train right: shouldersterry kane, physiotherapist

you are an exercise scientist

train right = results & referrals.

Appropriate Exercise for client

“X”

Inappropriate Exercise for client

“X”

Appropriate Dose for client “X”

Results & Referrals

Injury

Inappropriate Dose for client “X” (too much)

Injury Injury

Inappropriate Dose for client “X”(too little)

No change No change / Injury

What’s appropriate for one client may not be appropriate for another

train right

Hippocratic Oath

If in doubt, first do no harm.

Personal Training Oath

If in doubt, first do no harm.

Clients expect you share the same oath as healthcare professionals.

They expect that every exercise that you give them is safe for them...that’s why they pay you.

5

What we know

Mechanisms of Injury

Mechanisms of Injury

1. Acute

2. Overuse

3. Acute on Vulnerable Genetics Age Fatigued tissue Old injury Recent injury

6

there is no such thing as a ‘bad’ exercise….

But there are exercises that are;

1. Inappropriate for the client

2. Inappropriately executed

3. Inappropriate dose

a. Past medical history

b. Current medical conditions

c. Neuromotor Skills

d. Experience

e. Flexibility

f. Strength

g. Endurance

7

there is no such thing as a ‘bad’ exercise….

But there are exercises that are:

1. Inappropriate for the client

2. Inappropriately executed

3. Inappropriate dose

a. Poor technique

b. Inexperience

c. Inadequate instruction

d. Incorrect instruction

8

there is no such thing as a ‘bad’ exercise….

But there are exercises that are;

1. Inappropriate for the client

2. Inappropriately executed

3. Inappropriate dose

a. Too much too soon

b. Sudden increase in frequency

c. Sudden increase in intensity

d. Sudden increase in volume of exercise.

review

Anatomy

Scapula

Coracoid process

Acromion

Glenoid fossa

Glenoid labrum

Subacromial space

Clavicle

Humerus

Bicipital groove

Greater tuberosity

Lesser tuberosity

review

Muscles

Rotator Cuff

Subscapularis

Supraspinatus

Infraspinatus

Teres minor

Biceps

Long head

Short head

Scapular stabilizers

Serratus Anterior

Trapezius

Rhomboids

Levator scapulae

Latissimus Dorsi

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

review

Biomechanics

Scapular plane

Scapulohumeral rhythm

Subacromial impingement

Painful arc

Winging scapula

Apprehension sign

Stress-Strain Curve

Quick Scan Exam

If in doubt, first do no harm.

Jury of Your Peers

Would another personal trainer agree that a given shoulder exercise you prescribed is safe and appropriate for the same client?

Medical / Health profile

Technique Dose

If in Doubt

1. Elbows below 60 d of abduction (impingement)

2. Hands and elbows visible throughout entire motion (scapular plane)

3. Slow and controlled (stress-strain curve)

4. Appropriate load (stress-strain curve)