Have clients with history of shoulder impingement?

Background: Shoulder impingement is a common condition affecting men> women(2:1) where someone complains of anteromedial pain that has gradually developed. Contributing factors: History of individual working out predominantly shoulder press, chest press, anterior raises and front of body. Muscle imbalances, type of work and lifestyle. Two types: Primary(Mechanical) impingement: Is caused by a mechanical dysfunction such as bursa, AC joint, acromion, humerus or rotator cuff/supraspinatus tendon beneath the coracromial arch. This is a mechanical problem that may result from sub acromial crowding. Secondary(Structural) impingement: Is caused by a relative decrease in sub acromial space caused by instability of the glenohumeral joint, tight posterior capsule and weakness of scapulothoracic musculature. Evidenced training recommendations: Emphasis is to create scapular stability/balance the shoulder muscles dynamically. • Posterior capsule stretching • Chest stretching • Scapular protraction(strengthening serratus anterior/upper trapezius/low trapezius biomechanically, together all cause an upward rotation of the scapula to maintain the sub acromial space above 90 degrees of shoulder elevation. • Scapular retraction via mid row with tubing or cable (decreases load to front of the shoulder). • External rotation strengthening: ideal is side lying which is more isolative for teres minor and infraspinatus recruitment(decreases the load to the anterior shoulder). Prevention: Keep stretching pectorals and posterior capsule. Avoidance of shoulder press or military press, avoidance of anterior raises and client engaging in regular “balanced “ workout. Targeting weaker phasic muscles(rhomboids, low trapezius, external rotators, scapular depressors).

Human Movement and Corrective Exercise Seminar Comes to Boston, MA June 4th 2016

Pinnacle Training & Consulting Systems is coming to Boston, MA June 4th 2016 teaching a one-day, dynamic lecture and practical applied seminar on human movement and corrective exercise. Each participant will learn: • Foundation and how to perform corrective exercise training • Biomechanics of the entire body and how it works from the inside out • Gain insight about overactive and underactive dysfunction • Practice new static and dynamic movement assessments including why to examine muscle length • Common dysfunctions of the ankle, knee, hip, shoulder and spine and evidenced based training • Deeper about program design, exercise prescription and how to ‘tweek exericses’ Course outline: Saturday 8:00am-8:50am: Introduction to Corrective Exercise Training: Understanding Impairments (different movement patterns, gait, joint specific)(L/lab) 8:50am-10:00am The biomechanics of ankle, knee, hip, shoulder and spinal movement(L)how everything works together) 10:00am-10:10am BREAK 10:10am-11:30am Continuum movement: normal vs. abnormal(overactive vs. underactive dysfunction) 11:30am-12pm Scope of Practice(L) 12-1pm LUNCH 1:00pm-2:15pm Assessing movement dysfunction: static assessment, movement assessment and assessing muscle length (L/lab) 2:15pm-3:15 pm Foundation of corrective exercise (L/lab) 3:15pm-5:15pm Common dysfunctions of ankle, knee, hip, shoulder and spine and evidenced based exercise prescription and program design (L/lab) Each attendee receives the following: •Access to multiple videos from the PTCS website that highlights, clarifies and compliments the Synergy of Human Movement Material • Ability to earn CEU’s .8 NASM, NSCA and ACE pending • Attendance to the one-day Human Movement/Corrective Exercise Seminar • Live course manual that is evidenced based with glossary and numerous pictures and exercises • Receives a copy of our one-day Synergy of Human Movement DVD • All examination costs • Opportunity to become an advanced training specialist (A.T.S.) • Opportunity to ask PTCS any questions regarding material covered To sign up for the seminar, go to www.pinnacle-tcs.com http://www.personaltrainerceu.com/workshops-1.html and click on personal trainer workshops.

Working with the older client: Part 1 by Chris Gellert, PT, MMusc & Sportsphysio, MPT, CSCS, AMS

Introduction According to the 2012 Census, people over the age of 65 make up almost 14% of the US population. That means there are over 43 million seniors (adults 65 or older) today, with the numbers continuing to grow, reaching 70 million by 2030. This aging population creates a unique opportunity for the fitness professional to work with. In this article, we will review the effects of aging on the musculoskeletal system, learn simple functional assessments and understand benefits of strength strengthening. In part 2, strength training guidelines and programming for common aging conditions will be discussed. Effects of Aging on the Musculoskeletal System The aging process is accompanied by both structural and functional changes of numerous systems of the body. Research has shown that skeletal muscles with age, specifically type II, there is a loss in these fibers, they atrophy over time, and decrease in size (Brunner et al. 2007). Research has consistently shown that muscle strength decreases with age(Lindle RS, Metter E. 1997). Physiologically it has been studied that maximal strength capacity reaches a peak sometime around the second or third decade of life, and by the fifth decade, begins a gradual decline(Peterson et al. 2010). The strength of people in their 80s is about 40% less than that of people in their 20s(Chiung-Ju Liu, 2011). The decline in muscle strength is associated with an increased risk of falls and physical disability in older adults. Functional assessments of older client Balance tests Assessing an older client’s balance needs to be objective and not guesswork. There are many tests available, but few are objective, measureable, and supported with research as the timed up and go test and the sit to stand test. 1)Timed Up and Go Test Use a standard armchair. Place the line ten feet from the chair. The score is the time taken in seconds to complete the task. The subject is encouraged to wear regular footwear and to use any customary walking aid. No physical assistance is given. Have the subject walk through the test once before being timed, to become familiar with the test. To test the subject, give the following instructions: • Rise from the chair • Walk to the line on the floor (10 feet) • Turn, return to the chair • Sit down again Scoring: Persons who take 10 seconds or less to complete this sequence of maneuvers are at low risk of falling. Persons who take >20 seconds to complete this sequence are at high risk of falling. 2)Sit to stand test Have the client sit with their back against the back of the chair. Ask the client to stand from the seated positing, counting each stand aloud so that the client remains oriented. Stop the test when the patient achieves the standing position on the 5th repetition. Age Time(seconds) 60-69 11.4 70-79 12.6 80-89 14.8 Scoring-Age Norms: Benefits of Strength Training For Older Adults for function There are numerous benefits of strength training for the older adult client. Because large muscle groups, including shoulders, arms, trunk, hips and legs, are important to perform activities of daily living(ADLs) and are susceptible to the aging process, training should targets these muscle groups. The latissimus dorsi muscle (assists with sit to stand). Glute maximus is a primary hip extensor muscle involved in walking and climbing stairs. The hamstring muscles are important in flexing the knee and extending the hip, which are involved in everyday activities such as walking, sit to stand, and negotiating stairs. Glute medius and minimus muscles are lateral stabilizers that are important for getting in and out of bed or car or stepping into a bathtub. Strength training physiologically improves strength of bones and connective tissue, size of fast and slow-twitch fibers, reduces blood pressure, improves blood flow with many more benefits. Research has shown specifically that strength training improves gait mechanics(Persch et al. 2009), reduces the risk for falls in the elderly (Karlson, MK et al. 2013, Trombetti, A et al. 2011, Sherrington et al. 2008 & Zhen-Bo, Cao, et al 2006). Summary Aging is inevitable. Falls can be prevented. Arming yourself with more knowledge about the body will enable you to help your clients’ age gracefully reaching optimal health.

Human Movement and Corrective Exercise Seminar Comes to Boston June 4th 2016

Pinnacle Training & Consulting Systems is coming to Boston, MA June 4th 2016 teaching a one-day, dynamic lecture and practical applied seminar on human movement and corrective exercise. Each participant will learn: • Foundation and how to perform corrective exercise training • Biomechanics of the entire body and how it works from the inside out • Gain insight about overactive and underactive dysfunction • Practice new static and dynamic movement assessments including why to examine muscle length • Common dysfunctions of the ankle, knee, hip, shoulder and spine and evidenced based training • Deeper about program design, exercise prescription and how to ‘tweek exericses’ Course outline: Saturday 8:00am-8:50am: Introduction to Corrective Exercise Training: Understanding Impairments (different movement patterns, gait, joint specific)(L/lab) 8:50am-10:00am The biomechanics of ankle, knee, hip, shoulder and spinal movement(L)how everything works together) 10:00am-10:10am BREAK 10:10am-11:30am Continuum movement: normal vs. abnormal(overactive vs. underactive dysfunction) 11:30am-12pm Scope of Practice(L) 12-1pm LUNCH 1:00pm-2:15pm Assessing movement dysfunction: static assessment, movement assessment and assessing muscle length (L/lab) 2:15pm-3:15 pm Foundation of corrective exercise (L/lab) 3:15pm-5:15pm Common dysfunctions of ankle, knee, hip, shoulder and spine and evidenced based exercise prescription and program design (L/lab) Each attendee receives the following: •Access to multiple videos from the PTCS website that highlights, clarifies and compliments the Synergy of Human Movement Material • Ability to earn CEU’s • Attendance to the one-day Human Movement/Corrective Exercise Seminar • Live course manual that is evidenced based with glossary and numerous pictures and exercises • Receives a copy of our one-day Synergy of Human Movement DVD • All examination costs • Opportunity to become an advanced training specialist (A.T.S.) • Opportunity to ask PTCS any questions regarding material covered To sign up for the seminar, go to www.pinnacle-tcs.com http://www.personaltrainerceu.com/workshops-1.html and click on personal trainer workshops.

Video 23 Analyzing common sports with training recommendations 1

Video 22 Importance of lumbo-pelvic stabilization training

video 21 Understanding Integrative Training Principles 1