SFM: Shoulder Pain with Impingement with Scapular Dyskinesia: Phase 3 (3-26-18)

Phase 3

• This week will add a some progressions to the current daily sequence and some strength movements to incorporate in the strength sequence
• Look fir updates in BOLD
• Focus will be on progressing into a daily movement sequence and strength circuits to progress postural strength and endurance
• Initial strength sequences will utilize body weight and resistance bands
  • Purchasing a pack of resistance bands of various resistance is probably worth it
• Daily Sequence
  • This is meant to be somewhat easy and focused on maintaining mobility and muscle activation
  • You should choose a couple of these movements as options to do gently throughout the day to break up static postures
  • 10-20 reps of each movement is recommended
  • They can be done in a circuit 1-2x a day along with doing a couple of them frequently throughout the day as able
• Strength Circuits
  • These are meant to challenge you and should be done every other day in addition to the daily stuff
  • Goal is to try and remain in a range where you are able to achieve muscle fatigue with the least amount of pain
  • Typical issues arise when individuals push too far into a movement to quickly
    • I would rather you remain in a shorter range of motion and do 20-40 reps versus do 5 too deep into the notion and get pain
  • If any of these movements cause an increase in pain, either try to adjust the exercise or email me…if have a pretty extensive arsenal of options so if something doesn’t feel right I can probably find a better alternative
  • Do all reps slow and controlled in a range of 5-30 reps ( I know that is a wide range)
    • I would rather you do 5 very slow and controlled reps with great form rather then rushing to 30 reps out of boredom
    • At the same time I want you to get to some muscle fatigue with more of and emphasis initially on higher reps and endurance, so don’t stop at 10 because we are somehow programmed that 3 sets of 10 reps is the golden rule for exercise
  • Sometimes I switch to doing an exercise for time for those who refuse to count, rush to get to 30reps, don’t have the attention span to count. time goal is 30sec to 2 minutes
    • This works better for some as it takes away the motivation to rush through and exercise
    • Either option is fine
  • IF YOU WANT TO GET BETTER, DO EACH REP SLOWLY, FOCUSED ON TECHNIQUE AND CONTROL, AND DO IT UNTIL YOU FEEL TIRED OR AN INCREASE IN PAIN…TRY TO REMAIN IN A RANGE OF MOTION THAT DOES NOT HURT…AT ALL IF POSSIBLE 
• Daily Movements
  • 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
    • Do this one frequently
  • Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
    • 5) Neck Rotation Self SNAG VIDEO
    • 3) Chin Tuck with Side Bending VIDEO
      • if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
      • Only do these if they feel beneficial….otherwise they can be skipped
  • 51) Prone Cervical and Scapula Positioning Drill VIDEO
    • This is meant to assess your ability to keep neck relaxed as you isolate scapular control
  • 10.1) Supine Wing ER Breathing VIDEO
    • Light movement that will set us up for some posterior shoulder strengthening
    • Do this on the floor after a long work day
    • PROGRESSION
      • 26) Cross Leg Lower Trunk Rotation Pec Stretch VIDEO
  • 11.3) Pillow Case Active Shoulder Extension Hands Progress Closer VIDEO
    • Make sure you don’t go too far too fast
    • I want to know is this feels tighter on the R
  • 51.1) Humeral Head Depression at 90deg Abduction VIDEO
    • Ideally light pulling in the front of the shoulder is ok, not on the top or in the back, stay short of feeling top or back of shoulder in regards to pinching or pain
    • 47) Rolling with Side Lying Rotation VIDEO
      • Progress to this
• Strength Circuit #1
  • 122) Wall Sit Active/Band Abduction VIDEO
    • Pay attention to the details
  • 84) Arm Bar VIDEO
    • Slow controlled transition from each point without putting weight down
  • 31.1) Hands Elevated Plank Variation VIDEO
    • Make sure you control low back position
  • 79.2) Plank With Single Arm Holds High to Low VIDEO
    • Start with 5 sec holds each arm and gradually ramp up hold time by 5 sec until you fatigue
  • 115.1) Squat With Single Arm Support Progression VIDEO
    • can use sink at home or TRX below
    • 123.1) TRX Reverse SidePlank VIDEO
    • Can do for time or reps for both