down.
Again, this doesn't even come close to what you'll get with a true ART session, but it's still much better than a plain ol' massage from your wife or girlfriend who really doesn't know what she's massaging. Just don't expect your training partner to give you a "happy ending."

Shoulder Saver #18: Band Traction
Dave Tate has raved about traction work in the past. And if something gives results on a shoulder girdle as messed up as Dave's, you better take notice!
Many shoulder problems result from a compromised subacromial space: there isn't enough room between the humeral head and the acromion process. As a result, the tendons of the rotator cuff are impinged upon as the arm is elevated.
Now, we've got plenty of tools in our training arsenal to correct the problem (see Parts I and II for details), but that's not to say that there isn't some extra work we can do to help the cause. Traction with bands (or a partner pulling on the arm) can give those tendons a little breathing room to offer both short-term pain relief and longer-term favorable changes to joint structure.
You can perform the traction from any of several positions. Check out Dave's article, The Band Man, for details.

Shoulder Saver #19: Blue Heat
Okay, it's a veterinary product, but it's not what you think!
Some guys just need that extra help when it comes to warming up. Blue Heat is a mainstay in the South Side arsenal. When you walk into the gym for the Friday bench session, this is the first thing you smell. Blue Heat definitely helped me out a ton in overcoming an acromioclavicular (AC) joint problem I had in the past, and I always keep a bottle in my training bag for the days that the ol' taters need a little extra help in getting warmed up. Works great on elbows, too.
At only $4.99, you've got nothing to lose. Pick one up from the good folks atEliteFTS and give it a shot.

Shoulder Saver #20: Don't Overdo It On Bands
Benching against bands is a phenomenal way to bust through plateaus. Unfortunately, it's also a recipe for shoulder pain if you don't incorporate the bands correctly.
Most lifters can bench with chains and weight-releasers until the cows come home and never have any problems, but bands are a whole other story in the world of accommodating resistance. While the results with bands are undeniably better, the added eccentric overload really gets to some lifters' shoulders.
I've found that some athletes just can't take bands at all. I used to be one of those lifters, but I've improved my shoulder stability to the point that I can handle two weeks of consecutive speed work against bands before I need to drop off to straight bar weight or chains in lieu of bands.
Most lifters will do best with three consecutive weeks of bands followed by a "washout" period of at least one week (preferably more). I would, however, recommend starting with a two-on, two-off approach and see how it goes. Keep in mind that all this refers to benching against bands and not benching withbands (as in reverse band presses).

Shoulder Saver #21: Be Careful With Speed Work
It takes a ton of strength and shoulder stability to decelerate the bar at the end of a bench press performed at maximal speed. Many lifters can handle this, but for others it's a disaster waiting to happen. In particular, I've found that those with a history of AC joint pathology just don't tolerate speed work well.
Regardless of the camp into which you fall, you can do a lot to make speed work safer by making sure that you don't protract the scapulae at the top of the movement. In other words, stay tight as you prepare for the next rep. Just follow all the benching principles from Part I, but with more speed.

Shoulder Saver #22: Proprioception Work
We've spent a lot of time addressing the fact that the shoulder joint is built for mobility at the expense of stability. The stability we have comes from a combination of active (e.g. muscles) and passive (e.g. ligaments) restraints. The majority of the training interventions I've outlined have been efferent (motor or feed-forward) in nature, but it's important to note that there's an afferent (sensory or feedback) component to all of our muscular actions.
The afferent system provides info to our spinal cord and brain so that the central nervous system can relay appropriate messages to the peripheral nerves that tell our muscles what to do. Therefore, it stands to reason that any training endeavors that improve afferent efficiency can help our CNS recruit key stabilizers more rapidly to quickly establish stability and protect our shoulders.
There are three categories of movements that have merit in this regard: unilateral movements, open-loop deceleration/catch drills, and unstable surface training:
1) Unilateral movements — Regardless of whether they're performed with dumbbells, barbells, kettlebells, or some other implement, unilateral movements require the shoulder girdle to work synergistically with the opposite-side core musculature, increasing the overall stability challenge. Here are a few movements I like to use:
2) Deceleration/Catch Drills — These drills are pretty simple and just involve tossing a light medicine ball against a trampoline or dribbling it against the wall. Each time the ball comes back to you, the muscles of your shoulder girdle need to decelerate it. You can also use "dumbbell rebound drop-catches" in various planes of motion. Here are a few examples:
Remember that with these exercises, the emphasis is on reaction, not loading. These drills can also be somewhat replicated in an open-loop fashion by just having a partner randomly apply forces to your arm in various planes of motion. Your job is to respond as quickly as possible to resist those forces.
3) Unstable Surface Training — Not to toot my own horn, but after all the research I've done over the past three years, I can say without wavering that I'm one of the world's premier authorities on the appropriate utilization of unstable surface training. I won't open a huge can of worms until the results of my Master's thesis are published, but I will say that I feel that unstable surface training has merit when used judiciously in the upper body.
While loading is compromised, total muscle activation is likely unchanged; the issue is simply that the muscles have switched over from prime movers to joint stabilizers. For this reason, stability ball dumbbell bench presses can be a valuable implement for deloading phases and repetition work.
Additionally, I've found that higher-rep push-ups and scap push-ups on unstable surfaces are valuable inclusions in scapular stability/rotator cuff circuits. Simply do your exercises with your hands positioned on Dyna-Discs, Swiss balls, half-dome stability balls, or Airex pads.
I'll have a lot more to say on this front in a few months, I promise.

Shoulder Saver #23: Isometric Elevated Push-up Holds
Here's a tool that needs to be in your toolbox regardless of whether you're a coach, trainer, or lifter.
First off, the isometric elevated push-up hold has tremendous value in rehabilitation context, as it allows you to work around painful joint ranges-of-motion while building strength. I've used these holds with outstanding success early on in rehabilitation with individuals with a variety of shoulder problems.
The shoulder girdle is most stable in closed-chain motion, so it makes sense to start with a push-up where you can modify positioning based on the lifter's feedback. As the pain subsides, the lifter can progress in range of motion and ultimately work back to open-chain movements (i.e. benching).
Second, these holds are awesome because they a) actually teach proper positioning for a bench press (elbows tucked, shoulder blades back and down) and b) help beginners understand how to transfer force from the lower body to the upper body (need to stay tight in your midsection). Unless you're morbidly obese or completely deconditioned, you've got no business bench pressing unless you can do a proper push-up.
One final note: you aren't just "hanging out" in the hold position. You should be busting your butt to maximally activate all the involved muscles. Your triceps, posterior deltoids, and mid-back musculature should be going crazy, and you should start to feel more of a stretch in your pecs as the duration of the set goes on. This isn't about getting a pump in your pecs; they should actually be relaxed to allow the appropriate range of motion and elbow position.

Shoulder Saver #24: Watch Out For Low Bar, Wide Grip Squatting
I can't tell you how many bum shoulders I've encountered because lifters lacked the shoulder flexibility to squat with their hands in somewhat close. I'm not saying that you need to have your hands right up in your armpits, but you have to find a happy medium. If you really have to move your hands out wide and take the bar position ultra-low to even get under the bar, you're on the fast track to shoulder problems — especially bicipital tendonosis.
People really do squat like this!
I cut bigger lifters some slack on this one, but that's not to say that they couldn't use some extra external rotation range of motion to help the cause. Some classic doorway stretches for the pecs and lats will do a world of good on this front.
If you're still having trouble moving the hands in, take your pinky off the bar. You'll be amazed at how much this subtle modification will improve your ability to get your hands in closer. Ultimately though, you need to improve shoulder flexibility. The pinky-less grip is just something to get you by in the meantime.

Shoulder Saver #25: Be Careful With Incline Dumbbell Curls
Here's one curl variation that those with a history of shoulder problems would be wise to exclude from their programming.
The proximal tendon of the long head of the biceps is one of the most commonly injured structures of the shoulder joint. It's highly susceptible to overuse and even rupture if the degeneration is allowed to proceed. Given the long head of the biceps' interaction with the highly important glenoid labrum, you want to be very careful to avoid irritating this tendon.
When you take your elbow and shoulder into full extension simultaneously, you lengthen the long head of the biceps. Now, put yourself in the incline curl position, and you turn that shoulder extension into hyperextension. Tendons with a history of trauma don't typically like to be taken to extremes, especially under load.
Now, since I know the bodybuilders in the crowd will bust out the, "But I have to have specific exercises to train both the long and short head of the biceps" tantrum, I'll just say this: Relax, fellas. It's a freakin' curl. Pick your battles.

Closing Thoughts
I think we've hammered home the shoulder saver message hard enough by now. Where we go from here is up to you, T-Nation. What would you like to "save" next? Hips? Lower back? Elbows? Knees? Neck? Speak up, and we'll take care of you in the weeks and months to come.

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