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Overhead Shoulder Rehab
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Pain with overhead motions can be challenging to deal with, particularly with overhead athletes or people who weight lift. The goal early on is to restore the shoulders ability to perform overhead range of motion with no pain. If tolerated, I’ll also try some light strengthening and closed chain exercises to gradually introduce loading.
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Here are four exercises I like using in the early phases of overhead shoulder rehab:
1️⃣ Childs pose rock backs - one of my favorite ways to gradually introduce overhead motion in close chain. The feedback from the floor sometimes allows them to go further and it’s creating a relative overhead motion in this position.
2️⃣ Foam roller wall slides - another overhead mobility exercise I like to use. This gets the serratus anterior activate to help with overhead mobility.
3️⃣ TRX Rows - typically a safe way to get the shoulder moving and work on some mid trap/rhomboid strengthening.
4️⃣ Shoulder taps - close chain exercise that helps to provide some tactile feedback to the joint. I started with her on her knees and will progress to a full plank position.
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So true
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And glad that the stigma around going to therapy is getting better.
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Therapy is helpful for everyone IMO.
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Real talk: there is NO shame in going to therapy.
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Raise your hand if you go to therapy ♀️
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PS @theeatingdisordercenter we treat people of all ages.
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Looking for help?
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Schedule a free 15 minute consult for therapy or coaching-worldwide via video. Link in my bio. ☝️
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Shoulder rehab
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The term “impingement” is probably overused as it simply just means something is being pinched and causing pain. This could be due to weakness, overuse of improper shoulder mechanics. The goal is to restore pain free motion and then restore strength.
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The posterior cuff or external rotators are typically not trained which can potentially be a cause of shoulder pain. Here are two exercises focused on the external rotators.
1️⃣ No moneys - a simple bilateral external rotation and scap retraction exercise,m. I’m always a fan of trying to find an exercise that’s easy to do at home if necessary.
2️⃣ Banded ER with trunk rotation - another ER exercise but the added trunk rotation increases demand of the scap retractors.
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ACL Rehab - Early Change of Direction
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It’s always a big milestone when an athlete regains the agility to jog comfortably. It takes months of hard work to regain the strength to jog with no compensations. Building off of that success is key. Most athletes recovering from an ACL year need to regain the agility to change directions confidently. It is a huge part of most sports and gradually introducing this to patients is key.
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I’ll always start with light and controlled change of direction tasks. Light meaning they’re jogging at a slower pace and controlled meaning the understand when exactly they’ll be changing directions. I personally believe people jump into this and don’t keep the big picture in mind. Jogging and changing directions is the glamorous stuff but building the foundation on strength (after full ROM) is always key.
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Here are three mid stage change of direction exercises I like to utilize.
1️⃣ Hurdle lateral shuffles - working on continuous lateral cutting in short spaces is extremely common in sports.
2️⃣ Angled shuffles - mimicking playing defense in sports such as basketball, lacrosse or soccer.
3️⃣ N-drill - again working on change of direction in a structured way as she knows exactly when she is changing direction.
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It is highly variable on when someone can do this. Please do not ask about how far out she is or when you can do this. ACL rehab is not dependent on a time based protocol but rather individualized treatment.
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There needs to be formal education on ACL rehab which is why I started an ACL Mastermind Group. It’ll feature video content on ACL rehab and will he a continuously growing database of assessments, movement breakdown, exercise breakdown, case studies, and exercises. There is also a private forum group to discuss articles, cases, resources, etc with other like-minded people. If you’re interested send me a DM or click the link in the bio!
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Injured Athletes Don’t Need Rest!
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I see athletes with varying injuries and severity levels. I see athletes who are non-weight bearing or partial weight bearing. One example is a bad ankle sprain and the ortho puts them in a boot for X amount of weeks. The norm from surgeons and the general public is to rest until they can fully weight bear again. While the intent is for good, issues that arise include muscle atrophy and becoming deconditioned.
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Many of my patients play sports at a high level. The teams they play on require the athletes to pass run tests. How is an athlete supposed to pass a run test if they can’t run for 4-6 weeks (if not even longer). How are their muscles going to handle the demands of sports if they aren’t exercising for months? I believe in training around the limitation and addressing it once it is safe to do so. This allows muscle strength at a minimum to be maintained.
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Here are 4 exercises I used with a patient who was in a boot. We did this for a few weeks under surgeons orders but we were still able to get an effective session in.
1️⃣ Side plank clams
2️⃣ Banded Bridges
3️⃣ Ball hamstring curls
4️⃣ Half kneeling pallof press
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Saying invalidating things like ‘happiness is a choice’ or ‘what do you have to be depressed about?’ Is SO stigmatizing, ableist, and unhelpful.
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I’m so tired of the product/media messaging of ‘good vibes only’ and ‘be happy.’
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ALL vibes are welcome here and if you are struggling right now-I see you.
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You are so strong.
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Even if you can’t see it yourself right now.
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Image via @mental.sisters
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Ps. I prefer and use person first language but liked the overall sentiment of this image.
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Looking for help?
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Schedule a free 15 minute consult for therapy or coaching-worldwide via video. Link in my bio. ☝️
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Shoulder Stability Rehab
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When addressing shoulder instability, my goal is to challenge the shoulder in a variety of ways. The shoulder has the most degrees of freedom out of any joint in the body, and ensuring it regains stability is important. The goal in early rehab is to gradually introduce load and pain free exercises. Exercises should focus on shoulder and scapula stabilizers, while combining both open and closed chain exercises. Additionally, exercises must progress to a high enough level to meet the demands the demands of their sport.
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Here are three exercises I like to use to address shoulder stability using a physioball. The goal is to safely promote strengthening and stability within the joint.
1️⃣ Trunk rotation with hand on ball - patients will typically feel safe in close chain and in this exercise, we’re rotating the scapula on the head of the humerus by keeping the arm still and rotating the body.
2️⃣ Plank on ball - nice and safe exercise to work on close chain stability.
3️⃣ Plank on ball with perturbations - progression from the last video as she has to react to me pushing the ball.
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