Biomechanics Q & A: Post your questions here

What exercises were you recommended initially Hazel?

Is there any change in the pain - in terms of intensity, frequency, when it comes on, how long it takes to go?

Any change in mobility?

hi hazel, rach hasnt been able to get on for a few days due to work commitments.

we were talking about it at weekend though, shame you didnt mention it when she was there with james!  shes back again in just under 4 weeks though!

Rach - thanks for the exercises last week.

I have them all in hand.  But please remind me: you gave me one to introduce where I lie on the floor, knees bent, and find my natural lower back postion, brace but do not arch.  How long do I hold this and do I rep it?

Hazel


Hi Rach

I have been told the problem with my right shoulder is a tear in the shoulder capsule.  I have been advised to avoid overhead movements, pull downs etc for 6 weeks and was given some exercises, basically to stretch the shoulder too.  I am about 4 weeks in now and not much improvement in the pain.  Can you recommend any other exercises/ treatments please?  Maybe easier to ask you next time you come to see James!

Thank you.

 
HI Hazel
I would need to know exactly what you have torn first. The shoulder capsule is too general a term to be able to understand what the damage being suggested is.
Can you get an exact diagnosis?
Probably best to see you when I am next in too, grab me then.

James


Rach - thanks for the exercises last week.

I have them all in hand.  But please remind me: you gave me one to introduce where I lie on the floor, knees bent, and find my natural lower back postion, brace but do not arch.  How long do I hold this and do I rep it?

Ok with the brace technique it is advisable to practise this with low intensity contractions of a single rep held for about 6-10 seconds to start and then progress to holding for longer. Then begin to vary the intensity also to higher intensity with a shorter hold again. Breathing during the brace.
The idea of this brace technique is for it to become second nature in all you do during daily living and during exercise so you need to be able to perform it in a variety of ways. For example while you are driving or sitting at a desk the intensity will be lower but for a longer duration, yet during training it will be a more intense contraction for a shorter length of time.
Start just by nailing the technique first which may 'seem' to be an easy thing to do but many of us struggle with the perfect technique on this which is why lower back pain is so common.
Many people do not realise that when they 'switch on' their abs, they are in fact 'switching off' the multifidus in the back which are as much a stabiliser of the trunk as the abs are.
Hope this helps.
Love your commitment James! :)

Ak_88


What exercises were you recommended initially Hazel?

Is there any change in the pain - in terms of intensity, frequency, when it comes on, how long it takes to go?

Any change in mobility?

Difficult to explain in text, but turning head each side with arms out at shoulder level and outing alternate hand up.
Stretching arm down while holding small weight
back against wall, chin to chest
lots of stetching, have had longterm neck probem too.
Avoid weight training exercises that use overhead movement
Still get shooting pains in hands
Painful to do front raises.
Lying on the shoulder is painful too.

Thanks

Rachfit

Hazel


Hi Rach

I have been told the problem with my right shoulder is a tear in the shoulder capsule.  I have been advised to avoid overhead movements, pull downs etc for 6 weeks and was given some exercises, basically to stretch the shoulder too.  I am about 4 weeks in now and not much improvement in the pain.  Can you recommend any other exercises/ treatments please?  Maybe easier to ask you next time you come to see James!

Thank you.

 
Hi Hazel
I would need to know exactly what you have torn first. The shoulder capsule is too general a term to be able to understand what the damage being suggested is.
Can you get an exact diagnosis?

The anterior part if that helps but will have
Probably best to see you when I am next in too, grab me then.

The anterior part if that helps but will have to grab you next time! Thanks

thats great that given me an understanding of my back problem, next problem its not really painfull but i have sloping forward shoulders and when i try to do normal squats bar on shoulders i cant seem to grab hold of the bar  with my range of motion any help would be great thanx ???

english


thats great that given me an understanding of my back problem, next problem its not really painfull but i have sloping forward shoulders and when i try to do normal squats bar on shoulders i cant seem to grab hold of the bar  with my range of motion any help would be great thanx ???

hi mate, might be a day or so untill rach can get on, as shes working away at the moment, but will let her know about your question.
 
where do you live mate?  with you having back problems and being tight on the shoulders, it would be well worth the cost of you getting a full screen done, more than possible that both can be helped!
 
 

hi cheers from aldershot just waiting for phisio but nhs and all could wait for months

english


thats great that given me an understanding of my back problem, next problem its not really painfull but i have sloping forward shoulders and when i try to do normal squats bar on shoulders i cant seem to grab hold of the bar  with my range of motion any help would be great thanx ???

Hi
Ok I am afraid as with most queries on here it is imortant to understand I cannot make a completely accurate response without actually screening you in person. What I can do is maybe give a clearer idea of the types of issues that can be affecting you biomechanically.
One very common issue is the protracting shoulders you describe due to a number of reasons like sitting at a desk, driving a lot or poor posture.
What most people will do is attempt to stretch the areas that appear to be 'tight' which is completely understandable. The problem is knowing if the shoulders are 'tight' or in fact in spasm. If a muscle is in a sub-clinincal spasm the worst thing to do is try and stretch it. It could be in spasm as it is wanting to protect the joint area for some reason and so trying to stretch it will just compound the issue.
So we recommend first using a muscle release technique that can have profound and sometimes an immediate affect.
Using the 20/20 technique 4 sets 4 times daily is the usual recommendation.
The problem is that there are likely to be other biomechnical issues combined with this one so I strongly suggest you find a Biomechanics coach in your area.
If you have no luck come back to me certainly before you get any medical treatment.

Rachfit


Ok with the brace technique it is advisable to practise this with low intensity contractions of a single rep held for about 6-10 seconds to start and then progress to holding for longer. Then begin to vary the intensity also to higher intensity with a shorter hold again. Breathing during the brace.
The idea of this brace technique is for it to become second nature in all you do during daily living and during exercise so you need to be able to perform it in a variety of ways. For example while you are driving or sitting at a desk the intensity will be lower but for a longer duration, yet during training it will be a more intense contraction for a shorter length of time.
Start just by nailing the technique first which may 'seem' to be an easy thing to do but many of us struggle with the perfect technique on this which is why lower back pain is so common.
Many people do not realise that when they 'switch on' their abs, they are in fact 'switching off' the multifidus in the back which are as much a stabiliser of the trunk as the abs are.
Hope this helps.
Love your commitment James! :)

Thanks, Rach!  I have that sorted inmy head now.

Let me pose the question:
Can you load rectus abdominus dynamically without flexing the spine?

thanx for your help thats great, i think its due to my terible posture ...

english


thanx for your help thats great, i think its due to my terible posture ...

your welcome and it can be helped by understanding your biomechanics and how to rectify them.
Take a look at our website if you want to know more :)

Wrist, elbow, shoulder and arm pain is most commonly due to some sort of Biomechanical dysfunction. Often a tethered Madian nerve can create discomfort anywhere along its path or just off it.
It is a very common cause of shoulder injuries and is in fact a very simple problem to solve.
Do you want to know how to test it and mobilise it?

Ok, well if you're still reading I guess you do!
So you need know that it runs down the side of the neck to the front of the shoulder on the same side. Down the front of the arm, across the inside of the elbow and the palm of the hand to the thumb and 2 fore fingers.
To test if it is tethered stand facing a mirror so you can judge that your shoulder stays down-(this is important because if tethered, when lifting the arm, the shoulder may rise sub-consciously to relieve the tension in the nerve) it is important to move slowly too as nerves are visco-elastic and do NOT like to be stretched and certainly NOT quickly.
Keeping the shoulder down flex the wrist/hand back and turn your hand backwards with palm facing down to the floor so your fingers are pointing behind you (note:keep thumb and fingers as straight as you can to create the tension and just check your shoulders in the mirror are both still held down).
If at this point you feel tension, tingling, heat or any sensation, while trying to avoid actual pain, at any point along the route of the Median nerve STOP-now keeping your hand in that position shrug your shoulder up to your ear. If the tension disappears then this demonstrates it must be caused by Median nerve tethering.
To mobilise it you stay in that position and add and release tension, WITHOUT PAIN, by extending and flexing the wrist 15 times twice and t be done twice daily-certainly before lifting weights. You may feel the tension ease off if so then you can take this to the next level.
The next level is also for those who didn't feel anything at the first level. At this point keeping the wrist flexed now SLOWLY take the arm out to the side ( NOT backwards or forwards of the body) until you find some tension and then repeat as before by lifting the shoulder to see if the sensation goes away. If it does then you mobilise here by doing the same action of flexing and extending the wrist to mobilise the nerve under the fascia.
This can have immediate relief or for some it may not be so quick and can take up to 6 weeks but in our research we have proved that strength can be increased by 14% just from 2 sets of nerve mobilisation.
Give it a try and let me know what you think or if you have any biomechanics questions ... Good luck!!

"Keeping the shoulder down flex the wrist/hand back and turn your hand backwards with palm facing down to the floor so your fingers are pointing behind you (note:keep thumb and fingers as straight as you can to create the tension and just check your shoulders in the mirror are both still held down). "

Hi Rachel, you don't say whether you should turn inwards or outwards with the palm facing the floor. I definitely get more nerve pulling sensation turning my palms inwards as I turn them towards the back. 

This is good stuff, I definitely have a tethered median nerve then. Thanks for posting this information and help.

To mobilise it you stay in that position

 
Sorry, this is important for me! :) do you mean stay in the shoulder shrugged position when you do the flexing of the wrist?
 
 

HI
Sorry I wasnt clear in my first description and I am glad you asked Nev.
Turn the hand outwards and back and you only shrug to test that it is median nerve that changes the sensation. (If the sensation doesnt go away it could just be tension in the soft tissues)
so replace the shoulder down into the depressed position to mobilise with the wrist flexing.
Just remember not to take it into pain. I recommend you dont do it as soon as you wake up even thought that is when you feel worst.
Let your body wake up for about an hour first.
Let me know how it goes...
;)

Brilliant, thanks for the top advice, I'll let you know..