LETS TALK SHOULDER PART 2

Holla , Rehab studs. This weekly blog happens to be my first video blog ever (on the downside I paid a decent buck to upload these videos so feel free to share if you like)!!! You may see only four videos here but I had to re-take them multiple times as I didn’t want to upload YouTube videos here and I am clearly not a natural in front of the camera as you will see shortly (apologies, however I will get better). The reason for uploading my own videos is that physios are great observers and I wanted to have some of your expert feedback on my techniques, cues etc. Quick disclaimer – I made these drills on common patterns I often find and the correctives I use for them as a continuation of the first part. These are not the only interventions and their selection depends upon a thorough evaluation ( this disclaimer was for any trolls out there, a prudent therapist knows this all to well).

1. Mobility drills for that gnarly exaggerated thoracic kyphosis- I find most of my patients love these drill after the initial discomfort they feel when their poor upper back is moved into the extended position. Some patients also report feeling more upright and a little taller after the intervention. Important point to remember is discomfort is acceptable but this intervention should not be painful. Progress slowly.

 

Lets not neglect  rotation-

 

 

2. The ‘W’ exercise for rotator cuff weakness- though there are a number of exercises for strengthening the rotator cuff  this one is my favorite. As mentioned in the video, I don’t like to knock out 3 sets X 10 reps. I would rather train the rotator cuff for endurance with longer holds in the externally rotated shoulder position ( actually depending upon patient tolerance I might do both). Lets not forget the primary goal of the RC is supporting the head of the humerus into the glenoid and secondary action is IR/ER. What is your one favorite ‘go-to’ exercise for RC training?

 

 

3. The ‘Y’ exercise for lower traps- I have seen big guys benching close to 200 lbs struggle during this exercise with a tiny pink 5lbs dumbbell attempting full shoulder scaption ; hence give this exercise it’s due respect.

 

 

 

Remember that we only scratched the surface with this blog posts. We also must think about other big players like the serratus anterior, lat dorsi, Levator scapula etc. To work on the pec minor I use different manual therapy techniques which is a blog post for another day. I would love to hear some of the exercises you commonly use during your rehab. Feel free to post links of videos if you can. I envision this blog not just as a medium for me to express my thoughts but a common ground to exchange ideas. Until next time.

Pursue excellence
Abhijit Minhas PT
(BPT,MS,CMP,FMT)
(Ps- I wear my physical therapy shirt with pride).

6 thoughts on “LETS TALK SHOULDER PART 2”

  1. V well demonstrated and thnx for going for the shoulder…many face problems and are sure goin to benefit……

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  2. Great job! The thoracic extension exercise is one of my favorites for shoulder patients and I tend to have them do it following a thoracic grade V mobilization. I always give it as a HEP. The W’s are also one of my fave rotator cuff strengthening exercises. I have them do it palm up (no money) to really hit the rotators and emphasize scapular retraction and depression to hit middle and lower trap as opposed to rhomboids. Great read! I am going to try the thoracic rotation.

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    1. Thank Kayla, you have an excellent point about working on scapular retraction and depression while doing the W’s, something I’m gonna tweak when I cue it next time for my patients. Is there any particular reason you prefer doing palm up as opposed to neutral grip? EMG studies for RC? I have done it in both positions but didn’t check up on any research even though this point did come to my mind.

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  3. Tonight I will try the Y exercise! I just don’t know how much weights to pick on the dumbbells though. So, I’ll just go with 8 lbs ones that I have at home. Is there a minimum weight/a suggestion that one should pick up to make this exercise work? or a maximum weight that one should not go over to hurt themselves. Akhi, I’m a gym goer trying to shift some of my exercise habits from gym to home. The shoulders are something that took an immense hit on the posture over the years. So I am kinda looking forward to utilizing this exercise at home for some to correct my current form posture.

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