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Old 12-31-2008, 04:28 PM   #1
Tish Traster
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Limited Shoulder ROM PT Client Advice Please

http://www.youtube.com/watch?v=cTlYszoKEhkPLEASE ENSURE YOU ANNOTATE ALL LINKS WHETHER WORK AND FAMILY SAFE.

Thanks in advance for the help

Tish
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Last edited by Lynne Pitts; 12-31-2008 at 04:53 PM..
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Old 12-31-2008, 05:41 PM   #2
Tish Traster
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Re: Limited Shoulder ROM PT Client Advice Please

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Originally Posted by Tish Traster View Post
http://www.youtube.com/watch?v=cTlYszoKEhkPLEASE ENSURE YOU ANNOTATE ALL LINKS WHETHER WORK AND FAMILY SAFE.

Thanks in advance for the help

Tish
Work and Family Safe
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Old 12-31-2008, 06:18 PM   #3
Robert Callahan
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Re: Limited Shoulder ROM PT Client Advice Please

Not really sure what you are looking for here... Only comment I would have is that whoever is doing the shoulder dislocates in that video needs to get a wider grip and not let one shoulder lead the other. I fix this problem in myself by doing the dislocates in front of a mirror and starting wide enough so that I can maintain symmetry throughout the motion, then slowly narrow the grip a inch or so at a time and work on keeping that symmetry. Eventually you'll hit a point where it breaks down and that is where you stop.

Hopefully that is useful... Like I said before I am not entirely sure what the purpose was...

-Robert
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Old 01-01-2009, 02:56 AM   #4
Tish Traster
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Re: Limited Shoulder ROM PT Client Advice Please

Thanks Robert. I have him doing this daily. I think you're correct, he does need a wider grip and needs to work with the wider grip until he can get past his sticking point.

I really don't know what I'm looking for either, LOL. He does not want to consult an ortho, because he wouldn't have any type of surgery if it was suggested anyway.

My concern is this: He wants to continue to increase his load on lifts. When he lifts or pushes, push-ups etc..all of his lifts are somewhat crooked. I can see his body twisting to compensate. Can increasing load lead to back and hip problems down the road becasue of this?

Thanks for the feedback.
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Old 01-01-2009, 06:08 AM   #5
Sara Fleming
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Re: Limited Shoulder ROM PT Client Advice Please

Tish,

I'm training my dad right now who's 65 years old. I have to frequently give him some dynamic stretches and exercises between his lifts to increase his range of motion and I've been using the shoulder dislocator and overhead squat as a flexiblility test throughout our workouts as well.

A really good flexibility exercise that has worked for him has been to warm up with some sideways medicine ball throws. We stand about 10 feet apart facing the wall and toss the ball side to side in a single plane. We then progress to a sideways slam where we are standing still facing the wall, but turned slightly towards one another. As he throws the ball to me, he supports the ball with both hands, but the outside shoulder circumducts back, around, up and as it comes down, slams the ball down between us (hope that makes sense, if not I'll try and video it for you). It basically forces the shoulder to track through that full range of motion and as it draws back to slam the ball with power, it will inhibit the stretch inhibition. We do 2 sets of 10 of each of these and find a HUGE difference in his flexibility afterwards.

Sara
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Old 01-01-2009, 05:14 PM   #6
Michael H. Tjo
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Re: Limited Shoulder ROM PT Client Advice Please

Tish,

Happy New Year! I'm new here, but I've been a Certified Personal Trainer for 15 years and have had clients with all sorts of shoulder issues ranging from dislocations to "frozen shoulder". Has your client tried just doing some Trigger Point Massage or Myofascial or Active Release? I don't believe in surgeries or cortizone shots either. Have you tried manually stretching him? All my clients benefit from me stretching them, combined with trigger point massage. Just my .02. Hope this helps and good luck.
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Old 01-01-2009, 07:18 PM   #7
Donald Lee
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Re: Limited Shoulder ROM PT Client Advice Please

Therabands could also be a better option for the shoulder dislocates than the PVC pipe. They can be used for strengthening the shoulder girdle, in addition to stretching. And they stretch out, so you shouldn't have as much of the compensation problem.
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Old 01-01-2009, 07:54 PM   #8
Brent Sallee
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Re: Limited Shoulder ROM PT Client Advice Please

Tish, first of all, are you a personal trainer or a physical therapist (couldn't distinguish from PT)? Second of all, I have volunteered in several physical therapy clinics and NEVER seen the shoulder dislocates actually used. This is because it attempts to warm the joint up by being hypermobile while people who required physical therapy need to first address their injury/pathology through strengthening and MUCH lighter flexibility drills. Some people with shoulder injuries will never be able to/should never do shoulder dislocates due to possible harm to the joint.

In all honesty, I would tell him to go to a doctor to get the diagnosis on the shoulder (whether it's rotator cuff injury, RC weakness, other weakness, labrum tear, etc). His form is a very bad sign already, which is why I suggest the doctor's visit. I understand that his arms should also be much further apart to try to correct form, but I would definitely suggest stopping doing those until a physical therapist actually sees him and clears him.

Last edited by Brent Sallee; 01-01-2009 at 07:58 PM..
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Old 01-02-2009, 04:06 AM   #9
Sara Fleming
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Re: Limited Shoulder ROM PT Client Advice Please

To support what Michael posted, my dad is currently working with a trigger point massage therapist on his shoulder inflexibility. She has been enthusiastically supportive of the functional training we've been doing.
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Old 01-02-2009, 04:07 AM   #10
Tish Traster
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Re: Limited Shoulder ROM PT Client Advice Please

Quote:
Originally Posted by Brent Sallee View Post
Tish, first of all, are you a personal trainer or a physical therapist (couldn't distinguish from PT)? Second of all, I have volunteered in several physical therapy clinics and NEVER seen the shoulder dislocates actually used. This is because it attempts to warm the joint up by being hypermobile while people who required physical therapy need to first address their injury/pathology through strengthening and MUCH lighter flexibility drills. Some people with shoulder injuries will never be able to/should never do shoulder dislocates due to possible harm to the joint.

In all honesty, I would tell him to go to a doctor to get the diagnosis on the shoulder (whether it's rotator cuff injury, RC weakness, other weakness, labrum tear, etc). His form is a very bad sign already, which is why I suggest the doctor's visit. I understand that his arms should also be much further apart to try to correct form, but I would definitely suggest stopping doing those until a physical therapist actually sees him and clears him.
Hi Brent,


Personal training client, PT...meaning personal training client. Not my creditials. (Me, BS Education / Radiation Therapist) I have suggested he see an ortho and get this checked out as recently as this past Monday.

This client injured his shoulder many years ago and is adamant about not seeing a doctor for it, because it causes him no pain. His medical doctor has cleared him to workout. He's not symptomatic of rotator cuff injury, no pain at night, no pain with overhead lifting or rotation.

He performs most exercises with good form until the shoulder becomes fatiqued, then of course the back and hips start trying to compensate. That concerns me. I know he wants to increase load. So, I'll require him to get cleared by an ortho prior to letting him to that.
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