NJB: Partial Rotator Cuff Tear: Phase 3 (3-19-18)

Phase 3:

This week will will set up 2 categories
Sorry for the long explanation below, but believe me it is necessary
Below the explanations you will fond your movements for the week with new ones in BOLD
- Light movements that I call “Daily Sequence”
  - This is a sequence that is all about light movement and muscle activation
  - It is meant to improve mobility and possibly serve as a warm up, cool down, or a light sequence in the morning or at night to improve mobility
  - I will continue to give you some alternative options over the next few weeks to include in this sequence
  - The goal is to isolate 4-5 movements that you feel are most effective in moving parts of your body that are stiff/painful and feel that they improve mobility/stiffness
  - You will do one set of 10-20reps for each movement so this sequence should be very quick and user friendly
  - There is something called the “5 Tibetan Rites” that had a great impact on me
    - Basically, these monks for thousands of years did this sequence, some calling it “The Fountain of Youth”
    - I do not necessarily hand out the 5 rites, but I do believe that everyone should have their own personalized version of 5 movements that are not incredibly challenging, that move areas of their body that they do no move enough in their daily life
    - This sequence should be brief and take only 5-10 minutes at the most
    - I do my own 5 rite sequence before bed each night and I do it as a warm up pre workout/wrestling practice/jujitsu
- Strength Circuits
  - These are meant to challenge you with the goal of creating fatigue or tension in muscle without overloading painful structures
  - Your goal with this is to feel muscle tension and hopefully fatigue
  - Each movement will have a time goal or a rep goal, once you achieve that goal with no negative side effects, you are ready for a new challenge
  - When your body fatigues, you may start to get pain and that is your cue to stop
  - Pay attention to what you feel later that day and the next day
    - Mild pain is alright as long as it goes back to baseline within 24 hours
    - If pain is more severe you have a couple options
      - 1) Ice right after to minimize inflammation
      - 2) Try to decrease the intensity of the exercise by not going through as much range of motion or not pushing so hard
        
        In my mind, most exercises can be made painful or not painful by the way that you go about it
        
        Example: If I give you a squat variation, there are many ways to decrease risk of pain
        
        Don’t go as deep into the motion, do it slower, keep weight more on the heels, hold an isometric position squat without moving in whatever range is least painful, do only 2-5 reps
        
        Have the mind set of getting through new exercises making it super easy just to find a safe zone…you can always increase the challenge from there
Daily Sequence: Complete everyday
- 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
- Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Establish cervical stabilization
  - Hold 5-10sec 10-20x
  - This can be done throughout the day and should be applied lightly to all strengthening movements
  - There is a progression within this video so you may progress as able through the 3 position options
- Prone Latissimus Extension Off Edge of Bed VIDEO
  - Initiation of posterior rotator cuff activation and scapular stabilization
  - Hold each 5sec and lower down slowly 5-20 reps
- 25) Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Go through the progression as described in video and try to get to the cross leg stretch at the end
  - 5-20 reps
Strength Sequence: Complete every other day, if sore, wait until soreness completely goes back to baseline prior to completing it again which may require 2 day rest
- First time through, try for just one set, if that goes well you can go through it 2x on strength day
- 73.1) Updated Band Tricep Extension VIDEO
  - 10-20 reps
  - Be aware of shoulder blade position, especially as you straighten your elbows. When elbows straighten the shoulder blades will want to tip forward as you get tired
  - Band can be attached up high with a knot in the middle and closed in a door, or one arm at a time with end of band closed in the top of door
  - If there is pain in the elbow try to cut back the amount of reps a little strating with 5-10 reps
- 92.1) Full Can Regression Raise From Counter Height with Progression Laterally VIDEO
  - make sure you have no bicep tendon pain with this one
  - 8-10 reps slow
- 79.2) Plank With Single Arm Holds High to Low VIDEO
  - Start with the weight shift onto each arm side to side progressing to a 5-10sec hold on each arm
  - Once again make sure you keep elbow tucked in and shoulder blade down
- Band External/Internal Rotation Progression
  - 116) Laying on Back External Rotation Phase 1 VIDEO
    - Start with just Isometric holds of the band in your hand without actually moving
    - If that is fine progress to small motions just barely moving arm through a small range
    - This is a really important motion to strengthen, but I find some people go wrong if they go through too much motion and create a pinch or pressure in the shoulder
    - 8-20 reps moving in a small range or and isometric hold the band with some tension on it for 30-90sec