TFV: R Shoulder Pain with Postural Deficits and Scapular Dyskinesias: Phase 4 (2-19-18)

  • Week 4
    • You will find updates below in BOLD
    • Organization
      • Monday: Daily Movements + Strength Circuit #1 (2x through the circuit)
      • Tuesday: Daily Movements
      • Wednesday: Daily + Strength Circuit #2 (2x through the circuit)
      • Thursday: Daily
      • Friday: Daily + Strength Circuit #1 + Strength Circuit #2 (1x through each)
      • Saturday: Daily
      • Sunday: Rest
    • This  week we will continue to progress upper extremity strength, specifically trying to identify movements that feel weaker in the problematic upper extremity
    • I recommend that all single arm movements be done on both arms to attempt to assess if one arm is much weaker then the other
    • You will continue to do the daily movements with incorporation of a couple alternative positions to try
      • The goal with the daily sequence is to establish a sequence of 4-5 movements that you do daily to move areas of your body that typically don’t move enough during our day
      • As new options are introduced you want to pick and choose the movements that you feel are most beneficial
      • Judge that based on movements that feel really tight or movements that feel good/ pull on areas  that typically feel tight/uncomfortable
    • Strength Circuits
      • These will begin to get more challenging, so be careful with all newer movements
      • Each exercise will have a goal for time or for a certain number of reps
      • If you achieve the goal, you are probably ready to increase the resistance or the challenge
        • For example: I usually give a range of 8-20 reps for an exercise, if you get to 20 reps, you are probably ready to increase the weight and start back at 8-10 reps again gradually working your way up to 20 reps
        • Make sure you don’t rush it and end up increasing pain
        • IDEALLY: You should feel fatigue in muscle with very little to no tendon pain
        • If you are getting tendon pain, you want to adjust the parameters of the exercise to see if you can keep it less painful
          • This could be less weight, going through less motion, doing less reps
  • 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
  • Strength Circuit #1
  • Strength Circuit #2