Tiger Woods golf swing in slow motion

The almighty bench press.

I would like to preface this post by saying I neglected my shoulder problems too long and caused irreversible damage and I’m paying for it now. Thus, I’ve made it one of my missions to become one of the most knowledgeable doctors on non-surgical treatment of the shoulder. If you read anything that is incorrect please let me know. I hope this information will enlighten you.

Why the shoulder pain?

First, there is a huge list of reasons why your shoulder is hurting while bench pressing, too many to list. However, I will discuss a few potential causes. The forced horizontal adduction of the bench press puts an abnormally large load on the acromioclavicular joint (AC joint) causing pain. The AC amplifies the range of motion of the humerus yet lacks structural support. Another reason for frequent injury. Excessive weight also causes the glenohumeral (GH) joint to become a weight-bearing joint. These forces can lead to premature degeneration of the shoulder complex. The bench also pins down your shoulder blades. You’ve seen the guy benching with his rear in the air, not so good. This places excessive stress to their thoracic spine, possibly exacerbating or creating back pain, and immobilizing the scapulothoracic complex. Fluid scapular motion and a strong rotator cuff are key to a healthy shoulder. So what happens if your shoulder blades can’t work in harmony with the rest of your arm? Excessive motion about the AC and GH joint, leading to pain and/or instability.

More on the rotator cuff.

Many gym junkies rip out 30 minutes on the bench and go home, neglecting the rotator cuff (RTC). You could quit benching for two weeks, strengthen the RTCs and see an increase in your max. The RTC is vital for shoulder stability and strength. The rotator cuff is a set of four muscles; the supraspinatus, infraspinatus, teres minor and subscapularis. Most people have no idea what the rotator cuff actually is, so you’re ahead of the game. A few sources indicate that your RTC strength should be 9.8% of your one rep bench max. Not sure how much validation there is behind that number but its worth mentioning.

Fixing the pain.

I give props to everyone in the gym, but some of the routines I see are only contributing to bad shoulders. There are plenty of great RTC strengthening programs/exercises, but if you really want to fix your shoulder consult with a sports doctor. Remember I mentioned the huge list of possible reasons why your shoulder hurts? They’ve memorized it and know it. Each person is different, that is why it’s key to have a thorough evaluation to identify any pathologies, muscle weaknesses and supply a comprehensive strengthening package. A doctor certified in Active Release Technique (ART) is the best route to go. Almost every profession sports team in the U.S. has an ART doctor. No idea what this is? Watch the video below. Or visit this link: http://www.activerelease.com/

Conclusions.
I’m not saying everyone should skip the bench, but if you keep hurting yourself doing it stop and fix the problem. Strengthen your RTCs, try free weights if its pain free and if you can afford it, get an ART and/or a sports medicine doc to evaluate you. Lastly educate yourself, I highly suggest the Buchberger-12 it’s a Rotator cuff and Scapular Strengthening Program designed by Dale Buchberger D.C., P.T. and CSCS.

Other exercises to consider limiting or cutting out of your program:
1. Lat pull downs behind the neck.
2. Military press.
3. Upright rows.
4. Empty can exercises.


*Don’t hurt yourself, consult with your doctor to see what you should and shouldn’t be doing.

What is Active Release Technique? Watch and find out.

US Army General Rebecca Halstead

In honor of Veterans Day, watch this video of US Army General Rebecca Halstead discussing why chiropractic care is essential in ensuring our troops in Afghanistan are battle ready.

New D.C.? Go electronic for cheap.

To all my fellow D.C. friends,
Our generation of health care providers must migrate towards electronic note taking; the government will soon require it and start penalizing offices in 2015 that don’t. Plus, if you're like me you're not entering any penmanship contests soon . Thus, I have done a little research to find a solution for POOR D.C. graduates. I was recently talking to a new graduate about an electronic health care records company called future health. He got my attention when I heard I didn’t need $15,000 to start. The basic program is around $25/month then you add “apps” as you need them. I haven’t actually used this program in a working clinic, but have downloaded it for a free 3 month trial. They do NOT collect any credit card information, so if you hate it then uninstall with no consequences. I attached an introduction video for your convenience. If anyone has actually been using this software in practice I would love to hear your thoughts. I have no affiliation with this company.

Poppin' Bottles

As an alternative health care provider to be, I’m constantly surrounded by the world of supplementation. I’ve attended many health seminars with various supplementation companies represented. To be quite frank many of them are flat out garbage. Money talks and it shows. I believe there is a time and place for supplementation, however, we have been trained that the answer lies in a capsule or powder. In my opinion, our focus/efforts should be turned toward shopping, cooking and eating habits. Diet and exercise can go a long way to cure disease. Start the change this week! I’m not meaning throw out all your food and start growing everything in your backyard. Make the change slowly, buy one “new” fruit or vegetable each time you shop this month and buy one less unhealthy item. I grew up in a family where eggs, bacon and pancakes were the well rounded breakfast. It took me years to escape the trap and to shed the pounds. No ideas? Buy a handful of Kiwi fruit and throw it in with your cereal or yogurt. They are cheap and chalked full of Vitamin C. If you are still reading this, thanks, and please spend 30 seconds to respond to my questionnaire in the upper right corner of this page.

ElliptiGO. No more stationary elliptical workouts.

We all understand the benefits of the low impact cardiovascular machine. It’s a great way to sweat and keep your knees edema free, but how many hours have you been on the elliptical bored out of your mind? The new ElliptiGO bike might just be the solution to this problem. It’s a hybrid between a traditional bike and an elliptical. The ElliptiGO was created by a former cyclist and Ironman triathlete that found traditional biking uncomfortable and elliptical workouts in the gym boring. The ElliptiGO has 8 speeds and according to their website and customer reviews they are very easy to ride, including hill climbs. The only down side to the product is that it costs a little over $2,000. However, there are demo locations around the U.S. as well as a 60-day money back guarantee. It’s worth checking out.

http://www.elliptigo.com/

Exercise physiology: Clinical Application

Understanding exercise physiology on a microscopic level allows the practitioner to make clinical decisions macroscopically. This knowledge can be used in a number of different clinical settings. The knowledge has led to the use of muscle energy techniques such as Hold-Relax, Contract-Relax, and Hold-Relax with agonist contraction. The chiropractic school (University of Western States) teaches and recommends this treatment in their curriculum. Knowing that calcium is key to muscle function and that CoQ10 is a crucial component of the electron transport chain for aerobic energy (ATP) production may lead us to make diet or supplemental recommendations based on the patients needs. We can tailor our rehabilitation programs based on which muscle fiber types our patient needs to focus on. The 60 year old with low back pain may benefit more from slower concentric, eccentric and isometric contractions of core stabilizers than ballistic exercises that increase type II fibers. (As a side note it’s important to know that eccentric muscle contractions place the most amount of stress on the muscle. This can be used for training purposes or in the clinic for orthopedic evaluation of muscles.) It may be useful to tell the 60 year old that reduced pain or incidence of low back pain episodes doesn’t mean exercise can be stopped. Educating the patient on continually working these muscle groups to allow long-term stabilization is important in the clinical setting. The more ballistic activity would benefit the sprinter more than it would the marathon runner. This knowledge allows us to select specific types of programs to optimize the patient’s health and performance.

In summary, understanding exercise physiology can allow us to make specific physical activity recommendations based on our patient’s specific needs. The understanding of the body’s energy systems and biochemical needs allow us to aid the patient in their dietary needs. The marathon runner may need to supply his/her body with the proper nutrition’s to optimize their physiological potential before and after an event. Finally, the information can allow the practitioner to make clinical treatment decisions. This is evident with the muscle energy techniques utilized by many health professionals. In a sense, knowing exercise physiology boils down to making physical activity, diet and treatment recommendations in the clinical setting. Exercise physiology is a rapidly evolving field that is becoming increasingly important in the delivery of health care especially for the sports chiropractor.