MRD: Shoulder Impingement Monthly Program Phase 1 (8-15-18)

  • YOU WILL SEE SOME UPDATES AND POSSIBLE ALTERNATIVE POSITIONS IN BOLD AND ALL CAPS BELOW
  • WHEN COMPLETING THE MOVEMENTS BELOW FOR AN ADDITIONAL WEEK, YOU CAN REPEAT DAY 5-6 SECTION EACH DAY SO LOOK TO THAT SECTION FOR THE UPDATES
  • Hopefully you are about to learn a lot these first couple weeks
  • I want you to make sure you master each movement before progressing to the next
    • If it is challenging or PAINFUL, stay with that movement only for a couple days until you feel you have figured out the threshold to remain short of increasing symptoms
    • There is no absolute rule book and everyone progresses differently…if something doesn’t feel right or no matter what you do you have more pain afterwards….STOP DOING IT AND EMAIL ME…I have ALOT of alterative positions and variations
    • If you jump to the next phase and its not going well, DON’T PANIC
      • Go back to the previous phase and incorporate one new move at a time
        • If any of the movements feel awkward or not like I describe in the video, email me about it and skip it for now
  • Goals:
    • Minimize Irritation using ice as needed
    • Avoid over stretching, this will likely cause significant pain….this phase will focus alot on mobility but it is common that people get a little over excited with stretching and make it sore
    • Light controlled motion well short of pain, this phase is meant to be easy
    • Pay attention to anything that feels different on the painful side and does it feel more like the non-painful side as you do it more
  • NOW….Time to get started
    • Do each movement 5-20 reps SLOW and CONTROLLED, the slower the better
    • 1-2x/day
    • Some of these movements may feel good and help to relieve pain, you are welcome to do a couple of them frequently throughout the day to help reduce/prevent pain
    • Day 1-2: Pec Minor Mobility Phase 1
      • Shoulder Extension Mountain Pose VIDEO
        • Light movement full through motion without eliciting a strong stretch, remain short of any significant pulling
        • Goal:5-20 reps slowly in pain free range
        • This is easy and just something to do throughout the day…do it after or during any periods where you have been sitting or reaching forward for extended periods of time
      • 7) Self Myofascial Release Pec VIDEO
        • Can be done standing or on your stomach. Don’t torture yourself and don’t do it for 20 min. It should be slightly uncomfortable but not so painful that you are tense because it is so uncomfortable. The goal is to take a tight and over active muscle and get it to relax
        • This can be done 1-3x/day depending on your schedule but be careful that you don’t do it too much and get overly sore, so start with 1x the first day and progress to multiple times per day the following day
    • Day 3-4: Pec Minor Mobility Phase 2
      • Shoulder Extension Mountain Pose VIDEO
        • Light movement full through motion without eliciting a strong stretch, remain short of any significant pulling
        • Goal:5-20 reps slowly in pain free range
        • This is easy and just something to do throughout the day…do it after or during any periods where you have been sitting or reaching forward for extended periods of time
      • 7) Self Myofascial Release Pec VIDEO
        • Can be done standing or on your stomach. Don’t torture yourself and don’t do it for 20 min. It should be slightly uncomfortable but not so painful that you are tense because it is so uncomfortable. The goal is to take a tight and over active muscle and get it to relax
        • This can be done 1-3x/day depending on your schedule but be careful that you don’t do it too much and get overly sore, so start with 1x the first day and progress to multiple times per day the following day
      • 24) Supine Long Duration Pec Stretch VIDEO
        • Longer duration pec stretch…It is better to spend longer amounts of time in the position in a less aggressive stretch position rather then the opposite. I have may people who sit at a desk all day and one of the things they benefit most from is spending some time at the end of the day, lying on the floor working on this position for GENTLY for and extended period of time
        • 1-3x/day begin with total of 3-5min and work up to 10-15min
      • 25) Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
        • 5-20 reps slow
        • Slow and controlled
        • No hold with this one just slow movement in and out
  • Day 5-6: Incorporate posterior shoulder mobility
    • Shoulder Extension Mountain Pose VIDEO
      • Light movement full through motion without eliciting a strong stretch, remain short of any significant pulling
      • Goal:5-20 reps slowly in pain free range
      • This is easy and just something to do throughout the day…do it after or during any periods where you have been sitting or reaching forward for extended periods of time
      • PROGRESSION
    • 7) Self Myofascial Release Pec VIDEO
      • Can be done standing or on your stomach. Don’t torture yourself and don’t do it for 20 min. It should be slightly uncomfortable but not so painful that you are tense because it is so uncomfortable. The goal is to take a tight and over active muscle and get it to relax
      • This can be done 1-3x/day depending on your schedule but be careful that you don’t do it too much and get overly sore, so start with 1x the first day and progress to multiple times per day the following day
      • JUST SOME INFORMATION ABOUT THE MOVEMENT ABOVE
        • SOMETIMES THE MOVEMENT ABOVE WILL DECREASE MUSCLE TONE AND ALLOW YOU TO MOVE DEEPER INTO SOME OF THE STRETCH POSITIONS I HAVE GIVEN YOU WITH LESS PAIN. THIS IS NOT ALWAYS THE CASE. FOR EXAMPLE: IF YOU TRY TO DO ANY OF THE PEC STRETCH OPTIONS, THEN YOU DO THE TENNISBALL, THEN YOU TRY IT AGAIN. YOU SHOULD SEE IMPROVEMENT IN PAINFREE MOTION. IF THAT IS NOT HAPPENING DON’T WASTE YOUR TIME WITH THE TENNISBALL. I ONLY USE IT TO IMPROVE THE ABILITY TO MOVE INTO THESE POSITIONS AND SOMETIMES IT HELPS AND SOMETIMES IT MAKES NO DIFFERENCE
    • 24) Supine Long Duration Pec Stretch VIDEO
      • Longer duration pec stretch…It is better to spend longer amounts of time in the position in a less aggressive stretch position rather then the opposite. I have may people who sit at a desk all day and one of the things they benefit most from is spending some time at the end of the day, lying on the floor working on this position for GENTLY for and extended period of time
      • 1-3x/day begin with total of 3-5min and work up to 10-15min
    • 25) Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
      • 5-20 reps slow
      • Slow and controlled
      • No hold with this one just slow movement in and out
    • 12.3) Standing Behind the Back Self Stretch VIDEO
      • This one can give you the after effect pain if you do it too hard or too long
      • Move slowly in and out of the motion…the first time, make it so easy that you feel nothing because too much of this stretch with compress bicep and RTC and give you the after effect pain
      • Do it 10-15x 1-2x/day
      • THIS COMBINES PEC MINOR AND POSTERIOR CAPSULE WITH CREATING COMPRESSION ON THE SHOULDER. IT COMBINES SHOULDER EXT AND INTERNAL ROTATION
    • 31.1) Hands Elevated Variation VIDEO
  • Day 7
    • Email me with some feedback on how you did with the movements above so I can make changes for phase 2
    • remember to ice if sore after wards 10-20 minutes
    • Ideally, try to remain short of pain with all movements