Shoulder Rotator Cuff Strain: Resisted Clock Reaches

If you’ve been doing the “Clock Reaches” exercise and it has been getting super easy without resistance then this progression will help further strengthening the rotator cuff and the shoulder after an injury.

With a light resistance band loop wrapped around your wrists, kneel down in 4 point position with your fists on the ground and keep your spine in neutral posture with your inner core muscles engaged. Imagine there is clock face numbered 9 to 3 O’clock on the ground in front of you.

Begin by reaching the right hand to 9 O’clock and then back to the start position. Proceed to continue to 1O, 11, 12, 1, 2 and then 3 O’clock, and then reverse back to 9 O’clock again. Repeat this for your left hand. Perform 3 sets of 5 for each side.

This exercise is also great to do if you want to increase strength even when you’re not injured. If you have any pain during the exercise or are unsure about what you are doing, consult your local Physiotherapist before continuing. 

Golfer’s Elbow (Medial Epicondylitis)

What is “Golfer’s Elbow” ?
Not to be confused with tennis elbow, golfer’s elbow is caused by damaged muscle tissue at the medial epicondyle, (inner part of the elbow), whereas tennis elbow is as a result of damage to the
lateral epicondyle (outer part of the elbow). It occurs when more force is applied to this area than the normal healthy tissues can handle. Although this is most commonly found within the golfing community, it can also appear as a result of any activities requiring the lifting, throwing, or a hitting motion. This includes racket sports, such as tennis, throwing sports, weight training, or any forceful, repetitive occupational movements.

Symptoms of golfer’s elbow include pain and tenderness, usually felt on the inner side of the elbow, stiffness, weakness, and numbing or tingling that radiates into the fingers. This pain can come on suddenly or gradually, and can worsen with certain movements such as swinging a golf club. 

Prevention?
Strengthening your forearm muscles
  · Use light weights
  · Squeeze a tennis ball
Fix your form
Using proper equipment
  · Ex. Ensuring your racket has proper grip, or a lighter head
Rest at first sign of elbow pain

Perform stretches before your activity such as the following:

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Martin, E.A., & McFerran, T.A. (2017). A dictionary of nursing. Retrieved from http://www.oxfordreference.com.ezproxy.library.ubc.ca/view/10.1093/acref/9780198788454.001.0001/acref-9780198788454-e-3672

Knee ACL Injury: Squat Clock Reaches

This is a great exercise for developing strength, balance, and proprioception after you have sprained the ACL ligament in your knee.

Start with nice tall posture and engage your core muscles below the belly button by drawing the lower ab muscles inward toward the spine. Then, stand on one leg and hold a stick with the butt end about 2 and a half feet away. Bend down through the hips to touch the stick to the floor at the 9 O’Clock position like a grid on a clock. Come back up and then bend down to touch the end of the stick at the 10 O’Clock position.

Repeat this until you get to the 3 O’Clock position and then reverse coming back to the 9 O’Clock position again to complete the full set. When doing this exercise maintain your knee alignment with the second toe, the knee over the ankle and bend through the butt more. Do 2 full sets 2 times a day.

IT Band Syndrome

What is IT Band Syndrome?
Iliotibial Friction Syndrome is one of the most common causes of “Runner’s Knee” and can account for up to 22% of overuse injuries in runners (Worp et al., 2012). The ITB attaches to a bony protuberance on the outside of the knee, and slides back and forth across this point with movement. Repetitive sliding in this area can create excess friction, especially when the knee is bent at 30 degrees, which is the motion that commonly happens just as your foot strikes the ground while running. ITB Syndrome is typically caused by poor biomechanics due to underlying muscle imbalances, such as weak hip rotators, gluteal muscles, or core muscles. 

Symptoms of ITB Syndrome include sharp or burning pain right above the outer part of the knee, swelling over the outside of the knee, and pain during early knee bending. ITB Syndrome also worsens with continuance of running or other repetitive activities. If you detect any symptoms, the best way to get rid of ITB syndrome is to rest immediately, and take a break from running for a few days (Worp et al., 2012). 

Prevention?

  • Decrease your mileage or take a day off when you feel pain outside of your knee 
  • Walk as a warm up before you begin running
  • Replace shoes that are worn out along the outside of the sole 
  • Run on flat surfaces

Perform exercises or stretches such as the following:

Lateral Quad Stretch:

Rolling Out The IT Band:

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Worp, M., Horst, N., Wijer, A., Bacx, F., & Sanden, M. (2012). Iliotibial band syndrome in runners: A systematic review. Sports Medicine. 42(11). doi:10.1007/BF03262306

Superior Labral tear from Anterior to Posterior (SLAP) Tear

What is a SLAP tear?

The shoulder labrum is a ring of cartilage around the shoulder socket that stabilizes the head of the upper arm bone. As one of the most complex joints in the body, the shoulder joint is held together by an intricate network of tendons, ligaments and soft tissue. A SLAP tear is a torn piece of cartilage in the inner portion of the shoulder joint that can be caused by chronic or acute injuries, as well as aging (Knesek et al., 2012). 

Athletes participating in sports requiring repetitive overhead motions, such as baseball, swimming or weightlifting, are at risk of developing a SLAP tear over time. Acute trauma, such as falling on an outstretched arm, or quickly moving the arm over shoulder level can also be a cause of a SLAP tear. Tearing or fraying the labrum can also develop as a part of general aging, and is not uncommon in people over 40 years of age. 

Symptoms of a SLAP tear can include pain when moving or holding the shoulder in specific positions, reduced range of motion, decrease in shoulder power, locking or clicking in the shoulder, or discomfort when lifting items (Knesek et al., 2012).

Prevention?

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Knesek, M., Skendzel, J., Dines, J., Altchek, D., Allen, A., & Bedi, A. (2012). Diagnosis and management of superior labral anterior posterior tears in throwing athletes. The American Journal of Sports Medicine. 41(2). doi:10.1177/0363546512466067

Knee Sprain ACL, MCL: Bosu Ball Lateral Shuffle

One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

Place your left foot onto the Bosu and push off on it shuffling it over to allow the right foot to land on the Bosu while you aim to place the left foot on the other side of the Bosu and then finish with both feet on the ground on the other side of the Bosu ball.

When you place your foot on the Bosu ball, keep your knee in line with your 2nd toe and bring your hip over the ankle so you can push off on your entire upper thigh so you avoid pushing off with just your foot. Repeat this going left to right for 1 minute for 3 sets in total.

This is great for strengthening the knee after post anterior cruciate ligament, or ACL surgery or after having sustained a minor strain to your anterior cruciate or medial collateral ligaments. If you have any pain during the exercise or are unsure about what you are doing, consult your local Physiotherapist before continuing. 

Addressing Low Back Pain while Performing a Squat (Weighted or Unweighted)

Athletes around the world regularly perform weighted squats. Research has shown that squatting has a direct impact on your body’s power, which is the ability to overcome a resistance with speed (Loxtercamp, 2018). Therefore, squatting can result in great power and an increase in sprint speed. General benefits include increased flexibility, greater core strength, as well as protection from injury as a result of better coordination of the body. 

However, squats have been known to cause unwanted low back soreness. Although squatting will work the muscles of the lower back, if the low back becomes the most targeted region during the squat, chronic soreness and overuse injury can occur. Previous injury to the lower back, poor technique, as well as weakness of the core or surrounding muscles can contribute to this overuse of the back muscles (Gordon & Bloxham, 2016). Barbell back squats are also the most common for causing back pain as the weight is loaded across the back (Loxtercamp, 2018). If you find this movement difficult, but still want to add weight to your squats, you may want to opt for goblet squats or front squats. 

Goblet Squats

Front Squats

Prevention

  • Proper footwear
  • Progressing weight/load too quickly when squatting
  • Correct stance and posture
    • https://www.youtube.com/watch?v=Q_CuIKf227A
  • Spinal alignment
    • Ensure you’re looking straight ahead or an upward gaze 
  • Joint mobility 

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Gordon, R., & Bloxham, S. (2016). A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare. 4(2). doi:10.3390/healthcare4020022

Loxtercamp, B. (2018). Influence of attentional focus on a weighted barbell back squat among experienced performers. Medicine and Science in Sports and Exercise. 50(1). doi:10.1248/01.mss.0000536504.18312.43

Shoulder Rotator Cuff Strain: Clock Reaches

This is a great exercise for strengthening the rotator cuff and the shoulder complex muscles after straining the rotator cuff.

Kneel with your fists on the ground and keep your spine in neutral posture with your inner core muscles engaged. Imagine there is clock face numbered 9 to 3 O’clock on the ground in front of you.

Begin by reaching the right hand to 9 O’clock and then back to the start position. Proceed to continue to 1O, 11, 12, 1, and then 2 and then 3 O’clock. and then reverse back to 9 O’clock again. Repeat this for your left hand. Perform 3 sets of 5 for each side.

If you have any pain during the exercise or are unsure about what you are doing, consult your local Physiotherapist before continuing. 

Turf Toe Injuries/MTP Sprain

What are Turf Toe Injuries? 
Commonly reported as a sports-related injury, turf toe refers to a condition where there is damage to structures around the big toe caused by hyperextension (bending the toe back too far) (McCormick & Anderson, 2010). Pushing forcefully off the big toe, as people do when they begin to run or jump, places repeated stress on the metatarsophalangeal joints (MTP) around this area. Sports that involve frequent stopping, starting, and sudden changes of direction (e.g. basketball, soccer, etc.) can be a main cause of turf toe. 

Symptoms of turf toe include pain when extending the big toe, or bearing weight upon it, a “popping” feeling in the foot when the injury occurs, swelling and inflammation, as well as instability and limited movement of the big toe. According to a report by McCormick & Anderson (2010), most turf toe injuries are mild and do not require surgical treatment, however in more severe cases, surgical procedures may be necessary. 

Doctors grade turf toe injuries from 1 to 3 depending on the extent of damage to the MTP joint, sesamoids, and surrounding tissues, ligaments, and tendons (McCormick & Anderson, 2010). 

Grade 1: Plantar complex is stretched, leading to tenderness and swelling 

Grade 2: Partial tearing of the plantar complex, resulting in tenderness, swelling, and bruising. Movement is restricted

Grade 3: Plantar complex is torn, leading to severe tenderness, swelling and bruising. The toe is very painful and difficult to move. 

Prevention?

  • Wearing flexible footwear while running on artificial turf, or other hard surfaces
  • Wearing shoes with better support, to stop the toe from bending excessively when a person pushes off of it
  • A physical or sport therapist can work with individuals to correct an problems with their gait, which could enhance their techniques while playing sports
  • Performing exercises and stretches such as the following, to improve body alignment (Jenn, 2016):
    • Shin Dorsiflexor Release
      • Find a stable, firm surface roughly at knee height
      • Place a tennis ball under the front of the shin and kneel onto it
      • Move the ball along the sore spots to target the entire muscle
      • Perform on each leg for 3-5 minutes
    • Soleus Release
      • Sit on the ground with your lower calf on top of a tennis ball or foam roller
      • Place the other leg over the one being released to add pressure
      • Roll yourself up and down over the ball, focusing on the tender spots
    • Big toe mobilization with movement 
      • Stand with one foot in front of you, and one behind, with the weight on the front foot
      • Anchor a resistance band attached to your front foot to a chair behind you
      • Rock your front knee forward as far as you can without raising your heel, pushing your knee outward
      • Repeat for 3 sets of 10

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Jenn, F. (2016). Podiatrist-recommended turf toe exercises for athletes. Retrieved from https://healingfeet.com/sports-injury-2/podiatrist-recommended-turf-toe-exercises-athletes

McCormick, J., & Anderson, R.B. (2010). Rehabilitation following turf toe injury and plantar plate repair. Clinical Sports Medicine. 29(2). doi:10.1017/j.csm.2009.12.010

Shoulder Rotator Cuff Strain Injuries: In / Out Rotation With Resisted Movement

If you have injured your shoulder rotator cuff but can still move it then this might be the right exercise for you.

With a light exercise band tied at shoulder level proceed to take up the slack. Then placing a folded towel between your side and elbow and place your opposite hand onto your shoulder lightly to prevent it from hiking upwards.

With the thumb up, slowly rotate the lower arm and wrist in towards your body making the upper arm and elbow the pivoting point and then bring the arm back to the start position with control. Prevent the elbow from pinching in towards your side or doing a chicken wing coming out. Do 3 sets of 10 repetitions for each side.

Doing the unaffected side will also help with the neuromuscular rehab of the rotator cuff muscles. If you have any pain during the exercise or are unsure about what you are doing, consult your local Physiotherapist before continuing.