Brian Schiff’s Blog

I get daily email from people suffering shoulder injuries all over the world. Many have questions regarding their MRI reports that somehow go unanswered by the MD or just are not explained clearly enough. Sound familiar?

One such email yesterday described an injury as a slat tear. I knew the customer probably meant SLAP tear even though he did not know the true description. Face it – deciphering MRI reports is like reading a foreign language unless you have medical training. Many people suffering from rotator cuff tears/tendonitis may also be suffering from a SLAP injury as well.

What does SLAP stand for? Superior Labrum Anterior to Posterior to be exact. Even more confusing, right? Think of it simply as an injury to the long head of your biceps tendon as it joins with the glenoid labrum (shoulder cartilage) in the top of your shoulder. This is actually more common than you may think. It can occur through a traumatic injury (fall for example) or through gradual stress/degeneration.

The long head of the biceps tendon assists the rotator cuff in depressing the humerus during elevation of the arm and overhead activities like throwing. In my experience, SLAP tears often require arthroscopic surgery to repair them in order to restore function and eliminate pain. If you have a torn labrum, minimize overhead stress or extending the arm fully beyond the plane of your body, especially with a straight arm under resistance.

Exercises in the gym that would place harmful stress on the labrum include full range bench press, military press, incline biceps curls, dips, upright rows above 90 degrees, and deep push-ups or flies and pull-ups. To rehab this injury conservatively, you should focus on scapular stabilization and rotator cuff strengthening, always taking care not to load the shoulder joint with significant weight at end ranges of motion.

I included a screenshot from one of my webinars of a few scapular strengthening exercises guaranteed to improve your shoulder function if you have such an injury. It includes a prone serratus punch progression (starts on the knees and advances to the toes) to increase serratus anterior strength, a muscle often shown to be weak and lacking endurance in those suffering from shoulder pain.  You will also see some quadruped rocking and advanced progressions of the serratus push-up using a BOSU trainer and BOSU ballast ball.

I offer an on demand webinar on SLAP tears at www.alliedhealthed.com.  It includes anatomy, rehab, surgery and current research updates on the treatment of SLAP tears.

In this video, I briefly discuss my “threshold training system” for returning athletes and weekend warriors back to play. The principles are also applicable if you are doing pre-season conditioning and want to avoid injury or overtraining.

Yesterday, I revealed a simple yet effective way to strengthen the posterior cuff muscles for overhead athletes.  Today, I want to give you a slightly more difficult version while positioned prone on the ball.  It still targets the posterior cuff, but allows you to focus on both shoulders and stabilization too.

Again, move through a pain free range of motion and use a deliberately slow cadence on this exercise.  I typically like a 1/1/1 or a 2/1/2 pace to get full activation of the muscles throughout the range.  Deceleration of a throwing, stroking or hitting arm is one of the key roles the posterior cuff plays, so emphasizing eccentric strength is necessary to prevent and rehabilitate a shoulder injury. 

Perform 2 sets of 10-15 repetitions with a lighter weight, while maintaing strict form.  If you sense the upper torso is lifting off the ball, consider using less weight or moving to a position where the knees are on the floor to increase stability.

I have literally helped over 10,000 people rid themselves of shoulder problems in just the past 3 years with my Ultimate Rotator Cuff Training Guide. What has been the secret of my success? To be honest, it comes down to understanding how to systematically couple and progress specific exercises at definitive time intervals to deliver a positive rehab outcome.

Sounds easy enough, right? Well, I have found it is not. In the next few blog posts, I will share some critical shoulder exercises to incorporate into your program if you have weakness or pain related to poor rotator cuff and scapular muscle strength.

The first exercise today is seated dumbbell horizontal external rotation. It is imperative to keep the arm slightly forward of the plane fo the body (scapular plane is ideal) and move at a predictable pace through a pain free range of motion. Do not push back through pain as this only perpetuates inflammation.

This particular exercise is effective for increasing strength in the posterior cuff muscles and also for athletes participating in overhead sports such as volleyball, baseball, swimming, and golf to name a few. Do 2 sets fo 10-15 repetitions with a light weight. Tomorrow, I will reveal a more advanced progression of this exercise.

Some of you may know the IYCA (International Youth Conditioning Association) and some of you may not.  It has been around for a few years, but is rapidly growing and aiming to revolutionize the youth fitness industry.  Founder, Brian Grasso, is pictured below addressing the crowd at the Speed Clinic I attended today.

2009 IYCA Summit

As a youth training expert myself, I was eager to see the IYCA up close and gain a better understanding about its mission, leaders and members.  I left convinced Brian Grasso is just as intelligent and passionate as he always comes across in his newlsetters.  His vision is clear and the IYCA members at the summit all seeemed committed to one goal – raising the bar and providing the BEST training possible to our youth.  No egos – just a ground army of coaches looking to learn from one another and change the way youth training is delivered.

I also came away pleased to know that people like Brian Grasso and Lee Taft approach training in much the same way I do.  What exactly do I mean by this?  Here are just a few examples:

1. High speed treadmills are not the best tools to improve speed
2. Deceleration is often overlooked and one of the most critical phases of training we must teach our young athletes to reduce injury and increase performance
3. Leading our children with passion and positive energy is a must
4. Teaching our athletes and parents the “why” behind exercise selection does matter
5. Less is really more in many cases and training should be FUN

These are just a few of the concepts that resonated with me over the weekend.  I was so impressed with the mission and leadership of the IYCA, I became a member myself.  I feel confident that this organization will help train and develop great youth fitness specialists, while making the lives of our young people better for years to come.  As a physical therapist and seasoned coach myself, I am a tough critic.  But today, I salute the IYCA and its mission.  I look forward to being a part of the organization and working with them to continue providing the very best in youth athlete training.

My video blogs will return this week as I continue to give you valuable info on shoulder training – do’s and don’ts to ensure you are training safely and effectively in the gym.  If there are certain questions you have, please let me know.