четверг, 24 сентября 2015 г.

How to recover from rotator cuff injuries & injury proof your shoulders!

 
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It seems like most people I meet these days, who do regular strength training of some description, complain of shoulder pain and mention Rotator Cuff Injuries (RCI); or "weightlifter's"/"CrossFitter's" shoulder as it is also called these days!

Science says that the occurrence of RCIs (Rotator Cuff Injuries) in the general public is estimated to be approximately one in every three shoulder referrals. And unsurprisingly the occurrence and chances of repeat cases increase with age, in particular when you're over 50 and particularly if you have a history of RCIs.

So I've done some research, and I don't mean just Googling, to find out more about the prevalence and risk factors associated with RCIs in strength trainers, weightlifters and CrossFitters and how best to treat it.

Including some really good scientific references at the end too!

PictureJahan (World) Pahlavan Takhti
Just to be clear the rotator cuff muscles are imperative in ensuring shoulder stability, and when working optimally enables pain free ROM. So what does a RCI feel like? Painful in overhead movements, specially when weight bearing i.e. carrying a weight overhead.Essentially these science guys (listed in the footnotes), who are much better in writing research papers than I am, identified that placing the shoulder in an abducted, extended and externally rotated position, specially when weight bearing, increases the risks associated with RCIs of the shoulder. The main pain producing exercises have been identified as:
  1. Wide grip bench press
  2. incline and supine flys
  3. Bent arm pullovers
  4. Latissimus pull-downs
  5. Behind the neck military presses
  6. Power cleans
  7. Kipping type gymnastics exercises in CrossFit
It is clear that most people's favorite exercise, the wide grip bench press, is the main culprit and pain producing exercise.

Another mob reported from a survey they conducted on CrossFit athletes (these findings have been attacked by people in CrossFit circles as being unscientific and erroneous) that 73.5% of the study subjects, those who practice CrossFit on a regular basis (about 5 hours per week for the last 18 months), have sustained an injury during CrossFit training. Shoulder injuries predominating the injury profiles. Again no surprise that men got injured more often.

So what does science say about the best way of rehabilitating, or altogether avoiding, RCIs? It seems that the best way of minimizing the risk for RCI associated injuries and the optimum approach to recovery and rehabilitation, using nonsurgical methods, is using low weight, high repetition exercises that help increase the ROM, mobility and stability of the rotator cuffs in specifics and shoulders in general.

Furthermore it is suggested in the literature that exercises that increase coordination, endurance and circulation while allowing for a normal humeroscapular rhythm are the most effective form of rehabilitation. And I would like to add that it is not only a much safer, and preventative approach to strength training, but this modality is also much more beneficial since exercising this way helps develop additional physical skills like coordination, proprioception and endurance.

Enter the Meel :) the only tool (to my knowledge) that provides all the above mentioned benefits, and yet so much more, all at once through very simple and basic swings that anybody can learn to do for 5-10 minutes every other day or a couple of times a week.

It is no coincidence that world class elite wrestlers, martial artists and power athletes (both Iranian, Indian and Japanese) train with the Meel (or clubs); and again it is no coincidence that they favor lighter Meels over heavy ones. In fact it is very rare for Zurkhaneh Pahlavans to regularly train with heavy Meels, the most commonly used weights are between 4-10 kg sets, i.e. 2-5 kg each Meel.

When it comes to Meels do not obsess over big and heavy Meels, mastery is more important.  As you can see from the photo of Jahan Pahlavan Takhti, he is holding what appears to be a maximum 6kg set of Meels. And this man (may his spirit be in bliss and his memory eternal) is, if not THE greatest wrestler then at the very least, one of the greatest wrestlers who ever lived. And I have heard that Bozorg (grand) Pahlavan Razaz would swing light Meels in thousands of repetitions.

Not only does the Meel improve and increase the strength, mobility and stability of the shoulder but due to the shape and weight distribution and wooden material enables a much softer, more fluid (less jerky) and rhythmical swinging which can be done as an art form and as a spiritual physical practice...and it injury proofs your shoulders too.

So wait no more, invest in your health, get a pair of Meel and learn how to use them properly; and ensure a lifetime of painless mobility and stability of your shoulders. Because strength is a lifestyle, not only something you're into when you're 20 something.

Be tireless!

Kashi

References:
  1. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elb Surg [Internet]. Journal of Shoulder and Elbow Surgery Board of Trustees; 2010;19(1):116–20. 
  2. Haupt H. Upper extremity injuries associated with strength training. Clin Sports Med [Internet]. 2001;20(3):481–90. 
  3. Gross ML, Brenner SL, Esformes I, Sonzogni JJ. Anterior shoulder instability in weight lifters. Am J Sports Med. 21(4):599–603.
  4. Fees M, Decker T, Snyder-Mackler L, Axe MJ. Upper extremity weight-training modifications for the injured athlete. A clinical perspective. Am J Sports Med. 1998;26(5):732–42. '
  5. Hak, P., Hodzovic, E. and Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. 2013;1. 
  6. Weisenthal BM, Beck C a., Maloney MD, DeHaven KE, Giordano BD. Injury Rate and Patterns Among CrossFit Athletes. Orthop J Sport Med [Internet]. 2014;2(4):1–7. 
  7. Osterås H, Torstensen TA. The dose-response effect of medical exercise therapy on impairment in patients with unilateral longstanding subacromial pain. Open Orthop J. 2010;4:1–6.

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